Workplace bullying among Korean registered nurses: A meta-aggregation of qualitative studies / 한국간호교육학회지

Purpose@#This study aimed to conduct a qualitative synthesis of workplace bullying experiences among nurses in Republic of Korea. @*Methods@#Following the PRISMA guideline, a literature search was conducted using seven domestic and three international databases. Studies published in Korean or English from inception to December 31, 2022 were included. A meta-aggregation approach suggested by the Joanna Briggs Institute was used to synthesize the research findings. @*Results@#Fourteen studies were included in this review. As a result of a data analysis of the selected studies, 199 subthemes and supporting illustrations were identified and grouped into 36 related categories. Based on the subthemes and categories, five synthesized findings were developed: (1) the individual and organizational causes of workplace bullying; (2) the various types of physical violence and psychological harassment; (3) the negative impact of workplace bullying and its effect on self-growth; (4) active and passive coping efforts in dealing with bullying; and (5) strategies for preventing bullying incidents. @*Conclusion@#Based on the synthesized findings, four recommendations were made: (1) improving the challenging working conditions for nurses; (2) enhancing educational programs for new nursing graduates; and (3) promoting proactive responses from nursing managers in conjunction with an expansion of resilience training for nursing students. Finally, to address the issue of workplace bullying, (4) multi-center and multi-level research involving nursing organizations needs to be conducted.

Prevalence of workplace violence against registered nurses and their perceptions of relevant management systems in acute care hospitals / 한국간호교육학회지

Purpose@#This study investigated the prevalence and perceptions of workplace violence against registered nurses (RNs) in hospitals. @*Methods@#One thousand RNs replied to a nationwide survey from November 14 to December 22, 2022. They reported their general characteristics, prevalence of and their responses to different types of workplace violence from patients, family caregivers, physicians, and nurse peers, as well as their perceptions of workplace violence management systems. @*Results@#A total of 71.1% of the RNs reported that they had experienced workplace violence in the last six months. The violence and sexual harassment experienced from patients and family caregivers were 57.3% and 19.1%, respectively. Furthermore, violence, sexual harassment, and workplace harassment from physicians were experienced by 24.6%, 4.0%, and 7.4%, respectively, of the RNs, and those from nurse peers by 21.4%, 3.1%, and 11.3%, respectively. The RNs stated that they often responded to workplace violence with passive and inactive behaviors, which were more serious toward physicians’ workplace violence or sexual harassment from different perpetrators. Only 69.5% were aware of their hospital’s workplace violence management systems, while only 14.7%~27.4%, according to the type of hospital (p=.471), perceived the systems as effective. Multiple important strategies were identified to prevent workplace violence. @*Conclusion@#Critical suggestions are discussed for the prevention of workplace violence, including protecting the human rights of healthcare professionals, inter-organizational collaboration, and a culture of person-centered healthcare, and training nurse managers’ competency in managing workplace violence.

Interorganizational Networks for Smoking Prevention and Cessation: A Blockmodeling Approach

Purpose@#This study examined characteristics and patterns of interorganizational networks for smoking prevention and cessation in Korea. @*Methods@#We surveyed two community health centers, ninety-five hospitals or clinics, ninety- two pharmacies, and sixty-five health welfare organizations in two districts of Seoul in 2020. Data on the organizations’ characteristics of smoking cessation and interorganizational activities for information sharing, client referral, and program collaboration were collected and analyzed using network statistics and blockmodeling. @*Results@#Network size was in the order of information sharing, client referral, and program collaboration networks. Network patterns for interorganizational activities on information sharing, client referral, and program collaboration among four organizations were similar between the two districts. Community health centers provided information and received clients from a majority of the organizations. Their interactions were not unidirectional but mutual with other organizations. Pharmacies were involved in information sharing with health welfare organizations and client referrals to hospitals or clinics. Health welfare organizations were primarily connected with the community health centers for client referrals and program collaboration. @*Conclusion@#A community health center is the lead agency in interorganizational activities for smoking prevention and cessation. However, hospitals or clinics, pharmacies, and health welfare organizations also participate in interorganizational networks for smoking prevention and cessation with diverse roles. This study would be evidence for developing future interorganizational networks for smoking prevention and cessation.

Nurse educators’ experiences with student incivility: a meta-synthesis of qualitative studies / 보건의료교육평가

This study aimed to synthesize the best available qualitative research evidence on nurse educators’ experiences with student incivility in undergraduate nursing classrooms. A meta-synthesis of qualitative evidence using thematic synthesis was conducted. A systematic search was performed of 12 databases for relevant literature published by March 31, 2019. Two reviewers independently conducted critical quality appraisals using the checklist for qualitative research developed by the Joanna Briggs Institute. Eleven studies that met the inclusion criteria were selected for review. From the pooled study findings, 26 descriptive themes were generated and categorized into the following 5 analytical themes: (1) factors contributing to student incivility, (2) management of student incivility, (3) impact: professional and personal damage, (4) impact: professional growth, and (5) initiatives for the future. Many nurse educators became confident in their role of providing accountability as both educators and gatekeepers and experienced professional growth. However, others experienced damage to their personal and professional life and lost their motivation to teach. Nurse educators recommended the following strategies for preventing or better managing student incivility: institutional efforts by the university, unified approaches for student incivility within a nursing program, a faculty-to-faculty network for mentoring, and better teaching and learning strategies for individual educators. These strategies would help all nurse educators experience professional growth by successfully preventing and managing student incivility.

Identification of Knowledge Structure of Pain Management Nursing Research Applying Text Network Analysis

PURPOSE: This study aimed to explore and compare the knowledge structure of pain management nursing research, between Korea and other countries, applying a text network analysis. METHODS: 321 Korean and 6,685 international study abstracts of pain management, published from 2004 to 2017, were collected. Keywords and meaningful morphemes from the abstracts were analyzed and refined, and their co-occurrence matrix was generated. Two networks of 140 and 424 keywords, respectively, of domestic and international studies were analyzed using NetMiner 4.3 software for degree centrality, closeness centrality, betweenness centrality, and eigenvector community analysis. RESULTS: In both Korean and international studies, the most important, core-keywords were “pain,” “patient,” “pain management,” “registered nurses,” “care,” “cancer,” “need,” “analgesia,” “assessment,” and “surgery.” While some keywords like “education,” “knowledge,” and “patient-controlled analgesia” found to be important in Korean studies; “treatment,” “hospice palliative care,” and “children” were critical keywords in international studies. Three common sub-topic groups found in Korean and international studies were “pain and accompanying symptoms,” “target groups of pain management,” and “RNs' performance of pain management.” It is only in recent years (2016~17), that keywords such as “performance,” “attitude,” “depression,” and “sleep” have become more important in Korean studies than, while keywords such as “assessment,” “intervention,” “analgesia,” and “chronic pain” have become important in international studies. CONCLUSION: It is suggested that Korean pain-management researchers should expand their concerns to children and adolescents, the elderly, patients with chronic pain, patients in diverse healthcare settings, and patients' use of opioid analgesia. Moreover, researchers need to approach pain-management with a quality of life perspective rather than a mere focus on individual symptoms.

Identification of Knowledge Structure of Pain Management Nursing Research Applying Text Network Analysis

PURPOSE@#This study aimed to explore and compare the knowledge structure of pain management nursing research, between Korea and other countries, applying a text network analysis.@*METHODS@#321 Korean and 6,685 international study abstracts of pain management, published from 2004 to 2017, were collected. Keywords and meaningful morphemes from the abstracts were analyzed and refined, and their co-occurrence matrix was generated. Two networks of 140 and 424 keywords, respectively, of domestic and international studies were analyzed using NetMiner 4.3 software for degree centrality, closeness centrality, betweenness centrality, and eigenvector community analysis.@*RESULTS@#In both Korean and international studies, the most important, core-keywords were “pain,”“patient,”“pain management,”“registered nurses,”“care,”“cancer,”“need,”“analgesia,”“assessment,” and “surgery.” While some keywords like “education,”“knowledge,” and “patient-controlled analgesia” found to be important in Korean studies; “treatment,”“hospice palliative care,” and “children” were critical keywords in international studies. Three common sub-topic groups found in Korean and international studies were “pain and accompanying symptoms,”“target groups of pain management,” and “RNs' performance of pain management.” It is only in recent years (2016~17), that keywords such as “performance,”“attitude,”“depression,” and “sleep” have become more important in Korean studies than, while keywords such as “assessment,”“intervention,”“analgesia,” and “chronic pain” have become important in international studies.@*CONCLUSION@#It is suggested that Korean pain-management researchers should expand their concerns to children and adolescents, the elderly, patients with chronic pain, patients in diverse healthcare settings, and patients' use of opioid analgesia. Moreover, researchers need to approach pain-management with a quality of life perspective rather than a mere focus on individual symptoms.

Text Network Analysis of Newspaper Articles on Life-sustaining Treatments

PURPOSE: This study tried to understand discourses of life-sustaining treatments in general daily and healthcare newspapers. METHODS: A text-network analysis was conducted using the NetMiner program. Firstly, 572 articles from 11 daily newspapers and 258 articles from 8 healthcare newspapers were collected, which were published from August 2013 to October 2016. Secondly, keywords (semantic morphemes) were extracted from the articles and rearranged by removing stop-words, refining similar words, excluding non-relevant words, and defining meaningful phrases. Finally, co-occurrence matrices of the keywords with a frequency of 30 times or higher were developed and statistical measures—indices of degree and betweenness centrality, ego-networks, and clustering—were obtained. RESULTS: In the general daily and healthcare newspapers, the top eight core keywords were common: “patients,” “death,” “LST (life-sustaining treatments),” “hospice palliative care,” “hospitals,” “family,” “opinion,” and “withdrawal.” There were also common subtopics shared by the general daily and healthcare newspapers: withdrawal of LST, hospice palliative care, National Bioethics Review Committee, and self-determination and proxy decision of patients and family. Additionally, the general daily newspapers included diverse social interest or events like well-dying, euthanasia, and the death of farmer Baek Nam-ki, whereas the healthcare newspapers discussed problems of the relevant laws, and insufficient infrastructure and low reimbursement for hospice-palliative care. CONCLUSION: The discourse that withdrawal of futile LST should be allowed according to the patient's will was consistent in the newspapers. Given that newspaper articles influence knowledge and attitudes of the public, RNs are recommended to participate actively in public communication on LST.

Instruments and Taxonomy of Workplace Bullying in Health Care Organizations

PURPOSE: This study was aimed to evaluate the methodological issues and comprehensiveness of workplace bullying instruments and to suggest a taxonomy of psychological abuse. METHODS: Nineteen instruments applied in health care organizations and 469 questionnaire items mainly regarding psychological abuse were collected through a literature review. Three researchers classified the questionnaire items according to a “taxonomy of psychological abuse in the workplace.” RESULTS: Many instruments of workplace bullying were developed in the 2000s using a reflective measurement model, but their psychometric property was not sufficient and the measurement model is questioned. Based on the questionnaire items, the “taxonomy of psychological abuse in the workplace” was modified by adding two new subcategories (unachievable work and unfair treatment) and clarifying some operational definitions. According to the modified taxonomy of 11 (sub)categories, the reviewed instruments assessed 6.5 (sub)categories on average. No instrument measured all (sub)categories. Category 4.2 (disrespect, humiliation, and rejection of the person) was measured in all instruments, followed by Categories 5 (professional discredit and denigration) and 1.2 (social isolation) behaviors. CONCLUSION: The current instruments are not comprehensive enough. It is suggested that the modified taxonomy is verified and guide more reliable and inclusive instruments in the future. Furthermore, a formative measurement model, which defines a bullying as an inventory of different types of behaviors, should be used.

A Comparison of Hospice Care Research Topics between Korea and Other Countries Using Text Network Analysis

PURPOSE: This study aimed to identify and compare hospice care research topics between Korean and international nursing studies using text network analysis. METHODS: The study was conducted in four steps: 1) collecting abstracts of relevant journal articles, 2) extracting and cleaning keywords (semantic morphemes) from the abstracts, 3) developing co-occurrence matrices and text-networks of keywords, and 4) analyzing network-related measures including degree centrality, closeness centrality, betweenness centrality, and clustering using the NetMiner program. Abstracts from 347 Korean and 1,926 international studies for the period of 1998–2016 were analyzed. RESULTS: Between Korean and international studies, six of the most important core keywords-“hospice,”“patient,”“death,”“RNs,”“care,” and “family”-were common, whereas “cancer” from Korean studies and “palliative care” from international studies ranked more highly. Keywords such as “attitude,”“spirituality,”“life,”“effect,” and “meaning” for Korean studies and “communication,”“treatment,”“USA,” and “doctor” for international studies uniquely emerged as core keywords in recent studies (2011~2016). Five subtopic groups each were identified from Korean and international studies. Two common subtopics were “hospice palliative care and volunteers” and “cancer patients.” CONCLUSION: For a better quality of hospice care in Korea, it is recommended that nursing researchers focus on study topics of patients with non-cancer disease, children and family, communication, and pain and symptom management.

Clinical Nurses' Perceived or Experienced Obstacles and Supportive Behaviors in Providing Care for Terminally Ill Cancer Patients

PURPOSE: The purpose of this study was to examine obstacles and supportive behaviors perceived or experienced by clinical nurses providing care for terminally ill cancer patients. METHODS: Beckstrand's survey questionnaire was translated into Korean and verified by an expert committee and through a preliminary study. A survey that used 26 questionnaire items on obstacles and 24 on supportive behaviors, was conducted among 228 registered nurses with more than one year of experience at medical-surgical general wards in a hospital. RESULTS: The highly-perceived and frequently-experienced obstacles in providing care for terminally-ill cancer patients were related to patients' uncontrollable pain or psychologically unstable family members. The highly-perceived and frequently-experienced supportive behaviors were related to caring family members or having supportive family members. However, nurses' perceptions or experiences of multiple obstacles and supportive behaviors differed by hospital type, career length, and department. CONCLUSION: Nurses seem to be in need of training for pain management for terminal cancer patients and of family care in general. Highlyperceived and highly-experienced obstacles or highly-perceived but rarely-experienced supportive behaviors should be intervened without delay considering a hospital type or nurses' career length.

Characteristics of Nursing and Caring Concepts Measured in Nursing Competencies or Caring Behaviors Tools / 간호행정학회지

PURPOSE: The purpose of the study was to identify characteristics of nursing and caring concepts measured by nursing competencies or caring behaviors tools for general nurses working in acute care hospitals. METHODS: Five major nursing literature databases were used to identify the relevant tools. The study included 19 nursing competencies tools with a total of 843 measurement items and 12 caring behaviors tools with 334 items. According to the International Council of Nurses (ICN)'s Competencies Framework and 8Cs suggested by Roach (1987) and Pusari (1998), the measurement items were classified by two researchers independently first and in agreement finally. RESULTS: Competency of ‘key principles of care’ including sub-areas of the ICN Framework was most commonly found: on average 49.3% of nursing competencies items and 91.9% of caring behaviors items. 97.0% of the caring behaviors items were classified into one of six Cs: competence (27.5%), confidence (21.3%), compassion (17.1%), commitment (16.5%), communication (9.9%), or conscience (4.8%). CONCLUSION: Nursing competencies tools were more likely to measure ‘what to do’ focusing on tasks, while caring behaviors tools were to measure ‘how to do’ focusing on nurses' attitudes or values. Nursing practices should be evaluated with both nursing competencies and caring behaviors tools, considering that nursing and caring were differently conceptualized in the quantitative tools.

A Validation Study of the Modified Korean Version of Ethical Leadership at Work Questionnaire (K-ELW)

PURPOSE: The purpose of this study was to validate the Korean version of the Ethical Leadership at Work questionnaire (K-ELW) that measures RNs' perceived ethical leadership of their nurse managers. METHODS: The strong validation process suggested by Benson (1998), including translation and cultural adaptation stage, structural stage, and external stage, was used. Participants were 241 RNs who reported their perceived ethical leadership using both the pre-version of K-ELW and a previously known Ethical Leadership Scale, and interactional justice of their managers, as well as their own demographics, organizational commitment and organizational citizenship behavior. Data analyses included descriptive statistics, Pearson correlation coefficients, reliability coefficients, exploratory factor analysis, and confirmatory factor analysis. SPSS 19.0 and Amos 18.0 versions were used. RESULTS: A modified K-ELW was developed from construct validity evidence and included 31 items in 7 domains: People orientation, task responsibility fairness, relationship fairness, power sharing, concern for sustainability, ethical guidance, and integrity. Convergent validity, discriminant validity, and concurrent validity were supported according to the correlation coefficients of the 7 domains with other measures. CONCLUSION: The results of this study provide preliminary evidence that the modified K-ELW can be adopted in Korean nursing organizations, and reliable and valid ethical leadership scores can be expected.

Role Transition from Clinical Nurse to Case Manager for Medical-aid Beneficiaries: Taking Root in a Barren Land

PURPOSE: The purpose of this study was to explain the role transition process to nurse case managers (NCMs) for Medical-aid beneficiaries in Korea. METHODS: Fourteen NCMs were interviewed regarding their experiences of becoming proficient in the new role of case manger. Data were analyzed through the application of grounded theory. RESULTS: 'Taking root in a barren land' was the core category explaining the role transition process of NCMs. They engaged in four stages: launching, trial and error, proficiency, and wait-and-see stages. NCMs showed not only fear but also passion for case management practice. Despite their passion and effort, NCMs went through a period of trial and error. After becoming skilled, NCMs went through a stage of wait-and-see often because of job insecurity related to temporary position or few opportunities for promotion. Factors influencing NCMs' role transition process included their understanding of client characteristics, belief in case management, and support from their colleagues and families. CONCLUSION: NCMs experience many challenges in the process of becoming proficient NCMs. To help with their role transition, there is a need for education programs, preceptorship programs, research on their roles and functions, and regulation for securing NCMs' employment and career stability.

Current Status and Considerations for Education in Nursing Management / 간호행정학회지

PURPOSE: The purpose of this study was to explore the current status of education for nursing management in Korea. METHODS: A descriptive study was done using a questionnaire developed by the investigators. The data were collected by survey from 96 out of 129 nursing schools, between December 2010 and February 2011. RESULTS: For 22.9% of nursing schools, there was no faculty for nursing management. The credits and subjects included in nursing management varied among the nursing schools. Lectures in subjects related to nursing management were given not only by nursing management faculty but also by faculty with other majors. There were more faculty and credits for nursing management courses in 4-year nursing schools than in 3-year schools. CONCLUSION: To improve the quality of education in nursing management, there is a need to standardized courses and provide nursing faculty who have majored in nursing management.

Usability and Accessibility Evaluation of South Korean and American Health-Related Websites for the Elderly / 간호행정학회지

No abstract available.

Analysis of the Journal of Korean Academy of Nursing Administration for 3 Years (2007-2009) / 간호행정학회지

PURPOSE: The purpose of this study was to identify the major trends of research in the Journal of Korean Nursing Administration from 2007 to 2009. METHOD: Research designs, participants, research domains, and key words were analyzed from the Journal of Korean Nursing Administration. RESULTS: Job satisfaction, organizational commitment, job stress, turnover intention, nursing performance, self-efficiency, leadership, empowerment, nursing informatics, and quality control were the major key words commonly listed in the journal articles. Of the research in the Nursing Administration Journal, quantitative methods were used in 94.5% of the research studies and qualitative methods in only 5.5%. The major participants in the research were nurses, nurse managers, and patients. Statistical methods like ANOVA, correlation, t-test, regression, chi-square test, LISREL were the dominant method of analysis used in the research. The primary domains in the journal articles were directing, organizing, control, planning, and informatics. CONCLUSION: Through this study, the trend of research in nursing administration can be identified. We recommend that collaboration, nurse work environment, evidence-based practice, scheduling, coaching, patient falls and safety, and positive culture should be included as topics for the future research.

A Study on the Satisfaction of Web-Based Health Education Programs

PURPOSE: This study was to present the process of web-based educational program (WEP) development and to identify factors affecting satisfaction with WEP for the certificate of healthcare managers working at the National Health Insurance Corporation (NHIC). METHODS: Subjects were healthcare managers and voluntary participants of WEP. A total of 1,449 respondents were surveyed through an online questionnaire about their satisfaction with the educational contents and system. RESULTS: The mean contents satisfaction was 3.75 (SD 0.54), and system satisfaction 4.68 (SD 0.54). According to statistical analysis, the type of certification, experience and professional career of health care management affected contents satisfaction. And factors affecting system satisfaction were the type of certification and gender. CONCLUSION: WEP was utilized as a pre-requisite course for the certificate program of healthcare managers. However, the development of advanced WEP is suggested to meet the educational needs of healthcare managers who have certificate or license and their job related to healthcare management.

Case Management Process identified from Experience of Nurse Case Managers

PURPOSE: The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. METHODS: A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. RESULTS: Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. CONCLUSION: This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

Analysis of the Nursing Interventions Performed by Public Health Nurses in Health Centers Using the NIC / 간호학회지

PURPOSE: The purpose of this study was to identify nursing interventions performed by public health nurses in health centers. METHOD: Data was collected by the taxonomy of Nursing Intervention Classification (NIC 3rd: 486 nursing interventions) from 131 public health nurses in health centers and analyzed using descriptive statistics. RESULT: As its result, more than 50% of public health nurses performed 137 nursing interventions at least monthly. The most frequently used intervention class was 'activity and exercise management', followed by 'physical comfort promotion', 'community health promotion', 'life span care', 'coping assistance', 'Self care facilitation', 'information management', 'nutrition support', 'community risk management' and 'patient education'. One hundred twenty nursing interventions were rarely performed by 90% or more of the nurses. Most of them were the physical complex domain. CONCLUSION: In conclusion, 137 interventions were performed by public health nurses at least monthly. NIC is helpful to build a standardized language for public health nursing.