The Pathways of Nurse Turnover in Long-term Care Hospitals / 한국직업건강간호학회지

Background@#This study explores the pathways of nurse turnover in long-term care hospitals (LTCHs) and its underlying conditions in Korea. Although the factors of staying or leaving of nurses in LTCHs have been reported, few studies have examined the trajectory and conditions of nurses staying in and leaving LTCHs. @*Methods@#A qualitative study design with a grounded theory approach was conducted. Data were collected in one-to-one interviews. Purposive and theoretical sampling led to the inclusion of 20 registered nurses from 15 LTCHs in South Korea. @*Results@#Seeking work-life balance was the core category of the nurses' turnover pathway. The consequences of the nurses' turnover pathway were categorized into three groups: thriving, surviving, and leaving. Thriving nurses found meaning in their work, fostered good relationships, and saw opportunities for growth. Surviving nurses were enduring their jobs in LTCHs, having a work-life balance, and supportive nursing leaders. Leaving group nurses wished to leave LTCHs due to a lack of professional growth, unappealing work, continued conflict, and social stigma. @*Conclusion@#This study provided the trajectory and conditions for nurses to enter, stay, move, or leave. Understanding the pathways for staying or leaving can be used as a strategy for successful retention of registered nurses in LTCHs.

Factors Affecting Fall-Prevention Behavior of Long-Term Care Nurses / 한국직업건강간호학회지

Purpose@#The purpose of this study was to identify factors influencing fall-prevention behaviors of nurses working in long-term care hospitals. @*Methods@#Participants included 147 nurses working in 10 long-term care hospitals in B city. Data were collected from September 20-October 12, 2016. SPSS/WIN 21.0 was used for analysis with t-test, ANOVA, Scheffé ́ test, Pearson correlation coefficients, and multiple regression. @*Results@#It was found that attitude toward fall (r=.29, p<.001) and patient safety culture (r=.25, p=.002) had a significant positive correlation with fall-prevention behaviors of nurses working in long-term care hospitals. The factors influencing fall-prevention behaviors in participants were clinical career and patient safety culture (β=.21, p=.012), contributing to 19% of the total variance in fall- prevention behaviors. @*Conclusion@#The findings showed that systematic delivery of differentiated fall prevention education is preferred to nurse's clinical career as a private factor to improve fall-prevention behaviors of nurses in long term care hospital. Particularly, it is imperative to conduct periodical and practical fall-prevention education for nurses to prevent career discontinuity. An independent report system and open communication system as well as a scheme that can disseminate patient safety culture in individual departments to implement patient direct nursing are required to encourage patient safety culture in organizations.

Impact of Anger Expression Style and Occupational Stress on the Risk of Cardiovascular Disease in Middle-aged Male Workers / 한국직업건강간호학회지

Purpose@#This study aimed to investigate the factors affecting cardiovascular disease in middle-aged male workers. @*Methods@#The participants were 137 male office workers over 40 years old and under 60 years old working in small- and medium-sized workplaces from three southern provinces of Korea. Data were collected through self-reported questionnaires and health screening reports from the 2014 National Health Examination. The influencing factors included general characteristics of participants, anger expression style, and occupational stress. Data were analyzed using t-test, ANOVA, and regression analysis with SPSS 22.0. @*Results@#The mean score of risk of cardiovascular disease was 6.73±4.69 and there were significant differences in exercise (t=2.13, p=.035) working time (t=-2.15, p=.034). Logistic regression analysis showed that, when adjusted for exercise and working time, the probability of becoming under a cardiovascular disease risk was 21% higher for those who anger-in (OR=1.21, 95% CI=1.02~1.44, p=.027) and 12% higher for those perceived occupational stress (OR= 1.12, 95% CI=1.01~1.24, p=.030). @*Conclusion@#The results suggest developing the strategies for middle-aged male workers to encourage exercise and to decrease occupational stress, as well as an appropriate anger expression style to improve holistic aspect of health considering their demographic characteristics.

Transition Experiences of the Elderly from Long-Term Care Hospital to Home: Focusing on the Elderly Living Alone of Community Care Project

Purpose@#The purpose of this qualitative study was to explore the transition experiences of the elderly from long-term care hospitals to their homes. @*Methods@#The participants were eight elderly medicaid beneficiaries, who had been the subjects from the community care project in Korea. The data were collected with one-on-one interviews from April to November in 2020, and analyzed by phenomenological steps. @*Results@#The seven themes derived in this study were ‘Space to escape’, ‘Reliable supporter opened the way to discharge’, ‘Comfortable life at home’,‘Obstacles to independent life’, ‘Struggling to live alone’, ‘Fence for community life’, and ‘Energizing in daily life’ @*Conclusion@#The results revealed the positive aspects of Community Care program in Korea. However, it is suggested that active communication between hospitals and community care institutions, and improvement of home environment to live in the community before discharge should be required. And system revision is needed to adjust activity in their home and support health problems of the elderly in the early stage of discharge. The results of this study can be referred to as the foundation of transitional care for the elderly.

Nurses' Experiences of End-of-life Care for Elderly Patients in Long-term Care Hospitals

Purpose@#The purpose of this qualitative study was to describe the essence and the meaning of nurses’ experiences of end-of-life care (EOLC) for elderly patients in the long-term care hospitals (LTCHs). @*Methods@#Data were gathered from 12 nurses who had been working at LTCHs in Korea through one-on-one interviews and the data were analyzed by Colaizzi's phenomenological method. @*Results@#The emergent 5 themes were ‘Doing the best for protecting patients’ life’, ‘Providing a comfortable dying process for patients’, ‘Supporting a family’s keeping on patient’s death’, ‘Reflecting on life’ and ‘Desiring for the establishment of a humanity end-of-life care environment’. @*Conclusion@#The end-of-life care for the elderly patients includes supporting elderly patients’ comfortable dying process and helping the family keep the death of the elderly. The results indicated that physical facilities and end-of-life nursing capacity should be established in LTCHs for improving the quality of EOLC.

Analysis of Spiritual Care Experiences of Acute-Care Hospital Nurses / 한국호스피스완화의료학회지

Purpose@#The purpose of this study was to analyze the experiences of acute care hospital nurses’ on spiritual care with focus group interviews. @*Methods@#Data were collected from 24 nurses recruited from one acute-care hospital in a southern province of Korea. Six focus groups were assembled considering age and religion. All interviews were recorded and transcribed. Data were analyzed using qualitative content analysis. @*Results@#Five categories with 14 sub-categories emerged: 1) ambiguous concept: confusing terms, an additional job; 2) assessment of spiritual care needs: looking for spiritual care needs, not recognizing spiritual care needs; 3) spiritual care practices: active spiritual care, passive spiritual care ; 4) outcomes of spiritual care: comfort of the recipient, comfort of the provider; and 5) barriers to spiritual care: fear of criticism from others, lack of education, lack of time, space constraints, and absence of a recording system. @*Conclusion@#Participants perceived spiritual care as an uncertain concept. Some participants recognized it as a form of nursing care, and others did not. They practiced spiritual care in acute-care settings according to their personal perceptions of spiritual care. Therefore, in order to perform spiritual nursing in acute-care hospitals, it is a priority for nurses to recognize the concept of spiritual nursing accurately. It is also necessary to prepare a hospital environment suitable for the provision of spiritual care.

The Effect of Health Literacy and Self-care Performance on Health Care Utilization of Medicaid Elderly

PURPOSE: The purpose of this study was to examine the effect of health literacy and self-care performance on health care utilization of medicaid elderly.METHODS: A total of 203 medicaid elderly over 65 and living in B-metropolitan city were interviewed. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and Hierarchical Multiple regression.RESULTS: The average score of the health literacy was 7.88±2.84 out of 12. The average score of self-care was 3.26±0.77 points on the 5 point scale. The frequency of health care utilization by the subjects was 6.65±5.25 a month. The health literacy and self-care performance showed a statistically significant positive correlation. The health literacy and self-care performance showed a statistically significant negative correlation with health care utilization. The factors affecting health care utilization of the subjects were self-care performance, health literacy, and religion, and the explanatory power was 25%.CONCLUSION: The results indicate that the self-care performance, health literacy, religion are significant factors of health care utilization in medicaid elderly. Therefore, it is necessary to develop strategies to improve their self-care performance and health literacy for reasonable health care utilization. Also, it is necessary to provide the elderly with correct information about medical use from accessible religious institutions, senior community center, and welfare centers.

Withdrawal of Life-Sustaining Treatment from Children: Experiences of Nurses Caring for the Children

PURPOSE: The purpose of this study was to describe feelings and actions of nurses following withdrawal of life-sustaining treatment from children being cared for by the nurses. METHODS: Data were collected by in-depth interviews with 7 nurses from different hospitals where children receiving nursing care had life-sustaining treatment withdrawn. The interviews were conducted from August 2016 to February 2017 when all data were saturated. Interviews lasted 30~90 minutes and were conducted 2~3 times per participant. Data were analyzed using Giorgi's phenomenological research methodology. RESULTS: The following factors constituted experiences of nurses working in pediatric wards when life-sustaining treatment was withdrawn from children: “agony and conflict in the aspects of care”, “heavy mind and regret for exhausting care”, “intentionally avoiding parents' sadness”, “comforting sadness in the heart” and “orientation in the role of caring for children undergoing withdrawal of life-sustaining treatment.” CONCLUSION: Findings indicate that support systems and intervention programs need to be developed so that nurses can understand and wisely deal with experiences of withdrawal of life-sustaining treatment from children who receive care from nurses.

Person-centered Care and Nursing Service Quality of Nurses in Long-term Care Hospitals

PURPOSE: This study investigated the correlation between person-centered care (PCC) and nursing service quality of nurses in long-term care hospitals. METHODS: The subjects were 114 nurses working in 8 long-term care hospitals. Instruments for evaluating PCC and nursing service quality were used. The data were analyzed by descriptive statistics, two samples-test, one-way ANOVA, Pearson's correlation and Multiple regression. RESULTS: The mean of PCC was 3.25±0.45 out of 5 and the nursing service quality was 3.87±0.40. There were significant differences in PCC in terms of age and income satisfaction, the application of their opinions, the satisfaction of hospital managers, administrators and nurse managers. There were significant differences in nursing service quality according to age, position, the satisfaction of hospital managers, administrators and nurse managers. Nurses' PCC showed a significant positive correlation with nursing service quality. Factors influencing nursing service quality included PCC, their position and age and the most influencing one was PCC. CONCLUSION: This study suggests that the PCC is the strongest affecting element to the quality of nursing service in long-term care hospitals. Therefore, the strategies to improve the practice of person-centered care should be carried out to enhance the quality of nursing service.

Acculturative Stress and Depression of Vietnamese Immigrant Workers in Korea

PURPOSE: The purpose of this study was to investigate the correlation between acculturative stress and depression of Vietnamese immigrant workers in Korea. METHODS: The subjects were 230 Vietnamese immigrant workers residing legally in B or K City. Data were collected from July 12, 2014 to August 3, 2014, and were analyzed using the SPSS PASW 21.0 program. RESULTS: The average level of acculturative stress was 2.91 and there were significant differences in the score according to whether to have a religion, the number of homeland friends, and Korean language skill. The average depression level of the subjects was 15.3 and the level was different significantly according to whether to have a religion, the number of homeland friends, salary, working hours, and Korean language skill. Acculturative stress and depression showed a significant positive correlation with each other. The influencing factors of depression were acculturative stress and the number of homeland friends. The most significant factor was acculturative stress. CONCLUSION: This result shows the necessity of various programs to diminish acculturative stress to control the depression of immigrant workers.

The Experiences of Family Caregivers under the Long-term Care Insurance

PURPOSE: The purpose of this study was to explore the experiences of family caregivers who care for the elderly under Long-term Care Insurance. METHODS: Data were collected using focus group interviews and analyzed using a phenomenological approach. The four focus groups consisted of eight caregivers, two social workers and three nurses in B city, Korea. RESULTS: Five themes were identified: 'Obtaining a care-helper certification for employment', 'Taking care of the elderly in their homes', 'Difficulties due to life changes', 'Difficulties due to reduced wages' and 'Dissatisfaction with the Long-term Care Insurance operating system'. CONCLUSION: The results of this study demonstrate that the long-term care system for family caregivers faces many systematic challenges in providing care for the elderly harmoniously in their home. To help them succeed in their tasks, Long-term Care Insurance system must offer respite and support programs to family caregivers.

Perception and Practice of Hospital Infection Control of Nursing Staff depending on the Supplementation of Nurses in Long-term Care Hospitals / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to describe the perception and practice of hospital infection control of nursing staff in long-term care hospitals by the level of supplementation of nurses. METHODS: The participants were 212 nurses and nurse assistants in 13 long-term care hospitals in a metropolitan city and the data were gathered by self-reported questionnaires during August 2011 and analyzed by SPSS/WIN program. RESULTS: The beds per a nurse were 15, and the proportion of nurses among nursing staff in long-term care hospitals was about 33%. In general, the level of infection control in practice was lower than that of perception. The highest perception and practice domain was 'Management of disinfection/contamination', and the lower level domains were 'Personal hygiene' and 'Hand washing' There were statistically significant differences in the hospital infection control of perception and practice depending on age, education, career in long-term care hospital, job position, the quantity of beds, nurse, and nurse assistant, beds per a nurse and proportion of nurses in hospitals. CONCLUSION: According to these results, the systematic and continual education on hospital infection control of the nursing staff in long-term hospitals should be carried out. In addition, the policy to add more nurses into long-term care hospitals must be implemented.

Influencing Factors on the Need of Community Care Services in the Family Caregivers of Hospital-based Home Care Patients

PURPOSE: The purpose of this study were to examine the need of community care services and the influencing factors of the need in the family care givers of hospital-based home care patients. METHODS: Data were collected from 256 family caregivers, who were recruited from 10 hospitals in a metropolitan city. A structured questionnaire on the characteristics of caregivers, resources, and patients was administered. Also, questions on the need of community care services were added. Logistic regression analysis was used to identify the influencing factors of the need for community care services. RESULTS: The participant needed more transportation service, lease of health care devices, visiting bath, caring, visiting hair dressing than that of housekeeping, short-term care, and day care service. Various variables from the three factors were found to be influenced on the need of community care services. CONCLUSION: The accessibility of the higher need of community care services should be increased for hospital-based home care users. Also, the factors of Family care giver, Resource, and Patient might be considered to provide community care services of hospital-based home care users.

Scale Development of Free Nursing Home-Adjustment for the Elderly / 간호학회지

PURPOSE: The purpose of this study was to develop a scale of free nursing home adjustment for the elderly in Korea. METHOD: The developmental processes were construction of a conceptual framework, development of preliminary items, verification of content validity, twice data gathering, verification of construct validity, and reliability of final items. The first 53 preliminary items were obtained through review of literatures about nursing home adjustment and in depth interviews with 5 staffs of nursing home. These items were reviewed by five specialists for content validity and 39 items were chosen. The first data was collected from 107 elderly residing in 3 nursing homes and the second survey was from 147 residents who were living in five nursing homes. Finally this data was analyzed for construct validity and reliability. RESULT: There were 23 final items which were sorted into 5 factors. The factors were identified as 'Relocation distress symptom'(8items), 'Making friends'(4items), 'Acceptance of new residence' (6items), 'Difficulty in group life'(3items), and 'Having self-worth'(2items). The cumulative percent of variance was 53.466%. The reliability of the scale, Cronbach's alpha was .837. CONCLUSION: The result of this study could be used for measuring nursing home adjustment of the elderly. However, for further validity and reliability, repeated researches are needed.

Relationship between Satisfaction of Volunteering and Meaning in Life of the Elderly: based on Hospital Voluntary Activity

No abstract available.

Development of a Critical Thinking Disposition Scale for Nursing Students / 간호학회지

PURPOSE: The purpose of this study was to develop a critical thinking disposition scale for nursing students. METHOD: The developmental process was construction of a conceptual framework, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity and extraction of final items. The conceptual framework and first preliminary 60 items were obtained through a review of relevant literature and the development of critical disposition scales by 10 researchers who had been studying critical thinking for one year. These items were reviewed by five specialists for content validity and finally 55 items were chosen. The data was collected from October 1 to 15, 2004 and was analyzed using factor analysis and Cronbach's alpha with the SPSS program. The subjects were composed of 560 Bachelor of Science nursing students from 8 nursing schools. RESULT: There were 35 final items which were sorted into 8 factors. The factors were identified as 'intellectual integrity(6 items)', 'creativity(4 items)', 'challenge(6 items)', 'open-mindedness(3 items)', 'prudence(4 items)', 'objectivity(4 items)', 'truth seeking(3 items)' and 'inquisitiveness(5 items)'. The cumulative percent of variance was 55.107%. The reliability of the scale, Cronbach's alpha was .892 and the factors' ranged from .562-.836. CONCLUSION: The result of this study could be used for measuring critical thinking dispositions of nursing students. However, for further validity and reliability, repeated research is necessary.

Effects of Pain Control Education on Pain Control Barrier, Postoperative Pain and Pain Control Satisfaction in Gynecological Patients / 간호학회지

PURPOSE: The purpose of this study was to evaluate the effects of preoperative pain control education on the pain control barrier, postoperative pain and pain control satisfaction in gynecological patients. METHOD: The study was a quasi-experimental research design. There were 58 subjects who were admitted for gynecological surgery to D University Hospital in B city. Pain control education was provided individually to the experimental group one day before their operation day for 20 minutes with the 'Pain Control Guide Book' in the patient's admission room. The education book was made by researchers based on pain management references and patient interviews. For assessing the pain control barrier, a simplified version of Barriers Questionnaire was used, postoperative pain was assessed on a numeric scale(0-10) and satisfaction of pain control was assessed by one question. RESULTS: The pain control barrier(F=15.828, p<.001) and the post pain score of the experimental group was lower than that of the control group. In addition, pain control satisfaction of the experimental group(t=3.612, p<.001) was higher than the control group's. CONCLUSION: With the above results, preoperative pain control education could be an effective nursing intervention for pain control of surgical patients.

Scale Development of Job Stress for Home Care Nurses / 간호학회지

The purpose of this study was to develop a job stress scale for hospital-based home care nurses in Korea. The process was construction of the conceptual framework, development of the preliminary items, verification of the content validity, item analysis and test of the reliability. The preliminary items were based on literature review and in-depth interviews with home care nurses. As a result, eight categories and sixty items were selected. These were reviewed by seven specialists for content validity and finally fifty one items were chosen. Data was collected from 180 home care nurses who were engaged in 87 hospitals from August to September 2003. The result of item analysis one was excepted. The final item count was 50. Categories were as follows: overload work(8 items), lack of specialized knowledge and technique(5 items), ethical dilemma(4 items), role conflict(5 items), interpersonal relationships(6 items), visiting home environment(9 items), driving conditions(4 items) and lack of administrative support(9 items), The reliability of the scale by Cronbach's alpha was .948 and the domain's reliability ranged from .649 to .841. The result of this study could be used to measure the job stress of home care nurses. However, for further validity and reliability, repeated studies will be necessary.

A Grounded Theory Approach to the Adjustment Process of the Institutionalized Elderly: The Control of Reluctance / 간호학회지

PURPOSE: The number of residents in elderly institution has been increasing due to the change of the family support system. This study was focused on understanding the process of adjustment of the institutionalized elderly using the Grounded Theory approach. METHOD: There were seven participants, 4 men and 3 women living in 3 different elderly facilities. The data was collected through in-depth interviews and participant observation from June 20, 1999 to January 10, 2000 and analyzed by the Strauss and Corbin's analysis method. RESULT: 125 concepts were found and grouped into 30 sub-categories and then grouped into 13 categories. These categories are , , , , , , , , , , , and , which were synthesized into the process of adjustment. being the core category. The adjustment process of the facility elderly consisted of: 1. expressive phase of 'reluctance' 2. control phase of 'reluctance' 3. latent phase of 'reluctance' CONCLUSION: This study offers better understandings on the adjustment process of the institutionalized elderly and provides more appropriate nursing care to the New Comers of these facilities.