Mediating Effects of Sleep Quality on the Relationship between Job Stress and Stress Response of Shift-Working Nurses

PURPOSE: The aim of this research was to identify the mediating effect of sleep quality on the relationship between job stress and stress response of shift-working nurses.METHODS: The participants in this study were 150 nurses who had more than 6 months of shift-working experience. A survey was conducted from May to June 2017 in a hospital in Gyeonggi-do, South Korea. The data were collected through self-report questionnaires. The collected data were analyzed using SAS 9.4 program. The analysis was based on Baron and Kenny's model to examine the mediating effects of sleep quality on the relationship between job stress and stress response of shift-working nurses.RESULTS: In the first and second steps, job stress was identified as a significant predictor of sleep quality (β=.29, p=.001) and stress response (β=.24, p=.004). In the third step, sleep (β=.55, p < .001) was observed as a significant predictor of stress response, and the direct relationship between job stress and stress response was not significant (β=.07, p=.291). Sleep quality was found to exhibit complete mediating effect on the relationship between job stress and stress response.CONCLUSION: The results of this study suggest that strategies for managing the stress of shift-working nurses should include effective ways to ensure sleep quality.

Adolescent Health Behaviors according to Body Mass Index

PURPOSE: The purpose of this study was to analyze differences in health behaviors among adolescents in order to provide fundamental data to develop an effective body weight control program. METHODS: Secondary analysis was done using data from the 9th (2013) Online Survey on Ado-lescents' Health Behaviors by the Korea Centers for Disease Control and Prevention. The adolescents were divided into low weight, normal weight, overweight, and obesity groups according to body mass index (BMI). Differences in health behaviors were analyzed. RESULTS: Gender, grade, socioeconomic status, perceived-health status, exercise, breakfast, fast food, ramen noodles, snacks, carbonated soft drinks, fruits and vegetables, satisfaction with sleep, stress, smoking, and alcohol consumption were significantly different among the groups. Ingestion of carbonated soft drinks and snacks was significantly higher in the low weight group compared to the normal weight group. Eating fast foods, ramen noodles, and snacks was significantly lower in the overweight and obesity groups compared to the normal weight group. CONCLUSION: Findings indicate that health behaviors among the groups differ from traditional knowledge about obesity. To develop optimal programs and improve efficacy, prior knowledge should be used to think differently and individualized programs should be based on an understanding health behaviors of adolescents.

Development and Psychometric Evaluation of the Transcultural Self-efficacy Scale for Nurses

PURPOSE: This methodological study was conducted to develop and psychometrically test the Transcultural Self-efficacy scale (TCSEscale) for nurses. METHODS: Initial 41 items for the TCSE-scale were generated based on extensive literature reviews and in-depth interviews with 18 nurses who had experience in caring for foreign patients. Cultural Competence and Confidence model was used as a conceptual framework. Content validity was evaluated by an expert panel. Psychometric testing was performed with a convenience sample of 242 nurses recruited from four general hospitals in the Seoul metropolitan area and Gyeonggi-do province of South Korea. To evaluate the reliability of TCSE-scale, a test-retest reliability and an internal consistency reliability were analyzed. Construct validity, concurrent validity, criterion validity, convergent validity and discriminative validity were used to evaluate the validity. RESULTS: The 25-item TCSE-scale was found to have three subscales-Cognitive, Practical, and Affective domain-explaining 91.5% of the total variance. TCSE-scale also demonstrated a concurrent validity with the Cultural Competence Scale. Criterion-related validity was supported by known-group comparison. Reliability analysis showed an acceptable-to-high Cronbach's alpha-.88 in total, and subscales ranged from .76 to .87. The ICC was .90, indicating that the TCSE-scale has internal consistency and stability of reliability. CONCLUSION: This preliminary evaluation of the psychometric scale properties demonstrated an acceptable validity and reliability. The TCSE-scale is able to contribute to building up empirical and evidence based on data collection regarding the transcultural self-efficacy of clinical nurses. We suggest further testing of the applicability of TCSE-scale in different settings and community contexts.

Corrigendum: Development and Psychometric Evaluation of the Transcultural Self-efficacy Scale for Nurses

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Mediating Effect of School Nurses' Self Efficacy between Multicultural Attitude and Cultural Sensitivity in Korean Elementary Schools

PURPOSE: This study examined the mediating effect of school nurses' self efficacy, which is one of the significant cognitive factors influencing cultural sensitivity, on the mutual relationships between multicultural attitude and cultural sensitivity in Korean elementary schools. METHODS: A cross-sectional descriptive survey design was used. Participants were 157 school nurses in elementary schools located in Gyeonggi-do, South Korea. The survey instruments included Teacher Multicultural Attitude Survey, Teacher Efficacy Scale, and Multicultural Sensitivity Scale. Data were analyzed using three regression equations to test the mediation model. RESULTS: The mean score of the school nurses' cultural sensitivity was relatively low. A positive correlation among multicultural attitude, self efficacy, and cultural sensitivity was noted. Self efficacy of school nurses showed a significant mediating effect on the relationships between multicultural attitude and cultural sensitivity. CONCLUSIONS: Given the meaningful influence of positive multicultural attitude on cultural sensitivity and significant mediator effect of self efficacy as a school nurse between the two variables, the strategies to cultivate a positive multicultural attitude and enhance school nurses' self efficacy in their unique role should be considered in a training program. School nurses' health care services will benefit from the improvement of cultural sensitivity toward young children from multicultural families.

The Trends and Status of Work-related Musculoskeletal Diseases under Korean Worker's Compensation System / 한국직업건강간호학회지

PURPOSE: This study was conducted to analyze the characteristics of work-related musculoskeletal diseases (MSD) and the factors for approving MSD by the parts of the body. METHODS: The analysis was done using the data which were drawn from the Industrial Accident Compensation Insurance that is operated by the Korea Worker's Compensation & Welfare Service. The data were composed of total cases related to the work-related diseases from 2006 to 2009. In addition, MSD data input by an investigator were collected. The factors associated with MSD were analyzed using x2 and multiple logistic regression. RESULTS: MSD approved cases have increased since 2006 and the proportion of the approved work-related MSD cases in the workers with work-related diseases in 2009 were 33.4%. Spinal approved cases were the highest percentage and upper and lower extremities cases gradually increased. The factors for approving upper extremity were found to be age, company size, type of industry, working duration, and in the case of spine to be company size and heavy lifting. CONCLUSION: Work-related MSD have increased and the factors that affected MSD by the parts of the body varied. Management strategy must be established to prevent MSD by the parts of the body.

The Burden of Aged Parents Caring for Adult Children with Disabilities

PURPOSE: This study was to describe the burden of aged parents caring for adult children with disabilities and related factors. METHODS: The subjects were 123 caregivers aged over 65 who were caring for 18-year-old or older children with disabilities. The research tool of this study was a structured questionnaire on family burden. Data were collected from June 3 to 25, 2010, and analyzed by Cronbach's alpha, mean, standard deviation, t-test, and ANOVA using SAS 9.2 program. RESULTS: The major findings of this study were as follows. Elderly parents caring for adult children with disabilities perceived a moderate level of burden. The burden from concern over their children's future was highest, and economic and physical burdens were higher when the parents were younger. Burden was significantly different according to parents' characteristics such as gender, perceived health status, disease, the costs of caring for disabled children, and children's characteristics such as disability rating, health status, and ADL. CONCLUSION: In order to reduce the burden of elderly parents caring for adult children with disabilities, we need to improve their health status and assess comprehensive policies.

Accuracy of References in Eight Nursing Journals in Korea / 간호학회지

PURPOSE: This study was to investigate the reference accuracy in major nursing journals in Korea. METHODS: The references in articles from eight nursing journals from 2006 were compared with PubMed for authors, year, title, journal, volume, and page accuracy. Four hundred sixty-six references were reviewed. Errors were classified as major or minor and categorized by bibliographic headings (author, title, journal, year, volume and page). RESULTS: Of the 466 references, 223(47.9%) had citation errors. The reference error rates ranged from 28.6% to 58.7%. Most errors occurred in the author element (37.9%), followed by title (20.9%), journal (19.0%), page (13.9%), volume (5.9%), and year (2.4%). CONCLUSION: This study identified a considerable error rate in the references of nursing journals. Inaccuracy of references is a reflection on scholarly work of authors and journals. Authors and Editorial committees are responsible for the accuracy of references.

Analysis of Research Papers Published in the Journal of Korean Academy of Nursing / 간호학회지

PURPOSE: This study was to determine the current trend of nursing research as exploring both quantitative and qualitative methodologies, and to provide the explicit direction to improve the quality of published papers. METHODS: Total of 366 articles published between 2004 and 2006 was reviewed using the criteria of analysis. RESULTS: There was more number of quantitative studies than qualitative studies. More studies were conducted with subjects who had health problems, and studies that targeted women and elderly population have been significantly increased. In quantitative methodology, utilization of experimental and quasi-experimental designs has been increased, however descriptive study was dominant as yet. In qualitative methodology, studies using grounded theory and phenomenology were frequently published. It was noted that theoretical framework and rational for sample size were rarely presented in quantitative study. Philosophical position and the process of preparation for study, which guided the research, were not clearly described in qualitative study. CONCLUSION: The findings of this review suggest that published studies have been improved and diversified, however, detailed and clear evaluation tool that assesses study process and method should be developed as a way to further improve the quality of published papers.

Developmental Direction for Review System of the Journal of Korean Academy of Nursing / 간호학회지

PURPOSE: This study was performed to identify current characteristics of the Journal of Korean Academy of Nursing and to explore a way to elevate it to an international level and to critique the overall review process so as to delineate the advanced, objective paper appraisal in this journal. METHODS: Data was collected using self administered questionnaires to 75 journal reviewers belonging to the Korean academy of nursing and its division academy of nursing from August 15th to September 30th, 2006. RESULTS: The majority of reviewers pointed out a lack of discrimination between the Journal of Korean Academy of Nursing and other journals. Among the main answers of reviewers, Creativeness(52.3%) and excellence of nursing(38%) will be critical factors to develop in order to elevate to an the journal to an international level. In specific evaluation areas, reviewers preferred a subjective critique method(60%), and the condition of the decision making process regarding paper acceptance as a combination of checklist and subjective evaluation(84%). Subjective evaluation opinions with major categories will occur in the next revised evaluation format. 76% of reviewers agreed with the current objective evaluation form. CONCLUSIONS: The journal review process should be evaluated on a regular basis to elevate the journal level and a mutual agreement of the journal's scope, range, and purpose will be necessary. As a recommendation, an attempt at various approaches in journal reviews and reviewer training should be made.

Developmental Direction for Review System of the Journal of Korean Academy of Nursing / 간호학회지

PURPOSE: This study was performed to identify current characteristics of the Journal of Korean Academy of Nursing and to explore a way to elevate it to an international level and to critique the overall review process so as to delineate the advanced, objective paper appraisal in this journal. METHODS: Data was collected using self administered questionnaires to 75 journal reviewers belonging to the Korean academy of nursing and its division academy of nursing from August 15th to September 30th, 2006. RESULTS: The majority of reviewers pointed out a lack of discrimination between the Journal of Korean Academy of Nursing and other journals. Among the main answers of reviewers, Creativeness(52.3%) and excellence of nursing(38%) will be critical factors to develop in order to elevate to an the journal to an international level. In specific evaluation areas, reviewers preferred a subjective critique method(60%), and the condition of the decision making process regarding paper acceptance as a combination of checklist and subjective evaluation(84%). Subjective evaluation opinions with major categories will occur in the next revised evaluation format. 76% of reviewers agreed with the current objective evaluation form. CONCLUSIONS: The journal review process should be evaluated on a regular basis to elevate the journal level and a mutual agreement of the journal's scope, range, and purpose will be necessary. As a recommendation, an attempt at various approaches in journal reviews and reviewer training should be made.

The Parenting Image of Modern Korean Society Described in Modern Novels / 아동간호학회지

PURPOSE: The purpose of this study was to explore the parenting image of modern Korean society through modern novels published during in the stage of modern change in Korea. METHOD: The data were analyzed through latent content analysis. Modern Korean novels (N=138) written during the Korean modernization stage were chosen for analysis. Five categories and seventeen meaningful sub-categories were drawn out from 636 significant sentences. RESULTS: The parenting images expressed in modern Korean society were as follows: From the category of [Devotional love], 5 sub-categories were drawn: Hedgehog's love, Lavish love, Sacrificial care, Exertion of the mind, and Prayer for the future of their children. From the category of [Stern father and affectionate mother], 3 sub-categories were drawn: Stern and Strict father, Tender and loving mother, and Strong maternal love. From the category of [Enthusiasm for their children's education], 3 sub-categories were drawn: Sense of duty to provide good education for their children, Zeal for their children's education, and Satisfaction with their hard-working children. From the category of [The head of family], 3 sub-categories were drawn: Person who has the right to make decisions, Reliable protector, and Object of filial devotion. From the category of [sexual discrimination], 3 sub-categories were drawn: Preference and favoritism to sons, Attaching importance to education of sons, Regarding daughters as those who help support the family. CONCLUSIONS: The results of this study will help to improve the basic understanding the parenting image and parent-child relationship in present day Korea.

A Study on Evaluation of District Visiting Nursing Services of Urban Health Center

PURPOSE: The purpose of this study was to present the outcomes of the district visiting nursing services. METHOD: We analyzed nursing records and inspected public health center data for evaluating nursing tasks. and conducted a telephone survey of 651 district inhabitants. RESULTS: According to the result, the coverage of the district population, the rate of new registration and overall program activities increased. Meanwhile, accessibility of visiting health care, the level of health problem management, personal cognition and satisfaction concerning visiting nursing care increased, but there was little change in personal perception of health improvement. Furthermore, the status of client management was improved. In the analysis of participation in national cancer screening program, we found that there was twice higher participation in the district than others. CONCLUSION: We suggest that this district visiting nursing system takes responsibility for district inhabitant health management. Based on the study, we also suggest that the government and local autonomous entities should increase administrative and financial supports to execute the district-based visiting nursing system in wider areas.

Nursing Need of Patients with Chronic Illness: A Primary Study for Development for the Nursing Center of Chronic Illness / 간호학회지

PURPOSE: The purpose of this descriptive study was to identify the nursing needs of patients with chronic illness. METHOD: The subjects of this study were 636 patients with chronic illness, 323 general nurses, and 106 public health nurses. The instruments used for this study were questionnaires including perceived functions of nursing from the center for chronic illness, preference to placement, intention to use, needs to receive services from the center for chronic illness, strategies management for nursing, and nursing needs of chronically ill patients. RESULTS: The mean of perceived functions for nursing from the center were 3.1(0.5) in public health nurses, 2.9 (0.59) in general nurses, and 2.4(1.33) in chronically ill patients. Regards of needs to receive on services of the nursing centers were, the regularly physical examination, for health educational services which was perceived highest request amongst chronically ill patients. We found the means of each specific need as 2.2(0.6), for physical health, 2.1(0.7), for psychosocial health, and 1.8(0.6) for spiritual health. CONCLUSION: From the results of this study, it is suggested that establishing a nursing center for chronically ill patients consider physical, psychosocial, for spiritual health needs of chronically ill patients. It is also a consideration that direct care for symptom management and health education in the nursing center be implemented.

A Meta-Analysis of the Effects of Imagery / 간호학회지

PURPOSE: This study was to identify the trends and contents of imagery interventions and to evaluate the effects of imagery interventions by using meta-analysis. METHOD: The materials used for this study were 15 imagery intervention studies carried out from Jan. 1995 to Dec. 2001. The studies were analyzed and evaluated in different categories: 1) types of dependent variables 2) types of imagery 3) interval of imagery 4) total duration of imagery 5) sample characteristics 6) intervention method. RESULT: 1) Behavioral imagery was more prevalent than dynamic imagery. There were wide variations in duration, and interval of interventions. Imagery intervention had moderate effects on psychological variables (state of anxiety, depression & and stress etc.) and had moderate to large effects on physiological variable(pulse rate, cortisol etc.). Behavioral imagery had larger effects than dynamic imagery. Imagery applied to the public had larger effect on decreasing the state of anxiety and stress than applied to the patients. But imagery applied to the patients had a larger effect on decreasing depression than applied to the public. The imagery intervention method by using the individual approach had greater effect than group approach method. CONCLUSION: These results of this study will be used to guide the development of imagery interventions to nursing practice. Also, various types of imagery interventions need to be developed based on the characteristics of nursing practice.

The Effects of Guided Imagery on Nursing Students Performing Intramuscular Injections / 간호학회지

PURPOSE: The anxiety and stress of nursing students on performance intramuscular injection diminished nursing skill performance. The purpose of this study was to identify the effects of the guided imagery program on anxiety, stress and nursing skill performance of nursing students. METHOD: The study design was time series with a nonequivalent control group pretest- posttest study. The Data were collected from the 30th of Oct. to the 6th of Nov. 2001. The objects of this study were 36 sophomores of university(18 for the experimental group, 18 for the control group). The Instruments used in this study were State Trait Anxiety Inventory developed by Spielberger (1972), Visual Analogue Scale for Stress and Nursing skill performance developed by the researcher. The guided imagery was provided through audiotapes to the subjects for 8 minutes. The pretest was given before the therapy to measure variables for both groups and the posttests were performed after intervention. The data were analyzed by the SAS program using t-test and paired t-test. RESULT: The results of this study are as follows. The level of anxiety of students who received the guided imagery were significantly lower than that of control group. the level of stress had a deeling tendency and the nursing skill performance level was significantly higher than that of control group. CONCLUSION: The guided imagery suggested as an effective nursing intervention did reduce the anxiety and promoted nursing skill performance of nursing students.

The Parent-Child Relationship in Traditional Korean Society Described in Korean Classic Novels / 아동간호학회지

The purpose of this study was to explore the parents and child relationship in traditional Korean society through the Korean classic novels. The Data were analyzed through latent content analysis in focusing on the parents and child relationship. Forty-six Korean classic novels written in Chosun Dynasty (from 1392 to 1910 AD) were chosen to analyze and they were represented the characteristic Confucian ideas. The sentences containing the expression of child-care and parent-child relationship were selected during intensive reading line by line and analyzed. Sixty-nine meaningful concepts were drawn out from 258 significant sentences by the similar meaning and common theme and classified as 3 categories and 11 sub-categories. The important parent-child relationship expressed in Korean traditional society were as follows: From the category of the Meaning of Child, 4 sub-categories were drawn; gift of heaven, successor of the family line, driving power of life, and rewards from the offspring. From the category of attitude to the child, 3 sub- categories were drawn; a notion of preferring a son to a daughter, close maternal-child relation, and expectation to the future of child. From the category of nurturing behavior, 4 subjects were drawn; Tae-Gyo(fetal education), affective behavior, socialization, and health management behavior. Above result helps to improve the basic understanding the relationship of parent and child in modern society. And by the understanding of child in the family, unhealthy relationship of parent and child can be prevented and furthermore family centered child health promotion can be achieved.

Effects of Guided Imagery on Stress of Adolescents / 아동간호학회지

The purpose of this study was to identify the effects of the guided imagery program on stress of adolescents. The study design was nonequivalent control group pretest-posttest study. The Data were collected from the 1st to 30th of September in 2000. Two schools were selected as an experimental group and a control group. Each group included two classes. The experimental group was consisted of 40 male students and 42 female students and the control group was consisted of 41 males and 42 females. The guided imagery was provided with audiotapes to the subjects in the classroom for 8 minutes per each therapy, 5 times a week for 4 weeks. The pretest was given before the therapy to measure variables for both groups and the posttests were performed twice after 2 weeks and 4 weeks from the start of intervention. The Instruments used in this study were perception of stress scale developed by Park(1996), Vividness of Imagery Scale; short form of bett's test scale developed by Sheenhan(1967). The data were analyzed by the SAS program using Chi-square test, t-test, repeated measure ANOVA and Bonferroni correction. The results of this study are as follows: "The level of stress of adolescents who received the guided imagery will be significantly lower than that of control group" was supported(F=10.14, p=.00). In conclusion, the guided imagery was suggested as an effective nursing intervention did reduce the stress of adolescents which school nurses could utilize for adolescents at school.

A Survey of the Nursing Interventions Performed by Neonatal Nursing Unit Nurses Using the NIC / 아동간호학회지

The purpose of this study was to identify nursing interventions performed by neonatal nursing unit nurses. For data collection this study used the taxonomy of Nursing Intervention Classification(NIC : 486 nursing intervention) which was modified by McCloskey & Bulecheck(2000). The new 58 nursing interventions was translated into Korean, and then modified by pannel group, which consist of clinical experts and nursing scholars and finally the 419 nursing interventions was selected. The data were collected from 112 nurses. 168 nursing interventions were performed at least monthly by 50% or more of the nurses. The high frequency of performed nursing interventions were Family domain. 37 nursing interventions were performed at least once a day. The nursing interventions receiving the highest item mean score were neonatal care, neonatal monitoring, phototherapy; neonate, bottle feeding and temperature regulation. 56 nursing interventions were rarely performed by 90% or more of the nurses. Most of them were in the behavioral domain. The rarely used interventions were urinary bladder training, art therapy, religious addiction prevention, religious ritual enhancement and bladder irrigation. Therefore, neonatal nursing units nurses used interventions in the Physiological: basic domain most often on a daily basis and the interventions in the behavioral domain least often. These findings will help in building of a standardized language for the neonatal nursing units and enhance the quality of nursing care. Further study will be needed to classify each intervention class and nursing activity and validate NIC in pediatric care unit.

A status of Assessment and Management about Children in Pain / 아동간호학회지

This study was performed to understand pediatric pain management status and nurses' knowledge and attitudes toward it. In addition, it aimed to provide basic data in order to establish effective nursing intervention strategies by confirming the barriers of effective pain management in practice. The subjects were 195 nurses working in pediatric units(general pediatric unit, oncology unit, neonatal unit, neonatal ICU, pediatric ICU) of 8 university hospitals and one general hospital. Data was collected by the questionnaire from the 3rd of August to the 20th of September in 1999. The instrument developed by Sanna(1999) to measure nurses' knowledge and their attitudes and the other tool by Cleeland(1984) to evaluate barriers in effective pain management was used. Results of this study are summarized as follows : 1. Most nurses learn about the pain management knowledges from through regular curriculum of nursing school(62.0%). And almost nurses(90.8%) don't used to utilize pain assessment tool, but the "Faces Rating Scale" is the most frequently used by nurses. 2. The use of pain medication(65.6%) is most frequently taken by nurses as pain management and is followed by massage (55.9%), distraction(27.7%). 3. Nurses' knowledge level is moderate (Mn=3.07). Nurses don't seem to understand pediatric physical development (Mn= 2.86), psychological development(Mn=2.94) well, meanwhile they seem relatively quite knowledgeable about the way pain emerges. 4. Nurses' attitudes toward pain is based on behavioral and physiological responses to pain. They believe 'changes in behavior are a way of assessing pain in child' and 'acute pain increases the number of respiration'. Nurses are ready to accept pediatric pain, but are not positive in adopting pain intervention in practice. 5. The barriers of effective pain management are inadequate assessment of pain and pain relief(81.5%), ineffective incorporation among health professionals(80%), and lack of equipment or skills(80.0%).