[Influence of Nurses' Self-leadership on Individual and Team Members' Work Role Performance].

PURPOSE: The purpose of this study was to examine correlations between nurses' self-leadership and individual work role performance and correlations between self-leadership in nursing units and team members' work role performance. METHODS: Participants were 202 conveniently selected general nurses from 5 general hospitals in Korea. The study was carried out on 35 nursing units. Data were collected during February 2015 with self-report questionnaires. RESULTS: For factors affecting individual work role performance, self-expectation, self-goal setting, constructive thought, clinical career in the present nursing unit and marital status accounted for 44.0% of proficiency, while self-expectation, self-goal setting, constructive thought, and marital status accounted for 42.3% of adaptivity. Self-expectation, self-goal setting, constructive thought, self-reward, clinical career in the present nursing unit and position accounted for 26.4% of proactivity. In terms of team members' work role performance, self-reward and self-expectation in nursing units explained 29.0% of team members' proficiency. Self-reward and self-expectation in nursing units explained 31.6% of team members' adaptivity, and self-reward in nursing units explained 16.8% of team members' proactivity. CONCLUSION: The results confirm that nurses' self-leadership affects not only individual self-leadership but also team members' work role performance. Accordingly, to improve nurses' work role performance in nursing units of nursing organizations, improvement in nursing environment based on self-leadership education is necessary and nurses' tasks rearranged so they can appreciate work-autonomy and challenges of work.

[Analysis of Mission Statements and Organizational Performance of Hospitals in South Korea].

PURPOSE: The purpose of the study was to examine mission statements and their elements and to investigate correlations between mission statements and organizational performance. METHODS: The current research was a descriptive study based on the examination of mission statements of 353 hospitals that posted mission statements on their webpage and 92 hospitals that made their income statements public. RESULTS: The most common mission element was 'identification of principal services', which accounted for 92.6%. Mission statements of hospitals included the average of 4.82 mission elements out of 9, and the objective of medical quality improvement was 0.81 among 6 objectives of IOM (Institute of Medicine). Net profit of hospitals with mission statements that have above average number of mission elements were significantly higher (t=2.71, p=.008) than those of other hospitals. Net profit was significantly correlated with mission statements (r=.26, p<.001), and mission elements (r=.29, p<.001). CONCLUSION: The results of the study empirically reveal that mission statements in the hospital affect organizational performance. That is, better organizational performance is shown for hospitals with better, more diversified, and more firmly stated mission statements which include identification of target customers, identification of principal services, contribution to society as a non-profit organization, and concern for employees.

[Validity and reliability of the Korean version of the pain assessment checklist for seniors with limited ability to communicate].

PURPOSE: This study was done to develop and test the validity and reliability of the Korean version of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-K) in assessing pain of elders with dementia living in long-term care facilities. METHODS: The PACSLAC-K was developed through forward-backward translation techniques. Survey data were collected from 307 elders with dementia living in 5 long-term care facilities in Korea. Data were analyzed using descriptive statistics, Pearson correlation, Spearman's rho, paired t-test, ROC (receiver operation characteristic) curve with the SPSS/WIN (20.0) program. RESULTS: The PACSLAC-K showed high internal consistency (.90), inter-rater reliability (.86), intra-rater reliability (.93), and high concurrent validity (.74) in paired t-test with PAINAD. Discriminant validity also showed a significant difference compared with no pain. The PACSLAC-K showed a sensitivity of .93, specificity of .88, and Area Under the Curve of .95 in the ROC curve. CONCLUSION: The findings of this study demonstrate that PACSLAC-K is useful in assessing pain for elders with dementia living in long-term care facilities.

Comparison of the tuberculin skin test and interferon gamma release assay for the screening of tuberculosis in adolescents in close contact with tuberculosis TB patients.

BACKGROUND: The tuberculin skin test (TST) frequently yields false positive results among BCG-vaccinated persons thereby limiting its diagnostic value particularly in settings with high BCG vaccination rate. We determined the agreement between IGRA and TST using 2 cutoff values and identified possible relationships between the results of these tests and the development of active tuberculosis. METHODOLOGY: Adolescents aged 11-19 years in close contact with smear-positive tuberculosis cases and with normal chest radiographs were recruited from middle and high schools in South Korea. The TST was conducted by trained nurses, and blood was drawn for the QuantiFERON-TB Gold In-Tube (QFT-GIT). Participants were followed up for 2 years to check for incidence tuberculosis. RESULTS: A total of 2,982 subjects were included in the study, the average age was 15.1 years (SD 1.3), 61% had BCG vaccination scars. The agreement of QFT-GIT and the TST was low (κ = 0.38, 95% CI 0.32 to 0.42) using 10 mm cutoff; however, when the 15 mm cutoff was used, the agreement was intermediate (κ = 0.56, 95% CI 0.50 to 0.61). The odds ratio (OR) for the development of active tuberculosis was 7.9 (95% CI 3.46 to 18.06) for QFT-GIT positive patients, 7.96 (95% CI 3.14-20.22) for TST/QFT-GIT+ and the OR 4.62 (95% CI 2.02 to 10.58) and 16.35 (95% CI 7.09 to 37.71) for TST 10 mm and 15 mm cutoff respectively. CONCLUSIONS: The results of this study suggest that the TST cutoff point for patients aged 11-17 years would be 15 mm in other study. The OR of QFT-GIT for the development of active tuberculosis and its intermediate agreement with TST using 15 mm cutoff demonstrates its role as an adjunct diagnostic tool to current clinical practice. Positive responders to both TST and QFT-GIT at the outset may benefit from chemoprophylaxis.

Prediction of bacterial proteins carrying a nuclear localization signal and nuclear targeting of HsdM from Klebsiella pneumoniae.

Nuclear targeting of bacterial proteins is an emerging pathogenic mechanism whereby bacterial proteins can interact with nuclear molecules and alter the physiology of host cells. The fully sequenced bacterial genome can predict proteins that target the nuclei of host cells based on the presence of nuclear localization signal (NLS). In the present study, we predicted bacterial proteins with the NLS sequences from Klebsiella pneumoniae by bioinformatic analysis, and 13 proteins were identified as carrying putative NLS sequences. Among them, HsdM, a subunit of KpnAl that is a type I restriction-modification system found in K. pneumoniae, was selected for the experimental proof of nuclear targeting in host cells. HsdM carried the NLS sequences, (7)KKAKAKK(13), in the N-terminus. A transient expression of HsdM-EGFP in COS-1 cells exhibited exclusively a nuclear localization of the fusion proteins, whereas the fusion proteins of HsdM with substitutions in residues lysine to alanine in the NLS sequences, (7)AAAKAAA(13), were localized in the cytoplasm. HsdM was co-localized with importin o in the nuclei of host cells. Recombinant HsdM alone methylated the eukaryotic DNA in vitro assay. Although HsdM tested in this study has not been considered to be a virulence factor, the prediction of NLS motifs from the full sequenced genome of bacteria extends our knowledge of functional genomics to understand subcellular targeting of bacterial proteins.