Factors influencing satisfaction with emergency department medical service: Patients' and their companions' perspectives.

AIMS: To examine the individual determinants that influence satisfaction with medical services at the emergency department and to compare the factors that influence satisfaction for the patients, compared with their companions. METHODS: Using data from the 2009 Korea Health Panel Survey, Andersen's behavioral model was used to examine the factors that affect satisfaction with service. A logistic regression analysis was conducted with the data. RESULTS: Patients who were older, female, and employed were more satisfied with the service, as were patients who visited more frequently and those who had non-surgical treatment. Companions who had less education, were accompanying non-Medicaid-holders, and spent a longer time in the emergency department were less likely to be satisfied. This was in contrast to those who spent a shorter amount of time in the emergency department and who visited due to illness, rather than injury; these companions were more satisfied with the service. When all the factors were analyzed simultaneously, they differed significantly between the two groups of patients and companions. CONCLUSIONS: Different factors contributed to the satisfaction with the services for the patients and their companions. In order to increase the satisfaction levels and improve the quality of care in emergency departments, it is necessary to consider more specific approaches that reflect the different perspectives of the visitors to the emergency department.

Stress, Depression, and Lifestyle Behaviors in Korean Adults: A Latent Means and Multi-Group Analysis on the Korea Health Panel Data.

It has been reported that stress can induce depression, with the patient's age and sex as moderating factors. Associations between depression and lifestyle in Korean adults have not been addressed. This study was designed to examine if the relationships among stress, problem drinking, exercise, and depression differ by age and sex. For this study, the Korea health panel data was utilized, and a structural equation model using AMOS was employed. The major findings were as follows: women were more likely to experience stress and depression than men. Individuals over 40 showed a higher tendency toward stress and depression than those under 40. Age- and sex-specific paths from stress to problem drinking, exercise, and depression were positively inter-correlated; the path from exercise to depression indicated an inverse association. These results indicate the need for evidence-based stress-management programs for the psychological well-being of Korean adults.

[Structural equation modeling on burnout in clinical nurses based on CS-CF model].

PURPOSE: The purpose of this study was to construct and test a structural equation modeling on burnout of clinical nurses based on CS-CF model. METHODS: A survey using a structured questionnaire was conducted with 557 clinical nurses. Data were analyzed using structural equation modeling. RESULTS: The modified hypothetical model yielded the following χ(2)=289.70, p<.001, RMSEA=.09, GFI=.93, TLI=.91, CFI=.94, PCFI=.65, AIC=363.21, SRMR=.05 or less and showed good fit indices. Nursing work environment, patient safety culture and resilience showed indirect effects on burnout while compassion fatigue and compassion satisfaction had direct effects. CONCLUSION: Results of this study suggest that compassion fatigue must be decreased and compassion satisfaction has to be increased, while burnout is lowered by enhancing the clinical nursing work environment, patient safety culture and resilience. In addition, more variables and longitudinal studies are necessary to validate the clear cause-and-effect relationship between the relevant variables.

[Analysis of burnout and job satisfaction among nurses based on the Job Demand-Resource Model].

PURPOSE: The purpose of this study was to examine burnout and job satisfaction among nurses based on Job Demand-Resource Model. METHODS: A survey using a structured questionnaire was conducted with 464 hospital nurses. Analysis of data was done with both SPSS Win 17.0 for descriptive statistics and AMOS 18.0 for the structural equation model. RESULTS: The hypothetical model yielded the following Chi-square=34.13 (p = <.001), df=6, GFI=.98, AGFI=.92, CFI=.94, RMSR=.02, NFI=.93, IFI=.94 and showed good fit indices. Workload had a direct effect on emotional exhaustion (ß = 0.39), whereas supervisor support had direct effects on emotional exhaustion (ß = -0.24), depersonalization (ß = -0.11), and low personal accomplishment (ß = -0.22). Emotional exhaustion (ß = -0.42), depersonalization (ß = -0.11) and low personal accomplishment (ß = -0.36) had significant direct effects on job satisfaction. CONCLUSION: The results suggest that nurses' workload should be decreased and supervisor's support should be increased in order to retain nurses. Further study with a longitudinal design is necessary.

Structural equation modeling on life-world integration in people with severe burns.

PURPOSE: The aim of this study was to construct and test a structural equation modeling on life-world integration in people with severe burns. METHODS: A survey design was used. Data were collected in 2008 from 376 people who had experienced severe burns using questionnaires. The data were analyzed using structural equation modeling. RESULTS: The fitness parameters of the modified model (χ(2)/df = 3.15, goodness of fit: .91, normal fit index: .93, Tucker Lewis Index: .93, root mean square error of approximation: .07, root mean square residual: .04, and comparative fit index: .95) indicated its suitability as the research model. Physical function directly influenced burn factor, and family support indirectly influenced life-world integration. CONCLUSION: Physical function should be directly improved to adjust to life-world integration. A comprehensive integration approach is also necessary to help people with severe burns successfully return to society.

[Effects of compassion satisfaction and social support in the relationship between compassion fatigue and burnout in hospital nurses].

PURPOSE: The purpose of this study was to identify the effects of compassion satisfaction and social support in the relationship between compassion fatigue and burnout among hospital nurses. METHODS: The participants were 430 nurses working in general hospitals. Data were collected with self-administrated questionnaires and analyzed by hierarchical multiple regression. RESULTS: (a) Compassion fatigue had a significant positive effect on burnout; (b) social support and compassion satisfaction had negative effects on burnout, and (c) social support and compassion satisfaction did not moderate the effects of compassion fatigue on burnout. CONCLUSION: These findings provide strong empirical evidence for the importance of compassion fatigue, compassion satisfaction and social support in explaining burnout of nurses. Also, it would be of great value to further define compassion fatigue and compassion satisfaction even though these concepts are not accepted in the realities of health care.

[A social network analysis of research topics in Korean nursing science].

PURPOSE: This study was done to explore the knowledge structure of Korean Nursing Science. METHODS: The main variables were key words from the research papers that were presented in the Journal of Korean Academy of Nursing and journals of the seven branches of the Korean Academy of Nursing. English titles and abstracts of the papers (n=5,936) published from 1995 through 2009 were included. Noun phrases were extracted from the corpora using an in-house program (BiKE Text Analyzer), and their co-occurrence networks were generated via a cosine similarity measure, and then the networks were analyzed and visualized using Pajek, a Social Network Analysis program. RESULTS: With the hub and authority measures, the most important research topics in Korean Nursing Science were identified. Newly emerging topics by three-year period units were observed as research trends. CONCLUSION: This study provides a systematic overview on the knowledge structure of Korean Nursing Science. The Social Network Analysis for this study will be useful for identifying the knowledge structure in Nursing Science.

Organizational culture, quality of work life, and organizational effectiveness in Korean university hospitals.

PURPOSE: This study investigated correlates and predictors of organizational effectiveness, focusing on organizational culture and quality of work life. DESIGN: Convenience sample of 145 nurses working in Korean university hospitals responded to a self-administered questionnaire. FINDINGS: There were significant correlations between organizational culture, quality of work life, and organizational effectiveness. R2 was 44.7% in the hierarchical multiple regression model, explaining and predicting organizational effectiveness. DISCUSSION: Intact organizational culture and quality of work life for nurses will undoubtedly lead to improved organizational effectiveness. Without efficient and effective nursing care, desired patient outcomes cannot be achieved.

[Factors affecting eating attitude of female undergraduates in regard to BMI].

PURPOSE: The purpose of this study was to examine the factors affecting eating attitude of female undergraduates according to BMI. METHODS: A descriptive survey design with a convenience sampling was used and data collection was done using a self-report questionnaire answered by 406 female undergraduates from four universities located in Seoul, Kangwon, Gyeongsangbuk and Chungcheongnam Provinces. ANOVA, Pearson correlation coefficients, and hierarchial multiple regression were used the SPSS WIN 17.0 Program to analyze the data. RESULTS: With respect to BMI, the students were found to be in 3 groups, whose differences in eating attitude were significant. Eating attitude had significant positive correlation with height (r=.118, p=.017), weight (r=.267, p<.000), BMI (r=.239, p<.001), and depression (r=.375, p<.001), and negative correlation with subjective well-being (r=-.153, p=.002) and body esteem (r=-.287, p<.001). In the hierarchial multiple regression analysis, college major, height, weight and religion, were controlled. Depression and body esteem regarding weight significantly predicted 40.7% of eating attitude for the underweight group and normal weight group, body esteem: weight and depression were significant predictors for 27.5% of eating attitude for the normal weight group. Body esteem: weight explained 32.6% of eating attitude for the overweight group. CONCLUSION: Findings of this study allow a comprehensive understanding of eating attitudes and related factors among female undergraduates in Korea. Further study with a larger random sample from various universities is necessary.

[The determinants of job satisfaction of nurses: focused on work rewards].

PURPOSE: The purpose of this study was to investigate the determinants of job satisfaction of hospital nurses. The focus was on work rewards. A causal model of job satisfaction of hospital nurses was constructed based on situational perspectives. METHODS: The sample for this study consisted of 505 nurses from 2 general hospitals located in Seoul and Kyeonggi Province, Korea. Data were collected with self-administrated questionnaires and analyzed by hierarchical multiple regression. RESULTS: All variables except workload were positively correlated with job satisfaction. It was found that three task reward variables (workload, meaning, and participation), two organizational reward variables (security and promotional chances) and one social reward variable (family support) had significant influence on nurses' job satisfaction. The explained variance for job satisfaction was 41.4%. The data further indicate that task rewards were the most significant determinants of nurse job satisfaction. CONCLUSION: Theses findings provide strong empirical evidence for importance of task, organizational and social reward variables in explaining job satisfaction of nurses. The model used for this study will be useful for predicting nurse job satisfaction.

Internet addiction and interpersonal problems in korean adolescents.

The purpose of this study was to examine the levels of Internet addiction and interpersonal problems, explore the relationship between the two, and identify the relevant factors of Internet addiction in Korean middle school students. A cross-sectional survey design was used. The participants were 676 middle school students. A Korean version of the Internet addiction self-test scale and a Korean version of the Inventory of Interpersonal Problems were used. Among the participants, 547 (80.9%) were identified as general users, 108 (16%) were potential risk users, and 21 (3.1%) were high-risk users. There were statistically significant positive correlations between Internet addiction and interpersonal problems (r = 0.425, P = .000). There were significant positive correlations between Internet addiction and hours spent playing games. Internet-addicted adolescents also had more interpersonal problems. It is important to raise awareness about Internet addiction, and close attention must be paid not only to students at risk of Internet addiction but also to students at low risk to prevent students from becoming addicted to the Internet.

Korean older adults' perceptions of the aging process.

This qualitative study was conducted to describe Korean older adults' perceptions of the aging process. A total of 18 Korean older adults were interviewed, and a grounded theory approach was used to analyze the interview data. The participants were found to perceive aging as a process of Generating, Expressing, and Transforming of Growing Futility. The degree to which they perceived their Growing Futility depended on the actions and interactions of a set of conditional structures. This study revealed five patterns of Korean older adults' perception of the aging process. These findings allow for the possibility of a more refined theoretical development for the aging process, especially when a comparative study becomes available through cross-cultural qualitative research.

Prediction of pain outcomes in Korean older adults: use of a structural equation model.

OBJECTIVE: To construct a structural equation model of pain adjustment outcomes (e.g., depression and fatigue) in Korean older adults based on the cognitive-behavioral model of chronic pain. METHODS: Nonexperimental research design. Data were collected by questionnaires from 271 Korean older adults. Data analysis was conducted with SPSS 10.1 for descriptive statistics and a PC-LISREL program for covariance structural analysis. RESULTS: In this study, based on the modifications, chi-square statistics were changed, the goodness-of-fit index was 0.97, the adjusted goodness-of-fit index was 0.93, the root mean square residual was 0.04, the normal fit index was 0.98, and the non-normed fit index was 0.98. Path coefficients and their statistical significance for the revised model were as follows: pain adjustment and pain beliefs were found to have a significant direct effect on pain coping. The variable directly related to pain beliefs was pain adjustment, and variables directly influencing fatigue were pain coping and pain beliefs. Lastly, pain adjustment, pain coping, and fatigue were found to have a significant direct effect on depression. Also, pain adjustment, pain coping, and pain beliefs were found to have a significant indirect effect on depression. In conclusion, pain adjustment, pain coping, pain beliefs, and fatigue all contributed to depression. Fifty-four percent of depression could be explained by these variables. CONCLUSIONS: This modified model is considered appropriate for explaining and predicting pain adjustment outcomes in Korean older adults. Also, the findings support the development of an intervention strategy to improve pain coping, negative pain beliefs, fatigue, and depression caused by poor pain adjustment.

A comparative study of patients' and nurses' perceptions of the quality of nursing services, satisfaction and intent to revisit the hospital: a questionnaire survey.

BACKGROUND: Although it is very important to clarify the factors influencing the patients' and nurses' satisfaction with nursing services, very little research has been performed in this area. OBJECTIVES: The purpose of this study was to compare the nursing service quality, satisfaction and intent to revisit the hospital perceived by hospitalized patients and nurses in Korea. METHODS: SERVQUAL scale, an overall satisfaction and intent to revisit the hospital questionnaires were used. The sample consisted of 272 patients and 282 nurses. The data were collected using paper and pencil self-rating questionnaires and analyzed using frequency, %, mean, standard deviation, t-test and Pearson correlation coefficient. RESULTS: Overall, nurses' expectations and performance were higher than those of patients, while patients' overall satisfaction with nursing and medical care was higher than that of nurses. There was a strong positive relationship between satisfaction with nursing and medical care and intent to revisit the hospital for both groups. CONCLUSIONS: The performance was relatively lower than expectations, resulting in poor nursing care quality. Differences between expectations and performance for both patients and nurses need to be further reduced.

Consumers' use of the internet for health information.

Although health information is one of the most frequently sought subjects on the Internet, little research has been performed in this area. This study was designed to examine the use of the Internet for health information by the consumers. A questionnaire was administered to a sample of 212 consumers who were using health care. Only small percentages of the consumers accessed the Internet for health information. This result indicates that different marketing strategies based on geographic characteristics should be developed for consumers who wish to get health care information.

[Impact of clinical nurses' power and empowerment on job satisfaction and organizational commitment].

PURPOSE: This study was performed to analyze effects of the power and empowerment on job satisfaction and organizational commitment. This study was based on the Kanter's theory of organizational empowerment. METHOD: A predictive, non-experimental design was used to test the model in a sample of 688 nurses working in 7 university hospitals that have over 500 beds in Seoul, Kyunggi and Kangwon provinces. The data were collected from December, 2003 to January, 2004. It was analyzed with descriptive statistics and Pearson correlation of SPSS and with path analysis of LISREL. RESULT: The formal and informal power had direct effects on empowerment. Formal power also had direct effects on informal power. Empowerment had direct effects on job satisfaction and organizational commitment. Organizational commitment had direct effects on job satisfaction. There was positive effects in all of the variables. CONCLUSION: The positive changes show on personal behaviors and attitudes when the nurses who have formal and informal power are empowered. These findings would be important resource to nurse administrators for clinical implication.

Effects of a CD-ROM educational program on sexual knowledge and attitude.

This study evaluated a CD-ROM educational program in sexual violence prevention for middle school students. A randomized control-group pretest-posttest design was used. Seventy-nine students were randomly assigned to either an experimental (n = 39) or control (n = 40) group. The experimental group watched the CD-ROM, whereas the control group did not. Both groups were pretested for the levels of knowledge and attitude about sexual violence prevention prior to intervention. A CD-ROM titled Educational Program for the Prevention of Sexual Violence was used for the intervention. The instrument contains 32 true-false items that measure knowledge level and 20 items comprising a four-point Likert-type scale that measure the attitude to sexual violence. There was a significant increase in knowledge in the experimental group, while no differences on attitude were found between the experimental and control groups. A CD-ROM-based program can be effective for delivering instructions on sexual violence prevention in the classroom.

Integration of Internet-based learning and traditional face-to-face learning in an RN-BSN course in Korea.

This article describes the development of and student satisfaction with a distance learning course using both online and face-to-face methods in an RN-BSN program in Korea. Four steps were used for course development: (1) assessment of students' learning needs and determination of objectives of the course, (2) designing of module/assignment instructions, (3) development of the Internet-based learning platform, and (4) evaluation of course and Internet-based learning platform. Student satisfaction was evaluated by using a 4-point Likert-type questionnaire. Forty-eight (92.3%) questionnaires were returned. Overall satisfaction with this course was high (X = 3.29). Appropriateness of learning methods (X = 3.35) was rated the most satisfactory, followed by appropriateness of content (X = 3.31). Most of the students enjoyed the course and they wanted more nursing courses to be offered through the online and on-site format. On the basis of the findings, additional courses using both online and face-to-face methods for RN-BSN students should be developed and implemented for RN-BSN nursing programs in Korea.

[The effects on health information education for the deaf].

PURPOSE: The purpose of this study was to evaluate the effects on health information education for the deaf. METHOD: One group pre-test and post-test research design was applied to 46 deaf people. The instrument developed by research team was used for data collection. The questionnaire consisted of 91 items including demographics and 5 diseases, such as hypertension, cancer, diabetes, pulmonary tuberculosis, and hepatitis. RESULT: The degrees of knowledge on 4 diseases, such as, hypertension, diabetes, pulmonary tuberculosis, and hepatitis were significantly improved. There was no educational effect on cancer even though the degree of knowledge during the pre-test was the highest. There were educational effects on 5 diseases by gender, but no effects by age and hearing/deaf status of parent. CONCLUSION: This study was the first for the deaf in nursing. Further studies are needed for the deaf who have low education. Also, good educational materials using video and CD need to be developed.

[The role of social support in the relationship between job stress and job satisfaction/organizational commitment].

PURPOSE: The purpose of this study is to investigate the role of social support in the experience of job stress among hospital nurses. METHOD: This study was carefully designed to overcome methodological shortcomings found in past research, and examined two organizational effectiveness variables(job satisfaction and organizational commitment) as outcome variables. The sample used in this study consisted of 602 nurses from 5 general hospitals. Data were collected with self-administered questionnaires and analyzed using hierarchical regression and LISREL technique. RESULT: It was found that: (a) three job stress variables(workload, role conflict and conflict with other medical staff) have negative effects on job satisfaction and organizational commitment; (b) social support have positive main effects on the two output variables; (c) the negative effects of job stress variables on job satisfaction and organizational commitment are not buffered by social support, and (d) social support mediates the effects of job stress on job satisfaction and organizational commitment, and the size of the mediating effects is small. CONCLUSION: Further research needs to be done to further refine this study.