Development and Psychometric Test of the Inpatients Experiences Measurement Scale (IEMS).

Purpose: In South Korea, hospitalized patients' experiences significantly impact satisfaction and treatment outcomes. This study developed and evaluated the Inpatients Experience Measurement Scale (IEMS) for its psychometric properties. Patients and Methods: Participants from three hospitals were recruited using convenience sampling. Scale item generation involved patient interviews and a Delphi survey with experts. Psychometric testing used Exploratory Factor Analysis (EFA) with 150 participants and Confirmatory Factor Analysis (CFA) with 151 participants. Results: A total of 301 patients participated, resulting in a 20-item scale across four factors: "Care Quality and Information Provision", "Patient Safety and Dietary Services", "Facility and Comfort Infrastructure", and "Comprehensive Patient Support Services". Rated on a 5-point Likert scale, the scale showed a high Content Validity Index (CVI) over 0.80. EFA explained 61.43% of the variance. The four-factor model was validated using CFA with favorable fit indices. The IEMS demonstrated strong convergent validity, supported by high composite reliability (CR) and average variance extracted (AVE) values. Significant correlations with the Patient Satisfaction Scale reinforced its convergent validity. Discriminant validity was confirmed, and all reliability measures exceeded the minimum threshold of 0.80. Conclusion: The IEMS effectively captures inpatients' experiences, demonstrating robust reliability and validity. This scale is a valuable tool for assessing patient experiences, facilitating enhancements in patient care and satisfaction within hospital settings.

Effectiveness of a service design training program to improve clinical nurses' compassion and problem-solving in Korea.

Service design is an innovative tool used to improve the quality of patient experience, therefore, making it necessary for nurses to be able to implement it. The aim of this study was to examine the effects of a training program for patient experience-based nursing service design (PEN-SD) on clinical nurses' compassion and problem-solving ability. This study employed a mixed-methods design: a one-group, pretest-posttest design was used as the quantitative approach, and structured interviews were used as the qualitative approach. The participants were 21 nurses recruited from a university hospital in Korea. A PEN-SD training program was conducted from September 1 to October 6, 2018. After the training program, the participants' compassion significantly improved (p = .025) but there was no significant difference in their problem-solving ability (p = .313). In the structured interviews, majority of the participants (n = 17) felt that they were able to consider problems from the patient's perspective. They also reported being able to identify solutions to problems through careful observation (n = 5). The PEN-SD training program was effective in improving compassion among nurses.

[Influence of Learning Presence of Non-Face-to-Face Class Experience in Nursing Students on Academic Achievement: Mediating Effect of Learning Flow and Moderated Mediation of Digital Literacy].

PURPOSE: This study aimed to identify the mediating effect of learning flow and the moderated mediation effect of digital literacy on the effect of the learning presence of non-face-to-face class experience in nursing students on academic achievement. METHODS: Participants were 272 nursing students from six universities in two different cities. A self-report questionnaire was used to measure learning presence, learning flow, digital literacy, and academic achievement. Analysis was performed using SPSS 26.0 and SPSS PROCESS Macro (4.0). RESULTS: The mediating effect of learning flow on the effect of learning presence on academic achievement was 0.42, and the moderated mediation index of digital literacy was 0.17. Learning flow showed a mediating effect on the relationship between learning presence and academic achievement. Digital literacy had a moderated mediation effect on the relationship between learning presence and academic achievement that was mediated by learning flow. CONCLUSION: The intensity of the mediating effect of nursing students' learning presence on academic achievement through learning flow increases as the level of digital literacy increases. These results suggest that educational programs considering the level of learning presence, learning flow, and digital literacy are required to promote the academic achievement of nursing college students.

Mediating Effects of Emotion Regulation between Socio-Cognitive Mindfulness and Achievement Emotions in Nursing Students.

BACKGROUND: Mindfulness is known as an effective emotion regulation strategy and is beneficial for improving emotions. While meditative mindfulness has been widely studied, socio-cognitive mindfulness has received little attention in nursing literature, despite its potential benefits to the field. This study investigated relationships between nursing students' socio-cognitive mindfulness, emotion regulation (reappraisal and suppression), and achievement emotions, and explored the mediating effects of emotion regulation. METHODS: A total of 459 nursing students from three universities in Korea completed the questionnaire measuring the study variables. Structural equation modeling and path analysis were conducted to test the hypotheses. RESULTS: Socio-cognitive mindfulness was found to positively influence reappraisal while negatively influencing suppression. Additionally, socio-cognitive mindfulness positively predicted positive achievement emotions but negatively predicted negative emotions. Reappraisal positively influenced positive emotions, whereas suppression positively influenced negative emotions. Furthermore, reappraisal mediated the link between mindfulness and positive emotions, and suppression mediated the link between mindfulness and negative emotions. CONCLUSIONS: Socio-cognitive mindfulness may be effective in regulating emotions among nursing students by enhancing reappraisal and reducing suppression. Mediating effects highlight the relevance of students' emotion regulation in nursing education, suggesting the need to develop emotion regulation education programs.

Nursing Students' Meditative and Sociocognitive Mindfulness, Achievement Emotions, and Academic Outcomes: Mediating Effects of Emotions.

BACKGROUND: This study integrates the underexamined sociocognitive mindfulness and achievement emotions in nursing. PURPOSE: This study examined the relationships between meditative and sociocognitive mindfulness and between mindfulness, achievement emotions, and academic outcomes. It also investigated the mediating effects of achievement emotions. METHODS: In total, 459 Korean nursing students completed a questionnaire measuring mindfulness, achievement emotions, and academic outcomes. Three-step regression analysis and Sobel test were performed to explore the mediating effects of achievement emotions. RESULTS: Meditative and sociocognitive mindfulness correlated with each other; they correlated positively with positive achievement emotions and academic outcomes and negatively with negative emotions. Students' positive emotions correlated positively with academic outcomes, whereas negative emotions correlated negatively. The mediating effects of emotions on the relationships between mindfulness and academic outcomes were found. CONCLUSIONS: Both mindfulness perspectives are related to enhancing students' positive emotions and reducing negative emotions, ultimately influencing their academic outcomes. The mediation results emphasize the benefits of positive emotions and disadvantages of negative emotions between mindfulness and outcomes.

Do depression, anxiety, emotional intelligence, and sleep quality affect diabetes management self-efficacy in Korean women with gestational diabetes in pregnancy?: a descriptive correlational study.

Purpose: This study aimed to identify factors associated with diabetes management self-efficacy in pregnant women with gestational diabetes mellitus (GDM) in Korea. Methods: A total of 173 pregnant women with GDM in Korea were recruited by posting announcements at two Korean online communities focusing on pregnancy and GDM. Participants completed a structured online survey from July to September 2018. Thirteen inappropriate responses were excluded and a total of 160 questionnaires were used in the final analysis. Descriptive statistics were calculated and multiple regression with the enter method was done to identify the associations of depressive mood, anxiety, emotional intelligence, and sleep quality with diabetes management self-efficacy. Results: Respondents reported a moderately depressive mood (mean, 10.36), low to moderate anxiety (mean, 41.65), above-average emotional intelligence (mean, 78.04), moderate sleep quality (mean, 42.01), and above-average diabetes management self-efficacy (mean, 52.29). The major factor associated with diabetes management self-efficacy of pregnant women with GDM was emotional intelligence (ß=.51, p<.001). Other factors, in descending order of influence, were sleep quality (ß=.22, p<.001) and exercise (ß=.18, p=.004). Taken together, the aforementioned factors explained 34.6% (F=39.53, p<.001) of the total variance. Conclusion: The results of this study suggest that to improve the diabetes management self-efficacy of pregnant women with GDM, it is necessary to develop an education program that can also enhance emotional intelligence, sleep quality, and exercise.

Effect of structured pre-simulation preparation and briefing on student's self-confidence, clinical judgment, and clinical decision-making in simulation.

Background: The importance of preparation and briefing before simulation has been overlooked. A 'think-before-action' strategy is needed in simulation.Purpose: To determine the effect of structured preparation and briefing prior to simulation on nursing students' learning outcomes.Method: In the experimental group, structured pre-simulation preparation and briefing lasted for a total of 35 minutes before simulation. The control group were performed in a conventional manner. Subjects were 80 senior students in one university in Korea (40 students in each group). Data were analyzed using independent t-test.Results: Scores for self-confidence for problem solving (F = 17.414, p < 0.001), clinical judgment (F = 123.781, p < 0.001), and clinical decision-making (F = 45.593, p < 0.001) in the experimental group were significantly higher than those in the control group.Conclusions: Structured preparation and briefing prior to simulation can effectively improve nursing-students' self-confidence for problem solving, clinical judgment, and clinical decision-making.

The Performance of Healthcare-associated Infection Control Guideline among Hospital Nurses: A Structural Equation Model.

BACKGROUND: To improve efficient and systematic management and following of healthcare-associated infection guidelines, the relationship among various factors must be understood. Efforts should be made to strengthen or reduce relevant factors. We developed a structural equation model for following HAI-control guidelines. METHODS: Overall, 388 Korean registered nurses participated in this study and data collection was conducted Jul 21-Aug 31, 2014 using a self-reported questionnaire, and 392 of 400 copies were collected (98% recovery rate). Data were analyzed using descriptive statistics, reliability, and Pearson's coefficient. Model identification evaluation was conducted by goodness-of-fit index and impact analysis. RESULTS: Results of goodness-of-fit of modified model were as follows: χ2=120.57 (df=16, P<.001), GFI (Goodness of Fit Index)=.95, RMSEA (Root-Mean-Square Error of Approximation)=.10, SRMR (Standardizes Root-Mean-Square residual)=.06, NFI (Normal Fir Index)=.90, CFI (Comparative Fit Index)=.90. Factors with a statistically significant direct impact on behavioral intention are as follows; perceived behavior control (ß=.35, P=.008), subjective norm (ß=.27, P=.002), and job demands (ß=-.08, P=.083). Organizational factors directly influenced following guidelines. Explanatory power of organizational factors on guideline compliance was greatest (C.R. [Critical Ratio] =5.67, P<.001). CONCLUSION: Supportive leadership and a positive organizational culture development strategy are essential. The hospital leader group should provide adequate resources to facilitate compliance with guidelines as well as create an atmosphere of on-site support that ensures guidelines will be followed, and engage in continuous monitoring and feedback regarding following of guidelines.

Structural Equation Modeling on Health-related Quality of Life of Patients with Ankylosing Spondylitis.

BACKGROUND: Ankylosing Spondylitis (AS) is a chronic, progressive, and inflammatory disease. The objective of this study was to construct a hypothetical model to determine factors affecting health-related quality of life (HRQOL) of AS patients (ASHRQOL). METHODS: A survey was conducted on 275 patients who visited Chonnam National University Bitgoeul Hospital. Data of different variables were collected over two months in 2015. RESULTS: A hypothetical model did not reach recommended level of fit verification. Therefore, health perception variable was eliminated on theoretical basis. Path between function and HRQOL was added after eliminating unimportant path before completing the final modified model. CONCLUSION: The final revised model met recommended levels of fit test except AGFI. The model explained 57.6% of ASQOL. Further study is needed to develop efficient interventional strategy for improving ASHRQOL.

[Structural Model of Evidence-Based Practice Implementation among Clinical Nurses].

PURPOSE: This study was conducted to develop and test a structural model of evidence-based practice (EBP) implementation among clinical nurses. The model was based on Melnyk and Fineout-Overholt's Advancing Research and Clinical Practice through Close Collaboration model and Rogers' Diffusion of Innovations theory. METHODS: Participants were 410 nurses recruited from ten different tertiary hospitals in Korea. A structured self-report questionnaire was used to assess EBP knowledge/skills, EBP beliefs, EBP attitudes, organizational culture & readiness for EBP, dimensions of a learning organization and organizational innovativeness. Collected data were analyzed using SPSS/WINdows 20.0 and AMOS 20.0 program. RESULTS: The modified research model provided a reasonable fit to the data. Clinical nurses' EBP knowledge/skills, EBP beliefs, and the organizational culture & readiness for EBP had statistically significant positive effects on the implementation of EBP. The impact of EBP attitudes was not significant. The dimensions of the learning organization and organizational innovativeness showed statistically significant negative effects on EBP implementation. These variables explained 32.8% of the variance of EBP implementation among clinical nurses. CONCLUSION: The findings suggest that not only individual nurses' knowledge/skills of and beliefs about EBP but organizational EBP culture should be strengthened to promote clinical nurses' EBP implementation.

Effects of Education Programs on Evidence-Based Practice Implementation for Clinical Nurses.

This study was conducted to identify the effectiveness of an education program for evidence-based practice (EBP) implementation of clinical nursing. EBP knowledge/skill, attitude, and belief; information search ability; and EBP implementation were significantly higher in the experimental group than in the control group. Furthermore, the effect on implementation was maintained at week 4 and week 8, indicating that the education program practically promotes the EBP implementation of nurses. Results confirm that the education program for EBP implementation is critical and the continuous education program is an essential part of EBP implementation. Also, to promote EBP implementation and disseminate it to nursing organizations, an immediate concern should be the cultivation of mentors for EBP and fortification of the belief and ability regarding EBP implementation. J Contin Educ Nurs. 2016;47(8):363-371.

[Effect of a simulation-based education on cardio-pulmonary emergency care knowledge, clinical performance ability and problem solving process in new nurses].

PURPOSE: This study was conducted to examine the effects of simulation-based education regarding care in a cardio-pulmonary emergency care as related to knowledge, clinical performance ability, and problem solving process in new nurses. METHODS: An equivalent control group pre-post test experimental design was used. Fifty new nurses were recruited, 26 nurses for the experimental group and 24 nurses for the control group. The simulation-based cardio-pulmonary emergency care education included lecture, skill training, team-based practice, and debriefing, and it was implemented with the experimental group for a week in May, 2009. Data were analyzed using frequency, ratio, chi-square, Fisher's exact probability and t-test with the SPSS program. RESULTS: The experimental group who had the simulation-based education showed significantly higher know-ledge (t=5.76, p<.001) and clinical performance ability (t=5.86, p<.001) for cardio-pulmonary emergency care compared with the control group who had traditional education but problem solving process was not included (t=1.11, p=.138). CONCLUSION: The results indicate that a simulation-based education is an effective teaching method to improve knowledge and clinical performance ability in new nurses learning cardio-pulmonary emergency care. Further study is needed to identify the effect of a simulation-based team discussion on cognitive outcome of clinical nurses such as problem solving skills.

[Development of a measurement of intellectual capital for hospital nursing organizations].

PURPOSE: This study was done to develop an instrument for measuring intellectual capital and assess its validity and reliability in identifying the components, human capital, structure capital and customer capital of intellectual capital in hospital nursing organizations. METHODS: The participants were 950 regular clinical nurses who had worked for over 13 months in 7 medical hospitals including 4 national university hospitals and 3 private university hospitals. The data were collected through a questionnaire survey done from July 2 to August 25, 2009. Data from 906 nurses were used for the final analysis. Data were analyzed using descriptive statistics, Cronbach's alpha coefficients, item analysis, factor analysis (principal component analysis, Varimax rotation) with the SPSS PC+ 17.0 for Windows program. RESULTS: Developing the instrument for measuring intellectual capital in hospital nursing organizations involved a literature review, development of preliminary items, and verification of validity and reliability. The final instrument was in a self-report form on a 5-point Likert scale. There were 29 items on human capital (5 domains), 21 items on customer capital (4 domains), 26 items on structure capital (4 domains). CONCLUSION: The results of this study may be useful to assess the levels of intellectual capital of hospital nursing organizations.

[Validity and reliability of a clinical performance examination using standardized patients].

PURPOSE: The purpose of this study was to test the validity of a modified clinical performance examination (CPX) for preclinical students in nursing. METHOD: 70 nursing students in their second semester of the junior year at C University participated in CPX. Scenarios and checklists were developed by our research team from September to October 2005. Six stations were organized. Evaluation included physical examination of a patient with lung cancer, education on usage of a metered dosage inhaler, and lobectomy postoperative care. Students were randomly assigned to a station. RESULT: There was a difference in the CPX scores according to stations. The agreement of scoring between trained faculty members and SPs was more than moderate (r=.647). The correlation between the CPX score and the average grade in the previous semester and between the CPX score and the average grade of a paper and pen test of the pulmonary system of adults was low (r=.276; r=.048). CONCLUSION: Traditional CPX is generally recommended, however, modified CPX is appropriate for preclinical students in the current Korean Nursing school setting if there are additional scoring systems to balance the testing level at each station.

Internet addiction and psychiatric symptoms among Korean adolescents.

BACKGROUND: The aims of this study were to identify the independent factors associated with intermittent addiction and addiction to the Internet and to examine the psychiatric symptoms in Korean adolescents when the demographic and Internet-related factors were controlled. METHODS: Male and female students (N = 912) in the 7th-12th grades were recruited from 2 junior high schools and 2 academic senior high schools located in Seoul, South Korea. Data were collected from November to December 2004 using the Internet-Related Addiction Scale and the Symptom Checklist-90-Revision. A total of 851 subjects were analyzed after excluding the subjects who provided incomplete data. RESULTS: Approximately 30% (n = 258) and 4.3% (n = 37) of subjects showed intermittent Internet addiction and Internet addiction, respectively. Multivariate logistic regression analysis showed that junior high school students and students having a longer period of Internet use were significantly associated with intermittent addiction. In addition, male gender, chatting, and longer Internet use per day were significantly associated with Internet addiction. When the demographic and Internet-related factors were controlled, obsessive-compulsive and depressive symptoms were found to be independently associated factors for intermittent addiction and addiction to the Internet, respectively. CONCLUSIONS: Staff working in junior or senior high schools should pay closer attention to those students who have the risk factors for intermittent addiction and addiction to the Internet. Early preventive intervention programs are needed that consider the individual severity level of Internet addiction.

A blended learning program on undergraduate nursing students' learning of electrocardiography.

This study sought to evaluate the feasibility of applying the blended learning program that combines the advantages of face-to-face(FTF) learning and e-learning. The blended learning program was developed by the authors and implemented for 4 weeks. 56 senior nursing students were recruited at a university in Korea. Significant improvement was noted in learning achievement. No significant differences were noted between FTF and web-based learning in learning motivation. Learning satisfaction and students' experience in taking this course revealed some positive effects of blended learning. The use of blended learning program for undergraduate nursing students will provide an effective learning model.

[Development of a critical thinking disposition scale for nursing students].

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.

[Comparison of cancer nursing interventions recorded in nursing notes with nursing interventions perceived by nurses of an oncology unit--patients with terminal cancer].

PURPOSE: The purposes of this study were to determine the core nursing interventions in nursing notes and the practice which was perceived by nurses of an oncology unit with patients with terminal cancer. Also, comparing interventions in nursing notes with interventions in perceived practice was done. METHOD: Subjects were 44 nursing records of patients with terminal cancer who had died from Jan. to Dec. 2002 at C University Hospital and 83 nurses who were working on an oncology unit for more than one year. Data was collected using a Nursing Interventions Classification and analyzed by means of mean and t-test. RESULTS: The most frequent nursing intervention was 'nausea management' in the nursing note and was 'medication administration: oral' in perceived practice. The frequency of nursing interventions in the nursing record was lower than in perceived practice. CONCLUSION: This study finds that nurses actually practice nursing care, but they may omit records. To correct for omitted nursing records, development of a systematic nursing record system, continuous education and feedback is recommended.

[Perception about problem-based learning in reflective journals among undergraduate nursing students].

OBJECTIVE: The aim of this study is to explore the variation in perceptions about problem-based learning(PBL) according to the level of academic achievement and learning attitude in the nursing students of a junior college (3-year program). METHOD: Students (n=39) learned the respiratory and cardiac system with seven PBL packages and group-based learning for a semester in 2002. Students were asked to write reflective journals that focused on their learning perception after an experience with each learning package. A total of 208 journals were used for analysis. RESULT: Students positively perceived that PBL making them increase their sense of responsibility for learning and felt satisfaction with the learning process, and had a confidence in the use of clinical nursing interventions. On the other hand, they negatively perceived that PBL was a burden because it took more time than traditional learning tasks, and they experienced an anxiety about regular tests and felt conflicts and diffidences in the learning process. The negative perceptions were expressed more often from students with a low academic achievement and low learning attitude compared to others. CONCLUSION: Students perceived the PBL as effective in understanding the learning concepts in the clinical practice environment. PBL need to be supplemented by feedback-based lecture and facilitative strategies for academically low-achieved students.