Development of a Positive Nursing Organizational Culture Measurement Tool

Purpose@#The purpose of this study was to develop a measurement tool for a positive nursing organizational culture and to verify its reliability and validity. @*Methods@#A conceptual framework and construct factors were extracted through an extensive literature review and indepth interviews with nurses. The final version of the preliminary tool for the main survey was confirmed by experts through a content validity test and a preliminary survey of 40 nurses. Subsequently, the final tool was developed using a validity and reliability test containing 43 preliminary items. The final version of the tool was used with 327 hospital nurses in the testing phase for the main survey to assess validity and reliability. @*Results@#From the factor analysis, 4 factors and 26 items were selected. The factors were positive leadership of the nursing unit manager, pursuit of common values, formation of organizational relationships based on trust, and a fair management system. The entire determination coefficient was 67.7%. These factors were verified through convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (Cronbach’s α = .95). @*Conclusion@#Both the validity and reliability of the scale were confirmed demonstrating its utility for measuring positive nursing organizational culture. It is expected to be used for education, research, and practical performance policies regarding the nursing organizational culture.

Development of a Positive Nursing Organizational Culture Measurement Tool

Purpose@#The purpose of this study was to develop a measurement tool for a positive nursing organizational culture and to verify its reliability and validity. @*Methods@#A conceptual framework and construct factors were extracted through an extensive literature review and indepth interviews with nurses. The final version of the preliminary tool for the main survey was confirmed by experts through a content validity test and a preliminary survey of 40 nurses. Subsequently, the final tool was developed using a validity and reliability test containing 43 preliminary items. The final version of the tool was used with 327 hospital nurses in the testing phase for the main survey to assess validity and reliability. @*Results@#From the factor analysis, 4 factors and 26 items were selected. The factors were positive leadership of the nursing unit manager, pursuit of common values, formation of organizational relationships based on trust, and a fair management system. The entire determination coefficient was 67.7%. These factors were verified through convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (Cronbach’s α = .95). @*Conclusion@#Both the validity and reliability of the scale were confirmed demonstrating its utility for measuring positive nursing organizational culture. It is expected to be used for education, research, and practical performance policies regarding the nursing organizational culture.

Factors Affecting New Graduate Nurses' Intention on Retention in Hospitals: Focused on Nursing Organizational Culture, Empowering Leadership and Organizational Socialization / 간호행정학회지

Nursing Students' Communication Experience with Professor / 간호행정학회지

Purpose@#The aim of this study was to gain in-depth understanding and insight into how student nurses experienced communication with professors. @*Methods@#The research method was a qualitative study in which data were collected and analyzed through in-depth interviews with individual students. Colaizzi's phenomenological research method was used. The participants in this study were students who graduated from the nursing department and were considered able to describe the communication experience between professors and students in the college of.nursing. @*Results@#The analysis showed that the communication experiences between professors and students who had graduated from the college of nursing consisted of six themes for a total of 15 themes clusters and 78 meaningful statements. The 6 theme-clusters were ‘invisible barrier between participant and professors’, ‘motivational driving force’, ‘enrich meta cognition through experiential discourse’, ‘having a dream of lifelong development’, ‘wanting to have meaningful encounters’. @*Conclusion@#The participants were not able to easily form relationships with the professors of the college of nursing during their academic life, but they learned the practical know-how from the strengths and experiences of the professors that led them from beginning student to graduate nurse.

Effect of Emotional Coaching Program for Clinical Nurses on Resilience, Emotional Labor, and Self-efficacy

Purpose@#This study aimed to assess the effect of the emotional coaching program for hospital nurses. @*Methods@#The study used anon-equivalent control group pretest-posttest design, and participants included 60 nurses (30 in the experimental group and 30 in thecontrol group) who worked at a general hospital. The experimental group attended four sessions, one per week, with each session lastingtwo and a half hours. Collected data were analyzed using descriptive statistics, Fisher’s exact test, x2 test, t-test, paired t-test, and repeatedmeasures ANOVA using SPSS WIN 23.0 program. @*Results@#Significant differences were shown between the experimental and the controlgroups regarding emotional labor (F=68.40, p<.001), resilience (F=48.77, p<.001), and self-efficacy (F=15.31, p<.001). @*Conclusion@#Theemotional coaching program for nurses is useful for enhancing nurses’ emotional labor management, resilience, and self-efficacy. In addition,this program may serve as a basis for providing emotional coaching to nurses in the future.

Validity and Reliability of the Clinical Teaching Behavior Inventory (CTBI) for Nurse Preceptors in Korea

PURPOSE: The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI). METHODS: The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses' preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's α was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis. RESULTS: The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated (χ²=366.30, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's α for the overall scale was .93, and the six subscales ranged from .72 to .85. CONCLUSION: The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.

A Study of Desired Work Conditions of Nurses in Small-Medium Hospitals / 간호행정학회지

PURPOSE: This study was done to analyze the problems and desired work conditions of nursing organizations in small-medium hospitals. METHODS: Delphi Technique was used. In the first stage, the work conditions of nurses in small-medium hospitals were identified through a literature review. In the second stage, through 3 consultations with 20 nurse advisory groups, feedback was received on the desired work conditions for nurses in small-medium hospitals. In the third stage, 415 nurses and nurse managers were selected to examine the content validity and importance of the desired work conditions identified in the second stage. RESULTS: Sixty-four items were developed along eight domains of desired work conditions for nurses in small-medium hospitals. The survey on the desired work conditions revealed the following in order of importance: ‘wages’, ‘personnel’, ‘job’, ‘work hours’, ‘welfare’, ‘education’, ‘culture’, and and ‘other incentives’. CONCLUSION: The results of this study suggest that small-medium hospitals need to recognize the desired work conditions desired by nurses and accordingly change policies through the efforts of hospitals and professional groups.

Experience of Nursing Management Practice in Graduate Nurses / 간호행정학회지

PURPOSE: The purpose of this qualitative study was to evaluate nursing students' experience during nursing management practicum. METHODS: Data were collected from 10 in-depth interviews. The main question was “Could you describe your experience during the nursing management practicum?” The qualitative data from the field notes and transcriptions of the interviews were analyzed using Colaizzi's method. RESULTS: The experiential themes of students' experience during a nursing management practicum were ‘differentiate clinical practice which is immersed in the nursing management process’, ‘understand nurse managers’ leadership qualities and influence of communication', ‘understand why the general nurse engages in management tasks on duty’, ‘gain insight into organizational operations from new and diverse perspectives’, ‘engage in nursing practice through abundant interaction’. CONCLUSION: The results show that the nursing management practicum focuses on the management of nurses and nurse manager, so instruction and guidance by professors and practicing leaders is needed for students to practice these goals, In addition, in the clinical practice field, students should be provided with a practical environment and guidance in accordance with the goal of management practice.

Validity and Reliability of the Clinical Teaching Behavior Inventory (CTBI) for Nurse Preceptors in Korea

PURPOSE@#The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI).@*METHODS@#The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses' preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's α was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis.@*RESULTS@#The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated (χ²=366.30, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's α for the overall scale was .93, and the six subscales ranged from .72 to .85.@*CONCLUSION@#The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.

Factors Influencing Nursing Students' Choices of a Place of Employment

BACKGROUND@#Despite increasing the number of newly licensed nurses across Korea, shortages caused by geographical imbalances remains a significant concern. Therefore, understanding nursing students' attitudes to working and living, factors influencing where they first choose to work after graduation is useful in formulating appropriate interventions to retain nurses in regional areas.@*METHODS@#A total of 329 senior nursing students from areas outside Metropolitan Seoul completed self-report questionnaires. Data were analyzed using t-test, chi-square test and multiple logistic regression analysis.@*RESULTS@#Of the respondents, 57.8% reported that they planned to work in the region in which their school was located. The three factors ranked as having the greatest influence on their decision to work in non-metropolitan regions were: the cost of living, housing costs, and the proximity to family. Enjoyable aspects of rural life contributed positively to students' intentions to work in non-metropolitan regions, whereas isolation and socialization problems negatively affected their intentions to work in such areas.@*CONCLUSIONS@#Greater consideration should be given to improving working conditions and housing environments in non-metropolitan regions.

Factors Influencing Nursing Students' Choices of a Place of Employment

BACKGROUND: Despite increasing the number of newly licensed nurses across Korea, shortages caused by geographical imbalances remains a significant concern. Therefore, understanding nursing students' attitudes to working and living, factors influencing where they first choose to work after graduation is useful in formulating appropriate interventions to retain nurses in regional areas. METHODS: A total of 329 senior nursing students from areas outside Metropolitan Seoul completed self-report questionnaires. Data were analyzed using t-test, chi-square test and multiple logistic regression analysis. RESULTS: Of the respondents, 57.8% reported that they planned to work in the region in which their school was located. The three factors ranked as having the greatest influence on their decision to work in non-metropolitan regions were: the cost of living, housing costs, and the proximity to family. Enjoyable aspects of rural life contributed positively to students' intentions to work in non-metropolitan regions, whereas isolation and socialization problems negatively affected their intentions to work in such areas. CONCLUSIONS: Greater consideration should be given to improving working conditions and housing environments in non-metropolitan regions.

Experience of Incivility to Nursing Students during Clinical Practice / 간호행정학회지

PURPOSE: The purpose of this qualitative study was to evaluate nursing students' experience of incivility during clinical practice. METHODS: Data were collected from 11 in-depth interviews. The main question was “Could you describe your experience of incivility during clinical practice?” The qualitative data from the field notes and transcriptions of the interviews were analyzed using Colaizzi's method. RESULTS: The experiential themes of incivility to nursing students during clinical practice were ‘exposure to verbal abuse’, ‘receiving unjust reproaches’, ‘treated as an insignificant person’, ‘excluded from nursing as a bothersome person’, and imidated in an unfamiliar atmosphere'. CONCLUSION: Nursing students experienced incivility in many ways and from a variety of sources, such as nursing staff, patients, patients' families, and other employees during clinical practice as part of the 3rd and 4th year curriculum. Therefore, it is necessary to provide a safer environment for clinical practice. Also finding solutions to these incivility problems should lead to improvement in students' clinical practice.

Development and Effects of Simulation Program for Fall Management / 간호행정학회지

PURPOSE: This study was carried out to develop simulation scenarios for the management patient falls and to evaluate the effects of using the scenarios with student nurses. METHODS: The research design was a quasi-experimental study using a methodology study. Study participants were 30 students who were in 4th year of nursing at one College of Nursing. RESULTS: When comparing knowledge of falls before and after the simulation program, it was found that knowledge increased by 4.90 (from 24.60 pre-test to 29.50 post-test). For clinical performance of fall management, the score for assessment was 10.17 out of 16, for intervention 5.97 out of 10, and for evaluation 7.33 out of 8. The average score for reporting a fall to the doctor was 19.87 out of 30 based on SBAR. Prior to the implementation of the simulation program, the confidence of reporting to the physician was less than 5 in all four areas, but self-confidence improved by more than 6 points in all four areas after the program was implemented. CONCLUSION: Findings indicate that results of fall management simulation practice can contribute to nursing students' knowledge of falls, as well as to nursing interventions and post-treatment following a patient fall.

A Literature Review of Team Effectiveness on Hospital Nursing Units / 간호행정학회지

PURPOSE: The purpose of this study was to analyze literature related to nursing team effectiveness and to summarize the definition variables included, measurement tools, and findings. Basic data on operation and research for team effectiveness in nursing units was sought. METHODS: A literature search was performed to identify all studies published between 2003 and 2016 from periodicals indexed in PUBMED, CINAHL, SCIENCE DIRECT, RISS, KISS, and NAL databases. The following keywords were used in the search: ‘team effectiveness’, ‘nurse’, ‘nursing’, and ‘hospital’. Ten studies were analyzed. RESULTS: The analysis included domestic and international literature on nursing team effectiveness. The foreign literature included studies of various organizations including nurses, use of various research tools, leadership programs and/or new nursing delivery systems. In the Korean studies, most of the research on team effectiveness surveyed nurses on team satisfaction, team commitment, and team performance in general nursing units, operating rooms, and intensive care units. CONCLUSION: The findings show the necessity to develop a definition of team effectiveness that can be accepted comprehensively in nursing organizations in Korea. The definition should reflect team effectiveness that includes all cooperating units not only nurses of the nursing unit but also all other related health care teams.

Validity and Reliability of the Korean Version of Empowering Leadership Questionnaire

BACKGROUND: The manager's empowering leadership has been reported to have a positive impact on employees' psychological empowerment, motivation, creativity, and increase commitment and turnover intentions. However, there is a lack of Korean version of empowering leadership tools that have been verified for validity and reliability, so that they can be applied to Korean nursing organizations. The aim of this study was to develop the Korean version of Empowering Leadership Questionnaire (K-ELQ) and to examine its' psychometric properties. METHODS: Translation of the K-ELQ was validated through forward-backward translation. Participants were 322 staff nurses working in four general hospitals in South Korea. To test reliability and validity, content validity index, Cronbach's alpha, Pearson's correlation, confirmatory factor analysis were used. RESULTS: The K-ELQ consisted of 34 items to evaluate empowering leadership of nursing managers. Construct validity of K-ELQ was verified by confirmatory factor analysis (CMIN/DF=2.72, Root Mean square Residual=0.03, Goodness of Fit Index=0.91, Normal Fit Index=0.87). Cronbach's alpha was 0.98. Criterion validity compared to the psychological empowerment of nurses showed significant correlation (r=0.19, P=0.001). CONCLUSIONS: The K-ELQ is an appropriate instrument to measure empowering leadership of nursing managers. Further studies are needed to utilize K-ELQ in leadership education and to identify related factors of empowering leadership.

Experience of Nurses Participating in Comprehensive Nursing Care / 간호행정학회지

PURPOSE: This study was conducted to examine the experience of nurse in comprehensive nursing care. METHODS: Experiential data collected from 9 nurses through in-depth interviews. Participants were selected from nurses working in the comprehensive nursing care unit at general hospital. The main question was “Can you describe your experience in the comprehensive nursing care unit?” All interviews were recorded and transcribed, then analyzed using Colaizzi's method. RESULTS: Nine themes were derived from the analysis: 'Practice nursing care', 'Feel thankful of the client', 'Difficulty in nursing due to absence of patients' guardian', 'Tired of over-demanding patient and distrust of guardian', 'Confusion regarding one's identity as a nurse', 'Not enough to support system','Insufficient pre-training for nurse and client', 'Requirement of work establishment for nurse and nurse aid', 'Concerns about low rewards and high safety accidents'. CONCLUSION: As a comprehensive nursing service, the nurses provided total patient care, and patient satisfaction and expression of appreciation increased. However, disadvantages were identified, such as patients' excessive needs, communication difficulties, lack of support systems, low compensation, and a high number of safety accidents. Therefore, systematic comprehensive nursing will be achieved if these shortcomings are addressed.

An Adaptation Experience of Male Nurses at General Nursing Unit / 간호행정학회지

PURPOSE: This study was conducted to examine the adaptation experience of male nurses working in general wards. METHODS: Experiential data was collected from 16 general ward nurses through in-depth interviews. Participants were selected from male nurses working in the general wards with over one year of clinical experience at a tertiary university hospital. The main question was “Can you describe your adaptation experience in the general ward as a nurse?” All interviews were recorded and transcribed, then analyzed using Colaizzi's method. RESULTS: Four categories were derived from the analysis: ‘difficulties from task adaptation by characteristics’, ‘limited nursing situation and circumstance as a male nurse’, ‘efforts to adapt at general nursing unit’, and ‘self-worth, and worry about something as a male nurse’. CONCLUSION: Male nurses had a difficulty adapting to work in wards due to lack of multi-tasking skills, as well as some social prejudice or negative views on male nurses. Establishing reasonable guidelines for male nurses in practice, promoting their responsibilities to patients, developing mentoring programs, and reassessing the policy of assigning male nurses to general wards are recommended to help in better adaptation.

A Study on the Classification of Nursing Management Competencies and Development of related Behavioral Indicators in Hospitals

PURPOSE: The aim of this study was to classify nursing management competencies and develop behavioral indicators for nurse managers in hospitals. Also, levels of importance and performance based on developed criteria were to be identified and compared. METHODS: Using expert survey we classified nursing management competencies and behavioral indicators with data from 34 nurse managers and professors. Subsequently, data from a survey of 216 nurse managers in 7 cities was used to analyze the importance-performance comparison of the classified nursing management competencies and behavioral indicators. RESULTS: Forty-two nursing management competencies were identified together with 181 behavioral indicators. The mean score for importance of nursing management competency was higher than the mean score for performance. According to the importance-performance analysis, 5 of the 42 nursing management competencies require further development: vision-building, analysis, change management, human resource development, and self-management competency. CONCLUSION: The classification of nursing management competencies and behavioral indicators for nurse managers in hospitals provides basic data for the development and evaluation of programs designed to increase the competency of nurse managers in hospitals

A Structural Model of Hospital Nurses' Turnover Intention: Focusing on Organizational Characteristics, Job Satisfaction, and Job Embeddedness / 간호행정학회지

PURPOSE: This study was done to build and verify a model of clinical nurses' turnover intention using organizational characteristics, job satisfaction and job embeddedness. METHODS: The study participants were 389 hospital nurses. SPSS and AMOS 22.0 program were used to analyze the data and the modeling of turnover intention. RESULTS: A total of 41% of turnover intention was explained by job satisfaction, job embeddedness and organizational characteristics. Nurses with higher job satisfaction and job embeddedness showed lower turnover intention, while organizational characteristics had an indirect effect on their turnover intention. It was found that organizational characteristics had positive effects on both job satisfaction and job embeddedness, and job embeddedness played a mediating role between organizational characteristics and turnover intention. CONCLUSION: To reduce nurses' turnover intention, hospitals' organizational characteristics should be considered. Nurse managers should strive to increase nurses' job satisfaction and job embeddedness through an understanding of the factors of organizational characteristics such as organizational fairness, nursing work environment, motivation, organizational citizenship behavior, and transformational leadership.

Meta Analysis of Variables related to Emotional Labor of Hospital Nurses / 기본간호학회지

PURPOSE: The purpose of this study was to use meta-analysis to evaluate factors and variables related to the emotional labor of hospital nurses. METHODS: The study included variables obtained from 66 recently published studies, doctoral dissertations, and master's theses. RESULTS: The related variables were categorized into five factor groups: internal character factor, nursing care related factor, environmental factor, emotional response, and job response. For the defensive variable, job related response (effect size [ES]=-.17), environment (ES=-.14), internal character (ES=-.08), nursing care (ES=-.06), and emotional response (ES=-.06) showed significant effect size among the five categorized variable groups. For the risk variable, internal character (ES=.44), emotional response (ES= .46), environment (ES=.27), job related response (ES=.27), and nursing care (ES=.19) showed significant effect size among the five categorized variable groups. CONCLUSION: The results of this study identified defensive and risk variables related to emotional labor of hospital nurses. Self-efficacy, social support, leaders' care, and communication are important factors for managing emotional labor of hospital nurses.