Job autonomy, perceptions of organizational policy, and the safety performance of nurses.

AIMS: This study aimed to identify the relationship between nurses' job autonomy, perceptions of organizational policy, and safety performance by identifying the safety performance predictors of nurses working in acute health care settings in South Korea. METHODS: Using data from a structured questionnaire, this cross-sectional descriptive study assessed the relationship between nurses' job autonomy, perceptions of organizational policy, and safety performance. In 2016, of the 290 nurses from nine acute care hospitals in South Korea invited to participate in the survey, 254 successfully did. Using cross-sectional data, characteristics of hospitals and nurses were analysed with t tests, one-way analyses of variance, Pearson correlations, and regression models. RESULTS: On a scale of one to five, the mean job autonomy was 3.37, mean perceptions of organizational policy was 3.09, and mean safety performance was 3.75. Statistically significant positive correlations were found among job autonomy, perceptions of organizational policy, and safety performance. Multiple regression results found 44% of the variation in safety performance explained by job autonomy, length of employment, and perceptions of organizational policy. CONCLUSION: Job autonomy and perceptions of organizational policy were positively related to safety performance. Hospital executives and nurse managers should work to enhance job autonomy and positive perceptions of organizational policy, to contribute to improving patient safety.

Activities of daily living in nursing home and home care settings: a retrospective 1-year cohort study.

OBJECTIVE: Korea introduced universal long-term care insurance (LTCI) for physically dependent older adults in 2008. Older adults, their family members, and policy makers in Korea want to know patient outcomes in different care modalities because older adults who have a similar functional status and LTC needs can choose either nursing home care or home care. The aim of this study was to compare activities of daily living (ADLs) in nursing home care and home care settings for physically dependent older adults in Korea. DESIGN: A retrospective 1-year cohort study using national LTCI data. SETTINGS: This study used the LTCI dataset from the National Health Insurance Service in Korea. PARTICIPANTS: Participants were identified from among those in the LTCI dataset who enrolled from July 2008 to June 2010. We extracted a sample consisting of 22,557 older adults who consistently received either nursing home care (n = 11,678) or home care (n = 10,879) for 1 year. MEASUREMENTS: The outcome variable was change in ADLs after 1 year. Covariates were an older adult's home geographical region, LTC level, age, sex, primary caregiver, Medicaid beneficiary status, bedridden status, medical diagnosis, baseline ADLs, cognitive function, behavioral problems, nursing and special treatment, and rehabilitation needs. Multiple regression analysis of all participants unmatched and a paired t-test with a propensity-score-matched cohort were performed to explain the association of changes in ADLs with the types of LTC. RESULTS: Multiple regression analysis with all participants (n = 22,557) unmatched showed that compared with older adults who received home care, those who received nursing home care had deteriorated further in terms of ADLs after 1 year (ß = 0.44108, P < .0001). After propensity-score matching, paired t-test analysis also found that the ADLs of older adults had deteriorated less in the home care group compared with the nursing home group after 1 year (P < .0001). CONCLUSIONS: The ADLs of older adults who received home care showed significantly less deterioration than those of the older adults in nursing home care after 1 year. The ADLs of older adults could differ according to the type of LTC they receive, and home care could result in better maintenance of ADLs than nursing home care.

Clinical ladder program implementation: a project guide.

This article describes the development of a clinical ladder program (CLP) implementation linked to a promotion system for nurses. The CLP task force developed criteria for each level of performance and a performance evaluation tool reflecting the self-motivation of the applicant for professional development. One year after implementation, the number of nurses taking graduate courses increased, and 7 nurses were promoted to nurse manager positions.

Prevalence and risk factors of metabolic syndrome in the Korean population--Korean National Health Insurance Corporation Survey 2008.

AIM: To determine the factors affecting the prevalence of metabolic syndrome in younger and older Koreans. BACKGROUND: Metabolic syndrome, in combination with other, interrelated predisposing factors, is a risk factor for cardiovascular disease. In Korea, the prevalence of this syndrome, like those of other chronic diseases, has increased continually in recent years. DESIGN: This is an analytic, descriptive cross-sectional study. METHODS: This survey targeted 690,283 examinees that had undergone a medical examination on a life transition period performed by the National Health Insurance Corporation from January-December 2008. For the purpose of this study, the diagnosis of metabolic syndrome was based on the criteria of the American Heart Association and the Heart, Lung, and Blood Institute. The relationship between the risk factors and prevalence rate was shown using a multiple logistic regression model. RESULTS: The prevalence of metabolic syndrome was 24·8% in the 40 year olds and 40·8% in the 66 year olds. Among the younger adults, the prevalence in women was only 0·57 times that in men. A multiple logistic regression analysis demonstrated that heavy obesity and family history of cardiovascular disease are the strongest independent predictors of metabolic syndrome among younger and older Koreans. CONCLUSION: As a management strategy, a nursing intervention strategy for the improvement of lifestyle factors including self-care through proper diet and exercise should be developed and implemented.

Group cohesion and social support of the nurses in a special unit and a general unit in Korea.

AIM: To identify the degree of group cohesion and social support of nurses in special and general units in hospitals in Korea, and to compare group cohesion and social support between the two groups. BACKGROUND: The level of commitment nurses have to their organizations has been shown to correlate with work group cohesion and social support. METHODS: The participants were 1751 nurses who were working in Korean hospitals. Data were collected using a structured questionnaire and were analysed using SAS. The statistical methods included: descriptive statistics, t-test, anova and Pearson's correlation coefficients. RESULTS: Group cohesion of nurses on special wards was significantly higher than for nurses on general wards. No significant difference was found between types of units in terms of social support. The degree of group cohesion was significantly different in terms of the respondents' clinical experience, position, religion, job satisfaction, number of supportive superiors and number of supportive peers. A statistically significant correlation was found between group cohesion scores and degree of social support. CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT: Hospital management can accomplish their goals more effectively through knowledge of the level of group cohesion, superior support and peer support for nursing staff in accordance with unit specialty.

The effects of a cognitive-behavioral therapy on career attitude maturity, decision making style, and self-esteem of nursing students in Korea.

The purpose of this study was to find out about the effectiveness of a cognitive-behavioral program for nursing student's career attitude maturity, decision making style, and self-esteem in Korea. The ultimate goal of this paper is to prepare career strategies so that they can improve career maturity development, on the basis of better understanding of one's self. The subjects were 40 nursing students from one college located in Gyeonggi Province; following the informed consent procedure, twenty participants were randomly assigned to an experimental group, and 20 were assigned to a control group. The cognitive-behavioral therapy consisted of 8-sessions and was implemented for 60 min during an 8 week period. Data were collected from May to June 2004, and analyzed χ(2)-test, Fisher's exact test and t-test were used in the analysis of the data. After treatment with cognitive-behavioral therapy, the experimental group significantly increased in the mean score for career attitude maturity, self-esteem compared to the control group, especially for confidence and independence. In conclusion, cognitive-behavioral therapy had a positive effect for increasing the career attitude maturity and self-esteem for nursing students in Korea. Therefore, cognitive-behavioral therapy for nursing student is recommended as a group counseling program on career maturity inventory.

Effects of self-efficacy, affectivity and collective efficacy on nursing performance of hospital nurses.

AIM: This paper is a report of a study conducted to examine the influence of self-efficacy and affectivity (individual-level variables) and collective efficacy (group-level variable) on nursing performance among hospital nurses. BACKGROUND: Previous studies of nursing performance, which have focused on individual factor outcomes, have shown limitations. Due to the heavy focus on the analysis of single-level performances, the influence of organizational contextual factors on nursing performance has rarely been studied. Hence, for a better understanding of nurses' professional development and effective functioning in hospitals, there is a need to study the effects of organizational characteristics as well as individual characteristics on nursing performance. METHOD: A descriptive-correlational design was used with a convenience sample of 1996 nurses selected from 182 nursing units in 28 hospitals in six metropolitan cities and seven provinces in Korea. Data were collected in 2006 using self-administered questionnaires, which were analysed with using descriptive statistics, Pearson correlation coefficients and multilevel analysis. RESULTS: Individual-level variables, including job position, years of experience, employment status, self-efficacy and positive affectivity were positively related to nursing performance. Collective efficacy and the number of in-service meetings within units were statistically significant group-level variables. Group-level variables reduced the error variances in nursing performance. CONCLUSION: Understanding the effects of group-level variables on nursing performance improves performance management approaches in hospitals.

[Identification of factors related to hospital nurses' organizational citizenship behavior using a multilevel analysis].

PURPOSE: The purpose of this study was to identify factors related to nurses' organizational citizenship behavior using multilevel analysis which included both nurse characteristics at individual levels and nursing unit characteristics at group levels. METHODS: The sample was composed of 1,996 nurses who were selected from 182 nursing units in 28 hospitals in six metropolitan cities and seven provinces using cluster sampling. Data were collected using self-reported questionnaires from February to March 2006. RESULTS: The results of the study indicated that individual level variables related to organizational citizenship behavior were religion, job position, clinical career, self efficacy, positive affectivity, and supervisor support. The group level variables related to organizational citizenship behavior were collective efficacy, number of nurses in a nursing unit, and the average salary level of a nursing unit. 30.9% of individual level variances of organizational citizenship behavior were explained by the nurses' individual level variables. The explanatory power of group level variables, which is related to group level variances of organizational citizenship behavior, was 75.5%. CONCLUSION: This research showed that it was necessary to develop appropriate strategies related to not only individual factors, but also higher-level organizational factors such as collective efficacy, to improve individual performances in the hospital.

[Development of a performance measurement scale for hospital nurses].

PURPOSE: The aim of this study was to develop a performance measurement scale for nurses in the hospital setting and to test the reliability and validity of the scale. METHODS: This study was conducted in three phases including an application of conceptual framework, development of scale items, and test of validity and reliability of the scale. In order to test validity and reliability, data was collected from 1,966 nurses who work in twenty eight hospitals nation-wide. The data was analyzed by the SAS 8.0 program using descriptive statistics, factor analysis, and reliability coefficients. RESULTS: The Performance measurement scale consisted of 4 factors which included competency, attitude, willingness to improve, and application of nursing process, and a total of 17 items. The Four factors explained 63.45% of the total variance, and Cronbach's alpha of the scale was .92. CONCLUSION: The performance measurement scale developed by this study is a reliable and valid instrument that is utilized effectively to evaluate the performance of hospital nurses. Furthermore, it could be used as a stepping stone to assess educational needs of nurses, develop professionalism among nurses, and improve quality of nursing care in the hospital setting.