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 a Situational Module Learning Course on Critical Thinking Disposition and Metacognition in Nursing Students: A Quasi-experimental Study / 한국간호교육학회지

PURPOSE: This study aimed to identify the effect of a situational module learning course on critical thinking disposition and metacognition in sophomore nursing students. METHODS: This study was a non-equivalent control-group pretest-posttest quasi-experimental design; the participants included 64 nursing students (32 in the experimental and 32 in the control group) from two Korean universities. Critical thinking disposition and metacognition between the control and intervention groups were measured before and after program participation. Data collection was conducted between September 1 and December 15, 2016. An independent t-test was used to determine differences in critical thinking disposition and metacognition between the groups and Pearson's correlations were measured for correlation with critical thinking disposition and metacognition. RESULTS: The intervention group showed higher critical thinking disposition (t=3.16, p=.002); intellectual integrity (t=2.85, p=.006); and open-mindedness (t=3.30, p=.002) relative to those of the control group. However, there were no statistical differences in metacognition between the two groups (t=−0.14, p=.888). A significant positive correlation between metacognition and critical thinking disposition was found. (r=.62, p<.001). CONCLUSION: The situational module learning course developed in this study could be used to promote critical thinking disposition in nursing students.

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.

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.

Physicians' Experience of Communication with Nurses related to Patient Safety: A Phenomenological Study Using the Colaizzi Method

PURPOSE: This study attempted to understand the core experiences of physicians related to communicating with nurses in Korea. METHODS: Ten physicians who worked at four tertiary university hospitals were interviewed. Data were analyzed using the phenomenological method developed by Colaizzi. RESULTS: The following six categories of participants' experience of communication with nurses were extracted from the analysis: (a) “Complex situations and heavy roles that cannot afford safety,” (b) “Forcing a superior position in an authoritative environment,” (c) “Different perspectives on patient care and difficulties in establishing relationships,” (d) “Communicating key clues and receiving feedback from each other,” (e) “Apathetic agreements rather than improvements,” and (f) “Gradually developing mutually complementary communication.” CONCLUSION: The present findings revealed that physicians lacked an understanding about the roles and tasks of nurses. The participants engaged in mutually complementary communication with experienced nurses, obtaining desirable patient outcomes and perceived order filtering by nurses as a safety mechanism. It is important for managers to act as proactive change agents to improve communication. Furthermore, the importance and different forms of complementary communication between physicians and nurses need to be described and taught in depth with practical cases.

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.

Analysis of Qualitative Research Published in the Journal of Korean Academy of Nursing Administration (First publication to the end of 2016) / 간호행정학회지

PURPOSE: This study was done to analyze qualitative research published in the Journal of Korean Academy of Nursing Administration (JKANA). METHODS: Selected studies included 38 qualitative studies in which an interview was used and which were published in JKANA from 1995 to 2016 (22 years). Consolidated Criteria for Reporting Qualitative Research (COREQ), a reporting guideline for analysis of qualitative research was employed. RESULTS: Items that were included in less than half of the selected studies were as follows: interviewers' credentials, occupation, gender, and relationship established with participants in the 1st domain; non-participants, presence of non-participants, and transcripts returned in the 2nd domain; participant checking in the 3rd domain. CONCLUSION: Findings indicate that future challenges face JKANA qualitative researchers. First, the expansion of qualitative research should be ensured to explain complex interaction between humans and the environment. Second, a variety of qualitative research methods should be considered to enhance understanding of nursing fields. Third, research procedures should be described more precisely to increase transparency of research results. Fourth, not only personal information on the researcher but also how subjective opinions of the researcher reflected in the research process should be explained in detail to clarify the relationship between researchers and participants.

Analysis of Research Articles Published in the Journal of Korean Academy of Nursing Administration for 3 Years (2013~2015): The Application of Text Network Analysis / 간호행정학회지

PURPOSE: This study aimed to identify research trends in the Journal of Korean Academy of Nursing Administration from 2013 to 2015. METHODS: For this study, 171 articles were analyzed. Research designs, participants, research settings, sampling, and data analyses methods were reviewed using established analysis criteria. Keyword centrality and clusters were generated by keyword network analysis. RESULTS: Most of studies used quantitative methods (82.5%), and sampling mainly focused on nurses (68.8%). The most commonly used data analyses methods were t-test, ANOVA, correlation, and regression. The most central keywords were turnover and empowerment. Network analysis generated four network groups: 1) burnout; 2) turnover; 3) happiness; and 4) nursing professionalism. CONCLUSION: The results of this study identify current trends and interests in Korean nursing administration research. The findings from this study suggest that future studies include a variety of research methods and maintain appropriate research ethics.

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.

Experience of Role Adaptation from Nurse to Member of the Nursing Faculty

PURPOSE: The purpose of this qualitative study was to evaluate the experience of role adaptation from nurse to member of the nursing faculty. METHODS: Data were collected from 13 members of a nursing faculty through in-depth interviews. The main question asked was "Could you describe your experience from being a nurse to becoming a member of the nursing faculty?" Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. RESULTS: The core experiential category of role adaptation from nurse to member of the nursing faculty was 'striving for survival from culture shock'. The participants used the following three interactional strategies: 'recognizing everything and entering the school environment', 'self-reflection on being a professor and integration of experiences', and 'finding a way of adapting'. CONCLUSION: The participants tried to adapt to life as a professor and reflected on and integrated their experiences into their new life on the faculty. College faculty need to understand the impact of changes and challenges faced by new professors during role adaptation and to support this adaptation through mentorship and organized orientation programs.

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.

Operating Room Nurses' Experiences of Securing for Patient Safety

PURPOSE: This study was done to evaluate the experience of securing patient safety in hospital operating rooms. METHODS: Experiential data were collected from 15 operating room nurses through in-depth interviews. The main question was "Could you describe your experience with patient safety in the operating room?". Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. RESULTS: The core category of experience with patient safety in the operating room was 'trying to maintain principles of patient safety during high-risk surgical procedures'. The participants used two interactional strategies: 'attempt continuous improvement', 'immersion in operation with sharing issues of patient safety'. CONCLUSION: The results indicate that the important factors for ensuring the safety of patients in the operating room are manpower, education, and a system for patient safety. Successful and safe surgery requires communication, teamwork and recognition of the importance of patient safety by the surgical team.

Nurses' Experience of Health Communication with Doctors in the Clinical Fields / 간호행정학회지

PURPOSE: The purpose of this study was to describe nurses' experience of health communication with doctors in the clinical fields. METHODS: Eight experienced clinical nurses working in various units of general hospitals participated. Data were collected through in-depth individual interviews and analyzed using the Colaizzi' method. RESULTS: Five themes of nurses' experience of communication were identified: exploring the speaker seriously, becoming aware of emotions and controlling them, developing relationships after lining up for battle, having superficial and withered relationships with doctors, having few resources to promote communications with doctors. CONCLUSION: The results of the study indicate that humanistic and warm interpersonal relationships and genuine sharing of information are necessary to ensure effective communication. Thus, practice guidelines should be re-evaluated and developed to meet the proposed standards; safety-net programs and education for health communication should also be established. Nurse managers should create a high-touch work environment.

Gender Differences in Factors Influencing The Framingham Risk Score-Coronary Heart Disease by BMI

PURPOSE: This study was to investigate factors influencing the Framingham risk score-Coronary heart disease (FRS-CHD) according to gender and body mass index (BMI) of adults who participated in the 5th Korea National Health and Nutrition Examination Survey (KNHANES V-3). METHODS: This study used a cross-sectional design with secondary analysis with KNHANES V-3. The FRS-CHD scores were measured with ages, sex, blood pressure, cholesterol, high density lipoprotein, smoking, and diabetes mellitus. With demographic characteristics, family history of ischemic heart disease, types (intensity) and days of physical activities, perceived stress, drinking, menopause (in female), and BMI scores were measured. The data were analyzed with descriptive statistics, Pearson's correlation coefficients, and multiple regressions. RESULTS: FRS-CHD was significantly associated with types (intensity) and days of physical activities, educational level, occupation, and marital status, explaining 19.1~76.8% of the variance in men. FRS-CHD was significantly associated with types (intensity) and days of physical activities, menopause, and education level, explaining 55.0~59.5% of the variance in women. CONCLUSION: Factors influencing FRS-CHD were significantly different according to gender and BMI. To reduce the risk of coronary artery disease, it is necessary to develop gender-specific physical activity programs according to BMI.

Comparison of Hospital Nurses' Recognition of the Team System and Effects on the Nursing Organizational Team System / 간호행정학회지

PURPOSE: The purpose of this study was to identify hospital nurses' recognition of the team system and the effectiveness of the team system as an organizational structure. METHODS: A self-report questionnaire was used to collect data from 247 general hospital nurses during 4 months in 2013. Analysis was done using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and factor analysis with SPSS 18.0. program. RESULTS: There was no significant difference in nurses' recognition of team structure (t=2.06, p=.153) or effect of team structure (t=0.36, p=.549) according to use of team system. In hospitals with a team system, there were positive correlations between recognition of the effect of the team system and age (r=.25, p=.033), and total clinical career (r=.26, p=.012). In hospitals not using a team system, nurses' recognition of team structure as an organizational system (r=.31, p<.001), nurses' recognition of team structure, total (r=.30 p<.001) correlated significantly with the effects of team system. CONCLUSION: Results of this study provide a retrospection view of the team system in nursing organizational systems. The nursing team system's ultimate goal needs to be confirmed for complementary nursing care. Also, more studies on nurses' perceptions of, and effectiveness of the team system are necessary.

Nurses' Experience of Incivility in General Hospitals

PURPOSE: This study was done to describe nurses' experience of incivility in hospitals and to consider nurses' work environment. METHODS: Data were collected through in-depth interviews and analyzed using Colaizzi' phenomenological analysis methodology. Participants were seven experienced clinical nurses working on a general ward (2 nurses), or in an intensive care unit (2 nurses), emergency room (2 nurses), or operating room (1 nurse). RESULTS: The incivility that nurses experienced was categorized as follows: 'being afflicted as a weak person', 'being treated as less than a professional', 'being overwhelmed by shock and anger', 'experiencing an untenable situation', 'struggling to survive', and 'pursuing professional growth'. CONCLUSION: Behavior guidelines should be developed to reduce incivility, and incivility cases should be continuously monitored by the nursing department. Also, to handle incivility problems in clinical nursing areas, a reporting and counseling system and education programs are needed.

Orthostatic Intolerance Ambulation in Patients Using Patient Controlled Analgesia

BACKGROUND: Opioid analgesics are widely used to reduce postoperative pain and to enhance post-operative recovery. However, orthostatic intolerance (OI) induced by opioid containing intravenous patient controlled analgesia (IPCA) may hinder postoperative recovery. This study investigated factors that affect OI in patients receiving IPCA for postoperative pain control. METHODS: OI was instantly evaluated at the time of first ambulation in 175 patients taking opioid containing IPCA after open and laparoscopic subtotal gastrectomies. Patients were classified as having OI if they experienced dizziness, nausea/vomiting, blurred vision, headache, somnolence and syncope. Factors contributing to OI were assessed with logistic regression analysis. RESULTS: Out of 175 patients, 61 (52.6%) male and 44 (74.6%) female patients experienced OI at the time of first ambulation. The frequency of OI related symptoms were dizziness (97, 55.4%), nausea (46, 26.3%), headache (9, 5.1%), blurred vision (3, 1.7%) and vomiting (2, 1.1%). Significant risk factors for OI were gender (P=0.002) and total amount of opioids administered (P=0.033). CONCLUSIONS: The incidence of OI is significantly higher in male than in female patients and is influenced by the opioid dose.

Path Analysis for Workplace Incivility, Empowerment, Burnout, and Organizational Commitment of Hospital Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to examine nurses' experience of workplace incivility from coworkers, supervisors, patients or patients' families, and doctors. The researcher identified the relationships among empowerment, burnout, and organizational commitment of hospital nurses. METHODS: The sample included 415 hospital nurses. Data were collected through questionnaires and analyzed using SPSS and AMOS. RESULTS: The average incivility score was 2.94 from doctors and 2.89 from patients or patients' families, higher than from supervisors (1.90) and coworkers (1.87). The variables affecting burnout included direct effect of empowerment (beta=-.46, p<.001), direct effect of patients or patients' family incivility (beta=.14, p<.001), direct effect of supervisor incivility (beta=.12, p<.001), and direct effect of doctor incivility (beta=.09, p<.001). The variables affecting organizational commitment were direct effect of burnout (beta=-.58, p<.001), indirect effect of empowerment (beta=-.23, p<.001), indirect effect of patients or patients' family incivility (beta=-.12, p<.001), indirect effect of supervisor incivility (beta=-.10, p<.001), and indirect effect of doctor incivility (beta=-.09, p<.001). CONCLUSION: The results indicate that incivility affecting nurses results in a high degree of burnout and a low degree of organizational commitment. Therefore, it is necessary to assess incivility cases and to hold workshops designed to curb incivility and establish healthy workplaces.

Structural Equation Modeling on Nursing Productivity of Nurses in Korea

PURPOSE: The purpose of this study was to propose and test a predictive model that could explain and predict nursing productivity. METHODS: A survey using a structured questionnaire was conducted with 360 nurses in Korea. The data were analyzed using SPSS Windows 18.0 and AMOS 19.0 program. RESULTS: Based on the constructed model, burnout and organizational commitment were found to have direct effects on nurses' turnover intention and nursing productivity. While nursing work environment was found to have indirect effects on nurses' turnover intention and nursing productivity. CONCLUSION: This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with nursing productivity. Comprehensive organizational interventions to improve nursing productivity should focus on improving the nursing work environment. Findings from this study can be used to design appropriate strategies to decrease nurse turnover in Korea. Further studies are needed to prospectively verify these causal relationships with larger samples.

A Model on Turnover Intention of Chief Nurse Officers

PURPOSE: The purpose of this study was to test the turnover intention model for chief nurse officers in general hospitals. The variables for the study included job stress, social support, job satisfaction, and organization commitment. METHODS: A predictive, non-experimental design was used with a sample of 144 chief nurse officers from 144 general hospitals. Data were collected using self-administered questionnaires and analyzed using SPSS, AMOS program. RESULTS: The overall fitness of the hypothetical model to the data was good (chi2=16.80, p=.052, GFI=.96, AGFI=.90, NFI=.97, CFI=.99). Job stress, social support, job satisfaction, and organization commitment explained 59.0% of the variance in turnover intention by chief nurse officers. Both organization commitment and social support directly influenced turnover intention for chief nurse officers, and job stress and job satisfaction indirectly influenced turnover intention. CONCLUSION: The results imply that chief nurse officers in hospitals need social support and management of job stress to increase job satisfaction and organization commitment, and lower turnover intention.