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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

Objective The purpose of this study was to explore the association of nurse staffing and overtime with nurse-perceived patient safety, nurse-perceived quality of care, and care left undone. Design A cross-sectional survey. Setting and participants A total of 65 hospitals were selected from all of the acute hospitals ( n =295) with 100 or more beds in South Korea by using a stratified random sampling method based on region and number of beds, and 60 hospitals participated in the study. All RNs working on the date of data collection in units randomly selected from the list of units in each hospital were invited to participate. The analyses in this study included only bedside RNs ( n =3037) and hospitals ( n =51) with responses from at least 10 bedside RNs. Methods We collected data on nurse staffing level, overtime, nurse-perceived patient safety, nurse-perceived quality of care, nurse-reported care left undone, and nurse characteristics through a nurse survey. Facility data from the Health Insurance Review Agency (HIRA) were used to collect hospital characteristics. Multilevel logistic regression models considering that nurses are clustered in hospitals were used to analyze the effects of hospital nurse staffing and overtime on patient safety, quality of care, and care left undone. Results A higher number of patients per RN was significantly associated with higher odds of reporting poor/failing patient safety (OR=1.02, 95% CI=1.004–1.03) and poor/fair quality of care (OR=1.02, 95% CI=1.01–1.04), and of having care left undone due to lack of time (OR=1.03, 95% CI=1.01–1.05). Compared with RNs who did not work overtime, RNs working overtime reported an 88% increase in failing or poor patient safety (OR=1.88, 95% CI=1.40–2.52), a 45% increase in fair or poor quality of nursing care (OR=1.45, 95% CI=1.17–1.80), and an 86% increase in care left undone (OR=1.86, 95% CI=1.48–2.35). Conclusions Our findings suggest that ensuring appropriate nurse staffing and working hours is important to improve the quality and safety of care and to reduce care left undone in hospitals.

Purpose: This study aimed to describe nurses` experience in transition from new graduate nurses to professional clinical nursees in a hospital. Methods: Ten new clinical nurses working in a hospital participated in this study. Data collected through in-depth interviews were analyzed using phenomenology. Results: The analysis yielded five core category themes from new nurses for becoming a professional nurse: (a) beginning of hardship journey (b) feeling of inability in workplace (c) struggling hard to develop skills (d) enduring hardships by soothing oneself and peer support (e) beginning of an exciting journey. Conclusion: Over time, new nurses face many difficulties in transition to a professional status. To enhance the role development of new clinical nurses in hospital settings, nursing schools and clinical fields must teach and prepare them. Nursing schools should teach a strong theoretical base as well as nursing skills. In addition, in the clinical nursing department, education, teaching the integrated systems, staff development, support, evaluation, and feedback are needed for new nurses`s development.

We conducted a prospective observational study for premenopausal women receiving adjuvant adriamycin and cyclophosphamide-containing regimens to define the pattern of chemotherapy-induced amenorrhea (CIA), the menopause-specific quality of life (MENQOL), and the hormone profiles.From October 2003 to July 2007, 387 patients with breast cancer who underwent curative surgery were prospectively included. Patient self-assessment by MENQOL questionnaires and blood samples for hormone assays were taken before chemotherapy, and 1, 6, and 12 months after chemotherapy was completed.Patients were categorized into three groups according to their duration and reversibility of amenorrhea, with 312 eligible patients split into long-term CIA (n = 180, 57.7 %), temporary CIA (n = 113, 36.2 %), and menstrual irregularity (n = 19, 6.1 %) groups. Risk factors for long-term CIA were identified as age ≥40 years (p 0.001), the addition of taxane (p = 0.01), and tamoxifen use (p = 0.03). MENQOL was worst immediately after the completion of adjuvant chemotherapy, and this was not fully recovered even 12 months after chemotherapy had finished. Age ≥40 years and tamoxifen exposure were inversely associated with MENQOL. In long-term CIA patients, the level of follicle-stimulating hormone increased after chemotherapy; this level, however, was reduced in patients who received tamoxifen, but remained high and stable in those who did not (p 0.001 at 6 months; p 0.001 at 12 months).This study showed that most premenopausal breast cancer patients who received adjuvant chemotherapy experienced clinically significant CIA, followed by impaired MENQOL. Our findings may be relevant in the decision-making processes for premenopausal women with breast cancer.

Purpose: The purpose of the study was to understand and describe the team manager`s experience in relation to the team system in the hospital organization. Methods: In-depth individual interviews for collection of data were conducted from October to November 2011. Participants were chosen purposely among team managers who had worked as team managers under the team manager system in Seoul for more than three years. Content of all interviews was recorded and transcribed according to information collected by interviewers. Data were analyzed using Colaizzi`s analysis. Results: Six categories were derived from the analysis: 1) Strengthening of team manager`s authority; 2) Sharing of multifaceted leadership role; 3) Demonstrating people-oriented leadership; 4) Complete interpersonal relationship and communication; 5) Self-empowering with web-like plans and practices; and 6) Going through rigorous commitment for team performance. Conclusion: Results of the study demonstrate various positive factors in association with the team system in spite of the short period of time since its introduction in the hospital organization; however, some negative aspects of the team system need to be reevaluated.

Awareness of advance directives (AD) among 293 nurses working in acute hospitals was evaluated through a structured questionnaire. Nurses were poorly acquainted with AD. Education about AD and related concepts are required in college and field experience to improve practice and communication with patients at the end of life.

Purpose: This study was done to develop a performance appraisal tool (PAT) for neonatal intensive care unit (NICU) registered nurses (RNs). Methods: The PAT was developed in three steps: 1) a standard of NICU nursing was established; 2) a draft was made; and 3) the PAT was ratified and its reliability and validity were tested. Results: The standard of practice of NICU nursing was predominantly based on role description and responsibilities for nurses. We identified 4 domains of nursing: professional practice, education, research, and leadership. The validity score for each item ranged from 3.93 to 3.27. The PAT consisted of 76 indicators, 49 reflecting components of professional practice, 5 related to responsibility for education, 3 representing research, and 19 relating to leadership. Cronbach`s averaged 0.99 for the 76 items. Conclusions: The PAT for NICU RNs that we created was found to be reliable and valid. This PAT would be very useful in evaluating nursing performance and facilitate the professional growth of nurses.

Purpose: This paper was intended to identify various kinds of specialized in-service educational programs in the hospital. Method: The data was collected from June to July, 2006. The subjects were 67 general hospitals in Korea. Result: Specialized in-service educational programs were present at 36 general hospitals. Thirty-three programs were operating in the field of intensive care nursing. The purposes of specialized in-service education programs were to improve the quality of nursing care. Conclusion: Since the clinical nurse specialist was legally established in 2005 in Korea, various kinds of specialized in-service education programs for nurses are needed under the organized framework of the career development system.

This study aimed at recognizing the effect of group communication activity (GCA) program for nursing students. Study design was one-group pretest posttest experimental design participating 33 students. Data were collected through Global Interpersonal Communication Competence scale questionnaire consisted of 48 items including 16 sub-categories at pre and post- test and analyzed using descriptive statistics, t-test. The GCA program was performed with lecture and practice as developed-portfolio for the health- communication. Performed practice by students was filmed in the program. Filmed contents of communication was reviewed and feedback after soon in the same program. The average score of the students' interpersonal communication competence was 3.51 and 3.74 in the pre and post-test respectively which showed statistically significant. There were statistically significant increase between pre and post-test in the sub-categories such as self-disclosure (3.19±0.74,, 3.60±0.72, t=2.29, p=.025), interaction management (3.50±0.53, 4.28±0.50, t=6.80, p

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.

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%) fe male 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. (Korean J Pain 2013; 26: 277-285)

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.

The purpose of this study was to identify the role adaptation process experienced by executive directors of nursing department of general hospitals.Data were collected from 9 executive nursing directors though in-depth interviews about their experiences. The main question was "How do you describe your experience of the process of role adaptation as an executive nursing director?" Qualitative data from field and transcribed notes were analyzed using StraussCorbin's grounded theory methodology.The core category of experience of the process of role adaptation as an executive nursing director was identified as "entering the center with pushing and pulling". The participants used five interactional strategies;'maintaining modest attitudes','inquiring about trends of popular feeling','making each person a faithful follower','collectingdisplaying power','leading with initiative'. The consequences of role adaptation in executive nursing directors were'coexisting with others','immersing in one's new role with dedication', and'having capacity for high tolerance'. The types of role adaptations of executive directors in nursing department were friendly type, propulsive type, accommodating type.The results of this study produced useful information for executive nursing directors on designing a self-managerial program to enhance role adaptation based on interactional strategies.

This study was conducted to cross-map nursing statements with International Classification of Nursing Practice (ICNP) Version 1 and to develop and evaluate ICNP-based Electronic Nursing Record System. Among the 7,631 nursing statements which were cross-mapped, 5,970(78.2%) nursing statements were completely expressed and 1,520(19.9%) statements were partially expressed. ICNP-based Electronic Nursing Record System was developed for the Asan Medical Center in Korea. Most nursing statements (6,671 of 7,931, 87.0%) and Most cross-mapped ICNP terms (965 of 1,015, 94.9%) were documented by user in all the units from July, 2007 to August, 2008.

This study was conducted to develop the clinical-decision support system for the nursing process in the Electronic nursing record system. Nursing diagnoses were linked to 4 components of the nursing process (except for diagnoses) and applied to ENR in 2007.

Aim. To identify the effects of cryotherapy on patient discomfort following craniotomy. Background. Following craniotomy, many patients suffer from unexpected discomfort, including pain, eyelid oedema and ecchymosis. Cryotherapy is regarded as a safe method for managing these postcraniotomy problems. Design. Randomised controlled trial. Methods. A total of 97 Korean patients who underwent elective supratentorial craniotomy were randomly assigned to a cryotherapy or a control group. In the cryotherapy group, ice bags were applied to surgical wounds, and cold gel packs were applied to periorbital areas, for 20 minutes per hour, beginning three hours postoperatively and for three days thereafter. The level of patient pain was measured using the visual analogue scale while the eyelid oedema was measured using the Kara & Gokalan’s scale. Ecchymosis was also classified according to its extent. Results. The level of pain three hours after craniotomy was similar in the cryotherapy and control groups (57·9 vs. 58·7). Three days after surgery, pain had significantly decreased in the cryotherapy group (p = 0·021). After adjusting diagnosis by analysis of covariance (ancova), pain score did not differ significantly between the two groups. The mean eyelid oedema scores were lower in the cryotherapy group than in the control group (0·59 vs. 2·29, p

The vacuum UV photolysis of ethyl chloride at 163.3 nm was studied over the pressure range 1 – 77 Torr of the reactant at room temperature using a bromine atom resonance lamp. Pressure effects were investigated with and without the addition of CF 4 or CH 4 and scavenging effects were monitored by addition of NO gas as radical scavenger. The major products of the reaction were CH 4 , C 2 H 4 , C 2 H 6 , C 3 H 8 , C 2 H 3 Cl and n -C 4 H 10 formed via two-channel competition between molecular elimination and radical formation. On addition of NO gas, the formation of CH 4 , C 2 H 6 , C 3 H 8 and n -C 4 H 10 was completely suppressed and formation of C 2 H 4 and C 2 H 3 Cl was reduced. The decomposition modes in the primary process were molecular elimination (25%) and radical reaction (75%). The extinction coefficient of C 2 H 5 Cl at 163.3 nm was determined to be 27.8 atm −1 cm −1 from the absorption cross-section data.

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.

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.

Among 53 Acinetobacter baumannii isolates collected in 2004, nine imipenem-resistant isolates were obtained from clinical specimens taken from patients hospitalized in Busan, Korea. Nine carbapenemase-producing isolates were further investigated in order to determine the mechanisms underlying resistance. These isolates were then analyzed via antibiotic susceptibility testing, microbiological tests of carbapenemase activity, pI determination, transconjugation test, enterobacterial repetitive consensus (ERIC)-PCR, and DNA sequencing. One outbreak involved seven cases of infection by A. baumannii producing OXA-23 beta-lactamase, and was found to have been caused by a single ERIC-PCR clone. During the study period, the other outbreak involved two cases of infection by A. baumannii producing IMP-1 beta-lactamase. The two clones, one from each of the outbreaks, were characterized via a modified cloverleaf synergy test and an EDTA-disk synergy test. The isoelectric focusing of the crude bacterial extracts detected nitrocefin-positive bands with pI values of 6.65 (OXA-23) and 9.0 (IMP-1). The PCR amplification and characterization of the amplicons via direct sequencing showed that the clonal isolates harbored blaIMP-1 or blaOXA-23 determinants. The two clones were characterized by a multidrug resistance phenotype that remained unaltered throughout the outbreak. This resistance encompassed penicillins, extended-spectrum cephalosporins, carbapenems, monobactams, and aminoglycosides. These results appear to show that the imipenem resistance observed among nine Korean A. baumannii isolates could be attributed to the spread of an IMP-1- or OXA-23-producing clone. Our microbiological test of carbapenemase activity is a simple method for the screening of clinical isolates producing class D carbapenemase and/or class B metallo-beta-lactamase, in order both to determine their clinical impact and to prevent further spread.

Purpose: The purpose of this study was to evaluate the experience of hospital nurses regarding their intention to stay at hospital. Methods: Experiential data were collected from 10 experienced nurses through in-depth interviews. The main question was "Could you describe your experience and your work during your years at the hospital?" Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. Results: The core category of experience regarding hospital nurses’ intention to stay was ‘following a stable rather than a challenging path’. Participants used three interactional strategies: ‘being encouraged via rapport with peers’, ‘accept reality’, and ‘find vitality in academic pursuits’. Conclusion: The retention of experienced nurses is critical to human resource management in nursing departments. This study found that experienced nurses have a vague uncertainty about their future in the hospital. Therefore, nursing managers should support experienced nurses by providing them with the opportunities needed to develop their careers, by managing conflicts in nursing units, and by implementing new programs to increase confidence.

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 (β=-.46, p

This study was done to describe nurses' experience of incivility in hospitals and to consider nurses' work environment.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).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'.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.

Purpose: The purpose of this study was to identify the role experience of preceptor nurses in general hospitals. Methods: Data were collected from 10 experienced preceptor nurses through in-depth interviews about their experiences. The main question was “How do you describe your experience as a preceptor in the process of role adaptation?” Qualitative data from field and transcribed notes were analyzed using Strauss & Corbin's grounded theory methodology. Results: The core category of experience in the process of role adaptation as a preceptor nur se was identified as ‘being responsible to teach from beginning to end’. The participants identified five interactional strategies; ‘abrup tly having to take the role as a preceptor unwilling’, ‘difficulties in field training with variable situations’, ‘preceptor and new nurse with love and hate relationships’, ‘bring up preceptee as a child’, ‘redefining the concept of preceptor’. Conclusion: The results of this study provide useful information for understanding the role of preceptor nurses in general hospital who have to teach new nurses with patience and responsibility. It will be needed to establishment of preceptor’s role and educational standards, and policy for their rewards by nurse manager. Additionally, making cooperative educational climate in nursing ward is important for teaching new nurse.

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 (χ 2 = 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.

Purpose: The purpose of this study was to identify and describe nurses’ experience of a career ladder program (CLP) in a general hospital in Korea. Methods: The data were collected from 15 nurses who participated in the CLP. Each nurse completed individual in-depth interviews, for which the main interview question was “How do you describe your experience of CLP?” All interview data were transcribed and were analyzed using the grounded theory method. Results: The core category of the experience of CLP was identified as “challenging to rebirth as an expert”. The participants used five action/interaction strategies such as “taking some time for introspection”, “appreciating the essence of nursing”, “making use of feedback positively”, “throwing away doubts about their own capabilities”, “exerting themselves with confidence”. The consequence of the process of adjusting to CLP was “positioning a differentiated expert.” Conclusion: The results of this study show that participants recognized CLP as a powerful resource which leads them to professional growth and development. Thus, CLP could be utilized as a clinical career-promoting program and ultimately as a program for providing high-quality nursing services.

Purpose: The purpose of this study was to investigate how nurses perceive the Career Ladder System(CLS). Methods: This study was a descriptive survey using questionnaires. Questionnaires were developed by an expert group. Participants included 161 nurses working in the Children's Hospital. The data were analyzed using factor analysis, Cronbach's alpha, descriptive statistics, -test and ANCOVA. Results: This study revealed that nurses who advanced in their career ladders have a significantly higher perception of participation in their professional activities and a general comprehension of the CLS more than the nurses who did not advance in their career ladders. However, nurses who advanced in their career ladders have a significantly lower perception of the expected outcome of the CLS more than nurses who did not. Conclusions: This result showed that nurses who had experienced in clinical advancement and recognition were highly motivated with their professional activities via the CLS as well as they considered it to allow professional growth.