Purpose: The purpose of this qualitative study is to investigate the nature of tacit nursing knowledge practiced in the clinical field in Korea using hybrid models, and to clarify the definitions and attributes of the concept. Methods: The definition and nature of tacit nursing knowledge, obtained through a review of the extensive literature at the theoretical stage of the research, and the analysis of the in-depth interview data conducted by the career nurses in the fieldwork stage, are compared and analyzed. Results: The tacit nursing knowledge was found in three dimensions as knowledge related to the person, the clinical situation work context, the self, the others, and the task. The tacit nursing knowledge was defined as personal nursing knowledge and artistic skills that show up as unconscious behavior patterns, learned informally, and internalizedthrough repeated clinical practice experience based on professional nursing knowledge. Conclusion: Tacit nursing knowledge has been widely used in clinical practice and has been shown to have a great impact, directly or indirectly, on clinical nursing. Therefore, individual and organizational efforts are needed for validation and clarification using the generation, sharing, collection, and peer review of sound implicit nursing knowledge to ensure that it is properly applied.

Purpose: The purpose of this study was to develop and examine the effects of combined exercise program for older adults with sarcopenia based on transtheoretical model (TTM). Methods: A non-equivalent control group with a pretest-posttest design was used. The subjects consisted of 43 older adults with sarcopenia in precontemplation stage, contemplation stage and preparation stage of TTM (experimental group: 22, control group: 21). The developed program consisted of 36 sessions for 12 weeks including combined exercise (60 minutes) and TTM based strategies for enhancing exercise behavior (10 minutes) per session. Data were collected before, immediately after the program between July 31 to October 27, 2017. The data were analyzed using independent t-test, Mann-Whitney U test with SPSS/WIN 18.0. Results: Compared with their counterparts in the control groups, older adults with sarcopenia in the experimental group showed a significantly greater improvement in process of exercise behavior change, pros and cons of decisional balance for exercise behavior, exercise self-efficacy, parameters of muscle, and the level of physical performance. Conclusion: The study findings indicate that this combined exercise program for older adults with sarcopenia based on TTM model was effective and can be recommended as a nursing intervention for older adults with sarcopenia.

Purpose: The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer. Methods: A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast. Results: Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group. Conclusion: These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.

Purpose: This study was aimed at identifying the types of perceptions of ethical issues among perioperative nurses. Methods: Q-methodology focusing on individual subjectivity was used with data collected in November 2016. Thirty-four Q-statements were selected and scored by the 35 participants on a 9-point scale with normal distribution. Participants were perioperative nurses working in advanced general hospitals and general hospitals. The data were analyzed using the PC-QUANL program. Results: A total of 35 perioperative nurses were classified into 4 factors based on the following viewpoints: self-centered (type 1), onlooking and avoiding (type 2), patient-centered (type 3), and problem-centered (type 4). The 4 factors accounted for 57.84% of the total variance. Individual contributions of factors 1, 2, 3, and 4 were 41.80%, 7.18%, 5.20%, and 3.66%, respectively. Conclusion: The major contribution of this study is the clarification of perioperative nurses' subjective perceptions of ethical issues. These findings can be used in formulating effective strategies for nursing educators, professional nurses, and nursing administrators to improve ethical decision-making abilities and to perform ethical nursing care by the appropriate management of ethical issues in everyday nursing practice.

Purpose: We aimed to examine the effects of an integrated physical activity (PA) program developed for physically inactive workers on the theoretical basis of the PRECEDE-PROCEED model. Methods: Participants were 268 workers in three departments of L manufacturing unit in South Korea. The three departments were randomly allocated into integration (n=86) (INT), education (n=94) (ED), and control (n=88) (CT) groups. The INT group received self-regulation, support, and policy-environmental strategies of a 12-week integrated PA program, the ED group received self-regulation strategies only, and the CT group did not receive any strategies. After 12 weeks, process evaluation was conducted by using the measures of self-regulation (autonomous vs. controlled regulation), autonomy support, and resource availability; impact evaluation by using PA measures of sitting time, PA expenditure, and compliance; and outcome evaluation by using the measures of cardiometabolic/musculoskeletal health and presenteeism. Results: Among process measures, autonomous regulation did not differ by group, but significantly decreased in the CT group (p=.006). Among impact measures, PA compliance significantly increased in the INT group compared to the CT group (p=.003). Among outcome measures, the changes in cardiometabolic/musculoskeletal health and presenteeism did not differ by group; however, systolic blood pressure (p=.012) and a presenteeism variable (p=.041) significantly decreased only in the INT group. Conclusion: The integrated PA program may have a significant effect on increases in PA compliance and significant tendencies toward improvements in a part of cardiometabolic health and presenteeism for physically inactive workers. Therefore, occupational health nurses may modify and use it as a workplace PA program.

Purpose: This study was conducted to examine the effects of a communication empowerment program based on situated learning theory for nursing students. Methods: A non-equivalent control group pretest-posttest design was used. The study participants were 61 nursing students (31 in the experimental group and 30 in the control group) from G city. Data were collected from November 3, 2015 to December 10, 2015. The experimental group received eight sessions of the program, which were scheduled twice a week, with each session lasting two hours. The data were analyzed using chi-square test, Fisher's exact test, and an independent t-test using SPSS/WIN 20.0. Results: There were significant increases in self-efficacy for communication (t=2.62, p=.011), emotional intelligence (t=2.66, p=.010), and interpersonal communication competence (t=2.87, p=.006) in the experimental group compared to the control group. Conclusion: Based on the findings, our study suggests a need to include content from communication curricula or clinical communication training programs for improving undergraduate nursing students' communication skills in practice settings.

Purpose: The purpose of this study was to investigate patient safety teaching competency of nursing faculty and the extent of teaching patient safety topics in the nursing curriculum. Methods: A national survey was conducted with full-time nursing faculty in 4-year nursing schools. Regional quota sampling method was used. An online survey was sent to 1,028 nursing faculty and 207 of them were completed. Among the 207, we analyzed data from 184 participants. The revised Health Professional Education in Patient Safety Survey was used. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation analysis, and multiple linear regression analyses. Results: The faculty's self-confidence was lower than their perceived importance of patient safety education. The mean score of teaching patient safety was $3.52{\pm}0.67$ out of 5, and the contents were mostly delivered through lectures. The extent of faculty's teaching varied depending on faculty's clinical career, teaching subjects, participation in practicum courses, and previous experience of patient safety education. The significant predictors of the extent of teaching patient safety were the faculty's self-confidence in teaching patient safety (${\beta}=.39$) during clinical practicum, their perceived importance of patient safety education during lectures (${\beta}=.23$), and the teaching subject (${\beta}=.15$). Conclusion: To enhance the competency of nursing faculty for effective patient safety education, a patient safety education program tailored to faculty characteristics should be developed and continuously provided for faculty. In addition, it is necessary to improve patient safety curriculum, strengthen clinical and school linkages, and utilize various education methods in patient safety education.

Purpose: The purpose of this study was to test a hypothesis explaining direct and indirect relationships among the factors affecting self-care behaviors of kidney transplant patients, based on self-determination theory. Methods: Data were collected from 222 outpatients with kidney transplantation. The endogenous and exogenous variables of the hypothetical model consisted of healthcare provider's autonomy support, duration after kidney transplantation, basic psychological need satisfaction, autonomous and controlled motivation, depression, and self-care behaviors. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0. Results: The hypothetical model demonstrated a good fit: RMSEA=.06, SRMR=.04, TLI=.94, CFI=.97. Statistically significant explanatory variables for the self-care behaviors of kidney transplant patients were duration after transplantation and basic psychological need satisfaction. Healthcare provider's autonomy support was indirectly significant, while autonomous motivation, controlled motivation and depression were not statistically significant for self-care behaviors. The variables accounted for 59.5% of the self-care behaviors of kidney transplant patients. Conclusion: It is necessary to develop an autonomy support program for healthcare providers to enhance the self-care behaviors of kidney transplant patients. Preventing the deterioration of self-care behaviors will be possible by conducting this program at one year and six years post-transplantation. In addition, the results suggest the need to developing personalized autonomy support programs for healthcare providers that can meet the basic psychological need satisfaction of kidney transplant patients.

Purpose: This study aimed to explore the effects of a community-based first and third Intergenerational Exchange Program (IGEP) on older adults' health-related quality of life (HRQoL), loneliness, depression, and walking speed, and on 4~5-year-old preschool children's learning-related social skills. Methods: This study employed a non-equivalent control group pre-post-test design. The experimental group included 42 older adults and 42 children who participated in the IGEP for 8 weeks, and the control group included 39 older adults. The experimental group participated in the IGEP once a week for 8 weeks. It comprised a traditional play program based on the intergroup contact theory. Results: Compared to the control group, there was a significant increase in scores on the HRQoL-Visual analogue scale (VAS) and a decrease in loneliness and depression in older adults in the experimental group (p<.05). Children who participated in the IGEP showed an improvement in their learning-related social skills (p<.001). Conclusion: These results confirm that the IGEP is an effective intervention to improve HRQoL-VAS, loneliness, and depression among older adults and learning-related social skills among preschool children in the community.