Purpose : Based on Quint's theory and the relevant literature, this study constructed a structural equation model for explaining and predicting end-of-life care performance in clinical nurses. Methods : A self-administered questionnaire was used to collect data from 265 nurses between September 1 and September 30, 2016. The data were analyzed using SPSS ver. 21 and AMOS ver. 21. Results : The goodness of fit of the modified model was found to be relatively satisfactory (χ2=114.82, Nomed χ2(χ2/df)=2.44, SRMR=.06, GFI=.94, AGFI=.89, CFI=.95, TLI=.91, RMSEA=.07). End-of-life care performance was affected by the attitudes toward nursing care of the dying, working unit, and death anxiety. The attitudes toward such care had the highest effect on end-of-life care performance. Conclusion : The results suggest that end-of-life care performance is directly and indirectly affected by attitudes toward nursing care of the dying, participation in end-of-life care education, working unit, death perception, and death anxiety. To improve clinical nurses' end-of-life care performance, effective programs to promote death anxiety and attitudes toward nursing care of the dying need to be developed. In addition, hospital nursing organizations should attempt to produce concrete measures for death anxiety and terminal care attitudes in clinical nurses.

Purpose : This study examined the effects of work environment and organizational culture on tertiary hospital nurses' turnover intention. Methods : A cross-sectional design was used, with a convenience sample of 371 hospital nurses from 16 units of three tertiary hospitals in South Korea. Data were collected through a self-report survey conducted during September and October 2016. Data were analyzed using the chi-square test, Fisher's exact test, independent t-test, and binary logistic regression analysis. Results : A total of 43.7% of the participants were identified as having turnover intention within 1 year. Factors related to turnover intention among hospital nurses were age, marital status, and total clinical career. Furthermore, a relationship-oriented organizational culture showed a negative association with turnover intention. Conclusion : These findings suggest it is important to provide appropriate motivational programs and incentives for nurses according to their clinical career to decrease turnover intention. Moreover, establishing a relationship-oriented organizational culture will also help to reduce the turnover intention of tertiary hospital nurses.

Purpose : This study investigated the occurrence of postoperative ileus and its related factors in patients after spinal surgery. Methods : After a retrospective review of data from patients who underwent spinal surgery at a single hospital located in Busan from 2012 through 2016, a total of 253 patients were included. The subjects were divided into non-ileus and ileus groups. We compared patient-, surgery-, and postoperative hematological-related factors. Results : A total of 41 (16.2%) out of 253 patients experienced postoperative ileus. Data analysis revealed significant differences between the two groups in mean age (68.44 vs 60.50 years), occupation (9.8 vs 28.8%), cardiovascular comorbidity (63.4 vs 37.7%), approach of surgery (supine/prone: 29.3/70.7 vs 12.7/87.3%), duration of anesthesia (5.86 vs 4.43 hours), narcotic use (75.6 vs 56.6%), postoperative serum hemoglobin level (3 days: 10.81 vs 11.41 g/dL), postoperative serum protein (immediately/3 days: 5.30/5.43 vs 5.62/5.68 g/dL), postoperative albumin level (3 days: 3.17 vs 3.40 g/dL), postoperative C-reactive protein level (3 days: 11.44 vs 8.36 mg/dL), postoperative bed stabilization period (3.32 vs 2.50 days), and onset of bowel movement (2.59 vs 1.94 days). In multivariate logistic regression, age and time of anesthesia were independent risk factors of postoperative ileus. Conclusion : To detect ileus after spinal surgery early, nurse education is needed with intensive screening on advanced age, surgery-related factors, and postoperative hematological indices.

Purpose : This study identified the factors affecting the clinical competence of emergency unit nurses caring for foreign patients. Methods : This study utilized a descriptive correlation design. Participants were 112 emergency unit nurses working in different hospitals designated as the government's emergency medical centers and agencies in 2018. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple linear regression analysis. Results : Subjects' clinical competence showed positive relationships with cultural competency (r=.45, p<.001) and intercultural communication (r=.53, p<.001). Factors that affect the clinical competence of subjects showed intercultural communication (β=0.38, p=.001). Conclusion : It is necessary to develop programs to improve intercultural communication, factors that influence clinical competence of emergency unit nurses, and apply them to practical fields.

Purpose : This study examined the effects of an integrated management program on physical function, cognitive function, and depression in patients with subacute stroke. Methods : A nonequivalent control group design was adopted. The participants were assigned to either the experimental group (n=20) or control group (n=23). The experimental group received an 8-week integrated management program and standard rehabilitation service (i.e., physical therapy and occupational therapy), while the control group received the standard rehabilitation service only. Physical function was measured as gait speed and balance ability using the Berg Balance Scale (BBS). Cognitive function was measured with neuro-behavioral cognitive status examination (NCSE), and depression was measured using the Beck Depression Inventory-II (BDI-II). Repeated measure ANOVA was used to determine changes in physical function, cognitive function, and depression over 8-weeks. Results : The interaction between group and time was significant, indicating that the experimental group showed improvement in gait speed, balance ability, cognitive function (linguistic ability, linguistic memory, reasoning), and a decrease in depression compared to the control group. Conclusion : These results indicate that the integrated management program developed herein was beneficial in restoring physical function, cognitive function, and depression in subacute stroke patients.

Purpose : The purposes of this study were to examine the relationships between knowledge, awareness, safe environment, and performance of standard precautions and identify factors associated with performance of standard precautions. Methods : This study was a descriptive research. A structured questionnaire on knowledge, awareness, safe environment, and performance of standard precautions was used for the survey with a convenience sample of 150 caregivers. Data were collected from July to August 2019 and were analyzed using descriptive statistics, independent t-test, one way ANOVA, Pearson's correlation coefficient, and multiple regression with SPSS/WIN 25.0 program. Results : The mean scores on knowledge, awareness, safe environment, and performance of standard precautions were 15.77±3.34, 7.35±1.91, 4.55±2.05, and 55.20±10.11 respectively. Performance of standard precautions showed a statistically significant positive correlation with knowledge (r=.54, p<.001), awareness (r=.54, p<.001), and safe environment (r=.50, p<.001). Awareness (β=.24, p=.025) and safe environment (β=.35, p<.001) were significantly associated with factors of performance of standard precautions. Also, education level (high school and above college), affiliated institution (private association), and importance of infection control education (moderate) were significantly associated with factors of performance of standard precautions. Conclusion : The results of the study indicate that factors influencing the performance of standard precautions of caregivers were awareness and safe environment. Therefore, to improve implementation of the standard precautions among caregivers, a safe environment within the hospital must be supported, and appropriate infection management education needs to be provided to caregivers to improve their knowledge and awareness of the standard precautions.