Purpose: The purpose of this study was to investigate the relationship between nurse managers' facilitative communication as perceived by nurses and nurses' self-esteem. Methods: The subjects were 256 staff nurses at B hospital of C University in Kyeonggi-do. The data were collected between December 1, 2009 and January 12, 2010. The collected data were analyzed using the SAS program through t-test, ANOVA, Scheff$\acute{e}$ test, Pearson's correlation coefficients. Results: Nurses' self-esteem was higher when nurse managers perceived them as facilitative communicators in empathic understanding and genuineness subgroup of facilitative communication (p<.05). There was a positive correlation between nurse managers' facilitative communication and nurses' self-esteem(r=.15, p=.015). Also there was a positive correlation among the nurse managers' facilitative communication subgroups, empathic understanding; genuineness; concreteness(r=0.18, p=.004; r=0.18, p=.003; r=0.19, p=.002) and nurses' self-esteem. Conclusion: Nurse managers are in need of facilitative communication. Therefore, job education and training for improving nurse managers' communication skills particularly related to empathic understanding, genuineness and concreteness are required.

Purpose: This study was to examine the effects of 3 domains of continuing education (CE) for healthcare managers. Methods: A group of 20 healthcare managers, attending 3 levels of CE, were the subjects. The data were collected by structured questionnaires before and after each education. The data were analyzed by Friedman test, Wilcoxon Signed Ranked Test, and Bonferroni correction. Results: After completing CE, there was significant improvement on the scores of knowledge, attitude, and skills. Conclusion: This study suggests that CE for healthcare managers is an effective strategy to promote the competency of healthcare managers, who take care of the chronically ill patients.

Purpose: The purpose of this study aimed to investigate job stress levels of occupational health managers and whether job stress levels were affected by various factors such as size and types of company and work-related characteristics of occupational health managers. Methods: The study was conducted from May to September 2011 in the chemicals manufacturing factories in Korea and total subjects were 59 occupational health managers. We measured job stress levels of occupational health managers using Korean occupational stress scale (KOSS) questionnaires and the information of company characteristics was obtained using a self-reported questionnaire. Results: The characteristics of company such as type, size and industries and job characteristics of occupational health managers were significant factors in job stress. Job demand, job control, job insecurity, organizational system and occupational environment scores were significantly associated with type, size and industries of company. In multiple regression analyses, we found that job demand was significantly associated with occupational position and type of company, and job insecurity was significantly associated with working hour. Also, we found that lack of reward was significantly associated with education level, speciality, duration of work and hour and type of company. Conclusion: These results indicate that job stress of occupational health managers is significantly associated with work-related characteristics and company's characteristics.

Purpose: This study aims at comparing nurses' knowledge, attitudes and nursing intention toward AIDS and Chronic Hepatitis B(CHB). Methods: The data were collected through self-reported questionnaires from 245 nurses between July and August, 2011. The nurses were recruited from 3 hospitals located in Seoul and Gyeonggi province. Pearson correlation coefficient and stepwise multiple regression were adopted to analyze the data. Results: Regarding AIDS, higher knowledge level was correlated with positive attitudes only(r=-.22, p<.001), which were correlated with favorable nursing intention(r=-.41, p<.001). Higher CHB knowledge level was correlated with both positive attitudes toward CHB(r=-.14, p= .030) and favorable nursing intention(r=.18, p= .004). Nursing intention toward AIDS was affected by attitudes(${\beta}$=.58, p<.001) and explained 16.6% of the variance. Both knowledge(${\beta}$=.35, p=.028) and attitudes(${\beta}$=-.49, p<.001) influenced nursing intention toward CHB and explained 19.1% of the variance. Conclusion: We need to promote nurses' positive attitudes toward AIDS to increase their nursing intention for people living with AIDS.

Purpose: This study examined the influencing factors for metabolic syndrome and the annual medical expenditures of metabolic syndrome among public officials. Methods: The National Health Insurance data in 2009 were collected for 364,932 public officials and the heath examination results and annual medical expenditures were analyzed using PASW 18.0 program. Results: The prevalence of metabolic syndrome is 17.6%, and it was higher in male officials than that of females in all age groups. In men, the influencing factors for metabolic syndrome were: age, family history of stroke, cardiovascular disease, hypertension, and diabetes mellitus, smoking, alcohol consumption, exercise, and obesity. However, in women, health-related behaviors such as smoking, alcohol consumption and exercise did not affect metabolic syndrome. People who had metabolic syndrome showed significantly higher medical expenditures than those without metabolic syndrome. The odds ratios of having the highest quartile in medical expenditures were 1.372 (95% CI 1.252~1.504, p<.001) in women with metabolic syndrome and 1.213 (95% CI: 1.184~1.243, p<.001) in men. Conclusion: The results implied that health-related behaviors were associated with metabolic syndrome, and resulted in higher medical expenditures. In order not only to decrease the risk of metabolic syndrome but also reduce medical expenditures, nurses should plan health promotion strategies to educate public officials about healthy life strategies.

Purpose: The purpose of this study was to identify the degree of satisfaction of part-time work of the mentally disabled and the factors affecting their job satisfaction. Methods: The subjects of this study were 106 part-time workers with mental illness in the city of B and Y. The data were collected from February 1, 2012 to May 30, 2012 using self-report questionnaires including the measurement scales of job satisfaction, family support, work volition and the degree of satisfaction with work environment. The data were analyzed using t-test, ANOVA, Pearson correlation coefficients, multiple regression with the SPSS/WIN 18.0 program. Results: The mean of score for job satisfaction was $61.8{\pm}13.84$. Job satisfaction was highly related to family support, work environment and work volition. The associated factor of the subjects job satisfaction were family support, work environment, work volition, and the period of employment. The combination of these four factors showed an explanation for job satisfaction at the rate of 80.2%. Conclusion: The results imply that job satisfaction needs to be increased for the job continuity of employees with mental illness. In addition to this, work environment, work volition and family support should first be improved for the increase of job satisfaction.

Purpose: The purpose of this study was to measure the fatigue of operating room nurses and examine factors contributing to their fatigue. Methods: The subjects of this study were 115 nurses who worked in operating rooms of three hospitals. Data were collected from September 15, 2009 to September 30, 2009. Fatigue and job stress were measured by using the Symptom's Fatigue Scale and the job stress measurement tools in operating room nurses. Results: The mean score of fatigue level was $3.10{\pm}0.61$. We analyzed fatigue according to characteristics of subjects and found that there were significant differences in marital status, number of children and sleeping hours in general characteristics. Career, daily participation hours in the surgery relating to job related characteristics. Significant positive correlations were found between job stress and fatigue(r=.233, p= .012). Three significant variables influencing fatigue of operation rooms nurses were job stress, daily participation hours in the surgery, and sleeping hours (Adj. $R^2$=0.284, F=4.773, p<.001). Conclusion: An integrative care program that takes job stress, daily participation hours in the surgery and sleeping hours into consideration is essential to reduce fatigue in operating room nurses.

Purpose: This study is the narrative investigating research to comprehend the climacteric symptoms, depression and health promoting behavior of the male workers and to develop the nursing intervention. Methods: The research was done from August to September 2011, and the subjects were the middle-aged males between 40 and 64 working in capital cities of Chungcheongnamdo. Among the 220 questionnaires, 189 were retrieved and used for the analysis. The data analysis was done by $x^2$-test, and t-test using the SPSS/WIN 19.0 program. Results: The 70.9% of the subjects showed male climacterium and among them, those in their 40s showed high rate to the change in the body and emotions whereas those in their 50s showed high rate to the sexual function-related symptoms. Also, having the climacteric symptoms showed significant changes in depression and health promoting behavior. Conclusion: To promote health of the middle-aged male workers and the nursing intervention for those who show depression, verifying whether these males have climacteric symptoms is necessary.

Purpose: This study is designed to identify major factors that affect morale among staff of long-term care insurance in National Health Insurance Corporation. Methods: In order to collect the data, a survey was conducted by using the structured questionnaire based on 161 staff members of long-term care insurance of 50 long-term care operation centers, which were randomly selected by the table of random numbers in the whole centers of National Health Insurance Corporation from September 1 to 30, 2011. As for the data analysis, SPSS 18.0 was used to conduct the descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, mutiple regression, and path analysis. Results: The average point of morale was 3.37, and had a negative correlation with the job stress, while it had a positive correlation with the social support, professional identity, and self-efficacy. Job stress, social support, and professional identity have a significant effect on morale among the independent variables. These variables have significant effects on morale, and also have a positive effect on self-efficacy. The findings show that self-efficacy mediates the process of morale. Conclusion: In this study, the factor which influences the morale was identified. It turned out that the morale could be improved by reinforcing the professional identity, managing the health status as well as rotating the working place. As such, it expects both the improvement of long-term care insurance services outcome and its quality through the morale management.

Purpose: The purpose of this study is to identify the influence of job stress and empowerment on nursing performance of clinical nurses working in small and medium hospital. Methods: The empirical data were collected from a self-administered survey using a structured questionnaire with 404 nurses working in 4 medium-sized hospitals (less than 300 beds), located in I-city. The data were analyzed using stepwise multiple regression with the SPSS/WIN 17.0 program. Results: There were significant differences in nursing performance depending on general characteristics (age, marital status, religion, shift work, education level, position, clinical experience, department, and monthly salary). Empowerment correlated with nursing performance. Factors influencing on nursing performance were empowerment, clinical experience, job stress, and marital status with $R^2$ value of 36.3%. The most influencing factor was empowerment (${\beta}$=.47), followed by clinical experience (${\beta}$=.24), job stress (${\beta}$=.20), and marriage (${\beta}$=.12). Conclusion: It is needed to implement specific empowerment strategy, control job stress, and reward experienced and married nurses working in medium-sized hospital for improving nursing task performance.

Purpose: The objective of this study was to investigate the relationship among self-efficacy, nursing organizational culture and the emotional labor in clinical nurses. Methods: The subjects of this study were the clinical nurses working at 3 general hospitals in D city. The self-reported questionnaires were administered to 293 clinical nurses and data were analyzed with SPSS/WIN 19.0. Results: The levels of self-efficacy, nursing organizational culture and emotional labor of the subjects were revealed moderate to high. Significant explanatory variables of the degrees of self-efficacy included age, career of work and job satisfaction and nursing organizational culture included position, nursing method and job satisfaction and emotional labor included education, number of patient and job satisfaction. Correlations between self-efficacy and emotional labor and nursing organizational culture and emotional labor were negative while self-efficacy and nursing organizational culture were positive. Conclusion: The findings suggested the intervention program in order to improve job performance and job satisfaction, develop effective nursing organizational culture and reduce role conflicts among clinical nurses.

Purpose: The study is to investigate the effect of communication and self-leadership on nursing performance. Methods: The subjects of study were composed of 358 nurses at a G city university hospital, tested with structured questionnaire from September 15 to 30, 2010. The collected data were analyzed with ANOVA, Pearson's correlation coefficients and multiple regression analysis. Results: The level of communication, self-leadership, and nursing performance was 3.37, 3.38 and 3.70 respectively in average. The variables showing significant difference in communication were as follows: age, marital status, religious status, education, monthly income, work department and work experience. Also, the variables in nursing performance were as follows: age, marital status, religious status, education, education, monthly income, position, working department and work experience. Communication, self-leadership and nursing performance of nurse showed significant positive correlation. Nursing performance was positively correlated with monthly income, when it exceeded 2.01 million won, career experience and self-leadership (p<.001). These variables explained 53.7% of the regression model. Conclusion: Since monthly income, work experience, communication and self-leadership have positive effect on nursing performance, an effective strategy is required to improve self-leadership and nurse's communication.

Purpose: The purpose of this study was to identify the effects of the social support and ego-resilience on the nursing performance among hospital nurses. Methods: The subjects of this study were 369 nurses in a senior general hospital. We used the self-reported questionnaire to assess the level of ego-resilience, social support and nursing performance of hospital nurses. The data were analyzed using descriptive statistics, frequency, t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: This study showed the positive relationship between the social support and ego-resilience on tne the nursing performance of hospital nurses. The higher group of the social support and ego-resilience showed the more performance of hospital nurses. And, the influencing factors on the performance are age, ego-resilience, social support, night working days a month in the order. Conclusion: Further studies will be needed to promote the performance of nurse in hospital and policies to be develop to elevate the social support and ego-resilience of nurses.

Purpose: The purpose of this study was identify the influences of occupational stress and burnout on turnover intention of caregivers in geriatric hospitals. Methods: The data were collected from 176 caregivers working at three geriatric hospitals located in Gyeonggi province. A self-reported questionnaires was used to assess the level of occupational stress, burnout and turnover intention. The data were analyzed with descriptive statistics, t-test, ANOVA and Pearson correlation coefficients and multiple regression by SPSS/WIN 18.0 program. Results: The turnover intention was positively correlated with occupational stress(r=.438, p<.01) and burnout(r=.418, p<.01). The influencing factors of turnover intention were occupational stress(${\beta}$=.290, p<.001), burnout(${\beta}$=.253, p=.001) and education level(${\beta}$=.182, p=.006). Conclusion: The results of this study indicate that it is necessary to develop stress management program so that caregivers in geriatric hospitals can reduce occupational stress and burnout.

Purpose: This descriptive study attempted to identify the influence of internal marketing perception, empowerment, and job satisfaction on customer orientation of clinical nurses. Methods: The subjects were 411 nurses with over one year working experience in a university hospital, located in I-city. The data were collected from April 20 to 30, 2012. using a self-report questionnaire. The data were analyzed using hierarchical multiple regression with the SPSS/WIN 17.0 program. Results: There were significant differences in customer orientation depending on general characteristics(age, marital status, education, position, clinical experience, and department). Internal marketing perception, empowerment, and job satisfaction correlated with customer orientation. As the results of hierarchical multiple regression analysis for impact factors on nurses' customer orientation show, factors are the outpatient department in working places(${\beta}$=.10), education and training in internal marketing perception(${\beta}$=.12) and empowerment(${\beta}$=.44), which accounted for 31.1% of customer orientation. Conclusion: Therefore, nurse managers should identify the needs to perceive nurses as internal customers, and the internal marketing strategy should be performed to empower nurses. Also, it is needed to place nurses with high customer orientation at the outpatient department.

Purpose: The purpose of this study was to describe the perception and practice of hospital infection control of nursing staff in long-term care hospitals by the level of supplementation of nurses. Methods: The participants were 212 nurses and nurse assistants in 13 long-term care hospitals in a metropolitan city and the data were gathered by self-reported questionnaires during August 2011 and analyzed by SPSS/WIN program. Results: The beds per a nurse were 15, and the proportion of nurses among nursing staff in long-term care hospitals was about 33%. In general, the level of infection control in practice was lower than that of perception. The highest perception and practice domain was 'Management of disinfection/contamination', and the lower level domains were 'Personal hygiene' and 'Hand washing' There were statistically significant differences in the hospital infection control of perception and practice depending on age, education, career in long-term care hospital, job position, the quantity of beds, nurse, and nurse assistant, beds per a nurse and proportion of nurses in hospitals. Conclusion: According to these results, the systematic and continual education on hospital infection control of the nursing staff in long-term hospitals should be carried out. In addition, the policy to add more nurses into long-term care hospitals must be implemented.

Purpose: This study was to examine the effects of noise block on anxiety and vital sign of gynecologic laparoscopic surgery. Methods: The data were collected from March to May 2011. Participants were sixty patients with gynecologic laparoscopic surgery, divided into 30 of experimental group and 30 of control group at C University hospital located in I city. The day before surgery, demographic data, trait-state anxiety and vital signs were measured at ward. After noise block, the data were measured using VAS anxiety and vital signs before anesthesia and in recovery room. And then state anxiety and vital signs were measured in ward after surgery. The data were analyzed by $x^2$-test, t-test, repeated measured ANOVA and Bonferroni comparison method using SPSS/WIN 19.0. Results: After conducting noise block program, the experimental group showed significant decrease in state anxiety and heart rate compared to those of the control group. But there were not significant differences in VAS anxiety, systolic pressure and diastolic pressure between two groups. Conclusion: This program can be regarded as an effective nursing intervention for the management of anxiety with gynecologic laparoscopic surgery.