• Proceedings of the KSR Conference
• /
• 2006.05b
• /
• pp.1179-1187
• /
• 2006

• Journal of Korean Academy of Nursing Administration
• /
• v.19 no.5
• /
• pp.668-678
• /
• 2013

Purpose: This study was done to develop a realistic clinical case and investigate nurses' decision-making about nurses' ethical dilemmas with physicians in the fields of nursing practice. Methods: Case development and a hypothetical case study were used. Participants were 52 nurses. Data were collected in 2012 and 2013 using an open-ended questionnaire and interviews and analyzed using content analysis and descriptive statistics. Results: Various dilemma situations between nurses and physicians, such as violence, deathbed, medication prescription, and physicians' incapacity unfairness, were suggested. A clinical dilemma case about medication prescription was developed based on nurses' experiences. Nurses' responses to the developed case situation and responses were classified into five types. Various reasons were given for making the decisions and about 56% of the nurses decided to notify their supervisor without deleting nursing records. Conclusion: In this study, a realistic clinical dilemma case was developed, and nurses' ethical decision making was identified. These findings can be used in developing effective strategies for nurses to solve ethical dilemmas and to improve ethical decision-making abilities.

• Journal of Korean Critical Care Nursing
• /
• v.13 no.1
• /
• pp.27-43
• /
• 2020

Purpose : This integrative review aimed to synthesize studies on intensive care unit (ICU) nurses' attitude, perceptions, and experiences toward end-of-life care decision-making. Methods : Using Whittermore and Knafl (2005)'s methods, we identified and synthesized research articles published in domestic journals between the years 2003 and 2019 and evaluated the quality of selected articles using the Mixed Methods Appraisal Tool. Results : In the 13 studies reviewed, 12 were published prior to enactment of the "The Act for Hospice and Palliative Care and Decision-Making about Life-Sustaining Treatment (2018)." All nine quantitative studies identified were based on cross-sectional descriptive survey. In four qualitative studies, content analysis (n=2) and phenomenology (n=2) were used. Overall, ICU nurses were well-aware of the necessity of communicating and limiting life-sustaining treatments. Many ICU nurses had positive attitude towards limiting life-sustaining treatments to promote patients' comfort and dignity. Although nurses were willing to take active roles, they also reported having experienced high stress in the process of decision-making and implementation. Conclusions : It is important to prepare ICU nurses with proper knowledge and attitude regarding the topic area. It is also equally important to develop systems to support nurses' emotional stress and moral distress during communication, decision-making, and implementation.

• Korean Journal of Adult Nursing
• /
• v.22 no.5
• /
• pp.488-498
• /
• 2010

Purpose: The purpose of this study was to explore clinical nurse's reported conflict experience toward end-of-life medical decision making. Methods: Data were collected by in-depth interviews with eight nurses from three different wards of university hospital in D city of Korea. Conventional qualitative analysis was used to analyze the data. Results: Results were three major themes and twelve categories from the analysis. The three major themes were prioritization of treatment, non-disclosure of diagnosis, and hierarchical and power relations. Conclusion: The results of this study suggest that shared decision making in end of life among patient, family members, physician, and nurse may contribute to improve end-of-life care performance as well as dignified dying of patient in end of life.

• Journal of the Korean Society for Aviation and Aeronautics
• /
• v.28 no.3
• /
• pp.52-60
• /
• 2020

The purpose of this study was to analyze the effects of Student Majoring in Flight Operation's propensity, safety behavior and aeronautical decision-making. According to the analysis results, First, parents' criticism of perfectionism factor is found to have a negative effect on safety behavior. Second, student pilot's proactive personality has a positive impact on both safety participation behavior and safety compliance behavior. Third, both safety participation behavior and safety compliance behavior are found to have a significant effect on situation awareness, solution generation and solution implementation of decision making stages. Therefore, this study is intended to provide useful basic data that can be applied to studies such as appropriate psychological counseling, optimal training directions and teaching methods in order to cultivate excellent human resources through safe flight training.

• Journal of the Korean Institute of Educational Facilities
• /
• v.8 no.2
• /
• pp.5-12
• /
• 2001

As the exiting school facilities become old and unfit for new curriculum, the systematical remodelling process based on its educational and physical functions is required. due to the inadequate maintenance and repairing practices, unnecessary costs are expended. Therefore, this study aims to establish a remodelling decision-making model for improving the educational environment of the existing school facilities. According to the budget system, it proposes the concept of remodelling that includes the activities of extension, reconstruction, repair and improvement. This study classifies the performance evaluation for school facilities as that of safety, durability and educational function, and articulates the assessment standards, methods and elements. In the end, it suggests a rational model for remodelling decision-making that can provide efficient and comprehensive remodelling process, economic and sustainable school development.

• Journal of the Korean Society of Safety
• /
• v.18 no.2
• /
• pp.86-91
• /
• 2003

The utility and the nuclear research institutes in korea have conducted research for improving inefficient requirements in technical specifications using the results of probability risk assessments and informations with risk. However, the guidance for reviewing the improved technical specifications has not been developed. The objective of this study is to develop a decision-making framework for investigating and reviewing the technical documents associated with the to changes of technical specification This study has developed a decision-making framework for reviewing the improvements of the RI-TS(Risk-Informed Technical Specifications). This work may contribute to enhancing both the safety and the efficiency of nuclear power plants by changing Technical Specifications proposed by the utility.

• Korean Journal of Biological Psychiatry
• /
• v.24 no.3
• /
• pp.155-161
• /
• 2017

Objectives Decision-making in patients with schizophrenia has been known to be inefficient in both cognitive and affective aspects. The purpose of this study was to investigate the influence of anhedonia and self-esteem on the decision-making process in schizophrenia. Methods Twenty patients with schizophrenia and 21 healthy controls performed the 'apparel purchase decision-making task', during which they were asked to respond to the preference, fitness, and price suitability, before making the final purchase decision. Generalized estimating equation and correlation analysis were conducted to explore for the difference of decision making patterns and influential factors between the two groups. Results The patients showed lower odds ratio (OR) of the fitness on the apparel purchase decision than the controls [OR 0.190 ; 95% confidence interval (CI) 0.047-0.762, p = 0.019). In the patient group, there was no correlation between the number of purchased trials and the severity of anhedonia, but the number of purchased trials was negatively correlated with the Rosenberg Self-Esteem Scale score at a trend level (R = -0.436, p = 0.055). Conclusions Patients with schizophrenia considered the fitness of clothes less than healthy controls on apparel purchasing decisions. Schizophrenia patients with lower self-esteem were intended to buy more clothes.

• Journal of Korean Academy of Nursing
• /
• v.46 no.6
• /
• pp.894-904
• /
• 2016

Purpose: The purpose of this study was to explore decision making experiences of Korean women with breast cancer who underwent breast reconstruction with/after a mastectomy. Methods: Data were collected during 2015-2016 through individual in-depth interviews with 10 women who had both mastectomy and breast reconstruction, and analyzed using phenomenological method to identify essential themes on experiences of making a decision to have breast reconstruction. Results: Five theme clusters emerged. First, "expected loss of sexuality and discovery of autonomy" illustrates various aims of breast reconstruction. Second, "holding tight to the reputation of doctors amid uncertainty" specifies the importance of a trust relationship with their physician despite a lack of information. Third, "family members to step back in position" describes support or opposition from family members in the decision making process. Fourth, "bewilderment due to the paradox of appearance-oriented views" illustrates paradoxical environment, resulting in confusion and anger. Lastly, "decision to be made quickly with limited time to oneself" describes the crazy whirling process of decision making. Conclusion: Findings highlight aims, worries, barriers, and facilitators that women with breast cancer experience when making a decision about breast reconstruction. Deciding on breast reconstruction was not only a burden for women in a state of shock with a diagnosis of breast cancer, but also an opportunity to decide to integrate their body, femininity, and self which might be wounded from a mastectomy. These findings will help oncology professionals provide effective educational counselling before the operation to promote higher satisfaction after the operation.

• Journal of Korean Neurosurgical Society
• /
• v.55 no.4
• /
• pp.195-199
• /
• 2014

Objective : Age is a strong predictor of mortality in traumatic brain injuries. A surgical decision making is difficult especially for the elderly patients with severe head injuries. We studied so-called 'withholding a life-saving surgery' over a two year period at a university hospital. Methods : We collected data from 227 elderly patients. In 35 patients with Glasgow Coma Score 3--8, 28 patients had lesions that required operation. A life-saving surgery was withheld in 15 patients either by doctors and/or the families (Group A). Surgery was performed in 13 patients (Group B). We retrospectively examined the medical records and radiological findings of these 28 patients. We calculated the predicted probability of 6 month mortality (IPM) and 6 month unfavorable outcome (IPU) to compare the result of decision by the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) calculator. Results : Types of the mass lesion did not affect on the surgical decision making. None of the motor score 1 underwent surgery, while all patients with reactive pupils underwent surgery. Causes of injury or episodes of hypoxia/hypotension might have affected on the decision making, however, their role was not distinct. All patients in the group A died. In the group B, the outcome was unfavorable in 11 of 13 patients. Patients with high IPM or IPU were more common in group A than group B. Wrong decisions brought futile cares. Conclusion : Ethical training and developing decision-making skills are necessary including shared decision making.