A considerable change of the Korean nursing system has been made during the last decade not only in its philosophy but also in its function and structure to meet political and scientific need of the modern society. The main purpose of this study is to develope the new concept of comprehensive nursing care, both its Philosophy and ethics, as the basic of modern clinical nursing theory and practice. Comprehensive nursing care is the concept of human centered nursing care, and it helps a man to meet the basic physical, psychological, environmental, socioeconomic and teaching needs. It also helps him to help himself to meet these needs. This concept starts from the individualized nursing care and its ultimate goal is to improve a man to have a better position in his own community so that he may able to have a meaningful life. To accomplish this goal, an individualized nursing care plan as a nursing diagnosis and problem solving method should be set up for different patients with similar diagnosis to meet their needs, because each patient has a different social background. from this viewpoint, nursing is a science as well as abstruse humanity. The performance of comprehensive nursing care is a goal and issue of modern clinical nursing care. If nursing is a science and a profession for man, it should have ethics which recognize the dignity of man and offers infinite service voluntarily, and should be able to show leadership in carrying out the nursing responsibility. This leadership finds a person's potential and encourages him to utilize it. Such concepts should develop into a nursing ideology and this ideology should become a priority in comprehensive nursing care. The following statements are the conclusion of this study. 1) Modern nursing has been developed from disease centered nursing care to comprehensive nursing care based on humanity. The primary principle of nursing was to assist in the treatment of disease, but it has been changed to the professional nursing system independently. 2) The concept of nursing is one of continuous or endless scope of dispersion. It proves that nursing is grasping the professional responsibility to be able to coordinate scientific principles Patient health problems are according to scientific principles rather than adhering to nursing technical discipline as a daily work. 3) In chapter I and Ⅱ, the philosophy and ideology of nursing have been discussed and the flow of concept of clinical nursing and the rate of progress which emerges from naturalizing performance of the concept of comprehensive nursing in clinical nursing studied. The discussion developed the theory that a nurse should be to embody nursing ideas and objectives by establishing definite conviction of professions and study. 4) In chapter lil, nursing planning based on nursing diagnosis as a method to attain ideal nursing care for humanity with a definite idea of establishing philosophy of nursing was presented. 5) From the result of survey on patient needs about treatment and nursing, it was observed that all patient had emotional stress from unknown factors. Therefore it was concluded that nurses should not only educate the patient but also give them the opportunity to communicate freely their needs and anxieties. Furthermore complaints and doubts of the patient should be carefully noted and must be considered to meet these needs. 6) Patient teaching is the most important part of comprehensive nursing care. In chapter, Ⅲ, the important of patient teaching was emphasized by demonstrating the effect of patient teaching for diabetic patient. 7) In Chapter Ⅳ, from the result of the study on nurses attitudes to comprehensive nursing care, it was pointed that the evolution of nursing education and the establishment of a complete concept and value of comprehensive nursing was necessary.
Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.
Lee, Mi Kyoung;Jeong, Jeong Hee;Lee, Eun A;Oh, Kyung Hwa
Journal of Home Health Care Nursing
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v.27
no.3
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pp.259-270
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2020
Purpose: This study aimed to identify nursing competencies of outpatient nurses, to develop a tool to assess the same, and to verify the validity and reliability of the tool. Method: Preliminary items of the scale were developed based on a literature review and nurses' interviews. The tool's content validity was verified by an expert panel and by conducting a pilot study. Subsequently, to verify the validity and reliability of the scale, data were collected from 233 outpatient nurses from 7 certified tertiary hospitals. Data were analyzed using exploratory factor analysis, independent t-test, and internal consistency and correlation analysis. Result: The factor analysis revealed the following 9 factors for the 48 items of the scale: organizational management, customer orientation, personality and ethics, problem solving, nursing practice, interpersonal relationships, communication, crisis management, and professionalism. The Cronbach's α coefficient of the final instrument was .97. Conclusion: The tool developed in this study exhibited adequate validity and reliability. It was effective in reflecting the changing roles of outpatient nurses. Therefore, in future, this tool is expected to help improve outpatient nurses' competencies and nursing quality.
Purpose: The traditional ethical study only suggests a blurred insight on the research using medical big data, especially in this rapid-changing and demanding environment which is called "4th Industry Revolution." Current institutional/ethical issues in big data research need to approach with the thoughtful insight of past ethical study reflecting the understanding of present conditions of this study. This study aims to examine the ethical issues that are emerging in recent health care big data research. So, this study aims to survey the public perceptions on of health care big data as part of the process of public discourse and the acceptance of the utility and provision of big data research as a subject of health care information. In addition, the emerging ethical challenges and how to comply with ethical principles in accordance with principles of the Belmont report will be discussed. Methods: Survey was conducted from June 3th August to 6th September 2020. The online survey was conducted through voluntary participation through Internet users. A total of 319 people who completed the survey (±5.49%P [95% confidence level] were analyzed. Results: In the area of the public's perspective, the survey showed that the medical information is useful for new medical development, but it is also necessary to obtain consents from subjects in order to use that medical information for various research purposes. In addition, many people were more concerned about the possibility of re-identifying personal information in medical big data. Therefore, they mentioned the necessity of transparency and privacy protection in the use of medical information. Conclusion: Big data on medical care is a core resource for the development of medicine directly related to human life, and it is necessary to open up medical data in order to realize the public good. But the ethical principles should not be overlooked. The right to self-determination must be guaranteed by means of clear, diverse consent or withdrawal of subjects, and processed in a lawful, fair and transparent manner in the processing of personal information. In addition, scientific and ethical validity of medical big data research is indispensable. Such ethical healthcare data is the only key that will lead to innovation in the future.
The Journal of the Convergence on Culture Technology
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v.4
no.1
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pp.153-163
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2018
The purpose of this study was to investigate nurses' ethical dilemma and professionalism in long-term care hospitals. Participants in this study were 210 nurses working in 14 long-term care hospitals. Data analysis was done using SPSS / WIN 24.0 program. As a result of this study, the ethical dilemma of the nurse was moderate. The highest sub-area was 'nurse-patient relationship' and 'respect of life and human rights' was the lowest sub-area. The professionalism of the subjects was moderate, and the score of 'sense of mission' area was the lowest. Nursing ethics guidelines should be developed that reflect the ethical dilemma of nurses in long-term care hospitals, and will provide the right values for the ethical dilemma that nurses face in their workplace. When planning the nurses' professionalism education, it is necessary to have a strategy to enhance the sense of mission by emphasizing beliefs and values about nursing care.
This study investigated the relationship among home care nurses' perception of ethical values and conflicts and job satisfaction. The subjects of the study were 257 home care nurses working at 101 institutions involved in home care practice, the data were collected between December 28, 2004 February 14, 2005. The instruments were perception of ethical values, ethical conflicts, and job satisfaction and it was revised by the author. The reliability of Cronbach's a was .74, .93, .85, respectively. SAS 8.0 program was used to analyze the data, and frequency, percentage, unpaired t-test, ANOVA, $Scheff\`{e}$ test, and Pearson's Correlation Coefficient were calculated for data analysis. Followings are the results of the study: The scores of home care nurses' perception of ethical values were average 3.8points (5points scale). There was no significant difference between the groups according to general characteristics such as age (P=.001), religions (P=.001), ethical standard (P=.018), and current job satisfaction (P=.000). The scores of home care nurses' ethical conflicts were average 2.9points (5points scale). There was significant difference according to pay (P=.008) and employment status (P=.001) of general characteristics; conflicts was showed to go up with higher pay and temporary employment status. The scores of home care nurses' job satisfaction were average 3.3points (5points scale). There was significant difference among the groups according to age (P=.023), pay (P=.001), job career of home care (P=.030), and current job satisfaction (P=.000) of the general characteristics. There was significant positive correlation between subject's perception of ethical values and ethical conflicts (P=.004) and perception of ethical values and job satisfaction (P=.005). However, ethical conflicts and job satisfaction (P=.772) showed negative correlation, but it was not significant. With the results, home care nurses showed firm perception of ethical values and relatively higher job satisfaction. However, they showed ethical conflicts regarding the lack of administrative support and dignity of human life. In conclusion, It requires some alternative measures to solve the ethical conflicts and to enhance job satisfaction of home care nurses through the support in policy, continuous ethics education, rewarding system, and introducing laws to protect individual home care nurses.
This study examines the effects of community child care center workers' perception of professionalism on their job satisfaction. This study conducts a survey of 221 community child care workers in Seoul, Gyeonggi, and Gangwon provinces in Korea. Results show that the level of perception of professionalism and job satisfaction are over intermediate. The perception on professional values and ethics are slightly higher than the perception on professional knowledge and skills. The workers are more satisfied with intrinsic job factors such as achievement and responsibility than extrinsic job factors such as compensation and working conditions. Regression analysis reveals that the workers' perception of professionalism is positively associated with both intrinsic and extrinsic job satisfaction. Based on the findings, this study provides suggestions to enhance the workers' professionalism and job satisfaction, which will contribute the quality of services in community child care centers.
There are two aspects of clinical practice guidelines that act as non-legal control before medical practice and as legal control standards after medical practice. The essential purpose of clinical practice guidelines is the former, but the latter action cannot be excluded. The clinical practice guidelines are a means of linking law and medical care. The negative perception of clinical practice guidelines that medical professionals' autonomy can be violated by the enactment of clinical practice guidelines is an excessive negative evaluation of clinical practice guidelines. Rather, judicial judgment based on clinical practice guidelines plays a role in respecting the autonomy of medical professionals. In other words, the clinical practice guidelines suppress legal regulations on medical care as much as possible and are based on doctors' professional ethics and self-discipline, and patient awareness and cooperation. In order to establish an ideal relationship of cooperation between doctors and patients, 'medical ethics' must be incorporated as a legal means. Clinical practice guidelines are the most appropriate means for incorporating such medical ethics into legal procedures. The lawyer solves the case with a legal syllogism that establishes a norm and applies facts to it to conclude. For the resolution of medical disputes, Clinical practice guidelines are used to establish norms that doctors should perform for specific diseases, and conclusions are drawn by applying the established norms to specific medical practices. When it is not easy to apply the established norms to specific medical practices, medical judgments by experts, such as emotions, expert testimony, and explanations by expert members, are used. As such, the Law respects the autonomy of medical care even in the establishment of norms and the application of norms. In particular, Clinical practice guidelines prepared independently by the medical community are referred to in establishing norms, which are the prerequisites for legal syllogism. This shows that doctors participate in the formation of precedents and contribute to the formation of norms. The use of clinical practice guidelines in trials is respect and consideration for the autonomy of medical care. Although there may be an aspect in which the autonomy of individual doctors is limited by clinical practice guidelines, it should be considered that the autonomy of doctors as a group is respected. In this way, the clinical practice guidelines play a role in protecting the autonomy of the "medical" group from the logic of the "law."
This study aims to carry out empirical analysis on the effect of care workers' awareness of professionalism on the service quality, and to provide policy level and action oriented recommendations for the improvement of care workers' awareness of professionalism and service quality based on the key findings. The study targeted care workers who work at the senior citizen care take centers at the S and Y cities in the Jeollanam-do Province, carrying out survey research. A total of 190 questionnaires among the collected questionnaires were used for the analysis. Key research methods included factor analysis, reliability analysis, descriptive statistic analysis, correlation analysis, t/F-verification and regression analysis. The following are the results. First, conviction of the care workers' awareness of professionalism towards public service and the empathy of service quality were manifested at the highest level. Second, there was a difference in the service quality according to the care workers' experience. Third, care workers' awareness of professionalism affected service quality while service quality increased as the awareness of professionalism increased. The research results were utilized to recommend the need to develop and to disseminate structured education program for the care workers, to set the guideline for the care workers' employment form and salary, and to develop structure for the care workers' ethics.
The Journal of the Convergence on Culture Technology
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v.7
no.4
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pp.491-501
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2021
Purpose: This study is designed to provide care workers with basic data on the development of job training programs for enhancing professionalism of senior care services by identifying and analyzing job recognition and education requirements according to the type of work place. Methods: Data were collected from April to July 2019 from 177 care workers working at the Elderly Care Facilities, Elderly Housing Welfare Facilities and Rehabilitation Facilities in the B Metropolitan City. It was analyzed using the SPSS Win 21.0 Statistical Program. Results: The results of job recognition of care worker according to the type of work place shows as follows. As for health care welfare facilities for senior citizens and residential welfare facilities for the elderly was the highest level for physical change and mobile care protection belonging to basic care protection technologies. For the rehabilitation and welfare facility, human rights and prevention of abuse among senior citizens which is belonging to occupational ethics and attitudes of care workers showed the highest. Conclusion: It is required for differentiated job training to enhance capacity for care workers according to the type of work place, and it is needed to developed systematic and specific customized hands-on training to perform, not for simple knowledge.
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