• Journal of Korean Critical Care Nursing
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• v.13 no.2
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• pp.60-72
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• 2020

Purpose : The aims of this study was to provide basic data to enhance the professional self-concept of nurses in intensive care unit and identify the relationship between job stress, working bullying, self-efficacy and professional self-concept and identify the factors influencing professional self-concept in intensive care unit nurses. Methods : This study was conducted from June to August, 2018 at five general hospitals over 500 beds. Structured questionnaire were completed by 120 nurses who had agreed to understand and participate in the study. The collected data were analyzed using the SPSS win 24.0 program. Results : Factors affecting the professional self-concept of the subjects were self-efficacy, working bullying, unsatisfaction and satisfaction of nursing job satisfaction, age. The explanatory power of these variables on professional self-concept was 55.1%. Conclusion : The self-efficacy, working bullying, nursing job satisfaction, and age of the intensive care unit nurses were identified as the major factors influencing the professional self-concept. Therefore, it is necessary to develop and apply an educational program to improve self-efficacy and nursing job satisfaction and reduce working bullying, which are influencing factors of professional self-concept of intensive care unit nurse.

• Journal of Korean Critical Care Nursing
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• v.10 no.1
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• pp.1-12
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• 2017

Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.

• Journal of Korean Critical Care Nursing
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• v.13 no.2
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• pp.45-59
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• 2020

Purpose : The purpose of this study was to identify relation of the communication skills, humanistic knowledge and professional quality of life and to investigate the enhancing ways of professional quality of life in intensive-care unit nurses. Methods : The study design was a descriptive survey from 152 intensive-care unit nurses, from December 1 to 30, 2019. The data analysis was with ANOVA, Scheffé test, Pearson's correlation coefficient and Multiple regression using the SPSS/WIN 23.0 program. Results : The factors affecting compassion satisfaction were communication skills (β=0.42, p=.001), satisfaction for working (β=0.61, p=.001), marriage (β=0.23, p=.005), humanistic knowledge (β=0.47, p=.008) and these factors explained 35.6%. The factors affecting secondary traumatic stress were job stress (β=0.19, p=.011), number of patients per nurse (β=-0.36, p=.004) and these factors explained 9.4%. The factors affecting burnout were job stress (β=-0.25, p=.001), communication skills (β=-0.29, p=.001), working period(β=-0.18, p=.010), satisfaction for working (β=-0.31, p=.001), self care (β=-0.11, p=.033) and these factors explained 36%. Conclusion : Therefore, it is necessary to develop solution to improve professional quality of life in intensive-care unit nurses. It needs to develop programs to improve communication skills and humanistic knowledge in order to enhance compassion satisfaction and to improve communication skills to prevent burnout.

• Journal of Korean Academy of Nursing
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• v.44 no.5
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• pp.573-580
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• 2014

Purpose: This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation. Methods: Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model. Results: Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients). Conclusion: Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.

• Journal of Korean Academy of Nursing
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• v.37 no.4
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• pp.586-593
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• 2007

Purpose: The purpose of this study was to describe patients' anxiety in the ICU and to investigate related factors on the anxiety level. Methods: An exploratory cross-sectional survey design was used. Forty-eight patients participated in the study. Questionnaires were asked to patients who had been cared in the ICUs. Results: Related to the anxiety level, the mean of the total anxiety score was 5.47, and 60% of the patients had moderate or severe level of anxiety. Patients from the coronary care unit had a significantly higher level of anxiety than those from surgical intensive care unit or pulmonary surgery care unit. Moreover, significantly different levels of anxiety were found among patients who had been stayed for 2, 3, or 4 days. Conclusion: Patients who were from the coronary care unit or had been stayed longer (up to 4 days) in the ICU were significantly associated with higher anxiety level.

• Journal of Korean Critical Care Nursing
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• v.11 no.3
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• pp.1-11
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• 2018

Purpose : This study compares experiences of ethical dilemma between nurses working in intensive care units and those in general units under specific situations of treatment decisions and confidentiality. Method : This cross-sectional descriptive study utilizes the self-report survey method. The survey questionnaires were completed by 50 and 52 nurses working in intensive care units and general units, respectively. The instrument, which consisted of 16 items of ethical dilemma situations about treatment decision and confidentiality, was used. The mean scores for each item were compared between the two groups. Results : The study found no differences in terms of age, gender, education level, clinical experience in years, and being educated on healthcare ethics. For 9 out of 16 items, the mean scores of nurses in intensive care units were significantly higher than those of nurses in general units. Conclusions : Nurses in intensive care units experienced ethical dilemmas regarding treatment decisions and confidentiality more often than those in general units. This study emphasizes the need to establish strategies for improving the ethical competence of critical care nurses.

• Journal of Korean Critical Care Nursing
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• v.11 no.3
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• pp.95-107
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• 2018

Purpose : This study aimed to investigate the public's perception of reimbursement for the education and counseling services provided to advanced practice nurses in intensive care units. Method : This was a secondary data analysis study. The original data were collected utilizing an online panel. The sample comprised 615 individuals aged between 19 and 49 years nationwide. The study variables included the public's perception of reimbursement for education and counseling services, age, gender, education level, income, and health status. Variables such as past experience of being admitted to an intensive care unit by self, family, or relatives and the recognition of advanced practice nurses were also examined. Results : The mean of the perception score was 3.15 on a 4-point scale ranging from 1 (strongly disagree) to 4 (strongly agree). Among the participants, 89.2% answered "somewhat agreed" or "strongly agreed" to the question about the education and counseling services being covered by the National Health Insurance. Moreover, education level, past experience of being admitted to an intensive care unit by self, family, or relatives, and recognition of advanced practice nurses were significantly associated with the perception score. Conclusion : Efforts should be made to publicize the need for the education and counseling services that are provided to advanced practice nurses in intensive care units.

• Journal of Korean Academy of Nursing
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• v.36 no.5
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• pp.691-700
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• 2006

Purpose: This study was done to analyze variations in unit staffing and recommend policies to improve nursing staffing levels in intensive care units (ICUS). Method: A cross-sectional study design was used, employing survey data from the Health Insurance Review Agency conducted from June-July, 2003. Unitstaffing was measured using two indicators; bed-to-nurse (B/N) ratio (number of beds per nurse), and patient-to-nurse (P/N) ratio (number of average daily patients per nurse). Staffing levels were compared according to hospital and ICU characteristics. Result: A total of 414 institutions were operating 569 adult and 86 neonatal ICUs. Tertiary hospitals (n=42) had the lowest mean B/N (0.82) and P/N (0.76) ratios in adult ICUs, followed by general hospitals (B/N: 1.34, P/N: 0.97). Those ratios indicated that a nurse took care of 3 to 5 patients per shift. Neonatal ICUs had worse staffing and had greater variations in stafnng ratios than adult ICUs. About 17% of adult and 26% of neonatal ICUs were staffed only by adjunct nurses who had responsibility for a general ward as well as the ICU Conclusion: Stratification of nurse staffing levels and differentiation of ICU utilization fees based on staffing grades are recommended as a policy tool to improve nurse staffing in ICUs.

• Journal of Korean Clinical Nursing Research
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• v.23 no.1
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• pp.64-72
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• 2017

Purpose: This study aimed to explore the distributions of nurse staffing grades and to report changes in staffing grades in general wards and adult and neonatal intensive care units(ICUs) by hospital type and location. Methods: Data collected from the Health Insurance Review and Assessment Service were analyzed. Nurse staffing was categorized from grades 1 to 6 or 7 for general wards, 1 to 9 for adult ICUs, and 1 to 4 for neonatal ICUs based on the nurse-to-bed ratio. Results: The staffing grade for the general wards improved during 2008-2016 in 69.8% of the tertiary hospitals, 58.5% of the general hospitals, and 31.7% of the non-general hospitals. The adult ICUs at tertiary hospitals exhibited a greater improvement in staffing grades (48.8%) than did those of general hospitals (44.2%) during 2008-2015. Tertiary hospitals in non-capital regions showed a greater improvement than those in the capital region. The majority of neonatal ICUs (67.1%) had no change in the staffing grade during 2008-2015. Conclusion: Improvements in nurse staffing differed by hospital type and location. Government policies to improve nurse staffing in non-tertiary hospitals and those in non-capital regions are required to reduce variations in nurse staffing.

• Korean Journal of Adult Nursing
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• v.27 no.5
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• pp.548-558
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• 2015

Purpose: The purpose of this study was to explore the experience of workplace violence among intensive care unit nurses. Methods: The participants of this research were twelve registered nurses who work in the intensive care units (ICU) at the hospitals in Seoul and Gyunggido. Data were collected by individual in-depth interviews and analyzed using the phenomenological methodology by Colaizzi. Results: From significant statements, five theme clusters emerged as follow; 1) vulnerable young women to violence, 2) my own reflection was bruised and exhausted, 3) a hopeless everyday, 4) seeking a solution in relation, 5) establishing one's status as a professional nurse. Conclusion: This study provides a profound understanding on the experiences of workplace violence among ICU nurses. The hospitals are suggested to provide a safe environment by developing programs and policies to prevent and cope with hospital workplace violence for ICU nurses.