• Journal of Korean Academy of Nursing
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• v.46 no.1
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• pp.59-68
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• 2016

Purpose: Increase in suicide rate for senior citizens which has become widespread in our society today. It is not a normal social phenomenon and is beyond the danger level. The contents of this study include Korean senior citizens' suicide related risk factors and warning signs, and the development of a simple Geriatric Suicide Risk Scale. Methods: This study is Methodological Research to verify reliability and validity of the Geriatric Suicide Risk Scale according to the tool development process suggested by Devellis (2012). Results: For predictive validity assessment, high suicide screening accuracy was showed with an Area under the ROC curve (AUC) of .93. For the optimal cutoff point of 11, sensitivity was 93.9%, and specificity, 75.7% which are excellence levels. Cross validity for assessment of generalization possibility showed the Area under the ROC curve (AUC) as .82 and in case of a cutoff point of 11, sensitivity was 73.7%, and specificity, 65.9%. Conclusion: When it comes to practical nursing, it is significant that the Korean Geriatric Suicide Risk Scale has high reliability and validity through adequate tool development and the tool assessment step to select degree of suicide risk of senior citizens. Also, it can be easily applied and does not take a long time to administer. Further, it can be used by health care personnel or the general public.

• Journal of Korean Academy of Nursing
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• v.50 no.1
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• pp.132-146
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• 2020

Purpose: The purpose of this study was to develop a new version of Spirituality Assessment Scale (N-SAS) and verify its reliability and validity. Methods: The total of 59 preliminary items for the N-SAS were selected through a literature review, two rounds of experts' content validation, cognitive interviews, and pre-tests. Verification of its reliability and validity was divided into two phases. In Phase I, questionnaires were collected from 219 adults. Reliability was tested using Cronbach's alpha, validity with item analysis, and exploratory factor analysis. In Phase II, questionnaires developed based on the results of Phase I were collected from 225 adults. Reliability was tested using Cronbach's alpha, validity with confirmatory factor analysis, and criterion validity. Results: The final version of the N-SAS comprised two dimensions (vertical and horizontal), four domains (relationship with God; meaning of life and self-integration; self-transcendence; and relationship with others, neighborhoods, and nature), and 44 items were identified. Total Cronbach's α was .97; those of each subscale ranged from .79 to .98. N-SAS scores were positively correlated with the scores of Howden's Spiritual Assessment Scale (r=.81, p<.001). Conclusion: Findings suggest that the N-SAS can be used to measure spirituality in adults. The use of N-SAS is expected to facilitate perceiving patient's spiritual needs and providing spiritual care.

• Journal of Korean Academy of Nursing
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• v.50 no.3
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• pp.333-348
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• 2020

Purpose: The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. Methods: The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. Results: Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. Conclusion: Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.

• Journal of Korean Academy of Nursing
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• v.47 no.3
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• pp.420-430
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• 2017

Purpose: The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls. Methods: Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis. Results: Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls. Conclusion: The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.

• The Journal of Korean Academic Society of Nursing Education
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• v.29 no.4
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• pp.405-414
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• 2023

Purpose: This study used a descriptive investigative design to compare the educational needs and priorities of education-dedicated nurses and preceptors regarding clinical nurse educator competency. Methods: A survey was conducted from March to April 2023 with 308 participants, including 140 education-dedicated nurses and 168 preceptors. The collected data were analyzed using descriptive statistics and a paired t-test with the IBM SPSS 26.0 program. For the purpose of analyzing educational needs, we further analyzed data through the Borich needs assessment and the locus for focus model. Results: Among the clinical nurse educator competency, both education-dedicated nurses and preceptors identified "new theory and practice" as the highest priority educational need. Additionally, education-dedicated nurses prioritized "teaching design ability," "teaching evaluation ability," and "evidence-based nursing/practice and research," while preceptors prioritized "clinical nursing knowledge" and "professional development ability" as their educational needs. Conclusion: While both education-dedicated nurses and preceptors responded that education is necessary for all the competency areas required of clinical nurse educators, variations were observed in their reported educational needs and priorities. Thus, it is imperative to develop and implement a differentiated education program for enhancing the competency of clinical nurse educators that considers the distinct requirements of education-dedicated nurses and preceptors.

• Journal of Korean Public Health Nursing
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• v.28 no.3
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• pp.495-508
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• 2014

Purpose: This study was conducted in order to evaluate the reliability, validity, sensitivity, and specificity of the Short Form of Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS-SF). Methods: A validation study was conducted on 207 elderly patients aged over 65 who were admitted to Bobath Memorial Hospital. Fall risk scores of BMFRAS, composed of eight subscales (age, fall history, physical activity, consciousness level, communication, fall risk factors, underlying disease, and medications) were assessed from the electronic medical record. BMFRAS-SF was derived from eight subscales of the BMFRAS representing the significance between fallers and non-fallers (fall history, physical activity, fall risk factors, underlying disease, and medications). Internal consistency reliability and interrater reliability were assessed by Cronbach's alpha and kappa coefficient. Validity was assessed by Spearman correlation analysis, factor analysis. Sensitivity, specificity, positive predictive and negative predictive values, and a receiver-operating characteristic curve (ROC) were generated. Results: Fallers had significantly higher risk scores than non-fallers in fall history, physical activity, fall risk factors, underlying disease, and medication scales. The BMFRAS-SF demonstrated acceptable Cronbach's alpha (.706) and kappa coefficients of .95. The BMFRAS-SF subscales showed good convergent validity and construct validity. The BMFRAS-SF presented good sensitivity(86.7%), specificity(67.9%), positive predictive value(42.9%) and good negative predictive value(94.8%) at a cut-off score of 5. Areas under the ROC curves were .860 for the BMFRAS and .861 for the BMFRAS-SF. Conclusion: The BMFRAS-SF was proved to be reliable and valid. It could be used for time-saving assessment and evaluation of the high risks for falls in clinical practice settings.

• Journal of Korean Academy of Nursing
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• v.42 no.4
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• pp.549-558
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• 2012

Purpose: The purpose of this study was to validate the Needs Assessment Tool for Case Management (NATCM) for use with Korean medical aid beneficiaries. Methods: Psychometric testing was performed with a sample of 645 Korean medical aid beneficiaries, which included 41 beneficiaries who were selected using proportional sampling method, to examine intraclass correlation coefficients (ICC). Data were evaluated using item analyses, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's alpha, and ICC. Results: Through psychometric testing the final version of NATCM was found to consist of two subscales: 1) Appropriateness of Health Care Utilization (5 items) and 2) Self Care Ability (6 items). The two subscale model was validated by CFA (RMSEA=.08, GFI=.97, and CFI=.93). Internal consistency measured by Cronbach's alpha was .82, and subscale reliability ranged from .79 to .84. The ICC of the NATCM between case managers was .73 and between case managers and health care professionals. .82. Conclusion: This study suggests that the final version of NATCM is a brief, reliable, and valid instrument to measure needs of Korean medical aid beneficiaries. Therefore, the NATCM can be effectively utilized as an important needs assessment as well as outcome evaluation tool for case management programs in Korea.

• Healthcare Informatics Research
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• v.24 no.4
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• pp.381-386
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• 2018

Objectives: This study aimed to describe the process of utilizing a mobile application for ecological momentary assessment (EMA) to collect data on stress and mood in daily life setting. Methods: A mobile application for the Android operating system was developed and installed with a set of questions regarding momentary mood and stress into a smartphone of a participant. The application sets alarms at semi-random intervals in 60-minute blocks, four times a day for 7 days. After obtaining all momentary affect and stress, the questions to assess the usability of the mobile EMA application were also administered. Results: The data were collected from 97 police officers working in Gyeonggi Province of South Korea. The mean completion rate was 60.0% ranging from 3.5% to 100%. The means of positive and negative affect were 18.34 of 28 and 19.09 of 63. The mean stress was 17.92 of 40. Participants responded that the mobile application correctly measured their affect ($4.34{\pm}0.83$) and stress ($4.48{\pm}0.62$) of 5-point Likert scale. Conclusions: Our study investigated the process of utilizing a mobile application to assess momentary affect and stress at repeated times. We found challenges regarding adherence to the research protocol, such as completion and delay of answering after alarm notification. Despite this inherent issue of adherence to the research protocol, the EMA still has advantages of reducing recall bias and assessing the actual moment of interest at multiple time points that improves ecological validity.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.2
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• pp.17-40
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• 1997

The purpose of this descriptive, correlational study was to identify, describe the patterns of nursing unit culture, nursing performance, job satisfaction and turnover intention in the hospital setting, and to analyze the relationships between nursing unit culture, nursing performance, job satisfaction and turnover intention among the characteristic of the subjects The subject consisted of 223 nurses who were employed in medical & surgical units of 3 different University hospitals in Seoul. Data collection was done in November, 1996 by means of questionnaire. The instruments used for this study were the questionnaire based on the Nursing unit cultural assessment tool developed by Coeling(1993), Nursing performance scale used by Yoon(1991), Job satisfaction scale developed by Slavitt, et al.(1978) and Turnover intention scale used by Lee(1995). The data were analyzed by percentage distribution. Pearson correlation coefficient and ANOVA. The summarized results were as follows: 1. There was significant differences in the nursing unit culture between individual cultural behavior and group cultural behavior. 2. There was positive correlation between nursing unit culture, nursing performance and job satisfaction. 3. There was negative correlation between nursing unit culture and turnover intention. 4. There was significant difference in nursing performance efficiency according to the age, educational level, professional carrier in the nursing unit, in the hospital. 5. There was significant difference in turnover intention according to the age, educational level. According to these results, the following implications can be made ; 1. It needs to study on the nursing unit culture in other size hospitals and compare them to these results. 2. It is necessary to assess nursing unit culture and endeaveor good climate for the nursing organizational outcomes and prepare the training course of leadership of nurse manager. 3. In nursing administration, there should be an emphasis on assessment of staff nurses' cultural behavior in case of nurses' orientation, allocation, recruitment, continuning education, so that staff nurses' performance and job satisfaction will be increased and trunover intention will be decreased.

• Research in Community and Public Health Nursing
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• v.19 no.4
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• pp.575-586
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• 2008

Purpose: The purpose of this study is to identify factors affecting the constipation of the elderly at nursing homes. Method: A total of 184 elders at 7 nursing homes in P City participated. Information about constipation status (Constipation Assessment Scale). functional status (Katz' Activities of Daily Living). nutritional status (Mini-Nutritional Assessment). and depressive symptoms (Geriatric Depression Scale Short Form Korea version) were collected through interviews. Descriptive statistics. Chi-square test. and t-test were used to describe and compare the non constipation group and the constipation group. Multiple logistic regression analysis was used to determine factors affecting constipation status. Results: The prevalence of constipation was 47.5% (Men 37%. women 51%). Elders suffering from a disease (P=.021) and having low sleep satisfaction (P= .000) were more likely to be constipated than those who did not. The factors affecting the constipation of the elderly at nursing homes were gender (OR=3.558), sleep satisfaction (OR=.580), and depressive symptoms (OR=1.132). Conclusion: According to the result, to reduce the constipation rate of old women at nursing homes, we have to develop guidelines that can solve problems related to constipation cause by sleep-satisfaction and depressive symptoms.