• Journal of Korean Academy of Nursing Administration
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• v.4 no.1
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• pp.183-214
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• 1998

The purpose of the present study was to examine the causal model of nurses' organizational commitment. Based on literature review and Fishbein's behavioral intentions model ((Fishbein, 1967;Fishbein & Ajzen. 1975), the organizational commitment was conceptualized within a motivational framework that mediate between antecedents variables and outcome variables. Antecedent variables were pay, promotional chances, continuing education opportunity, rigidity of the administration, paticipative decision making, latitude, group support, role conflict, work load, need for achievement, experience and pride for professional nursing. Outcome variable was turnover intention. The subjects were 373 nurses who were working at 2 large general hospitals located in Seoul. It represents a response rate of 94%. Data for this study was collected from August 29 to September 22 in 1997 by Questionnaire. Path analysis with LISREL 7.16 prigram was used to test the fit of the proposed conceptual model to data and to examine the causal relationships among variables. The result showed that both the proposed model and the modified model fit the data excellently. It needs to be notified, however, that path analysis can not count measurement errors; measurement error can attenuate estimates of coefficient and explanatory power. Nontheless the model revealed considerable explanatory power for organizational commitment (58%). pride for professional nursing (50%) and turnover intention(40%). In predicting nurses' organizational commitment. the findings of this study clearly demonstrated 'the pride for professional nursing' might be the most important variables of all the antecedent variables. Group support. role conflict, need for achievement were also found to be important determinants for the organizational commitment and turnover intention. The result showed experience might be a predictor for 'pride for professional nursing' and 'turnover intention' but not 'organizational commitment'. 'Rigidity of the administration' and latitude were also found to have important roles in predictor for the organizational commitment, while participative decision making might have an impact on turnover intention. On the other hand promotional chance had an influence on all the outcome variables, while pay only on turnover intention. In predicting turnover intention, the result clearly revealed 'the pride for professional nursing' and 'organizational commitment' might be the most powerful predictors among all the variables. Theses results were discussed, including directions for the future research and practical implications drawn from the research were suggested.

• Journal of Korean Academy of Nursing Administration
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• v.13 no.1
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• pp.98-108
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• 2007

Purpose: The objective of this research was to explore the levels of patient satisfaction and job satisfaction according to the level of nurse manpower, in order to provide effective management for nurses. Methods: The research was conducted from November 1 to December 30, 2006, with a survey of 310 nurses and 240 patients at eight tertiary hospitals in Seoul. Data were collected according to the level of nurse manpower from the first (a nurse vs. patient ratio of below 2.0) to the sixth (a ratio of over 4.0) rank. The survey tools were used Park-Yoon's job satisfaction (1992) and Wandelt and Ager (1974)'s patient satisfaction. The acquired data were analyzed with SPSS $PC^+$ 12.0 program using descriptive methods, ${\chi}^2$ test, ANCOVA, and Scheffe. Results: Overall job satisfaction of nurses showed 3.10 and patient satisfaction of patients showed 4.15. Analysis based on the level of nurse manpower showed that hospitals of first and second rank had higher scores than those of lower rank for nurse's job satisfaction and patient satisfaction. Conclusion: Hospitals with a higher level of nurse manpower showed higher score of nurse's job satisfaction and patient satisfaction.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.1
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• pp.169-191
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• 2002

As the tendency of the society is centralized into consumers and services, patients are getting to ask better medical services. The consumers influenced from various social surroundings became to have some expectation of nursing service. Compared with their expectation, the quality of the services which they virtually get may be recognized and evaluated. So it is necessary to know exactly what the consumers want in nursing services. The purpose of this study is to examine the determinants which can evaluate the quality of nursing services by researching into consumers' expectation and perception of the nursing services depending on the consumer-oriented attributions on the basis of the model of SERVQUAL. 1,144 of outpatients were selected as the subjects for this research. They used to continuously visit the same hospital after being hospitalized and nursed in 9 hospitals randomly selected among the second-level medical organizations in Seoul from January to February, 2001. The collected data are analyzed into the Descriptive Statistics, t-test, GLM and Multiple Regression through the SAS program. Delphi was used for the research tool and the results of the research are as follows; the determinants in evaluating the quality of nursing services consist of 5 categories such as Tangibility, Reliability, Responsiveness, Assurance, Empathy. The values of Cronbach' $\alpha$ appeared to be 0.96 in the expectation of nursing services, 0.94 in the perception of nursing services and 0.96 in the importance of nursing services. The determinants in the expectation of nursing services were ranged in the order of Assurance, Empathy, Reliability, Responsiveness and Tangibility. And those in the perception of nursing services were in the order of Assurance, Empathy, Reliability, Tangibility and Responsiveness. Those in the importance of nursing service were in the order of Empathy, Assurance, Reliability, Tangibility and Responsiveness. Finally, those in the quality of nursing service were in the order of Tangibility, Responsiveness, Empathy, Reliability and Assurance. Each expectation of nursing services appeared different depending on the subjects' age, gender, clinical department and reason for hospitalization. The hypothesis examined in this research shows that the group having higher personal needs shows meaningful differences in the expectation of nursing services, and the subjects who have had external communication show higher perception of nursing service than uncommunicative ones. After all, we can see that the statistical differences in the perception of nursing services depend on whether the subjects have external communications or not. The determinants in the expectation of nursing services can explain the quality of nursing service up to 14.96%. The statistically meaningful determinants in the expectation could be arranged in the order of Reliability, Assurance and Tangibility. And the more expectation brings about the lower evaluation of the quality of nursing services. The determinants in the perception of nursing service can explain the quality of nursing services up to 29.85%. The statistically meaningful determinants in the perception could be arranged in the order of Responsiveness, Reliability, Tangibility, Empathy, and Assurance. And the more perception brings about the higher evaluation of the quality of nursing services. According to the result of the above research, I would like to propose as follows. As long as this research is oriented to get knowledge of the consumer-oriented nursing services, it should be continued to draw the other elements determining the quality of the nursing services. Furthermore, this research is based upon the Parasuraman, A., et al.'s SERVQUAL Model(1991), which deals only expectation, perception and quality of consumer-oriented nursing services, so it will be necessary to inspect and verify it through the other models containing the offerers of nursing services in the future. On the other hand, as this research evaluates the actual quality of nursing services based on the expectation and perception of nursing services, it can be utilized as fundamental data to develop the marketing strategies and to estimate the qualities as well. I hope this research will be periodically estimated to be the useful data to develop the marketing strategies in the nursing service area.

• Journal of Korean Academy of Nursing Administration
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• v.22 no.5
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• pp.496-506
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• 2016

Purpose: This study was conducted to examine the adaptation experience of male nurses working in general wards. Methods: Experiential data was collected from 16 general ward nurses through in-depth interviews. Participants were selected from male nurses working in the general wards with over one year of clinical experience at a tertiary university hospital. The main question was "Can you describe your adaptation experience in the general ward as a nurse?" All interviews were recorded and transcribed, then analyzed using Colaizzi's method. Results: Four categories were derived from the analysis: 'difficulties from task adaptation by characteristics', 'limited nursing situation and circumstance as a male nurse', 'efforts to adapt at general nursing unit', and 'self-worth, and worry about something as a male nurse'. Conclusion: Male nurses had a difficulty adapting to work in wards due to lack of multi-tasking skills, as well as some social prejudice or negative views on male nurses. Establishing reasonable guidelines for male nurses in practice, promoting their responsibilities to patients, developing mentoring programs, and reassessing the policy of assigning male nurses to general wards are recommended to help in better adaptation.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.1
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• pp.181-195
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• 1999

This study was done to develope a computer program for the evaluation of quality of nurisng care. Because the professional nursing care should be evaluated consistantly, computer program for the measurement of quality of nursing care is necessary for the effective and efficient management of nursing quality. In this study, a computer program for gastrointestinal surgery patients was developed as a module. Visual basic 4.0 was used as a basic program for the development of this program, and Access 7.0 was used for the data base construction of the program. The systems of evaluation criteria were hierarchical. and the titles of the hierarchical criteria were evaluation area-evaluation item-indicator. Each evaluation area contained several items and each evaluation item contained several indicators. The numbers of the evaluation criteria for gastrointestinal surgery patients were 7 evaluation areas, 32 evaluation items. and 71 indicators. Content validity of the evaluation criteria(in this case, 32 evaluation items) was .95. Scoring could be possible with the evaluation items. For the scoring types of this program were two. norm-referenced type(option 1) and criterion-referenced type(option 2), the user can choose the type according to the purpose of the evaluation. With this computer program. accurate and consistant evaluation of the quality of nursing care could be expected. Also. by the rapid feedback to nursing care practice. quality of nursing practice could be improved rapidly. and the systems of the evaluation criteria developed in this study could be used for the development of other moduls for various kinds of patient groups. Because this computer program was developed only for the purpose of research, it is necessary to be refined commercially to be used in real nursing situation.

• Journal of Korean Academy of Nursing Administration
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• v.20 no.3
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• pp.247-256
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• 2014

Purpose: The purpose of this study was to investigate provide basic data for improving patient safety in nursing homes in Korea by measuring the patient safety culture of nursing homes and understanding its influencing factors. Methods: This study is a secondary analysis of a descriptive research study using data from development and validation of the Korean patient safety culture scale for nursing homes. A total of 982 cases were analyzed using the SPSS Statistics 20 program. Results: For the safety culture of the patient, there was a significant difference based on the size and location of the facility. For the degree of patient safety, age, education, occupation, marital status, and the size of the nursing home were significant factors. Patient safety culture and the degree of patient safety had a positive correlation. The regression model of the degree of patient safety was significant (F=20.73, p<.001) and the explanatory power of the model was 27.4%. Conclusion: The study results indicate that patient safety culture is a factor influencing safety of elders in nursing homes. To improve patient safety for nursing homes in Korea, continuous evaluation and improvement projects need to be done at a national level.

• Journal of Korean Academy of Nursing Administration
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• v.6 no.2
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• pp.211-225
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• 2000

With the drastically changing healthcare market, the adoption of DRG system and the use of Critical Pathway will be increased gradually in order to care hospitalized patients qualitatively and manage cost-effectively in Korea. The purpose of this quasi-experimental research is to apply and analyze the developed critical pathway to the patients with Cesarean section. 35 eligible subjects for the control group were chosen from postpartum patients who has delivered at H-hospital in Kwang-ju, and were questioned after appling previous care plan from May to December, 1998. For the experimental group, 37 subjects were chosen and questioned after applying Critical Pathway service from January to June, 1999. The instruments are a critical pathway for the patients with Cesarean section developed by chung(1998) and a questionnaire that evaluate patients and family members' satisfaction level. Also, educational materials were used to inform them in the process of Critical Pathway application. As a result of chi-square test on general characteristics, there is significant difference between control group and experimental group only in terms of room size(p= .010). There are no significant differences in the average length of stay in the hospital between control group and experimental group(t=.078). Also, the average medical consult fee has no difference significantly between two groups(t= .105). The findings showed that the experimental group with critical pathway service scored significantly higher than control group on the satisfaction level toward care services(p=.000). The items are post-operative care, postpartum exercise technique, breast feeding and breast manage through educational materials. In conclusion, the research indicates that the application of planned Critical Pathway can have a positive impact on satisfaction level of inpatients with Cesarian section.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.1
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• pp.85-95
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• 2002

The purpose of this study was to develope a critical pathway for the chemotherapy of non-small cell lung cancer patients and to identify its effects after implementation. Critical pathway was developed through 5 steps including content and clinical validity tests with collaborative efforts of nurses, clinicians, and other allied healthcare professionals with the aim of improving the quality of patient care, while minimizing cost to the patients. This paper was described an evaluation of the impact of a developed critical pathway on complication rate, length of stay, costs, the interval of treatment and patient satisfaction by nonequivalent control group posttest-only non-synchronized research design.Results were compared between the two groups of patients. There were no significant differences in demographic variables and the occurrence of bone marrow suppression between experimental group and control group(t=-0.01, p=0.992). There were statistically significant decreases in the average length of stay(t=-10.45, p=0.000), in the average cost(t=-2.988, p=0.004), and in the interval of treatment(t=-6.75, p=0.000) after implementation of the critical pathway compared to control group. Also, there was a statistically significant improvement of the patient satisfaction after implementation of the critical pathway compared to control group(t=4.57, p=0.000). This paper concludes that critical pathway in chemotherapy for lung cancer, implemented in the context of an general hospital, is the useful tool to shorten the hospital stay, reduce treatment costs, and improve the quality of life in cancer patients. Further study needs to be conducted to identify other clinical outcomes including job satisfaction, collaboration among health professionals and potential for use in education. Also, it is recommended that nurses should revise continuously the developed critical pathway through clinical implementation and maintain their role of patient advocacy through monitoring pathway compliance.

• Journal of Korean Academy of Nursing Administration
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• v.21 no.3
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• pp.308-316
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• 2015

Purpose: The purpose of this study was to identify the level of project perception for those nurses from research-driven hospitals and to analyze the effect of research-relevant performance in the health care field focusing on the mediated effect of research capacity and job satisfaction. Methods: Data were collected from June, 2014 to July, 2014, and participants were 106 research nurses in Research-driven hospitals. Descriptive statistics, Independent t-test, One-way ANOVA, structural equation modeling (SEM). Results: As a result, Research-relevant performance according to project perception of research nurses from Research-driven Hospitals was not statistically significant, but research capacity and job satisfaction had a mediating role. Evaluation System Perception was significantly different from Research Capacity (p<.001), Research Capacity was significantly different from Job Satisfaction (p<.001), Job Satisfaction was significantly different from Research Performance (p<.001) Conclusion: The results indicate that research capacity building and job security research nurses are able to contribute to improving research performance of research-driven hospitals.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.351-361
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• 1998

The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.