Professional nurse Autonomy is an essential attribute of a discipline striving for full professional status. Purpose: This study was to clarify the concept of professional nurse autonomy to provide basic data needed for development of professional autonomy enhancing strategies. Method: This study use the process of Walker & Avante's concept analysis based on Wade's research (1999), and field data of 21 nurses. Results: Professional nurse autonomy is defined as competency and creative performance of the professional nurse in practice, to decide independently or interdependently nursing activities and to be had accountable for results of decisions, that reflect advocacy and caring. It was identified that critical attributes include responsible discretionary decision making, collegial interdependence, initiative, creativity, and caring, advocacy, cooperative relationship with clients, receptive capacity to others, activeness, self confidence, and devotion and responsibility to their profession. Antecedents include personal characteristics, educational background, experience and structural characteristics that enhance professional nurse autonomy. Consequences of professional nurse autonomy are feelings of self-efficacy, empowerment, job satisfaction, reduction of intention to leave their job. Conclusion: According to these results, it is recommended that the curriculum provides an environment for learning professional nurse autonomy, and that is used as basic data to develope strategies to enhance professional autonomy of nurse in practice and it's effects
Purpose: The purpose of this study was to review nursing studies with regard to simulation- based learning in Korea. Methods: This systematic review examines the literature on simulation in nursing education from 2003 to 2012. The electronic databases reviewed included: RISS, the National Assembly Library, the National Library of Korea, and major nursing journal databases in Korea. The MeSH search terms included nursing, simulation, simulator, and standardized patient. Results: In total, 52 studies were included in the literature review. We included 21 quasi-experimental studies and 25 studies using high-fidelity simulation. They included knowledge and problem-solving ability in the cognitive domain; self efficacy, learning satisfaction, interpersonal relationships and communication, and confidence in the affective domain; and clinical performance ability and learning performance evaluation in the psychomotor domain. This systematic literature review revealed that simulation is useful in nursing education but uncovered a gap in the literature pertaining to the transfer of knowledge to performance and how to learn from cognitive reflection. Conclusions: This result suggests that it is necessary to conduct additional research on the cognitive learning process and transition to performance.
Purpose: This study was conducted to analyze and clarify the concept of the effective breastfeeding. Methods: This study used Walker and Avant's process of concept analysis. Results: Effective breastfeeding is how to give infant adequate milk, which fulfills needs of mother and infant, from her breast so that they can be satisfied with the process and results. It included the effective breastfeeding properties as follows: feeding behaviors (positioning, latch on, and suckling), transferring a breast milk to an infant, mother-infant interaction, and satisfying their desires (satisfaction, comfort, mother's self-confidence, infant's adequate weight gain and defecation, adequate breastfeeding interval). The antecedent of effective breastfeeding were anatomical and functional normal breast, breastfeeding knowledge and steady-state of mother, and feeding desire, rooting reflex and normal oral cavity of infant. The consequences of effective breastfeeding were exclusive breastfeeding, infant and maternal health and wellbeing, and achievement of mother and infant attachment. Conclusion: The meaning of effective breastfeeding defined in this study will contribute to develop the effectiveness breastfeeding assessment tool and the nursing intervention for ineffective breastfeeding.
Purpose: This study aimed to identify the relationships among disease severity, anxiety, depression, social support, unpleasant symptoms and self-care among patients with atrial fibrillation based on the unpleasant symptom theory, and to examine the mediating effects of unpleasant symptoms. Methods: A cross-sectional study was conducted. The participants were 216 patients with atrial fibrillation who were being followed up on an outpatient basis at a university hospital in Seoul. Data were collected from November 1, 2020 to June 30, 2021, using self-report questionnaires. Data were analyzed using IBM SPSS/WIN 27.0 and PROCESS macro with 95% bias-corrected bootstrap confidence interval(CI). Results: The average age of participants in this study was 66.0years. Disease severity (β=10.19, p<.001) and depression (β=1.53, p<.001) had significant positive relationships with unpleasant symptoms. Also, unpleasant symptoms (β=-0.03, p=.006) had a negative relationship with physical activity, which is a subscale of self- care. Social support (β=0.06, p<.001) was positively related with physical activity. Unpleasant symptoms showed a mediation effect in the relationship between disease severity and physical activity (Bias corrected bootstrap CI -0.65, -0.04). Depression had an indirect effect on physical activity that was mediated by unpleasant symptoms (Bias corrected bootstrap CI -0.11, -0.00). Conclusion: The findings of this study suggest that integrated strategies including physical, psychological, and social factors should be considered to promote self-care in patients with atrial fibrillation.
This study was to provide understanding for the juvenile problem of drug brought about by industrialization, and the importance people that we should take a role in helping to resolve the problem. The purpose of this study lies in approaching the effective methods to prevent Korean adolescents from being involved in drug by examining the factors of their experience. The method of this study is designed to grasp the adolescents' drug experience, its meaning, its structure and the nursing intervention ways. By applying a phenomenological approach which is based on a qualitative research method, the researchers hoped to reveal key data in each group. It has been carried on from October 1998 until September 1999 with sample of 5 adolescent inmates in K mental hospital located in Seoul. The data were collected by sereous personal deep interviews and observations. Collected data were analyzed according to the phenomenological method suggested by Giorgi. The results of this study are as follows: First, pleasure seeking: curiosity, joy, and fun; Second, affiliation: formation of clique with the same age; Third, escape from reality: loneliness, emptiness, heroic mind, self- confidence, self-absorption, and comfort; Forth, feeble- mindedness: anxiety, fear, and temptation; Fifth, psychological unadaptation: wandering, forfeiture, and incompetence; Sixth, physical counteraction: headache, vomiting, loss of memory, loss of appetite and loss of sensibility; Seventh, psychological confusion: illusion, auditory hallucination and dream; Eighth, recovery of self-consciousness: repentance, desire and awareness This study results in the following suggestions of the nursing intervention 1. To cultivate a wholesome game culture for the adolescents. 2. To make up the group activities so that the adolescents can establish their sense of identity through a variety of group counseling program. 3. To foster the capability to cope with the change in the process of social accommodation. 4. To enforce the social life skill for the adolescents. 5. To practice the systematic education about drug use. 6. To develop the social education programs. 7. To help the adolescents build up their sense of identity by applying the adolescent cure programs. Above all, it is necessary that school and community as well as home should establish the educational environment paying special concern and consideration to the adolescents.
Purpose: This study was to understand the meaning of women's experience of spontaneous delivery with midwives at midwifery clinics or home. Methods: van Kaam's Psychophenomenological method composed of a four-stage, 12-step format was used. In-depth interviews were carried out from January to July, 2011, with twelve women. Results: Through the data analysis, 403 significant statements, 172 elements, 48 subcategories, and 19 categories were extracted, and from the 19 categories, 8 themes were drawn. The eight themes were: "Conflict on whether a hospital or a midwifery clinic", "Choosing natural delivery with the assurance of her ability to delivery spontaneously and having trust in the midwives." "Being encouraged by a midwife and family members with one accord", "Experience of the spontaneous delivery process on body", "Comfortable delivery in spite of painful process", "Deeply impressed by the overwhelming joy of birth", "Satisfaction with spontaneous delivery", and "Deeper love among family members". Conclusion: Through this study, women's delivery experiences with midwives was of spontaneous delivery. Women's birth of self-confidence and trust between the midwives and the women to predict a spontaneous delivery is a powerful factor. Also, family support and midwives delicate care was identified as factors in spontaneous delivery.
The characteristics of health behavior related pregnancy and childbirth have reflected on the cultural belief and value in the society. The efforts for women's health promotion through the current illumination of the traditional health care are the prompting assignment to be in nursing. The process of motherhood already progress before the motherhood actually. The functional state as the expectant mother can be the important predicting factor of the postpartum state, the quality of a married life. Motherhood was analyzed by Walker and Avant's method to clarify the concept 'to be a mother' using the various concepts like Koreans' Taekyo, transition to motherhood, maternal identity, maternal role attainment, maternal fetal attachment, and maternal fetal interaction. Upon the concept analysis, naturalness, responsibility, attachment, readiness, controllability were identified as the defining characteristics of motherhood. The antecedents of motherhood were consist of maternal affection, positive self esteem, pregnancy acceptance, fetus recognition and the consequences of motherhood were consist of positive maternal identity, maternal fetal attachment, confidence about the maternal role, the healthy mother and the healthy baby. The empirical referents of motherhood were consists of recognition of motherhood, expectation about motherhood, fetal recognition with ultrasonography and fetal movement, experience of unification between mother and fetus, expression of affection to the fetus, concern about fetal health, concern and practice about Taekyo, adaptation behavior about physical change and discomfort due to pregnancy. Therefore it is necessary to develop the instruction program of motherhood including the defining attributes identified in this study.
Purpose: This study was to identify the attributes, antecedents, their consequences, and empirical indicators of rehabilitation motivation in rheumatoid arthritis patients. Methods: Walker and Avant's method was used to analyze the concept. Articles published after 1990 were searched in Medline, CINAHL, NSDL, and RISS databases using "rehabilitation", "motivation" and their combination as keywords. Results: The attributes of rehabilitation motivation are: 1) certitude and trust toward rehabilitation treatment; 2) confidence in the rehabilitation process; 3) efforts and commitments to achieve health goals; 4) psychological needs to act toward health recovery. Its antecedents include: 1) rights of self-determination; 2) goal setting and goal-oriented attitude; 3) personal needs; 4) getting rewards; 5) social and family support; 6) professional behavior of healthcare providers; and 7) least risks or costs for actions taken. Conclusion: The study results could be used as a conceptual framework for developing tools to measure the motivation of rheumatoid arthritis patients.
This study was conducted to provide the basic data necessary for the improvement of the teaching method for basic nursing practice as well as the effectiveness of the practice by examining the students' competency in cleansing enema after doing the self study instead of the traditional education. To examine the competency in cleansing enema after the self study, this study is an one group pretest-posttest design that subjects did the enema practice through the self study. The subjects were 89 sophomore students at Y University. College of Nursing. In basic nursing lab practice class, cleansing enema self study module was given to the students which was developed by the researcher based on the literature review and asked them to finish doing the pre study and checking the self study evaluation criteria after reading the goal, learning activities and theoretical guideline. After watching the video tape, students practiced the process in the module by themselves. For the competency in cleansing enema. repeated autonomous practices were done during the open lab other than the regular class. Whenever the practice was done, the frequency and time were measure and documented. When the student felt confident through repeated practices, the competency was evaluated by the researcher and two assistants based on the evaluation criteria. And the process was repeated till the student could perform all the items on evaluation criteria completely. The data were collected for 42 days from Oct. 15 to Nov. 26 in 1996. Collected data were analyzed by frequency, percentage, Pearson correlation coefficient and variance analysis. The results are summarized as follows : 1. 43.2% of the students were favorable to nursing and 63.6% like lecture, but 71.6% like practice. So they were more interested in practice than in lecture. 2. 62.3% of the students scored high in written test, 97.8% scored high in practice. So the practice score was better. 3. The frequency of repeated practice to pass the test ranged from 1 to 4 and the average is 2.2. 4. The average time needed in preparation and the performance was nearly the same regardless of the frequency. It took 5 to 38 minutes for those who passed the test after practicing once and the average was 16 minutes. 5 to 60 minutes were taken for those who practiced twice to pass the test and the average was 21 minutes. Those who passed the test after three practices needed 8 to 30 minutes and the average was 15 minutes, which was similar to the time that the students who passed the test for the first trial. Only one student passed the test after 4 practices and it took 10 minutes. 5. 64% of the students agreed that the context and the content of the module were appropriate for the self study and 68.2% were satisfied. And 71.9% said that the module helped them to practice the enema self study 6. Though only 42% of the students were satisfied with the video. 50.6% said that it was helpful for the self study. 7. 52.3% of the students were satisfied with the self study method, and 86.6% obtained self-confidence when performing the enema. 8. The lower the student's practice score was, the more practices were needed for them to pass the test(r=-.213, P<.05). As a result, for performing the enema practice competently, two or more practice opportunities were needed to be given. And it is possible to obtain the less complex nursing skills through the self study, when enough learning resources and assistance such as learning guidance or video tapes are provided. Based on this study. I want to suggest that. 1. There must be college policy that can support the new method instead of the traditional learning method for the students to attain the proficiency in basic nursing skills. 2. The assistant materials should be developed as soon as possible to promote the self study of basic nursing skills.
This study was conducted to investigate the degree of PSI (self-evaluative awareness of problem solving ability) in PMHNP (psychiatric mental health nurse practitioners) and to identified the factors predicting problem solving ability of them, in order to provide basic data for the development of the specific education programs to improve problem solving ability. Data was collected from 355 subjects who have the certificates of PMHNP working in hospitals and public centers. Chun Seok Kyun's instruments (1993) based on the Heppner and Petersen's Problem Solving Inventory (1982) was used to determine PMHNPs' PSI. The results were as follows; 1. The average score of PSI of PMHNP was $2.81\pm0.23$. Of the three factors. there marked the lowest score in the factor 3. personal control $(2.56\pm0.43)$, and the highest score was in the factor 1. problem-solving confidence $(2.95\pm0.34)$. 2. The differences in PSI were significant for degree of education and career in psychiatric settings (p=0.000l, p=0.0187). 3. Job satisfaction was the highest factor predicting PSI of PMHNP$(17.9\%)$. When degree of education, career in psychiatric setting and marital status were added, the total predictors explained $24.3\%$. As a result, it is necessary to conduct further research in relation to the problem-solving process, the development of education program. skill acquisition and measurement of problem solving in nursing practice.
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