Purpose This study aimed to identify the factors affecting patient satisfaction in an emergency department based on the use of the Korea Triage and Acuity Scale (KTAS). Methods A survey and medical record review were conducted. Participants included 100 patients and 20 nurses from an emergency medical institution located in B city, between June and August 2020. Data were analyzed using descriptive statistics, independent t-test, one way analysis of variance, partial correlation, and multiple regression. Results The mean score of patient satisfaction was 3.99±0.63. The mean waiting time, duration of stay, and occupation rate were 14.29±10.97 min, 104.96 ±67.35 min, and 22.0±7.4%, respectively. From the multiple regression analysis, waiting time (β=-.36, p<.001), nurse’s self-efficacy (β=.19, p=.013), and professional competence (β=.36, p<.001) explained 57.9% of the patients’ satisfaction with their use of the emergency medical institution (F=34.50, p<.001). Conclusion Patient satisfaction after experiencing the KTAS was influenced by waiting time, nurses’ self-efficacy, and professional competence. Therefore, institutions need to define an appropriate waiting time that does not reduce patient satisfaction, and introduce an internal marketing strategy to increase nurses’ professional competence and self-efficacy.
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Purpose The purpose of this study was to identify the moderating effect of teaching effectiveness and students’ anxiety in the relationship between simulation design characteristics and clinical reasoning competence among nursing students.
Methods: The participants were 123 nursing students who underwent simulation practice. Data were collected from September 1 to October 30, 2020 using self-report questionnaires. The collected data were analyzed using descriptive statistics, independent t-test, Pearson’s correlation coefficient, and SPSS PROCESS Macro program (to study the multiple additive moderation effect).
Results: Significant positive correlations were observed between clinical reasoning competence and simulation design characteristics (r=.57, p<.001), clinical reasoning competence and teaching effectiveness (r=.49, p<.001), while negative correlations were observed between clinical reasoning competence and students’ anxiety (r=-.33, p<.001). Teaching effectiveness and students’ anxiety had a multiple additive moderating effect on the relationship between simulation design characteristics and clinical reasoning competence among the nursing students (F=15.10, p<.001).
Conclusion: The relationship between simulation design characteristics and clinical reasoning competence differed depending on the students’ anxiety. To improve the clinical reasoning competence of nursing students in simulation practice, developing interventions and techniques to manage students’ anxiety levels are important.
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Purpose This study aims to explore the mediating effect of burnout and the moderating effect of nursing work environment in the relationship between nursing competence and patient-centered care among nurses caring for patients with chronic disease.
Methods: This study uses a cross-sectional descriptive research design. The participants were 150 nurses at a general hospital. The data were collected from February 10 to May 10, 2020. The questionnaire consisted of measuring tools for general characteristics, patient-centered care, nursing competency, nursing work environment, and burnout. The SPSS/25.0 program was used to analyze the data using descriptive statistics, Pearson's correlation coefficient, independent t-test, one-way ANOVA, Scheffé test, and hierarchical multiple regression.
Results: The average score of patient-centered care was found to be 3.75±0.44. Nursing competency had a mean score of 3.64±0.44, nursing work environment of 3.04±0.43, and burnout of 2.91±0.68. Patient-centered care was significantly associated with nursing competency, nursing work environment, and burnout. In the relationship between nursing competency and patient-centered care, burnout had a partial mediating effect. The relationship between nursing competency and patient-centered care showed that nursing work environment had no moderating effect.
Conclusion: The results revealed that patient-centered care was performed well if nursing competency was high. It is necessary to lower burnout and increase nursing competency such that patient-centered care can be performed better. In addition, since nursing work environment has a significant effect on nursing competency and patient-centered care, it is necessary to improve nursing work environment to improve nursing competency and patient-centered care performance.
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Purpose This study investigates the mediating effects of self-care competence on the relationship between uncertainty and quality of life in stroke patients.
Methods: This study adopts a descriptive research approach using 158 patients diagnosed with ischemic or hemorrhagic stroke through brain Magnetic Resonance Imaging (MRI) or Computed Tomography (CT). The data collection period was from May 20, 2020 to September 29, 2020. The data were analyzed using descriptive statistics, Pearson’s correlation coefficient analysis, and a three-step regression analysis using Baron and Kenny’s method for mediation.
Results: The mean scores for uncertainty, self-care competence, and quality of life were 3.07±0.49, 3.66±1.07, and 3.54±0.93, respectively. Self-care competence was found to completely mediate the relationship between uncertainty and quality of life (z=-5.31, p<.001), and its explanatory power was 77.2%.
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PURPOSE This study aimed to explore the mediating effect of self-care competence on the relationships between uncertainty, self-care competence, and quality of life in patients undergoing hemodialysis. METHODS This study used a descriptive correlation design. Participants were 169 patients who were receiving hemodialysis treatment. Data were collected from November 01, 2017, to June 30, 2018. Measurements included the Patient Assessment of Mishel Uncertainty in Illness Scale, Self-as-Carer Inventory Scale, and the Medical Outcomes Study Short Form-12 (MOS SF-12). The MOS SF-12 comprises the Physical Component Score (PCS) and Mental Component Score (MCS). Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and a three step regression analysis using Baron and Kenny's method for mediation. RESULTS Mean scores were 2.78±0.03 and 3.96±0.07 for uncertainty and self-care competence, respectively. The mean PCS score was 41.90±17.45) and the mean MCS score was 55.23±15.09. Self-care competence had a partial mediating effect (z=−3.50, p<.001) between uncertainty and PCS as well as an explanatory power of 20%. Self-care competence had a partial mediating effect (z=−2.36, p<.001) between uncertainty and MCS as well as an explanatory power of 11%. CONCLUSION To improve the quality of life of hemodialysis patients, developing programs suitable for patients with high uncertainty or programs that increase the self-care competence abilities of the patients should be considered.
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PURPOSE The purpose of this study was to evaluate the effects of a simulation based clinical reasoning practice program on clinical competence in nursing students. The program was based on the theoretical frameworks of simulation models and experiential learning theory. METHODS The program consisted of eight scenarios which includes three main symptoms (abdominal pain, changes in mental status, dyspnea), for improvement of clinical competencies in nursing students. A nonequivalent control group pretest-posttest design was used for evaluation of the effects of the program. Fifty-two junior nursing students in Y University participated in the experimental group (n=25) or control group (n=27). Critical thinking was measured using a self-administered questionnaire. Clinical judgment and clinical performance were measured by a rater using the Rubric. Descriptive analysis, t-test, Mann-Whitney U, Wilcoxon signed rank test was used for data analyses. RESULTS Clinical judgment and clinical performance increased in the experimental group, but there were no significant differences in critical thinking. CONCLUSION Results indicate that the program developed in this study is a useful strategy to enhance clinical judgment and clinical performance in nursing students. However, the program did not significantly enhance critical thinking disposition, and further study is needed to measure integrated clinical competence including critical thinking skills.
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PURPOSE This study was to describe the process of healthy dieting and develop a substantive theory that explains lifestyle in obese male college students. METHODS The participants were 11 students who had participated in self-dieting program in a health center. Data were collected with in-depth interviews and analyzed by grounded theory in Strauss and Corbin (1990). RESULTS Through analyzing process, 36 concepts, 18 subcategories, and nine categories were deduced. In axial coding, casual condition, 'shrinking themselves' and 'oriented to selfish lifestyle', context condition, 'distress in mutual understanding' impacted on phenomenon, 'making health with autonomous living pattern'. Intervening conditions were 'practicing with active measures' and 'growing the willpower' and action-interaction condition, 'devoting realistic plan with positiveness' totally lead to consequence in 'regaining social relationship' and 'pursuing harmonious sound of mind and body'. The periods of process were divided four stages, reflecting self-characteristics, situational copping phase, applying period realistic strategies, and developing phase of social relationship. The core category, 'developing communication competency' incorporated the relationship between and among all categories and explained the process. CONCLUSION The findings indicate that self leading health program helped to develop the communication competency. Therefore, we would consider about internalized motives and external incentives in health programs.
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PURPOSE The purpose of this study is to identify the relationship among clinical competence of diabetic diet education on standardized patients, self-efficacy, communication skill, learning satisfaction, and professional values of nursing students. METHODS The present study was a descriptive research. The participants were 144 junior nursing students in a university. The clinical competence on diabetic diet education was assessed by trained evaluators when nursing students performed diabetic diet education using the standardized patients. The students' self-efficacy, communication skill, professional values, and learning satisfaction were measured by themselves using the questionnaires. RESULTS The clinical competence on diabetic diet education showed positive correlations with communication skill and learning satisfaction, while the competence was not correlated to self-efficacy and professional values. CONCLUSION The results of this study suggest that clinical competence on diabetic diet education may be more related to communication skills and learning satisfaction than self-efficacy and professional values. Promoting communication skills and learning satisfaction using a standardized patient may increase nursing students' competence on diabetic diet education.
PURPOSE The present study was designed to understand the conceptual definition and attributes of the clinical critical thinking ability(CCTA) in nursing and to grasp the characteristics of clinical critical thinking abilities. METHODS The data were analyzed using the Hybrid model of Schwartz-Barcott and Kim(2000). RESULTS Having the skills and dispositions to think critically, CCTA refers to something that implies the cognizant ability to interpret contextual meanings, analyze the relationships between materials or circumstances, draw out the best conclusions, predict things using relevant information and evaluate the reliability of information and the strength of inference on the one hand and the emphatic disposition to be curious, open-minded, intellectually integral, systematic and creative and to reflect on things in contextual terms on the other. CONCLUSION CCTA is characterized by clinical circumstances, such as guessing the reasons for facts, predicting things, connecting theory to practice and approaching individual situation in total terms as well as by the Korean circumstances, such as taking another person's perspective. Hence, this study proposes developing the tools to measure the clinical critical thinking ability and the strategies to improve the clinical critical thinking ability and seeking to verify their validity, on the basis of the findings.
PURPOSE This study was conducted to develop a simulation-based education course and to evaluate the results after the application for second year nursing students. METHODS: This study was a non-equivalent control pre-post design. Based on the clinical situation scenarios about patients with COPD and MI, a total of two simulation-based learning modules was developed. Pretest and posttest was conducted to evaluate the difference in critical thinking disposition, problem solving, and clinical competence between two groups of 102 students for the experimental group, 2007 and 90 students for the control group, 2006. The experimental group conducted a clinical performance evaluation in the final test, on December 10, 2007. RESULTS: In the experimental group, knowledge related to learning objectives was significantly increased and core intervention was performed almost exactly, but the same result was not observed in domains of analysis of laboratory test, and nursing education for patients. Self-evaluated clinical competence and problem solving level were significantly more improved in the experimental group than control group, but critical thinking disposition level wasn't. CONCLUSION: In conclusion, a simulation-based education course needs to utilize self-directed learning module like computer-based learning through web contents and MicroSim and video productions for improving nursing students' critical thinking.
PURPOSE The purpose of this study was to validate the scale of Informatics Competencies for Nurses developed by Staggers, Gassert & Curran(2001) among Korean nurses. METHODS: The subjects of this study were 58 RN-BSN students and 314 nurses in Busan, Ulsan and Kyoungnam province. Data were collected by questionnaires from June to August, 2006 and from October, 2006 to August, 2007 and were analyzed by Principal Component Analysis for construct validity and Cronbach's alpha coefficient for reliability. RESULTS: A factor analysis was conducted and 30 items that had a factor loading more than .40 were extracted. The explained variance from 5 factors was 55.33% of the total variance. The factors were named 'basic computer usage', 'medical informatics-related software usage', 'computer related information management', 'perception of informatics', and 'information search using internet'. The first factor consisted 10 items which explained 29.89% of the total variance and the second factor contained 7 items. The Cronbach's alpha coefficient was .91 among the 30 items. CONCLUSION: This scale, Informatics Competencies for Nurses, was proved as a proper instrument to apply to Korean nurses.
PURPOSE This study was to evaluate clinical competence in relation to self-directed learning, critical thinking disposition, and participating in PBL(Problem-Based Learning) group activities of nursing students. METHODS Data were collected from 108 nursing students in Oct. 2006. RESULTS Clinical competence had a significant positive correlation with self-directed learning, critical thinking disposition, and participation in PBL group activities. There was a significant difference in clinical competence according to interpersonal relationship. Participation in PBL group activities was the most influential factor of clinical competence(R2=.34). Also, the influence of clinical competence increased with the addition of self-directed learning(R2=.42). CONCLUSION It is essential to encourage the self-directed learning and participation in PBL group activities for the improvement of clinical competence. It is relatively important for clinical competence to consider the educational environment systematically.
PURPOSE The purpose of this study was to identify the effect of web-based learning for ventilator practice on the knowledge and clinical competence of nursing students. METHOD The research design was a non-equivalent control group pre-post non-synchronized design. Twenty five nursing students were collected for the experimental group from August 23 to November 26, 2004 and nineteen nursing students for the control group from August 22 to November 25, 2005. All subjects experienced clinical practices in an intensive care unit of a hospital in G city for 2 weeks. The web-based learning for ventilator practice was conducted in the experimental group only. The data were analyzed with t-test and ANCOVA using SPSS 10.1 program. RESULT The 2 week web-based clinical practice learning significantly improved the knowledge scores for the experimental group, however, there was no significant differences in the score for the clinical competence between experimental and control group. CONCLUSION These findings suggest that a self-directed web-based learning for ventilator practice of nursing students can facilitate the knowledge of care for a ventilated patient. Therefore, faculties should develop a variety of web-based multimedia content programs for clinical instruction based on clinical situation.
PURPOSE The purpose of this research was to describe how nurses in intensive care units (ICU) work. METHOD A total of 18 ICU nurses participated in the research. The data was collected through individual in-depth interviews and analyzed by grounded theory method using NUDIST 4.0 software program. RESULTS Three different patterns regarding nursing performance among ICU nurses were identified. These are 1) nursing performance of nurses who perform excellently, 2) nursing performance of nurses who do not perform well because of their lack of experience, and 3) nursing performance of nurses who do not perform well in spite of their good years of experience. These three different nursing performances were described in terms of seven different categories; 1) assessing and monitoring nursing problems, 2) clinical decision making, 3) interpersonal relationships, 4) holistic care, 5) technical skills, 6) problem solving, 7) working independently and creatively. This study also identified two intervening factors that influenced the advancement of their expertise. CONCLUSION The results of this study might help nurse managers in developing continuing educational programs for inexperienced nurses or those nurses not performing well to become experts by a deeper understanding of the nature of nursing performance and the factors that influence nursing performance in ICU settings.
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