Purpose: This study aimed to examine the differences in Korean nurses' cultural competence perceived by nurses and foreign patients in a general hospital. Methods: The study participants were recruited from outpatient clinics and wards in H General Hospital located in Busan. Cultural competence was measured by the Cultural Competence Scale for Korean Nurses, consisting of 4 subscales: cultural perception, cultural knowledge, cultural sensitivity, and cultural skills. Data were collected from March 31 to April 30, 2014 by distributing and collecting a self-administrated questionnaire set. Data of the 90 foreign patients and 90 nurses were analyzed using PASW statistics 18.0 for independent t-test and ANOVA. Results: The level of cultural competence of Korean nurses perceived by foreign patients was significantly higher than that of nurses. On the cultural awareness dimension, nurses rated themselves more highly than foreign patients did while ratings on the dimensions of cultural knowledge and cultural skill were the opposite. Conclusion: This study indicates that there was a statistically significant difference in the perception of nurses' cultural competence between nurses and foreign patients. The findings can be used for developing education programs to enhance nurses' cultural competence, integrating the perspectives of foreign patients.

Purpose: This study was conducted to investigate the relationship between uncertainty in illness and the future, sick role behavior with what diet, weight control, no smoking, abstinence, doctor visits, medications, etc, and quality of life of rehospitalized patients after percutaneous coronary intervention in a cardiology ward. Methods: A total of 120 patients participated in the study. Data were collected using a questionnaire and analyzed using t-test, ANOVA, $Scheff{\grave{e}}$ test, and Pearson's Correlation Coefficient. Results: The mean score for uncertainty was $3.45{\pm}1.08$. Sick role behavior of the patients showed a moderate value with a mean of $3.68{\pm}0.79$. The mean score for quality of life was $3.52{\pm}0.64$. Uncertainty in illness and the future was significantly correlated to sick role behavior with that diet, weight control, no smoking, abstinence, doctor visits, medications, etc (r=-.27, p=.002), and quality of life (r=-.35, p<.001), and sick role behaviors were significantly correlated to quality of life (r=.62, p<.001). Conclusion: The results implicate that there is a need to decrease the levels of uncertainty and reinforce positive behaviors by patients in order to improve their quality of life.

Purpose: The purpose of this study was to identify sexual activities of males with spinal cord injury (SCI) and influential factors of sexual adjustment. Methods: A correlational survey was conducted among a total of 135 males with SCI. Results: After SCI, patients maintained low levels of sexual adjustment, and a main obstacle of sexual rehabilitation was decreased erectile function (65.2%). Sexual desires recovered in 84.4%, with 62.4% patients reporting more than once intercourse experiences. The erectile function of participants with normal, decreased or no erectile function were 13.0%, 62.6% and 24.4%, respectively. 8.1% of the participants reported no problem with ejaculation. Patients with incomplete SCI had better preserved erectile function than those with complete SCI (t=-4.627, p<.001). Patients with upper motor neuron injury had better preserved erectile function than those with lower motor neuron injury (t=2.446, p =.016). Sexual adjustment was relevant to age, job, degree of injury, post-injury period, sexual desire, intercourse experience, erection therapy, erectile function, and sexual health. Sexual adjustment was a factor of sexual health with a power of 24.2%. Conclusion: The main obstacle of sexual rehabilitation for males with SCI decreased erectile function. Erection and ejaculation are dependent on the severity and level of SCI. The major influence on sexual adjustment is sexual health.

Purpose: This study aimed to use the DACUM analysis technique and identify the job description among nurses of the Central Supply Department, in order to clarify their duty and task descriptions, identify the characteristics of job. Methods: Through a DACUM workshop, job descriptions, and the job duties and tasks were derived. A total of 150 nurses from the Central Supply Departments of medical Institutions over 100 beds were surveyed using drafting and a job analysis table. Individual jobs' frequency, importance and difficulty were measured using a 3-point scale, and the results were analyzed using SPSS. Results: The nurses' job in the Central Supply Department consisted of 13 duties and 64 tasks. Duties with highest importance and difficulty was 'sterilization assurance system', the second was 'employee safety management' and the duty with highest frequency was 'manage packaging before sterilization'. Conclusion: This study clarified the types of nursing jobs in the Central Supply Departments, as well as identified the job characteristics and status in the given setting. Given the sterilization assurance system for preventing hospital infection, and safety management for ensuring work environment safe were found to be important duties, it is suggested for the department to stress those important jobs for managing hospital safety.

Purpose: This study aimed to develop the protocol of kangaroo care for premature infants and to evaluate its effects including physiologic responses of premature infants, their parents'anxiety, and neonatal nurses'perception regarding the kangaroo care. Methods: Kangaroo care protocol was developed through a literature review and validation of an expert group. The developed kangaroo care protocol was tested with 27 preterm infants, 24 parents, and 60 nurses in one neonatal intensive care unit in S hospital. Data were collected from December 2012 to February 2013 and analyzed by descriptive statistics and t-test using the SPSS/Win statistical program. Results: Physiologic responses including heart rate, respiration rate, oxygen saturation, body temperature among premature infants received the kangaroo care were maintained within normal limit. The anxiety levels of the parents who provided kangaroo care for their infants were significantly decreased as it was compared before and after care (t=3.43, p=.002). There were no significant differences in nurses'perceptions about kangaroo care before and after the application of the protocol. Conclusion: The developed kangaroo care protocol is proved to be effective and can be used safely in nursing practice.

Purpose: The purpose of this study was to compare the effectiveness of heparin and 0.9% normal saline solution flushing for maintaining patency of non­tunneled central venous catheters in patients with surgery. Methods: A randomized controlled clinical trial was performed. Fifty­eight patients were prospectively enrolled and fifty-four patients were completed the study. The heparin group consisted of 30 patients given 100u/ml diluted heparin flushing and the normal saline group consisted of 24 patients with 0.9% sodium chloride flushing. Results: There was no significantly difference in occlusion between the heparin group and the normal saline group in non­tunneled central venous catheters' occlusion. Also there was no difference between these two groups in catheter­related infections. Conclusion: Flushing with 0.9% normal saline is as effective as flushing with heparin solution in maintaining the patency of non­tunneled central venous catheters. In this study, however, the duration of central line use was short and the infection occurrence was little. Further studies are warranted with a larger sample size at multiple centers.

Purpose: Deep Vein Thrombosis (DVT) is the cause of fatal diseases such as pulmonary embolism, due to a prolonged immobility, surgery, paralysis, and injuries. This study aimed to develop an evidence-based practice guideline for DVT prevention and apply it to patients with surgery in diverse nursing sites in South Korea. Methods: A 24-staged processes of adaptation was carried out on the basis of "adaptation of nursing practical guidelines" developed by Gu et al., in 2012. Results: Developed nursing guidelines of DVT prevention are composed of 79 recommendations in 8 domains. The extent and ratings of each recommendation with its evidence were addressed along with the background information. Conclusion: The developed DVT prevention guideline is necessary to be added to the evidence-based practice guidelines for the fundamentals of nursing practice. The developed guideline is needed to be disseminated to diverse nursing clinical settings in order to prevent DVT and enhance the quality nursing care.

Purpose: This was a descriptive correlation study to identify emergency room (ER) nurses' coping types and factors affecting compassion satisfaction (CS) and compassion fatigue. Methods: During March and April 2013, 170 questionnaires were distributed to ER nurses working in general hospitals in D and C regions. Data were analyzed using descriptive statistics, t-test, ANOVA, correlation analysis, and stepwise regression analysis. Results: Compassion fatigue was most strongly affected by emotional expression for burnout and by practical support pursuit for secondary traumatic stress. Positive coping, emotional expression, position, positive reinterpretation, and self-blame explained 42% of CS. Conclusion: Results indicate that nurses with moderate levels of career had high compassion fatigue and low compassion satisfaction. Thus these nurses need to be given an opportunity to achieve self-development and improve their ability as nurses; interventions that can reinforce positive coping strategies should be provided as personal coping strategies affect compassion fatigue and compassion satisfaction.

Purpose: This study was done to identify the core concepts and structure of difficult experiences of charge nurses in general hospitals. Methods: Data were collected from August 1 to September 5, 2014. Participants were 10 nurses from general hospitals in D and S cities. Parse research method was applied to examine lived experiences of the participants. The procedure of study was based on dialogical engagement and data were analyzed by extraction-synthesis and interpreted heuristically. The research question was "Would you tell me about your difficult experiences as a charge nurse?" Results: Job-related difficulties of the charge nurses were conflicts due to ineffective communication, heavy workload, not feeling respected, role conflict, and struggling to overcome difficulties with sense of responsibility to the work. The conceptual integration was: to be in the process of being originated and transformed through connecting-separating and enabling-limiting with valuing. Conclusion: Structural conversion of these concepts reveals that charge nurses suffer from the job-related difficulties identified in this study, but they endure to proceed with a sense of mission. It is suggested that supportive interventions should be made to let charge nurses express their feelings, identify their needs, and develop self-care or coping skills for themselves.

Purpose: The purpose was to determine the content validity of a semantic revision of items on a reliable and valid instrument, the Sieloff-King Assessment of Group Outcome Attainment (Power) within Organizations in Korea (K-SKAGOAO). Methods: The target population for research was chief nurse officers (CNOs) of all hospital within Korea. A sample of 303 hospitals from across the Korea was selected through a stratified random sampling process. A total of 174 CNOs comprised the final sample. Psychometric evaluation of the K-SKAGOAO included: (a) criterion-related validity (b) factor analysis and (c) internal consistency reliability using Cronbach's alpha coefficients. Results: The Convergent validity and criterion-related validity were supported. Cronbach's alpha coefficient for the K-SKAGOAO was .95. Subscale alphas ranged from .60 to .86. Conclusion: The K-SKAGOAO and related subscales show validity and internal reliability. A nursing group of any size can use the K-SKAGOAO to both assess the group's level of outcome attainment and develop strategies to further improve that level.

Purpose: To improve professional intensive care by analyzing admission causes, causes of death, disease conditions, and treatment processes in patients with hematological malignancies admitted to intensive care units (ICUs) in South Korea. Methods: This was a retrospective study approved by IRB, and conducted on admission with 559 adults, in the hematology ICU of a hospital located in Seoul. The study was carried out from April 2009 to March 2012. Data were analyzed using SAS. Results: Pneumonia was the most frequent cause of ICU admission and death, followed by sepsis. The condition at discharge was death (53.6%), recovery (39.9%), or hopeless (5.1%). Mortality of patients in states of incomplete remission was higher than that of patients with complete remission and of patients with multiple myeloma, severe aplastic anemia, and lymphoma. Conclusion: Results show that pneumonia and sepsis are the most frequent causes of ICU admission and for the death of patients with hematological malignancies. The most frequent status at discharge of patients with hematological malignancies was death (53.6%), with mortality of patients at Incomplete Remission status, of mechanically ventilated patients, and of patients on continuous renal replacement therapy (CRRT) being higher than others.

Purpose: This study was a descriptive correlation research designed to provide basic data on family nursing interventions by examining burden, social support and quality of life for family caregivers of patients on hemodialysis. Methods: Data were collected from 132 family caregivers of patients on hemodialysis and analyzed using frequency analysis, correlation analysis, independent samples t-test method, one-way ANOVA and post-hoc analysis of $Scheff{\grave{e}}$, and multiple regression analysis. Results: Burden for family caregivers of patients on hemodialysis was 3.03, social support, 4.77, and quality of life, 3.26. Burden showed a negative correlation with social support (r=-.34, p<.001), and with quality of life (r=-.54, p<.001). There was a positive correlation between social support and quality of life (r=.54, p<.001). Factors predicting quality of life for family caregivers, were a significant and positive effect from social support (t=5.72, p<.001) and a negative effect from family burden (t=-5.62, p<.001). Conclusion: Results of the study indicate that burden of these family caregivers can be reduced by social support which plays an important role in improving quality of life. A nursing intervention program which goes beyond simply caring for patients and includes assessment of family burden and support for overall family caretaking needs to be developed.

Purpose: Screening of delirium using delirium assessment tools could promote delirium detection, however, there is lack of report about regular delirium assessment in Korea. This study was intended to describe the prevalence and related risk factors of delirium in intensive care unit (ICU). Methods: The Confusion Assessment Method for the ICU (CAM-ICU) data which were evaluated by nurses in ICUs was obtained through retrospective chart review. Data were analyzed using descriptive statistics, Chi-square test, t-test, Mann-Whitney U test, and stepwise logistic regression. Results: Delirium was evaluated in 125 patients. The incidence rate of delirium was 27.2% with a high prevalence of hypoactive delirium compared to hyperactive delirium (61.8 vs. 38.2%). Those with delirium were older, had hypertension, stayed longer in hospital, receiving ventilator support, had more number of catheters, had low serum protein and albumin level. Delirium incidence also varied according to diagnosis. Age, diagnosis of gastrointestinal disease, and application of ventilator were the significant risk factors for the incidence of delirium. Conclusion: Routine delirium screening is important for early detection of delirium. Identification of high-risk group and running delirium prevention programs could improve early recognition of delirium in ICU.