Purpose: The study was to examine the effects of the individual education about chemotherapy for cancer patients as well as their family who are receiving the first chemotherapy on self-care knowledge, self-care performance, family support, and anxiety level. Methods: A non-equivalent control group was used in this interventional study. A total of 50 patients with cancer aged above 19 in the K university hospital, Seoul, Korea, participated in the study (Experimental group: n=25, Control group: n=25). The education about chemotherapy was offered one week after hospital discharge, which was followed by telephone counseling Data were analyzed by the SPSS/WIN 20.0 program using percentage, frequency, mean, standard deviation, $x^2$ test, and independent t-test. Results: The experimental group showed a significantly better self-care knowledge (t=4.094, p<.001), self-care performance (t=3.532, p=001), family support (t=2.170, p=.035), and anxiety control (t=4.780, p<.001) than the control group. Conclusion: The findings suggest that the individual education should be considered for cancer patients and their family in the clinical fields.

Purpose: This study was performed to establish the role and to analyze the job of MFICU (Maternal Fetal Intensive Care Unit) nurses using DACUM (Developing a curriculum). Methods: A DACUM workshop was held to define MFICU nurses' role and identify their duties and tasks. A DACUM committee was consisted of 7 nurses, 2 nursing professors and 1 medical doctor and as a result, a survey was developed which contained duties and tasks of MFICU nurse. Pre-test was carried out for the validity, finally collected the data from 97 nurses who worked at 7 MFICU and 10 delivery room. Results: A total of 60 duties, 115 tasks and 822 elements of tasks were defined on the DACUM chart and survey. The importance, frequency and difficulty of the tasks were presented the determinant coefficient (DC), the highest DC duty was 'Manage maternal ventilator' (15.09) and the lowest DC was 'Provide nursing care for leisure to gestation extension mother' (6.52). Twenty-eight tasks were differentiated between MFICU and delivery nurses significantly. And the most important, frequently, difficulty task perceived by MFICU nurse was 'Check fetal heartbeat with electronic fetal heart monitor'. Conclusion: The organized educational program and policy was needed to develop for MFICU nurses.

Purpose: The purpose of this study was to investigate the effect of SBAR communication program on nurse's perception about communication and attitudes toward patient safety. Methods: A single-group pre-post experimental study was conducted. A SBAR education program was provided to 167 nurses working in 9 general wards of a hospital in Seoul. A total of 153 questionnaires were included for the final analysis. Statistical analysis included analysis of variance, paired sample t-test, and Cochran-Mantel-Haenzel test. Results: After applying SBAR communication education, nurses perceived significant improvement in three of the five categories of communication between nurses and doctors; satisfaction (p=.001), accuracy (p=.001), and understanding (p=.002). The indicators of communication between nurses were also improved significantly in the order of accuracy (p=.001), satisfaction (p=.001), shift communication (p=.001), and openness (p=.016). The scores of nurse's attitudes toward patient safety demonstrated a significant increase in the five categories out of the six; perception of management (p=.001), working condition (p=.001), safety climate (p=.001), teamwork climate (p=.001), job satisfaction (p=.012). Conclusion: It is recommended that nurses and doctors use SBAR communication in their practice. Developing education programs and utilization methods is required for the effective establishment of SBAR communication.

Purpose: This study was aimed to identify the difference in satisfaction and importance of nursing care between patients in comprehensive nursing care unit (CNCU) and general nursing care unit (GNCU). It also confirms the difference between practice environment of nursing work and nurse's intention to work. Methods: Nursing care satisfaction and importance levels were measured from 202 patients. Practice environment of nursing work and nurse's intention to work were measured from 54 nurses. Results: The satisfaction level was higher in the CNCU in comparison to the GNCU (p<.001). There was no significant difference between the importance and satisfaction level of nursing care for patients at the CNCU (p=.973), whereas in the GNCU, patients' satisfaction level was lower than the importance level (p<.001). The score for practice environment for nursing work was higher in the CNCU than in the GNCU (t=3.34, p=.002). The nurse's intention to work in the CNCU was higher than that of the GNCU, but there was no statistically significant difference. Conclusion: Through the survey, the paper suggests that comprehensive nursing care is a service type that satisfies the nursing demand (importance) that patients consider important. Results from nurses showed no significant differences.

Purpose: This study aimed to explore and understand the experience of decision making among women undergoing or forgoing selective fetal reduction who have higher-order multiple pregnancies through assisted reproductive techniques. Methods: A qualitative study was conducted from August 1, to October 30, 2013. Eight participants were interviewed and the interviews were audio-recorded and transcribed verbatim. Six persons participated in in-depth interviews in person and two participated over the telephone. A thematic analysis was conducted. Results: Four themes were identified and carefully named: Confusion after higher-order multiple pregnancy; Obstacles to choice: Uncertain safety; Weighing between reality and ideality and; Influences of medical professionals. Conclusion: The results demonstrated a wide range of factors considered by women when making decisions about selective fetal reduction, and mothers' feelings of conflict and distress in the decision-making process. The results suggest that it is important for nurses to provide emotional support and consolation, in addition to sufficient information. These findings will help nurses improve their counseling techniques by understanding the situation of infertile couples.

Purpose: This quasi-experimental study was done to develop image-use medication education for older inpatients and to evaluate the effects on their knowledge, self-efficacy, and misuse of medication. Methods: Fifty nine elders (experimental group - 30, and control group - 29) received medication education once a week for 3 weeks. Data were collected before (pretest), right after (post 1), and 4 weeks after the program finished (post 2). Drug Use Knowledge Scale, Self-efficacy for Appropriate Medication Use Scale, and Drug Misuse Scale were used. Analysis included descriptive statistics, $x^2$ test, repeated measured ANOVA. Results: Findings showed significant differences in knowledge of medication and drug misuse between groups according to time(pretest, post 1, and post 2). At post 1 and post 2, knowledge and self-efficacy levels were significantly higher and misuse scores were lower in the experimental group compared to the control group. Conclusion: Findings indicate that elder-tailored medication education consisting of group education and individual guidance with images is effective and practical for medicine safety in elderly inpatients. Moreover, it could lead to a healthier life for elders, even elders with multiple chronic diseases and taking several medications.

Purpose: This study was done to explore the relationship between expectations of the clinical ladder system (CLS), career commitment and turnover intention in nurses employed in small-medium sized hospitals. Methods: Participants were 154 nurses from 3 small-medium sized hospitals in Gyeonggi Province and Gwangju City. From February, 8 to April, 14, 2017, self-report questionnaires were collected and analyzed using frequency, t-test, ANOVA, $Scheff{\acute{e}}$ test, and Person correlation coefficients. Results: Of the participant nurses, 61% perceived the CLS as needed. The mean score for expectation of CLS, career commitment, and turnover intention on 5-point scale were 3.38, 3.17, 3.21, respectively. There were no significant differences in expectation of CLS according to general characteristics, but career commitment and turnover intention did show significant differences depending on age, position, type of work shift. Expectation of CLS correlated positively with career commitment (r=.23, p=.005), and career commitment correlated negatively with turnover intention (r=-.49, p<.001). Conclusion: The results of this study show that there is a need to adopt the clinical ladder system to improve career commitment.

Purpose: For this study an examination was done of relationships between intensive care unit (ICU) nurses' knowledge related to sedation and their clinical competencies in sedation practice. Methods: Ninety one ICU nurses were recruited from two tertiary hospitals in South Korea. A self-report questionnaire was used to examine the levels of knowledge related to sedation and nursing practice competence based on Ajzen's theory of planned behavior. Descriptive statistics, independent t-tests, one-way ANOVA, and Pearson correlations were performed using the IBM SPSS 21.0 Results: ICU nurses are more knowledgeable about general information on sedation rather than up-to-date information. Continuing education on sedation was related to difference in knowledge levels. However, the levels of knowledge were not related to competence in sedation practice. Instead, a positive attitude toward sedation practice was significantly related to the subjective norms; orders and goals, perceived behavioral control, practice of sedation, and intention to use. Conclusion: The results of this study provide fundamental information on levels of knowledge related to sedation practices of Korean ICU nurses. Continuing education should emphasize up-to-date information on sedation practice and need for positive attitudes which influence all other competencies towards sedation practices to achieve optical care of sedation in the ICU.

Purpose: This study aim to determine the effect of chewing gum on the reduction of postoperative ileus and recovery after surgery. Methods: The study was conducted as a randomized controlled trial among 82 patients who underwent spine surgery between May 2015 and October 2015. Patients in experimental group chewed sugarless gum 3 times daily for 30 minutes each time until POD 5. Abdominal discomfort, the first defecation, and CAS score (Constipation Assessment Scale) were monitored. Results: After the experiment, abdominal discomfort was significantly decreased in the experimental group compared to that of the control group (F=2.46, p=.044). However, the first defecation occurred on postoperative hour 69.6 in the chewing gum group and on hour 60.2 in the control group (t=-1.63, p=.107). CAS was significantly decreased in the experimental group compared to that of the control group (F=3.51, p=.012). Conclusion: Chewing gum is expected to help patient recover after surgery as safe nurse intervention which can reduce abdominal discomfort and constipation during early postoperative days after spine surgery.

Purpose: The purpose of this study was to examine triage nurses' the Korean triage and acuity scale(KTAS) performance ability, perception of importance, education needs and identify the factors influencing triage nurses' the KTAS performance ability. Methods: A descriptive correlational study was conducted among 146 emergency nurses working in 13 hospitals from March to May, 2017. Data were collected utilizing a questionnaire developed to measure performance ability, perception of importance, and educational needs of 192 items of the KTAS. Statistical analysis included t-test, analysis of variance, correlation analysis and multiple regression analysis. Results: The triage nurses' the KTAS performance ability was rated as 3.3/4.0 points, perception of importance as 3.2/4.0 points, and education needs as 3.1/4.0 points. Factors influencing the KTAS performance of the participants were perception of importance, education needs, and work experience at the emergency department, explaining 26.7% of total variance. Conclusion: The KTAS performance ability of triage nurses could be improved through training programs designed to enhance their perception of importance and provide knowledge about the KTAS. Nurses' emergency department work experience needs to be considered as an important factor for the KTAS performance ability.

Purpose: This study was to investigate the factors affecting smoking behavior in patients with pulmonary tuberculosis. Methods: The participants were 130 pulmonary tuberculosis patients at a national tuberculosis hospital. Using a descriptive survey design, data were collected from January to March in 2016 and were analyzed using binominal logistic regression. Results: As a result of a correlation analysis of the data, depression had a significant positive correlation with smoking (r=.19, p=.030), stress (r=.54, p<.001), respectively. And depression had a significant negative correlation with smoking-related self-efficacy (r=-.20, p=.023). Smoking-related self-efficacy, smoking (r=-.79, p<.001), and stress (r=-.23, p=.008) had a significant negative correlation with each other, respectively. The factors affecting the smoking behavior were smoking-related self-efficacy (OR=1.46, p<.001), sex (OR=67.36, p=.001), occupation (OR=17.51, p=.014), and depression (OR=1.16, p=.024). Those factors explained 84.7% (Negelkerke's $R^2=.847$) of pulmonary tuberculosis patients' smoking behavior. Conclusion: Developing and applying a prevention eduction for reducing depression and enhancing smoking-related self-efficacy may become a venue toward good prognosis of the patients with pulmonary tuberculosis.

Purpose: The purpose of this study was to revise the KPCS-1 and to standardize the three patient classification systems for general ward, ICU and NICU. The actual utilization of the KPCS-1 score and each nursing activity was evaluated and the relationships between KPCS-1 score and nursing related variables were reviewed. Methods: The 47,711 KPCS-1 scores of 6,931 patients who discharged from $1^{st}$ to $30^{th}$ April 2017 were analyzed and the statistical significance between KPCS-1 score and nursing related variables was reviewed by Generalized Estimating Equation. The revision of the KPCS-1 was carried out by Partial Least Square model. The 3 patient classification systems (KPCS-1,KPCSC and KPCSN) were standardized by professional reviews. Results: KPCS-1 was a valid instrument to express nursing condition adequately and was revised as a new version which has 34 nursing activity items. The names and terminologies of pre-existing 3 patient classification systems developed by KHNA were standardized as KPCS-GW, KPCS-ICU, KPCS-NICU. Conclusion: KPCS-1 was a valid instrument to represent diverse nursing conditions precisely and was revised as a 34-item KPCS-GW. The terminologies of the other patient classification systems by KHNA were standardized as KPCS-ICU and KPCS-NICU.