Purpose: The purpose of this study was to examine the effects of aromatherapy on stress responses, autonomic nervous system (ANS) activity, and blood pressure in patients hospitalized to receive coronary angiography (CAG). Methods: A non-equivalent control group with a pretest-posttest design was used. The subjects were patients admitted to the day angiography room to receive CAG at E University Hospital (34 in the experimental group and 30 in the control group). The experimental group treatment was inhalation of the aroma oil blended with lavender, ylang-ylang, and neroli at a ratio of 4:2:1 twice before and after CAG. The measurements of stress index, ANS activity, and blood pressure were performed 5 times as follows: at admission, at pre-CAG after treatment I, at post-CAG, 2 hours after treatment II, and 4 hours after treatment II. The data were analyzed using the Mann-Whitney U Test and repeated-measures analysis of variance. Results: Significant interactions in the high frequency of ANS (F=5.58, p=.005) were observed between group and time. Stress index (z=2.14, p=.016), systolic blood pressure (z=4.14, p<.005), and diastolic blood pressure (z=3.28, p=.001) were significantly different between the experimental and control groups after 4 hours of treatment II. Conclusion: The findings showed that aromatherapy was not effective before CAG, but was effective after CAG. Therefore, aromatherapy can be used as a nursing intervention for patients receiving CAG.

Purpose: This study was performed to develop the Job Satisfaction Scale for Clinical Nurses (JSS-CN) and verify its validity and reliability. Methods: A preliminary 42-item version of the JSS-CN was developed through literature reviews and in-depth interviews. The draft scale was developed using thirty-seven items selected following content validity evaluation. Finally, thirty-three items with response options on a 5-point Likert scale were selected based on internal consistency reliability and construct validity. Subsequently, the test-retest reliability and convergent validity of the JSS-CN were verified. Results: Six factors, namely, recognition from the organization and professional achievement, personal maturation through the nursing profession, interpersonal interaction with respect and recognition, accomplishment of accountability as a nurse, display of professional competency, and stability and job worth, were identified, which explained 59.7% of the total variance. The JSS-CN's Cronbach's ${\alpha}$ for the total scale was .95, and the intra-class correlation coefficient was .90. The correlation coefficient between the scores of the JSS-CN and Slavitt's scale was .75, and that between the JSS-CN and job performance was .53. Conclusion: Results showed that the JSS-CN has good reliability and validity. Therefore, it is concluded that the JSS-CN could be a useful tool for the measurement of the job satisfaction of clinical nurses in Korea.

Purpose: The aim of this study was to evaluate the effects of active mandibular exercise (AME) in patients with limited mouth opening after maxillomandibular fixation (MMF) release. Methods: The study used a quasi-experimental, nonequivalent control group and a pre test-post test design. Sixty-two patients with Maxillomandibular Fixation Release were assigned to the experimental (n=31) or control group (n=31). The AME was performed in the experimental group for 4 weeks. The exercise AME consisted of maximal mouth opening, lateral excursion and protrusive movement. These movements were repeated ten times a day. After the final exercise of the day, the number of tongue blades used for mouth opening was noted. The effect of AME was evaluated after MMF release at different time intervals: a) immediately, b) after 1 week, c) after 2 weeks, d) after 4 weeks, and e) after 12 weeks. The exercise was assessed using the following criteria: a) mandibular movements, b) pain scores associated with maximal mouth opening, c) discomfort scores associated with range of movement, and d) daily life activities that involve opening the mouth. Results: The experimental group showed significant improvement regarding the range of mandibular movements (maximal mouth opening (F=23.60, p<.001), lateral excursion to the right side (F=5.25, p=.002), lateral excursion to the left side (F=5.97, p=.001), protrusive movement (F=5.51, p=.001)), pain score (F=39.59, p<.001), discomfort score (F=9.38, p<.001). Daily life activities that involve opening the mouth were more favorable compared to those in the control group. Conclusion: The AME in patients after MMF release is helpful for increasing mandibular movement range, decreasing pain and discomfort, and improving day life activities that involve opening the mouth. Therefore, AME is highly recommended as an effective nursing intervention.

Purpose: This study aimed to develop an instrument to assess the quality of childbirth care from the perspective of a mother after delivery. Methods: The instrument was developed from a literature review, interviews, and item validation. Thirty-eight items were compiled for the instrument. The data for validity and reliability testing were collected using a questionnaire survey conducted on 270 women who had undergone normal vaginal delivery in Korea and analyzed with descriptive statistics, exploratory factor analysis, and reliability coefficients. Results: The exploratory factor analysis reduced the number of items in the instrument to 28 items that were factored into four subscales: family-centered care, personal care, emotional empowerment, and information provision. With respect to convergence validation, there was positive correlation between this instrument and birth satisfaction scale (r=.34, p<.001). The internal consistency reliability was acceptable (Cronbach's alpha =.96). Conclusion: This instrument could be used as a measure of the quality of nursing care for women who have a normal vaginal delivery.

Purpose: The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients. Methods: This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis. Results: Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (${\beta}=-.39$, p=.013) and 4 sub-scales of QoL were also affected by uncertainty. Among the 4 sub-scales of QoL, physical well-being (PWB) (${\beta}=.17$, p=.026), social well-being (SWB) (${\beta}=.49$, p=.010), and functional well-being (FWB) (${\beta}=.38$, p=.009) were affected by marital intimacy but emotional well-being (EWB) was not affected by it. The mediating effect of marital intimacy on the impact of uncertainty on QoL was confirmed. Marital intimacy showed a significant indirect effect on PWB (${\beta}=-.07$, p=.024), SWB (${\beta}=-.19$, p=.008), and FWB (${\beta}=-.15$, p=.005), and it means that marital intimacy has a partial mediating effect on the impact of uncertainty on PWB, SWB, and FWB. Conclusion: Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.

Purpose: The purpose of this study was to investigate variables and construct paths that affect complicated grief. Methods: Participants in this cross-sectional, descriptive study were 164 bereaved spouses of cancer patients at least 12 months before the death. Data were collected from October 2016 to February 2017 using self-report structured questionnaires and were analyzed using IBM SPSS 21.0 and AMOS 20.0. Results: The variables affecting complicated grief of bereaved spouses of cancer patients were the quality of end-of-life care (${\gamma}=.15$, p<.001), preparedness for death (${\beta}=-.06$, p=.005), and coping with bereavement (${\beta}=-.24$, p<.001), whereas the quality of death and dying did not show any effects. Preparedness for death had multiple mediating effects in the relationship between the quality of end-of-life care and complicated grief (z=-2.20, p=.028), and in the relationship between the quality of end-of-life care and coping with bereavement (z=2.11, p=.035). Coping with bereavement had a mediating effect on the relationship between preparedness for death and complicated grief (z=-2.39, p=.017). Conclusion: This study revealed that preparedness for death and coping with bereavement play a prominent role in complicated grief. Therefore, it is important to help in preparing for death and enhancing coping with bereavement of spouses providing end-of-life care to cancer patients. In addition, investigating cultural differences in the relationship between the quality of end-of-life care and complicated grief is recommended.

Purpose: This study was conducted to evaluate the validity and reliability of the Korean version of the clinical learning environment, supervision and nurse teacher evaluation scale (CLES+T) that measures the clinical learning environment and the conditions associated with supervision and nurse teachers. Methods: The English CLES+T was translated into Korean with forward and back translation. Survey data were collected from 434 nursing students who had more than four days of clinical practice in Korean hospitals. Internal consistency reliability and construct validity using confirmatory and exploratory factor analysis were conducted. SPSS 20.0 and AMOS 22.0 programs were used for data analysis. Results: The exploratory factor analysis revealed seven factors for the thirty three-item scale. Confirmatory factor analysis supported good convergent and discriminant validities. The Cronbach's alpha for the overall scale was .94 and for the seven subscales ranged from .78 to .94. Conclusion: The findings suggest that the 33-items Korean CLES+T is an appropriate instrument to measure Korean nursing students'clinical learning environment with good validity and reliability.

Purpose: This qualitative study aimed to explore the experience of incivility among nursing students. Methods: Sixteen nursing students who had experienced incivility during their clinical placement were invited for one-on-one interviews until the point of theoretical saturation. The grounded theory approach of Corbin and Strauss was adopted to analyze transcribed interview contents. Results: Incivility occurred in the context of a hierarchical organizational culture, due to nursing students' position as outsiders, non-systematic clinical education, and poor nursing work environment. The experience of incivility was identified as "being mistreated as a marginal person," and nursing students responded to this phenomenon in the following three steps: reality shock, passive action, and submissive acceptance. This process caused students to lose self-esteem and undergo role conflict. Furthermore, nursing students' experience of incivility could eventually lead to workplace bullying in nurses. Conclusion: The results of this study suggest that nursing students' experience of incivility can be a process that threatens their identity. It is necessary to develop educational programs and provide appropriate counseling services so that nursing students can actively cope with the incivility. In addition, institutional plans are needed to ensure safe and supportive clinical learning environments.

Purpose: This study aimed to construct and test a hypothetical model of the quality of life of school-age children with asthma based on the health-related quality of life model by Wilson and Cleary. Methods: Data were collected from 205 pairs of pediatric outpatients diagnosed with asthma and their parents in Seoul and Gyeonggi-do from July 2016 to April 2017. The exogenous variables were asthma knowledge, number of accompanying allergic diseases, and social support. The endogenous variables were asthma self-efficacy, asthma symptom control, perceived health status, parental quality of life, and children's quality of life. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. Results: Eighteen of the twenty-four hypotheses selected for the hypothetical model were attentive and supported statistically. Quality of life was explained by asthma self-efficacy, asthma symptom control, perceived health, parental quality of life, and asthma knowledge with 83.5%. Conclusion: Strategies for promoting self-efficacy and enforcing asthma knowledge will be helpful for the improvement of health-related quality of life with school-aged asthmatic children.

Purpose: This study was conducted to examine the longitudinal effects of parenting stress and parental control attitudes on problem behaviors in preschool children, using a latent growth model. Methods: Participants were 1,724 pairs of parents and 1,724 preschool children who had completed the panel survey on Korean children ($5^{th}{\sim}7^{th}$ survey panels). Results: An analysis of the multivariate latent growth model of parenting stress, parental control attitudes, and children's problem behaviors suggested that the parents' intercepts for parenting stress influenced their intercepts for parental control attitudes (father: ${\beta}=.21$, p<.001; mother: ${\beta}=.55$, p<.001). In addition, the slopes for fathers' parenting stress was the only aspect that affected the slopes for mothers' parental control attitudes (${\beta}=.77$, p<.001). Moreover, both the intercepts and slopes of parenting stress and parental control attitudes significantly affected the children's problem behaviors. Conclusion: This study is significant as it provides longitudinal evidence of the impact of parenting stress and parental control attitudes on children's problem behaviors. The findings suggest that accurately assessing changes in parenting stress and parental control attitudes and developing intervention programs to reduce them will be effective in reducing problem behaviors in children.