• Journal of Korean Academy of Nursing Administration
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• v.11 no.1
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• pp.79-88
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• 2005

Purpose: This study was conducted to assess the effects of shift-work on psychological factors in university hospital's nurses. Method: The subjects were 276 nurses who have worked in a university hospital and the nurses were questioned with self-reported questionnaire forms. We investigated psychological factors(anxiety, depression, stress and self-esteem), nurses' general characteristics and shift-work. The data was analyzed by using SAS for Windows 9.13. Results: The frequency of nurses with anxiety, depression and high stress were 56.5%, 44.9% and 19.6%, respectively. The mean score of self-esteem was 30.03. Stress was higher in cases of having shift-work. Immediately after doing shift-work, nurses had higher depression and stress, and lower self-esteem scores. After controlling confounding variables, psychological factors affected by shift-work was stress. An upward tendency in anxiety, depression and stress were found in cases of doing shift-work for more than 5 years. Conclusions: It is necessary to develope a program for reducing psychological disturbance at the early times of shift-work and to plan adequate shift-work intervals.

• Health Policy and Management
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• v.19 no.2
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• pp.36-50
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• 2009

Korean Government had performed three pilot programs to introduce the long term care insurance system. Persons aged 65 or older who are dependent on others for daily living could use long term care services in the pilot program. The long-term care insurance covered nursing home services, home care services and cash benefits. The cash benefits are included that for elderly at home and for patients in geriatric hospital. This study investigated whether there had been any change in the medical care utilization according to cash benefits for geriatric hospitalization. This study used National Health Insurance claims and Long term Care Insurance claims 2003 through 2006. Data were composed of subjects who undertook both insurance coverage. The subjects was divided into two groups. Case group included participants with the cash benefits of geriatric hospitalization. Control group included persons without the cash benefits selected by random sampling according to the distribution of case group. This study showed that the amount of medical care utilization of the case group is more significantly increased than the control group after adjusted their health condition and functional condition. This result will be helpful for making decisions on whether the cash benefit of geriatric hospitalization can be introduced into long term care insurance system.

• Health Policy and Management
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• v.19 no.2
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• pp.111-126
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• 2009

The purposes of this study were (1) to describe the effects of transformational leadership and transactional leadership on the hospital member's organizational commitment and turnover intention, (2) to provide with fundamental data in enhancing organizational effectiveness. For this purpose, the types of leadership, organizational commitment and turnover intention were evaluated among hospital members. A survey was conducted with 827 respondents working in a general hospital in Sungnam-shi. For the data analysis SPSS 10.0 was utilized. To verify the reliability and validity of variables, Chronbach's ${\alpha}$ and confirmatory factor analysis were processed. After descriptive analysis, regression analysis was conducted. In these progresses all the statistical significant levels were set at ${\alpha}$= 0.05. Results of the study can be summarized as follows. First, the types of leadership had differences in the level of organizational commitment and turnover intention of the hospital members and then transformational leadership had a more influence than did transactional leadership. Second, there were significant correlations for organizational commitment and turnover intention with overall characteristics of leadership(p<.05). Third, the factor influencing hospital member's organizational commitment and turnover intention were transformational leadership(p<.001). Total explanatory powers($R^2$) were 20.2% (organizational commitment) and 12.1%(turnover intention). Multiple regression analysis demonstrated that organizational commitment significantly high when transformational leadership was higher and it also showed turnover intention was significantly lower. In conclusion, the results of this study show that the leadership influence hospital member's organizational commitment and turnover intention and they are different the types of leadership. This results suggest that in order to be as successful leaders in hospital, the leaders should know their employee's behaviors and change their leadership styles.

• Journal of Korean Academy of Nursing Administration
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• v.20 no.1
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• pp.69-81
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• 2014

Purpose: The aim of this study was to investigate and identify work environment, job embeddedness, and burnout among general hospital nurses in Korea. Methods: The participants were 563 clinical nurses working in 13 general hospitals across the country. Data were analyzed using SPSS and Microsoft Excel programs. Results: Mean scores were 2.62 for nurses' work environment, 2.97 for job embeddedness, and 3.61 for burnout. Nurses' work environment showed a positive correlation with job embeddedness (r=.70, p<.001), but a negative correlation with burnout (r=-.49, p<.001). Subcategories of nurses' work environment that predicted job embeddedness included satisfaction and happiness, hospital support for the work environment, patient care environment, satisfaction with work schedule, manager leadership, supportive environment for nurses' work, and computer problems. Subcategories of nurses' work environment that predicted burnout included satisfaction and happiness, violence within ward, hospital support for work environment, and patient care environment. Conclusion: Findings from this study indicate the need to evaluate and improve the work environment for nurses to increase job embeddedness and control burnout. Future studies should explore ways in which turnover intention can be decreased by changing nurses' work environment.

• Journal of Korean Academy of Nursing Administration
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• v.20 no.2
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• pp.145-153
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• 2014

Purpose: The purpose of this study was to identify the relationship between the practice environment of nursing and the critical thinking disposition of clinical nurses in local general hospitals. Methods: A convenience sample of 468 registered nurses was obtained from three local general hospitals. Data were collected by a self-administered questionnaire during November, 2012. The survey tools were the K-PES-NWI verified by Cho et al (2011) and the critical thinking disposition instrument developed by Yoon (2004). Data were analyzed using descriptive statistics, one-way ANOVA with Scheff$\acute{e}$ test and multiple regression with SPSS/WIN 18.0. Results: The mean score for practice environment of nursing was $3.3{\pm}0.4$ and for critical thinking disposition, $2.3{\pm}0.4$. There were statistically significant differences in critical thinking disposition according to age, education, length of career, current position, and marital status. In multivariate analysis, factors related to critical thinking disposition were collegial nurse-physician relations and education level. Conclusion: The results of the study indicate that collegial nurse-physician relations in the nursing practice environment are related to nurses' critical thinking disposition, and thus, it is important to improve the practice environment as well using individual approaches including on-the-job training to improve nurses' critical thinking disposition.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.1
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• pp.151-167
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• 2002

Purpose : The purpose of this study is to present the direction of service marketing for improving customers' satisfaction by comparing the difference in medical and nursing service satisfaction between internal and external customers. Method : The subjects were outpatients and inpatients as the external customers and nurses, doctors, and staffs as the internal customers, in a university hospital. Data were collected from April 25 to May 2, 2001 through questionnaires. The 2 structured instruments were used for collecting the data: Customer Satisfaction Measurement 2000 developed by Korean Society of Quality Assurance in Health Care(1999) and nursing service satisfaction questionnaires by the researcher. Data were analyzed using SPSSWIN 9.0 with t-test, one-way ANOVA, scheffe test.Result : 1. In overall medical service satisfaction scores, external customers' satisfaction showed significantly higher than internal customers'(p=.000) and there was no significant difference between external customers(p>.05). But there was significant difference between internal customers(p<.05). 2. There was no significant difference in nursing service satisfaction between the external and internal customers (p>.05). In the external customers, inpatients' nursing service satisfaction showed significantly higher than outpatients' (p<.001). And there was significant difference in nursing service satisfaction between internal customers(p<.05). Conclusion : To increase external customers' satisfaction with medical and nursing service, hospital should carry out internal marketing strategies for improving internal customers' satisfaction. Also to increase outpatients' satisfaction, it should conveniently improve procedures of use and provide more information and education for outpatients.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.4
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• pp.551-561
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• 2002

Purpose : The purpose of the present study was to examine the causal relationships among head nurses' leadership (consideration oriented leadership, structure initiated leadership), nursing unit culture (human development culture, task development culture), and nurses' organizational commitment. Method : Four large general hospitals located in and around Seoul were selected to participate. The total sample of 286 registered nurses represents a response rate of 90 percent. Data for this study was collected from August to September in 2000 by questionnaire. Path analyses with LISREL program were used to test the fit of the proposed model to the data and to examine the causal relationships among variables. Result : Both the proposed model and the modified model fit the data adequately. The model revealed relatively high explanatory power. 52% of human development culture was explained by predicted variables and 44% of task development was explained by predicted variables; 47% of the organizational commitment was explained by predicted variables. In predicting developmental (both human and task) nursing unit culture, the findings of this study clearly demonstrated that head nurses' consideration oriented leadership might be the most important variable. The result also showed that head nurses' consideration oriented leadership might be the most important variable among the predicted variables in predicting organizational commitment. Conclusion : Based on the findings of this study, it was suggested that various studies, for example, matching leadership and nursing unit culture, were needed.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.363-385
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• 1998

The purpose of this study is to investigate the relationship between organizational culture types and organizational effectiveness in the hospitals and to identify the cultural and organizational characteristics of the hospitals with high organizational effectiveness. Data were collected from May 12 to June 14. 1997 through questionnaire taken by 1.118 nurses working in 10 hospitals with more than 800 beds and from annual reports published by the hospitals. The instruments were used for collecting the data: Organizational Culture Questionnatire and Organizational Characteristics Questionnatire developed by the researcher. Mowday's Organizational Commitment Questionnaire. Taylor & Bovver's General Satisfaction Scale. The Results were as follows: 1. The meta culture of the hospital organizations was the conservative culture. 2. There were significant differences of the four organizational cultural types - affiliative culture. innovative culture. conservative culture. task culture among the hospitals(p=.00). 3. The hospital organizations were classified in to three cultural patterns. each of which had similar cultural composition. on the basis of the scores indicating the similarity and difference of the foul' organizational cultural types among the hospitals. The organization of each group represents conservative- dominant culture. innovative-dominant culture and competitive culture. 4. Nurses' organizational commitment and job satisfaction were significantly different among the cultural patterns(p=.00). In other words. the hospitals with innovative-dominant culture showed higher organizational commitment and job satisfaction than ones with conservative-dominant culture and competitive culture. And also. the growth rate of outpatients and inpatients were significantly different among the cultural patterns(p<.05). The hospitals with innovative -dominant culture showed higher growth rate of outpatients and inpatients than ones with conservative-dominant culture and competitive culture. 5. The hospitals with conservative-dominant culture and competitive culture showed higher level of centralization than ones with innovative -dominant culture(p=.00) And the hospitals with competitive and innovative-dominant culture showed higher level of communication than those with conservative-dominant culture(p=.00) Finally. the hospitals with innovative-dominant culture showed higher level of managerial strategy than those with conservative-dominant and competitive culture. among which the latter showed higher level of managerial strategy than the former(p=.00).

• Journal of Korean Academy of Nursing Administration
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• v.11 no.2
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• pp.195-207
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• 2005

Purpose: The purpose of this study was to confirm the change of nursing organizational characteristics and to define the difference of organizational outcome by measuring the organizational commitment and job satisfaction perceived by nursing staffs and patient satisfaction before and after organizational redesign. Method: The structured questionnaires of which contained organizational characteristics, organizational commitment and job satisfaction were developed from previous published studies after modification by researcher. The questionnaires were distributed to 1,200 and 679 nurses before and after nursing organizational change. patient satisfaction were measured before and after organizational change by direct interview with structured questionnaire from 1,566 and 1,291 patients. Results: 1. The organizational characteristics were significantly increased and the leadership of team leader and head nurse was significantly increased among the factors of organizational characteristics. 2. Organizational commitment was showed decreased tendency, but the difference was not significant. Job satisfaction was increased significantly and administration, autonomy, and job tasks were increased significantly in the factors of job satisfaction. Patient satisfaction was also increased significantly. 3. There was significant positive correlation between organizational commitment and job satisfaction and also job satisfaction and nursing organizational characteristics. All factors of organizational characteristics and satisfaction in present working unit were major factors to influence organizational commitment and explained 43.8% in a significant level by multiple regression analysis. The major factor which affect job satisfaction were the factors of nursing organizational characteristic except 'interaction with team leader' and satisfaction in present working unit among general characteristics and these factors explained 58.8% of job satisfaction. Conclusion: In conclusion, the nursing organizational change was very effective to bring about desirable change in nursing organizational characteristics and also to improve job satisfaction and patient satisfaction. Therefore the nursing productivity and comparability would be increased when the nursing organizational change is accomplished by the way of improving the factors of organizational characteristics and it would be followed by the promotion of job satisfaction and organizational commitment.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.4
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• pp.559-569
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• 2003

Purpose: The purpose was to investigate nurse staffing levels and patient outcomes(nosocomial infection, patient fall, pressure ulcer). Method: The subjects of this study were 305 nurses from 20 general hospitals who worked at 39 medical and surgical wards. Self-reporting questionnaire which was developed by the writer through preceding study was used. In data analysis, SPSS WIN 10.0. program was utilized for descriptive statistics, ANOVA. Result: The mean of patient-to-nurse ration was 5.2:1. 65% among 20 hospitals was over 300 beds, 90 was located in urban area and 55 was private hospitals. Patient-to-nurse ration of hospitals in under 300 beds or rural area or private ownership was lower than hospitals in 300 beds or urban area or public ownership. 89.9 among 39 wards was medical or surgical wards. The mean of length of stay, 8-14 days got a majority and showed higher patient-to-nurse ration. Of the general characteristics, rural was significantly hight to patient fall(F=3.205, p<.05), medical unit was significantly high to patient fall, pressure ulcer(patient fall: F=8.890, p<.001, pressure ulcer: F=3.399, p<.05) and over 15 days was significantly higher than under 14 days of the mean of length of stay. And there was significant relationship between over 6.0:1 and over 4.0:1 to less than 5.0:1(F=4.817,p<.01). Conclusion: This study has shown a relationship between patient-to-nurse ration and patient fall using not objective research tool but self-reporting questionnaire. Therefore further research is needed to study using objective research tool. Based on this study, the effect of nurse staffing levels on patient outcome also has to be studied.