• Journal of Hospice and Palliative Care
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• v.11 no.3
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• pp.136-139
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• 2008

Purpose: Epidural morphine infusion has been used to control pain in cancer patients whose cancer pain can not be controlled high dose intravenous morphine injection. To study the effectiveness and side effects of epidural morphine for the treatment of cancer pain in terminal patients at Hospice Ward, we evaluated the change in morphine equivalent daily dose for effectiveness and complications of epidural morphine infusion. Methods: We retrospectively analyzed 24 terminal cancer patients who were treated with continuous epidural morphine between 2001 and 2004 at Hospice Ward of St. Vincent's Hospital. Results: The median of baseline morphine equivalent daily dose was 615 mg, whereas the median dose of initial epidural morphine was 16 mg. The median of morphine daily equivalent daily dose dropped from 615 mg to 274 mg in one week after epidural morphine infusion therapy (P-value=0.000). The median survival from the time of the first catheter insertion was 35 days. In 6 patients, the catheter was removed due to complications, however the catheter was reinserted in 3 patients. Conclusion: Cancer pain management by epidural morphine infusion is very effective method with low rate of severe complication.

• Journal of Hospice and Palliative Care
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• v.10 no.2
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• pp.78-84
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• 2007

Purpose: The prevalence of lung cancer is increasing continuously these days. We studied clinical characters of the terminal lung cancer patients who had died in hospice units and our study is the basic report for efficient hospice and palliative care to the lung cancer patients. Methods: We retrospectively reviewed the medical records of 129 terminal lung cancer patients who had died in Sam Anyang Hospice Unit from March 2003 to December 2006. The survival days during the hospice and palliative care were analyzed using Kaplan-Meier method of SPSS 13.0. Results: There were 93 males (72%) and 36 females (28%), and median age of patients was 68 years (range $37{\sim}93$). Eighty two patients (64%) took analgesics, the others 47 (36%) not. The most prevalent reason for admission was dyspnea (47 patients, 36%) and it was different from the terminally ill cancer patients being hospitalized because of pain. And the most common symptom was general weakness (103 patients, 80%). One hundred twenty of the paitents (93%) were administered opioid analgesics, and IV morphine shots were mostly used (103 patients, 80%). Sedation was used in 87 patients (67%), and midazolam was mostly used (68 patients, 53%). The median survival in hospice and palliative care was 35 days and the median hospitalization was 24 days. Conclusion: It is very important to manage dyspnea in terminal lung cancer patients. The length of hospice and palliative care for the terminal lung cancer patients is still short. Therefore continuous education and promotion of hospice and palliative care is needed for an effective care for the patients, their families and doctors.

• Korean Journal of Occupational Health Nursing
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• v.19 no.2
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• pp.236-245
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• 2010

Purpose: The purpose of this study was to examine the relationship of psychosocial distress, intention to quit and nursing performance. Methods: The data were collected through structured questionnaires from 210 registered nurses in a general hospital. They were analyzed by descriptive statistics, t-test, ANOVA, scheffe test, Pearson's correlation coefficient and multiple regression with the SPSS WIN program. Results: The results of the analysis showed that the mean of the psychosocial distress was $25.38{\pm}7.26$, intention to quit was $3.51{\pm}0.78$, and nursing performance was $3.67{\pm}0.46$. In the correlation analysis, the nursing performance had negative correlation with psychosocial distress(r=-.371, p=.000) and intention to quit(r=-.211, p=.002). There were statistically significant differences in nursing performance depending on age, marital status, position and work experience. The psychosocial distress and age explained 15.1% of nursing performance. Conclusion: This study showed psychosocial distress and intention to quit affects the nursing performance. Therefore, nursing executives and unit managers need to concern on the significance of the stress management programs so that these can be organizational support.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.4
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• pp.404-412
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• 2008

Purpose: To analyse hospital nurse staffing level of the general nursing unit, ICU, ER and OR in general hospitals. Method: The study sample was 105 acute general hospitals which had reported the bed size and number of nurses by the nursing units. Number of bed per nurse was analysed by the hospital characteristics and the staffing levels of the doctors and the nursing assistant personnels using t-test or ANOVA and Pearson's correlation. Results: Number of bed per nurse was 3.86 in general nursing units and 0.95 in ICU. Tertiary hospitals employed more nurses in general nursing units and ICU than general hospitals. Hospitals located in Seoul and public hospitals employed more ICU nurses. OR nurse staffing level was higher in academic hospitals. Hospital size was positively correlated with nurse staffing level of the general nursing unit, ICU, ER and OR respectively. Total nurse staffing level of the hospital was positively correlated with doctor and nursing assistant personnels staffing levels. Conclusion : Differentiated nursing fee schedule was needed to implement in ER or OR. Regulation policy should be needed for the hospitals which violated hospital nurse staffing level of the law.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.4
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• pp.413-420
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• 2008

Purpose: To examine the relationship between nurse staffing level and nurse perception of nursing performance. Method: The subjects of this study were 724 nurses from 70 medical or surgical wards in 23 hospitals from February to March 2006. A self-reporting questionnaire, which was developed by the researcher through a preceding study, was used. In data analysis, SAS program was utilized for descriptive statistics, t-test, ANOVA, and Tukey test. Results: The mean score of the nursing performance was 53.3. The mean of bed-to nurse ratio was 3.39:1. The study revealed a negative correlation between bed-to nurse ratio and the nurses' perception of nursing performance. There was a significant relationship between above 3.5:1 and below 2.5:1(F=4.59, p=0.010). Conclusion: We found that the higher the nurse staffing, the better the nursing performance. It is recommended that future research measures nurses' performance and nursing organizational performance using objective measurement tools including clinical indicators.

• Journal of Korean Academy of Nursing
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• v.40 no.3
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• pp.307-316
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• 2010

Purpose: The purpose of this study was to identify the levels of relocation stress syndrome (RSS) and influencing the stress experienced by Intensive Care Unit (ICU) patients just after transfer to general wards. Methods: A cross-sectional study was conducted with 257 patients who transferred from the intensive care unit. Data were collected through self-report questionnaires from May to October, 2009. Data were analyzed using the Pearson correlation coefficient, t-test, one-way ANOVA, and stepwise multiple linear regression with SPSS/WIN 12.0. Results: The mean score for RSS was $17.80{\pm}9.16$. The factors predicting relocation stress syndrome were symptom experience, differences in scope and quality of care provided by ICU and ward nursing staffs, satisfaction with transfer process, length of stay in ICU and economic status, and these factors explained 40% of relocation stress syndrome (F=31.61, p<.001). Conclusion: By understanding the stress experienced by ICU patients, nurses are better able to provide psychological support and thus more holistic care to critically ill patients. Further research is needed to consider the impact of relocation stress syndrome on patients' health outcomes in the recovery trajectory.

• Korean Journal of Adult Nursing
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• v.26 no.6
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• pp.603-613
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• 2014

Purpose: The purpose of this study was to explore and identify the role adaptation processes of family caregivers with patients transferred from intensive care unit to general ward. Methods: Using a grounded theory methodology, in-depth individual interviews were conducted. Data were collected from 11 participants. The participants were asked about their experiences of role adaptation considering situational contexts and interactional strategies. Transcribed data and field notes were analyzed using constant comparative analysis. Results: The core category was 'becoming almost a nurse with hope and fear'. The identified phenomena by the participants were the joy of being alive, having hope for a full recovery, anxiety and fear of uncertain future, feeling burdensome on a given role. The results included both role adaptation and mal-adaptation of caregivers. Conclusion: The role adaptation processes of family caregiver with patients transferred from intensive care unit to general ward can be explained as becoming almost a nurse with hope and fear. The findings of the study provided fundamental information for developing programs to support the given family caregivers for successful role adaptation.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.3
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• pp.219-228
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• 2008

Purpose: The purpose of this study was to develop a measurement scale of nursing competence for nurses working in general wards, and to test the validity and reliability of the scale. Method: A methodological study design was used, consisting of 3 steps as conceptual framework decision, measurement items development, and testing of validity and reliability. In order to verify content validity, 16 experts reviewed the concept of each competences and measurement items. The developed measurement items were tested from 301 nurses in one hospital. Factor analysis and item analysis were applied to establish the scale's construct validity and reliability. Result: The final scale consists of nine dimensions with 70 items. The overall scale reliability had a Cronbach's alpha of 0.98, and the demensions Cronbach's alpha ranged from 0.88 to 0.95. The factor loading of construct validity was from 0.40 to 0.83. The explained variance from the 9 extracted factors was 70.93% of the total variance, and final factors were labeled as critical thinking, resources management and professional development, ability of ward management, application of nursing process, ethical accountability, respectful consideration, patient centered approach, crisis management, and leadership. Conclusion: This measurement scale can be utilized to evaluate nursing competence for nurses working in general wards.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.15 no.2
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• pp.143-152
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• 2008

Purpose: A survey was done on knowledge and attitude toward CPR and provision of CPR education to nurses on general wards. Method: A survey of 280 nurses on general wards in four university hospitals with 700 beds or more in the city of Pusan was done. The data were collected from September 10, to September 22, 2007. Results: The mean score for knowledge of Basic Life Support was 12.71 (mean converted to 100: 63). About 76% of the nurses believed that they had a responsibility to perform CPR, but 53.3% of the nurses were not confident to perform CPR. About 94% of the nurses had received education on CPR but 32.3% of those took it 6 to 12 years ago. About 41% of the nurses spent 3-4 hours for the education and 73.2% of those took simulation education. Conclusion: Although most of the nurses had received CPR education, they were not knowledgeable or confident. Therefore, better CPR education programs including up-dated knowledge are needed. More reinforced education should be offered every six months or on a yearly basis in order to enhance lasting efficiency.

• Asian Oncology Nursing
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• v.7 no.1
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• pp.26-35
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• 2007

Purpose: The purpose of this study was to set the strategy that clinical nurses can efficiently cope with the stress from bereavement care, by examining and analyzing stress factors and coping methods of nurses' bereavement care. Methods: A total of 628 nurses were recruited from four university hospitals, two cancer specialized hospitals, and three public hospitals. Stress was measured using the bereavement care stress measurement tool, and coping was done using the cope with stress scale. Results: The stress level about bereavement care of the nurses working in the cancer unit was significantly higher than the level of the nurses working in the general unit. However, there was no difference of coping level between nurses working in cancer unit and general unit. Conclusions: It is important to ensure the methods that contrive to perform bereavement care efficiently by generating hospice nurses and by activating the system for nurses specialist who perform bereavement care.