• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.113-127
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• 2021

Purpose : This systematic review was conducted to identify which dyadic intervention could be implemented for heart failure patient-family caregiver dyads to improve patient and/or their family caregivers outcomes. Method : Eleven databases were searched from their inception to July, 2021. This review considered any randomized controlled trials that evaluated the effectiveness of intervention including heart failure patient-family caregiver dyads. Two reviewers independently evaluated the methodological quality using the Cochrane Collaboration's tool for assessing risk of bias and extracted details of the included studies. The studies included in this review were not suitable for meta-analysis and therefore the results were presented as a narrative summary. Results : Six studies including 900 dyads were included and mainly primary family caregiver of patients was spouse. Majority of dyadic intervention were focused on psychoeducational intervention excepting one study on mobile health intervention. All studies included in this review focused on patients' outcomes compared to family caregivers' outcomes and dyadic outcomes. Individual interventions improved quality of life among heart failure patients and their family caregivers in two articles. The overall quality of selected articles was low. Conclusions : This study provides moderate support for the use of a dyadic intervention to improve quality of life among heart failure patients and their family caregivers. More rigorous high-quality studies investigating interventions to meet the needs of patient and family caregivers in heart failure care are needed.

• Journal of Korean Critical Care Nursing
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• v.12 no.2
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• pp.39-49
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• 2019

Purpose : The purpose of this study was to identify the extent to which intensive care unit (ICU) nurses' perceptions of life-sustaining treatment decisions and "a good death" affect attitudes toward terminal care. Method : Participants included 109 ICU nurses from three university hospitals. Data were collected using structured questionnaires, and collected data were analyzed using a t-test, ANOVA, the $Scheff{\acute{e}}$ test, Pearson correlation coefficients, and a multiple regression analysis (SPSS 24.0 program). Results : Perceptions of life-sustaining treatment decisions and a sense of closeness (a constituent for the awareness of "a good death") were positively correlated with terminal care attitudes. The factors affecting terminal care attitudes were a clinical career in ICU (${\beta}=.20$, p =.035), a sense of closeness(${\beta}=.19$, p =.041), and the perception of a life-sustaining treatment decision (${\beta}=.22$, p =.017). This finding indicates that more than 10 years of experience in ICU, a greater sense of closeness, and a higher view of life-sustaining treatment decisions results in more positive attitudes toward terminal care. The explanatory power of these variables on terminal care attitudes was 14% (F=6.84, p < .001, Adj $R^2=.140$). Conclusion : A sense of closeness and the perception of life-sustaining treatment decisions were identified as the factors affecting terminal care attitudes. Thus, various programs must be developed to raise awareness among ICU nurses of "a good death" and perceptions of life-sustaining treatment decisions.

• Journal of Korean Academy of Nursing
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• v.49 no.4
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• pp.423-436
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• 2019

Purpose: The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. Methods: Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through indepth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. Results: Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced 'balancing emotions' and 'authenticity' in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. Conclusion: The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.

• Journal of Korean Critical Care Nursing
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• v.12 no.3
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• pp.50-60
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• 2019

Purpose : The purpose of this study was to explore and describe the meanings of hands among clinical nurses. Methods : A descriptive qualitative study design was used. Participants were 1,048 nurses working in a tertiary hospital in G city. From April to May 2018, an open-ended survey on how nurses felt about their hands and what their hands meant to them was conducted. The collected data were analyzed using MAXQDA 2018 version as well as content analysis. Results : A total of 1,048 pieces of data were analyzed, and 2,094 units of analysis were categorized based on their attributes, resulting in physical, emotional, and social domains. The data in the social domain were reported in a narrative format; thus, they were analyzed using content analysis. Three themes and eight sub-themes were elicited. The three themes included "meaning as an instrument," "meaning of infection control," and "meaning of caring." Conclusion : Nurses imbue essential meanings of caring on their hands even though they face negative skin symptoms. Furthermore, nurses understand the importance of hand hygiene on infection control. The findings of this study provide an in-depth look into nurses' perceptions of their hands.

• Journal of Korean Critical Care Nursing
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• v.14 no.2
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• pp.42-56
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• 2021

Purpose : The purpose of this study was to understand and describe the experiences of the advanced nurse practitioner (APN) system used by healthcare providers including APNs, doctors who worked with APNs, and APN master's course professors at a graduate school. Methods : Qualitative data were collected via snowball sampling. The participants were nine APNs, six doctors, and three professors. They were divided into three focus groups, each of which consisted of all three types of healthcare providers. Data were collected via interviews with the three focus groups conducted from September to October 2019. All interviews were audiotaped and transcribed verbatim. The transcribed data then underwent qualitative content analysis. Results : Based on the data, we extracted four themes and 14 categories. The themes were "Role and system of APNs started according to healthcare environment changes", "Optimal healthcare provider to ensure quality of care", "Confused role and system of APNs due to incomplete medical law", and "Tasks for the stable operation of the APN system." Conclusion : For quality treatment and safety of patients, a legal basis must be established for the APN system. For its stable operation, social consensus regarding legislation about APNs' scope of practice is required. Finally, a discussion is necessary about the integration of APNs' 13 fields.

• Journal of Korean Critical Care Nursing
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• v.15 no.1
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• pp.58-68
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• 2022

Purpose : This study aimed to provide basic data for developing strategies to improve the nursing performance of nurses working in the intensive care unit by identifying the degree of their communication ability, job satisfaction, organization commitment, and nursing performance, and the relation between each of these variables in the intensive care unit by examining the factors affecting nursing performance. Methods : The participants comprised of 150 nurses working in the intensive care unit in two advanced general hospitals. Data were collected using structured questionnaires and analyzed using a t-test, ANOVA, the Scheffé test, Pearson's correlation coefficients, and multiple regression analysis using the SPSS/WIN 25.0 program. Results : Nursing performance of the participants was positively correlated with communication ability (r=.64, p<.001), job satisfaction (r=.26, p<.001), and organization commitment (r=.29, p<.001). Factors significantly influencing the participants' nursing performance included academic background (𝛽=.16, p=.032) and communication ability (𝛽=.50, p<.001). The explanatory power of these variables for nursing performance was recorded at 49.9% (F=19.04, p<.001). Conclusion : The use of various programs in the hospital and the development of effective communication ability with medical staff and other departments among nurses will help improve nursing performance, cooperation with other departments, and patient care.

• Journal of Korean Critical Care Nursing
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• v.15 no.2
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• pp.39-49
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• 2022

Purpose : This study investigated coronavirus disease-19 (COVID-19) related stress, resilience, and organizational commitment, and determined the factors influencing nurses' organizational commitment at an infectious disease hospital of COVID-19. Methods : A cross-sectional descriptive survey was conducted with 138 nurses. Data analysis, including descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlations, and multiple regression analysis, were performed using SPSS 26.0 program. Results : Factors influencing organizational commitment included resilience (𝛽=0.31, p<.001), position (𝛽=0.31, p<.001), COVID-19 related stress (𝛽=-0.26, p<.001), and COVID-19 nursing period (𝛽=-0.19, p=.012). These variables explained 29.6% of the organizational commitment. Conclusion : In order to enhance the organizational commitment of nurses in infectious disease hospitals of COVID-19, active program development and intervention are required at the organizational level to improve nurses' resilience and relieve stress related to nursing infectious disease patients..

• Journal of Korean Critical Care Nursing
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• v.16 no.2
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• pp.42-53
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• 2023

Purpose : This retrospective mixed-methods study aimed to explore key considerations for designing effective simulated education in nursing, focusing specifically on the recognition and response to deteriorating patients. Methods : Quantitative and qualitative data were analyzed to assess the clinical judgment and performance of the nursing students. Descriptive statistics were used to analyze quantitative data related to prior knowledge, simulation satisfaction, clinical judgment, and nursing performance during deteriorating patient simulations. Qualitative content analysis was conducted for the reflective journal entries of the participants. Results : Quantitative analysis showed that most participants demonstrated a "being skillful" level of clinical judgment (33.1%) in effective response. At the beginner level, clinical judgment varied across effective noticing(39.7-82.8%), effective interpretating(77.6-82.8%), effective responding(3.4-86.2%), and effective reflecting(90.0-95.4%). Nursing performance in assessing patient respiration or SpO2 after request from a physician ranged from 46.6-48.3%. Qualitative analysis indicated that 48.5% of the participants anticipated a deteriorating condition and initiated appropriate actions, while 70% noticed patient unresponsiveness for the first time. Conclusion : To design an effective simulation program for identifying and addressing deteriorating patient care, a framework for observation and interpretation is essential, along with regular simulated training. It is important to design and assess simulation programs and to conduct thorough interviews with nursing students to gain insight into their clinical decision-making.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.62-72
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• 2023

Purpose : This study aims to assess the extent of work value, psychological ownership, the nursing work environment, and retention intention, examine the correlation between these variables, and identify the factors that influence retention intention. The goal is to provide foundational data to enhance retention intention. Method : The study involved 159 nurses employed at a tertiary general hospital and a general hospital. Data were gathered through structured questionnaires and analyzed using an independent t-test, one-way ANOVA, Scheffé test, Pearson correlation coefficient, and multiple regression analysis with a simultaneous stepwise method, all conducted using the SPSS 26.0 software. Results : The intention to remain in the profession was found to have a positive correlation with work value (r = .45, p < .001), psychological ownership (r = .37, p < .001), and the nursing work environment (r = .27, p = .001). Significant factors influencing the intention to stay included total clinical career (𝛽 = .17, p = .016), work value (𝛽 = .38, p < .001), and psychological ownership (𝛽 = .19, p = .020). These variables accounted for 24.1% of the variance in the intention to remain in the profession (F = 17.71, p < .001). Conclusion: To enhance the intention of hospital staff to remain in their positions, it is crucial to identify and bolster positive psychological competencies, such as a sense of work value and psychological ownership.

• Journal of Korean Critical Care Nursing
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• v.17 no.1
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• pp.68-82
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• 2024

Purpose : This scoping review was designed to identify gaps in knowledge and guide future directions for clinical nursing practices and research on oral hygiene care for endotracheally intubated patients in Korean intensive care units. Methods : We conducted a scoping review using the methodological framework proposed by Arksey and O'Malley. PubMed, CINAHL, RISS, Science On, and DBpia databases were searched. Two reviewers independently selected the studies and extracted data. A total of 445 studies were identified, of which 17 were included in the final analysis. Results : No research has been conducted from 2021 to the present. A total of 12 instruments were utilized in 13 studies to assess the effectiveness of oral hygiene care. All studies investigating the effectiveness of oral hygiene care have consistently documented that chlorhexidine has the most significant effect. The frequency and time of oral hygiene care were each examined in one study. Conclusion : A research study is necessary to develop a measurement tool for assessing the effectiveness of oral hygiene care suitable for endotracheal intubated patients in intensive care units. Interventional studies should be conducted to determine the effects of chlorhexidine and the appropriate frequency and time of oral hygiene care. Thereafter, revision of domestic evidence-based clinical practice guidelines by integrating these results will be necessary.