• Title/Summary/Keyword: Nurse Practitioners

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Intention to Delegate Clinical Practice of Medical Specialists in Accordance with the Enactment of the Scope of Practice for Advanced Practice Nurses (전문간호사 업무범위안 제정에 따른 전문의의 업무 위임 의향)

  • Kim, Min Young;Choi, Su Jung;Kim, Jeong Hye; Leem, Cho Sun;Kang, Young-ah
    • Journal of Korean Academy of Nursing
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    • v.53 no.1
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    • pp.39-54
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    • 2023
  • Purpose: This study aimed to investigate the nationwide intention to delegate clinical practice of medical specialists in accordance with the enactment of the scope of practice for advanced practice nurses (APNs). Methods: Data were collected from October to December 2021 using Google Surveys. In total, 147 medical specialists from 12 provinces responded to the survey. The survey questionnaire was categorized into four legislative draft duties, according to the scope of practice (a total of 41 tasks): Twenty-nine tasks on treatments, injects, etc., performed under the guidance of a physician and other activities necessary for medical treatment (treatment domain); two tasks on collaboration and coordination; six tasks on education, counseling, and quality improvement; four regarding other necessary tasks. Participants were asked whether they were willing to delegate the tasks to APN. Results: The intention to delegate tasks to APN was higher for non-invasive tasks such as blood sampling (97.3%) or simple dressing (96.6%). Invasive tasks such as endotracheal tube insertion (10.2%), sampling: bone marrow biopsy & aspiration (23.8%) showed low intention to delegate in the treatment domain. Participants who were older, male, and had more work careers with APN, showed a higher intention to delegate tasks. Conclusion: To prevent confusion in the clinical setting, a clear agreement on the scope of APN practice as APN delegated by physicians should be established. Based on this study, legal practices that APN can perform legally should be established.

Reflections on the Prospects of Korean Advanced Practice Nurses : Based on Flexner's Professional Characteristics (한국 전문간호사의 전망에 관한 고찰: Flexner의 전문직 특성을 기반으로)

  • Kim, Eun Mi;Choi, Su Jung
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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    • pp.1-10
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    • 2023
  • Purpose : This study explores the professional status of Advanced Practice Nurses (APNs) in Korea, who, despite being legally certified, face instability in their professional standing, including their scope of practice and compensation. Method : The study uses Flexner's professional characteristics as a framework to analyze and project the future trajectory of Korean APNs. Results : First, to ensure social accountability, professional bodies need to establish uniform nursing policies related to job roles, and healthcare institutions must adhere to these policies. Second, nursing leaders should spearhead the creation of nursing knowledge essential for the profession's advancement, aiming to establish it as the foundation for nursing practice through a consensus process within the nursing community. Third, the curriculum for APNs should enhance the quantitative and qualitative aspects of practice in response to societal needs. Fourth, professional bodies should formulate consistent nursing policies based on a thorough analysis of the healthcare environment and legal considerations, and guide their implementation in clinical practice through a consensus process within the nursing community. Lastly, guidelines should be established for professional standards suitable for the Korean context. Conclusion : Based on this review, it is recommended that all APNs adhere to the professional standards set by their respective organizations, actively participate in personal quality improvement initiatives, and fulfill their duties and roles as members of these professional bodies. Furthermore, these organizations should devise practical strategies to solidify the APN system and should spearhead a systematic consensus process that garners the agreement of all members within the nursing community.

Development of Task Guidelines for Hospice Team Members (호스피스 팀 구성원의 직무지침 개발)

  • Ro, You-Ja;Han, Sung-Suk;Yoo, Yang-Sook;Yong, Jin-Sun
    • Journal of Hospice and Palliative Care
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    • v.4 no.1
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    • pp.26-40
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    • 2001
  • Purpose : The purpose of this study was to develop task guidelines for hospice team members. The task range of all personnel who work for hospice institutions was identified, and a tool describing roles and tasks of the hospice team members was developed based on review of related literature, both domestic and international. Methods : The content validity of the tool was assured by an expert panel through two phases of discussion. The first phase of the study included a survey conducted from December 1999 to January 2000 for a total of 126 hospice experts and practitioners affiliated with domestic hospice institutions. The second phase of the study included 35 subjects. The data were collected using a survey when the investigators visited each hospice institution. The data were analyzed using descriptive statistics. Results : 1) In the first phase of the study, all items scored over 80 points in CVI were selected as the roles and tasks of hospice coordinator, nurse, pastor, social worker, pharmacist, nutritionist, therapist, volunteer, and nurse aide. However, two items were excluded because they scored below 80 points: an item describing eligibility of a physician, a person who has a license for managing anesthetic agents was scored as 78.6 points, and an item describing the eligibility of the team leader of volunteers, a person educated at the graduate level was scored as 74.7 points. 2) In the second phase of the study, all items scored over 80 points in CVI were selected as the roles and tasks of hospice nurse, pastor, social worker, pharmacist, nutritionist, therapist, volunteer, and nurse aide. Of the roles of the hospice coordinator, however, the item scored as 77.9 points, assess and plan a patients physical, social, emotional, and spiritual status, and, of the roles of the team leaders of volunteers, the item scored as 78.6, attend a team meeting once a week and participate in building an standard nursing plan for patients were included in the tool since they scored over 80 points in the first phase of the study. Conclusion : The developed task guideline should be further modified and revised based on the findings of a preliminary application in the actual field. There is also a need of continuous research for developing more culturally-appropriate task guidelines for hospice team members.

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Conceptual Model for Women s Health (여성건강을 위한 개념적 모형)

  • 이경혜
    • Journal of Korean Academy of Nursing
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    • v.27 no.4
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    • pp.933-942
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    • 1997
  • There has recently been an increased interest in women's health from, various disciplines, with different perspectives presented according to each profession's academic background. This has led to many instances of incorrectly defining, or misinterpretation, of the issues even among professionals. Nurse scholars as well as practitioners who work in women's health care need to have a clear conceptual understanding of women's health in order to build a body of knowledge, delineate curricular activities, and set directions for professional nursing interventions. In addition, a conceptual model that may be directly utilized in practice is needed to maintain and promote women's health issues. The purpose of this study was to apply a Hybrid model, analyzing conceptual definitions and discussions related to women's health gathered from review of the literature. Further to compare analyticals the concepts and properties observed from field work, so as to present a final definition of women's health and, build a conceptual framework for a united comprehensive perspective on the concept as well as on nursing practice. Data collection and analysis consisted of a theoretical stage, field work stage, and final analysis. A heterogeneous group of professionals and lay persons, 39 in all, participated in the field work. Study findings Include several subconcepts under the concept of women's health : a woman's whole life, holistic health, quality of life, awareness of being a woman, individual nursing, self care ability, reproductive health, and family health. Thus, a comprehensive definition was built, 1. e., "Women's health care be defined as improvement in the quality of life of women through attainment of holistic health throughout the life span. With reproductive health at the core, the concept is directly related to family and national health, and includes taking care of one's own health based on awareness of being a woman and utilizing self care activities. Women's health care issues are unique and allow various responses, therefore women's health professionals need to apply individual approaches to reach solutions in attaining holistic health and improving quality of life." The constructual factors of women's health were found to be reproductive functions, diseases more common in woman, self actualization, mental health, women's health policies, sexuality, midlife changes, and marital relations, with each factor having more than three properties. Positive factors affecting women's health were found to be a normal childbearing process, a healthy lifestyle, active health management, health information, support, and resources, and interpersonal relationships. Negative factors were found to be overwhelming role stress, cultural oppression, gender inequality, distorted sexual identity, economic difficulties, misuse and/or abuse of substances, and stress. The model of women's health may be visualized as a balance scale set upon a woman's life, supporting 4 concentric circles. The innermost circle and second circle incorporate conceptual definitions of women's health, and the outer two circles represent the constructional factors and properties of women's health. Each circle has its own color that symbolizes the conceptual meaning. Positive and negative factors are represented as weights at either end of the scale, and are affected by nursing intervention, i. e., health and wellness increase when positive factors are stronger, whereas disease and illness increase when negative factors are stronger. This model is only a preliminary effort and requires much discussion and testing to be further developed. Continuous research is also required.

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A Study on Prevalence and Nursing Intervention of Bed Sore Patients who Received Regional Home Care Services (가정간호 대상자의 욕창발생 및 간호중재에 관한 조사연구)

  • Kim Keum-Soon;Cho Nam-Ok;Park Young-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.1
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    • pp.43-60
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    • 1997
  • This study was to identify the nursing intervention method in finding out the incidence, risk factor, prevention and treatment of bed sore cilents who received regional home care nursing services. The eleven home care nurse practitioners took the survey on 97 patients who received home care nursing service from Seoul City Nurses Association for one month from September 26 to October 26 1996. A modified version of Braden's bed sore assessment tool for bed sore risks and a tool for assessment of bed sore stage and measurement bed sore sizes by Bergstrom, Braden, Laguzza and Holman(1987) were as research tools for this study and a questionnare with 40 questions and 12 items on nursing activities was used to find out the prevention and treatment of bed sores. Also, two open ended questions were used on current approaches and efforts of the treatment being applied to clients. The finding of the study were summarized as following : 1. The rate of bed sore occurrence was 47.4% 2. The areas of bed sore occurrence were hip(28.9%), sacrum(18.6%), great trochanter(14.4%) and the average number of sore spots were 2.26 3. Two groups-one with bed sores and the other without-were studied to determine prediction factors for bed sore risks. Sensory function, humidity, level of activity, mobility, nutrition, skin friction and chapping and body temperature turned out to be statistically significant factors for bed sores. Also the age of clients turned out to be a individual characteristic variable significantly affecting the rate of bed sore occurrences. 4. The education for clients and family on systematic skin assessment and bed sores and practice of active/passive R.O.M. are mainly used as nursing activities for bed sore care. 5. The treatment method varied by stages of bed sores. Sometimes folk remedies like applying the powders of dried elm tree roots to sores were used. Good nutrition, frequent position change and skin care turned to be the most effective means to fast recovery of sores.

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Study on the Perceived Stress Level of Mothers in Neonatal Intensive Care Unit (NICU에 입원한 미숙아 어머니의 스트레스)

  • Kim, Tae-Im
    • Journal of Haehwa Medicine
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    • v.8 no.1
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    • pp.865-878
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    • 1999
  • With advances in neonatal medicine, smaller and sicker infants are surviving premature birth. As these tiny patients battle for their lives, their parents also struggle with psychological consequences of an unexpected role. The birth of a sick infants has long been documented as stressful events for the parents. High stress levels may alter parents' interaction with their baby and impair their communication with health professionals, which can in turn affect parents' participation in care planning and decision making. Nursing interventions aimed at reducing the parental stress and anxiety levels during this crisis may have a positive impact on their ability to form an attatchment to their baby and make prudent decisions about his care. The planning of such interventions would be inhanced if the contributions of various factors to increased parental stress levels were identified. This descriptive study was conducted to understand the contents and degree of parental stress in the NICU during their premature's hospitalization, and to give a baseline data in developing nursing intervention program. Subjects were the 60 mother of hospitalized newborn in NICU of 2 University Hospital in Taejon City from April 1st, 1999 to June 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales:NICU(PSS:NICU) developed by Miles et al.. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior nursing intervention(19 items), parental role alteration and relationship with their baby(10 items), health team communication(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from "not stressful" (1) to "extremely stressfu1"(5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's ${\alpha}$ coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers of premature baby was slightly high($3.66{\pm}1.1$). The highest scored dimension was 'relationship with their baby and parental role change'($4.21{\pm}0.9$), and next were 'appearance and behavior of the baby'($3.92{\pm}1.1$), 'communication with health team'($3.32{\pm}1.3$), 'sight and sounds of NICU'($3.30{\pm}1.1$). 2. There were statistically significant correlation noted ; mother's perceived severity of the baby's condition(F=8.0012, P= .0125) and baby's gestational age(r = -.4724, P = .0500). In summary, information about physical environment of NICU, the mother's perceived severity of premature baby's state, maternal role change related variables and the knowledge of characteristics of premature baby must be included in nursing intervention program of mother's of premature baby in reducing the parental stress and anxiety level. It is suggested that each NICU needs to develop a nurse managed supportive care program for parents of premature baby. Also, it is suggested that there need to investigate the coping mechanism of mother of premature baby.

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Knowledge and Attitudes about HIV/AIDS among Health Care Officers in S. Korea (보건복지 공무원의 에이즈에 대한 지식과 태도에 대한 연구)

  • Choi, Eun-Jeung;Kim, Wha-Son;Jung, Sun-Bok;Whang, In-Sook;Yang, Jeoung-Nam
    • Korean Journal of Health Education and Promotion
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    • v.26 no.5
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    • pp.41-55
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    • 2009
  • Objective: This study explores the level of knowledge and attitude towards HIV/AIDS and the relationship between knowledge and attitude among social workers and nurses working in the public sector in Gwangju, S. Korea. Methods: The sample was composed of 121 nurse and 124 social workers. For the purpose of this research participants completed a questionnaire designed to assess their knowledge and attitudes about HIV/AIDS. The data was collected between December 2008 and January 2009. All data was analyzed using SPSS WIN version 12.0 for technical statistics. t-Test, ANOVA and multiple regression analysis was employed. Results: First, the result of this research showed that the level of participants knowledge on HIV/AIDS was 85.9%. The nurses score was significantly higher than social workers on knowledge. Second, the outcome also showed that nurses generally had a more positive attitude about HIV/AIDS patients than social workers but it was not significant. Third, participant's attitudes towards HIV/AIDS was significantly influenced by the level of knowledge and previous education about HIV/AIDS. Fourth, the results also showed that knowledge on HIV/AIDS is the most important influencing factor towards the participants attitude. Conclusion: This result has important implications for future education programs designed for health care professionals including nurses and social workers. Given the importances of the role of public officers as practitioners and policy makers on HIV/AIDS, the education program should not only focus on lectures but also include a sharing of practical experience and knowledge.

Health Educational Program for Women's Health in Women's Health Care Center (여성건강교육 프로그램 개발에 관한 연구 - 여성건강간호센터에서의 교육을 중심으로 -)

  • Lee, Eun-Hee;Choi, Sang-Soon;So, Ae-Young
    • Women's Health Nursing
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    • v.6 no.1
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    • pp.67-81
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    • 2000
  • The purpose of this study was to analyze women's health problems using Green & Kreuter's(1991) PRECEDE model and to develop health education program for women's health. The subjects were recruited women from Wonju city 18 years or older. 1. The results showed that about 50% of the women were satisfied with their lives as women, 23% of the sample felt there was a need for a women's health care center. The mean number of health problems was 3.1 and the prevalence rate, 44.4%. 2. We developed on educational program according to group differences related to health problems, diagnosis of disease, variables influencing health promotion behavior, and programs which each group wanted. Also we stressed self-efficacy and self-help group for the management of individual health to all groups. 3. The diagnoses of diseases that were experienced premarital over the past year were gastritis, bronchitis, spinal disk, and fracture, for the childbearing/rearing group, gastritis, vaginitis and cervicitis, cervical cancer and cystitis and nephritis and arthritis and for the middle-aged/elderly group arthritis, gastritis, vaginitis and cervicitis, and spinal disk. Of the sample 30.5% did not have a health exam in the past year, and only 10% of the premarital group, 12.5% of the childbearing/child-rearing group, and 18.3% of the middle aged-elderly group were concerned about their health and did something for their health. 4. The average score on the HPLP was 2.41. the HPLP was scores according to group were found to have significant differences. self-efficacy, family functions, health attention and were considered important variables in the premarital group, in the childbearing/child-rearing group self-efficacy, family functions, internal locus of control, health attention, and health perception and power others locus of control and then for the middle aged-elderly group self-efficacy, health attention, internal locus of control, family functions and health perception. 5. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. The premarital group requested the educational programs on diet, health exercise, family health and stress management. Also the childbearing/child-rearing group wanted programs on diet, family health, stress management, and health exercise, and the middle-aged/elderly group wanted that of family health, diet, climacteric changes stress management and health exercise. The program suggested that this program should be applied to women in the community to insure adequate management of women's health. Follow-up research with PROCEED is needed to analyze health outcomes, also, a women's health nursing specialist system is required to develop health promotion, and improve the quality of life for women.

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Relationship of Clinical Nurses' Task Complexity, Critical Thinking Disposition and Intuition (임상간호사의 업무의 복잡성, 비판적 사고 성향 및 직관의 관계)

  • Park, Min kyung;Shin, Hwa jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.8
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    • pp.66-74
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    • 2019
  • The purpose of this study was to analyze work complexity, critical thinking disposition, and the degree of intuition for nurse practitioners and determine the associations among the variables. 150 nurses at hospitals and general hospitals in D City participated in this study and data collection was performed from June 15 to July 8, 2017. The data were processed by using SPSS WIN 24.0 to estimate the mean, standard deviation and Pearson's correlation coefficient and perform one-way ANOVA. They scored $2.33{\pm}.45$ for work complexity, $3.58{\pm}.36$ for critical thinking disposition, and $2.69{\pm}.52$ for intuition. Work complexity differed significantly by age (F=4.55, p=.012), education (F=11.61, p=<.001), department (F=26.69, p=<.001), and clinical career (F=4.30, p=.006) among their general characteristics. Critical thinking disposition differed significantly by education (F=5.25, p=.006) and position (F=5.35, p=.006) and differed statistically insignificantly by intuition. Work complexity was positively correlated with critical thinking disposition (r=.323, p=<.001) and intuition (r=.201, p=.013) and no significant correlation was found between critical thinking disposition and intuition (r=.033, p=.685). On the basis of these results, it is necessary to develop education and programs that can allow nurses who regard nursing work as complex to improve their critical thinking disposition and intuition.

Comparing Perceptions, Determinants, and Needs of Patients, Family Members, Nurses, and Physicians When Making Life-Sustaining Treatment Decisions for Patients with Hematologic Malignancies

  • Kim, Semi;Ham, Eun Hye;Kim, Dong Yeon;Jang, Seung Nam;Kim, Min kyeong;Choi, Hyun Ah;Cho, Yun A;Lee, Seung A;Yun, Min Jeong
    • Journal of Hospice and Palliative Care
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    • v.25 no.1
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    • pp.12-24
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    • 2022
  • Purpose: This descriptive study compared the perceptions, determinants, and needs of patients, family members, nurses, and physicians regarding life-sustaining treatment decisions for patients with hematologic malignancies in the hematology-oncology department of a tertiary hospital in Seoul, Korea. Methods: In total, 147 subjects were recruited, gave written consent, and provided data by completing a structured questionnaire. Data were analyzed using analysis of variance, the chi-square test, and the Fisher exact test. Results: Nurses (F=3.35) and physicians (F=3.57) showed significantly greater familiarity with the Act on Decisions on Life-Sustaining Treatment than patients (F=2.69) and family members (F=2.59); (F=19.58, P<0.001). Many respondents, including 19 (51.4%) family members, 16 (43.2%) physicians, and 11 (29.7%) nurses, agreed that the patient's opinion had the greatest effect when making life-sustaining treatment decisions. Twelve (33.3%) patients answered that mental, physical, and financial burdens were the most important factors in life-sustaining treatment decisions, and there was a significant difference among the four groups (P<0.001). Twenty-four patients (66.7%), 27 (73.0%) family members, and 21(56.8%) nurses answered that physicians were the most appropriate people to provide information regarding life-sustaining treatment decisions. Unexpectedly, 19 (51.4%) physicians answered that hospice nurse practitioners were the most appropriate people to talk to about life-sustaining treatment (P<0.001). Conclusion: It is of utmost importance that the patient and physician determine when life-sustaining treatment should be withdrawn, with the patient making the ultimate decision. Doctors and nurses have the responsibility to provide detailed information. The goal of end-of-life planning is to ensure patients' dignity and respect their values.