• Journal of Korean Critical Care Nursing
• /
• v.10 no.1
• /
• pp.63-74
• /
• 2017

Purpose: The purpose of this study was to examine the effect of professional autonomy, organizational commitment, and perceived patient safety culture on patient safety management activities of nurses in medium and small-sized hospitals. Methods: A cross-sectional design was employed. Self-reported questionnaires were completed by 121 nurses with at least 3 months of working experience in medium and small-sized hospitals located in B city. Data were analyzed using descriptive statistics, a t-test, a one-way ANOVA, Pearson correlation coefficients, and a multiple regression analysis. Results: Professional autonomy (r=.22, p=.016), organizational commitment (r=.34, p<.001), and perceived patient safety culture (r=.55, p<.001) had a statistically significant positive correlation with patient safety management activities. The factors that might affect patient safety management activities were professional autonomy (${\beta}=.23$, p=.003) and perceived patient safety culture (${\beta}=.55$, p<.001). The explanatory power of these factors for patient safety management activities was 33.5% (F=21.19, p<.001). Conclusions: The development of repetitive and continuous education programs is needed to improve a nurse's professional autonomy and perceived patient safety culture.

• The Korean Society of Law and Medicine
• /
• v.18 no.2
• /
• pp.105-138
• /
• 2017

This is case comments of several representative legal cases regarding self- determination right of patient. In a case in which an intoxicated patient attempted suicide refusing treatment, the Supreme Court ruled that the medical team's respect for the patient's decision was an act of malpractice, and that in particular medical situations (medical emergencies) the physician's duty to preserve life supersedes the patient's rights to autonomy. Afterwards, at the request of the patient's family, and considering the patient's condition (irrecoverable death stage, etc.) consistent with a persistent vegetative state, the Supreme Court deduced the patient's intention and decide to withdraw life-sustaining treatment. More recently, regarding patients who refuse blood transfusions or other necessary treatment due to religious beliefs, the Supreme Court established a standard of judgment that can be seen as conferring equal value to the physician's duty to respect patient autonomy and to preserve life. An empirical study of legal precedent with regard to cases in which the physician's duty to preserve life conflicts with the patient's autonomy, grounded in respect for human dignity, can reveal how the Court's perspective has reflected the role of the patient as a decision-making subject and ways of respecting autonomy in Korean society, and how the Court's stance has changed alongside changing societal beliefs. The Court has shifted from judging the right to life as the foremost value and prioritizing this over the patient's autonomy, to beginning to at least consider the patient's formally stated or deducible wishes when withholding or withdrawing treatment, and to considering exercises of self determination right based on religious belief or certain other justifications with informed refusal. This will have a substantial impact on medical community going forward, and provide implicit and explicit guidance for physicians who are practicing medicine within this environment.

• Journal of the Korea Convergence Society
• /
• v.12 no.8
• /
• pp.381-391
• /
• 2021

The purpose of this study was to validate the Korean version of autonomy preference index (K-API) for chronic patients. Participants were 569 chronic patients. Construct validity and reliability of K-API were examined using exploratory and confirmatory factor analysis, and Cronbach's α test. Original API was translated to Korean, and we conducted contents validity test, and pilot test. The K-API consisted of 10 items divided into two domains: (i) Decision making preference (DMP); (ii) Information seeking preference (ISP). K-API explained 53.4% of autonomy preference; the two-factor structure showed an acceptance fit. Cronbach's α was. 77 for DMP, and. 75 for ISP. Validity and reliability of the K-API were established, and this study provides additional evidence for the usage of the API in Asian region.

• Tuberculosis and Respiratory Diseases
• /
• v.58 no.3
• /
• pp.213-229
• /
• 2005

The first and the longest criminal indictment case of Korean medico-legal battle, so called BORAMAE Hospital Incident, was finally on its end by Korean Supreme Court's decision on June 24, 2004, after 7 years long legal dispute via Seoul District Court and Seoul Superior Appeal Court's decision. Boramae Hospital case was the first Korean legal case of Withdrawing Life-sustaining treatment of mechanical respirator on 58 years old Extradural Hematoma victim who was on Respirator under Coma after multi-organ failure postoperatively(APACHE II score: 34-39). Two physicians who have involved patient's care and had helped to make discharge the Near-death patient to home after repeated demand of patient's wife, due to economic reason, were sentenced as homicidal crime. This review article will discuss the following items with the review of US cases, Quinlan(1976), Nancy Cruzan(1990), Barber (1983), Helen Wanglie(1990), Baby K (1994) and Baby L cases, along with Official Statement of ATS and other Academic dignitaries of US and World.: [1] Details of Boramae Hospital incident, medical facts description and legal language of homicidal crime sentence. [2] The medical dispute about the legal misinterpretation of patient's clinical status, regarding the severity of the victim with multi-organs failure on Respirator under coma with least chance of recovery, less than 10% probability. [3] Case study of US, of similar situation. [4] Introduction of ATS official Statement on Withdrawing/ Withholding Life sustaining treatment. [5] Patient Autonomy as basic principle. [6] The procedural formality in Medical practise for keeping the legitimacy. [7] The definition of Medical Futility and its dispute. [8] Dying in Dignity and PAS(Physician Assisted Suicide)/and/or Euthanasia [9] The Korean version of "Dying in Dignity", based on the Supreme Court's decision of Boramae Hospital incident (2004.6.24.) [10] Summary and Author's Note for future prospects.

• Research in Community and Public Health Nursing
• /
• v.5 no.2
• /
• pp.203-215
• /
• 1994

The purpose of this study was to investigate the needs for exercise of adult inpatients and ultimately to provide basic data for planning nursing intervention of patients who need exercise. The tool used for this study was a structured questionnaire which consisted of 42 items. The test items were classified into seven factors. The seven factors of the needs for exercise were need for achievement, need for activity, need for affiliation, need for autonomy, need for catharsis, need for homeostasis, and need for exhibition. Subjects of this study were 127 patients in two general hospitals in Seoul, and one general hospital in Chun Ann City. The needs of exercise were identified and the data were analyzed by gender, age, occupation, education level, monthly income, size of patient room, patient group who requires exercise and the other patient group who requires bed rest, using one-way ANOVA and Scheffe test as post-hoc. The findings of this study were as follows ; 1) Among the needs for exercise of adult patients, the highest level of the needs was the need for homeostasis. The next highest was the need for achievement, then need for activity, need for catharsis, need for autonomy, need for affiliation, and the lowest was the need for exhibition. 2) Maintaining physical fitness stood first in the need for homeostasis, relieving psychological and physical powerlessness in the need for activity, mood diversion in the need for catharsis, happiness of the family in the need for affiliation, maintaining the balanced body figure in the need for exhibition, practicing planned life in the need for achievement, and improving the ability to overcome the crisis in the need for autonomy. 3) Male patients exhibited the higher level of the needs than female patients in all factors except the need for exhibition and homeostasis. 4) There was no statistical difference in the needs between age, occupation, monthly income, and the size of patient room. 5) The need for achievement was high as the level of education goes higher. 6) The patients who performed regular exercise before admission had higher needs for activity, achievement, and autonomy, compared with the patients who did not perform the regular exercise before admission. 7) There was no statistical difference in the needs between patient group who requires exercise and the other patient group who requires bed rest. The need for homeostasis was the highest in both groups. The results from this study suggest that the need for exercise of adult inpatients should be assessed before planning exercise intervention.

• Journal of Digital Convergence
• /
• v.20 no.4
• /
• pp.715-724
• /
• 2022

The purpose of this study was investigates the effects of perception the importance of patient safety management, professional autonomy and safety climate on patient safety nursing activity on hospital nurses. Participants were 211 nurses working in 4 general hospitals. Data were collected with structured questionnaires from January 11 to January 25, 2021. Data were analyzed descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression with SPSS 21.0 program. Factor affecting the patient safety nursing activity were safety climate(β=.297, p<.001), perception the importance of patient safety management(β=.287, p<.001), and work place(β=.169, p=.004). In summary, in order to promote patient safety nursing activities, it is necessary to develop and apply educational programs considering the work of nurses' working place and various characteristics, improve perception the importance of patient safety, and positive safety climate. This study is meaningful in providing basic data for the development of programs related to the promotion of patient safety nursing activities for hospital nurses.

• Safety and Health at Work
• /
• v.4 no.4
• /
• pp.210-215
• /
• 2013

Background: This study aimed to identify the impacts of job stress and cognitive failure on patient safety incidents among hospital nurses in Korea. Methods: The study included 279 nurses who worked for at least 6 months in five general hospitals in Korea. Data were collected with self-administered questionnaires designed to measure job stress, cognitive failure, and patient safety incidents. Results: This study showed that 27.9% of the participants had experienced patient safety incidents in the past 6 months. Factors affecting incidents were found to be shift work [odds ratio (OR) = 6.85], cognitive failure (OR = 2.92), lacking job autonomy (OR = 0.97), and job instability (OR = 1.02). Conclusion: Patient safety incidents were affected by shift work, cognitive failure, and job stress. Many countermeasures to reduce the incidents caused by shift work, and plans to reduce job stress to reduce the workers' cognitive failure are required. In addition, there is a necessity to reduce job instability and clearly define the scope and authority for duties that are directly related to the patient's safety.

• The Journal of the Korea Contents Association
• /
• v.21 no.2
• /
• pp.236-247
• /
• 2021

The purpose of the study was to investigate the influencing factors of autonomy preference on decision-making among chronic disease patients. Data were collected from 522 chronic disease patient and it was analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple linear regression, using SPSS 26.0 ver. program. Significant factor influencing decision-making preference was health concern (β=-.17, p<.001), and factors influencing information-seeking preference were gender (β=-.20, p<.001) and number of questions during the treatment (β=.09, p=.030). Healthcare providers should take into account the characteristics of patients and establishment of a strategy to improve the quality of communication.

• Korea Journal of Hospital Management
• /
• v.27 no.1
• /
• pp.11-19
• /
• 2022

Purposes: This study was to investigate intention to exercise the patient's right of self-determination on adopting the non-benefit medical services and was to identify factors associated with intention to self-determined decision. Methodology: A total of 1,000 adult respondents aged 20 to 65 years were recruited using stratified random sampling and surveyed by online. Multivariate logistic regression analysis was performed to identify factors associated with intention to self-determined decision using SAS 9.4(SAS Institute Inc. Cary, NC, USA). Findings: 61.9% of total participants(n=592) had intention to exercise patient's right of self-determination on adopting the non-benefit medical services. Significant differences were observed in the exercise of self-determination in relation to prior explanation and opportunity for self-determination. Practical Implications: This study suggested that explanation duty of provider might influence on increasing intention to exercise the patient's right of self-determination. Considering appropriate use of non-benefit services, it is important to enhance explanation duty of provider.

• Journal of Korean Academy of Nursing
• /
• v.47 no.5
• /
• pp.663-675
• /
• 2017

Purpose: The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory. Methods: Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers' autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program. Results: The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers' autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers' autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management. Conclusion: The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients.