• 간호행정학회지
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• 제7권2호
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• pp.301-314
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• 2001

The main purpose of this research is to describe comprehensively the processes of clinical decision making in novice critical care nurses through clinical experience. This research was an exploratory, longitudinal study using a fieldwork approach incorporating "think-aloud" method and in-depth interviews with the study participants. The study participants consisted of 5 novice nurses assigned to critical care units at a tertiary medical center located in Seoul, among a group of 27 novice nurses who started at the same period at this hospital. The data were collected from March 1999 to April 2000. The major findings of the study is that the novice nurses followed the analytic linear model of clinical decision making in the beginning, but were changed increasingly to follow the comprehensive, integrated model of clinical decision making. Through repeated experience that resulted in increasing repertoire of clinical schema and familiarity of task environments of clinical practice the novice nurses expanded their ability to arrive at comprehensive integration of information and to arrive at accurate and time-efficient decisions. Both the analytic, linear model mostly used at the beginning period and the comprehensive, integrated model that seems to be the mode significantly dependent upon experience seem to have strengths and weaknesses as decision making processes in clinical situations. Hence, it is imperative to develop an effective orientation and training program for novice nurses through the use of clinical preceptors. In addition, students should be exposed to the process of clinical decision making early in their nursing education through an appropriate clinical experiences and clinical assignments.

• 간호행정학회지
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• 제20권5호
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• pp.492-504
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• 2014

Purpose: The purpose of this study was to understand the meaning and essence of happiness by exploring and describing career nurses' lived experiences. Methods: Qualitative research was used in this study. Hospital nurses who had 3~5 years of experience in the clinical setting were interviewed and the data were analysed using Giorgi's phenomenological method. Results: Six main meanings and seventeen themes emerged. The six main meanings were as follows: self-confidence as a professional nurse, passion for self-realization, feeling of satisfaction in performance of nursing care, being grateful for working environment, emotional intimacy in interpersonal relationships, and taking delight and pleasure in leisure life. Conclusion: The results of this study provide deep understanding of happiness as positive experiences that increase job satisfaction and aid retention to the nursing profession. These results can be used in the development of effective strategies to improve and expand nurses' happiness.

• 대한간호학회지
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• 제31권6호
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• pp.988-997
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• 2001

This study aimed at uncovering the experience of adaptation of the new nursing staff in hospital setting. Methods: For this study, 15 new graduate nurses participated. The data was collected through the in-dept interviews and analysed in terms of Strauss and Corbin′s grounded theory methodology. Results: The core category was identified with "entering orbit". The new graduate nurses, who experienced the taeoom because of their unskilled professions, tried to enter orbit by overcoming difficult situations through reducing stress, maintaining good interpersonal relationship, grasping, compensating, persisting, and introspecting. Noticeably, in the process of adaptation, negative image of nursing, conflict of interpersonal relationship and the educational program for the new nursing staff had effect on the intervening factors. Finally, this study confirmed that the processes of new nurses′ adaptation are confusing, confrontating, becoming a member and settling in hospital setting. Conclusion: Therefore, the educational programs reflecting new nursing staffs′ experiences should be developed.

• 종양간호연구
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• 제8권2호
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• pp.128-137
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• 2008

Purpose: To explore and describe the essence of oncology nurses' experiences of counseling with cancer patients. Methods: Qualitative research with a phenomenological study. Participants were 6 oncology nurses who had worked as a clinical nurse specialist or an education-counseling nurse. Data were collected through individual semi-constructed interviews and analyzed with a thematic approach according to Colaizzi's method. Results: Seven themes emerged from the data: harmony of education and counseling, burdening, useless self-blaming, getting more matured, experiencing rewards and meanings, internalized strategies for counseling, and needs for self growth. Conclusion: The study highlights the significant impact of counseling with cancer patients by oncology nurses. Oncology nurses experienced both positive and negative aspects of being involved in cancer care. They stated that they were personally growing and getting maturated with the counseling experience. Sometimes they felt sad when the patient's status was progressed. They learned and internalized counseling skill during the communication with cancer patients. They wanted to learn about the practical course of counseling and communication method and the psychology of cancer patients.

• Journal of Acupuncture Research
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• 제25권6호
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• pp.153-161
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• 2008

Objectives : This study was designed to find out whether normal saline(NS) acupuncture is able to be constituted as an appropriate control group for Cervi Cornu Parvum herbal acupuncture(CC). Methods : NS and CC were injected into Quchi($LI_{11}$) of the subjects. The subjects completed a questionnaire rating the intensity of 21 kinds of acupuncture sensation(hurting, penetrating, sharp, aching, intense, spreading, radiating, tingling, pricking, stinging, pulling, heavy, dull, numb, electric, shocking, hot, burning, cool, pulsing, and throbbing) and side effects. We compared subjective evaluations of acupuncture sensation and side effects between two groups. Results : As for CC most of the acupuncture sensation items were not significantly different from NS especially in less acupuncture-experienced subjects(average 2, below 10 time experiences) rather than more acupuncture-experienced subjects(above 10 time experiences). Conclusions : We found that NS might be an appropriate placebo herbal acupuncture for CC in small amount of acupuncture-experienced subjects. Further study is needed for new placebo herbal acupuncture for CC in more acupuncture-experienced subjects.

• Korean Journal of Acupuncture
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• 제29권4호
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• pp.581-597
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• 2012

Objectives : To explore the experiences of patients with chronic low back pain(CLBP) in a randomized controlled trial(RCT) of acupuncture. Methods : Five qualitative focus group interviews were conducted at three Korean Medicine Hospitals. Two to 4 participants from the same group(real or sham acupuncture) in the RCT of acupuncture for CLBP discussed their experiences and perceptions of the clinical trial and the acupuncture treatment. Transcribed data were read independently by researchers and analyzed to categorize information and identify themes. Results : A total of 14 participants were included. Most of them discovered positive aspects of being a study subject and a patient. They recognized the differences between experimental and real-world clinical settings such as formal procedures of treatment, and different acupuncture device. Participants also expressed the weaker sensation of acupuncture compared to the previous experience. Especially, they were well aware of the 'subjects' role themselves, thus they observed their changes of symptom closely. As subjects were generally satisfied with their treatment and they had a good feeling to acupuncture after the trial, they expressed their willingness to participate in the future clinical trial of acupuncture. Conclusions : Our finding suggests that the Korean patients' experience of participating in an RCT was generally positive. Their tendency to perform the 'subject' role might affect the trial's process or overall results.

• Journal of Hospice and Palliative Care
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• 제23권3호
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• pp.126-138
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• 2020

Purpose: In Korea, since the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life was implemented in February 2018, advance directives (ADs) have become legally effective and should be documented after sufficient explanation by a registered counselor. However, little is known regarding the adequacy of current AD counseling. This qualitative study aimed to explore the barriers to AD counseling based on counselors' experiences. Methods: We conducted focus group interviews using purposive sampling. Seven counselors working at hospitals, community health institutions, and non-profit organizations participated in this study. They were asked about the challenges and problems they encountered during AD counseling. Results: Three themes emerged from this study; 1) issues regarding consistency in AD counseling, 2) issues regarding AD counselors' competency and work environment, and 3) issues regarding the adequacy of the service system. The interviewees stated that the lack of a manual for standardized service made AD counseling inconsistent. The limited competency and poor work environment of counselors were pointed out as major barriers. The interviewees also stated that a proper service system considering individual circumstances is absent. Conclusion: The goals of AD counseling should be clarified and guidance should be implemented for providing standardized services. Further efforts to enhance the competency of AD counselors and to improve their working conditions are needed. Establishing an integrated framework for an adequate service system is also essential to overcome systematic barriers to AD counseling.

• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.197-204
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• 2015

Objective : Aneurysms arising from the pericallosal artery (PA) are uncommon and challenging to treat. The aim of this study was to report our experiences of the endovascular treatment of ruptured PA aneurysms. Methods : From September 2003 to December 2013, 30 ruptured PA aneurysms in 30 patients were treated at our institution via an endovascular approach. Procedural data, clinical and angiographic results were retrospectively reviewed. Results : Regarding immediate angiographic control, complete occlusion was achieved in 21 (70.0%) patients and near-complete occlusion in 9 (30.0%). Eight procedure-related complications occurred, including intraprocedural rupture and early rebleeding in three each, and thromboembolic event in two. At last follow-up, 18 patients were independent with a modified Rankin Scale (mRS) score of 0-2, and the other 12 were either dependent or had expired (mRS score, 3-6). Adjacent hematoma was found to be associated with an increased risk of poor clinical outcome. Seventeen of 23 surviving patients underwent follow-up conventional angiography (mean, 16.5 months). Results showed stable occlusion in 14 (82.4%), minor recanalization in two (11.8%), and major recanalization, which required recoiling, in one (5.9%). Conclusion : Our experiences demonstrate that endovascular treatment for a ruptured PA aneurysms is both feasible and effective. However, periprocedural rebleedings were found to occur far more often (20.0%) than is generally suspected and to be associated with preoperative contrast retention. Analysis showed existing adjacent hematoma is predictive of a poor clinical outcome.

• 대한한의학원전학회지
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• 제30권2호
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• pp.59-81
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• 2017

Objectives : This paper studies the pulse diagnosis as found in Youksimanpil, which is a series of medical charts containing 150 diagnosis records of Yi Suki, a doctor who was active in Joseon during the 17-18th centuries. Through this effort, the paper aims to shed light on how pulse was utilized in the Korean medicine, and in process tries to reveal the essence of Korean medicine's treatment method. Methods : 60 charts where pulse method was used are selected in Youksimanpil and a table is created with them. Figures are drawn to explain four steps of pulse-sensing from the simple method to highly advanced method. Charts are presented with the corresponding original texts and their translations. With these efforts, the paper attempts to reveal the broad understanding of the doctor of Joseon period who consistently kept to the most basic principle of pulse diagnosis. Results : The efficiency of pulse diagnosis depends on the unity and simplicity in diagnosis and prescription. There were continued efforts between the doctors in Joseon to collect and compare the experiences they gained from clinical practices in order to organize their findings and form a system. These are: (1) individual pulse, (2) patternized pulse, (3) balance between left and right pulses, (4) balance between pulse and body, and (5) the doctor's extemporaneous diagnosis. In that efforts, they protect the principle of holistic diagnosis, which is one of Korean medicine's core principles. Conclusions : Thanks to the existence of medical charts that presents in detail how the texts of Donguibogam were applied in real clinical practices, today we can see Korean medicine's highly advanced synergy between textual knowledge and clinical experiences as recorded in the form of charts.

• 임상간호연구
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• 제29권1호
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• pp.1-11
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• 2023

Purpose: The purpose of this study was to identify the influencing effects of job stress, professional autonomy, and reciprocity on the job embeddedness among comprehensive nursing care unit nurses. Methods: The participants in this study were 147 nurses who have worked for over 6 months in Comprehensive Nursing Care Unit. Data were collected from January 3 to January 31, 2022 from six general hospitals with more than 300 beds in three cities in G, G and P. Results: As the results of hierarchical regression analysis, job embeddedness was lower when nurses had clinical experiences for 1 to under 5 years (β=-.49, p<.001), 5 to under 10 years (β=-.27, p=.035), 10 to under 20 years (β=-.54, p<.001) compared to those who had clinical experiences for more than 20 years. Also, job embeddedness was higher when there was greater balance within team caregiving of reciprocality (β=.27, p<.001) and intrinsic reward (β=.22, p=.003), and lower role conflict (β =-.27, p<.001). Conclusion: The results of the study showed that job embededness would increase if the role conflict of comprehensive nursing care unit nurses reduces, if there was a culture that the members can make cooperative relationship with other health care professionals and, if there was an appropriate intrinsic reward depending on their work experience.