• Journal of Korean Public Health Nursing
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• v.4 no.1
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• pp.57-74
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• 1990

As the whole world took on the tendency to be highly industrialized, it became necessary for each field of occupation to require professional man power. Especially, since the World War n, the participation of woman power in economic activities has been continually increasing. In our country also, because of the rapid economic growth, change in the way of thinking of women as well as their participation in economic activities are increasing. Thus, woman power is being utilized in various occupational fields from simple physical labor to those that require high-professional skill. Also, continued economic development policies, by setting the establishment of welfare society as the ideology to be fulfilled, brought expansion of medical facilities in the field of public health and increase in man power in that field. As for the nursing specialists, more than 6000 have been being produced per year and as of the end of 1988, the total number of nursing specialists, reached 123, 115. Therefore, this study is done to recognize the professional knowledge and ability of nursing specialists, who take up $40\%$ of the total public-health related man power in our country, through evaluating their working environment and their disposition of character. This study, which was done from September 18th to September 30th 1989, took on the method of using formed questionnaires that had been amended and supplemented during two preparatory investigations, 322 of such questionnaires were used as an analytical material. In the formation of questionnaires, 12 questions were related to the working environment, and 26 in fortotal were related to the disposition of character, 5 for wise-disposition, 11 for activedisposition and 10 for open-disposition. The measuring method, which used 5-point-standard, allowed 5 points for affirmative recognition of the working environment, also 5 points for showing wise, active and open disposition of character and only point in opposite cases. Collected materials were analyzed, through an electronic calculation, into the average value, the standard deflection percentage, pearson corelative number and stepwise multiple regression. Summarizing the results from this study is as follows: 1. It was shown that the nursing specialists with the average of 3.07 have affirmative recognition of their working environment. The questions which drew most affirmative reaction were those concerning finance-management system such as hand, the questions that received negative reaction were those concerning communication method with the average of 2.49. Such reaction seems to have resulted from the cramming regulation by the superior authorities. Concerning the recognition of working environment in relation to employment conditions, more affirmative recognition is shown with the average of 3.14. at hospitals where injection job is not performed. The nursing specialists working at regular hospitals show more affirmative recognition than those at general hospitals, the averages being respectiely 3.16 and 3.03. 2. As for the disposition of character of the nursing specialists, active-disposition was highest with the average of 3.38, next was wise-disposition with 3.20 and the lowest was open-diposition with 2.98. Variable-wise disposition of character shows that wise-disposition and academic background are beneficially correlated by 0.12. Ative-disposition and open-disposition show correlation to the office term by respectively 0.16 and 0.21. In other words. better academic background leads to higher wise-disposition and more - experience results in higher active and open disposition. Also, the class that performs the injection job, in relation to the working environment, might cause change in the self-conceit that identify those in that class with the nurses; however, as far as professional judgment and action, in dealing with nursing job, being wise, active and open is concerned, not much effect is made. 3. The relation between the recognition of the working environment and the disposition of character is that more afirmative recognition- a nursing specialist has about her working environment, the higher the active-disposition becomes by 0.13. The degrees of the relation between recongnition of environment and wise and open dispositions show respectively 0.06 and -0.06 and -0.06. That is to say that when having more affirmative recognition of the working environment, a nursing specialist shows wise but closed disposition of character. This, howerver, didn't mean much statistically. When observing the results mentioned above, it is conspicuous that the nursing specialists, working as substitutes for the nurse at medical institutions of various sizes, get the feeling of being somewhat equal to the nurses and to some extent, fulfill their desire to accomplish their ego; however, as far as professional ability expansion if concerned. they lack wise and open dispositions. Therefore, considiering upon the results of this study, in medical institutions where the work of nursing specialists is regaded equal to that of the nurses, as a medical member who deals with human lives, it is desirable to make the nursing specialists work under the supervision of the nurses and to offer them continuous education to strengthen and improve their natural dispositions.

• Research in Community and Public Health Nursing
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• v.9 no.2
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• pp.533-549
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• 1998

This descriptive study was designed to measure the degrees of work stress and job satisfaction and use interpersonal conflict resolution strategy as an attempt to provide clinical nurses basic data to develop strategies releasing work stress and improving job satisfaction. These data were collected from 367 clinical nurses working in 9 hospitals nation-wide from May 1, to June 30, 1998. A structured questionaire was used for data collection. The questionnaire included Kim and Koo's work stress scale, Lee's interpersonal conflict resolution strategy scale and a Minesota satisfaction questionnaire. Data analysis was done by the use of the SAS computer program with descriptive statistics, t -test, ANOVA, Scheffe test, Pearson Correlation Coefficient and Cronbach - ${\alpha}$. The results were as follows 1. The mean score of work stress for the subjects was 4.34(SD=0.64). The highest scored reasons for work stress were 'inadequate com pensation' 4.93(SD=0.86), 'lack of professional knowledge and skill' 4.70(SD=0.92) and 'unsatisfactory relationship with superior authorities' 4.63(SD=0.97). The lowest scored reasons were 'unsatisfactory relationship with inferior staff' 3.72(SD=1.02), 'inadequate mechanical environment' 3.72(SD=1.11) and 'interpersonal problems' 3.85 (SD=1.06), The work stress in clinical nurses differed significantly depending on the hospital type (F=4.00, p=0.0082). 2. The clinical nurses used compromise(45.1%) as the best interpersonal conflict resolution strategy. The second was collaboration(32.8%), the third accomodation(14.2%), the forth avoidance(4.2%) and the fifth competition(3.6%). 3. The item score of job satisfaction of the subject was 3.00(SD=0.43), The job satisfaction in clinical nurses differed significantly depending on age(F=5.67, p=0.0000), marital status(t= -1.89, p=0.0511), academic career(F=5.84, 0.0001), official position (F=7.38, p=0.0001), and work career(F=6.33, p=0.0001). 4. The result of the analysis of relationship between work stress and job satisfaction was significant(r= -0.34, p=0.0000). In conclusion, it was found that work stress was very high in clinical nurses. They used interpersonal conflict resolution strategies to release their interpersonal problems and to increase their job satisfaction. Therefore, adequate stress management for clinical nurses will provide them with higher job satisfaction and hence lead to more qualitified nursing care.

• Journal of Hospice and Palliative Care
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• v.11 no.1
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• pp.30-41
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• 2008

Purpose: This study was designed to investigate various role changes of nurses who have cared both medical cases and hospice patients and what they experienced. Methods: Focus group interviews were done 3 times and participants were 12 nurses who have worked in the hospice unit of medical ward. Results: Role changes in 4 areas such as holistic care, end-of-life care, care fur rare givers, and coordination of hospice team were reported by the participants. What they felt were as follows : fear, confusion, maturation, increasingly labor, regret, accomplishment, sympathy and depression. Conclusion: Although hospice care in general medical ward added extra tasks, it helped clinical nurses recover professional identity and led to growth of nursing by acquiring new knowledge and skill in hospice care.

• The Journal of the Korea Contents Association
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• v.13 no.6
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• pp.370-379
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• 2013

In an effort to resolve the burden of patients hiring patient sitters, this study sought to review the Ministry-of-Health-and-Welfare-initiated pilot program of running hospitals without patient-sitter to identify its background, operation method, performance results, and limitations. Based on the review, the study derived the necessity of introducing a hospital system without patient-sitter as well as its operation and systemization methods. The ministry-initiated pilot programs were conducted twice: in 2007, and in 2010. A review of the 2007 pilot program revealed that the patients and families' satisfaction score with nursing services was 9.1 points (on a 10-point scale), their intention to reuse the service was 97.8%, and their intention to recommend the service was 98.0%, all high scores. Appropriate nursing manpower, derived from the 2007 pilot project, indicated 2.3 patients per nurse and 4.0 patients per nurse aid. The 2010 pilot project results indicated that the patients and families' satisfaction was high at 8.0-9.1 points (on a 10-point scale), and that the intention to reuse and recommend the service was also high. Compared with the 2007 pilot project, however, the types of medical institutions and the nurse to patient ratios were diverse, offering limitations. In conclusion, to systemize hospitals without patient-sitter, it is necessary to develop policies designed to establish criteria for the appropriate nurse to patient ratio and skill-mix, to standardize the work, to prepare finances for securing nursing staff, to evaluate the nursing demands, and to monitor the quality management.

• Journal of Korean Academy of Nursing
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• v.26 no.1
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• pp.15-32
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• 1996

The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed include confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient /family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who have had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.95-104
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• 2002

Purpose : This study was conducted to investigate the extent to which the professional self concept between the psychiatric mental health nurse practitioner (PMHNP) and general nurse in psychiatric ward was comparable. The results were expected to provide basic data for developing the construct of professional self concept and making awareness of the importance of the program increasing professional self concept. Method : The subjects of this study were 227 PMHNP and 436 general nurse in psychiatric ward. The instruments used for this study were PSCNI by Arthur (1990), PSI by Heppner and Peterson(1982) and the index of work satisfaction by Slavitt et al.(1978). With the aid of the SAS, t-test. two-way ANOVA and stepwise multiple regression were conducted. Result : 1. The average item score of PSCNI of PMHNP was $2.82\pm0.27$. and that of general nurse was $2.66\pm0.27$. Statistically significant difference between two groups was found(p=0.0000) 2. There was statistically significant difference between two groups in the score of professional practice(p=0.0000), satisfaction(p=0.0024), leadersbip(p=0.0000) , flexibility(p=0.0000) and skill (p=0.0000). 3. Statistically significant differences between the two groups were observed in terms of age(p=0.0003), marital status(p=0.0001). education(p=0.0005), religion(p=-.0144), motive (P=-.0001), length of service as a nurse(p=0.0121), the length of service in psychiatric unit(p=0.0143). However there were no significant interaction effect with group and age, marital state. education, religion, motive, length of service as a nurse, length of service in psychiatric unit. 4. Job satisfaction (JS) and problem solving inventory score(PS) were found to be the highest factor predicting the professional self concept between the PMHNP and general nurse. JS and PS accounted for $43.4\%$ in the professional self concept of PMHNP, whereas PS, JS, age and religion accounted for $53\%$ in the professional self concept of general nurse in psychiatric ward. In conclusion, this study suggested that we need to develop programs and polices to increase the professional self concept of nurse, particularly of psychiatric mental health nurse practitioners.

• Journal of Korean Academy of Nursing
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• v.28 no.2
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• pp.431-440
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• 1998

The purposes of this study were to determine the factors that influence job satisfaction for ICU nurses and to analyze group differences in job satisfaction based on the nurses' preference and perception of the work environment with an enhanced professional role. A total of 231 nurses who had been working in Intensive Care Units at least for 6 months at selected university hospitals participated in the study while head nurses or those with administrative positions were excluded. The study participants had an average of 33 months of clinical experience with an age range of 23 to 40 years. The data were analyzed by utilizing SPSSWIN and the results are as follows. 1) Hierarchical multiple regression analysis showed that work characteristics defined by Job characteristics theory and nurses' preference / perception of ideal work environment together explained 33% of variance in job satisfaction. Skill variety, task identity and autonomy as well as individual perception of work environment were significant variables for explaining job satisfaction. Job satisfaction was not significantly related to age, marital status, education, and clinical experience. 2) The groups classified by nurses' preference and perception of work environment were significantly different in their job satisfaction. Nurses with high preference and high perception showed significantly higher general and specific job satisfaction than other nurses. The nurses who showed high preference but perceived their work environment as not reflecting ideal job characteristics reported the lowest job satisfaction among the groups. In conclusion, the role of individual preference and perception of the work environment in explaining the relationship between the redesign of work environment and job satisfaction was supported by the study, The preferences of nurses to the innovative work characteristics should be considered in the process of enhancing job characteristics to lead job satisfaction and low turnover and ultimately to improve quality of care.

• Journal of Korean Academy of Nursing
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• v.25 no.4
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• pp.790-806
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• 1995

The present study examined the causal relationships among nurses' job environment /job characteristics(work overload, lack of autonomy, professional role conflict, interpersonal relationships), maturity, job stress, job satisfaction and turnover intention by constructing and testing a theoretial framework. Based on Katz and Kahn's (1978) theory of organizational open system and Kahn, Wolfe, Quinn, and Snoek's (1964) theory of stress, nurses' turnover intention, job satisfaction and job stress were conceived of as outcomes of the interplay between personal characteristics and work environment. Personal aspects associated with outcome variables included professional knowlege and skill, and maturity(challenge, commitment, control, responsibility). The work environment factors involved work overload, lack of autonomy, professional role conflict, and interpersonal relationships (social support). Three university hospitals located in Seoul were selected to participate. The total sample of 443 registered nurses represents a response rate of 96 percent. Linear structural relationships (LISREL) technique was used to test the fit of the proposed conceptual model to the data and to examine the causal relationships among variables. The result showed that both the proposed model and the modified model fit the data excellently, revealing considerable explanatinal power for job stress and job satisfaction. The explanatory power of turnover intention was relatively lower than those of stress and satisfaction. In predicting nurses' stress, satisfaction and turnover intention, the findings of this study clearly demonstrated that professional role conflict might be the most important variable of the all the environmental variables and personal characteristics. The results were dis-cussed, including directions for the future research and practical implications drawn from the research were suggested.

• Journal of Digital Convergence
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• v.13 no.6
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• pp.185-195
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• 2015

This study aims to study the change in the level of awareness of medical personnels regarding the patient safety culture(PSC) before and after the Leadership WalkRounds(LWR). The LWR in this study was based on the IHI and the models of the Patient Safety Rounds(PSRs) at University of Michigan, emphasizing the 5 steps of Preparation--Scheduling--Conducting--Reporting--Resolving. After the LWR the scores for the level of awareness showed a statistically significant increase from 2.63 to 3.36(p<.001). Among the participants, those who are pharmaceutists, women, 30.0~39.9 years old, or had work experience of a year or less showed particularly notable increase in awareness. The effect was significant across all categories of PSC, especially in Safety Accident Reporting(p<.001), then in Communication(p<.001). Therefore the LWR proved an convergent concept for applying new leadership skill and the concept of patient safety management as an method to elevate the frontline staffs' awareness of PSC.

• Quality Improvement in Health Care
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• v.19 no.2
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• pp.14-34
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• 2013

Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.