PURPOSE: The purpose of this study was to investigate the factors influencing nurses' clinical decision making focusing on critical thinking disposition. METHODS: The subjects of this study consisted of 505 nurses working at one of the general hospitals located in Seoul. Data was collected by a self-administered questionnaire between December 2006 and January 2007. Data was analyzed by one way ANOVA, Pearson correlation coefficients, and stepwise multiple regression using SPSS Win 14.0. RESULTS: The mean scores of critical thinking disposition and clinical decision making were 99.10 and 134.32 respectively. Clinical decision making scores were significantly higher in groups under continuing education, with a master or higher degree, with clinical experience more than 5 years, or with experts. Critical thinking disposition and its subscales have a significant correlation with clinical decision making. Intellectual eagerness/curiosity, prudence, clinical experience, intellectual honesty, self-confidence, and healthy skepticism were important factors influencing clinical decision making(adjusted R2=33%). CONCLUSION: Results of this study suggest that various strategies such as retaining experienced nurses, encouraging them to continue with education and enhancing critical thinking disposition are warranted for development of clinical decision making.
Adult ; Clinical Competence ; *Decision Making ; Female ; Humans ; Male ; Nursing Staff, Hospital/*psychology ; Questionnaires ; Thinking

PURPOSE: The purpose of this study was to investigate the factors associated with the supportive care needs of gynecologic cancer patients, and to provide basic data for patient-centered care. METHODS: The data were collected from 153 patients with ovarian/cervix/uterine cancer in 2016. For the data collection, the Korean version of the Supportive Care Needs Scale-gyne and electronic charts were used. T-test, one-way ANOVA, and logistic regression were used to analyze the data. RESULTS: The standardized scores for the supportive care needs of patients ranged from 19.45 to 35.66. The supportive care need in the psychological domain was the highest, followed by the emotional, physical, and information domains. The ten highest frequency items consisted of 5 items in information, 3 in psychological, 1 item each in the emotional and spiritual domain. Patients under 45 years old have more fear about treatment and disability, and uncertainty about their future. College graduates had higher needs for information about support groups and self-care. Patients with recurrence felt more bored and meaningless. CONCLUSION: Patients with gynecologic cancer have various supportive care needs according to their characteristics. In order to fulfil their needs, a more intensive and patient-centered individualized approach based on the patient's characteristics should be introduced.
Data Collection ; Female ; Genital Neoplasms, Female ; Humans ; Logistic Models ; Needs Assessment ; Patient-Centered Care ; Quality of Life ; Recurrence ; Self Care ; Self-Help Groups ; Uncertainty

PURPOSE: The purpose of this study was to identify the work environment related to the handling and administration of antineoplastic drugs in the members of the Korean Oncology Nursing Society.METHODS: The study was carried out from October 2018 to November 2018. The self-reported surveys included questions on the work environment, experience and concerns from occupational exposure, safe activities of antineoplastic drugs and use of personal protective equipment (PPE), hand hygiene, and type of PPE (e.g., gown, gloves, and mask).RESULTS: A total of 125 participants from 41 organizations were surveyed. The nurses were mostly educated on safe management of antineoplastic drugs (95.2%) and concerned about health threats caused by occupational exposure (7.23±2.14 out of 10). In addition, harmful activities were found, with gown use being the lowest when handling antineoplastic drugs.CONCLUSION: This study supports that appropriate staffing, equipment, and facilities, mandatory education, and establishment of policies are very important in creating a safe work environment for handling antineoplastic drugs.
Antineoplastic Agents ; Education ; Hand Hygiene ; Occupational Exposure ; Oncology Nursing ; Personal Protective Equipment ; Safety Management

Purpose: : This study aimed to identify the status of intrahospital transport (IHT) of critically ill patients and provide baseline data to form recommendations for safer transport. Methods: : Data were collected from 141 intensive care unit (ICU) nurses who attended national conferences between February and August, 2018. The collected data were analyzed using descriptive statistics and ANOVA, and post-hoc analysis was conducted with the Scheffé and Games-Howell tests. Results: : Of the nurses surveyed, 61.7% answered that their workplace had a transport guideline. In terms of the experience of ICU nurses, 31.2% of respondents answered that they had received training on IHT. This result indicated that the degree of implementation of the guidelines for IHT was generally high, but some, including guidelines on personnel, equipment, and monitoring, were not. Guidelines of IHT were well observed when the institutes had specific guidelines for IHT of critically ill patients with specified transport grades, a scoring system to assess stability of a patient, a checklist and a protocol for action in case of problems, and when healthcare providers were provided with training. Conclusion : These results suggest that organized infrastructure, such as a transport guideline with transport grades, a checklist to improve the implementation of guidelines, and a protocol for coping with a problem, should be provided for safe transport. Additionally, effective education and evaluation to improve the competency of staff participating in the transport of patients will help reduce the occurrence of adverse events in intensive care transport in hospitals and promote patient safety.

Purpose: This study aimed to identify symptom clusters over time and examine the severity of each symptom cluster in patients with non-Hodgkin’s lymphoma receiving chemotherapy. Methods: Data were collected from 110 patients using the Memorial Symptom Assessment Scale. The data were analyzed using factor analysis. Results: Lack of energy was the most prevalent symptom on the Day 7 of chemotherapy (T1). On the day of chemotherapy of the next cycle (T2), drowsiness was the most prevalent symptom. For the timeline of T1 and T2, seven and six symptom clusters were identified, respectively. The psychological and nutrition clusters were common to both T1 and T2. The symptom scores of energy and nutrition clusters were the highest at T1, while those of the nutrition and psychological clusters were the highest at T2. Although symptom scores at T2 tended to be lower than those at T1, the symptom scores of the severe groups were still high in the nutrition, skin changes, and psychological clusters. Conclusion Some symptom clusters can either change or appear stable over time. Furthermore, the severity of some clusters was found to be relatively high. Development of stable symptom cluster-based interventions is necessary to improve the quality of life.

PURPOSE: This study was performed to understand the perceived importance and performance frequencies of nursing interventions and identify the core and major interventions in oncology units. METHODS: Questionnaires using 151 nursing interventions were given to 45 nurses. The performance frequency was measured through the database of the nursing process recording system for 1 year. RESULTS: The perceived importance of the nursing interventions averaged out to be 3.5 among 4 and on average 36.5 times of nursing interventions were performed on each patient. Fifteen core nursing interventions including 'pain management' were identified and they made up 82.7% of the entire performance frequency rate. And 26 interventions including 'drug administration: Amphotericin-B' were identified as major nursing interventions and occupied 10.6% of the entire performance frequency rate. CONCLUSION: Since the core and the major nursing interventions were identified and these occupied 93.3% of the all nursing interventions, these results can be utilized as baseline data for establishing the guidelines and standards of nursing interventions and providing systematic education for oncology nurses in Korea.
Education ; Humans ; Korea ; Nursing Process ; Nursing* ; Oncology Nursing ; Tertiary Care Centers* ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to explore the effects of hand reflexology on the physiological?emotional responses and immunity of the patients with chronic illness. This study looked specifically at patients with chronic renal failure(CRF) and cancer patients. METHOD: This study was designed as a quasi-experimental nonequivalent control group pre and post test. Subjects were 54 patients who received dialysis and chemotherapy in one hospital. Thirty-one patients were assigned to the experimental group and 23 to the control group. The hand reflexology was applied to both hands of the experiment group for ten minutes each time, 5 times during three days. For data collection, physiological lab levels, immune cells of blood and questionnaires for emotional responses were measured before and after the program. RESULT: BT of the experiment group was decreased significantly on both of the 1st and the 5th application. PR and BP were decreased significantly on the 1st times, but not 5th times. Hb levels of the experimental group were significantly increased. And emotional responses, vigor and mood scores of the experiment group were significantly increased. B cell and CD19 were increased significantly on the experiment group. Suppressor T cell and NK cell showed significant decrease after the program, but no significant differences between the groups. CONCLUSION: We have found that the hand reflexology helps the chronic patients to improve physiological emotional responses and the immune reaction. Through this result, the hand reflexology is effective as a intervention of psychoneuroimmunologic function.
Chronic Disease* ; Surveys and Questionnaires ; Dialysis ; Drug Therapy ; Hand* ; Humans ; Kidney Failure, Chronic* ; Killer Cells, Natural ; Massage*

PURPOSE: The purpose of this study was to develop an e-Learning program about medication for nurses to enhance nurses' medication performance ability and to analyze learners' responses after studying with this program. METHOD: For the development of the e-Learning program, the NBISD(Network Based Instructional Systems Design) model, suggested by Jung(1999) was applied as a basic model and the instruction design theory of Gagne & Briggs(1979) and ARCS theory of Keller(1983) were applied. After the operation of this program for one month to 34 new nurses, learners' responses were analyzed. RESULT: Learners' knowledge of medication was greatly improved after this program. In addition learners' satisfaction with the overall education program, help in field applicability, ease of screen shift and exploration, and tutor activities were high and the contents were regarded suitable for e-Learning. Many things were advantageous such as easy accessibility, easy understandability with pictures and flash animation, practical cases and feedback from a tutor. Provision of a supplementary handout and improvement of a tight time schedule were pointed out as things to be improved. CONCLUSION: This e-Learning program can be used effectively for medication education for registered nurses, student nurses, and new nurses.
*Pharmaceutical Preparations ; *Internet ; Humans ; Female ; *Education, Nursing ; *Computer-Assisted Instruction ; Adult

PURPOSE: This study was done to identify factors influencing falls in inpatients. A comprehensive analysis of individual, disease, and environment related factors and an assessment of being in a risk factor group were included in the data. METHOD: The medical records of 325 inpatients were reviewed. Data were collected from January to July 2003. Frequencies, t-test and chi-square-test were used to analyze the data and the SPSS program was used. RESULTS: Individual-related factors for inpatients falls were age, drinking and weakness. Disease-related factors for inpatients falls were diagnostic department, admission from ER or OPD, admission by wheelchair or orther method and activity status. Environment-related factors for inpatient falls were re-education and side-rails. Assessment of the risk factor group related factors were age, history of falls, body balance, depression, communication, medication, chronic disease, urinary condition and total score for risk factors. CONCLUSION: Experienceing a fall among Korean inpatients was associated not only with individual factors, but also with disease and environmental factors. The findings of this study suggest that broad intervention programs should be provided to prevent inpatient falls.
Chronic Disease ; Depression ; Drinking ; Humans ; Inpatients* ; Medical Records ; Risk Factors ; Wheelchairs

PURPOSE: The purpose of this study was to propose a revised Clinical Ladder System(CLS) Model for nurses based on the evaluation of clinical competence and professional activities of nurses working in general hospitals. METHODS: Data were collected between September 10 and October 30, 2017. Participants were 50 head nurses from 10 general hospitals with over 400 beds located in Seoul City and Gyeonggi Province. Each head nurse evaluated clinical competence, qualifications, and professional activities of 5 staff nurses at each of the 5 levels of CLS in her unit. The total number of the nurses evaluated was 245. Data were analyzed with descriptive statistics and t-test, one-way ANOVA, and Scheffé. RESULTS: Over 80% of the nurses were university graduates. As the CLS levels increased, clinical competence, qualifications, and professional activities also increased significantly. Education material development and quality improvement activities were carried out by nurses from level 2, research and evidence based practice activities were carried out from level 3, and nurses at level 4 or 5 participated in most of the professional activities as leaders. CONCLUSION: In order to retain excellent nurses in general hospitals, recognizing and rewarding nurses according to the revised model of the CLS are recommended.
Career Mobility ; Clinical Competence ; Education ; Evidence-Based Practice ; Gyeonggi-do ; Hospitals, General ; Nursing, Supervisory ; Quality Improvement ; Reward ; Seoul