PURPOSE: The purpose of this qualitative study was to explore the workplace bullying experience of Korean nurses. METHODS: Participants were twenty current or former hospital nurses who had experienced workplace bullying. Data were collected through focus group and individual in-depth interviews from February to May, 2015. Theoretical sampling method was applied to the point of theoretical saturation. Transcribed interview contents were analyzed using Corbin and Strauss's grounded theory method. RESULTS: A total of 110 concepts, 48 sub-categories, and 17 categories were identified through the open coding process. As a result of axial coding based on the paradigm model, the central phenomenon of nurses' workplace bullying experience was revealed as 'teaching that has become bullying', and the core category was extracted as 'surviving in love-hate teaching' consisting of a four-step process: confronting reality, trial and error, relationship formation, and settlement. The relationship formation was considered to be the key phase to proceed to the positive settlement phase, and the participants utilized various strategies such as having an open mind, developing human relationships, understanding each other in this phase. CONCLUSION: The in-depth understanding of the workplace bullying experience has highlighted the importance of effective communication for cultivating desirable human relationships between nurses.
Bullying* ; Clinical Coding ; Focus Groups ; Humans ; Interpersonal Relations

PURPOSE: This research aimed to investigate the effects of a cognitive rehearsal program (CRP) on workplace bullying among nurses. METHODS: A randomized controlled trial was performed. Participants were 40 nurses working in different university hospitals in B city, South Korea. The experimental group was provided with a 20-hour CRP comprising scenarios on bullying situations, standard communication, and role-playing. To evaluate effects of the CRP, we measured interpersonal relationships, workplace bullying, symptom experience, and turnover intention at preand post-intervention. Follow-up effect was measured in the experimental group only at 4 weeks after the intervention. RESULTS: After the intervention, there were significant differences in interpersonal relationships (F=6.21, p=.022) and turnover intention (F=5.55, p=.024) between experimental and wait-list groups. However, there was no significant difference in workplace bullying or symptom experience between the 2 groups. The beneficial effects on interpersonal relationships and turnover intention lasted at least up to 4 weeks after CRP. CONCLUSION: The CRP for workplace bullying improves interpersonal relationships and decreases turnover intention. So it can be utilized as one of the personal coping strategies to reduce the the turnover among nurses. Further studies on the effects of unit- or hospital-based CRP and on the long-term effects of CRP are necessary.
Bullying* ; Cognitive Therapy ; Follow-Up Studies ; Hospitals, University ; Humans ; Intention* ; Korea ; Role Playing

PURPOSE: The purpose of this study was to build and test a model outlining the factors related to workplace bullying among nurses. The hypothesized model included authentic leadership and a relationship-oriented organizational culture as influencing factors, symptom experience and turnover intention as consequences, and positive psychological capital as a mediator of workplace bullying among nurses. METHODS: We obtained structured questionnaire data from 301 nurses working at hospitals in South Korea. Based on these data, the developed model was verified via a structural equation modeling analysis using SPSS and AMOS program. RESULTS: The fit indices of the hypothesized model satisfied recommended levels; χ2 = 397.58 (p < .001), normed χ2 (χ2/df) = 1.82, RMR = .05, TLI = .93, CFI = .94, RMSEA = .05. A relationship-oriented organizational culture had a direct effect on workplace bullying (β = −.48, p < .001). Furthermore, workplace bullying had a direct effect on symptom experience (β = .36, p < .001), and this relationship was mediated by positive psychological capital (β = .15, p = .003). Workplace bullying also had an indirect effect on turnover intention (β = .20, p = .007). Finally, symptom experience had a direct effect on turnover intention (β = .31, p = .002). CONCLUSIONS: These results suggest that workplace bullying among nurses may be prevented by constructing a relationship-oriented organizational culture, as long as employees have sufficient positive psychological capital. In this regard, workplace bullying among nurses should be addressed using a comprehensive strategy that considers both individual and organizational factors.
Bullying* ; Intention ; Korea ; Leadership ; Organizational Culture ; Personnel Turnover

PURPOSE: The purpose of this study was to investigate the effect of the perceived nursing work environment (NWE) on person-centered critical care nursing (PCCN) practices among nurses in intensive care units (ICUs).METHODS: A cross-sectional research design was adopted for this study; participants were 126 ICU nurses working in five hospitals in B city. From December 2018 to February 2019, a survey questionnaire on NWE and PCCN were conducted. The collected data were analyzed with a multiple hierarchical regression analysis.RESULTS: The mean score for NWE was 2.98±0.39. Among the factors, basic work system was the highest (3.39±0.41), followed by leadership of the head nurse (3.31±0.55), interpersonal relationships (2.77±0.62), and institutional support (2.58±0.52). The mean score for PCCN was 3.52±0.46. Among the factors, comfort was the highest (3.77±0.62), followed by respect (3.55±0.56), compassion (3.43±0.60), and individuality (3.38±0.56). The interpersonal relationship (β =.31, p=.001) and the number of patients per shift (β =−.23, p=.005) had a significant effect on PCCN, accounting for 25.9% of the total variance.CONCLUSION: These results suggest that it is necessary to enhance the relationship-oriented culture and reduce the workload of nurses in order to improve the quality of nursing care in ICUs.
Critical Care Nursing ; Critical Care ; Empathy ; Humans ; Individuality ; Intensive Care Units ; Leadership ; Nursing ; Nursing Care ; Nursing, Supervisory ; Patient-Centered Care ; Research Design

PURPOSE: The purpose of this study was to examine the relationship between perceived work environment and workplace bullying among Korean intensive care units (ICU) nurses. METHODS: This is a descriptive survey research, with 134 ICU nurses from five hospitals in Korea. The work environment was measured by the Korean Nursing Work Environment Scale. Workplace bullying was measured with the Korean version of the Negative Acts Questionnaire-Revised. RESULTS: ICU nurses reported moderate satisfaction with their work environment, with perception of the basic work system receiving the highest scores. A total of 94.0% of ICU nurses have experienced at least one negative act within the past 6 months, and the prevalence of bullying was 17.2% according to operational bullying criteria. The ICU nurses reported that they experienced more work-related bullying than other types of bullying. Significant negative correlations between the nursing work environment and workplace bullying were found. CONCLUSION: These findings indicate that the better the nursing work environment, the less workplace bullying nurses will experience. Further research needs to be done to identify factors that influence bullying in the nurses and to develop an intervention that prevents workplace bullying.
Bullying* ; Intensive Care Units* ; Korea ; Nursing ; Prevalence

PURPOSE: The purpose of this study was to analyze and identify recent trends of published research in Asian Oncology Nursing (AON). METHODS: A total of 140 studies were analyzed using a tool developed by the researchers, focusing on research design, research subject, research themes, and type of interventions and outcome variables of experimental studies. RESULTS: AON lacked studies which were supported by research funds (27.9%), or used an experimental study design (10.0%). In particular, there were only 2 studies (1.4%) conducted with randomized controlled trials (RCT). Research subjects were various, including patients with cancer, family care givers, healthy population, and oncology nurses. Based on a framework of cancer control continuum, most studies addressed issues of the treatment phase, whereas few studies addressed issues of diagnosis, survivorship, or the end-of-life (EOL) phase. Regarding research themes, psychosocial nursing including quality of life, anxiety, and depression was most frequently reported. In the experimental studies, an education program was most frequently applied and psycho-social-spiritual variables and symptoms were most frequently used to evaluate the effects of the intervention. CONCLUSION: The results suggest that further expansion of RCT and studies regarding diagnosis, survivorship, and EOL phases are needed. Also, our findings may contribute toward the development of a Korean oncology nursing research agenda.
Anxiety ; Asian Continental Ancestry Group* ; Caregivers ; Depression ; Diagnosis ; Education ; Financial Management ; Humans ; Nursing ; Nursing Research ; Oncology Nursing* ; Quality of Life ; Research Design ; Research Subjects ; Survival Rate

BACKGROUND: Androgenic alopecia (AGA) is the most common type of hair loss. It is likely inherited genetically and is promoted by dihydrotestosterone. 5α-reductase has been proven a good target through finasteride use. However, the pathogenesis of AGA cannot be fully explained based only on dihydrotestosterone levels. OBJECTIVE: To identify similar hairloss inhibition activity of RE-ORGA with mode of action other than finasteride. METHODS: We prepared RE-ORGA from Korean herb mixtures. We performed MTT assays for cytotoxicity, Cell Counting Kit-8 assays for cell proliferation, and western blot to identify expression levels of 5α-reductase and Bax. RNA-sequencing was performed for the expression patterns of genes in dihydrotestosterone-activated pathways. Anti-inflammatory activity was also assessed by the expression levels of tumor necrosis factor-alpha (TNF-α) and interleukin 6. RESULTS: REORGA could promote the proliferation of human dermal papilla cells and showed low cytotoxicity. It also inhibited the expression of 5α-reductases and Bax in the cells. RNA-sequencing results verified that the mRNA expressions of SRD5A1, Bax, transforming growth factor-beta 1 (TGF-β1), and TGF-β1 induced transcript 1 (TGFβ1I1) were decreased, whereas expression of protein tyrosine kinase 2 beta (PTK2β) was more elevated. REORGA also showed anti-inflammatory activity through decreased mRNA levels of TNF-α. CONCLUSION: Transcriptionally, up-regulation of PTK2β and concomitant down-regulation of TGFβ1I1 imply that RE-ORGA can modulate androgen receptor sensitivity, decreasing the expression of 5α-reductase type II and Bax together with TGF-β1 transcripts; RE-ORGA also showed partial anti-inflammatory activity. Overall, RE-ORGA is expected to alleviate hair loss by regulating 5α-reductase activity and the receptor's androgen sensitivity.
Alopecia ; Blotting, Western ; Cell Count ; Cell Proliferation ; Cholestenone 5 alpha-Reductase ; Dihydrotestosterone ; Down-Regulation ; Finasteride ; Hair ; Humans ; Interleukin-6 ; Protein-Tyrosine Kinases ; Receptors, Androgen ; RNA, Messenger ; Tumor Necrosis Factor-alpha ; Up-Regulation

PURPOSE: The purpose of this study was to develop a scale to measure person-centered critical care nursing and verify its reliability and validity. METHODS: A total of 38 preliminary items on person-centered critical care nursing were selected using content validity analysis of and expert opinion on 72 candidate items derived through literature review and qualitative interviews. We conducted a questionnaire survey with 477 nurses who worked in intensive care units. The collected data were analyzed using exploratory factor analysis (EFA) and confirmative factor analysis (CFA) with SPSS and AMOS 24.0 program. RESULTS: EFA was performed with principal axis factor analysis and Varimax rotation. The 15 items in 4 factors that accounted for 50.8% of the total variance were identified by deleting the items that were not meet the condition that the commonality should be .30 or more and the factor loading over .40. We named the factors as compassion, individuality, respect, and comfort, respectively. The correlation coefficient between this scale and the Caring Perception Scale was r=.57 (p < .001), which determined concurrent validity. The item-total correlation values ranged from .39 to .63, and the internal consistency for the scale was Cronbach's α=.84. CONCLUSION: The reliability and validity of the 15 item person-centered critical care nursing scale were verified. It is expected that the use of this scale would expand person-centered care in critical care nursing.
Critical Care Nursing* ; Critical Care* ; Empathy ; Expert Testimony ; Factor Analysis, Statistical ; Individuality ; Intensive Care Units ; Patient-Centered Care ; Reproducibility of Results

PURPOSE: Amendment to the Act on Decisions on Life-sustaining Treatment was recently enacted to designate long-term care hospitals as providers of hospice and palliative care. Despite its benefit of providing improved accessibility to end-of-life care, the amendment has raised concerns about its effect on quality of service. This study aimed to use information obtained from an expert group interview and previous studies to compare how cancer patients, family caregivers, physicians, and the general Korean population perceive the potential benefits and risks of this amendment.METHODS: We conducted a multicenter cross-sectional study from July to October 2016. The included participants answered a structured questionnaire regarding the extent to which they agree or disagree with the questionnaire items indicating the potential benefits and risks of the amendment. Chi-square tests and univariate and multivariate logistic regression analyses were performed.RESULTS: Compared with the general population, physicians agreed more that long-term care hospitals are currently not adequately equipped to provide quality hospice and palliative care. Family caregivers found improved access to long-term care hospitals more favorable but were more likely to agree that these hospitals might prioritize profits, thereby threatening the philosophy of hospice care, and that families might cease to fulfill filial responsibilities. Compared with the general population, cancer patients were more concerned about the potentially decreased service quality in this setting.CONCLUSION: Although potential service beneficiaries and providers expected improved accessibility of hospice and palliative care services, they were also concerned whether the system can provide adequate quality of end-of-life care.
Caregivers ; Cross-Sectional Studies ; Health Personnel ; Hospice Care ; Hospices ; Humans ; Interviews as Topic ; Logistic Models ; Long-Term Care ; Palliative Care ; Philosophy ; Risk Assessment ; Terminal Care

PURPOSE: Papillary thyroid carcinoma (PTC) is the most common malignant tumor of the thyroid and BRAFV600E mutation is the most frequent genetic alteration in PTC. BRAFV600E mutation has been demonstrated as a prognostic biomarker for prediction of poor clinicopathological outcomes, such as increased incidence of extrathyroidal extension, lymph node metastasis, and advanced stage. However, there is conflicting literature regarding the association of BRAFV600E mutation and aggressive clinicopathological features. In this study, we investigated the prevalence of BRAFV600E mutation in PTC and determined the association of BRAF mutation with indicators of poor prognosis for PTC. METHODS: We reviewed 1009 patients with PTC, who underwent thyroid surgery at Kyungpook National University Hospital between January 2013 and March 2014. BRAFV600E mutation analysis was performed using real-time polymerase chain reaction based amplification of DNA extracted from paraffin-embedded tumor specimens. RESULTS: BRAFV600E mutation was detected in 863 (85.5%) patients. In univariate analysis, histologic subtype, extrathyroidal extension, and advanced stage showed significant association with BRAFV600E mutation. In addition, concurrent Hashimoto's thyroiditis showed an association with low prevalence of BRAFV600E mutation. However, no statistically significant association was observed for age, gender, multifocal or bilateral tumor, and lymph node metastasis. Multivariate analysis showed an independent association of extrathyroidal extension with BRAFV600E mutation. CONCLUSION: In this study, extrathyroidal extension of PTC is an independent prognostic factor associated with BRAFV600E mutation status. However, conduct of further large scale studies with long term follow up is required before the BRAF mutation can be conclusively recommended as a prognostic biomarker.
DNA ; Gyeongsangbuk-do ; Humans ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prevalence ; Prognosis ; Real-Time Polymerase Chain Reaction ; Thyroid Gland ; Thyroid Neoplasms* ; Thyroiditis