BACKGROUND: The purpose of this study is to identify the relationship of sleep quality, physical stress, psychological stress, and job stress among residents and to examine correlations of sleep quality, physical stress, psychological stress, and job stress according to average of working hours per day, frequency of night duty, sleep onset time on night duty and sleeping hour on night duty. METHODS: A descriptive correlation study included 164 residents working at 13 secondary and tertiary hospitals in Gyeong-gi Province who completed a self-administered structured questionnaires. The data were collected from June 1 to August 31, 2016. and analyzed through frequency, percentage, t-test, ANOVA, Scheffe's test, multiple regression analysis by SPSS program version 22.0 (IBM Corp., Chicago, IL, USA). RESULTS: The average level of residents' sleep quality, physical stress, psychological stress, and job stress were 40.30, 16.74, 15.96, and 26.79, respectively. Sleep quality, physical, psychological and job stress have shown statistically significant correlations according to average of working hours per day, frequency of night duty, sleep onset time on night duty and sleeping hour on night duty. Poor sleep quality is related to higher physical, psychological and job stress. CONCLUSIONS: Residents' average of working hours per day is long and sleeping hour on night duty is scarce. Due to this, the level of residents' sleep quality is poor and physical, psychological and job stress are severe. Obviously, sleep quality showed a positive correlation with physical, psychological and job stress. It is necessary to develop effective program to improve the residents' sleep quality and reduce physical, psychological and job stress.
Statistics as Topic ; Stress, Psychological* ; Tertiary Care Centers

The locations and modalities of palliative care services to patients with severe/end-stage illness can be diverse, ranging from general hospitals to home-based care. The concept of palliative care hasn't been fully applied to medical practice by care providers in mainland China, where the seriously ill or terminal patients mainly receive medical care in hospitals. The implementation of palliative care in medical practice has developed greatly in Peking Union Medical College hospital in terms of clinical patient care, education, and research. This article gives an overview of it, and the experiences in team building, promotion, support seaking and fund raising were also discussed in this article. We hope to explore an effective dilivering model of palliative care for end-stage patients that is adaptive to Chinese culture and social environment.
China ; Humans ; Palliative Care ; statistics & numerical data ; Tertiary Care Centers ; statistics & numerical data

BACKGROUND: This study purposed to analyze the spatial accessibility of women in childbearing age to the healthcare organizations (HCOs) providing delivery services in Gangwon-do. METHODS: Network analysis was applied to assess the spatial accessibility based on the travel time and road travel distance. Travel time and travel distance were measured between the location of HCOs and the centroid of the smallest administrative areas, eup, myeon, and dong in Gangwon-do. Korean Transport Database Center provided road network GIS (Geographic Information System) Database in 2015 and it was used to build the network dataset. Two types of network analysis, service area analysis and origin-destination (OD)-cost matrix analysis, applied to the created network dataset. Service area analysis defined all-accessible areas that are within a specified time, and OD-cost matrix analysis measured the least-cost paths from the HCOs to the centroids. The visualization of the number of the HCOs and the number of women in childbearing age on the Ganwon-do map and network analysis were performed with ArcGIS ver. 10.0 (ESRI, Redlands, CA, USA). RESULTS: Twenty HCOs were providing delivery services in Gangwon-do in 2016. Over 50% of the women in childbearing age were aged more than 35 years. Service area analysis found that 89.56% of Gangwon-do area took less than 60 minutes to reach any types of HCOs. For tertiary hospitals, about 74.37% of Gangwon-do area took more than 60 minutes. Except Wonju-si and Hoengseonggun, other regions took more than 60 minutes to reach the tertiary hospital. Especially, Goseong-gun, Donghae-si, Samcheok-si, Sokcho-si, Yanggu-gun, Cheorwon-gun, and Taebaek-si took more than 100 minutes to the tertiary hospital. CONCLUSION: This study provided that the accessibility toward the tertiary hospital was limited and it may cause problems in high-risk delivery patients such as over 35 years. Health policy makers will need to handle the obstetric accessibility issues in Gangwon-do.
Dataset ; Delivery of Health Care ; Female ; Gangwon-do* ; Health Policy ; Humans ; Statistics as Topic ; Tertiary Care Centers

BACKGROUND: This study purposed to analyze the spatial accessibility of women in childbearing age to the healthcare organizations (HCOs) providing delivery services in Gangwon-do. METHODS: Network analysis was applied to assess the spatial accessibility based on the travel time and road travel distance. Travel time and travel distance were measured between the location of HCOs and the centroid of the smallest administrative areas, eup, myeon, and dong in Gangwon-do. Korean Transport Database Center provided road network GIS (Geographic Information System) Database in 2015 and it was used to build the network dataset. Two types of network analysis, service area analysis and origin-destination (OD)-cost matrix analysis, applied to the created network dataset. Service area analysis defined all-accessible areas that are within a specified time, and OD-cost matrix analysis measured the least-cost paths from the HCOs to the centroids. The visualization of the number of the HCOs and the number of women in childbearing age on the Ganwon-do map and network analysis were performed with ArcGIS ver. 10.0 (ESRI, Redlands, CA, USA). RESULTS: Twenty HCOs were providing delivery services in Gangwon-do in 2016. Over 50% of the women in childbearing age were aged more than 35 years. Service area analysis found that 89.56% of Gangwon-do area took less than 60 minutes to reach any types of HCOs. For tertiary hospitals, about 74.37% of Gangwon-do area took more than 60 minutes. Except Wonju-si and Hoengseonggun, other regions took more than 60 minutes to reach the tertiary hospital. Especially, Goseong-gun, Donghae-si, Samcheok-si, Sokcho-si, Yanggu-gun, Cheorwon-gun, and Taebaek-si took more than 100 minutes to the tertiary hospital. CONCLUSION: This study provided that the accessibility toward the tertiary hospital was limited and it may cause problems in high-risk delivery patients such as over 35 years. Health policy makers will need to handle the obstetric accessibility issues in Gangwon-do.
Dataset ; Delivery of Health Care ; Female ; Gangwon-do* ; Health Policy ; Humans ; Statistics as Topic ; Tertiary Care Centers

PURPOSE: This study identifies the effects of the educational leadership of nursing unit managers on team effectiveness and the mediating effects of organizational communication satisfaction; it highlights the importance of educational leadership and organizational communication and provides the data needed to enhance the education capacity of managers. METHODS: The participants were 216 nurses working at unit with nursing unit managers of staff nurses at a tertiary hospital located in Cheongju city, South Korea, and nurses who had worked for more than 6 months at the same unit. This study was conducted using questionnaires on educational leadership, team effectiveness, and organizational communication satisfaction. Data analysis was performed with a t test, analysis of variance, Scheffé test, Pearson's correlation coefficient, and simple and multiple regression analyses using SPSS, version 23.0. Mediation analysis was tested using Baron and Kenny's regression analysis and a Sobel test. RESULTS: The mean score for the educational leadership of nursing unit managers was 3.74 (±0.68); for organizational communication satisfaction, 3.14 (±0.51); and for team effectiveness, 3.52 (±0.49). Educational leadership was significantly positively correlated with team effectiveness and organizational communication satisfaction. Organizational communication satisfaction demonstrated a complete mediating effect on the relationship between educational leadership and team effectiveness (β = .61, p < .001) and was significant (Sobel test; Z = 7.40, p < .001). CONCLUSION: The results indicate that the educational leadership of nursing unit managers increases communication satisfaction among nurses; this supports the idea that educational leadership can contribute to team effectiveness. This suggests that the educational leadership and communication capacity of nursing unit managers must be improved to enhance the performance of nursing organizations.
Chungcheongbuk-do ; Education ; Humans ; Korea ; Leadership* ; Negotiating* ; Nurse Administrators ; Nursing* ; Statistics as Topic ; Tertiary Care Centers

PURPOSE: This study was undertaken to understand the determinants of job satisfaction for hospital nurses in Korea. Organization culture is deemed as a strong factor which contributes to overall job satisfaction. METHODS: A systematic review was conducted using five electronic databases to identify Korean studies for the years 1998 to 2017. The Comprehensive Meta-Analysis Software Ver 2.0 was then utilized in data analysis. RESULTS: A meta-analysis of data from 36 studies indicated that the overall effect size of correlation between organizational culture and job satisfaction was moderate (ESr=.36), and publication year was negatively associated with these factors in the meta-regression model. In addition, the magnitude of the types of organizational culture and job satisfaction varied according to size of the hospitals: innovation-oriented culture for secondary hospitals (ESr=.49) and relation-oriented culture for tertiary hospitals (ESr=.46). Lastly, of four different organizational cultures, innovation-oriented culture showed the strongest correlation with job satisfaction (ESr=.50), followed by relation-oriented culture (ESr=.49), and task-oriented culture (ESr=.30). CONCLUSION: Results indicate that nursing organization culture plays a significant role in Korean nurses' job satisfaction. The implication of the study is that creating an innovation-oriented and relation-oriented culture in hospitals may effectively promote nurses' job satisfaction more than hierarchy-oriented culture.
Job Satisfaction ; Korea ; Nursing ; Organizational Culture ; Publications ; Statistics as Topic ; Tertiary Care Centers

PURPOSE: The aim of this study was to investigate the influence of nurses' awareness of healthcare accreditation on their job stress and turnover intention. METHODS: Across-sectional correlation study design was used. Participants consisted of 143 nurses from two tertiary hospitals in Seoul and Gyunggido, South Korea. Data were collected in October 2016 using self-report questionnaires and analyzed using descriptive statistics, t-test, an ANOVA, Pearson's correlation coefficient, and multiple regression in SPSS/WIN 21.0. RESULTS: Awareness of health care accreditation correlated negatively with job stress (r=−63, p < .001) and turn over intention (r=−.50, p < .001). Awareness of health care accreditation was the factor that most influenced job stress, explaining 38% of the variance (F=23.10, p < .001). Awareness of health care accreditation and duty pattern were the factors that most influenced intention to leave, explaining 32% of the variance (F=10.35, p < .001). CONCLUSION: These findings suggest raising nurses' awareness of certification systems to reduce their job stress and turnover intentions. It will be necessary to provide support for the aggressive work nurses do and improve their work structure, highlighting the need for both manpower and institutional support. Accordingly, providing regular education programs and appropriate compensation schemes, by raising nurses' awareness of medical institutions' certification systems, is necessary.
Accreditation ; Certification ; Compensation and Redress ; Delivery of Health Care ; Education ; Intention ; Korea ; Personnel Turnover ; Seoul ; Statistics as Topic ; Tertiary Care Centers

PURPOSE: This study examined self-efficacy, emotional labor, and health promoting behaviors. It also investigated factors affecting health promoting behaviors of nurses working for tertiary and general hospital. METHODS: Between June and July 2013, a convenience sample of 233 subjects was collected from 2 tertiary hospitals and 4 general hospitals. The data analysis was done with ANOVA, t-test and stepwise multiple regression. RESULTS: Emotional labor of the subjects was slightly lower than that of other nurses and the average level of health promoting behaviors was lower than the median. Health promoting behaviors were differentiated by education, hospital type, and monthly income. Self-efficacy showed positive correlation with HPLP-II, but emotional labor showed negative correlation with self-efficacy and HPLP-II. The most significant factor affecting health promoting behaviors was self regulation(16.3%). The combination of self regulation, attentiveness to required display rules, BSN, preference to task difficulty, and monthly income(> or =300) accounted for 25.4% of health promoting behavior. Attentiveness to required display rules was a negative factor of HPLP-II. CONCLUSION: When developing health promotion programs for nurses, self-efficacy should be considered and further research is needed to identify mediating variables between emotional labor and health promoting behaviors.
Education ; Health Promotion ; Health Status ; Hospitals, General ; Negotiating ; Self Efficacy ; Self-Control ; Statistics as Topic ; Tertiary Care Centers

BACKGROUND: Although transfusion is a paramount life-saving therapy, there are multiple potential significant risks. Therefore, all adverse transfusion reaction (ATR) episodes require close monitoring. Using the computerized reporting system, we assessed the frequency and pattern of non-infectious ATRs. METHODS: We analyzed two-year transfusion data from electronic medical records retrospectively. From March 2013 to February 2015, 364,569 units of blood were transfused. Of them, 334,582 (91.8%) records were identified from electronic nursing records. For the confirmation of ATRs by blood bank physicians, patients' electronic medical records were further evaluated. RESULTS: According to the nursing records, the frequency of all possible transfusion-related events was 3.1%. After the blood bank physicians' review, the frequency was found to be 1.2%. The overall frequency of febrile non-hemolytic transfusion reactions (FNHTRs) to red blood cells (RBCs), platelet (PLT) components, and fresh frozen plasmas (FFPs) were 0.9%, 0.3%, and 0.2%, respectively, and allergic reactions represented 0.3% (RBCs), 0.9% (PLTs), and 0.9% (FFPs), respectively. The pre-storage leukocyte reduction significantly decreased the frequency of FNHTRs during the transfusion of RBCs (P<0.01) or PLTs (Pfalling dots0.01). CONCLUSIONS: The frequency of FNHTRs, allergic reactions, and "no reactions" were 22.0%, 17.0%, and 60.7%, respectively. Leukocyte-reduction was associated with a lower rate of FNHTRs, but not with that of allergic reactions. The development of an effective electronic reporting system of ATRs is important in quantifying transfusion-related adverse events. This type of reporting system can also accurately identify the underlying problems and risk factors to further the quality of transfusion care for patients.
Blood Transfusion/*adverse effects/statistics & numerical data ; Humans ; Republic of Korea/epidemiology ; Retrospective Studies ; Tertiary Care Centers ; Transfusion Reaction/*epidemiology/etiology

BACKGROUNDThere is no large population-based study of the distribution and changing trend of strabismus surgeries in China. This study aimed to investigate the distribution and the changing trend of strabismus surgery in a tertiary hospital of China.

METHODSA retrospective study of all the strabismus surgeries performed in Beijing Tongren Eye Center from 2003 to 2012 was carried out. Characteristics analyzed included the type of strabismus, age, and gender.

RESULTSTotally 26 524 strabismus surgeries were performed in Tongren Eye Center during the 10-year period. The number of surgeries increased steadily from 1 507 in 2003 to 3 482 in 2008 and slightly decreased to 3 124 in 2009, but there was a sharp drop to 2 569 in 2010 and then kept relatively steady at 2 760 in 2011 and 2 463 in 2012. Intermittent exotropia (30.3%) was the most common among all kinds of strabismus. The number of strabismus surgeries performed on children under 12 years of age (43.60%) was significantly higher than those of the other age groups (P < 0.05). Unilateral superior oblique paralysis was the most common subtype of paralytic strabismus (8.64%).

CONCLUSIONSThe type distribution of strabismus surgery has changed during the recent decade. The age and type distribution of different strabismus remained basically constant, among which intermittent exotropia was the most common.

Child ; Child, Preschool ; China ; Female ; Humans ; Infant ; Male ; Oculomotor Muscles ; Retrospective Studies ; Strabismus ; surgery ; Tertiary Care Centers ; statistics & numerical data