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Influence of Infection Control Fatigue and Social Support on Nurses' Burnout During the Coronavirus Disease 2019 Pandemic

Hee Jeong KANG ; Mi Hyang LEE ; Hyo Nam LIM ; Kyung Hwa LEE

Journal of Korean Clinical Nursing Research.2022;28(3):299-307. doi:10.22650/JKCNR.2022.28.3.299

Purpose: The purpose of this study was to understand the effects of infection control fatigue and social support on burnout among nurses during the Coronavirus Disease 2019 (COVID-19) pandemic. Methods: This study is a descriptive survey study designed to confirm the effects of nurses' infection control fatigue and social support on burnout among nurses during the COVID-19 pandemic. The collected data were analyzed using frequency, percentage, mean, standard devia analyzed using frequency, percentage, mean, standard deviation, independent t-test, One-way ANOVA, Scheffé test, Pearson’s correlation coefficient, and stepwise multiple regression analysis using SPSS Statistics 26.0. Results: An analysis of the correlations between fatigue from infection control, social support, and burnout showed a positive correlation between burnout and fatigue from infection control (r=.39, p<.001), and a negative correlation between burnout and social support (r=-.29, p<.001). Conflict and lack of support due to uncertain circumstances (β=.51, p<.001), support from supervisor's (β=-.22, p<.001), and experience of infection management education during the previous 1year (β=-.15, p=.007) were identified as the factors that influenced burnout among nurses, and explained 39.0% of the variance in burnout. Conclusion The results of this study demonstrate that fatigue from infection control and social support influence burnout levels among nurses, which suggests the need to establish a new kind of work culture. Additionally, the findings call for the development and implementation of interventional programs that can reduce fatigue from infection control and increase social support for nurses.

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The Relationship of Role Perception of Life-Sustaining Treatment and Good Death Perception with Nursing Stress on Life-Sustaining Treatment in General Hospital Nurses

Su Hyun KIM ; Mi Sook JUNG ; Myoungock JANG

Journal of Korean Clinical Nursing Research.2022;28(3):289-298. doi:10.22650/JKCNR.2022.28.3.289

Purpose: Nursing stress on life-sustaining treatment of nurses is a significant contributing factor to nursing care performance and patient care outcomes. We need to investigate the factors associated with nursing stress on life-sustaining treatment in hospital settings. The purpose of this descriptive study was to examine the relationship of role perception of life-sustaining treatment and good death perception with nursing stress on life-sustaining treatment among nurses in hospital settings. Methods: Using a cross-sectional study design, we recruited nurses at a hospital located in a metropolitan city in Korea. The nurses completed structured questionnaire questions which were composed of well-validated questionnaires. Descriptive statistics and hierarchical multiple regression model were utilized for data analysis. Results: A total of 205 nurses participated in the study (female 93.2%; aged 20~29 years 63.0%; single status 78.5%). In the hierarchical multiple regression model, there was a significant positive relationship between role perception of life-sustaining treatment and nursing stress on life-sustaining treatment (β=.27, p<.001). Higher education level and working at a ward setting were also significantly related to nursing stress on life-sustaining treatment (β=.13, p<.046 for education level; β=.22, p=.001 for work setting). However, there was no relationship between good death perception and nursing stress on life-sustaining treatment. Conclusion Education programs to reduce nursing stress on life-sustaining treatment are needed to develop for nurses who have higher role perception of life-sustaining treatment with higher education level working at ward settings in hospitals.

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Effects of the Insulin Therapy Adherence Program for Patients with Type 2 Diabetes: A Randomized Controlled Trial

Kyung Min PARK ; Jung Tae SON

Journal of Korean Clinical Nursing Research.2022;28(3):277-288. doi:10.22650/JKCNR.2022.28.3.277

Purpose: This study was conducted to evaluate the effects of the insulin therapy adherence program (INSTA GRAM) for patients with type 2 diabetes mellitus. Methods: This study examined a total of 63 patients with type 2 diabetes for whom the initiation of insulin therapy is being considered or within 6 months of undergoing insulin therapy. INSTAGRAM is a stage-specific intervention consisting of strategies for motivating patients to initiate and maintain insulin therapy using the transtheoretical model on the stages of change, the process of change, and self-efficacy. The participants were randomly assigned to either the INSTAGRAM group (experimental group, n=32) or the standard diabetes education group (control group, n=31). The INSTAGRAM group received 6 sessions over 8 weeks(face-to-face education was conducted in the first and last sessions, and telephone coaching was conducted from the second to fifth sessions). The outcomes were measured by psychological insulin resistance, self-efficacy, and glycosylated hemoglobin (HbA1c). Results: Psychological insulin resistance (p<.001), self-efficacy (p<.001), and HbA1c (p=.024) of the participants in the INSTAGRAM group significantly improved compared to those in the control group. Conclusion INSTAGRAM is effective in overcoming psychological insulin resistance and improving self-efficacy and HbA1c. Therefore, the INSTAGRAM can be recommended as a nursing intervention for type 2 diabetic patients who delay the initiation of insulin therapy.

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Validation of the Edmonson Psychiatric Fall Risk Assessment Tool for Psychiatric Inpatients: A Retrospective Study

Kyung Young KIM ; Young Sun SON ; You Ji LEE ; Ji Eun KIM ; Mi Kyung KIM ; Young Hee YI

Journal of Korean Clinical Nursing Research.2022;28(3):270-276. doi:10.22650/JKCNR.2022.28.3.270

Purpose: The purpose of this study was to validate the Edmonson psychiatric fall risk assessment tool (EPFRAT) for psychiatric inpatients. Methods: Data from retrospective study were collected from 670 adult inpatients in two departments of mental health medicine of a tertiary general hospital by reviewing their electronic medical records. There were 41 patients who experienced falls and 629 patients who did not experience falls during the period from January to December 2019. Data were analyzed by sensitivity, specificity, positive predictive value, negative predictive value, and a receiver-operating characteristic curve (ROC) for validity assessment using the IBM SPSS/WIN 26.0 program. Results: Factors affecting falls were the participant’s age, guardian’s residence, high-risk determination at the time of admission, and comorbidity. At the 85 points where the point of sum of the sensitivity and specificity was largest, the sensitivity, specificity, positive predictive value, and negative predictive value of EPFRAT were 92.7%, 79.7%, 22.9%, and 99.4%, respectively. The area under the ROC to assess the overall validity of the tool was .92 (95% CI 0.89~0.94). Conclusion The EPFRAT was proved to be valid and reasonable for predicting falls in psychiatric inpatients. Based on the results of this study, it could be used for the assessment of high-risk patients for falls in psychiatric units.

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Influencing Factors of Clinical Nurses' Knowledge of Child Abuse Reporting, Perception of Child Abuse, and Moral Sensitivity on the Attitude toward Reporting Child Abuse

Eun Mi JEONG ; Yu Jeong KIM

Journal of Korean Clinical Nursing Research.2022;28(3):260-269. doi:10.22650/JKCNR.2022.28.3.260

Purpose: The purpose of this study was to identify the factors affecting clinical nurses’ attitude toward reporting child abuse. Methods: The participants in this study were 200 clinical nurses. Data were collected as structured self-report questionnaires through the online portal site for nurses from November 24 to December 7, 2021. The questionnaires included general characteristics, knowledge of child abuse reporting, perception of child abuse, moral sensitivity, and attitude toward reporting child abuse. The SPSS/WIN 25.0 program was used for data analysis which included descriptive analysis, t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple linear regression. Results: As knowledge of child abuse reporting, perception of child abuse and moral sensitivity were increased, the attitude toward reporting child abuse was significantly increased. Multiple regression analysis showed that knowledge of child abuse reporting (β=.32) and perception of child abuse (β=.21) were significant influencing factors of attitude toward reporting child abuse. Conclusion These findings implied that knowledge of child abuse reporting and perception of child abuse would be related to attitudes toward reporting child abuse among clinical nurses. Therefore, it is necessary to develop education programs and public policies to improve the knowledge and perception of child abuse reporting among clinical nurses so that attitudes toward reporting child abuse can be improved.

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The Effects of Emotional Labor and Grit on Job Satisfaction among Pediatric Nurses

Hyo Eun KIM ; Jin Hee PARK ; Eun Ji SEO ; Mi Ae YOU

Journal of Korean Clinical Nursing Research.2022;28(3):251-259. doi:10.22650/JKCNR.2022.28.3.251

Purpose: This study aimed to identify the relationships among emotional labor, grit, and job satisfaction of pediatric nurses and factors affecting job satisfaction. Methods: A cross-sectional study was conducted on 137 pediatric nurses working in a general hospital in Seoul. Data were collected from January 1, 2022 to January 31. The data were analyzed using SPSS/WIN version 28.0.1.1. Results: The mean score of job satisfaction was 3.63±0.43 (out of 5), emotional labor was 3.70±0.39 (out of 5), and grit was 2.90±0.30 (out of 4). Job satisfaction had positively correlated with emotional labor (r=.27, p=.002) and grit (r=.65, p<.001). The regression analyses showed subcategories of grit had a significant influence on job satisfaction. The factors significantly affecting job satisfaction were persistence to achieve long-term goals (β=.39, p<.001), patient-oriented intrinsic motivation (β=.30, p<.001), and passion to become a nursing professional (β=.21, p=.004). Conclusion These results suggested a need to increase grit for improving the job satisfaction. Furthermore, it would be necessary to develop a diverse program to increase job satisfaction for pediatric nurses by improving grit.

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Application and Evaluation of the Pilot Program for the Education Nurse System in a Medical Institution

Won Hee SIM ; Ji Sun PARK ; Hyo Min LIM ; Eun Hye KIM ; Jin Hyun KIM

Journal of Korean Clinical Nursing Research.2022;28(3):242-250. doi:10.22650/JKCNR.2022.28.3.242

Purpose: This study was conducted to evaluate the performance following the application of the pilot program for the education nurse system of the Ministry of Health and Welfare in a medical institution. Methods: This study was employed a non-homogeneous comparative group design by comparing new nurses who entered the medical institution after the pilot project from December 2019 to April 2020 with new nurses who entered before the pilot project during the same period. Satisfaction, academic achievement, job adaptation, personal turnover within one year, and patient safety incident rate were investigated as performance indicators. Results: After the pilot project, the overall satisfaction among new nurses, preceptors, and fellow nurses increased, but there were no significant changes in academic achievement and job adaptation in new nurses. The personal turnover rate decreased from 15.6% to 9.1%, and the patient safety incident rate also decreased from 26.3% to 15.7%. Also, the preceptor overtime also decreased from 3.67 to 0.66 hours. Conclusion The performance of the pilot project for the education nurse system was related to improvements in satisfaction, turnover rate of new nurses, patient safety incident rate, and preceptor overtime. Above all long-term monitoring of each performance indicator is necessary through the continuation of the education nurse system of the Ministry of Health and Welfare.

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Relationship between Nurses' Positive Psychological Capital and Adaptation of Job Rotation

Young Hee SEO ; Jeong Yun PARK

Journal of Korean Clinical Nursing Research.2022;28(3):233-241. doi:10.22650/JKCNR.2022.28.3.233

Purpose: This study was conducted to identify the nurses’ positive psychological capital and adaptation of job rotation and to examine their relationship. Methods: This cross-sectional study was conducted from March 23, 2021 to March 31, 2021, the study participants were 160 nurses who worked at a general hospital in Seoul.The collected data were analyzed using the IBM SPSS/WIN 24.0 program with descriptive statistics, t-test, ANOVA, and Pearson's correlation coefficient. Results: The positive psychological capital of nurses scored an average of 3.30±0.43 out of 5. Nurses’ adaptation of job rotation scored an average of 3.00±0.35 out of 5. Positive psychological capital and adaptation of job rotation showed a significant positive correlation (r=.70, p<.001). Conclusion This study shows that the greater level of positive psychological capital was associated with the increased adaptation of job rotation among nurses. It is necessary to develop an practical program to help nurses, who have recently experienced job rotation, adapt to the changed job by improving the positive psychological capital.

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The Effect of Patient-Engaged Bedside Handoffs Protocol in Comprehensive Care Units

Bo Young LEE ; Kyung Jin PARK ; Jae Hyun IM ; A Reum SONG ; Mi Hyang YEON ; Hyun Ju SONG ; Do Jin JEON ; Kyu Won BAEK ; Joo Young JANG ; Su Jung CHOI

Journal of Korean Clinical Nursing Research.2022;28(3):223-232. doi:10.22650/JKCNR.2022.28.3.223

Purpose: The purpose of this study was to apply patient-engaged bedside handoffs in comprehensive care units, and to evaluate the effects of bedsides to nurses and patients. Methods: This study employed a cluster randomized cross-over design.Electrical Medical Record (EMR)-based handoffs and patient-engaged bedside handoffs were alternatively applied to 104 patients, who were assigned to a total of 30 clusters (nursing handoff teams) in 4 comprehensive care units at the S medical center in Seoul, and the patients evaluated each type of handoffs. A total of 139 nurses were also participated in the same units and evaluated each type of handoffs. Data were analyzed using t-test, Wilcoxon rank sum test, ANOVA, and Kruskal-Walls test. Results: The patient's satisfaction of the patient-engaged bedside handoffs was higher than that of the EMR-based handoffs (Z=-5.16, p<.001). On the other hand, the nurse's satisfaction of the patient-engaged bedside handoffs was significantly lower than that of the EMR-based handoffs (t=13.21, p<.001). There were no differences in length of the reporting time between two types of handoffs (t=-0.48, p=.634). Conclusion Patient satisfaction with the patient-engaged bedside handoffs was higher than that of EMR-based handoffs, and nurses' satisfaction with the patient-engaged bedside handoffs was significantly lower than that of EMR-based handoffs. Future studies are needed regarding the impacts of patient-engaged bedside handoffs on the quality of healthcare by identifying the benefits of the handoffs.

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Effects of Preparedness towards Delegation, Critical Thinking Disposition, and Communicative Competence on Job Satisfaction: A Comparison of Comprehensive Nursing Care Service Ward Nurses and General Ward Nurses

Da Hye WI ; Younkyoung KIM

Journal of Korean Clinical Nursing Research.2022;28(3):211-222. doi:10.22650/JKCNR.2022.28.3.211

Purpose: This study aimed to identify the effects of preparedness towards delegation, critical thinking disposition, and communicative competence on job satisfaction among comprehensive nursing care service ward nurses and general ward nurses. Methods: The participants in this study were 218 nurses from two university hospitals. Data were collected using self-administered questionnaires and were analyzed using SPSS Statistics/WIN 21.0, including descriptive statistics, x 2 test, Fisher's exact test, t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and multiple linear regression analysis. Results: For comprehensive nursing care service ward nurses, the significant influencing factors on job satisfaction were age (β=-.37, p=.041), marital status (β=.35, p=.001), critical thinking disposition (β=.29, p=.003), and communicative competence (β=.28, p=.002) with the explanatory power was 39.0% (F=12.00, p<.001). On the other hand, for general ward nurses, the significant influencing factors on job satisfaction were advanced degree (β=.29, p=.047), critical thinking disposition (β=.23, p=.040), and communicative competence (β=.42, p<.001) with the explanatory power was 33.0% (F=11.78, p<.001). Conclusion The results of this study suggest the importance of developing and applying education programs to improve critical thinking disposition and communicative competence of nurses. This would enhance the comprehensive nursing service and increase overall nursing manpower resources. In addition, further studies are needed to improve nursing work environments and to develop strategies for enhancing preparedness towards delegation, which would increase the job satisfaction of nurses in the comprehensive nursing care service wards.

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