1.The Influence of Clinical Decision-Making Ability and Role Conflict on Nursing Work Performance Ability in Emergency Room Nurses
Su Min SO ; Jeong Hyun CHO ; Seung Gyeong JANG
Journal of Korean Clinical Nursing Research 2025;31(1):59-68
Purpose:
This study aimed to examine the levels of clinical decision-making ability, role conflict, and nursing work performance ability and to identify factors influencing nursing work performance ability among emergency room nurses.
Methods:
This study emploved a descriptive correlational research design. A total of 137 emergency room nurses, were participated. Data were collected at three tertiary hospitals located in city B, from June 1 to August 25, 2024. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation, and multiple regression analysis using IBM SPSS 29.0 program.
Results:
The average score of clinical decision-making ability was 3.31, while role conflict and nursing work performance ability both had an average score of 3.77. Factors influencing nursing work performance ability included clinical decision-making ability, role conflict, and annual salary, which explained 20.0% of the variance in nursing work performance ability.
Conclusion
Clinical decision-making ability and role conflict significantly impact nursing work performance among emergency room nurses. Strategies to enhance clinical decision-making skills and mitigate role conflict should be developed at the organizational level. Additionally, further research is needed to on appropriate compensation systems and institutional measures to enhance nursing work performance.
2.The Influence of Clinical Decision-Making Ability and Role Conflict on Nursing Work Performance Ability in Emergency Room Nurses
Su Min SO ; Jeong Hyun CHO ; Seung Gyeong JANG
Journal of Korean Clinical Nursing Research 2025;31(1):59-68
Purpose:
This study aimed to examine the levels of clinical decision-making ability, role conflict, and nursing work performance ability and to identify factors influencing nursing work performance ability among emergency room nurses.
Methods:
This study emploved a descriptive correlational research design. A total of 137 emergency room nurses, were participated. Data were collected at three tertiary hospitals located in city B, from June 1 to August 25, 2024. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation, and multiple regression analysis using IBM SPSS 29.0 program.
Results:
The average score of clinical decision-making ability was 3.31, while role conflict and nursing work performance ability both had an average score of 3.77. Factors influencing nursing work performance ability included clinical decision-making ability, role conflict, and annual salary, which explained 20.0% of the variance in nursing work performance ability.
Conclusion
Clinical decision-making ability and role conflict significantly impact nursing work performance among emergency room nurses. Strategies to enhance clinical decision-making skills and mitigate role conflict should be developed at the organizational level. Additionally, further research is needed to on appropriate compensation systems and institutional measures to enhance nursing work performance.
3.Influence of Perception of Patient Safety Culture, Job Stress, and Nursing Work Environment on Patient Safety Nursing Activities by Emergency Room Nurses
Eon Mi LEE ; Jeong Hyun CHO ; Seung Gyeong JANG
Journal of Korean Academy of Fundamental Nursing 2025;32(2):264-274
Purpose:
This study aimed to investigate the influence of perceptions of patient safety culture, job stress, and nursing work environment on patient safety nursing activities among emergency room nurses.
Methods:
This correlational study was conducted from June 5 to July 31, 2024, and targeted 114 emergency room nurses in Busan. A structured self-report questionnaire was used to collect data. Descriptive statistics, independent sample t-tests, one-way ANOVA, Pearson's correlation coefficients, and multiple regression analyses were employed for data analysis.
Results:
Patient safety nursing activities significantly differed by age (F=6.17, p=.001) and total clinical experience (F=8.89, p<.001) among the participants' general characteristics. Positive correlations were identified with perceptions of patient safety culture (r=.70, p<.001) and nursing work environment (r=.27, p=.003). Multiple regression analysis indicated that perception of patient safety culture (β=.72, p<.001) and total clinical experience (β=-.32, p=.011) were significant predictors, accounting for 50.5% (F=20.24, p<.001) of the variance.
Conclusion
The findings indicated that perceptions of patient safety culture and total clinical experience are critical factors to be considered when designing interventions to enhance patient safety nursing activities among emergency room nurses.
4.The combination of CDX2 expression status and tumor-infiltrating lymphocyte density as a prognostic factor in adjuvant FOLFOX-treated patients with stage III colorectal cancers
Ji-Ae LEE ; Hye Eun PARK ; Hye-Yeong JIN ; Lingyan JIN ; Seung Yeon YOO ; Nam-Yun CHO ; Jeong Mo BAE ; Jung Ho KIM ; Gyeong Hoon KANG
Journal of Pathology and Translational Medicine 2025;59(1):50-59
Background:
Colorectal carcinomas (CRCs) with caudal-type homeobox 2 (CDX2) loss are recognized to pursue an aggressive behavior but tend to be accompanied by a high density of tumor-infiltrating lymphocytes (TILs). However, little is known about whether there is an interplay between CDX2 loss and TIL density in the survival of patients with CRC.
Methods:
Stage III CRC tissues were assessed for CDX2 loss using immunohistochemistry and analyzed for their densities of CD8 TILs in both intraepithelial (iTILs) and stromal areas using a machine learning-based analytic method.
Results:
CDX2 loss was significantly associated with a higher density of CD8 TILs in both intraepithelial and stromal areas. Both CDX2 loss and a high CD8 iTIL density were found to be prognostic parameters and showed hazard ratios of 2.314 (1.050–5.100) and 0.378 (0.175–0.817), respectively, for cancer-specific survival. A subset of CRCs with retained CDX2 expression and a high density of CD8 iTILs showed the best clinical outcome (hazard ratio of 0.138 [0.023–0.826]), whereas a subset with CDX2 loss and a high density of CD8 iTILs exhibited the worst clinical outcome (15.781 [3.939–63.230]).
Conclusions
Altogether, a high density of CD8 iTILs did not make a difference in the survival of patients with CRC with CDX2 loss. The combination of CDX2 expression and intraepithelial CD8 TIL density was an independent prognostic marker in adjuvant chemotherapy-treated patients with stage III CRC.
5.Prospective external validation of a deep-learning-based early-warning system for major adverse events in general wards in South Korea
Taeyong SIM ; Eun Young CHO ; Ji-hyun KIM ; Kyung Hyun LEE ; Kwang Joon KIM ; Sangchul HAHN ; Eun Yeong HA ; Eunkyeong YUN ; In-Cheol KIM ; Sun Hyo PARK ; Chi-Heum CHO ; Gyeong Im YU ; Byung Eun AHN ; Yeeun JEONG ; Joo-Yun WON ; Hochan CHO ; Ki-Byung LEE
Acute and Critical Care 2025;40(2):197-208
Background:
Acute deterioration of patients in general wards often leads to major adverse events (MAEs), including unplanned intensive care unit transfers, cardiac arrest, or death. Traditional early warning scores (EWSs) have shown limited predictive accuracy, with frequent false positives. We conducted a prospective observational external validation study of an artificial intelligence (AI)-based EWS, the VitalCare - Major Adverse Event Score (VC-MAES), at a tertiary medical center in the Republic of Korea.
Methods:
Adult patients from general wards, including internal medicine (IM) and obstetrics and gynecology (OBGYN)—the latter were rarely investigated in prior AI-based EWS studies—were included. The VC-MAES predictions were compared with National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) predictions using the area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC), and logistic regression for baseline EWS values. False-positives per true positive (FPpTP) were assessed based on the power threshold.
Results:
Of 6,039 encounters, 217 (3.6%) had MAEs (IM: 9.5%, OBGYN: 0.26%). Six hours prior to MAEs, the VC-MAES achieved an AUROC of 0.918 and an AUPRC of 0.352, including the OBGYN subgroup (AUROC, 0.964; AUPRC, 0.388), outperforming the NEWS (0.797 and 0.124) and MEWS (0.722 and 0.079). The FPpTP was reduced by up to 71%. Baseline VC-MAES was strongly associated with MAEs (P<0.001).
Conclusions
The VC-MAES significantly outperformed traditional EWSs in predicting adverse events in general ward patients. The robust performance and lower FPpTP suggest that broader adoption of the VC-MAES may improve clinical efficiency and resource allocation in general wards.
6.Influence of Perception of Patient Safety Culture, Job Stress, and Nursing Work Environment on Patient Safety Nursing Activities by Emergency Room Nurses
Eon Mi LEE ; Jeong Hyun CHO ; Seung Gyeong JANG
Journal of Korean Academy of Fundamental Nursing 2025;32(2):264-274
Purpose:
This study aimed to investigate the influence of perceptions of patient safety culture, job stress, and nursing work environment on patient safety nursing activities among emergency room nurses.
Methods:
This correlational study was conducted from June 5 to July 31, 2024, and targeted 114 emergency room nurses in Busan. A structured self-report questionnaire was used to collect data. Descriptive statistics, independent sample t-tests, one-way ANOVA, Pearson's correlation coefficients, and multiple regression analyses were employed for data analysis.
Results:
Patient safety nursing activities significantly differed by age (F=6.17, p=.001) and total clinical experience (F=8.89, p<.001) among the participants' general characteristics. Positive correlations were identified with perceptions of patient safety culture (r=.70, p<.001) and nursing work environment (r=.27, p=.003). Multiple regression analysis indicated that perception of patient safety culture (β=.72, p<.001) and total clinical experience (β=-.32, p=.011) were significant predictors, accounting for 50.5% (F=20.24, p<.001) of the variance.
Conclusion
The findings indicated that perceptions of patient safety culture and total clinical experience are critical factors to be considered when designing interventions to enhance patient safety nursing activities among emergency room nurses.
7.The Influence of Clinical Decision-Making Ability and Role Conflict on Nursing Work Performance Ability in Emergency Room Nurses
Su Min SO ; Jeong Hyun CHO ; Seung Gyeong JANG
Journal of Korean Clinical Nursing Research 2025;31(1):59-68
Purpose:
This study aimed to examine the levels of clinical decision-making ability, role conflict, and nursing work performance ability and to identify factors influencing nursing work performance ability among emergency room nurses.
Methods:
This study emploved a descriptive correlational research design. A total of 137 emergency room nurses, were participated. Data were collected at three tertiary hospitals located in city B, from June 1 to August 25, 2024. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation, and multiple regression analysis using IBM SPSS 29.0 program.
Results:
The average score of clinical decision-making ability was 3.31, while role conflict and nursing work performance ability both had an average score of 3.77. Factors influencing nursing work performance ability included clinical decision-making ability, role conflict, and annual salary, which explained 20.0% of the variance in nursing work performance ability.
Conclusion
Clinical decision-making ability and role conflict significantly impact nursing work performance among emergency room nurses. Strategies to enhance clinical decision-making skills and mitigate role conflict should be developed at the organizational level. Additionally, further research is needed to on appropriate compensation systems and institutional measures to enhance nursing work performance.
8.The combination of CDX2 expression status and tumor-infiltrating lymphocyte density as a prognostic factor in adjuvant FOLFOX-treated patients with stage III colorectal cancers
Ji-Ae LEE ; Hye Eun PARK ; Hye-Yeong JIN ; Lingyan JIN ; Seung Yeon YOO ; Nam-Yun CHO ; Jeong Mo BAE ; Jung Ho KIM ; Gyeong Hoon KANG
Journal of Pathology and Translational Medicine 2025;59(1):50-59
Background:
Colorectal carcinomas (CRCs) with caudal-type homeobox 2 (CDX2) loss are recognized to pursue an aggressive behavior but tend to be accompanied by a high density of tumor-infiltrating lymphocytes (TILs). However, little is known about whether there is an interplay between CDX2 loss and TIL density in the survival of patients with CRC.
Methods:
Stage III CRC tissues were assessed for CDX2 loss using immunohistochemistry and analyzed for their densities of CD8 TILs in both intraepithelial (iTILs) and stromal areas using a machine learning-based analytic method.
Results:
CDX2 loss was significantly associated with a higher density of CD8 TILs in both intraepithelial and stromal areas. Both CDX2 loss and a high CD8 iTIL density were found to be prognostic parameters and showed hazard ratios of 2.314 (1.050–5.100) and 0.378 (0.175–0.817), respectively, for cancer-specific survival. A subset of CRCs with retained CDX2 expression and a high density of CD8 iTILs showed the best clinical outcome (hazard ratio of 0.138 [0.023–0.826]), whereas a subset with CDX2 loss and a high density of CD8 iTILs exhibited the worst clinical outcome (15.781 [3.939–63.230]).
Conclusions
Altogether, a high density of CD8 iTILs did not make a difference in the survival of patients with CRC with CDX2 loss. The combination of CDX2 expression and intraepithelial CD8 TIL density was an independent prognostic marker in adjuvant chemotherapy-treated patients with stage III CRC.
9.Influence of Perception of Patient Safety Culture, Job Stress, and Nursing Work Environment on Patient Safety Nursing Activities by Emergency Room Nurses
Eon Mi LEE ; Jeong Hyun CHO ; Seung Gyeong JANG
Journal of Korean Academy of Fundamental Nursing 2025;32(2):264-274
Purpose:
This study aimed to investigate the influence of perceptions of patient safety culture, job stress, and nursing work environment on patient safety nursing activities among emergency room nurses.
Methods:
This correlational study was conducted from June 5 to July 31, 2024, and targeted 114 emergency room nurses in Busan. A structured self-report questionnaire was used to collect data. Descriptive statistics, independent sample t-tests, one-way ANOVA, Pearson's correlation coefficients, and multiple regression analyses were employed for data analysis.
Results:
Patient safety nursing activities significantly differed by age (F=6.17, p=.001) and total clinical experience (F=8.89, p<.001) among the participants' general characteristics. Positive correlations were identified with perceptions of patient safety culture (r=.70, p<.001) and nursing work environment (r=.27, p=.003). Multiple regression analysis indicated that perception of patient safety culture (β=.72, p<.001) and total clinical experience (β=-.32, p=.011) were significant predictors, accounting for 50.5% (F=20.24, p<.001) of the variance.
Conclusion
The findings indicated that perceptions of patient safety culture and total clinical experience are critical factors to be considered when designing interventions to enhance patient safety nursing activities among emergency room nurses.
10.The Influence of Clinical Decision-Making Ability and Role Conflict on Nursing Work Performance Ability in Emergency Room Nurses
Su Min SO ; Jeong Hyun CHO ; Seung Gyeong JANG
Journal of Korean Clinical Nursing Research 2025;31(1):59-68
Purpose:
This study aimed to examine the levels of clinical decision-making ability, role conflict, and nursing work performance ability and to identify factors influencing nursing work performance ability among emergency room nurses.
Methods:
This study emploved a descriptive correlational research design. A total of 137 emergency room nurses, were participated. Data were collected at three tertiary hospitals located in city B, from June 1 to August 25, 2024. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation, and multiple regression analysis using IBM SPSS 29.0 program.
Results:
The average score of clinical decision-making ability was 3.31, while role conflict and nursing work performance ability both had an average score of 3.77. Factors influencing nursing work performance ability included clinical decision-making ability, role conflict, and annual salary, which explained 20.0% of the variance in nursing work performance ability.
Conclusion
Clinical decision-making ability and role conflict significantly impact nursing work performance among emergency room nurses. Strategies to enhance clinical decision-making skills and mitigate role conflict should be developed at the organizational level. Additionally, further research is needed to on appropriate compensation systems and institutional measures to enhance nursing work performance.

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