1.The Influences of New Graduate Nurses’ Fatigue, Critical Thinking, and Nursing Work Environment on Patient Safety Nursing Behaviors
Journal of Korean Academy of Nursing Administration 2026;32(1):49-57
This study aimed to identify the influences of fatigue, critical thinking, and nursing work environment on patient safety nursing behaviors among new graduate nurses. Methods: The participants were 180 new graduate nurses who had been working for less than 12 months in hospitals. Data were collected using a structured, self-administered survey from December 15 to 30, 2023. The SPSS version 29.0 program was used for data analysis, which included descriptive analysis, the t-test, one-way analysis of variance (ANOVA), Pearson correlation coefficients, and hierarchical regression analysis. Results: Hierarchical regression analysis showed that critical thinking (β=.32, p<.001) and department orientation (β=.31, p<.001) were significant factors influencing patient safety nursing behavior. Conclusion: These results suggest that providing sufficient departmental orientation for new graduate nurses is necessary to support accurate and safe patient safety nursing practices. In addition, it is important to foster critical thinking and to develop and implement educational programs that enhance patient safety nursing behaviors, and to establish comprehensive support systems.
2.Mediating Effect of Empowerment in the Relationship between Nursing Professionalism and Job Satisfaction among Insurance Review Nurses
Eun Jung PARK ; Young-Ran KWEON
Journal of Korean Academy of Nursing Administration 2026;32(1):28-38
This study examined the mediating effect of empowerment on the relationship between nursing professionalism and job satisfaction, with the goal of informing strategies to enhance job satisfaction among insurance review nurses. Methods: A total of 165 insurance review nurses with more than 1 year of work experience in 12 general hospitals (≥500 beds) participated in this study. Data were analyzed using descriptive statistics, t-tests, analysis of variance, Pearson correlation analysis, and multiple regression analysis. The mediating effect was tested using the PROCESS Macro (model 4) in SPSS version 26.0 with 10,000bootstrap samples. Results: The mean scores for nursing professionalism, empowerment, and job satisfaction were 100.37 (standard deviation [SD], 17.03), 86.24 (SD, 17.70), and 45.44 (SD, 9.17), respectively. Significant positive correlations were observed between nursing professionalism and job satisfaction (r=.64, p<.001), empowerment and job satisfaction (r=.77, p<.001), and nursing professionalism and empowerment. Empowerment was found to partially mediate the relationship between nursing professionalism and job satisfaction (95% CI, .20–.44). Conclusion: Enhancing empowerment and strengthening nursing professionalism are essential for improving job satisfaction among insurance review nurses. Institutional interventions that promote professional identity and provide structural empowerment may increase job satisfaction and support retention within this specialized nursing workforce.
3.Factors Associated with Nursing Intention among Korean Clinical Nurses for COVID-19 Patient Care: a Cross-Sectional Study
Ji Hyun KIM ; Sung Hee SHIN ; Soojung JO ; Vicki SIMPSON
Journal of Korean Academy of Nursing Administration 2026;32(1):39-48
The coronavirus disease 2019 (COVID-19) pandemic has substantially influenced nursing environments and has underscored the importance of active patient care. Nursing intention plays a critical role in the provision of care for patients with COVID-19; however, limited evidence exists regarding the factors that influence nurses’ intention to provide patient care specific to COVID-19. This study aimed to examine factors associated with nursing intention for COVID-19 patient care, guided by the Theory of Planned Behavior. Methods: This study employed a cross-sectional descriptive design. Data were collected from August 30 to October 1, 2020, using structured questionnaires completed by 169 clinical nurses working in hospitals with more than 600 beds in Seoul, Korea. The collected data were analyzed using multiple regression analysis. Results: Behavioral beliefs (β=.34, p<.001) and perceived behavioral control (β=.24, p<.001) were significantly associated with nursing intention for COVID-19 patient care. Conclusion: There is a need to develop specific strategies and educational programs to enhance nursing intention for COVID-19 patient care in the context of emerging infectious diseases by strengthening behavioral beliefs and perceived behavioral control. Providing up-to-date care protocols or simulation-based education may help increase nurses’ behavioral beliefs and perceived behavioral control.
4.The Mediating Effect of Compassionate Competence in the Relationship between Perceptions of a Good Death and Attitudes towards End-of-Life Care among Ward Nurses in Younger Generations
Journal of Korean Academy of Nursing Administration 2026;32(1):19-27
This study aimed to confirm the mediating effect of compassionate competence in the relationship between perceptions of a good death and end-of-life care attitudes among ward nurses in younger generations. Methods: A total of 175 nurses in their 20s and early 30s who were working in general wards of a public hospital in Seoul were recruited. Data were collected using a self-report questionnaire from February 20 to March 20, 2023, and were analyzed using the IBM 29.0 program. Results: Participants’ end-of-life care attitudes were positively correlated with perceptions of a good death (r=.22, p=.004) and compassionate competence (r=.32, p<.001), and compassionate competence was positively correlated with perceptions of a good death (r=.32, p<.001). Nurses’ compassionate competence was identified as a significant predictor of end-of-life care attitudes. As a result of the mediation analysis, a complete mediating effect of compassionate competence was confirmed in the relationship between perceptions of a good death and end-of-life care attitudes. Conclusion: To improve positive end-of-life care attitudes among young generation ward nurses, educational initiatives that emphasize compassionate competence, as well as understanding of a good death, are needed in both nursing education and clinical practice.
5.Influences of Clinical Nurses’ Second Victim Experience after Patient Safety Incidents, Individual and Organizational Support, and Job Satisfaction on Turnover Intention
Journal of Korean Academy of Nursing Administration 2026;32(1):58-69
This study aimed to identify the relationships among clinical nurses’ second victim experience following patient safety incidents, individual and organizational support, job satisfaction, and turnover intention, and to examine the factors influencing turnover intention. Methods: A cross-sectional survey was conducted using a convenience sample of 187 clinical nurses from a general hospital who had been employed for more than 6 months and had either directly or indirectly experienced patient safety incidents. Data were collected using a self-report questionnaire. The collected data were analyzed using descriptive statistics, independent t-tests, one-way analysis of variance, the Scheffé test, Pearson correlation coefficients, and multiple regression analysis. Results: The mean scores for second victim experience, individual support, organizational support, job satisfaction, and turnover intention were 3.12, 3.94, 2.79, 3.05, and 3.87, respectively. The factors influencing turnover intention were organizational support (β=-.21, p=.042), job satisfaction (β=-.20, p=.047), and second victim experience (β=.14, p=.049). Conclusion: To alleviate clinical nurses’ turnover intention, it is necessary to implement strategies that reduce second victim experience and enhance organizational support and job satisfaction. In particular, hospital managers should recognize nurses’ second victim experience and make efforts to strengthen emotional care and establish organizational support systems for nurses following patient safety incidents.
6.Effect of a Nursing Practice Environment, Nursing Performance on Retention Intention: Focused on the Mediating Effects of Nursing Professional Pride
Shin Hee KIM ; Mi Sook OH ; Yun Bok KWAK
Journal of Korean Academy of Nursing Administration 2025;31(1):64-74
Purpose:
The study aims to confirm the mediating effect of nursing professional pride in the relationship between nursing practice environment, nursing performance, and retention intention.
Methods:
A descriptive cross-sectional survey was conducted from December 13 to 31, 2021, involving 127 nurses. The following statistical analysis was conducted: t-test, ANOVA, Scheffé test, Pearson's correlation coefficient analysis, and Hayes Process Macro Model 4 (to test the mediating effect).
Results:
Nursing practice environment showed a significant positive correlation with nursing performance, retention intention, and nursing professional pride. Nursing practice performance showed a positive correlation with retention intention and nursing professional pride, and retention intention showed a significant positive correlation with nursing professional pride. The mediating effect of nursing professional pride was found in the effect of nurses' nursing practice environment on their retention intention. In addition, the mediating effect of nursing professional pride was found in the effect of nurses' nursing practice performance on their retention intention.
Conclusion
Through this study, it was confirmed that nursing professional pride is a major A factor affecting retention intention in the hospital. Therefore, in order to increase nurses' retention intention to remain in Hospital, the basis of basic data was presented for strategy development.
7.Structural Equation Model for Intent of Return to Nursing Practice among Inactive Korean Nurses
Journal of Korean Academy of Nursing Administration 2025;31(1):87-98
Purpose:
This study aimed to predict and test a hypothetical model for the Intent of Return to Nursing Practice(IRNP) among inactive Korean nurses and to identify the interrelationships and influences of factors affecting IRNP.
Methods:
The conceptual model was developed by integrating Ajzen’s Theory of Planned Behavior and Herzberg’s Two-Factor Theory. Data were collected from 224 Korean nurses who experienced a career disruption of more than one year through online or offline surveys. Data were analyzed using SPSS 20.0 and AMOS 22.0.
Results:
The average nursing care length was seven years. The primary reason for leaving practice was rotating shifts, while the main barrier to reemployment was exhaustion. Among the variables, Career Commitment (β=.59, p<.001), Nursing Work Environment (β=.37, p<.001), and Attitude (β=.32, p<.001) had significant total effects on IRNP. Career Nursing Commitment, Subjective Norm, and Attitude showed direct effects, while the Nursing Work Environment had the second-largest total effect on IRNP, acting indirect by mediating Career Commitment.
Conclusion
The findings highlight the need for collaborative efforts among nurses, family, colleagues, hospitals, professional associations, and nursing policymakers to prevent the permanent loss of skilled nursing professionals.
8.Effects of Clinical Nurses' Ethical Climate and Ethical Nursing Competence on Moral Distress
Journal of Korean Academy of Nursing Administration 2025;31(1):25-35
Purpose:
This study aimed to identify the effects of clinical nurses' ethical climate and ethical nursing competence on moral distress.
Methods:
The participants were clinical nurses who provided direct nursing care; nurses with more than one year of work experience in general hospitals were targeted. The data were collected between January 3 and 19, 2024, and analyzed using t-test, analysis of variance, Games-Howell test, Pearson correlation coefficient, and multiple regression.
Results:
Moral distress was significantly and negatively correlated with ethical climate and ethical nursing competence. Factors affecting the moral distress of clinical nurses included having a position of charge nurse or higher, total clinical experience of more than 20 years, turnover intention from current job due to ethical issues, hospital sub factors of the ethical climate, and ethical behavior sub factors of ethical nursing competence, showing 27.0% explanatory power.
Conclusion
Establishing a positive ethical climate and improving ethical nursing competence providing opportunities for nurses to raise and solve ethical issues will contribute to resolving nurses' ethical conflicts and reducing moral distress.
9.Influence of Nurses' Moral Distress and Ethical Nursing Competence on Retention Intention
Ji-Hyun CHOI ; Mi-Jin BYUN ; Thi Ninh DO
Journal of Korean Academy of Nursing Administration 2025;31(1):36-44
Purpose:
This study aimed to ascertain the influence of moral distress and ethical nursing competence on retention intention among nurses.
Methods:
Participants included 191 nurses working in general hospitals. Data were collected from July 11 to 18, 2023 and analyzed using SPSS/WIN 23.0.
Results:
Factors Influencing retention intention were clinical experience in the present department (β=.22, t=3.20, p=.002), moral distress (β=-.22, t=-3.15, p=.002) and ethical nursing competence (β=.26, t=3.82, p<.001). These variables accounted for 19.7% of nurses' retention intentions.
Conclusion
Based on our findings, it is necessary to identify interventions aimed at alleviating moral distress, and establish and implement systematic programs to improve ethical nursing competence in order to increase the retention intention of nurses.
10.Acuquisition of Professional Nursing Intuition:A Grounded Theory Approach
Journal of Korean Academy of Nursing Administration 2025;31(1):1-13
Purpose:
This study aimed to analyze how professional nursing intuition is acquired and develop a corresponding theory.
Methods:
This qualitative study used the grounded theory method proposed by Strauss and Corbin (1998).
Results:
Through axial coding, conflict was identified as the causal condition directly leading to the establishment of ‘me’ as a professional nurse, the central phenomenon. Personal competence, educational needs, and work environment were revealed as the contextual conditions. Social recognition, autonomy, and professionalism were the mediating conditions. The actions and interactions were divided into indifference-realistic and compromise-selfdirected. Dissatisfaction-mechanical, ambivalence -technical, and self-actualization-qualitative and independent nursing were derived. Through selective coding, the core category was derived as ‘becoming a nurse is desirable for myself and others.’
Conclusion
To meet the contemporary need for nurses with professional intuition. It was confirmed that nurses must demonstrate self-will and make continuous efforts to establish ‘me’ as professional nurses. To motivate nurses to acquire professional intuition, measures for social and institutional improvement should be developed to enhance the nursing education curriculum, work environment, autonomy, and professionalism.

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