1.Formative versus reflective measurement models in nursing research: a secondary data analysis of a cross-sectional study in Korea
Eun Seo PARK ; Young Il CHO ; Hyo Jin KIM ; YeoJin IM ; Dong Hee KIM
Journal of Korean Academy of Nursing 2025;55(1):107-118
Purpose:
This study aimed to empirically verify the impact of measurement model selection on research outcomes and their interpretation through an analysis of children’s emotional and social problems measured by the Pediatric Symptom Checklist (PSC) using both reflective and formative measurement models. These models were represented by covariance-based structural equation modeling (CB-SEM) and partial least squares SEM (PLS-SEM), respectively.
Methods:
This secondary data analysis evaluated children’s emotional and social problems as both reflective and formative constructs. Reflective models were analyzed using CB-SEM, while formative models were assessed using PLS-SEM. Comparisons between these two approaches were based on model fit and parameter estimates.
Results:
In the CB-SEM analysis, which assumed a reflective measurement model, a model was not identified due to inadequate fit indices and a Heywood case, indicating improper model specification. In contrast, the PLS-SEM analysis, assuming a formative measurement model, demonstrated adequate reliability and validity with significant path coefficients, supporting the appropriateness of the formative model for the PSC.
Conclusion
The findings indicate that the PSC is more appropriately analyzed as a formative measurement model using PLS-SEM, rather than as a reflective model using CB-SEM. This study highlights the necessity of selecting an appropriate measurement model based on the theoretical and empirical characteristics of constructs in nursing research. Future research should ensure that the nature of measurement variables is accurately reflected in the choice of statistical models to improve the validity of research outcomes.
2.Formative versus reflective measurement models in nursing research: a secondary data analysis of a cross-sectional study in Korea
Eun Seo PARK ; Young Il CHO ; Hyo Jin KIM ; YeoJin IM ; Dong Hee KIM
Journal of Korean Academy of Nursing 2025;55(1):107-118
Purpose:
This study aimed to empirically verify the impact of measurement model selection on research outcomes and their interpretation through an analysis of children’s emotional and social problems measured by the Pediatric Symptom Checklist (PSC) using both reflective and formative measurement models. These models were represented by covariance-based structural equation modeling (CB-SEM) and partial least squares SEM (PLS-SEM), respectively.
Methods:
This secondary data analysis evaluated children’s emotional and social problems as both reflective and formative constructs. Reflective models were analyzed using CB-SEM, while formative models were assessed using PLS-SEM. Comparisons between these two approaches were based on model fit and parameter estimates.
Results:
In the CB-SEM analysis, which assumed a reflective measurement model, a model was not identified due to inadequate fit indices and a Heywood case, indicating improper model specification. In contrast, the PLS-SEM analysis, assuming a formative measurement model, demonstrated adequate reliability and validity with significant path coefficients, supporting the appropriateness of the formative model for the PSC.
Conclusion
The findings indicate that the PSC is more appropriately analyzed as a formative measurement model using PLS-SEM, rather than as a reflective model using CB-SEM. This study highlights the necessity of selecting an appropriate measurement model based on the theoretical and empirical characteristics of constructs in nursing research. Future research should ensure that the nature of measurement variables is accurately reflected in the choice of statistical models to improve the validity of research outcomes.
3.Formative versus reflective measurement models in nursing research: a secondary data analysis of a cross-sectional study in Korea
Eun Seo PARK ; Young Il CHO ; Hyo Jin KIM ; YeoJin IM ; Dong Hee KIM
Journal of Korean Academy of Nursing 2025;55(1):107-118
Purpose:
This study aimed to empirically verify the impact of measurement model selection on research outcomes and their interpretation through an analysis of children’s emotional and social problems measured by the Pediatric Symptom Checklist (PSC) using both reflective and formative measurement models. These models were represented by covariance-based structural equation modeling (CB-SEM) and partial least squares SEM (PLS-SEM), respectively.
Methods:
This secondary data analysis evaluated children’s emotional and social problems as both reflective and formative constructs. Reflective models were analyzed using CB-SEM, while formative models were assessed using PLS-SEM. Comparisons between these two approaches were based on model fit and parameter estimates.
Results:
In the CB-SEM analysis, which assumed a reflective measurement model, a model was not identified due to inadequate fit indices and a Heywood case, indicating improper model specification. In contrast, the PLS-SEM analysis, assuming a formative measurement model, demonstrated adequate reliability and validity with significant path coefficients, supporting the appropriateness of the formative model for the PSC.
Conclusion
The findings indicate that the PSC is more appropriately analyzed as a formative measurement model using PLS-SEM, rather than as a reflective model using CB-SEM. This study highlights the necessity of selecting an appropriate measurement model based on the theoretical and empirical characteristics of constructs in nursing research. Future research should ensure that the nature of measurement variables is accurately reflected in the choice of statistical models to improve the validity of research outcomes.
4.Formative versus reflective measurement models in nursing research: a secondary data analysis of a cross-sectional study in Korea
Eun Seo PARK ; Young Il CHO ; Hyo Jin KIM ; YeoJin IM ; Dong Hee KIM
Journal of Korean Academy of Nursing 2025;55(1):107-118
Purpose:
This study aimed to empirically verify the impact of measurement model selection on research outcomes and their interpretation through an analysis of children’s emotional and social problems measured by the Pediatric Symptom Checklist (PSC) using both reflective and formative measurement models. These models were represented by covariance-based structural equation modeling (CB-SEM) and partial least squares SEM (PLS-SEM), respectively.
Methods:
This secondary data analysis evaluated children’s emotional and social problems as both reflective and formative constructs. Reflective models were analyzed using CB-SEM, while formative models were assessed using PLS-SEM. Comparisons between these two approaches were based on model fit and parameter estimates.
Results:
In the CB-SEM analysis, which assumed a reflective measurement model, a model was not identified due to inadequate fit indices and a Heywood case, indicating improper model specification. In contrast, the PLS-SEM analysis, assuming a formative measurement model, demonstrated adequate reliability and validity with significant path coefficients, supporting the appropriateness of the formative model for the PSC.
Conclusion
The findings indicate that the PSC is more appropriately analyzed as a formative measurement model using PLS-SEM, rather than as a reflective model using CB-SEM. This study highlights the necessity of selecting an appropriate measurement model based on the theoretical and empirical characteristics of constructs in nursing research. Future research should ensure that the nature of measurement variables is accurately reflected in the choice of statistical models to improve the validity of research outcomes.
5.General Nurses’ Nursing Leadership Experience in Patient Care:Applying Focus Group Interviews
Ji-Mee KIM ; Haena LIM ; Yeojin YI ; Jung-Hee SONG
Journal of Korean Academy of Nursing Administration 2024;30(1):19-30
Purpose:
This study aimed to examine general nurses' nursing leadership in patient care using focus group interviews.
Methods:
This study was conducted after obtaining approval from the ethics committee of a university.After completing a focus group interview with 13 general nurses working at a general hospital, we performed qualitative content analysis according to Kreuger's guidelines.
Results:
A total of 170 meaningful statement units of nursing leadership that appeared in the clinical experience of general nurses were extracted, and 10 final sub-themes and the three themes connecting them were derived. The themes derived were “leading patients into nursing,” “experiencing the power of growth,” and “facilitating situations that allow focus on patient care.”
Conclusion
This study helps in understanding the nursing leadership of general nurses in patient care. To encourage general nurses to exert their nursing leadership and grow as autonomous nurses, nursing educators must appropriately present the learning outcomes and content of nursing leadership. Additionally, in the clinical setting, organizational support is necessary to foster understanding and the demonstration of general nurses' nursing leadership.
6.Development of Guidelines for the Delegation of Nursing Tasks in Integrated Nursing Care Service
Yeojin YI ; Haena LIM ; Ji-Mee KIM ; Jung-Hee SONG
Journal of Korean Academy of Nursing Administration 2024;30(2):114-129
Purpose:
The aim was to develop guidelines for delegating nursing tasks among nurses in integrated nursing care wards.
Methods:
This was a methodological approach. Literature reviews were conducted on delegation policies and practices for nurses in Korea and other countries to explore the area of nursing delegation. Focus group interviews were performed with nurses to identify the strength and weakness of the delegation of nursing tasks in clinical practice, and qualitative content analysis was conducted based on the interview. Ten areas and 115 items were derived through these steps, and their validity was confirmed using the Delphi technique.
Results:
The delegation guidelines of nursing tasks consisted of nine domains, 21 sub-categories, and 101 items, including Nurses and nursing assistants' duties, the necessity of delegation, definition of terms, scope of delegation, considerations for delegation, procedure, characteristics, and principles of delegation, and educational content for delegation.
Conclusion
These guidelines can help nurses to make decisions about delegating nursing tasks according to the delegation procedure.Education on the delegation of nursing tasks is necessary for both nurses and nursing assistants. The guidelines developed in this study can serve as a standard for delegating nursing tasks to ensure patient safety.
7.General Nurses’ Nursing Leadership Experience in Patient Care:Applying Focus Group Interviews
Ji-Mee KIM ; Haena LIM ; Yeojin YI ; Jung-Hee SONG
Journal of Korean Academy of Nursing Administration 2024;30(1):19-30
Purpose:
This study aimed to examine general nurses' nursing leadership in patient care using focus group interviews.
Methods:
This study was conducted after obtaining approval from the ethics committee of a university.After completing a focus group interview with 13 general nurses working at a general hospital, we performed qualitative content analysis according to Kreuger's guidelines.
Results:
A total of 170 meaningful statement units of nursing leadership that appeared in the clinical experience of general nurses were extracted, and 10 final sub-themes and the three themes connecting them were derived. The themes derived were “leading patients into nursing,” “experiencing the power of growth,” and “facilitating situations that allow focus on patient care.”
Conclusion
This study helps in understanding the nursing leadership of general nurses in patient care. To encourage general nurses to exert their nursing leadership and grow as autonomous nurses, nursing educators must appropriately present the learning outcomes and content of nursing leadership. Additionally, in the clinical setting, organizational support is necessary to foster understanding and the demonstration of general nurses' nursing leadership.
8.Development of Guidelines for the Delegation of Nursing Tasks in Integrated Nursing Care Service
Yeojin YI ; Haena LIM ; Ji-Mee KIM ; Jung-Hee SONG
Journal of Korean Academy of Nursing Administration 2024;30(2):114-129
Purpose:
The aim was to develop guidelines for delegating nursing tasks among nurses in integrated nursing care wards.
Methods:
This was a methodological approach. Literature reviews were conducted on delegation policies and practices for nurses in Korea and other countries to explore the area of nursing delegation. Focus group interviews were performed with nurses to identify the strength and weakness of the delegation of nursing tasks in clinical practice, and qualitative content analysis was conducted based on the interview. Ten areas and 115 items were derived through these steps, and their validity was confirmed using the Delphi technique.
Results:
The delegation guidelines of nursing tasks consisted of nine domains, 21 sub-categories, and 101 items, including Nurses and nursing assistants' duties, the necessity of delegation, definition of terms, scope of delegation, considerations for delegation, procedure, characteristics, and principles of delegation, and educational content for delegation.
Conclusion
These guidelines can help nurses to make decisions about delegating nursing tasks according to the delegation procedure.Education on the delegation of nursing tasks is necessary for both nurses and nursing assistants. The guidelines developed in this study can serve as a standard for delegating nursing tasks to ensure patient safety.
9.Factors Related to Post-traumatic Stress Disorder Symptoms Among Intensive Care Unit Nurses
Asian Nursing Research 2024;18(2):159-166
Purpose:
The aim of this study was to identify the factors affecting the post-traumatic stress disorder (PTSD) symptoms of intensive care unit (ICU) nurses. The variables include event experiences, cognitive flexibility, and co-worker support.
Methods:
A survey was conducted among 153 ICU nurses working in a general hospital or an advanced general hospital. The questionnaire was completed between October and December 2018, and 153 copies were used for the final analysis. Data were analyzed using multiple linear regression to determine the factors associated with PTSD symptoms among ICU nurses.
Results:
The level of PTSD symptoms of ICU nurses was 1.20 ± 0.82 out of 4. Full PTSD, signified by a total score of 25 or more, was reported by 45.1% of the study's 153 participants. The significant influencing factors of PTSD symptoms among ICU nurses were the “experience of traumatic events,” “trusted alliance,” which is a subarea of “coworker support,” and both “control” and “alternative,” which are subareas of “cognitive flexibility.” The explanatory power (49.8%) was statistically significant.
Conclusions
These results suggest that a program to enhance the cognitive flexibility and coworker support of ICU nurses needs to be developed to reduce the PTSD symptoms of ICU nurses.
10.General Nurses’ Nursing Leadership Experience in Patient Care:Applying Focus Group Interviews
Ji-Mee KIM ; Haena LIM ; Yeojin YI ; Jung-Hee SONG
Journal of Korean Academy of Nursing Administration 2024;30(1):19-30
Purpose:
This study aimed to examine general nurses' nursing leadership in patient care using focus group interviews.
Methods:
This study was conducted after obtaining approval from the ethics committee of a university.After completing a focus group interview with 13 general nurses working at a general hospital, we performed qualitative content analysis according to Kreuger's guidelines.
Results:
A total of 170 meaningful statement units of nursing leadership that appeared in the clinical experience of general nurses were extracted, and 10 final sub-themes and the three themes connecting them were derived. The themes derived were “leading patients into nursing,” “experiencing the power of growth,” and “facilitating situations that allow focus on patient care.”
Conclusion
This study helps in understanding the nursing leadership of general nurses in patient care. To encourage general nurses to exert their nursing leadership and grow as autonomous nurses, nursing educators must appropriately present the learning outcomes and content of nursing leadership. Additionally, in the clinical setting, organizational support is necessary to foster understanding and the demonstration of general nurses' nursing leadership.

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