Purpose: The aim of this study was to identify the double mediating effect of effect of diversity sensitivity orientation and positive nursing organizational culture between diversity management and organizational commitment. Methods: Participants were 245 nurses working in six tertiary hospitals located in 3 different regions. Data collection was conducted from February 13, 2023 to March 6, 2023 through online self-reported questionnaire. The data were analyzed by IBM SPSS Statistics 27 and SPSS PROCESS Macro 4.2 program. Results: The direct effect of diversity management on organizational commitment was significant (β = .21, p < .001). The indirect effect of diversity management on organization commitment was .34 (95% confidence interval [CI] = .23~.47). The double mediating effect of diversity sensitivityorientation and positive nursing organizational culture in the relationship between diversity management and organizational commitment was .02 (95% CI = .00~.05). Conclusion Diversity sensitivity orientation and positive nursing organizational culture show double mediating effect on the relationship between diversity management and organizational commitment. Education program and human resource management strategy for enhancing diversity management, diversity sensitivity orientation and positive nursing organizational culture should be provided to improve organizational commitment, and which are needed active support of the association and nursing organization.

Purpose: This study aimed to identify the occupational performance and development needs, and specifically the priority needs, of general hospital nurses according to their career levels so as to help create an effective nursing management competency development program. Methods: This is a cross-sectional study conducted with 203 nurses working at three advanced general hospitals in G metropolitan city and C province. The participants completed a questionnaire about behavioral indicators which measured their nursing management performance and development needs. Their career levels were divided into four. Data were analyzed using t-test, ANOVA, Borich need, and the Locus for Focus model. Results: The mean levels of nursing management performance and competency development needs were 2.78±0.75 and 4.07±0.58, respectively. There was a significant difference in nursing management performance and development needs according to career level (F=6.18, p<.001, F=12.35, p<.001). Priority need analysis showed that level 1, level 2, level 3, level 4 nurses had higher demands for self-development and adaptation to new changes/organizationursing work performance and information management role/creativity development, respectively. Conclusion The findings provide a basis for training systems that differentiate between contents and degrees of nursing management competency based on career level to develop nursing human resources.

Purpose: This study aimed to identify the mediating effect of learning flow and the moderated mediation effect of digital literacy on the effect of the learning presence of non-face-to-face class experience in nursing students on academic achievement. Methods: Participants were 272 nursing students from six universities in two different cities. A self-report questionnaire was used to measure learning presence, learning flow, digital literacy, and academic achievement. Analysis was performed using SPSS 26.0 and SPSS PROCESS Macro (4.0). Results: The mediating effect of learning flow on the effect of learning presence on academic achievement was 0.42, and the moderated mediation index of digital literacy was 0.17. Learning flow showed a mediating effect on the relationship between learning presence and academic achievement. Digital literacy had a moderated mediation effect on the relationship between learning presence and academic achievement that was mediated by learning flow. Conclusion The intensity of the mediating effect of nursing students’ learning presence on academic achievement through learning flow increases as the level of digital literacy increases. These results suggest that educational programs considering the level of learning presence, learning flow, and digital literacy are required to promote the academic achievement of nursing college students.

Background/Aims: Chitosan, a natural polymer widely used in the biomaterials field, has been proposed as a potential submucosal injection solution. The purpose of this study was to compare the performance and efficacy of aqueous chitosan solution and commercialized submucosal injection fluids using a three-dimensional sensor and to evaluate the efficacy of the measured parameters. Methods: Normal saline (0.9% NaCl), as a control, Eleview ® (Poloxamer 188), Blue Eye TM (0.4% hyaluronic acid), and aqueous chitosan solution (2.0%) were injected into the submucosa of porcine stomachs ex vivo. The mucosal elevation height, elevated surface area, and angle of the tangent of the submucosal fluid cushion were measured using a three-dimensional sensor. The rates of change for each variable were calculated, and the correlation between parameters was analyzed. Tissue specimens were stained with hematoxylin and eosin. Results: All variables exhibited the highest values under chitosan injection. The mucosal elevation height rate of change differed significantly between normal saline and chitosan solution (p=0.024). The elevated surface area rates of change for normal saline and Eleview® were significantly different from those for TS-905 and chitosan solution (p=0.006 and p=0.009, respectively). Further, height, area, and angle showed a positive correlation (p<0.001). A histological examination revealed an even distribution of aqueous chitosan within the submucosa without tissue damage. Conclusions Aqueous chitosan was superior to normal saline and Eleview® and was noninferior to TS-905. A three-dimensional sensor and the measured parameters were effective and useful for evaluating the performance of submucosal fluids.

Background: The clinical features of pediatric rhabdomyolysis differ from those of the adults with rhabdomyolysis; however, multicenter studies are lacking. This study aimed to investigate the characteristics of pediatric rhabdomyolysis and reveal the risk factors for acute kidney injury (AKI) in such cases. Methods: This retrospective study analyzed the medical records of children and adolescents diagnosed with rhabdomyolysis at 23 hospitals in South Korea between January 2007 and December 2016. Results: Among 880 patients, those aged 3 to 5 years old composed the largest subgroup (19.4%), and all age subgroups were predominantly male. The incidence of AKI was 11.3%. Neurological disorders (53%) and infection (44%) were the most common underlying disorder and cause of rhabdomyolysis, respectively. The median age at diagnosis in the AKI subgroup was older than that in the non-AKI subgroup (12.2 years vs. 8.0 years). There were no significant differences in body mass index, myalgia, dark-colored urine, or the number of causal factors between the two AKI-status subgroups. The multivariate logistic regression model indicated that the following factors were independently associated with AKI: multiorgan failure, presence of an underlying disorder, strong positive urine occult blood, increased aspartate aminotransferase and uric acid levels, and reduced calcium levels. Conclusions Our study revealed characteristic clinical and laboratory features of rhabdomyolysis in a Korean pediatric population and highlighted the risk factors for AKI in these cases. Our findings will contribute to a greater understanding of pediatric rhabdomyolysis and may enable early intervention against rhabdomyolysis-induced AKI.

PURPOSE: A task force appointed by the Korean Society of Acute Care Surgery reviewed previously published guidelines on antibiotic use in patients with abdominal injuries and adapted guidelines for Korea. METHODS: Four guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Five topics were considered: indication for antibiotics, time until first antibiotic use, antibiotic therapy duration, appropriate antibiotics, and antibiotic use in abdominal trauma patients with hemorrhagic shock. RESULTS: Patients requiring surgery need preoperative prophylactic antibiotics. Patients who do not require surgery do not need antibiotics. Antibiotics should be administered as soon as possible after injury. In the absence of hollow viscus injury, no additional antibiotic doses are needed. If hollow viscus injury is repaired within 12 hours, antibiotics should be continued for ≤ 24 hours. If hollow viscus injury is repaired after 12 hours, antibiotics should be limited to 7 days. Antibiotics can be administered for ≥7 days if hollow viscus injury is incompletely repaired or clinical signs persist. Broad-spectrum aerobic and anaerobic coverage antibiotics are preferred as the initial antibiotics. Second-generation cephalosporins are the recommended initial antibiotics. Third-generation cephalosporins are alternative choices. For hemorrhagic shock, the antibiotic dose may be increased twofold or threefold and repeated after transfusion of every 10 units of blood until there is no further blood loss. CONCLUSION: Although this guideline was drafted through adaptation of other guidelines, it may be meaningful in that it provides a consensus on the use of antibiotics in abdominal trauma patients in Korea.
Abdominal Injuries* ; Advisory Committees ; Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Cephalosporins ; Consensus ; Humans ; Korea ; Shock, Hemorrhagic

PURPOSE: This study was conducted to investigate perception, satisfaction and needs for continuing education for nurses in Korea. METHODS: Participants were selected 1,106 using disproportional stratified sampling for the 110,601 members of the 10 affiliated organizations of the Korean Nurses Association and 873 nurses participated in the online survey. Data were collected from February 2 to 27, 2015, and analyzed using the SPSS/WIN 24.0 program. Descriptive statistics, independent t-test, One-way ANOVA, and Scheffé test were conducted. RESULTS: The perception of continuing education averaged 0.69 on a scale of 1, satisfaction with continuing education was 3.66 out of 5, and need for continuing education was 4.33 out of 6. Perception, satisfaction and needs for continuing education showed significant differences depending on age, marriage, education, work department, type of work and clinical career, while perception and satisfaction differed more among type of institution and the affiliated groups. CONCLUSION: For the development of continuing education for nurses, it is necessary to establish an integrated information system for nurse continuing education and to develop various education programs for career development.
Education ; Education, Continuing ; Information Systems ; Korea ; Marriage

PURPOSE: This study was conducted to analyze research on reflection in Korean nursing, and suggest future directions for effective application of reflective practice in Korean nursing education and practice. METHODS: A review was performed using domestic databases including RISS, KISS, DBpia, and NDSL. Twenty-three papers were analyzed according to general characteristics, key variables regarding reflection, and findings regarding reflection. RESULTS: Reflection in nursing research has received attention since 2005, generating almost half the publications in the last 3 years. Key variables regarding reflection were classified into reflection-related general term (34.7%), reflective action (8.6%), and reflection writing method (56.7%). Findings regarding reflection were categorized into correlation of reflection with other variables (26.1%), learning evaluation using a reflective journal (22.2%), effects of applying reflection as an intervention (47.4%), and Korean Self-Reflection and Insight Scale validation (4.3%). CONCLUSION: Results indicate that reflection or reflective practice is an important component in integrating theories to practice, and that reflective practice is a prerequisite to becoming a professional nurse as well as a crucial tool for ideal changes in nursing. Considerable effort should be made to define the concept of reflective practice and effectively apply it to nursing education and practice in Korea.
Education, Nursing ; Korea ; Learning ; Methods ; Nursing Research ; Nursing ; Writing

PURPOSE: Purpose of this study was to analyze research on the service design process applied to domestic medical service areas. METHODS: A review was made through domestic databases including RISS, KISS, DBpia, and NDSL and for the analysis framework: a medical service classification code which integrated the medical service area and the design fields. RESULTS: In the healthcare service field there were 9 studies (69.2%) in the medical area, 1 study (7.7%) each in nursing and oriental medicine, and 2 studies (15.4%) in healthcare. According to analysis results based on the medical service classification code, there were 5 studies in prevention and management, 6 studies in curative care, 1 each in rehabilitation and ancillary care. Double diamond process was used in 8 studies. CONCLUSION: Service design was applied mainly to the curative care in the domestic medical settings but little research on service design in the long-term nursing care area was identified. As a strategy to improve the quality of nursing service, it is necessary to adopt the service design process for various nursing service areas in Korea.
Classification ; Delivery of Health Care ; Diamond ; Korea ; Medicine, East Asian Traditional ; Nursing ; Nursing Care ; Nursing Services ; Patient-Centered Care ; Quality Improvement ; Rehabilitation

PURPOSE: In this study a systematic review and meta-analysis was used to examine the variables related to self-leadership in Korean clinical nurses. METHODS: A search and screening of the literature uncovered, 49 related studies done between 2003 and 2016 were then reviewed. A meta-analysis of 44 studies from doctoral dissertations, master's thesis and published articles was also carried out. The correlational effect size (ESr) for each related variable was calculated. RESULTS: Sixty-nine related variables were identified from the systematic review. Twenty-three (5 personal, 13 professional and 5 organizational) variables were eligible for meta-analysis. The overall effect size was .47. The personal factors (ESr=.48) and the professional factors (ESr=.44) had larger effect size than the organizational factors (ESr=.28). Factors with the largest effect size among personal, professional and organizational factors were self-efficacy (ESr=.58), nursing service (ESr=.68) and supervisor's leadership (ESr=.36) respectively. CONCLUSION: The results of this study show that for Korean clinical nurses individual factors including personal or professional factors have a stronger impact on self-leadership than organizational factors. It is necessary to develop interventions and training programs which focus on improving self-efficacy to promote self-leadership in clinical nurses.
Education ; Humans ; Leadership ; Mass Screening ; Nursing Services