PURPOSE: During clinical placements, nursing students who come into close contact with patients and provide nursing interventions may be exposed to harmful pathogens. However, little is known about nursing students' experiences with standard precautions (SP) in clinical settings. METHODS: We conducted interviews with six focus groups of nursing students (n = 38) from two universities in South Korea. The focus group interviews each took 90e120 minutes and included 6e7 participants from two different universities. The meetings used semi-structured interview protocols. Qualitative content analysis was employed. RESULTS: Four themes and 9 subthemes were identified: (a) attitudes (knowledge deficit, sensitivity), (b) subjective norms (negative role models, classroom and in-field gaps, blind spots), (c) perceived behavioral control (psychological barriers, physical barriers, lack of information), and (d) intention (changes in compliance awareness). CONCLUSIONS: These focus groups revealed that many nursing students worked in vulnerable environments and risked pathogen exposure. Nursing students expressed the importance of SP but reported witnessing many instances of failure to comply with established measures. Several barriers were explored as reasons of SP noncompliance. By removing the barriers presented in this study, nursing students would be able to perform their duties in a safe clinical environment.
Focus Groups ; *Health Knowledge, Attitudes, Practice ; Humans ; Infection Control/*methods ; Interviews as Topic ; *Nursing Methodology Research ; Republic of Korea ; Students, Nursing/*psychology ; Universities

PURPOSE: The purpose of this study is to explore problems of clinical nurse performance appraisal system. METHODS: This study employed a descriptive qualitative approach. The participants were purposively selected from clinical nurses working across all of the hospital units in a large metropolitan teaching hospital in Tehran, Iran in 2012. Data were collected using five focus group interviews, which were audio taped. The number of participants in each group ranged from 7 to 10. The semi-structured interviews were guided by a set of nondirective questions, and continued until the data reached saturation. Data were analyzed using framework analysis. RESULTS: Four major themes regarding the problems of clinical nurse performance appraisal system emerged from the analysis of textual data. These themes were contextual problems, problems related to performance appraisal structure, problems related to performance appraisal process and those related to performance appraisal results. CONCLUSION: The findings of this study reveal that the nurse performance appraisal system confronts with various problems. Some of these problems are related to organizational context while the others concerned structure, process and results of the performance appraisal system. In order to achieve high quality of patient care as the final goal of performance appraisal, changing and revision of this system is necessary.
Adult ; *Clinical Competence ; Employee Performance Appraisal/*standards ; Female ; Focus Groups ; Humans ; Iran ; Male ; Middle Aged ; Nurse Clinicians/*standards ; *Nursing Methodology Research ; Nursing Staff, Hospital/*standards ; Qualitative Research

PURPOSE: The purpose of this study was to develop and validate of a knowledge scale for lymphedema in patients with breast cancer. METHODS: 34 preliminary items were made according to literature review, then verified content validity, construct validity, and reliability of the scale. 28 items among them were confirmed through content analysis by 4 experts. After a preliminary test, a survey for 156 breast cancer patients was performed for confirming construct validity and reliability. The data were analyzed using factor analysis, independent t-test, and KR-20. RESULTS: This scale had 28 items consisting of 2 categories: prevention and self-care of lymphedema. Construct validity was confirmed by known-group technique because there were some categories consisted of just one or two items, and some mismatches between categories and items in factor analysis. Women who were educated about lymphedema scored significantly higher than women who had not (t=-3.92, p<.001). Reliability was appropriate (KR-20=.81). A percentage of correct answers was 74.6%, but it was from 31.8% to 96.1%. CONCLUSION: The study shows that this scale is reliable and valid to measure the knowledge of lymphedema. This scale can be effective to assess and educate the patients with breast cancer.
Breast ; Breast Neoplasms ; Female ; Humans ; Lymphedema ; Nursing Methodology Research ; Reproducibility of Results ; Self Care

PURPOSE: This study was conducted to study the attitude of Korean lawyers toward withdrawal of life sustaining treatment, and compare and analyze different types of their attitudes. METHODS: Research design of this project was Q methodology approach. The study population was 24 lawyers, aged from 32 to 69 years. Q sample to investigate the attitude of the lawyers toward withdrawal of life sustaining treatment included 34 statements obtained from literatures, TV debate, and depth interviews of 5 lawyers among the lawyers included. After listening to the purpose and method of the study, the 24 lawyers agreed to fill out a survey asking sociodemographic information, and the information was distributed in 9 scale Q-sample. RESULTS: The collected data were processed through QUANL PC program and sorted into 5 types as follows: The first type was 'Choosing to withdraw life sustaining treatment', the second 'Withholding life sustaining treatment' regardless of the cost, the third is neutral type that claims that humans have the right to decide the death and life, and demands the proper legalization to protect such rights, the fourth type agrees to withdrawal of life sustaining treatment, nevertheless, admits that one has a rigt to withhold one's own life treatment, categorized as self contradiction type. The fifth type believed that 'Life and death are providential' with the faith, therefore, such authority to decide life and death belongs to God, but not human beings. CONCLUSION: In conclusion, the lawyer's attitudes toward withdrawal of life sustaining treatment were grouped into five different types as follows: 'Choosing to withdraw life sustaining treatment', 'Withholding life sustaining treatment', 'Demanding legalization', 'Self contradiction type', and 'Life and death are providential'.
Aged ; Human Rights ; Humans ; Lawyers ; Nursing Methodology Research ; Q-Sort ; Research Design ; Withholding Treatment

PURPOSE: Guided by Newman's theory of health as expanding consciousness, this study was done to explore the health experience of adolescents having depression. METHODS: The researcher engaged in six to eight in-depth interviews with six adolescents. To begin the dialog, the researcher asked each participant to recount the first important memory he/she had. All the narrative and diagram sharing between the researcher and participants were summarized according to recognized patterns and later elaborated in following interviews based on Newman's praxis methodology. RESULTS: The significant individual pattern of early health experience was during the binding stage. At the turning point, individual patterns for participants revealed a personal journey of self-discovery and then emergence of reflecting behaviors. After the turning point, the participants changed as they evolved from the initial period of disruption and disorganization to organization at a higher level. The results suggest that adolescents who are depressive find new ways of relating to friends, family, healthcare providers, and the community by expanding their consciousness. CONCLUSION: Newman's praxis methodology is a good way of helping and studying adolescents with depression because it emphasizes participant-nurse/researcher partnership and pattern recognition as nursing practice.
Adaptation, Psychological ; Adolescent ; *Adolescent Psychology ; Attitude to Health ; Consciousness ; *Depression ; Female ; Humans ; Interviews as Topic ; Male ; Nursing Methodology Research ; Young Adult

PURPOSE: The purpose of the study was to identify functional structure and patterns of dialogue sequence in conversations between elderly patients with dementia and nurses in a long-term care facility. METHODS: Conversation analysis was used to analyze the data which were collected using video-camera to capture non-verbal as well as verbal behaviors. Data collection was done during February 2005. RESULTS: Introduction, assessment, intervention, and closing phases were identified as functional structure. Essential parts of the conversation were the assessment and intervention phases. In the assessment phase three sequential patterns of nurse-initiated dialogue and four sequential patterns of patient-initiated dialogue were identified. Also four sequential patterns were identified in nurse-initiated and three in patient-initiated dialogues in the intervention phase. In general, "ask question", "advise", and "directive" were the most frequently used utterance by nurses in nurse-initiated dialogue, indicating nurses' domination of the conversation. At the same time, "ask back", "refute", "escape", or "false promise" were used often by nurses to discourage patients from talking when patients were raising questions or demanding. CONCLUSION: It is important for nurses to encourage patient-initiated dialogue to counterbalance nurse-dominated conversation which results from imbalance between nurses and patients in terms of knowledge and task in health-care institutions for elders.
Aged ; Aged, 80 and over ; *Communication ; Dementia/*psychology ; Female ; Humans ; Long-Term Care ; Male ; Nurse-Patient Relations ; Nursing Methodology Research ; Video Recording

PURPOSE: This quasi-experimental study was performed to evaluate the effectiveness of an early nursing intervention program to support mothers of children aged 0-3 yr living in poverty. METHODS: In this study, mothers who received financial support from the government were recruited from one city and assigned to an intervention group (24) and comparison group (18). They completed a baseline questionnaire about depression, child rearing burden, agreement on physical punishment, and child temperament. Also, Denver II screening of the children was performed by the researcher. Mothers in the intervention group received a home visit intervention every two weeks for three months. At 3-months post-baseline, questionnaire and Denver II screening were reused to compare these two groups. RESULTS: Mother's depression, child rearing burden, agreement on physical punishment, and child temperament were not significantly different between the two groups. However, the percentage of depression declined only in the intervention group. Mothers in the intervention group showed higher Home Observation for Measurement of the Environment (HOME) scores than mothers in the comparison group. CONCLUSION: The findings of the study show that this nursing intervention is an effective parenting program. The early nursing program for mothers with infant and toddlers in poverty is effective in promoting HOME, the child rearing home environment.
Adult ; Child Abuse ; *Child Rearing ; Child, Preschool ; Depression ; Female ; Humans ; Infant ; Infant, Newborn ; Interviews as Topic ; Male ; Mother-Child Relations ; Mothers/*psychology ; Nursing Methodology Research ; Parenting ; *Poverty ; Program Evaluation ; Questionnaires ; Social Support

PURPOSE: This paper analyzed the historical origins of the Qi concept and assesses its possible contributions to the development of complementary therapy and new nursing practices. METHODS: In order to clarify the Qi concept and measure its theoretical/clinical potentials, this study analyzed both historical data and experimental research that adopt and apply the concept. These include modern/contemporary research measuring its effects in promoting mental and physical health. Using the method of cross-cultural comparison, this study analyzed diverse approaches to the Qi concept and sought to find common features among the approaches. RESULTS: A historical, cross-cultural analysis revealed several fundamental similarities between Qi theories that have developed in the east and the holistic concepts that have evolved in the western traditions. Especially, the analysis of the more recent research on the Qi concept shows ample possibilities of its future contributions to the development of new diagnostic applications and the promotion of overall human health. CONCLUSION: The historical study of the Qi concept found some key common factors in the diverse philosophical traditions in the east and the west. Considering the growing popularity of complementary therapy among health professionals and the general public, the Qi concept and its clinical applications are expected to promote human health. In this context, this research contributes to developing new nursing practices based on the concept by clarifying its philosophical origins and theoretical backgrounds.
Concept Formation ; Humans ; *Mind-Body Relations (Metaphysics) ; Models, Nursing ; Nurses/*psychology ; Nursing Care ; Nursing Methodology Research ; Program Development ; *Qi ; *Yin-Yang

PURPOSE: The present study was done to discover the structure of universal actual experiences 'Considering tomorrow' of health and quality of life among North Korean refugees in terms of the socio-cultural context of South Korea. METHOD: The research question was 'what is the structure of the actual experience of 'Considering tomorrow?', which was examined based on the Parse's human becoming research method. Five North Korean adult refugees were recruited from a National Reconciliation Committee in Seoul/Incheon. The data was gathered from dialogues and collected from February, 2006 to November, 2006. RESULTS: The structures found in this study were: 'hope for future life by taking responsibility and having harmony with South Koreans, by forming an integrated identification; having a chance for positive engagement, by attaining human freedom and hope; feeling respected, by assimilating self to the new world; getting freedom back, by facing a new challenge and preparing self for a new social role; overcoming cultural differences with fortified hardiness for survival, by making a decision for a life course with individual growth. In addition, conceptual integration was that 'Considering tomorrow is transforming the enabling-limiting values'. CONCLUSION: Health professionals need to know North Korean refugees' psychological difficulties, expectations of treatment, help seeking behavior, and expectations from mainstream culture. Additionally, understanding North Korean refugees' needs for reality, health education and a multi-disciplinary team approach are necessary to improve their health.
*Acculturation ; *Adaptation, Psychological ; Adult ; Asian Continental Ancestry Group ; Female ; Humans ; Interviews as Topic ; Life Change Events ; Male ; Mental Health ; Nursing Methodology Research ; Refugees/*psychology ; Social Alienation ; Social Identification ; Tape Recording/methods

PURPOSE: This study was done to develop the concept of grief focusing on the process of spousal bereavement in Korea. METHODS: The Hybrid model was used for analysis according to the 3 phases. An extensive literature review was done for the Theoretical phase. In-depth interviews were conducted with 15 participants whose spouses died within the past 3 years in the Field phase. In the Final analytic phase, the results in the Theoretical and the Field phases were compared, analyzed, and integrated according to the process of grief. RESULTS: The antecedent of the concept of spousal grief was spousal death. The dimensions of grief were classified to inner dimensions related to oneself, relational dimensions related to family and others, and existential dimensions related to the meaning of being. The attributes of grief were physical suffering, decline of cognitive ability, heartbreaking sorrow, expectations and conflicts of a new life, social stigma, dependence on or resentment towards God, etc. The empirical referent of grief was physical, psychological, social, and spiritual health status. The grieving progressed through 3 phasesshock-emancipation, suffering, and integration. CONCLUSION: Nurses should recognize the importance of their unique position as supporters for grievers, and try to assess individual characteristics and to provide tailored nursing interventions.
Adaptation, Psychological ; Attitude to Death ; Attitude to Health ; *Bereavement ; *Concept Formation ; Family/psychology ; Female ; *Grief ; Health Status ; Humans ; Interviews as Topic ; Life Change Events ; Male ; Nursing Methodology Research ; Social Support ; Spouses/*psychology ; Widowhood/*psychology