Purpose: The aim of this study investigated the transition experience of novice nurses working in a tertiary hospital, focusing on the difference between nursing school education and clinical nursing practice. Methods: The data were collected through an unstructured, in-depth interview with 14 recently employed nurses from October 2020 to January 2021. The data were analyzed by qualitative content analysis. Results: The main theme of the transition experience perceived by new graduate nurses was confirmed as ‘reality shock’. In the process of identifying the main themes, five categories, sixteen sub- categories, and sixty-two concepts were derived. The five categories were, ‘Clinical field different from school education setting’, ‘Nursing school education in need of change’, ‘Strengths and limitations of clinical training in schools and hospitals’, ‘Difficulty in establishing relationships and communicating’, and ‘struggling to stand alone’. Conclusion: To minimize the reality shock experienced by novice nurses, nursing schools should innovate their traditional teaching methods based on the changing characteristics of the novice nurses and the clinical environment. In nursing practice, hospitals should grant more time to the nurses for adaptation and diversify mentoring programs comparable to internships for novice nurses.

본 연구는 병원간호사의 조직몰입 및 관련요인에 대한 선행연구를 체계적으로 고찰하고 메타분석을 시행하고자 한다. 이를 통해 병원간호사의 조직몰입에 대한 연구동향과 유효한 변수를 규명하고자 하 며, 간호사의 조직몰입 향상을 위한 전략 및 중재개발의 기초를 제공하고자 한다. 본 연구는 2008~2018년 발표된 연구에 대한 문헌고찰과 메타상관 분석을 실시하여 병원간호사의 조직몰입과 관 련된 요인들을 분석하였다. PRISMA표를 활용하여 연구에 대한 스크리닝과 질적 평가를 시행하였고, 최종 144개의 논문을 추출하였다. 조직몰입과 관련해서는 45개의 변수가 유의미하게 분류되었으며, Schaufeli’s Energy Compass Model에 따라 이 변수들을 6개 그룹(직무요구, 직무자원, 참여형 리더 십, 개인적 자원, 피고용인의 웰빙, 직무성과)으로 분류하였다. 이들 중 직무요구를 제외한 5개 범주가 조직몰입과 일정 정도의 강한 상관관계를 보였다. 또한, 조직몰입과 긍정적인 직무성과 간에는 강한 정(+)적 상관관계가 발견되었다. 본 연구 결과, 병원간호사의 조직몰입과 직무자원 간에는 상관관계가 존재한다는 것이 규명되었다. 본 연구 결과는 향후 병원간호사의 조직몰입을 높이기 위한 프로그램 개발 및 연구에 기초자료로 활용될 수 있을 것이다

With the enforcement of the “Act on decisions on life-sustaining treatment for patients at the end of life” in February 2018, discussion on advanced care planning (ACP) has increased. However, as decisions on life-sustaining treatments are still made in the intensive care unit, deaths related to the suspension of life-sustaining treatment account for a large proportion of deaths in the intensive care unit. The nurses encounter challenges in supporting the patient's dignified death; they experience an ethical dilemma in the ambiguity due to a lack of guidance on legal responsibilities regarding decisions on life-sustaining treatment. In order for the nurses to perform as a supporter providing care to the patients and as a advocate during the process of decision-making on life-sustaining treatment, there should be a systemic change to ensure the nurses' participation. In addition, an open and continuous discussion should be proposed to cultivate nurses’ ethical sensitivity and moral courage. This paper reports two ethical examples related to the decisions on life-sustaining treatment occurred in intensive care units of a tertiary hospital.

This study was conducted to understand the current status of regional health inequalities and nurse supply and demand policies, and to suggest ways to supply nurses to regions where nurses are scarce. Secondary data such as academic papers, government announcements, and related laws were analyzed, and the results were reviewed from various perspectives to derive policy proposals. Health professions were distributed around large cities including Seoul, and those regions had relatively high health levels. However, the number of hospital beds increased steadily, mainly in the non-metropolitan area. This seems to be one of the reasons why there is always a shortage of nurses in the local medical field despite the supply of nurses, and it can be a factor that aggravates regional inequalities. In order to solve the chronic shortage of nurses, supply-oriented policies such as increasing the admission quota and utilizing inactive nurses, and demand-oriented policies such as regulations on the nurse staffing level and improvement of the incentive scheme for quality evaluation of hospital service have been implemented. In the past, the focus was simply on the quantitative expansion of nurses, but recently, policies that emphasize the qualitative aspect of nursing are being promoted. However, the policy for the distribution aspect of nurses is still somewhat incomplete. Therefore, to solve this problem, strengthening the nurse staffing level in medical institutions, promoting nursing policies led by local governments, developing standard wage guidelines, and training nurses as public health personnel were proposed.

Purpose: This study was attempted to investigate the relationship among workplace bulling, organizational silence, organizational justice, ethical climate, and intent to leave in hospital nurses. Methods: This study was a cross-sectional survey. Data were collected from 267 full-time nurses working at one general hospital in South Korea from June 10 to 30, 2022 and analyzed using the SPSS 25.0 program. Results: As a result of the study, workplace bullying averaged 1.81 (out of 4), organizational silence 2.60 (out of 5), organizational fairness 3.06 (out of 5), ethical climate 3.57 (out of 5), and intent to leave was 2.88 (out of 5). The higher workplace bullying and organizational silence, the lower organizational justice and ethical climate, the intent to leave of hospital nurses was high. Organizational justice, workplace bullying, and age could explain their intent to leave of 37.0%. Conclusion: It Is found that it is important to increase organizational justice and prevent workplace bullying in order to lower hospital nurses' intent to leave. So it is concluded that managers should disclose the process and results of organization operation, and prepare measures to prevent bullying in the workplace centered the vulnerable.

Purpose: This study aimed to gain an in-depth understanding by analyzing and exploring the work experience of infection control nurses (ICNs) in response to the prolonged COVID-19 pandemic. Methods: Data were collected from 14 ICNs, (two in in-depth interviews and 12 in groups of six) from February 19, 2021, to March 20, 2021, and were analyzed according to the content. Results: In the prolonged COVID-19 pandemic, ICNs took the lead in responding to infectious diseases, where they felt pressure in doing everything. In addition, they were confused by a lack of workforce and undetailed job plans. ICNs have been exhausted by insufficient support and system, such as the lack of support in the hospital, communication with health authorities, and difficulties with patients and visitors. However, ICNs settle with the help and encouragement of those around them. For example, pride in the work that only ICN can do, change in the cooperation of hospitals, and development of ICNs’ unique method of perseverance. Conclusion: During the COVID-19 pandemic, ICNs experienced structural, physical, and mental difficulties at work. Nevertheless, the study found that a driving force enabled ICNs to endure, and that to efficiently respond to new infectious diseases in the future, it is necessary to secure ICNs and strengthen them.

Purpose: This study aimed to understand the impact of nurses’ psychosocial experiences in COVID-19 on their mental health and the psychosocial adjustment and growth of patients with COVID-19. Methods: This study used qualitative content analysis. Data were collected through individual in-depth interviews with 10 nurses with COVID-19 from February 24, 2022, to March 17, 2022. Results: Six themes were identified in the qualitative content analysis, including ‘Psychological burden after diagnosis’, ‘Acceptance of confirmed results’, ‘Difficulties caused by change in an unfamiliar environment’, ‘Confusion after returning to daily life’, ‘Mental state after a complete recovery’, ‘Incomplete prevention of infectious disease and control guidelines’. Conclusion: In the context of the COVID-19 pandemic, the physical and mental health of nurses can have a significant impact on the quality of medical care; therefore, an understanding of their psychosocial adjustment will help support nurses adjust better in future pandemic situations.

Purpose: The purpose of this study was to explore the nurses’ experience of the side effects of COVID-19 vaccination and understand its meaning. Methods: This study was a qualitative study using the content analysis method. The data collection period using a focus group was from October 26, 2021 to January 23, 2022. Results: The themes included: “Pressure from mandatory COVID-19 vaccination”, “Feeling relieved because the side effects are mild”, “Severe vaccine side effects cause negative emotions”, “Tolerating side effects and coping personally”, “Confusion and alienation about insufficient coping of side effects”, “Feeling skeptical about the COVID-19 vaccination policy”, “Thinking about how to build trust in the COVID-19 vaccine”. Conclusion: In the future, it is considered important to establish scientific evidence through continuous monitoring and data collection of the side effects of COVID-19 vaccination and to build trust in vaccines through transparent information disclosure.

This study was conducted to define the concept of social stigma related to COVID-19 and to identify attributes of nurses with experience in nursing COVID-19 confirmed patients. The study analysis method used the hybrid model of Schwartz-Barcott and Kim, and data was collected from literature related to social stigma and 7 nurses who had experience caring for confirmed COVID-19 patients. As a result of this study, the social stigma related to COVID-19 of nurses who have experience nursing confirmed patients was derived into three attributes. The three areas were derived from undervaluation, discrimination, and negative stereotypes. As a result, social rejection, social isolation, and lack of social support were found. As a primary result, cognitive response to inequality, emotional response to increased stress, increased anxiety, disappointment, alienation, and avoidance appeared. As a secondary result, negative self-concept, destruction of self-integration, self-stigmatization, and job satisfaction were shown. As a result, this study is meaningful in that it provided a practical foundation for a strategy to reduce social stigma related to COVID-19 of nurses who have cared for COVID-19 confirmed patients.

본 연구는 신규간호사를 대상으로 환자안전동기, 환자안전관리태도, 환자안전관리행위 정도와 상관관계를 확인하고 환자안전관리행위에 영향을 주는 요인을 알아보고자 실시하였다. 신규간호사 127명 을 대상으로 2020년 9월 11일부터 9월 30일까지 설문조사 하였으며, 수집된 자료는 SPSS 22.0 프로그램을 이용하여 t-test, ANOVA, Scheffe’s test, Person’s correlation coefficients, 다중회귀분석을 하였다. 환자 안전동기는 환자안전관리태도, 환자안전관리행위와 양의 상관관계를 보였으며, 환자안전관리태도는 환자안 전관리행위와 양의 상관관계를 보였다. 환자안전관리행위에 가장 유의한 영향을 준 요인은 환자안전동기, 환자안전관리태도, 환자안전관리 교육경험 이었다. 따라서 신규간호사의 환자안전관리행위 능력을 증진시 키기 위해 환자안전동기, 환자안전관리태도를 포함한 환자안전교육 프로그램의 개발과 적용을 제안한다.

본 연구는 제5차 근로환경조사(2017) 자료를 사용하여 간호사의 보상과 직무 열정과의 관련성 을 파악하고자 수행되었다. 연구대상은 확률표집에 의해 표집된 전국의 간호사 359명이다(청년 간호사 집 단 218명, 중년 간호사 집단 141명). 내외적 보상의 직무 열정에 대한 영향은 일반선형모형분석을 통해 파악하였다. 연구결과를 보면, 전체 간호사집단에서는 의사결정 참여, 성취감, 자존감, 경력발전 전망, 합당 한 업무인정, 일-삶의 균형의 외적 보상 등이 직무 열정에 영향을 미치는 요인이었다. 반면 청년 간호사 집 단에서 의사결정 참여, 성취감, 자존감, 경력발전 전망, 일-삶의 균형 등이, 중년 간호사 집단에서는 성취 감, 자존감, 합당한 업무인정 등이 직무 열정에 영향요인이었다. 결론적으로 간호사들의 직무 열정을 높여 주기 위해 의사결정 참여, 성취감, 자존감, 경력발전 전망, 합당한 업무인정, 일-삶의 균형 등을 포함하는 보상체계를 구축할 필요가 있다. 또한 보상체계 구축 시 연령 집단를 고려함으로써 효율성을 기할 수 있을 것이다.

Purpose: This study aimed to understand the effect of extra-corporeal membrane oxygenation (ECMO) preparation education implemented with smart glasses in augmented reality on the performance ability, performance confidence, and educational satisfaction of clinical nurses. Method: The participants were clinical nurses at B hospital—27 in the experimental group and 25 in the control group. The measurement tools were performance ability (24 items), performance confidence (11 items), and educational satisfaction (9 items). The experimental group intervention used augmented reality with smart glasses, and the control group used video resources. The collected data were analyzed by t-test, x2-test, and ANCOVA using the SPSS Statistics for Windows, version 25.0. Results: The performance was significantly higher in the experimental group than in the control group (F = 104.83, p < .001). Performance confidence was considerably higher in the experimental group than in the control group (F = 2.09, p = .041). Finally, educational satisfaction was significantly higher in the experimental group than in the control group (F = 4.52, p < .001). Conclusion: It was confirmed that ECMO education implementing augmented reality with smart glasses is an effective method for improving performance ability, performance confidence, and educational satisfaction among clinical nurses.

지금까지 간호사 교육프로그램들은 개별적으로 다양하게 연구되었으나, 그 연구를 종합하여 그 효과성을 보여주는 연구가 없었다. 그래서 개별적인 연구를 종합하여 효과성을 검정하는 연구가 필요하다. 본 연구의 목적은 간호사 교육프 로그램을 주제로 2002~2021년까지 20년간 국내에서 연구된 학술논문 22편(효과 크기 38개)에 대한 메타분석을 통해 효과성을 검정하는 것이다. 그 결과는 다음과 같다. 첫째, 전체 효과크기는 1.1196로 나타나 유의미한 효과성을 보여주었으며, 효과크기의 동질성보다는 이질성(Q값에 대한 유의확률 p=0.0001, I2 =86.2%)이 확인되어 랜덤효과모델로 해석되었다. 둘째, 효과변인 간의 동질성 검정 결과는 Q =12.07(df=5, p<0.0338), Q-df>0이므로 연구 간 분산이 실제 존재함을 보여준다. 셋째, 조절변인(Alpha와 ST)로 메타회귀분석을 한 결과 유의미한 설명력을 보여주지 못했다. 넷째, 효과변인 간의 효과크기 차이는 지식(7 개)에서 Hedges’ g=1.7434, 수행능력(6개)에서 Hedges’ g=1.7294, 자기효능감(8 개)에서 Hedges’ g=1.1666, 의사소통능력(5개)에서 Hedges’ g =0.6835, 스트레스 (7개)에서 Hedges’ g =0.6674, 태도(5개)에서 Hedges’ g =0.5648 순으로 나타났으며, 지식의 효과크기가 가장 컸고, 태도의 효과크기가 가장 낮았다. 출판편향을 분석하기 위해 깔때기 그림, Egger의 회귀분석, 안정성계수, 절삭-과-보충, 보정된 깔때기 그림 등을 분석해 본 결과를 살펴보았을 때, 본 연구의 출판편향의 문제는 없었다. 마지막으로 본 연구 결과의 의미와 시사점에 대해 논의하였다.

Purpose: This study explored and described the lived experiences of nurses in taking care of patients during COVID-19 pandemic in Korea. Methods: Data were collected through individual in-depth interviews with 10 nurses who involved in COVID-19 patient care. Verbatim transcripts were analyzed using Colaizzi’s phenomenological analysis. Results: Qualitative data analysis revealed three categories: ‘standing in front of the pandemic’, ‘harsh experience of caring for COVID-19 patients’, and ‘finding a way for better COVID-19 patients care’. The lived experience of nurses in caring of patients with COVID-19 infection was ‘finding the best way to provide proper care in unfamiliar and difficult pandemic situation’. Conclusion: The results illustrated the motivation, meaning, and value of pandemic care from the nurses’ perspective. Nurses felt proud of being a part of dedicated hard-working team but distressed by crumbling death without dignity and pressured by being thrown at the front-line in the COVID-19 battle. The advanced practice nurses’ hidden supports and advices were helpful for them to reinforce nursing capacity for optimal care. Nursing professionalism should be enhanced by establishing the scope of practices and providing systematic support with appropriate rewards.

Purpose: The purpose of this study is to understand the general nurses's experiences of missing patient identification. Methods: Participants were 12 nurses who experienced missing patient identification in general wards in hospitals. Data were collected with focus group interviews and individual in-depth interviews and data were analyzed using qualitative content analysis. Results: As the results of this study, 128 statements, 4 themes and 13 sub-themes were derived. The four themes derived were ‘Situations that we had not to check patient identification properly’, ‘Fear and pressure from the result of missing patient identification’, ‘Feeling guilty to the results of missing patient identification’and ‘Efforts to reassuring patient identification’. Conclusion: In order to prevent the failure of patient identification, we need specialized programs to cultivate patient safety culture not only for nurses, also patients and caregivers, and all departments of hospital. We also need institutional efforts and effective hospital investment and supports for accomplishing the goal.

The purpose of this study is to understand the relation of peer group caring interaction, Professional self-concept, and Nurses’ Retention. The subjects of this study are 133 nurses who have worked for more than three months at five general hospitals with more than 300 beds in S city. As a result of the study, nurses’ retenstion was higher than those of under 25 years of age between 30 and 35(F=3.313, p=.039).The professional self-concept of hospital nurses has been identified as an influence factor of intent to serve. Professional self-concepts have been shown to be better with higher peer-care and consideration(r=.397, P=.004). The peer group caring interaction behavior can occur not only between colleagues but also between managers. Therefore, it is necessary to proceed with the manager's group caring interaction as a follow-up study.

본 연구는 종합병원에서 근무하는 초보간호사의 임상수행능력에 영향을 주는 요인을 알아보고자 실시하였다. 초보간호사 155명을 대상으로 2020년 9월 11일부터 9월 30일까지 설문조사 하였으며, 수집된 자료는 SPSS 프로그램을 이용하여 t-test, ANOVA, Scheffe test, Person’s correlation coefficients, 다중회귀분석을 하였다. 월경곤란증은 2.77점, 임상수행능력은 3.44점 이었고 월경곤란증과 임상수행능력은 유의한 음의 상관관계를 보였다(r=-.226, p=.002). 임상수행능력에 유의한 영향을 준 것은 자율신경계 반응이고(β=-.261, p= .001) 설명력은 22.1%였다. 따라서 초보간호사의 임상수행능력을 증진시키기 위해 월경곤란증의 자율신경계 반응 완화를 위한 중재 교육 프로그램이 필요하다.

Nurses in an intensive care unit (ICU) often play key roles to improve the quality of end-of-life care. During those times, many nurses report they feel ambivalent in the caring between life and death. The purpose of this study was to analyze the concept of ambivalence that ICU nurses often experienced in end-of-life care. As a method, this study was conducted with the concept analysis using the hybrid model Schwartz-Barcott and Kim (1986) presented, naming the complex and dual feelings nurses experience during end-of-life care in ICU as ambivalence. In the theoretical phase and from the literature review, characteristics of ambivalence were identified. During the fieldwork phase, in-depth interviews were conducted with five nurses. In the final phases, a theoretical description was extracted of ambivalence in ICU nurses during end-of-life care. In terms of results, external factors (i.e., realistic context, contradictions in nursing activities themselves) and internal factors (i.e., personal tendencies, conflicting perceptions of dying, occupational awareness of nurses, role conflicts) were derived as antecedents of ICU nurses’ ambivalence during end-of-life care. Attributes were divided into intrinsic and existential dimensions. Intrinsic dimensions resulted in "coexistence of opposing equivalent values," "uncertainty," "hiddenization," "value confrontation may occur sequentially," and "absence of willingness to resolve." In existential dimensions, the following conflicts were derived: "pressure on work versus sympathy about family grief," "helplessness due to failure of medical care versus sadness for patient death" and "role as a nurse versus sadness felt during end-of-life care.” The results are organized into negative assessments of oneself and adaptations to ambivalence. In conclusion, through this concept analysis, the hope is that ICU nurses will be able to prevent progressing to burnout by accurately and actively facing and managing their own feelings during end-of-life care. Furthermore, this research is expected to serve as the cornerstone of developing theories for clinicians who provide end-of-life care.

본 연구는 요양병원에서 근무하는 간호사를 대상으로 표준주의지침 수행도에 미치는 영향 요인을 파악하기 위해 실시되었다. 분석결과 표준주의지침 인식 8.50, 건강신념 3.76점(하위영역- 지각 된 민감성 4.03점, 지각된 심각성 4.04점, 지각된 유익성 3.91점, 지각된 장애성 3.54점, 행동계기 2.92 점), 표준주의지침 수행도 37.90점이었다. 표준주의지침 수행도는 표준주의지침 인식(r=0.419, p<.001), 건강신념(r=0.443, p<.001), 건강신념 하위영역인 지각된 민감성(r=0.169, p=.044), 지각된 유익성 (r=0.207, p=.013), 지각된 장애성(r=0.486, p<.001), 행동계기(r=0.204, p=.014)와 양의 상관관계가 있었다. 표준주의지침 수행도에 미치는 영향요인은 지각된 장애성(β=0.373, p<.001), 행동계기(β=0.271, p<.001), 표준주의지침 인식(β=0.245, p=.004) 이었고 설명력은 32.5%이었다.

Purpose: This study attempted to enhance the nurses’ safety competence in administering medications by using simulation training focused on high-alert medication. Method: A total of 30 nurses from 14 teams participated in the simulation training using a high-fidelity patient simulator. Medication administration performance and built-in error recovery was observed using a medication administration safety assessment checklist. Medication safety knowledge and confidence were measured before and after simulation training. Data were analyzed using descriptive statistics and a paired t-test. Results: There were numerous variations in safe medication administration. The safety behavior by oral prescription was insufficient compared to that by routine medication prescription. Following simulation training, knowledge of medication safety increased significantly, but confidence did not. Conclusion: Nurse educators may consider simulation to be an effective strategy for enhancing nurses’ medication safety competence.