Journal of Korean Academy of Nursing

Review Paper

Risk factors for the readmission of patients with diabetic ketoacidosis: a systematic review and meta-analysis: Hyerim Ji, Sun-Kyung Hwang; J Korean Acad Nurs 2025;55(4):634-650. Published online November 21, 2025; DOI: https://doi.org/10.4040/jkan.25072

Abstract PDF ePub: Purpose
This study aimed to identify risk factors associated with the readmission of patients with diabetic ketoacidosis (DKA) through a systematic review and meta-analysis.
Methods
A systematic literature review was conducted in accordance with the PRISMA guidelines. Relevant studies were retrieved from international databases (PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, and Web of Science) and Korean databases (RISS, KoreaMed, KMbase, KISS, and DBpia). Study quality was evaluated using the Newcastle-Ottawa Scale. Meta-analysis was performed using a random-effects model with the Hartung-Knapp-Sidik-Jonkman adjustment to account for the limited number of studies and heterogeneity.
Results
Fifteen studies were included in the review, and eight were eligible for meta-analysis. From the systematic review, 21 risk factors for DKA readmission were identified and categorized into five domains: demographic, socioeconomic, diabetes-related, comorbidity, and health-behavioral factors. In the meta-analysis, significant risk factors included low income, psychiatric disorders, and discharge against medical advice.
Conclusion
This study demonstrates that DKA readmissions result from the complex interplay of multiple clinical and social factors. By identifying these risk factors and suggesting risk-stratification criteria, the findings may support the development of tailored interventions, such as self-management education, integrated mental health care, structured discharge planning, and coordinated post-discharge follow-up.

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Research Papers

Development of the Hybrid Clinical Practicum Environment Scale for Nursing Students: Seoyoung Yoon, Hye-Ah Yeom; J Korean Acad Nurs 2024;54(3):340-357. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.24016

Abstract PDF

Purpose
This study aimed to develop a Hybrid Clinical Practicum Environment Scale for Nursing Students (HCPES-NS) and verify its validity and reliability.
Methods
The HCPES-NS was constructed following the DeVellis guidelines. The initial items were written based on a literature review and individual in-depth interviews. Content validity was verified through an expert panel review. To confirm the validity and reliability of the scale, a survey was conducted with 449 nursing students enrolled in 12 nursing colleges. Data were analyzed using item analysis, exploratory factor analysis, confirmatory factor analysis, concurrent validity, and reliability tests.
Results
Factor analysis showed that the HCPES-NS consists of 15 items on five subdomains: clinical site atmosphere, interpersonal relationship, alternative online practicum contents, provision of learning information, and clinical performance facilitation. A higher score indicated a more positive perception of the clinical practicum environment. The concurrent validity of the HCPES-NS was confirmed by its positive correlation with the Clinical Learning Environment Scale (r = .77). The Cronbach’s α reliability of the HCPES-NS was .84.
Conclusion
The HCPES-NS is both valid and reliable. This scale reflects the clinical practicum environment and includes an online practicum factor. It may be used effectively by faculty members and educators to evaluate nursing students’ perceptions of clinical practicum environments.

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Environmental and Individual Factors Associated with Clinical Practice Stress in Korean Nursing Students: A Scoping Review
Ui Rim Song
Korean Journal of Adult Nursing.2025; 37(4): 355. CrossRef

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Effects of a Health Partnership Program Using Mobile Health Application for Male Workers with Cardiovascular Risk Factors in Small and Medium Enterprises: A Randomized Controlled Trial: Eun Jin Kim, Seon Young Hwang; J Korean Acad Nurs 2024;54(1):44-58. Published online February 29, 2024; DOI: https://doi.org/10.4040/jkan.23090

Abstract PDF

Purpose
This study aimed to apply a health partnership program using commercially available mobile health apps to improve cardiovascular risk factors in male employees and verify its effectiveness.
Methods
Using a randomized control group pretest-posttest design, male employees with cardiovascular risk factors from five small and medium-sized workplaces were randomly assigned to an experimental group (n = 32) and a control group (n = 31). The experimental group was encouraged to use three mobile health apps for 12 weeks to acquire the necessary cardiovascular disease-related information and practice strengthening training, walking, and diet management appropriate to their level. They also received feedback on their weekly activities and motivational text messages from health partners. Hypotheses were tested using the SPSS WIN 22.0.
Results
The experimental group showed a significant difference compared to the control group in terms of their perception of mobile health app (p < .05), self-efficacy for exercise and diet, self-management partnership, and cardiovascular disease prevention health behavior (p < .001). In particular, there were significant decreases in the body mass index, ratio, serum fasting blood sugar, total cholesterol, and triglyceride in the experimental group (p < .001); however, there was no significant difference in high-density lipoprotein-cholesterol.
Conclusion
Intervention using mobile apps based on partnership with health managers is effective in improving the objective cardiovascular risk index in male employees; therefore, such intervention should be continuously used as a useful lifestyle modification strategy in the workplace.

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Adherence to a Heart-Healthy Lifestyle
Yura Shin, Jina Choo, Songwhi Noh
Journal of Cardiovascular Nursing.2025;[Epub] CrossRef

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Development of Nursing Clinical Judgment Scale: Shi Nae Kwon, Hyojung Park; J Korean Acad Nurs 2023;53(6):652-665. Published online December 31, 2023; DOI: https://doi.org/10.4040/jkan.23042

Abstract PDF

Purpose
This study aimed to develop a nursing clinical judgment scale (NCJS) and verify its validity and reliability in assessing the clinical judgment of nurses.
Methods
A preliminary instrument of the NCJS comprising 38 items was first developed from attributes and indicators derived from a literature review and an in-depth/focus interview with 12 clinical nurses. The preliminary tool was finalized after 7 experts conducted a content validity test based on a data from a preliminary survey of 30 hospital nurses in Korea. Data were collected from 443 ward, intensive care unit, emergency room nurses who voluntarily participated in the survey through offline and online for the verification of the construct validity and reliability of the scale.
Results
The final scale comprised 23 items scored on a 5-point Likert scale. Six factors – integrated data analysis, evaluation and reflection on interventions, evidence on interventions, collaboration among health professionals, patient-centered nursing, and collaboration among nurse colleagues – accounted for 64.9% of the total variance. Confirmatory factor analysis supported the fit of the measurement model, comprising six factors (root mean square error of approximation = .07, standardized root mean square residual = .04, comparative fit index = .90). Cronbach’s α for all the items was .92.
Conclusion
The NCJS is a valid and reliable tool that fully reflects the characteristics of clinical practice, and it can be used effectively to evaluate the clinical judgment of Korean nurses. Future research should reflect the variables influencing clinical judgment and develop an action plan to improve it.

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How the nursing work environment moderates the relationship between clinical judgment and person-centered care among intensive care unit nurses
Mi Hwa Seo, Eun A. Kim, Hae Ran Kim, Mohammad Jamil Rababa
PLOS ONE.2025; 20(1): e0316654. CrossRef
Effects of Critical Thinking Disposition, Clinical Judgement, and Nurse–Physician Collaboration on Triage Competency Among Triage Nurses
Ji-Won Song, Hyung-Ran Park
Healthcare.2025; 13(4): 405. CrossRef
Effectiveness of a virtual reality nursing simulation for pediatric pneumonia care: a Korean pilot study using a single-group pre-post test design
Eun Joo Kim, Seong Kwang Kim, Sung Sook Song
Child Health Nursing Research.2025; 31(4): 198. CrossRef
The Influence of Clinical Nurses' Clinical Judgment, Nursing Work Environment and Ethical Nursing Competence on Patient Safety Nursing Activities
Eunseo Hong, Hyojung Park
Journal of Korean Public Health Nursing.2025; 39(3): 368. CrossRef

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Development of a Reward Scale for Hospital Nurses: Sun Hee Kim, Eun-Young Kim; J Korean Acad Nurs 2023;53(5):525-537. Published online October 31, 2023; DOI: https://doi.org/10.4040/jkan.23057

Abstract PDF

Purpose
This study aimed to develop and test a reward scale for hospital nurses.
Methods
The initial items were identified through a literature review and focus group interviews with ten hospital nurses. The content validity of the items was evaluated by ten experts. Fifty-one items were derived from the pilot survey. Four hundred eighty-eight nurses participated in the study: 248 for exploratory factor analysis (EFA) and 240 confirmatory factor analysis (CFA). Data were analyzed using item analysis, EFA, CFA, convergent validity, known-group validity, and internal consistency using IBM SPSS Statistics 29.0 and IBM SPSS AMOS 29.0.
Results
The final scale consisted of 31 items and eight factors (decent wage, opportunity to grow and develop, support for special situations, various benefits, flexibility of work, job-related achievement, reflecting career and performance, and recognition), which explained 67.3% of the total variance. The eight-subscale model was validated by CFA. Convergent validity was evaluated by analyzing correlation with intention to leave (r = - .63, p < .001) and job satisfaction (r = .54, p < .001). The known-group validity was evaluated by comparing the reward scales according to age, clinical career, income level and hospital type. The scale was found to be reliable with a Cronbach’s α of .89.
Conclusion
Both the validity and reliability of the reward scale for hospital nurses are verified, which can enhance the understanding of the range of rewards and may assist nurse managers in establishing an effective reward system.

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Optimized nursing management in the Central Sterile Supply Department and Gastroenterology Department: a retrospective controlled study
Dali Wang
American Journal of Translational Research.2024; 16(12): 7480. CrossRef

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Development and Validation of a Dignity in Care Scale of Terminally Ill Patients for Nurses: Yun Sil Ahn, Pok Ja Oh; J Korean Acad Nurs 2023;53(3):340-358. Published online June 30, 2023; DOI: https://doi.org/10.4040/jkan.23039

Abstract PDF

Purpose
This study aimed to develop an instrument to showcase Dignity in Care of Terminally Ill Patients for Nurses and to examine its validity and reliability.
Methods
A total of 58 preliminary items on dignity in care of terminally ill patients for nurses were selected using content validity analysis and expert opinions on 97 candidate items derived through a literature review and qualitative focus group interviews. Questionnaires were administered to 502 nurses caring for terminally ill cancer patients at hospice and palliative care institutions. The data were analyzed using item analysis, exploratory and confirmatory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity, reliability was tested using Cronbach’s alpha.
Results
The final instrument consisted of 25 items, with four factors identified through confirmatory factor analysis. Four factors-ethical values and moral attitudes, interaction-based communication, main-taining comfort, professional insight and competence–accounted for 61.8% of the total variance. Cronbach’s ⍺ for total items was .96, and test-retest reliability of intraclass correlation coefficient was .90.
Conclusion
Since its validity and reliability have been verified through various methods, the Dignity in Care Scale of Terminally Ill Patients for Nurses can be used for develop nursing interventions and improve dignity in care of terminally ill patients.

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Cultural adaptation and psychometric validation of the Korean version of the Intensive care unit Dignified Care Questionnaire (IDCQ)
Sejin Kang, So Hyun Park, Youn-Jung Son
BMC Nursing.2026;[Epub] CrossRef
Development and Psychometric Testing of the Nurses’ Professional Dignity Scale
Michela Piredda, Maddalena De Maria, Rosario Caruso, Anna Marchetti, Giorgia Petrucci, Anna Cerra, Joyce J. Fitzpatrick, Alessandro Stievano
Nursing Reports.2025; 15(4): 127. CrossRef
Concept Analysis of Compassionate Care among Nurses: A Hybrid Model
Ae Kyung Chang, Jin Ah Kim, Yu Kyung Jin, Woo Jung Hong, Yeon Kyung Cho, Ah Young Kim
Journal of Korean Academy of Fundamentals of Nursing.2025; 32(2): 275. CrossRef
Dignity in Care of Older Patients with Cancer in Korea: A Hybrid Model Concept Analysis
Yun Sil Ahn, Pok-Ja Oh, Gye Jeong Yeom
Healthcare.2025; 13(22): 2935. CrossRef
Development and Validation of a Dignity in Care Scale of Terminally Ill Patients for Nurses
Yun Sil Ahn, Pok Ja Oh
Journal of Korean Academy of Nursing.2023; 53(3): 340. CrossRef

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The Reliability and Validity of the Korean Version of the 5C Psychological Antecedents of Vaccination Scale: SuYeon Bae, HeeJu Kim; J Korean Acad Nurs 2023;53(3):324-339. Published online June 30, 2023; DOI: https://doi.org/10.4040/jkan.23021

Abstract PDF

Purpose
This study aimed to valuate the reliability and validity of the Korean version of the 5C Psychological Antecedents of Vaccination (K-5C) scale.
Methods
The English version of the 5C scale was translated into Korean, following the World Health Organization guidelines. Data were collected from 316 community-dwelling adults. Content validity was evaluated using the content validity index, while construct validity was evaluated through confirmatory factor analysis. Convergent validity was examined by assessing the correlation with vaccination attitude, and concurrent validity was evaluated by examining the association with coronavirus disease 2019 (COVID-19) vaccination status. Internal consistency and test-retest reliability were also evaluated.
Results
Content validity results indicated an item-level content validity index ranging from .83 to 1, and scale-level content validity index, averaging method was .95. Confirmatory factor analysis supported the fit of the measurement model, comprising a five-factor structure with a 15-item questionnaire (RMSEA = .05, SRMR = .05, CFI = .97, TLI = .96). Convergent validity was acceptable with a significant correlation between each sub-scale of the 5C scale and vaccination attitude. In concurrent validity evaluation, confidence, constraints, and collective responsibility of the 5C scale were significant independent predictors of the current COVID-19 vaccination status. Cronbach’s alpha for each subscale ranged from .78 to .88, and the intraclass correlation coefficient for each subscale ranged from .67 to .89.
Conclusion
The Korean version of the 5C scale is a valid and reliable tool to assess the psychological antecedents of vaccination among Korean adults.

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COVID-19 vaccine acceptance and 5C psychological antecedents amid the omicron surge in South Korea and China
Minjung Lee, Chenyuan Qin, Yubin Lee, Jie Deng, Myoungsoon You, Jue Liu
Vaccine.2025; 43: 126515. CrossRef
Comparative effectiveness of construal-level messaging in the COVID-19 Vaccine Injury Compensation Program in the Republic of Korea: a randomized controlled trial
Jihyun Moon, Se-Hoon Jeong, Young June Choe, Cho Ryok Kang, Taemi Kim, Dooyoung Kim, Jong-Koo Lee
Osong Public Health and Research Perspectives.2025; 16(5): 486. CrossRef
Discriminative Cut-Offs, Concurrent Criterion Validity, and Test–Retest Reliability of the Oxford Vaccine Hesitancy Scale
Jonathan Kantor, Samantha Vanderslott, Michael Morrison, Robert C. Carlisle
Vaccines.2025; 13(12): 1200. CrossRef

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The Effect of Socioeconomic Status to Depression of Perimenopause Women: Pathway Analysis Using the Reserve Capacity Model: Mi-Ran Park, Hye Seung Choi, Ju-Young Lee; J Korean Acad Nurs 2023;53(2):249-259. Published online April 30, 2023; DOI: https://doi.org/10.4040/jkan.22133

Abstract PDF

Purpose
Based on the Reserve Capacity Model, this study investigated the effects of pre- and postmenopausal women’s socioeconomic status (SES) on depression, focusing on the mediating effects of self-esteem, happiness, and family relationship satisfaction with social network relationships.
Methods
This cross-sectional study involved secondary analysis of national data on 771 perimenopause women gathered from the 16th Korea Welfare Panel Study (KOWEPS) 2021. A path analysis model was constructed to evaluate the relationship between SES, social network satisfaction, self-esteem, perceived health status, and depression. Data were analyzed using ADANCO 2.3.1 and Mplus 8.4.
Results
Although SES had no direct effect on depression, it did affect depression through self-esteem, happiness, and satisfaction with family relationships.
Conclusion
The findings of this study indicate that perimenopausal women’s personal resources—psychosocial variables such as self-esteem and happiness—had a higher effect on depression than tangible reserves like SES. Therefore, interventions for enhancing self-esteem and happiness may prevent depression in perimenopausal women effectively.

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Effects of Socioeconomic Status on the Health of Menopausal Mothers in Multicultural Families in Korea: A Test of the Reserve Capacity Model
Miran Park, Ju-Young Lee
Journal of Immigrant and Minority Health.2025; 27(2): 277. CrossRef

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Development and Psychometric Evaluation of the Ischemic Stroke Distress Scale (ISDS): Jaejin Kang, Yang-Sook Yoo; J Korean Acad Nurs 2023;53(1):12-27. Published online February 28, 2023; DOI: https://doi.org/10.4040/jkan.22090

Abstract PDF: Purpose
This study aimed to develop a scale to measure distress in patients with ischemic stroke and verify its validity and reliability.
Methods
Preliminary items were developed from literature review and in-depth interviews. The final preliminary scale was confirmed through a content validity test of eight experts and a preliminary survey of 10 stroke patients. The participants for psychometric testing were 305 stroke patients in the outpatient clinic. Validity and reliability analyses included item analysis, exploratory and confirmatory factor analysis, convergent validity, known-group validity, and internal consistency of the scale.
Results
The final scale consisted of 17 items and 3 factors. The three distinct factors were ‘self-deprecation, worry about future health, and withdrawal from society’ and this structure was validated using a confirmatory factor analysis. Convergent validity was supported by comparison with the Center for Epidemiologic Studies Depression Scale (r = .54, p < .001) and Brief Illness Perception Questionnaire (r = .67, p < .001). Known-groups validity was verified by dividing groups according to ‘duration since diagnosis’ (t = 2.65, p = .009), ‘presence of sequela’ (t = 10.16, p < .001), and ‘awareness of distress’ (t = 12.09, p < .001). The internal consistency of the scale using Cronbach’s α for the total items was .93.
Conclusion
The Ischemic Stroke Distress Scale is a valid and reliable tool that reflects stroke distress effectively. It is expected to be used as a basic tool to develop various intervention strategies to reduce distress in ischemic stroke patients.

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The Reliability and Validity of Korean Version of the Infertility Stigma Scale (K-ISS): Miok Kim, Minkyung Ban; J Korean Acad Nurs 2022;52(6):582-597. Published online December 31, 2022; DOI: https://doi.org/10.4040/jkan.22068

Abstract PDF

Purpose
This study aimed to translate the Infertility Stigma Scale (ISS) into Korean and to evaluate its reliability and validity in the Korean context.
Methods
Data were collected from 350 women who underwent in vitro fertilization (IVF). Data were analyzed using SPSS WIN 25.0 and AMOS 22.0. Content validity was analyzed using the item-level content validity index (I-CVI) and scale-level content validity index/averaging (S-CVI/Ave). The preliminary survey was conducted on 20 women who had experienced IVF at least once to check the level of understanding of the tool and the time required to fill out the questionnaire. Exploratory and confirmatory factor analyses were used to test construct validity. Additionally, hypothesis-testing construct validity were tested. Cronbach’s α was used to assess the reliability.
Results
The Korean-ISS (K-ISS) consists of 25 items, excluding two items from the original ISS questionnaire. Exploratory factor analysis identified four factors, which explained 75.6% of the total variance. The four distinct factors were infertility stigma with self-devaluation (56.8%), public stigma (8.1%), social withdrawal (6.5%), and family stigma (4.2%). In the confirmatory factor analysis, the 25 items in the four-factor structure were validated (χ² /df ≤ 3, RMSEA ≤ 10). The hypothesis-testing construct validity of K-ISS against FPI (r = .58∼.71, p < .001) and FQI (r = - .49∼- .65, p < .001) was tested and found to be significant. The internal consistency reliability of the K-ISS, assessed using Cronbach’s α, was .97.
Conclusion
The K-ISS has satisfactory construct validity and reliability; therefore, it can help minimize the negative impact of stigma by measuring the stigma associated with women experiencing infertility.

Citations

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Effects of Uncertainty on Depression in Women Undergoing Assisted Reproductive Technology: The Mediating Role of Perceived Stigma and the Moderated Mediation by Spousal Support
Miok Kim
Nursing & Health Sciences.2026;[Epub] CrossRef
Development and validation of the infertility stigma scale short form (ISS-SF): A cross-sectional study
Rong Li, Lan Luo, Nan Qin, Minhui Guan, Enuo Peng, Jia Qu, Guangpeng Wang, Shujuan Zhu, Dan Liu, Shuju Wei, Bing Fu, Jun Lei
Journal of Psychosomatic Research.2025; 194: 112160. CrossRef

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The Validity and Reliability of the Korean Version of Readiness for Practice Survey for Nursing Students: Tae Wha Lee, Yoonjung Ji, Yea Seul Yoon; J Korean Acad Nurs 2022;52(6):564-581. Published online December 31, 2022; DOI: https://doi.org/10.4040/jkan.22032

Abstract PDF

Purpose
This study aimed to evaluate the validity and reliability of the Korean version of the Readiness for Practice Survey (K-RPS).
Method
The English Readiness for Practice Survey was translated into Korean using the Translation, Review, Adjudication, Pretesting, and Documentation (TRAPD) method. Secondary data analysis was performed using the dataset from the New Nurse e-Cohort study (Panel 2020) in South Korea. This study used a nationally representative sample of 812 senior nursing students. Exploratory and confirmatory factor analyses were also conducted. Convergent validity within the items and discriminant validity between factors were assessed to evaluate con-struct validity. Construct validity for hypothesis testing was evaluated using convergent and discriminant validity. Ordinary α was used to assess reliability.
Results
The K-RPS comprises 20 items examining four factors: clinical problem solving, learning experience, professional responsibilities, and professional preparation. Although the convergent validity of the items was successfully verified, discriminant validity between the factors was not. The K-RPS construct validity was verified using a bi-factor model (CMIN/DF 2.20, RMSEA .06, TLI .97, CFI .97, and PGFI .59). The K-RPS was significantly correlated with self-esteem (r = .43, p < .001) and anxiety about clinical practicum (r = - .50, p < .001). Internal consistency was reliable based on an ordinary α of .88.
Conclusion
The K-RPS is both valid and reliable and can be used as a standardized Korean version of the Readiness for Practice measurement tool.

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Readiness for Practice among Senior Nursing Students in South Korea: A Cross-sectional Study
Jihye Kim, Kyungmi Lee, Hye Suk Jun
Journal of Korean Academy of Nursing Administration.2025; 31(1): 54. CrossRef
Readiness for Practice Among Nursing College Graduates: A Cross-Sectional Correlation Study
Kim Jihye, Lee Kyungmi
SAGE Open Nursing.2025;[Epub] CrossRef
The Moderating Effect of Grit on Nursing Education Satisfaction and Readiness for Practice Among Nursing Graduates During COVID-19: A Cross-Sectional Study
Lee Kyungmi, Kim Jihye
Pacific Rim International Journal of Nursing Research.2025; 29(4): 862. CrossRef
The influence of nursing informatics competency, clinical practice self efficacy, and grit on clinical practice readiness of nursing students
Hae Ok Kim
The Journal of Korean Academic Society of Nursing Education.2025; 31(4): 440. CrossRef
The mediating effect of transition shock on the relationship between readiness for practice and turnover intention of new graduate nurses in South Korea: A longitudinal study
Taewha Lee, Eunkyung Kim, Yoonjung Ji
Nurse Education Today.2024; 143: 106394. CrossRef

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Incidence and Risk Factors of Dyslipidemia after Menopause: Ihn Sook Jeong, Hae Sun Yun, Myo Sung Kim, Youn Sun Hwang; J Korean Acad Nurs 2022;52(2):214-227. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21188

Abstract PDF

Purpose
This study was aimed at investigating the incidence and risk factors of dyslipidemia in menopausal women using a Korean community-based longitudinal study.
Methods
The subjects were 245 postmenopausal women without dyslipidemia who had participated in the Ansan-Ansung cohort study from 2001~2002 (baseline) to 2015~2016 (seventh follow-up visit). The dyslipidemia incidence was measured as incidence proportion (%) and incidence rate per 100 person-years. The predictors of developing dyslipidemia were analyzed with Cox’s proportional hazard model.
Results
The incidence of new dyslipidemia during the follow-up period was 78.4% (192 patients), and 11.9 per 100 person-years. Mean duration from menopause to developing dyslipidemia was 5.3 years in new dyslipidemia cases. The triglyceride/high density lipoprotein (TG/HDL-C) ratio at baseline (hazard ratio = 2.20; 95% confidence interval = 1.39~3.48) was independently associated with developing dyslipidemia.
Conclusion
Dyslipidemia occurs frequently in postmenopausal women, principally within five years after menopause. Therefore, steps must be taken to prevent dyslipidemia immediately after menopause, particularly in women with a high TG/HDL-C ratio at the start of menopause.

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Comparison of the 5-Year Incidence of Dyslipidemia in the Obese and Nonobese Adult Population: Results of the Yazd Health Study (YaHS)
Parisa Peigan, Masoud Mirzaei, Pedro Marques-Vidal, Mohammadtaghi Sarebanhassanabadi
Advanced Biomedical Research.2026;[Epub] CrossRef
Middle-aged Korean women’s experiences of physical activity during the transition to menopause: a grounded theory approach
Hee Jung Cho, Sukhee Ahn
Women's Health Nursing.2025; 31(3): 215. CrossRef
Middle-aged women’s experiences of physical activity for managing menopausal symptoms: a phenomenological study
Hee Jung Cho, Sukhee Ahn
Korean Journal of Women Health Nursing.2023; 29(2): 104. CrossRef
Relationship between sleep duration and prevalence of hypertension among Korean postmenopausal middle-aged women
Eun Young Hong, Hye Ja Gu
Korean Journal of Health Education and Promotion.2023; 40(5): 43. CrossRef
Identification of subgroups with poor lipid control among patients with dyslipidemia using decision tree analysis: the Korean National Health and Nutrition Examination Survey from 2019 to 2021
Hee Sun Kim, Seok Hee Jeong
Journal of Korean Biological Nursing Science.2023; 25(2): 131. CrossRef

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Validity and Reliability of the Korean Version of the Couple Satisfaction Index: Suk-Sun Kim, Minji Gil, Daeun Kim, Sunhai Kim, Dayeon Heo, Nan Young Moon; J Korean Acad Nurs 2022;52(2):228-227. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21177

Abstract PDF

Purpose
The study aimed to translate the Couple Satisfaction Index (CSI 32) into Korean, to evaluate the reliability and validity of CSI 32 and short-form (CSI 16, 4) in the Korean context, and to determine a cut-off score for Korean couples.
Methods
Korean Versions of the Couple Satisfaction Index (K-CSI) 32 was translated, back-translated, and reviewed by five bilingual experts. Confirmatory factor analysis (CFA) was conducted with data from a sample of 218 couples (N = 436) to test construct validity. Validity and reliability were evaluated. The receiver’s operating characteristics curve analysis was used to obtain the cut-off score.
Results
The construct validities of K-CSI 32, 16, and 4 were verified using one-factor structures. The results of CFA showed a slightly better fit for K-CSI 16 and 4 than for K-CSI 32. Convergent validity was supported by significant positive correlations of K-CSI with Kansas Marital Satisfaction Scale, Dyadic Adjustment Scale, and Family Relationship Assessment Scale. Moreover, the significant differences in K-CSI between normal and depressive group demonstrated known-group validity. Cut-off scores of 105.5 on K-CSI 32, 50.25 on K-CSI 16, and 13.25 on K-CSI 4 were validated to identify distressed couple relationships.
Conclusion
For clinical practice, the reliable and valid K-CSI 32 has the potential to measure changes in couple satisfaction after couple therapy or interventions. Applying K-CSI 32 may facilitate research on couple and family relationships in nursing and contribute to the discussion on the role of couple satisfaction in mental health.

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Mediating Effects of Parental Family Adaptation on the Quality of Life of Children With Down Syndrome: A Study of Father–Mother Dyads
Seung Hyeon Yang, Chang Gi Park, Eun Kyoung Choi
Journal of Advanced Nursing.2025;[Epub] CrossRef
Online coaching blended couple‐oriented intervention for preventing depression among Korean middle adulthood: A feasibility study
Minji Gil, Suk‐Sun Kim, Daeun Kim, Sunhai Kim
Family Process.2023; 62(4): 1478. CrossRef

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The Development of a Tool for Assessment of Spiritual Distress in Cancer Patients: Jin Sook Kim, Il-Sun Ko, Su Jin Koh; J Korean Acad Nurs 2022;52(1):52-65. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21120

Abstract PDF

Purpose
This study was conducted to develop a scale to measure spiritual distress in cancer patients.
Methods
A total of 69 preliminary items for the spiritaul distress assessment tool (SDAT) were compiled, based on a literature review, selection of empirically relevant items through concept analysis of hybrid models, confirmation of content validity by experts, cognitive interviews, and a pretest. Self-administered questionnaires were collected between April 1 and July 31, 2018, from 225 cancer patients at four medical institutions and one nursing home. The data were analyzed using item analysis, exploratory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity. Reliability was tested by Cronbash’s α coefficient.
Results
The final version of the SDAT consisted of 20 items. Five-factors, loss of peace, burden of family, avoidance of confronting death, guilt and remorse, regret for not being able to apololgize and forgive were extracted, and showed 62.8% of total variance. The factors were confirmed through convergent and discriminant validity. Criterion validity was confirmed by functional assessment chronic illness therapy spiritual well-being scale 12 (FACIT-Sp12). The overall Cronbach’s α was .91, and the coefficients of each subscale ranged from .78~.83.
Conclusion
The SDAT for cancer patients is valid and reliable. It is suggested that the tool can be used to measure spiritual distress in cancer patients.

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Development of a measurement of doctor-patient communication quality scale
Jiayi Shao, Minhui Wen, Yuqing Zhang, Liping Zhang, Jiangjie Sun
Frontiers in Public Health.2025;[Epub] CrossRef
Validity and reliability of the integrated palliative care outcome scale (IPOS) in Korea: a multicenter study of terminally ill cancer patients
So-Jung Park, Yujin Park, Mira Han, Sun-Hyun Kim, In Cheol Hwang, Go-un Woo, Yoo Jeong Lee, Young Sung Kim, Hyun Jung Jho, Yoon Jung Chang
BMC Palliative Care.2024;[Epub] CrossRef
Family caregivers’ perceived value of caring for older patient: A hybrid model of concept analysis
Seon-Hye Heo, Hye-Ryoung Kim
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Incidence and Predictors of Cataract among People with Type 2 Diabetes Mellitus: Using Secondary Data Analysis from the Ansan Cohort of the Korean Genome and Epidemiology Study: Ihn Sook Jeong, Eun Joo Lee, Myo Sung Kim, Jung Ok Yu, Hae Sun Yun, Jeong Hee Jeong, Youn Sun 6 Hwang; J Korean Acad Nurs 2022;52(1):24-35. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21081

Abstract PDF

Purpose
This study investigated the incidence and risk factors of cataract in people with diabetes mellitus (DM) using data from Ansan cohort of the Korean Genome and Epidemiology Study (KoGES).
Methods
Data from a total of 329 patients with type 2 DM without cataract who participated in Ansan cohort of the KoGES from baseline survey (2001–2002) to fifth follow-up visit (2011–2012) were examined. The characteristics of the subjects were analyzed with frequency and percentage, and mean and standard deviation. Cataract incidence was measured as incidence proportion (%). For risk factors of cataract, hazard ratio (HR) and 95% confidence interval (CI) were obtained using the Cox proportional hazard model.
Results
The cataract incidence over a 10-year follow-up period was 19.1% (15.1 in males and 25.8 in females), and mean age at the incidence of cataract was 63.48 years (61.58 years in males and 65.31 years in females). Age (HR=1.09, 95% CI=1.05–1.13) and HbA1c (HR=1.21, 95% CI=1.07–1.37) or the duration of DM (HR=1.05, 95% CI=1.00–1.09) were found to be independently associated with cataract development.
Conclusion
Cataract development in people with DM is common, and its likelihood increases with age, HbA1c, and the duration of DM. Considering negative effect of cataract on their quality of life and economic burden, nurses should identify people with DM at a higher risk of cataract development, and plan individual eye examination programs to detect cataract development as early as possible.

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Validity and Reliability of the Turkish Version of the COVID Stress Scale: Demirgöz Bal Meltem, Dişsiz Melike, Bayri Bingöl Fadime; J Korean Acad Nurs 2021;51(5):525-536. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21106

Abstract PDF

Purpose
The aim of this study was to assess the Turkish adaptation of the COVID Stress Scale (CSS) on the basis of determining the stress caused by the coronavirus disease (COVID-19) pandemic, and to test its validity and reliability.
Methods
The English CSS was translated into Turkish using forward and backward translation. Data were collected online from 360 participants. Construct validity was evaluated using confirmatory factor analysis, exploratory factor analysis, and content validity. Pearson product-moment correlation, Cronbach’s alpha reliability coefficient, and test-retest methods were used to evaluate reliability.
Results
The Turkish version of the CSS has 36 items consistent with the original scale and has five factors: COVID danger and contamination, socioeconomic consequences of COVID, COVID xenophobia, traumatic stress due to COVID, and compulsive checking for COVID. The construct validity of the Turkish version of the CSS was verified by the adjusted goodness of fit index > .85, and comparative fit index > .95. The content validity index of each item was 91%. The corrected item-total correlations of the scale ranged from .51 to .89. Internal consistency was reliable, with a Cronbach’s α of .93.
Conclusion
The Turkish version of the CSS is valid and reliable. It can be used as a measurement tool for the assessment of COVID-related stress.

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Psychometric evaluation and item response theory analysis of the COVID Stress Scales in an older adult population
Kylie A. Arsenault, Ying C. MacNab, Gordon J. G. Asmundson, Thomas Hadjistavropoulos
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Validity and Reliability of Korean Version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale: Sook-Nam Kim, Hyun-Ju Lee, So-Young Kim, Nayoon Lee; J Korean Acad Nurs 2021;51(5):617-629. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21069

Abstract PDF

Purpose
The aim of this study was to examine the validity and reliability of the Korean version of the self-efficacy for managing chronic disease 6-item scale (SECD-6-K).
Methods
The English version of the Self-Efficacy for Managing Chronic Disease 6-item Scale first underwent forward and backward translation procedures. The SECD-6-K was then used to collect data from 350 adults diagnosed with chronic diseases. Content, construct, convergent, discriminant, and criterion validity were all evaluated. Reliability was assessed using Cronbach’s α. SPSS 25.0 and the data were analyzed using AMOS 26.0 software.
Results
The SECD-6-K consists of six items in two domains: disease management and health behavior. The results for construct, convergent, and discriminant validity were good. Exploratory factor analysis produced eigen values between 2.27 and 3.28, with factors total explained cumulative variance of 91.1%. Confirmatory factor analysis supported goodness of fit and reliability for the modified SECD-6-K model. The criterion validity also showed significant correlation with both the Patient Health Questionnaire and 12-item Short-Form Health Survey version 2. Finally, reliability was found to be excellent.
Conclusion
This study identified the high reliability and validity of SECD-6-K. The SECD-6-K is an appropriate tool for determining Korean patients’ self-efficacy in managing their chronic conditions. Therefore, this scale may be used in clinical settings as well as in educational and research settings.

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Validity and Reliability of the Korean Version of Person-Centered Practice Inventory–Staff for Nurses: Sohyun Kim, Sunghee H Tak; J Korean Acad Nurs 2021;51(3):363-379. Published online June 30, 2021; DOI: https://doi.org/10.4040/jkan.21027

Abstract PDF

Purpose
The purpose of this study was to evaluate the validity and reliability of the Korean version of Person-Centered Practice Inventory– Staff (PCPI-S) for nurses.
Methods
The English PCPI-S was translated into Korean with forward and backward translation. Data were collected from 338 nurses at one general hospital in Korea. Construct validity was evaluated with confirmatory factor analysis, convergent validity, and discriminant validity. Known-group validity was also evaluated. Cronbach’s α was used to assess the reliability.
Results
The PCPI-S Korean version consisted of 51 items in three areas: prerequisites, the care environment, and person-centered process. The comparative fit index (CFI) and values of person-centered care process were improved after engagement and having sympathetic presence items were combined as one component. The construct validity of PCPI-S Korean version was verified using four-factor structures (.05 < RMSEA < .10, AGFI > .70, CFI > .70, and AIC). The convergent validity and discriminant validity of the entire PCPI-S question were verified using a two-factor structures (AVE > .50, construct reliability > .70). There was an acceptable known-group validity with a significant correlation between the PCPI-S level and the degree of person-centered care awareness and education. Internal consistency was reliable with Cronbach’s α .95.
Conclusion
The Korean version of PCPI-S is valid and reliable. It can be used as a standardized Korean version of person-centered care measurement tool. Abbreviation: RMSEA = root mean square error of approximation; AGFI = adjusted goodness of fit index; AIC = Akaike information criterion; AVE = average variance extracted.

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Psychometric validation and cultural adaptation of the family-centered care Questionnaire-Revised for use among nurses in Saudi Arabia
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Cross-cultural adaptation and validation of the Person-centered Practice Inventory-Staff for Brazilian culture
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Adaptação transcultural e validação do Person-centred Practice Inventory-Staff para a cultura brasileira
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Development of a Positive Nursing Organizational Culture Measurement Tool: Mi Jung Kim, Jong Kyung Kim; J Korean Acad Nurs 2021;51(3):305-319. Published online June 30, 2021; DOI: https://doi.org/10.4040/jkan.21014

Abstract PDF

Purpose
The purpose of this study was to develop a measurement tool for a positive nursing organizational culture and to verify its reliability and validity.
Methods
A conceptual framework and construct factors were extracted through an extensive literature review and indepth interviews with nurses. The final version of the preliminary tool for the main survey was confirmed by experts through a content validity test and a preliminary survey of 40 nurses. Subsequently, the final tool was developed using a validity and reliability test containing 43 preliminary items. The final version of the tool was used with 327 hospital nurses in the testing phase for the main survey to assess validity and reliability.
Results
From the factor analysis, 4 factors and 26 items were selected. The factors were positive leadership of the nursing unit manager, pursuit of common values, formation of organizational relationships based on trust, and a fair management system. The entire determination coefficient was 67.7%. These factors were verified through convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (Cronbach’s α = .95).
Conclusion
Both the validity and reliability of the scale were confirmed demonstrating its utility for measuring positive nursing organizational culture. It is expected to be used for education, research, and practical performance policies regarding the nursing organizational culture.

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Original Article

Development of a Coping Scale for Infertility-Women (CSI-W): Miok Kim, Jung-Mi Ko; J Korean Acad Nurs 2020;50(5):671-685. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.20038

Abstract PDF

Purpose
The purpose of this study was to develop a Coping Scale for Infertility-Women (CSI-W).
Methods
The initial items were based on an extensive literature review and in-depth interviews with seven infertile women. Forty-three items were derived from a pilot survey. Data were collected from 216 women who had experienced intrauterine insemination (IUI) and in-vitro fertilization (IVF) more than once. The data were analyzed to verify the reliability and validity of the scale.
Results
Seven factors containing 28 items (four factors containing 17 items for active coping and three factors containing 11 items for passive coping) were extracted from the exploratory factor analysis to verify the construct validity. The four factors of active coping were confrontation, self-control, seeking social support (spouse), and seeking social support (colleagues and experts). The three factors of passive coping were distancing, escape, and avoidance. These items were verified through convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (active coping: Cronbach’s a = .78; passive coping: Cronbach’s a = .81).
Conclusion
As its validity and reliability have been verified through various methods, the CSI-W can contribute to assessing the coping strategies of infertile women.

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Factors Influencing the Intention for Continual Fertility Treatments by the Women Undergoing Assisted Reproductive Technology Procedures: A Cross-Sectional Study
Miok Kim, Minkyung Kim, Minkyung Ban
Journal of Korean Academy of Nursing.2024; 54(1): 59. CrossRef
Design and psychometric evaluation of the collaborative coping with infertility questionnaire in candidate of assisted reproductive techniques
Marzie Reisi, Ashraf Kazemi
Scientific Reports.2024;[Epub] CrossRef
Types and Characteristics of Stress Coping in Women Undergoing Infertility Treatment in Korea
Yumi Choi, So-Hyun Moon
International Journal of Environmental Research and Public Health.2023; 20(3): 2648. CrossRef

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Invited Paper

Analysis of Research Topics and Trends in the Journal of Korean Academy of Nursing to Improve Its International Influence: Soyoung Yu, Jeung-Im Kim, Jin-Hee Park, Sun Joo Jang, Eunyoung E. Suh, Ju-Eun Song, YeoJin Im; J Korean Acad Nurs 2020;50(4):501-512. Published online August 31, 2020; DOI: https://doi.org/10.4040/jkan.20167

Abstract PDF

Purpose
The purpose of this study was to analyze articles published in the Journal of the Korean Academy of Nursing (JKAN) between 2010 and 2019, along with those published in three international nursing journals, to improve JKAN’s international reputation.
Methods
The overall characteristics of JKAN’s published papers and keywords, study participants, types of nursing interventions and dependent variables, citations, and cited journals were analyzed. Additionally, the keywords and study designs, publication-related characteristics, journal impact factors (JIF), and Eigenfactor scores of International Journal of Nursing Studies (IJNS), International Nursing Review (INR), Nursing & Health Sciences (NHS), and JKAN were analyzed and compared.
Results
Among the four journals, JKAN’s score was the lowest in both the journal impact factor and Eigenfactor score. In particular, while the JIF of INR and NHS has been continuously increasing; JKAN’s JIF has remained static for almost 10 years. The journals which had cited JKAN and those which JKAN had cited were mainly published in Korean.
Conclusion
JKAN still has a low IF and a low ranking among Social Citation Index (E) journals during the past 10 years, as compared to that of four international journals. To enhance JKAN’s status as an international journal, it is necessary to consider publishing it in English and to continuously improve the conditions of other publications.

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Ten-year trends in research designs and keywords: a bibliometric comparison of the Journal of Korean Academy of Nursing and leading international nursing journals
Jin-Hee Park, Hyun Kyoung Kim, Gaeun Kim, Sun Hyoung Bae
Journal of Korean Academy of Nursing.2025; 55(4): 557. CrossRef
Commemorating the 50th Anniversary of Korean Society of Nursing Science and Contemplating Direction to Move Forward
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Journal of Korean Academy of Nursing.2020; 50(5): 641. CrossRef

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Original Articles

Validity and Reliability of the Korean Version of the Menopause-Specific Quality of Life: Jin-Hee Park, Sun Hyoung Bae, Young-Mi Jung; J Korean Acad Nurs 2020;50(3):487-500. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.20049

Abstract PDF

Purpose
This study aimed to evaluate the validity and reliability of the Korean version of Menopause-Specific Quality of Life (MENQOL).
Methods
The MENQOL was translated into Korean according to algorithm of linguistic validation process. A total of 308 menopausal womenwere recruited and assessed using the Korean version of MENQOL (MENQOL-K), the World Health Organization Quality of Life BriefVersion (WHOQOL-BREF), and Center for Epidemiological Studies Depression Scale (CES-D-K). In estimating reliability, internal consistencyreliability coefficients were calculated. Validity was evaluated through criterion validity and construct validity with confirmatory factor analysesusing SPSS 23.0 and AMOS 25.0 software.
Results
In item analyses, the “increased facial hair” symptom was excluded because of thelow contribution of MENQOL-K. The confirmatory factor analysis supported good fit and reliable scores for MENQOL-K model, and thefour-factor structure was validated (x²=553.28, p <.001, NC=1.84, RMSEA=.05, AGIF=.85, AIC=765.28). The MENQOL-K consists of 28 itemsin 4 domains, including vasomotor (3 items), psychosocial (7 items), physical (15 items), and sexual subscales (3 items). There was an acceptablecriterion validity with moderately significant correlation between MENQOL-K and WHOQOL-BREF. The Cronbach’s a for the 4subsacles ranged from .80 to .93.
Conclusion
The MENQOL-K is a valid and reliable scale to measure condition-specific quality of life forperimenopausal and postmenopausal women. It can be used to assess the impact of menopausal symptoms on the quality of life of Koreanwomen in clinical trials.

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Ideal Cardiovascular Health Metrics and Risk of Incident Early-Onset Vasomotor Symptoms Among Premenopausal Women
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Development of Job-Esteem Scale for Korean Nurses: Hyun Ju Choi, Kwuy Im Jung; J Korean Acad Nurs 2020;50(3):444-458. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.19209

Abstract PDF

Purpose
The purpose of this study was to develop the Job Esteem Scale for Korean Nurses (JES-KN) and verify its validity and reliability.
Methods
Preliminary items were based on the attributes and indicators elicited from a concept analysis study on Korean nurses’ job-esteem.The final preliminary tool for the main survey was confirmed through the content validity test of 10 experts and preliminary surveyof 20 hospital nurses. The final preliminary scale was used on 350 hospital nurses in the scale testing phase for the main survey designedto test the validity and reliability of the scale.
Results
The final scale consisted of 28 items and 6 factors, these factor explained 66.6% ofthe total variance. The correlation between the total score and factors ranged from .64 and .84, validating that each sub-factor is suitableto explain job esteem. The correlation coefficient between this scale and the Job Satisfaction Scale for Clinical Nurses ranged from .41 to.70, and the internal consistency for the scale using Cronbach’s a for the total items was .94.
Conclusion
The JES-KN is a valid and reliabletool that reflects the reality of clinical sites accordingly. The JES-KN may well be used effectively to assess and evaluate the job esteem ofKorean nurses.

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Cong Guo, Chunlin Zhang, Cuizhu Zhou, Mengqi Zhu, Lingling Chen, Youran Liu, Yequn Zhang, Jie Wang, Tengfei Liang
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The Influence of Ethical Atmosphere and Job‐Esteem on Moral Courage in Psychiatric Nurses
Yan Li, XiangDan Shen, Haishan Quan, Ying Li, Jianhua Li, Zhenzhen Zhang, Xinyang Xing
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Development of a Scale for Alcohol Drinking Prevention Behavior in Early Elementary School Based on Ajzen’s Theory of Planned Behavior: Younkyoung Kim, Chong Mi Lee, Seo Young Kang; J Korean Acad Nurs 2020;50(2):210-227. Published online April 30, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.2.210

Abstract PDF

Purpose
This study aimed to develop a scale to measure variables related to alcohol drinking prevention behavior in early elementary school, based on the theory of planned behavior.
Methods
A scale was developed to measure variables related to alcohol drinking prevention behavior. Initial items for direct evaluation were constructed through a literature review, and those for belief-based indirect measure were generated through interviews with 30 second- and third-grade elementary school students. The collected data from 286 third-grade elementary school students were then subjected to item analysis, exploratory and confirmative factor analysis, criterion-related validity testing, and internal consistency assessment.
Results
The final scale consisted of 35 items. Intention, attitudes, subjective norms, and perceived behavioral control explained 82.7% of the variance; behavioral beliefs, normative beliefs, and control beliefs explained 65.6% of the variance; and evaluation of outcome, motivation to comply, and power of control beliefs explained 72.8% of the variance. The confirmatory factor analysis indicated that the theoretical models had a satisfactory goodness of fit. Criterion-related validity was confirmed between the direct evaluation variables and the indirect measure variables (attitudes r=.64, p <.001; subjective norms r=.39, p <.001; perceived behavioral control r=.62, p <.001). Cronbach’s a was .89 for the direct evaluation variables and .93 for the indirect measure variables.
Conclusion
The scale developed in this study is valid and reliable. It could be used to measure and explain variables related to alcohol drinking prevention behavior in early elementary school.

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Development of a Web-Based Alcohol Prevention Program Linking School-Child-Family for Intermediate Elementary Students
Younkyoung Kim, Chong Mi Lee, Seo Young Kang, Hyunju Yang
Journal of Health Communication.2023; 28(2): 102. CrossRef
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Younkyoung Kim, Chong Mi Lee, Seo Young Kang
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Seungmi Park, Insun Jang, Soo-Young Yu
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Development and Validation of the New Version of Spirituality Assessment Scale: Il-Sun Ko, Soyoung Choi, Jin Sook Kim; J Korean Acad Nurs 2020;50(1):132-146. Published online January 31, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.1.132

Abstract PDF

Abstract Purpose:

The purpose of this study was to develop a new version of Spirituality Assessment Scale (N-SAS) and verify its reliability and validity.

Methods:

The total of 59 preliminary items for the N-SAS were selected through a literature review, two rounds of experts’ content validation, cognitive interviews, and pre-tests. Verification of its reliability and validity was divided into two phases. In Phase I, questionnaires were collected from 219 adults. Reliability was tested using Cronbach’s alpha, validity with item analysis, and exploratory factor analysis. In Phase II, questionnaires developed based on the results of Phase I were collected from 225 adults. Reliability was tested using Cronbach’s alpha, validity with confirmatory factor analysis, and criterion validity.

Results:

The final version of the N-SAS comprised two dimensions (vertical and horizontal), four domains (relationship with God; meaning of life and self-integration; self-transcendence; and relationship with others, neighborhoods, and nature), and 44 items were identified. Total Cronbach’s α was .97; those of each subscale ranged from .79 to .98. N-SAS scores were positively correlated with the scores of Howden’s Spiritual Assessment Scale (r=.81, p<.001).

Conclusion

Findings suggest that the N-SAS can be used to measure spirituality in adults. The use of N-SAS is expected to facilitate perceiving patient’s spiritual needs and providing spiritual care.

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Jinsook Kim
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Kyung-Ah Kang, Shin-Jeong Kim
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Effects of Spouse-Participated Health Coaching for Male Office Workers with Cardiocerebrovascular Risk Factors: So Hee Kang, Seon Young Hwang; J Korean Acad Nurs 2019;49(6):748-759. Published online December 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.6.748

Abstract PDF

Purpose

This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers.

Methods

A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers' stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email.

Results

After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention.

Conclusion

To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.

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Eun Jin Kim, Seon Young Hwang
Journal of Korean Academy of Nursing.2024; 54(1): 44. CrossRef
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Path Analysis for Delirium on Patient Prognosis in Intensive Care Units: Sunhee Lee, Sun-Mi Lee; J Korean Acad Nurs 2019;49(6):724-735. Published online December 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.6.724

Abstract PDF

Purpose

This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model.

Methods

This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24.

Results

In the final model, admission via emergency department (B=.06, p=.019), age over 65 years (B=.11, p=.001), unconsciousness (B=.18, p=.001), dependent activities (B=.12, p=.001), abnormal vital signs (B=.12, p=.001), pressure ulcer risk (B=.12, p=.001), enteral nutrition (B=.12, p=.001), and use of restraint (B=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (B=.06, p=.038), hospital length of stay (B=5.06, p=.010), and discharge to another facility (not home) (B=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium.

Conclusion

The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.

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Does ICU admission dysphagia independently contribute to delirium risk in ischemic stroke patients? Results from a cohort study
Hongtao Cheng, Simeng Song, Yonglan Tang, Shiqi Yuan, Xiaxuan Huang, Yitong Ling, Zichen Wang, Xiaoying Tian, Jun Lyu
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Yul Ha Lee, Hye-Ja Park
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Delirium Experience of the Intensive Care Unit Patients
Jaeyeon Jung, Sujin Jang, Seonmi Jo, Sunhee Lee
Journal of Korean Academy of Nursing.2022; 52(2): 134. CrossRef
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Young Sook Roh
Intensive and Critical Care Nursing.2021; 62: 102954. CrossRef
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Heejeong Kim, Sun-Mi Lee
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Jiyeon Kang, Min Jeong Choi
Journal of Korean Critical Care Nursing.2021; 14(3): 141. CrossRef

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Development of the Patient Caring Communication Scale: Myoung Lyun Heo, Sook Bin Im; J Korean Acad Nurs 2019;49(1):80-91. Published online February 28, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.1.80

Abstract PDF

Purpose

This study attempted to develop a scale that measures the level of patients' recognition of the nurses' care, based on Watson's caring theory, and confirmed its reliability and validity.

Methods

The items were developed through a literature review and an expert content validity test. The questionnaires were administered to 285 inpatients of internal medicine and surgical units at two general hospitals. Construct validity was tested using exploratory and confirmatory factor analysis, and reliability was tested using Cronbach's alpha.

Results

This process resulted in a preliminary scale composed of 34 items; We used item analysis and five exploratory factor analyses, and consequently selected 14 items composed of three factors (respect, genuineness, and relationality). The confirmatory factor analysis verified the model fit and convergent and discriminant validity of the final items; criterion validity was confirmed with the positive correlation with the measurement scale of the patient-perceived quality of nursing . The overall scale reliability had a Cronbach's alpha of .92, which indicated internal consistency and reliability.

Conclusion

The developed scale showed content, construct, and criterion validity, and reliability, as well as convergent validity for each item and discriminant validity between the factors. This makes it suitable for use in a diverse range of future studies on nurse communication using structural equation models.

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Won Hee Jun
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Anabela Fonseca Pereira, Joaquim Escola, Vitor Rodrigues, Carlos Almeida
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Validity and Reliability of the Korean Version of the Watson Caritas Patient Score
SookBin IM, MiKyoung CHO, MyoungLyun HEO
Journal of Nursing Research.2020; 28(2): e80. CrossRef

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Development of the Korean Geriatric Loneliness Scale (KGLS): Si Eun Lee; J Korean Acad Nurs 2019;49(5):643-654. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.5.643

Abstract PDF

Abstract Purpose

The purpose of this study was to develop and psychometrically test the Korean Geriatric Loneliness Scale (KGLS).

Methods

The initial items were based on in-depth interviews with 10 older adults. Psychometric testing was then conducted with 322 community-dwelling older adults aged 65 or older. Content, construct, and criterion-related validity, classification in cutoff point, internal consistency reliability, and test-retest reliability were used for the analysis.

Results

Exploratory factor analysis showed three factors, including 15 items explaining 91.6% of the total variance. The three distinct factors were loneliness associated with family relationships (34.3%), social loneliness (32.4%), and a lack of belonging (24.9%). As a result of confirmatory factor analysis, 14 items in the three-factor structure were validated. Receiver operating characteristic analysis demonstrated that the KGLS’ cutoff point of 32 was associated with a sensitivity of 71.0%, specificity of 80.2%, and area under the curve of .83. Reliability, as verified by the test-retest intraclass correlation coefficient, was .89, and Cronbach's α was .90.

Conclusion

As its validity and reliability have been verified through various methods, the KGLS can contribute to assessing loneliness in South Korean older adults.

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Effects of an Integrated Physical Activity Program for Physically Inactive Workers - Based on the PRECEDE-PROCEED Model -: Hye-Jin Kim, Jina Choo; J Korean Acad Nurs 2018;48(6):692-707. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.6.692

Abstract PDF

Abstract Purpose

We aimed to examine the effects of an integrated physical activity (PA) program developed for physically inactive workers on the theoretical basis of the PRECEDE-PROCEED model.

Methods

Participants were 268 workers in three departments of L manufacturing unit in South Korea. The three departments were randomly allocated into integration (n=86) (INT), education (n=94) (ED), and control (n=88) (CT) groups. The INT group received self-regulation, support, and policy-environmental strategies of a 12-week integrated PA program, the ED group received self-regulation strategies only, and the CT group did not receive any strategies. After 12 weeks, process evaluation was conducted by using the measures of self-regulation (autonomous vs. controlled regulation), autonomy support, and resource availability; impact evaluation by using PA measures of sitting time, PA expenditure, and compliance; and outcome evaluation by using the measures of cardiometabolic/musculoskeletal health and presenteeism.

Results

Among process measures, autonomous regulation did not differ by group, but significantly decreased in the CT group (p=.006). Among impact measures, PA compliance significantly increased in the INT group compared to the CT group (p=.003). Among outcome measures, the changes in cardiometabolic/musculoskeletal health and presenteeism did not differ by group; however, systolic blood pressure (p=.012) and a presenteeism variable (p=.041) significantly decreased only in the INT group.

Conclusion

The integrated PA program may have a significant effect on increases in PA compliance and significant tendencies toward improvements in a part of cardiometabolic health and presenteeism for physically inactive workers. Therefore, occupational health nurses may modify and use it as a workplace PA program.

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Development of a Triage Competency Scale for Emergency Nurses: Sun Hee Moon, Yeon Hwan Park; J Korean Acad Nurs 2018;48(3):362-374. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.362

Abstract PDF

Abstract Purpose

This study aimed to develop a triage competency scale (TCS) for emergency nurses, and to evaluate its validity and reliability.

Methods

Preliminary items were derived based on the attributes and indicators elicited from a concept analysis study on triage competency. Ten experts assessed whether the preliminary items belonged to the construct factor and determined the appropriateness of each item. A revised questionnaire was administered to 250 nurses in 18 emergency departments to evaluate the reliability and validity of the scale. Data analysis comprised item analysis, confirmatory factor analysis, contrasted group validity, and criterion-related validity, including criterion-related validity of the problem solving method using video scenarios.

Results

The item analysis and confirmatory factor analysis yielded 5 factors with 30 items; the fit index of the derived model was good (χ ²/df =2.46, Root Mean squared Residual=.04, Root Mean Squared Error of Approximation=.08). Additionally, contrasted group validity was assessed. Participants were classified as novice, advanced beginner, competent, and proficient, and significant differences were observed in the mean score for each group (F=6.02, p=.001). With reference to criterion-related validity, there was a positive correlation between scores on the TCS and the Clinical Decision Making in Nursing Scale (r=.48, p<.001). Further, the total score on the problem solving method using video scenarios was positively correlated with the TCS score (r=.13, p=.04). The Cronbach's α of the final model was .91.

Conclusion

Our TCS is useful for the objective assessment of triage competency among emergency nurses and the evaluation of triage education programs.

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Patient Satisfaction With the Level of Competence of the Triage Nurse in Hospital Emergency Departments
Meritxell López Hernández, Montserrat Puig‐Llobet, Sergio Higon Fernández, Marta Franco Freirut, Yolanda Moreno Mateos, Jordi Galimany Masclans
Journal of Clinical Nursing.2025; 34(9): 3893. CrossRef
Effects of Critical Thinking Disposition, Clinical Judgement, and Nurse–Physician Collaboration on Triage Competency Among Triage Nurses
Ji-Won Song, Hyung-Ran Park
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Hyo Jin Im, Ju Young Ha
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Yoonhee Seok, Hye-Ryeon Park
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Seon-Hyeong Kim, Ae-Ri Jung
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Gwiseon Jeong, Hyeongsuk Lee
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Seokhwa Hwang, Sujin Shin
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Jaehee Yoon, Heesook Son
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Boo Young Oh, Kisook Kim
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Jeongmin Ha, Kyeongmin Jang, Misuk An
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Development and Validation of a Measurement to Assess Person-centered Critical Care Nursing: Jiyeon Kang, Young Shin Cho, Yeon Jin Jeong, Soo Gyeong Kim, Seonyoung Yun, Miyoung Shim; J Korean Acad Nurs 2018;48(3):323-334. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.323

Abstract PDF

Abstract Purpose

The purpose of this study was to develop a scale to measure person-centered critical care nursing and verify its reliability and validity.

Methods

A total of 38 preliminary items on person-centered critical care nursing were selected using content validity analysis of and expert opinion on 72 candidate items derived through literature review and qualitative interviews. We conducted a questionnaire survey with 477 nurses who worked in intensive care units. The collected data were analyzed using exploratory factor analysis (EFA) and confirmative factor analysis (CFA) with SPSS and AMOS 24.0 program.

Results

EFA was performed with principal axis factor analysis and Varimax rotation. The 15 items in 4 factors that accounted for 50.8% of the total variance were identified by deleting the items that were not meet the condition that the commonality should be .30 or more and the factor loading over .40. We named the factors as compassion, individuality, respect, and comfort, respectively. The correlation coefficient between this scale and the Caring Perception Scale was r=.57 (p<.001), which determined concurrent validity. The item-total correlation values ranged from .39 to .63, and the internal consistency for the scale was Cronbach's α=.84.

Conclusion

The reliability and validity of the 15 item person-centered critical care nursing scale were verified. It is expected that the use of this scale would expand person-centered care in critical care nursing.

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Development of an Instrument to Assess the Quality of Childbirth Care from the Mother's Perspective: Geum Hee Jeong, Hyun Kyoung Kim, Young Hee Kim, Sun-Hee Kim, Sun Hee Lee, Kyung Won Kim; J Korean Acad Nurs 2018;48(1):38-49. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.1.38

Abstract PDF

Abstract Purpose

This study aimed to develop an instrument to assess the quality of childbirth care from the perspective of a mother after delivery.

Methods

The instrument was developed from a literature review, interviews, and item validation. Thirty-eight items were compiled for the instrument. The data for validity and reliability testing were collected using a questionnaire survey conducted on 270 women who had undergone normal vaginal delivery in Korea and analyzed with descriptive statistics, exploratory factor analysis, and reliability coefficients.

Results

The exploratory factor analysis reduced the number of items in the instrument to 28 items that were factored into four subscales: family-centered care, personal care, emotional empowerment, and information provision. With respect to convergence validation, there was positive correlation between this instrument and birth satisfaction scale (r=.34, p<.001). The internal consistency reliability was acceptable (Cronbach's alpha =.96).

Conclusion

This instrument could be used as a measure of the quality of nursing care for women who have a normal vaginal delivery.

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Geumhee Jeong, Hyun Kyoung Kim, Uri Bang
Frontiers in Public Health.2025;[Epub] CrossRef
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Bu Youn Kim, Sun Hee Lee, Sun Ok Lee
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Jung Mi Chae, Hyun Kyoung Kim
Journal of Korean Academy of Community Health Nursing.2021; 32(1): 116. CrossRef
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JungMi Chae, Hyun Kyoung Kim
Children and Youth Services Review.2021; 127: 106079. CrossRef
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Hyun Kyoung Kim, Hee Kyung Kim, Mirim Kim, Seohwa Park
Journal of Korean Academy of Nursing.2021; 51(4): 478. CrossRef
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Jimi Park, Ho Ran Park
Journal of The Korean Society of Maternal and Child Health.2019; 23(4): 269. CrossRef
Comparison of the Quality of Nursing Care as Perceived by Pediatric Nurses and Mothers of Hospitalized Children
So Yeon Yoo, Yae Young Kim, Haeryun Cho
Child Health Nursing Research.2018; 24(4): 373. CrossRef

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A Study on the Disturbing Factors Which Work against Therapeutic Atmosphere and Environment on Hospital Wards as Perceived by Patients and Nurses: Young Hae Kim, Myoung Eun Han; Journal of Nurses Academic Society 1997;27(1):178-188. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.1.178

Abstract PDF: As a descriptive survey, this study was attempted to get basic data necessary to recognize the factors that disturb the therapeutic atmosphere of hospital wards as perceived by nurses and hospitalized patients, to identify differences between the perceptions of the nurses and of patients. The subjects, 159 patients in Pusan National Hospital and 68 nurses working there were sampled between March 18 and April 13, 1996. The tool used to measure the disturbing factors was an amended form of the one developed by Kim, Mae Ja(1983). The differences between each subject's score for each factor were analyzed using means and SD, and the highest 3 items above the mean score for each factor were collected and compared. The results are described below : 1. Subject's perception of main disturbing factors : patients reported that the main factors were 'loss of role and economic trouble', 'the prognosis of disease', 'the change of daily life' but nurses replied that the main factors were 'the prognosis of disease', 'the communication trouble with the medical team and interpersonal relationships'. 'The change of daily life' was not a perceived factor by nurses, but ranked third by patients. 2. Subject's perception degree of each disturbing factor : (1) among the items related to interpersonal relationship, the patient group reported that the worst disturbance was due to severely ill patients in the same room' but the nurse group regarded 'greed to monopolize wheelchairs or other supplies' as the worst disturbance. (2) among the items related to physical factors, the patient group regarded 'limitations to wash their body, physical pain and limitations in physical activity' as the worst disturbance, but the nurse group regarded 'physical pain', and 'limitations to activity or change of appearance' as the worst disturbance. (3) among the items related to the change of daily activity, the patient group regarded 'the boredom of hospitalization or in favorable diet' as the worst disturbance, but the nurse group regarded 'too much noise or unclean room' as the worst disturbance. (4) among the items related to the communication trouble with medical team, the patient group regarded 'the ignorance of their disease due to poor information, the inability to understand the language of the medical team or the difficulty in seeing physician in time' as the worst disturbance, but the nurse group regarded 'the inability to trust physicians and physician's poor attention to patients' as the worst disturbance.

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Fatigue and its Related Factors in Patients on Hemodialysis: Hye Ryoung Kim; Journal of Nurses Academic Society 1996;26(1):53-72. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.1.53

Abstract PDF

The Purpose of this study was to identify characteristics of fatigue and the relationship between fatigue and related factors in patients on hemodialysis. This study was a survey study using a cross-sectional design. The subjects for this study were 101 patients on hemodialysis who were registered in the six hemodialysis clinics among a total of eleven clinics in Seoul. The period of data collection was from February 28, 1995 to May 2, 1995. Data were collected through an interview with a structured packet and the physiological data. The tools used in this study were the Visual Analogue Scale-Fatigue developed by Lee et al(1990) and translated by Lee (1991), the fatigue interview schedule developed by this reseacher, Zung's self rating depression scale (Zung, 1965), the self-efficacy scale developed by Sherer et al(1982) and the Norbeck Social Support Questionnaire (NSSQ) translated by Oh (1984). The collected data were analyzed using descriptive statistics (mean, standard deviation, frequency, range), Pearson correlation coefficients and Stepwise multiple regression. The results were as follows: 1. Characteristics of Fatigue of hemodialysis patients: 1) 79 of 101 hemodialysis patients complained fatigue. 2) The mean fatigue score as measured by the VAS-F was 36.2mm. 3) The mean duration of fatigue was 2.9 hours 2. Characteristics of fatigue related factors: 1) The physiologic factor which included Hgb, Hct, BUN, creatinine, potassium and inter-dialytic weight gain deviated from normal range. 2) The psychological factor which included depression and self-efficacy was about the same level as for patients with other chronic diseases. 3) The environmental factor which included social support had wide variation. 3. The relationship between fatigue and related factors: 1) Interdialytic weight gain in the physiological factor was the only valuable with fatigue (p<.05) 2) The relationship between fatigue and the psychological factor of depression showed a positive and strong correlation (p<.05). According to the findings of this study, fatigue was highly correlated with the depression, This indicates that nurses should try to assess and control psychological factors when patients complain of fatigue rather than just considering physiological factors. Nursing has to develop effective nursing interventions to reduce fatigue in patients with chronic diseases using the relationship between fatigue and physiological, psychological and environmental factors.

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Sun Mi Cha, Hye Sook Min
Journal of Korean Academy of Nursing.2016; 46(5): 642. CrossRef

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The Age at Menopause and Related Factors in Korean Women: Young Joo Park, Hesook Suzie Kim, Hyun Choel Kang; Journal of Korean Academy of Nursing 2002;32(7):1024-1031. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.7.1024

Abstract PDF

This cross-sectional design was to identify the age at menopause of Korean women using a national sample, and to examine relationships between age at menopause and the anthropometric, sociodemographic, biological and life style behavioral factors. Two thousand eight hundred seven naturally postmenopausal women aged between 41-65 years were recruited by self-selection from 7 metropolitans and 6 provinces in Korea from Dec. 20, 1998 to April 30, 1999. The age at menopause of Korean women was 49.2 years (mean) and 50.0 years (median). The range of age at menopause was 33.0 to 61.0 years. The significant influencing factors on age at menopause were body mass index, mother's and sister's age at menopause, alcohol use, physical activity, coffee preference, and residential area. The menopausal age of Korean women has slightly increased compared to a previous study.

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Effects of Motivation-Enhancing Program on Health Behaviors, Cardiovascular Risk factors, and Functional status for Institutionalized Elderly Women: Rhayun Song, Kyung Ja June, You Ja Ro, Chun Gill Kim; Journal of Korean Academy of Nursing 2001;31(5):858-870. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.5.858

Abstract PDF

This study was to compare changes in health behaviors, motivational factors, cardiovascular risk factors, and functional status (SIP) after implementing the 6-month motivation-enhancing program to institutionalized elderly women.
METHODS
Sixty-four elderly women participated. Face to face interviews with blood sampling and anthropometric assessment were conducted at the pretest, 10 weeks and 6 months during the program.
RESULTS
1. The program participants showed significantly better health behaviors over 6 months. The mean motivational level was also significantly improved, especially for perceived benefits, perceived barriers, and emotional salience. 2. The mean of cardiovascular risk factors for the participants was 21.8 at the level of low to moderate risk. After completing the program, total risk score was significantly decreased to 18.7 at 10 weeks, and further to 17.7 at 6 months. A significant reduction was also found in HDL and LDL-cholesterol levels, blood pressure, obesity, inactivity, and stress. 3. The functional status (SIP) was 11% at the baseline and significantly changed in positive direction at 10 weeks (M=9.3) and at 6 month (M=6.3). The significant improvement was also found in physical and psychosocial dimensions and sleep/rest dimension.
CONCLUSION
The motivation enhancing program was effective to reduce cardiovascular risks and to improve the functional status of institutionalized elderly women by motivating them to perform better health behaviors.

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A Study on the Elderly Patients Hospitalized by the Fracture from the Fall: Mi Yang Jeon, Hyeon Cheol Jeong, Myoung Ae Choe; Journal of Korean Academy of Nursing 2001;31(3):443-453. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.3.443

Abstract PDF

PURPOSE: To identify age, gender, medication, seasons and place of fall, and areas of the fractures from the fall among the hospitalized elderly patients in order to provide the basic data for future fall prevention program for the elderly.
METHODS
This study was conducted for 106 elderly patients admitted into a university hospital by fractures from the fall during the period from January 1, 1999 to December 31, 1999. Data on the age, gender, medication, season and place of the fall, areas of the fracture were collected based on their medical records.
RESULT
The age range of the subjects were from 60 to 96 years old. The subjects were aged between 60-69 years old 49(46.2%), between 70-79 years old 31(29.2%), between 80-89 years old 24(22.6%), and over 90 years old 2(1.9%). Male patients comprised was 34(28.3%), while female patients comprised 76(71.7%). The fall occurred in Winter most frequently 34(32%). The place of the fall included room 81(76.4%), streets 13(12.3%), bathroom 6(5.7%), stair 4(3.8%), and mountain 2(1.9%). Twenty-two subjects (20.8%) had medication regularly, while 84 subjects (79.2%) had no medication. The areas of the fracture from the fall included upper extremities 20(18.9%) and lower extremities 86(81.1%). Radius fracture (7.5%) was the area where the fracture occurred most frequently in upper extremities and femur fracture (52.8%) was the area where the fracture occurred most frequently in lower extremities. A significant difference was found in the fracture area by age, season and place of the fall (p<.05). No significant difference was found in the fracture area by gender and medication. In all age groups, seasons and places of the fall, occurrence of fracture in lower extremity was significantly higher than that in upper extremity.

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A Study on the Verification of the Profile of Seo's Elderly Stress Scale (SESS): Hyun Mi Seo, Su Jeong Yu, Yang Sook Hah; Journal of Korean Academy of Nursing 2001;31(1):94-106. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.1.94

Abstract PDF

The purpose of this study was to verify the use of Seo's Elderly Stress Scale (SESS), which was developed in 1996. Through the modified tool, it is possible to examine the stress of Korean elders and to contribute to the welfare of them. The subjects were 350 elders over 65 years old who live in Seoul, Kwang-Ju, Yang-Ju Gun Kyung-ki Do, Ui-Jong Bu, and Young-Am Kun, Jeun-Ra Nam Do. the data of 331 elders (94%) were analyzed. Data were collected between January and March in 1996 and analyzed using the SPSS Win 8.0. The result are as follows: 1. Items with low correlation with the total items were removed. So 27 items were removed and 37 items remained. This 37 items were death in the family and/or close friends, family member's behavior not meeting expectations, marriage of daughter, marriage of son, friction with daughter- in-law, argument among children, children refuse to live with parent, children leaving home, sex injury or accident, in frequest visits from children and grandchildren, providing care for your daughter or daughter-in-law post-partum, decrease in decision making and authority in home, Lunar new year and the harvest featival, house sitting, working in the house, performing a sacrificial rite, missed birthday, not living with the eldest son, decreased eyesight, decreased strength, decreased memory, sleep pattern changes, thoughts about death, loneliness, decreased hearing, change of dental condition, change in your diet or eating style, difficulty in self care, moving because of disease or aging, argument with friend or neighbour, travel, dealing with the procedure of heritage, loss of money or property, not enough pocket money, hearing on elderly neglect in television or radio, hope of going home and ignorant from others. 2. Overlapped items were discussed by colleagues and were modified. 'marriage of daughter' and 'marriage of son' were modified in 'marriage of children'. 'self injury or accidents' and 'family accidents' were modified in to self or family accidents. 3. Factor analysis was done in order to identify validity and three factors were obtained from the result. The first factor familial relation area, included 17 items. The second factor, physical area, included 9 items. The third factor, psycho-socio-economic area, included 9 items. Cronbach coefficient alpha for the 35 items was .923. 4. Pearson's correlation was .704 between SESS and SOS (Symptoms of Stress) in order to confirm construct validity. Based on the result, the following is suggested; 1. The modified SESS needs to be reverified with elder. 2. Korean elder's health promotion can be made by development of stress intervention which was accurately measured with SESS.

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Prevalence and Risk Factors for Diabetes Mellitus and Impaired Fasting Glucose of Adults: Hee Seung Kim, You Ja Ro, Nam Cho Kim, Yang Sook Yoo, Jin Sun Young, Jeong Ah Oh; Journal of Korean Academy of Nursing 2000;30(6):1479-1487. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.6.1479

Abstract PDF

This study was conducted to draw out prevalence and the risk factors of diabetes mellitus and impaired fasting glucose for adults,(age 30-69). The subjects were 2096 adults, who had regular health examinations between January and December of 1999 at K Hospital in Seoul. The data was analyzed using chi-square test, unpaired t-test and logistic regression. Diabetes Mellitus and impaired fasting glucose were diagnosed by ADA (American Diabetes Association, 1997) criteria. The results were as follows: 1. Mens' prevalence of Diabetes Mellitus was 7.9% and womens' prevalence of Diabetes Mellitus was 3.8%. Mens' prevalence of impaired fasting glucose was 10.4% and womens' prevalence of impaired fasting glucose was 6.5%. Prevalences of Diabetes Mellitus and impaired fasting glucose increased with age. 2. Prevalence of Diabetes Mellitus and impaired fasting glucose of obese subjects (relative body weight>=162) was higher than that of overweight subjects (110<=relative body weight<=119) in men and women. 3. The diagnoses of Diabetes Mellitus and impaired fasting glucose increased with systolic blood pressure and triglyceride. 4. Significant factors associated with diabetes in the logistic regression best gut model were age, relative body weight, systolic blood pressure, triglyceride in men, and systolic blood pressure in women. In conclusion, as age, weight, systolic blood pressure and triglyceride get higher, Diabetes Mellitus and impaired fasting glucose prevalence also increases, porportionally.

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The Psychological Effect of Hand and Arm Massage on Middle-Aged Women: Hee Jung Jang; Journal of Korean Academy of Nursing 2000;30(6):1389-1399. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.6.1389

Abstract PDF

Massage therapy is a traditional, alternative and nonphamacological means of promoting rest and relaxation. However, nursing intervention by massage for middle-aged women is rarely practiced by nurses. The purpose of this research was to examine the effects of the hand and arm massage as an independent nursing intervention tool for middle- aged women. The data used in this research were collected from forty-nine subjects using a nonequivalent control group non- synchronized design. Twenty-four persons for the experimental group and Twenty-five persons for the control group were selected from D city and C city from July 1997 to September 2000. Subjects' ages were between forty and fifty-six years old with mean the age of 45.6. Hand and arm massage developed by Cayce and Reilly was applied to the experimental group for a session of 15 minutes two or three times a week for four weeks. The instruments used for the measurement of the subjects' stress, anxiety, depression and the middle-life crisis were Langners's 22-item Screening Score, Spielberger's State Anxiety Inventory, Zung's Self-rating Depression Scale, and Kim's Middle Life Crisis Scale(1988). These psychological factors were measured before and after the implementation of hand and arm massage. The data were analyzed with mean+/-s.d, percent, t-test, and a paired t-test. The results were summarized as follows; 1. Before the treatment, there were no significant differences between the two groups. 2. After the treatment, there were significant differences in the stress and the occurrence of mid life crisis between the two groups. The findings suggest that the use of the hand and arm massage for middle-aged women made significant changes in the level of stress and middle life crisis. Therefore, it is recommended that hand and arm massage be used as an independent nursing intervention tool for middle-aged women. For further research, is needed replication of this concept of research with different subjects in a larger population. Also, it is recommended to investigate the effects of massage with aroma therapy for the berefit of decreasing womens' stress level further.

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A Study on the Physiological and Psychological Factors related to Successful Weaning from a Mechanical Ventilator: Cho Ja Kim, Hwasoon Kim, Yeon Soo Jang, Eun Sung Kim; Journal of Korean Academy of Nursing 2000;30(4):995-1005. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.4.995

Abstract PDF: This study was performed to identify the physiological and psychological variables related to successful weaning from a mechanical ventilator. The subjects of this study were 22 patients who received mechanical ventilation therapy for more than 3 days in intensive care units. Before the weaning trial, baseline data for following physiologic variables were obtained: spontaneous respiration rate, blood pressure, pulse rate, PaO2, PaCO2, PEEP, static compliance, minute ventilation, tidal volume, rapid shallow breathing index(f/VT), SaO2, PaO2/FiO2 and mean arterial pressure. During spontaneous breathing, physiologic and psychologic variables such as vital signs, ABG, perspiration, chest retraction, paradoxical respiration, dyspnea, anxiety, confidence and efficacy were measured. Successful weaning was defined as sustaining spontaneous respiration over 24 hours after extubation. Weaning failure was defined as the development of more than one of following signs: (1) hypoxemia, (2) CO2 retention or (3) perspiration, tachypnea, chest retraction, tachycardia, arrhythmia, hypotension or hypertension. Subjects (N=18) who successfully weaned from mechanical ventilator were compared with subjects (N=4) who failed. The results are as follows; Eighteen percents of the subjects failed during the weaning trial. Most subjects in the failed group were mechanically ventilated for long-time. This result shows that the success of weaning is more difficult in long-term ventilation patients. In the baseline data that was measured before weaning trial, the mean score of PaO2 in the successfully weaned group was 121mmHg. This is significantly higher than the mean score of PaO2 in the failed group(95mmHg). However, the scores of pH, tidal volume, f/VT, pulse rates, blood pressure, mean airway pressure, SaO2, and PaCO2 were similar between the two groups. Specially the scores of f/VT index as a predominant predictor for successful weaning were not significant (f/VT=44.4) and (f/VT=47). During spontaneous breathing, the scores of dyspnea and anxiety level in the successfully weaned group were less than those of the failed group. On the contrary, the scores of confidence and efficacy in the successful group were greater than those of the failed group. In conclusion, the baseline data that were measured before weaning trial were similar between the both groups, therefore future studies are needed to focus on searching other variables besides physiological parameters related to weaning outcome.

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A Study on the Circadian Blood Pressure Rhythm of Diabetic Patients: Hwa Soon Kim, Wha Sook Suh; Journal of Korean Academy of Nursing 2000;30(3):741-749. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.3.741

Abstract PDF: This study was performed to investigate the relationship between reversed circadian blood pressure and risk factors of peripheral vascular disease in non-insulin-dependent diabetes mellitus (NIDDM) subjects. The subjects in this study were 18 NIDDM patients who were hospitalized in a medical unit of an university medical center located in Incheon, Korea, between November, 1998 and March, 1999. Blood pressure was measured with a mercury sphygmomanometer by 2 trained examiners every 2 hours during 24 hours. NIDDM subjects were divided into a dipper group and non-dipper group. Dippers are defined as those who show a mean nighttime blood pressure(BP) drop of more than 10% compared with daytime BP. Non-dippers are defined as those who show a mean nighttime BP drop of less than 10%, or an elevation in BP compared with daytime BP. Daytime BP included values obtained between 6 a.m. and 10 p.m. Night time BP included values obtained between 10 p.m. and 6 a.m. Data was analyzed by SPSS/PC package. Chi-square( 2) test was used for the comparison of sex between The dipper group and non-dipper group. Mann-Whitney test was used for comparisons of values of the risk factors of peripheral vascular disease and the frequency of complications of diabetes between the dipper group and non-dipper group. The results are as follows. There were no significant differences in daytime systolic, diastolic, and mean blood pressures between the dipper group and non-dipper group. However, night time systolic, diastolic, and mean blood pressures in the non-dipper group were significantly nigher than those in the dipper group (p=.021). There were no differences in sex, age, body, weight, duration of diabetes, serum lipid levels, BUN and HbA1c between the two groups. On the contrary, 87.5% of non-dipper group subjects showed having hypertension, 30% of dipper group subjects showed having hypertension and this difference was statistically significant (p=.018). All of the non-dipper group subjects (N=8) showed having at least one diabetic complication. However, 40% of the dipper group subjects (N=10) showed having no diabetic complication at all and this difference was also statistically significant (p=.049). There were no significant differences in frequency of nephropathy, neuropathy and retinopathy between the dipper group and non-dipper group.

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The Reliability and Validity Test of psychosocial Well-being Index(PWI): Jeong Hee Kim; Journal of Korean Academy of Nursing 1999;29(2):304-313. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1999.29.2.304

Abstract PDF

The purpose of this study is to test the reliability and validity test of PWI to utility of PWI, this newly developed by Sejin Jang which measures stress. The subject were 186 workers in service area. Cronbach's alpha and Guttman split-half coefficient is used to test the reliability of PWI. Factor analysis and the correlation of the GHQ-60, GHQ-30, GHQ-28, GHQ-20, and GHQ-12 with the PWI is used to convergent validity and discriminant validity. The important results of this study are as follows : Cronbach's alpha coefficient of data was 0.894 and Guttman split-half coefficient was 0.7097. The PWI was classified as 13 principle component(eigenvalue>1.0). After exploring 4 factor structure according to previous study result, 4 factors was explained 40.5% out of the total variance. The factor 1 was explained 15.9% and then the rest three factor was 24.6%. Factor 2 and 4 showed good agreement but factor 1 and 3 did not. Depression-related items were classified two factors. Anxiety and depression-related items were loaded unifactor. It was not clear that the PWI was consist of 4 concepts(factors). The correlation of the GHQ-60, GHQ-30, GHQ-28, GHQ-20, and GHQ-12 with the PWI were 0.744~0.905. According to findings of this study, the PWI showed a high degree of validity and reliability. Thus it is recommended to use the PWI in general setting for screening for stress. In addition, it is necessary to clarify the concept of depression and anxiety. In the further study, it may be considered to the factor structure of PWI and studied to two or unidimensional factor structure.

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Elderly Sleep Pattern and Disturbing Factors Before and After Hospitalization: Mi Young Kim, Sung Hee Cho, Sang Mi Lee, Su Jung Jung, Kyung Sook Park; Journal of Korean Academy of Nursing 1999;29(1):61-71. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1999.29.1.61

Abstract PDF

Sleep is a necessity for survival, Disruption of sleep leads to numerous adverse physiological and psychological consequences. These could be particularly undesirable for older patients, who are subject to many additional factors. But there is limited research related to hospitalized elderly in Korea. The purpose of the study is to explore sleep patterns and disturbing factors of before and after hospitalization, in order to present basic information regarding elderly sleep to develop nursing intervention. The sample consisted of 32 elderly men and women between the ages of 60 and 87 years. Data collection was done from September to November 1997. Measures of sleep patterns and related factors were obtained from self-reported sleep questionnaires. Analysis of data was done by use of t-test, paired t-test, ANOVA, and Pearson Correlation Coefficient. The results of this study were summarized as follows : 1. In comparison between before and after admission of their sleep pattern, "sleep onset" tends to be delayed and nocturnal sleep time was significantly reduced. So, hospitalized elderly reported less total sleep time than before admission. 2. Regarding the sleep disturbing factors, medication(hypnotics : 37.5%), physiological factor(snoring : 59.4%) environmental factor(pillow : 78.1%), emotional factor(anxiety related to disease : 37.5%), and illness factor(fatigue : 34.7%) were reported. 3. Significant differences in gender were found. Men had more disturbances in sleep than women owing to difficulty in falling a sleep and lack of nocturnal sleep. Women consumed more sleep inducing drugs. Significant increase was reported in napping during the day with increasing age. 4. Significant differences between good sleepers and poor sleepers were found for the following variables : nocturnal sleep time, total sleep time, bed time, sleep onset latency time, sleep latency time after nocturnal awakening, time spent in bed upon arousal, environmental factors, and emotional factors. In conclusion, it was found that the quantity and quality of sleep were significantly altered in hospitalized elderly, but adequate strategies for better sleep were not practiced. Further research is needed to develop intervention strategies to promote sleep and to prevent sleep problems.

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Sleep patterns and it's influencing factors of hospitalized elderly in long-term care hospital
Hyo-Yoel Jang, Tae-Im Kim
Journal of the Korean Data and Information Science Society.2016; 27(3): 773. CrossRef
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Mi-Ryon Lee, Mun-Hee Nam
Journal of Korean Clinical Health Science.2014; 2(3): 176. CrossRef
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Lifestyles Effects on Stroke Risk in Different Regions in Korea: Smi Choi-Kwon, Eun Kyung Kim, Mi Yang Jeon; Journal of Korean Academy of Nursing 1998;28(3):729-738. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.3.729

Abstract PDF

BACKGROUND AND PURPOSE: Stroke is a leading cause of death in Korea. Early measurement to prevent stroke are extremely important since it has no cure. Korean might have different risk factors since their dietary habit and socio-economical status differ from most western countries. However, the risk factors for stroke in Korea have not yet been identified. Moreover, the lifestyle of health Korean adults has not been investigated. In this study we investigate the life of health adults living in Seoul and rural areas and compare the life style of the two. METHODS: One hundred seventy one subjects were studies. Among the subjects studied, 128 were from Seoul, the other 43 were from the country area. The age of the subjects was limited to over 40 years. Blood pressure, fast blood sugar, and cholesterol were measured. The subjects' height, weight, body mass index total body fat, skinfolds thickness of triceps, subscapular and abdomen were measured to determine obesity. Using a structured interview, we assessed : sodium intake, physical activity and exercise, consumption of vegetables, fat, fish and fruits. The results of the two groups were compared. RESULTS: There were no statistical differences in age and education between the two groups of subjects. The mean age of the subjects were 66 years old. The subjects residing in rural areas had a higher intake of sodium(p<0.05), lower physical active(P<0.05), and higher BMI and body fat(p<0.05) as compared to the subjects in Seoul. Subjects with hypertension were between 24% and 33% and the prevalence of hypertension was the highest was the highest when compared to the prevalence of DM, or hypercholesterolemia. However, the prevalence of hypertension, DM, hypercholesterolemia, were not significantly different in these areas. CONCLUSION: our results show that subjects living in rural areas eat more salty food, exercise less and tend to be obese. The finding of this study lead to speculation that Korean living in rural areas have less information about the effects diet of diet on health than city dwellers do. General health and nutrition education programs aimed at the prevention of stoke and other such conditions for rural area Korean may close the risk factor gap between rural and urban dwellers.

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Evaluation of the Korean Version of Physical Activity Scale for the Elderly (K-PASE)
Myoung-Ae Choe, Jeungim Kim, Mi-yang Jeon, Young-Ran Chae
Korean Journal of Women Health Nursing.2010; 16(1): 47. CrossRef
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Journal of Cardiovascular Ultrasound.2008; 16(1): 17. CrossRef

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Nursing Students' Perceptions on Diet and as Environmental Factors Related to Cancer Risk Factors: Hae Kyung Lee, Seong Joo Cheon, Mi Hye Hwang, Soon Rim Suh; Journal of Korean Academy of Nursing 1998;28(1):193-200. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.1.193

Abstract PDF

The purpose of this study was to identify how students majoring in nursing perceive cause of cancers and the effects of diet for preventing cancers. Data for the study were collected by 651 nursing students, who were registered in the second and third year in three technical colleges and third and fourth year in two universities. The research instruments included items on general characteristics of subjects, items about the degree of perception of the frequency of cancer onset and items on the perception of mortality, risk factors, preventive diets, knowledge, and high risk factor for cancer in specific body areas. The findings of this study are as follows : 1. Almost all subjects(92.8%) reported that the frequency of cancer onset increases and that it is 93.9% for people over 40. Degree of perception about cancer mortality was low at 33.0%. 2. As far as the perception of risk factors for cancer onset was concerned, smoking, stress, heredity, family history, and alcohol were rated high, over 80.0%. Risk factor in clouding, virus, hormones, pesticides were rated as low. 3. As to the perception of risk factor for body area as associated with diet salted and scorched food were rated at 44.5% for stomach cancer, alcohol, 50.4% for liver cancer, smoking, 72.8% for lung cancer, pregnancy times, 25.3%, and marriage age, 23.0% for uterine cancer, and no delivery experience, 40% for breast cancer. 4. The knowledge score for cancer was between 12 and 36, with a mean score of 26.75(SD=4.13). There was a statistically significant difference between experience in caring for cancer patients during clinical practice and knowledge score(t=3.09, p=.002).

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Literature Review of Structural Equation Models for Hospital Nurses' Turnover Intention in Korea
Eunhye Kim, Jinhyun Kim
Perspectives in Nursing Science.2014; 11(2): 109. CrossRef
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Gye Young Shin, Mee Kyoung Joo
Journal of Korean Oncology Nursing.2010; 10(2): 137. CrossRef

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Discriminative Factor Analysis of Juvenile Delinquency in South Korea: Hyun Sil Kim, Hun Soo Kim; Journal of Korean Academy of Nursing 2006;36(8):1315-1323. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2006.36.8.1315

Abstract PDF

Purpose

The present study was intended to compare difference in research variables between delinquent adolescents and student adolescents, and to analyze discriminative factors of delinquent behaviors among Korean adolescents.

Methods

The research design of this study was a questionnaire survey. Questionnaires were administered to 2,167 adolescents (1,196 students and 971 delinquents), sampled from 8 middle and high school and 6 juvenile corrective institutions, using the proportional stratified random sampling method. Statistical methods employed were Chi-square, t-test, and logistic regression analysis.

Results

The discriminative factors of delinquent behaviors were smoking, alcohol use, other drug use, being sexually abused, viewing time of media violence and pornography. Among these discriminative factors, the factor most strongly associated with delinquency was smoking (odds ratio: 32.32). That is, smoking adolescent has a 32-fold higher possibility of becoming a delinquent adolescent than a non-smoking adolescent.

Conclusions

Our findings, that smoking was the strongest discriminative factor of delinquent behavior, suggest that educational strategies to prevent adolescent smoking may reduce the rate of juvenile delinquency. Antismoking educational efforts are therefore urgently needed in South Korea.

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Public discourse on substance use behavior as a driver of public policy: a scoping review of South Korean academic and official literature
Meekang Sung, Jihye Han, Carrie G. Wade, Vaughan W. Rees
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Developing an Instrument to Measure Climacteric Symptoms among Korean and Japanese Women: AeRi Song, Kazuyo Oishi, Euy Hoon Suh, Harumi Miyahara, Hisayoshi Nakajima, Yuko Nakao, Miyuki Araki, Makiko Yamasaki; Journal of Korean Academy of Nursing 2006;36(4):637-644. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2006.36.4.637

Abstract PDF: Purpose
The purpose of this study was to construct a measurement instrument for climacteric symptoms among Korean and Japanese women.
Methods
From Dec. 1^st of 2003 to March 30^th of 2004, in-depth interviews were made with 26 women (15 in Jinju, Korea and 11 in Nagasaki, Japan) aged from 45 to 59 years who had not taken hormone replacement therapy to relieve the climacteric symptoms. A draft questionnaire with 45 items was constructed on the basis of the interview data and literature review. Three obstetricians, three PhDs in nursing science, and a chief nurse who was exclusively in charge of the climacteric management, examined the draft questionnaire to evaluate content validity. After deletions 39 items remained for a preliminary questionnaire. A survey was conducted by using a convenient sampling method in Jinju of Korea and Nagasaki of Japan during the period from April 1^st, 2004 to July 10^th, 2005.
Results
Factor analysis identified 4 factors, which were “mental and psychological symptoms”, “physical symp-toms”, “loss of autonomic nervous system symptoms”, “sexual symptoms”. These four factors explained 46.9% of total variance.
Conclusions
The results demonstrated that climacteric symptom scale was multidimensional, and the reliability and validity of the scale was supported.

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Comparison of Cardiovascular Risk Profile Clusters Among Industrial Workers: Seon Young Hwang, Ji Hyun Lee; Journal of Korean Academy of Nursing 2005;35(8):1500-1507. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.8.1500

Abstract PDF

Purpose

The purpose of this study was to identify subgroups of the physical and behavioral risk profiles for cardiovascular disease among industrial workers, and to examine predicting factors for the subgroups.

Sample and Methods

Health records of 2,616 male and female workers aged 19-56 years who were employed in an airplane manufacturing industry were analyzed. Data were analyzed using the Latent class cluster analysis.

Results

Four different clusters (two high-risk groups, one low-risk group, and one normal group) were found and these clusters were significantly different by age, gender, and work type (p<.05). The two high-risk groups had higher chances of drinking alcohol, elevated BMI, FBS, total cholesterol, having hypertension, and were significantly older, and had relatively high chances of being day workers rather than other groups. The low-risk group had higher chances of drinking alcohol, higher BMI and total cholesterols compared to normal group, and highest portions of current smokers and shift workers in the four clusters and their mean BP was within prehypertension criteria.

Conclusion

Industrial nurses should guide the lifestyle behaviors and risk factors of the high risk groups for CVD and need to intervene early for behavioral change for the low-risk group who are young and shift workers. Age, and work environment should be considered in planning for targeted preventive interventions for industrial workers.

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Factors Associated with Blue-collar Workers' Risk Perception of Cardiovascular Disease
Won Ju Hwang, OiSaeng Hong, Mi Ja Kim
Journal of Korean Academy of Nursing.2012; 42(7): 1095. CrossRef

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