Seieun Oh

Insufficient staffing often makes it difficult for nurses in South Korea to adjust their schedules when they have illnesses or other health problems, resulting in presenteeism. This study aimed to explore the experiences of the Acknowledged Care Expert (ACE) team as a substitution system for clinical nurses taking leave because of illness or health problems from the perspectives of ACE nurses, nurse managers, and shift nurses. We collected data for this qualitative study through individual in‐depth interviews with six ACE nurses, a focus group interview with five nurse managers, and two focus group interviews with five nurses who shared their experiences with the ACE team. Thematic analysis of the data identified the following four themes: expected and unexpected benefits of the ACE team; challenges in operating the ACE team; characteristics and competencies required of the ACE team; and recommendations for the ACE program. The findings showed that the ACE team was highly valued and received positive feedback from colleagues and administrators with whom they worked. Such positive impacts were made possible by team members’ clinical expertise and the collective engagement of both coworkers and team members. Further research to evaluate such substitute systems is necessary to establish a more stable and encouraging environment for clinical nurses, as well as for patient care.

This study aimed to further understand and compare the phenomenon of workplace bullying (WPB) among clinical nurses in various sociocultural contexts. The study sought to determine appropriate interventions, examining how said interventions should be delivered at individual, work-unit, and institutional levels. Qualitative meta-synthesis was chosen to achieve the study aims. Individual qualitative research findings were gathered, compared, and summarized using the thematic analysis suggested by Braun and Clark. Based on the predefined analytic points, the findings included the following themes: horizontal yet vertical violence, direct and indirect violence on victims, nurses feed on their own, accepting and condoning WPB embedded in ineffective work systems, and rippling over the entire organization. The results showed that the phenomenon of workplace bullying shares quite a few attributes across cultures in terms of the characteristics, types, perpetrators, subjects, and consequences. The findings suggest that interventions to change and improve organizational work culture must be developed and implemented.

김수현, et al. Korean J Adult Nurs. 2021 Aug;33(4):406-414. https://doi.org/10.7475/kjan.2021.33.4.406

Background: Accurate symptom perception is a fundamentally essential component of self-care for patients with heart failure (HF) so they can make appropriate decisions about their symptoms. Objective: The purpose of this integrative review was to describe the pathways of the symptom perception process and its contributing factors in patients with HF. Methods: A comprehensive literature search was conducted using PubMed, EMBASE, and PsycINFO databases to identify studies describing the symptom perception process (symptom detection, comprehension, and response) in adult patients with HF. Results: Two pathways of the symptom perception process were identified from 42 articles: ideal and undesirable pathways. Patients in the ideal symptom perception pathway had a comprehensive understanding of HF and a firm belief in the importance of self-care, were vigilant, and possessed good decision-making skills. They also were able to successfully use their experiences for future care. However, patients in the undesirable symptom perception pathway had a limited understanding of HF with poor symptom monitoring skills and inaccurate judgments about symptoms. Diverse factors contributing to the symptom perception process were identified (eg, levels of understandings of HF and social support). Conclusion: Our review indicated that symptom perception was likely to diversify the pathway of HF management. A variety of contributing factors to the symptom perception process were found to be intertwined. The findings of our review can inform the development of best patient education practice, although further research needs to be conducted to understand why and how patients can follow the most appropriate path from their past experiences.

In the context of population aging, enhancing the health of older patients has become an urgent issue for public health. Health education and health literacy need to be further understood from the healthcare providers’ standpoint to increase older patients’ effective application of such information into their daily lives. We aimed to further understand nurses’ perspectives on the education of older patients and their health literacy, as nurses are one of the frontline providers interacting with older patients. In total, 16 nurses and nurse practitioners who had 5 or more years of clinical experience participated. Data were collected via face-to-face interviews and emails. Data analysis followed the thematic analysis suggested by Braun and Clarke. Five themes emerged from the analysis, as follows: attitudes that are hard to change; physical and cognitive functional barriers to understanding teaching materials; family caregivers—surrogate vs. gatekeeper; major contexts that moderate the elderly’s health literacy; and strategies to enhance teaching effectiveness and health literacy. These findings illustrate the conditions pertinent to communication with older adults from the patients’, providers’ and healthcare delivery viewpoints. Systemic assistance and interventions specialized for older patients and their healthcare providers need to be developed and tested to improve clinical practice and patient health literacy.

Living with a person with dementia considerably affects the lives of both the primary caregiver and the entire family. This study aimed to synthesize the findings of qualitative studies that explored dementia caregivers’ experiences, to further understand the impact of dementia caregiving on family dynamics. Thirty-seven qualitative studies were analyzed and synthesized according to the meta-synthesis methods suggested by Sandelowski and Barroso. Four themes were identified to describe the impact of dementia caregiving on the family: cracked foundation of the family caused by dementia, voluntary or involuntary setup of a marked boundary of care, family as supportive foreground versus reluctant or interfering background, and re-established relationships within and outside the family. The findings illuminate that dementia caregiving has a destructive impact on the entire family, and therefore, it is imperative to develop interventions and infrastructures for both the caregiver and the entire family of individuals with dementia.

Purpose: The purpose of this study was to integrate and synthesize findings from qualitative studies exploring male students' experiences of adapting to nursing education programs so as to obtain further understanding of the phenomenon. Methods: The meta-synthesis process was primarily guided by Noblit and Hare's approach, which consists of four stages including searching, appraisal of an individual study's quality, data extraction for analysis, and meta-synthesizing the results. Results: Findings from the literature reviewed were synthesized into six themes: 1) extraordinary choice based on job stability and gender scarcity; 2) unexpected feeling of marginalization as minority far apart from the mainstream; 3) assimilation and negotiation for relational adaptation through perspective shift; 4) fortifying the vision and identity as nursing students by meaning making for adapting to the nursing major; 5) mutual support among colleague male students; and 6) serving in the military as way of hiding out and achieving maturation. Conclusion: The findings illustrate that nursing education programs need practical changes promoting male students' adaptation to the program itself as well as preparation to be a professional nurse in the future.

Ryu YM, et al. J Korean Acad Nurs. 2018 Oct;48(5):601-621. https://doi.org/10.4040/jkan.2018.48.5.601