Hyun-Ju Lee

Background/Objectives: Nursing performance in the operating room (OR) is associated with individual competencies, leadership, and teamwork. Based on McGrath’s Input–Process–Output model, this study examined the associations of OR nurses’ communication competence and nurses’ perceptions of nurse managers’ authentic leadership with nursing performance including indirect associations through teamwork. Methods: This cross-sectional study included 149 OR nurses working at three tertiary hospitals in Republic of Korea. Self-reported data were analyzed using PROCESS macro Model 4 with 5000 bootstrap resamples and 95% percentile bootstrap confidence intervals. Separate mediation models were supplemented by mutually adjusted models including both predictors and sensitivity analyses with modified teamwork scores. Results: OR nurses’ communication competence and nurses’ perceptions of nurse managers’ authentic leadership were each positively associated with teamwork and nursing performance. Their direct associations with nursing performance remained statistically significant across model specifications. Indirect associations through teamwork were significant in the separate models but not in the mutually adjusted model using the full teamwork measure. Both indirect associations were significant when the T-TPQ leadership subscale was excluded, with or without the communication subscale, although their estimates were smaller. Conclusions: Direct associations with nursing performance were consistent, whereas indirect associations through teamwork depended on model specification and teamwork measurement. These findings support considering teamwork alongside OR nurses’ communication competence and nurses’ perceptions of nurse managers’ authentic leadership without implying causal relationships.

Purpose: This study aims to construct and verify a path model for the factors affecting health-related quality of life (HRQoL) in community-dwelling vulnerable older adults with chronic diseases in Korea. Methods: The sample included 195 community-dwelling vulnerable adults aged 65 years and above with chronic diseases in Korea. Structured questionnaires were collected from April to June 2022. Data were analyzed using SPSS 28.0 and AMOS 28.0 programs. Results: The hypothesized path model significantly explained HRQoL in community-dwelling vulnerable older adults with chronic diseases, with a high explanatory power (48.0%). Self-rated health (SRH) and self-efficacy for managing chronic disease (SEMCD) had a significant direct effect on HRQoL. The number of diseases, depressive symptoms, social support, and digital literacy indirectly affected HRQoL. Conclusion: To improve HRQoL in community-dwelling vulnerable older adults with chronic diseases, integrated community health-management programs should focus on enhancing SEMCD and SRH, while incorporating depression screening, social support, and digital literacy education.

Background/Objectives: Family is a key protective factor for firefighters’ mental health, yet the home-related challenges of firefighting’s occupational demands remain underexplored in South Korea. This study aimed to establish an initial understanding of these challenges by conducting in-depth interviews with male firefighters and analyzing their lived experiences using a phenomenological approach. Methods: Twenty-nine married male firefighters (mean age = 43.4 years, range = 31–55) affiliated with the Busan Fire Department participated in individual telephone interviews between April and July 2022 during the COVID-19 pandemic. Data were analyzed using Giorgi’s descriptive phenomenological method, with NVivo Pro 12.0 employed for coding and organization. Results: Six themes were identified: (1) acting as an emergency commander at home, (2) reinterpreting traumatic experiences after marriage, (3) physical and emotional exhaustion from irregular schedules, (4) being national heroes misunderstood by families, (5) guilt-ridden and indebted Superman, and (6) striving to be Superman at home as well. These themes reflected the overarching meaning of a “lonely breadwinner struggling to be Superman both at work and home.” Participants described hyperarousal, emotional withdrawal, strained relationships, guilt over missed family events, and compensatory overextension. Distress was often concealed to protect families, but this limited emotional support. Conclusions: Korean male firefighters face significant work–family conflict shaped by cultural and occupational factors. These findings highlight the need for family-centered counseling, psychoeducation, and organizational interventions. Policy measures such as guaranteed rest after shifts, couple-based communication programs, and resilience-building initiatives are recommended to strengthen families as vital sources of psychological resilience.

Purpose: This study aimed to describe and understand the meaning and nature of the process of forming a therapeutic relationship among nursing students working with older patients with dementia in long-term care hospitals. Methods: In-depth interviews were conducted with 10 nursing students from September to October 2024. We examined and described the collected data based on Colaizzi's phenomenological method. Results: Seventeen theme clusters and five categories were derived from the nursing students' experiences. The five categories were as follows: preparing for scheduled encounters with unfamiliar people, embarking upon exploration to build a relationship, making various efforts to maintain a therapeutic relationship, facing obstacles in maintaining a relationship, and witnessing myself growing in a therapeutic relationship. Conclusion: Efforts should be made to develop and implement training programs that would reinforce nursing students' competencies to care for older patients with dementia through consistent interactions and exchanges with field practitioners.

Purpose: The purpose of this study was to identify the influence of digital literacy and patient activation on sick role behavior in vulnerable older adults with diabetes.Methods: This cross-sectional, descriptive study included 142 vulnerable older adults aged over 65 with diabetes who were seen at Busan Medical Center. Data were analyzed using descriptive statistics, the t-test, one-way analysis of variance, and stepwise multiple regression analysis with SPSS for Windows version 23.0.Results: Sick role behavior was significantly correlated with digital literacy (r=.68, p<.001) and patient activation (r=.83, p<.001). Digital literacy had a significant correlation with patient activation (r=.63, p<.001). Multiple regression analysis for sick role behavior revealed that the most powerful predictor was patient activation (β=.55, p<.001). Patient activation, digital literacy, gender (female), religiosity (being religious) and cohabitation (living with family) explained 81.0% of the variance in sick role behavior.Conclusion: Various factors were found to be related to the sick role behavior of vulnerable older adults with diabetes. Based on the results of this study, further development and application of a customized educational interventional program for improving the sick role behavior of older adults with diabetes will have a positive influence on disease treatment and health management for this population.

이현주, et al. J Korean Acad Nurs Adm. 2024 Sep;30(4):404-415. https://doi.org/10.11111/jkana.2024.30.4.404

Purpose: The purpose of this study was to identify factors related to the professional quality of life of nurses in long-term care hospitals. Methods: A descriptive survey was conducted among 144 nurses with more than 3 months of work experience in five long-term care hospitals in B metropolitan city. Data were collected from April 15 to 30, 2022 and analyzed using the independent t-test, one-way ANOVA, Mann-Whitney test, Pearson’s correlation coefficients, and stepwise multiple regression. Results: The regression model explained 51% of the variance of long-term care hospital nurses' compassion satisfaction (F=35.72, p<.001). Significant factors were dementia attitude (β=.23, p=.001), professional self-concept (β=.51, p<.001), marital status (married) (β=.16, p=.019) and more than 10 years of clinical experience at a long-term care hospital (β=-.29, p<.001). The regression model explained 36% of the variance of long-term care hospital nurses' compassion fatigue (F=12.93, p<.001). Significant factors were dementia attitude (β=-.27, p=.001), burden on behavioral psychological symptoms of dementia (β=.38, p<.001), women (β=.20, p=.005), more than 10 years of clinical experience at a long-term care hospital (β=.20, p=.004) and experience in education about dementia (yes) (β=-.16, p=.029). Conclusion: This study revealed several factors that are correlated with the professional quality of life of long-term care hospital nurses. To improve their quality of life, hospitals should help nurses have a positive attitude toward dementia, reduce the burden of behavioral psychological symptoms of dementia, and provide dementia care training.

Purpose: This study aimed to measure the influence of infection control fatigue and compassion competence on disaster nursing core competencies of nurses at COVID-19 designated hospitals.Methods: A descriptive survey was conducted among 128 nurses from two COVID-19 designated hospitals. Data were collected from June 1 to 14, 2022 and analyzed using the t-test, one-way analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression with SPSS for Windows version 26.0.Results: Disaster nursing core competencies had a significant correlation with compassion competence (r=.50, p<.001), but not with infection control fatigue. Multiple regression analysis for disaster nursing core competencies revealed that the most powerful predictor was communication (β=.31, p<.001). Communication, insight and having children explained approximately 30% of the variance in disaster nursing core competencies.Conclusion: The compassion competence of nurses at COVID-19 designated hospitals was a major factor influencing disaster nursing competence. Communication was the most important sub-factor of compassion competence. It will be necessary to develop and implement a program to enhance nurses' compassion competence to improve nurses' disaster nursing core competencies.

Purpose: South Korea has expanded its accelerated second-degree Bachelor of Science in Nursing program to resolve its supply-demand imbalance in nursing, although how these students are adapting to and performing in college after admission remains unclear. Therefore, this study aimed to conduct an in-depth exploration of how Korean accelerated second-degree Bachelor of Science nursing students interact with society and adapt to college life for establishing further supportive educational policies and programs.Methods: Participants comprised 20 South Korean accelerated second-degree Bachelor of Science in Nursing students. The data were collected via online or offline in-depth interviews and analyzed using Strauss and Corbin’s grounded theory and by applying a constant comparative method to achieve theoretical saturation.Results: The core category, derived using open, axial, and selective coding, was “process of the uncharted journey toward a new dream.” The participants’ college adaptation processes were found to involve three phases: trial and error, adjustment, and acceptance and integration.Conclusion: These findings can be used to develop, apply, test, and improve various support programs for accelerated second-degree Bachelor of Science in Nursing students and to advance the nursing profession by nurturing a workforce with diverse academic backgrounds and faster college life adaptation.

Purpose: The purpose of this study was to measure the influence of job stress, critical thinking disposition, and clinical decision-making ability on clinical nurses’ medication safety competence. Methods: A descriptive survey was conducted among 140 nurses with more than 6 months of work experience in 4 general hospitals in Busan metropolitan city. Data were collected from August 15 to October 30, 2021 and analyzed using the independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and stepwise multiple regression. Results: Medication safety competence had significant correlations with job stress (r=.20, p=.021), critical thinking disposition (r=.63, p<.001), and clinical decision-making ability (r=.54, p<.001). Multiple regression analysis for medication safety competence revealed that the most powerful predictor was critical thinking disposition. Job stress and critical thinking disposition explained approximately 45% of the variance in medication safety competence. Conclusion: This study confirms the need to make systematic efforts in clinical settings to improve nurses’ medication safety competence, and seeks ways to do so. To enhance clinical nurses’ medication safety competence in the future, programs that manage job stress and improve critical thinking disposition within the nursing department in particular and the hospital in general should be developed and implemented.