Purpose: This study primarily aimed to identify the factors influencing health-related quality of life (HRQoL) in adults with accident- or poisoning-related treatment experience in the past year. Methods: This study employed a cross-sectional descriptive design. The participants were 354 adults who had received medical treatment for accidents or poisoning within the past year. The analysis was based on data obtained from the 2023 Korea National Health and Nutrition Examination Survey. Complex-sample descriptive statistics and inferential tests, including frequencies, x2 tests, complex-sample t-tests, and multiple regression, were conducted using SPSS 29.0. Results: The significant predictors of HRQoL encompassed employment status, age, subjective health perception, activity limitation, high-sensitivity C-reactive protein, perceived stress, and anxiety, with the regression model explaining 41.8% of the variance. Conclusion: The HRQoL of adults who have received treatment for accidents or poisoning is determined by multiple dimensions, including their perceived health, functional limitation level, inflammation, stress, and anxiety, rather than merely by the existence of injury. Therefore, integrated nursing strategies that combine physiological surveillance, early evaluation of psychological status, and tailored interventions centered on functional recovery are required for improving HRQoL in this group.
Purpose: This study examined the associations between the nursing work environment, patient-centered communication, occupational coping self-efficacy, professional identity, and missed nursing care among nurses working in general hospitals. Methods: A descriptive cross-sectional design was adopted, using data collected in 2025 from 177 nurses working in a general hospital. The following questionnaires were used: the Practice Environment Scale of the Nursing Work Index-5, Patient-Centered Communication Scale for Nurses, Korean Version of the Occupational Coping Self-efficacy for Nurses Scale, Professional Identity in Nursing Scale 2.0, and MISSCARE Scale. Descriptive statistics, t-tests, Pearson’s correlation coefficients, and multiple regression analyses were performed. Results: Total clinical experience and overtime were negatively and positively correlated with missed nursing care, respectively. The nursing work environment, patient-centered communication, occupational coping self-efficacy, and professional identity were negatively associated with missed nursing care. Multiple regression analysis revealed that increased overtime hours (β=.24, p<.001) were associated with higher levels of missed nursing care, whereas a favorable nursing work environment (β=-.34, p<.001), effective patient-centered communication (β=-.21, p<.001), and strong professional identity (β=-.27, p<.001) were associated with lower levels of missed nursing care. Furthermore, these factors explained 47.4% of the variance in missed nursing care (F=32.74, p<.001). Conclusion: Professional identity and patient-centered communication were identified as new factors associated with missed nursing care among nurses in general hospitals. To potentially address missed nursing care and enhance patient safety, efforts to reinforce nurses’ professional identities and patient-centered communication should be considered.
Purpose: This study examined the relationships between night-shift noise exposure, alarm fatigue, and daytime sleep quality in intensive care unit (ICU) nurses, and the mediating effects of alarm fatigue on the associations of noise exposure and medical equipment alarm frequency with daytime sleep quality. Methods: This descriptive correlational study included 125 ICU nurses from a hospital in Busan, South Korea. Data were collected from April 21 to May 12, 2025. A GM-1356 meter measured noise levels in dBA. Validated Korean versions of the A Technology Hazard Survey and the Verran and Snyder-Halpern Sleep Scale assessed alarm fatigue and daytime sleep quality, respectively. Data were evaluated using correlation, hierarchical regression, and mediation analyses with SPSS version 27.0. Results: The mean night-shift noise level was 54.24±2.95 dBA. Alarm fatigue was negatively correlated with daytime sleep quality (r=-.51, p<.001) and was the strongest predictor (β=-.47, p<.001). Night-shift noise exposure and alarm frequency were not directly associated with sleep quality. Alarm frequency was positively correlated with alarm fatigue (r=.22, p=.012), which mediated its association with sleep quality (indirect effect β=-.24, 95% CI [-0.45, -0.07]). Nurses caring for three patients had poorer sleep quality than those caring for two (β=-.19, p=.031). Conclusion: ICU nurses were exposed to high night-shift noise levels and frequent alarms and experienced alarm fatigue and poor daytime sleep quality. Therefore, organizational interventions, including optimized alarm management and appropriate nurse staffing, are essential for reducing alarm fatigue and promoting patient safety and the well-being of nurses.
Purpose: This study explored the perceptions and needs of family members of older adults residing in long-term care facilities regarding end-of-life care. Methods: This qualitative study used Braun and Clarke’s thematic analysis. Participants were family members of older adults residing in long-term care facilities. Data were collected through in-depth interviews and analyzed according to the thematic analysis process. Results: Four overarching themes and nine subthemes were derived. The four themes were as follows: (1) avoidance of death-related conversations and a hospital-centered view of end-of-life care; (2) anxiety and discomfort regarding end-of-life care within long-term care facilities; (3) end-of-life care as a continuation of daily care that preserves dignity; and (4) end-of-life care as fulfilling filial duty in a second home. Conclusion: To ensure effective end-of-life care delivery in long-term care facilities, multifaceted strategies are needed, including improved communication with families, staff education programs on end-of-life care, and collaboration with external resources such as hospitals. Furthermore, a standardized end-of-life care program that reflects the realities and environments of long-term care facilities is needed to ensure consistent, high-quality care without qualitative disparities.
Introduction: This study analyzed the effects of shared leadership on nursing students' team performance in team-based learning, and the mediating effect of team efficacy on this relationship. The team-based learning literature tends to focus on personal-level performance, whereas research measuring team-level performance remains scarce. The present study was intended to address this gap. Methods: This study adopted a descriptive correlation design. A questionnaire survey was conducted with 77 third-year nursing students enrolled in a practical course implementing team-based learning at a university. Team-based learning was delivered through team-based simulation training for 8 weeks. Data were collected from February to June 2023. Pearson correlation coefficients were used to assess the relationships among shared leadership, team performance, and participants' perceived team efficacy. Regression analysis was used to test the effects of shared leadership on team performance and team efficacy, as well as the mediating role of team efficacy in the relationship between shared leadership and team performance. Results: Shared leadership had a significant positive effect on team performance in team-based learning, and team efficacy partially mediated this relationship. Conclusion: These results suggest that measures to enhance team efficacy among team members during team-based learning in universities may positively affect team performance and team efficacy, thereby contributing to positive learning outcomes. When implementing team-based learning in universities, instructor coaching, aimed at guiding team members to share leadership can encourage participation and role fulfillment, thereby strengthening shared leadership.
Purpose: This study investigated the effects of infection control awareness, infection control organizational culture, and nursing professionalism on infection control competence among nurses working in general hospitals. By analyzing both individual-level and organizational-level factors, this study sought to provide foundational data for improving infection control practices and for developing effective education and policy strategies. Methods: A total of 215 nurses working at general hospitals in Deajeon Metropolitan City who agreed to participate were surveyed using structured questionnaires. Data were analyzed using SPSS Statistics 29.0. Descriptive statistics, independent t-tests, and one-way ANOVA were conducted to examine group differences, whereas Pearson’s correlation coefficients and multiple regression analysis were used to explore relationships and predictive factors. Results: Correlation analysis revealed positive relationships between infection control competence and infection control awareness (r=.38, p<.001), organizational culture (r=.46, p<.001), and nursing professionalism (r=.46, p<.001). Multiple regression analysis showed that these three variables, together with working in an integrated nursing care ward, were significant predictors of infection control competence. Conclusion: This study highlights the need for multifaceted strategies to strengthen infection control competence among general hospital nurses. In particular, raising awareness through systematic and practice-oriented education programs is essential. Furthermore, fostering a positive organizational culture and reinforcing professional nursing identity should be addressed at the institutional level.
Purpose: The aim of this study was to investigate the effects of kinesiophobia, social support, and self-care behaviors on quality of life in the patients with heart failure. Methods: A total of 124 patients with heart failure were recruited from the cardiovascular center of a tertiary general hospital in Seoul. Data were collected from July to November 2025 using self-report questionnaires on kinesiophobia (Tampa Scale for Kinesiophobia-Heart), social support (Multidimensional Scale of Perceived Social Support), self-care behaviors (Self-Care of Heart Failure Index version 7.2), and quality of life (Minnesota Living with Heart Failure Questionnaire). Data were analyzed using SPSS version 31.0.1.0, including descriptive statistics, the independent t-test, one-way analysis of variance, Pearson's correlation coefficients, and multiple regression analysis. Results: The factors affecting quality of life were exercise (β=.19, p=.020), New York Heart Association (NYHA) class II (β=.22, p=.007), NYHA class III-IV (β=.43, p<.001), and symptom perception (β=.21, p=.020). The overall explanatory power was 40%. However, kinesiophobia, social support, self-care maintenance, and self-care management were not significant factors affecting quality of life. Conclusion: The results of this study showed that exercise, NYHA class, and symptom perception were factors affecting quality of life of patients with heart failure. To improve quality of life in these patients, it is necessary to develop a personalized program that takes disease severity, exercise capacity, and symptom perception into account.
Purpose: This study examined the use of teaching methods in the fundamental nursing practicum and explored faculty experiences using a mixed-method design. Methods: A nationwide survey of 78 faculty members and in-depth interviews with 7 participants were analyzed using descriptive statistics and Colaizzi’s qualitative method. Results: The quantitative findings showed that team-based learning (48.7%) and flipped learning (47.4%) were the most frequently used methods and were also rated as the most effective methods (29.5% each). Faculty members identified lack of time (64.1%) and financial constraints (47.4%) as the major barriers to adopting teaching methods and selected practicum environment quality (33.3%) and instructor expertise (29.5%) as the most important factors for improving quality. The qualitative findings yielded four theme clusters: professional practices for enhancing nursing competence, constraints on practicum under limited resources, uncertainty in applying new teaching methods, and the gap between education and clinical practice. Conclusion: This study examined the use of teaching methods and faculty experiences in the fundamental nursing practicum through a mixed-method design and identified factors that contribute to or restrict the quality of practicum education. These findings can serve as an evidence-based basis for the effective design and operation of the fundamental nursing practicum. Future studies are needed to clarify policy support for improving the practicum environment and strengthening instructor expertise.
Purpose: To investigate the experiences and perceptions of traditional Korean nurses and utilize the findings for policy recommendations on how nurses can effectively practice nursing in traditional Korean hospital settings. Methods: Through purposive sampling, 12 nurses were recruited from a university-affiliated traditional Korean hospital in Seoul. Semi-structured face-to-face interviews were conducted with two focus groups between January and February 2018. Results: The results comprehensively demonstrated that traditional Korean nurses consistently struggle to build a professional self in practice environments with deficient structural support. This overarching phenomenon unfolded across three distinct yet causally interconnected themes: 1) the emotional tension between relational reward and caregiving burnout, 2) regulatory constraints and structurally reproduced unpreparedness, and 3) role erosion through institutional role ambiguity and structural exclusion. Conclusion: This study highlights nurses’ eagerness to deepen their traditional Korean nursing practice proficiency, underscoring the need for targeted interventions and comprehensive educational frameworks to address their professional challenges and aspirations.
Purpose: This descriptive study aimed to examine the relationships among nurses’ awareness of safety guidelines on antineoplastic agents, hospital safety culture, anxiety about exposure to antineoplastic agents, and adherence to safety guidelines on antineoplastic agents. Methods: Data were collected from 135 nurses handling antineoplastic agents in hospitals located in Cheongju City and Sejong City city between February 19 and March 10, 2025. Statistical analyses were performed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson’s correlation, and multiple regression analyses with SPSS/WIN 29.0. Results: Nurses reported a high level of awareness of safety guidelines on antineoplastic agents, with environmental management scoring the highest among subdomains. Adherence to Safety guidelines differed significantly according to exposure status (t=-2.09, p=.039) and showed a positive correlation with hospital safety culture (r=.41, p<.001). Multiple regression analysis identified hospital safety culture (β=.40, p<.001) and exposure status (β=-.17, p=.028) as significant predictors, accounting for 19.0% of the variance in adherence to safety guidelines. Conclusion: Hospital safety culture and exposure status were significant predictors of adherence to safety guidelines on antineoplastic agents. These findings highlight the need for targeted educational and organizational interventions to increase compliance. Further research is warranted to explore additional factors influencing adherence to safety guidelines among nurses handling antineoplastic agents.
Purpose: Suicidal ideation is associated with multiple biopsychosocial conditions. Obstructive sleep apnea(OSA) is a common sleep-related condition that coexist with psychological, behavioral, and social factors. However, population-based evidence describing correlates of suicidal ideation across OSA risk groups remains limited. Methods: This cross-sectional secondary analysis used data from the 2022-2023 Korea National Health and Nutrition Examination Survey. OSA risk was classified using the STOP-Bang questionnaire as low (0~2) or high (≥3). Past-year suicidal ideation was self-reported. Multivariable logistic regression analyses accounting for complex sampling design were conducted separately within each OSA risk group. Results: Among 3,447 adults aged ≥40 years, suicidal ideation prevalence was 3.1% in the low-risk group and 4.0% in the high-risk group. Absence of depressive symptoms was associated with lower odds in both groups (high-risk: AOR=0.28, low-risk: AOR=0.11), whereas higher anxiety was associated with higher odds(high-risk: AOR=4.95, low-risk: AOR=5.21). In the high-risk group, current smoking (AOR=3.57) and not sharing meals (AOR=2.97) were additionally associated. In the low-risk group, short sleep duration (AOR=2.41), mental health consultation(AOR=4.20), and older age (AOR=0.26) were observed. Biological indicators were not significant after adjustment. Conclusion: Depression and anxiety were consistently associated with suicidal ideation across OSA risk groups. Additional behavioral, social, and sleep-related factors were observed within specific groups, although these findings reflect descriptive patterns rather than statistically confirmed heterogeneity. Incorporating sleep-related health context may enhance population-level suicide risk assessment and support subgroup identification for targeted screening. Longitudinal studies are needed to clarify temporal relationships and mechanisms.
Purpose: This study aimed to identify the levels of nursing work environment, nursing professionalism, communication skills, and integrated supportive care competence for cancer survivors among nurses who had experience caring for cancer survivors. In addition, the study examined the effects of nursing work environment, nursing professionalism, and communication skills on nurses’ integrated supportive care competence for cancer survivors. Methods: A total of 165 nurses working at general hospitals with ≥300 beds in Seoul City who had provided care to cancer patients for at least 3 months were included in this study. Data were collected using structured questionnaires from August 21 to September 4, 2024. The collected data were analyzed using descriptive statistics, tests of group differences, correlation analysis, and stepwise regression analysis. Results: The participants’ mean age was 31.28±5.24 years, and their mean duration of experience in caring for cancer survivors was 5.77±4.04 years. The factors influencing integrated supportive care competence for cancer survivors were communication skills (β=.48, p<.001), experience of receiving education on caring for cancer patients (β=.17, p=.011), and educational level (β=.14, p=.037). The regression model was statistically significant (F=25.35, p<.001) and explained 31% of the variance in integrated supportive care competence. Conclusion: Practical education programs for nurses should incorporate structured training to strengthen effective communication with cancer survivors. In particular, simulation-based training using authentic clinical scenarios is needed to support the acquisition and application of patient-centered communication skills. In addition, organizational efforts are required to expand and systematize educational opportunities that continuously strengthen nurses’ competencies in caring for cancer survivors.
Purpose: This study aimed to identify key infection control elements and analyze intervention strategies across the stages of the chain of infection framework in long-term care facilities in South Korea.Methods: An integrative review was conducted of 25 domestic studies published between 2008 and 2024, including quantitative, qualitative, and mixed-methods research. The selected studies were analyzed according to the six stages of the chain of infection and were categorized into eight major infection control factors.Results: The stages of “mode of transmission” and “susceptible host” were most frequently addressed in the reviewed studies, whereas the “infectious agent,” “reservoir,” “portal of exit,” and “portal of entry” stages received comparatively less attention. Notably, studies focusing on the prevention and management of chronic infections, such as multidrug-resistant organisms, were scarce. Among the eight infection control factors, “education” and “guidelines” consistently emerged as core interventions across all stages. In addition, the findings underscored the importance of deploying dedicated personnel, improving facility, environments, implementing simulation-based training, and strengthening education on aseptic techniques.Conclusion: By applying the chain of infection model, this study reconstructed infection control strategies in long-term care facilities and identified stage-specific gaps in existing interventions. The findings provide practical implications for strengthening infection prevention systems and offer foundational evidence to support policy initiatives, including the deployment of infection control nurses, development of tailored training programs, and reinforcement of national-level infection control guidelines.
Purpose: This study investigated the influence of nursing informatics competency and clinical decision-making ability on patient safety competency among clinical nurses.Methods: A cross-sectional study was conducted from November to December 2023 with 201 nurses working in general and tertiary hospitals. Data were analyzed using descriptive statistics, the independent t-test, analysis of variance, Pearson’s correlation analysis, and hierarchical multiple regression.Results: Patient safety competency was positively correlated with nursing informatics competency (r=.51, p<.001) and clinical decision-making ability (r=.52, p<.001). Hierarchical multiple regression analysis indicated that clinical decision-making ability (β=.38) and nursing informatics competency (β=.38) were the strongest predictors of patient safety competency, with working in special care units (β=.18) also contributing significantly. Together, these variables explained 42.8% of the variance in patient safety competency.Conclusion: This study demonstrated significant associations among clinical decision-making ability, nursing informatics competency, and patient safety competency among clinical nurses. By examining the integrated relationships among these competencies, the findings provide empirical evidence for understanding factors that may influence patient safety outcomes in increasingly digitalized healthcare environments.
Purpose: This study aimed to define and clarify the concept of restraint-free care within the context of nursing practice.Methods: A concept analysis was conducted using the Walker and Avant method. Literature published between 1990 and 2025 was systematically reviewed across domestic and international databases. Sixteen relevant articles were selected and analyzed to identify the defining attributes, antecedents, and consequences of the concept.Results: The concept analysis identified three defining attributes of restraint-free care: (1) nursing practice that avoids coercion and physical restraint, (2) implementation of person-centered care, and (3) care grounded in ethical values. Antecedents of restraint-free care included the establishment of standardized protocols for restraint use, enhancement of nurses’ ethical sensitivity, implementation of alternative interventions to physical restraints, establishment of interdisciplinary collaboration, and provision of systematic education programs for nurses. The identified consequences of restraint-free care included promotion of patient recovery, improvement in the overall quality of nursing care, strengthening of professional nursing identity, and positive transformation of organizational culture.Conclusion: Restraint-free care reflects a paradigm shift from control-based interventions toward ethical, individualized care. Clarifying this concept provides a theoretical framework for the development of clinical guidelines, nursing education, and interventions aimed at minimizing physical restraint use. Establishing a shared understanding of restraint-free care may promote consistent communication among healthcare providers and facilitate its broader adoption in clinical settings.
Purpose: The purpose of this study was to develop a nurse-led cardiac rehabilitation program for patients undergoing coronary artery bypass grafting (CABG), based on the information-motivation-behavioral Skills (IMB) model.Methods: This methodological study followed several sequential steps. A preliminary program was developed based on an integrative review and a nursing needs assessment conducted through in-depth interviews with patients undergoing CABG. The final program was refined using feedback from an expert committee, evaluated using the content validity index (CVI), and assessed for clinical validity with the participation of four patients.Results: Based on the theoretical framework of the IMB model, a conceptual framework was constructed. The purpose and specific components of the program were established by deriving three core concepts and nine sub-concepts from the nursing needs analysis. After content validity was verified by an expert panel, the preliminary program was applied to patients to assess clinical validity. As a result, a 12-week cardiac rehabilitation program was finalized.Conclusion: This study developed a nurse-led cardiac rehabilitation program based on the IMB model as a theoretical framework to enhance the continuity of cardiac rehabilitation, supported by the pilot program’s clinical feasibility. Future studies are recommended to validate the 12-week program in clinical practice using a sufficient sample size.
Purpose: This study aimed to examine how the nursing work environment and nursing professionalism influence medication safety competence among nurses working in general hospitals.Methods: A cross-sectional survey was conducted with 269 nurses who had at least six months of experience performing medication-related tasks in general hospitals. Data were collected from August 30 to September 10, 2024. Statistical analyses included independent t-tests, one-way analysis of variance, Pearson correlation coefficients, and hierarchical regression analysis with SPSS/WIN 30.0.Results: The mean scores for the nursing work environment, nursing professionalism, and medication safety competence were 2.72±0.44, 3.73±0.50, and 3.98±0.57, respectively. Significant correlations were identified between the nursing work environment and nursing professionalism (r=.51, p<.001), between the nursing work environment and medication safety competence (r=.26, p<.001), and between nursing professionalism and medication safety competence (r=.44, p<.001). Medication safety competence was significantly associated with nursing professionalism (β=.46, p<.001), total clinical experience (β=.32, p<.001), and experience with medication errors (β=.11, p=.023). The hierarchical regression model explained 37.5% of the variance in medication safety competence (F=20.35, p<.001).Conclusion: Strategies to strengthen nurses’ professionalism, utilize medication error experience as a learning opportunity, and support the maintenance of clinical experience are recommended.
Purpose: This study aimed to observe endotracheal suctioning (ETS) procedures performed by emergency room nurses, identify factors that impede adherence to established guidelines, and propose specific strategies to improve compliance with these guidelines.Methods: The performance of ETS by emergency room nurses was observed in a simulated clinical environment, and adherence to established ETS guidelines was systematically assessed. Following, the simulation, semi-structured interviews were conducted with all participants to explore perceived barriers to guideline adherence.Results: Nineteen emergency room nurses participated in both the simulation and the interviews. Most participants did not adhere to recommended standards, particularly with respect to hand hygiene, and contamination frequently occurred during catheter handling. In addition, catheters larger than those recommended were commonly used, and inserted beyond the suggested depth. Many participants applied suction pressures that exceeded recommended levels and reported that the guideline-recommended pressure was ineffective for adequate secretion removal. Interview findings further indicated that participants perceived regular, customized training, that includes the rationale for each guideline component as necessary to enhance compliance.Conclusion: This study confirmed that emergency room nurses demonstrate inadequate adherence to ETS guidelines, particularly regarding catheter size selection, aseptic technique, and suction pressure management. These findings indicate a clear need for enhanced and targeted education addressing these areas. In addition to reaffirming previous research, this study provides insight into the underlying reasons for noncompliance with ETS guidelines, as identified through participant interviews.
Purpose: End-of-life care is a multifaceted and holistic domain of nursing practice, and strengthening the competencies of nursing home nurses has become increasingly important in the context of a rapidly aging global population. This study aimed to apply the attention, relevance, confidence, and satisfaction (ARCS) model to a web-based end-of-life care education program and to evaluate its effects on learning motivation and end-of-life care competency among nursing home nurses.Methods: The education program was developed using the analysis, design, development, implementation, and evaluation (ADDIE) model. In Phase 1, needs and learner analyses were conducted through interviews with 20 nursing home nurses to inform the development of the educational content. In Phase 2, the effectiveness of the program was evaluated using a multisite, single-blind, quasi-experimental design. A total of 60 nursing home nurses were recruited and assigned to two groups. The experimental group received a web-based end-of-life care education program grounded in the ARCS model, whereas the control group received text-based online education.Results: The analysis demonstrated that all components of learning motivation and end-of-life care competency showed significantly greater improvement in the experimental group than in the control group.Conclusion: These findings support the effectiveness of ARCS-based instructional design in continuing education for nursing home nurses, particularly in addressing the growing demand for high-quality end-of-life care in aging societies.
Purpose: This study aimed to evaluate the perceived importance and performance of core nursing skills according to learning objectives, as assessed by fundamental nursing practice instructors, using the importance-performance analysis (IPA) method.Methods: A survey was conducted from December 1 to December 31, 2024, and responses from 147 participants were analyzed. A total of 27 structured questionnaire items were developed through preliminary item generation and content validity verification. The collected data were analyzed using IPA with SPSS version 30.0.Results: Fifteen core nursing skills were identified as having both high importance and high performance. However, fall prevention and pressure ulcer care were rated as highly important but low in performance.Conclusion: To strengthen educational competency, it is essential to reorganize the educational priorities of Level 1 core nursing skills in fundamental nursing practice and to develop appropriate educational strategies to address performance gaps.
