Pub Date : 2022-10-31DOI: 10.34250/jkccn.2022.15.3.23
Sun-Jung Moon, Haena Jang
Purpose : This study aimed to identify the factors influencing the professional quality of life of intensive care unit (ICU) nurses working in university hospitals.Methods : A survey was conducted on 171 ICU nurses in university hospitals in B City, South Korea. This study used the Professional Quality of Life instrument, which consists of three subscales, namely, compassion satisfaction, burnout, and secondary traumatic stress. Data were analyzed using stepwise multiple regression analysis.Results : Compassion satisfaction was influenced by resilience, ICU job satisfaction, and innovation-oriented culture, and these variables explained 37.1% of the variance in compassion satisfaction. Burnout was influenced by resilience, a hierarchy-oriented culture, and ICU job satisfaction, and these variables explained 42.9% of the variance in burnout. Secondary traumatic stress was influenced by a task-oriented culture and resilience, and these variables explained 12.5% of the variance in secondary traumatic stress.Conclusion : These findings suggest the importance of improving resilience and job satisfaction to enhance the professional quality of life in ICU nurses. Moreover, creating an innovation-oriented culture rather than a hierarchical and task-oriented culture can effectively improve the professional quality of life of ICU nurses.
{"title":"Factors Influencing Professional Quality of Life in Intensive Care Unit Nurses of University Hospitals","authors":"Sun-Jung Moon, Haena Jang","doi":"10.34250/jkccn.2022.15.3.23","DOIUrl":"https://doi.org/10.34250/jkccn.2022.15.3.23","url":null,"abstract":"Purpose : This study aimed to identify the factors influencing the professional quality of life of intensive care unit (ICU) nurses working in university hospitals.Methods : A survey was conducted on 171 ICU nurses in university hospitals in B City, South Korea. This study used the Professional Quality of Life instrument, which consists of three subscales, namely, compassion satisfaction, burnout, and secondary traumatic stress. Data were analyzed using stepwise multiple regression analysis.Results : Compassion satisfaction was influenced by resilience, ICU job satisfaction, and innovation-oriented culture, and these variables explained 37.1% of the variance in compassion satisfaction. Burnout was influenced by resilience, a hierarchy-oriented culture, and ICU job satisfaction, and these variables explained 42.9% of the variance in burnout. Secondary traumatic stress was influenced by a task-oriented culture and resilience, and these variables explained 12.5% of the variance in secondary traumatic stress.Conclusion : These findings suggest the importance of improving resilience and job satisfaction to enhance the professional quality of life in ICU nurses. Moreover, creating an innovation-oriented culture rather than a hierarchical and task-oriented culture can effectively improve the professional quality of life of ICU nurses.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83895114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.34250/jkccn.2022.15.3.12
Hyojeong Choi, R. Song
Purpose : This study aimed to examine the relationships of burnout and compassion competency with job satisfaction among nurses working in the intensive care units and emergency rooms.Methods : A correlational survey was conducted from August 1 to August 14, 2018 and involved in 102 nurses working at four university hospitals for more than 1 year. A structured questionnaire was used to measure burnout, compassion competency, and job satisfaction, and data were analyzed using hierarchical multiple regression and mediation effect analysis.Results : The mean scores of burnout, compassion competency, and job satisfaction were 2.58, 4.35, and 2.95, respectively. Burnout and compassion competency along with working night shifts and a wish to transfer explained 35.3% of variance in job satisfaction. Compassion competency showed a small but significant mediating effect in the relationship between burnout and job satisfaction (indirect effect -.0446, 95% CI -.1133, -.0075).Conclusion : Burnout and compassion competency were the significant influencing factors of job satisfaction among nurses working in intensive care units and emergency rooms. Since compassion competency showed a significant mediating effect, further studies should focus on intervention strategies for compassion competency to improve job satisfaction in this population.
目的:本研究旨在探讨重症监护室及急诊室护士职业倦怠、同情胜任力与工作满意度的关系。方法:于2018年8月1日至8月14日对在4所大学附属医院工作1年以上的102名护士进行相关调查。采用结构化问卷对倦怠、同情胜任力和工作满意度进行测量，并采用层次多元回归和中介效应分析对数据进行分析。结果:职业倦怠、同情胜任力和工作满意度的平均得分分别为2.58分、4.35分和2.95分。职业倦怠、同情心、能力、夜班工作和跳槽意愿解释了35.3%的工作满意度差异。同理心胜任力在职业倦怠与工作满意度之间的中介作用虽小但显著(间接效应)。0446, 95% ci -。1133年,-.0075)。结论:倦怠和同情胜任力是重症监护室和急诊室护士工作满意度的显著影响因素。鉴于同情胜任力具有显著的中介作用，进一步的研究应关注同情胜任力对提高该人群工作满意度的干预策略。
{"title":"Burnout and compassion competency to explain job satisfaction among nurses working in intensive care units or emergency rooms","authors":"Hyojeong Choi, R. Song","doi":"10.34250/jkccn.2022.15.3.12","DOIUrl":"https://doi.org/10.34250/jkccn.2022.15.3.12","url":null,"abstract":"Purpose : This study aimed to examine the relationships of burnout and compassion competency with job satisfaction among nurses working in the intensive care units and emergency rooms.Methods : A correlational survey was conducted from August 1 to August 14, 2018 and involved in 102 nurses working at four university hospitals for more than 1 year. A structured questionnaire was used to measure burnout, compassion competency, and job satisfaction, and data were analyzed using hierarchical multiple regression and mediation effect analysis.Results : The mean scores of burnout, compassion competency, and job satisfaction were 2.58, 4.35, and 2.95, respectively. Burnout and compassion competency along with working night shifts and a wish to transfer explained 35.3% of variance in job satisfaction. Compassion competency showed a small but significant mediating effect in the relationship between burnout and job satisfaction (indirect effect -.0446, 95% CI -.1133, -.0075).Conclusion : Burnout and compassion competency were the significant influencing factors of job satisfaction among nurses working in intensive care units and emergency rooms. Since compassion competency showed a significant mediating effect, further studies should focus on intervention strategies for compassion competency to improve job satisfaction in this population.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"133 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80448455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.34250/jkccn.2022.15.3.75
Hyun Kyoung Jung, Eun Nam Lee
Purpose : This retrospective investigation study aimed to determine the predictive validity of superficial surgical site infection assessment tools by measuring the risk score at the surgical site.Methods : This study included patients hospitalized to the general surgery department of a Hospital from January 2021 to December 31, 2021. The inclusion criteria were age ≥19 years, general abdominal surgery under general anesthesia, and hospital stay longer than 2 days. Patients who had undergone transplantation were excluded.Results : Tool validity results showed that tools including surgical time and operative procedure were more accurate than previously developed tools, with a sensitivity of 71.1%, specificity of 71.4%, positive prediction of 12.3%, negative prediction of 97.8%, and area under the curve of 0.743 (95% confidence interval, 0.678~0.745). The tool's cut-off score was 15, and the risks of infection was increased by 6.14 times at or above this cut-off point. Preoperative hair removal period, surgical wound classification, surgery time, body temperature on the second day after surgery, drainage tube type, and suture type affected the risk of infection at the surgical site.Conclusion : The incidence of healthcare-associated infections has been declining in the past decade; however, surgical site infections still account for a considerable proportion. Therefore, early identification of high-risk groups for surgical site infection is crucial for reducing the incidence of surgical site infection using appropriate management.
{"title":"Validation of the Risk Prediction Tool for Wound Infection in Abdominal Surgery Patients","authors":"Hyun Kyoung Jung, Eun Nam Lee","doi":"10.34250/jkccn.2022.15.3.75","DOIUrl":"https://doi.org/10.34250/jkccn.2022.15.3.75","url":null,"abstract":"Purpose : This retrospective investigation study aimed to determine the predictive validity of superficial surgical site infection assessment tools by measuring the risk score at the surgical site.Methods : This study included patients hospitalized to the general surgery department of a Hospital from January 2021 to December 31, 2021. The inclusion criteria were age ≥19 years, general abdominal surgery under general anesthesia, and hospital stay longer than 2 days. Patients who had undergone transplantation were excluded.Results : Tool validity results showed that tools including surgical time and operative procedure were more accurate than previously developed tools, with a sensitivity of 71.1%, specificity of 71.4%, positive prediction of 12.3%, negative prediction of 97.8%, and area under the curve of 0.743 (95% confidence interval, 0.678~0.745). The tool's cut-off score was 15, and the risks of infection was increased by 6.14 times at or above this cut-off point. Preoperative hair removal period, surgical wound classification, surgery time, body temperature on the second day after surgery, drainage tube type, and suture type affected the risk of infection at the surgical site.Conclusion : The incidence of healthcare-associated infections has been declining in the past decade; however, surgical site infections still account for a considerable proportion. Therefore, early identification of high-risk groups for surgical site infection is crucial for reducing the incidence of surgical site infection using appropriate management.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85972334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.34250/jkccn.2022.15.3.62
Da Eun Kim, H. Min
Purpose : This study aimed to identify the factors influencing physical restraint-related practice among nurses working in the intensive care unit (ICU).Methods : The participants consisted of 169 ICU nurses in three general hospitals in B and U cities. Data were collected from December 2021 to January 2022 through a structured selfadministered questionnaire. Demographic characteristics, physical restraint-related practice, Person-centered Critical Care Nursing (PCCN), work environment, and attitudes toward physical restraint use were measured. For data analyses, hierarchical multiple regressions were conducted using SPSS/WIN 25.0.Results : Clinical careers in the ICU, better work environments, higher PCCN levels, and more positive attitudes toward physical restraint use were associated with a better practice of physical restraints, which together explained 35.5% of the total variance of the outcome.Conclusion : Our findings suggest that to promote a safe physical restraintrelated practice among ICU nurses, it is important to improve the nursing environment, prepare guidelines for applying PCCN, and provide education for endorsing positive attitudes toward the use of physical restraints.
{"title":"Factors Influencing Nursing Practice for Physical Restraints among Nurses in the Intensive Care Unit","authors":"Da Eun Kim, H. Min","doi":"10.34250/jkccn.2022.15.3.62","DOIUrl":"https://doi.org/10.34250/jkccn.2022.15.3.62","url":null,"abstract":"Purpose : This study aimed to identify the factors influencing physical restraint-related practice among nurses working in the intensive care unit (ICU).Methods : The participants consisted of 169 ICU nurses in three general hospitals in B and U cities. Data were collected from December 2021 to January 2022 through a structured selfadministered questionnaire. Demographic characteristics, physical restraint-related practice, Person-centered Critical Care Nursing (PCCN), work environment, and attitudes toward physical restraint use were measured. For data analyses, hierarchical multiple regressions were conducted using SPSS/WIN 25.0.Results : Clinical careers in the ICU, better work environments, higher PCCN levels, and more positive attitudes toward physical restraint use were associated with a better practice of physical restraints, which together explained 35.5% of the total variance of the outcome.Conclusion : Our findings suggest that to promote a safe physical restraintrelated practice among ICU nurses, it is important to improve the nursing environment, prepare guidelines for applying PCCN, and provide education for endorsing positive attitudes toward the use of physical restraints.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86174753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.34250/jkccn.2022.15.3.115
Jiyeon Kang, Y. Kwon
Purpose : This study aimed to investigate sleep parameters and to identify differences according to respiratory support therapy, sedation, and pain medication in intensive care unit (ICU) patients.Methods : In this observational study, sleep parameters were measured using actigraphy. We observed 45 sleep events in 30 ICU patients receiving respiratory support therapy. We measured the sleep parameters, time, efficiency, and wakefulness after sleep onset (WASO). The differences in sleep parameters according to the respiratory support therapy were analyzed using the Mann-Whitney U test.Results : The average daily sleep time of the participants was 776.66±276.71 minutes, of which more than 60% accounted for daytime sleep. During night sleep, the duration of WASO was 156.93±107.91 minutes, and the frequency of WASO was 26.02±25.82 times. The high flow nasal cannula (HFNC) group had a significantly shorter night sleep time (χ2=7.86, p =.049), a greater number of WASO (χ2=5.69, p =.128), and a longer WASO duration (χ2=8.75, p =.033) than groups of other respiratory therapies.Conclusion : ICU patients on respiratory support therapy experienced sleep disturbances such as disrupted circadian rhythm and sleep fragmentation. Among respiratory support regimens, HFNC was associated with poor sleep parameters, which appears to be associated with the insufficient use of analgesics. The results of this study warrant the development of interventions that can improve sleep in ICU patients receiving respiratory support, including HFNC.
目的:本研究旨在探讨重症监护病房(ICU)患者的睡眠参数，并确定呼吸支持治疗、镇静和止痛药的差异。方法:在本观察性研究中，采用活动描记仪测量睡眠参数。我们观察了30例接受呼吸支持治疗的ICU患者的45例睡眠事件。我们测量了睡眠参数、时间、效率和睡眠后觉醒(WASO)。采用Mann-Whitney U检验分析呼吸支持治疗对睡眠参数的影响。结果:参与者的平均每日睡眠时间为776.66±276.71分钟，其中60%以上为白天睡眠。夜间睡眠时WASO持续时间为156.93±107.91 min, WASO发生次数为26.02±25.82次。高流量鼻插管组(HFNC)夜间睡眠时间明显短于其他呼吸治疗组(χ2=7.86, p = 0.049)， WASO次数明显多于其他呼吸治疗组(χ2=5.69, p = 0.128)， WASO持续时间明显长于其他呼吸治疗组(χ2=8.75, p = 0.033)。结论:接受呼吸支持治疗的ICU患者存在昼夜节律紊乱、睡眠片段化等睡眠障碍。在呼吸支持方案中，HFNC与睡眠参数差有关，这似乎与镇痛药的使用不足有关。本研究的结果保证了干预措施的发展，可以改善ICU患者接受呼吸支持，包括HFNC的睡眠。
{"title":"Actigraphy-Based Assessment of Sleep Parameters in Intensive Care Unit Patients Receiving Respiratory Support Therapy","authors":"Jiyeon Kang, Y. Kwon","doi":"10.34250/jkccn.2022.15.3.115","DOIUrl":"https://doi.org/10.34250/jkccn.2022.15.3.115","url":null,"abstract":"Purpose : This study aimed to investigate sleep parameters and to identify differences according to respiratory support therapy, sedation, and pain medication in intensive care unit (ICU) patients.Methods : In this observational study, sleep parameters were measured using actigraphy. We observed 45 sleep events in 30 ICU patients receiving respiratory support therapy. We measured the sleep parameters, time, efficiency, and wakefulness after sleep onset (WASO). The differences in sleep parameters according to the respiratory support therapy were analyzed using the Mann-Whitney U test.Results : The average daily sleep time of the participants was 776.66±276.71 minutes, of which more than 60% accounted for daytime sleep. During night sleep, the duration of WASO was 156.93±107.91 minutes, and the frequency of WASO was 26.02±25.82 times. The high flow nasal cannula (HFNC) group had a significantly shorter night sleep time (χ2=7.86, p =.049), a greater number of WASO (χ2=5.69, p =.128), and a longer WASO duration (χ2=8.75, p =.033) than groups of other respiratory therapies.Conclusion : ICU patients on respiratory support therapy experienced sleep disturbances such as disrupted circadian rhythm and sleep fragmentation. Among respiratory support regimens, HFNC was associated with poor sleep parameters, which appears to be associated with the insufficient use of analgesics. The results of this study warrant the development of interventions that can improve sleep in ICU patients receiving respiratory support, including HFNC.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77689629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.34250/jkccn.2022.15.3.37
Jiyeon Kang, Min-hyun Kim
Purpose : This study aimed to examine the item characteristics of the Korean version of the intensive care experience questionnaire (K-ICEQ) using the Rasch analysis model of the item response theory.Methods : In this methodological study, the validity of the scale was examined, and a secondary analysis was conducted using cohort data of patients who were discharged from the intensive care units (ICU). Data from 891 patients who responded to the K-ICEQ upon ICU discharge were analyzed. The WINSTEP program was used to analyze item characteristics, including item difficulty, fit indices, appropriateness scale, and separation reliability.Results : The difficulty level of all 26 items of the K-ICEQ was appropriate, and the fit indices of the 25 items, except for item 18, were good. The 5-point scale of the K-ICEQ was not appropriate in the three subscales. The item separation reliability was good in all subscales, but did not meet the criteria in terms of respondents.Conclusion : The results of examining the item characteristics of the K-ICEQ revealed a good degree of difficulty, fitness, and item separation reliability. To increase the validity of the K-ICEQ, we suggest the rearrangement of the overall item order, modification of the item description of the “recall of experience” subscale, and reduction of the scale response level.
{"title":"Item analysis of the Korean version of the Intensive Care Experience Questionnaire: Using the Rasch Model based on Item Response Theory","authors":"Jiyeon Kang, Min-hyun Kim","doi":"10.34250/jkccn.2022.15.3.37","DOIUrl":"https://doi.org/10.34250/jkccn.2022.15.3.37","url":null,"abstract":"Purpose : This study aimed to examine the item characteristics of the Korean version of the intensive care experience questionnaire (K-ICEQ) using the Rasch analysis model of the item response theory.Methods : In this methodological study, the validity of the scale was examined, and a secondary analysis was conducted using cohort data of patients who were discharged from the intensive care units (ICU). Data from 891 patients who responded to the K-ICEQ upon ICU discharge were analyzed. The WINSTEP program was used to analyze item characteristics, including item difficulty, fit indices, appropriateness scale, and separation reliability.Results : The difficulty level of all 26 items of the K-ICEQ was appropriate, and the fit indices of the 25 items, except for item 18, were good. The 5-point scale of the K-ICEQ was not appropriate in the three subscales. The item separation reliability was good in all subscales, but did not meet the criteria in terms of respondents.Conclusion : The results of examining the item characteristics of the K-ICEQ revealed a good degree of difficulty, fitness, and item separation reliability. To increase the validity of the K-ICEQ, we suggest the rearrangement of the overall item order, modification of the item description of the “recall of experience” subscale, and reduction of the scale response level.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86080281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.34250/jkccn.2022.15.3.88
Ju-Hee Lee, H. Choi
Purpose : This study aimed to identify risk factors for unplanned reintubation after planned extubation and to analyze the clinical outcomes in patients admitted to the intensive care unit after cardiac surgery.Methods : The study examined patients who underwent intubation and planned extubation admitted to the intensive care unit after cardiac surgery between January 1, 2017, and December 31, 2021. The reintubation group comprised 58 patients underwent unplanned reintubation within 7 days of planned extubation. The maintenance group comprised 116 patients who did not undergo reintubation and were matched with the reintubation group using the rational for matching criteria. Data were collected retrospectively from electronic medical records. We used the independent t-test, Mann-Whitney U test, χ2-test, Fisher’s exact test, and logistic regression analysis with SPSS/WIN 27.0.Results : The multivariate logistic regression analysis demonstrated that albumin (odds ratio [OR]=0.38, 95% confidence interval [CI]=0.20-0.72), surgery time (OR=1.54, 95% CI=1.20-1.97), PaO2 before extubation (OR=0.85 per 10 mmHg, 95% CI=0.75-0.97), postoperative arrhythmia (OR=2.82, 95% CI=1.22-6.51), reoperation due to bleeding (OR=4.65, 95% CI=1.27-17.07), and postoperative acute renal failure (OR=2.97, 95% CI=1.09-8.04) were risk factors for unplanned reintubation. The reintubation group had a higher in-hospital mortality rate (χ2=33.74, p＜.001), longer intensive care unit stay (Z=-7.81, p＜.001), and longer hospital stay than the maintenance group (Z=-8.29, p＜.001).Conclusion : These results identified risk factors and clinical outcomes of unplanned reintubation after planned extubation after cardiac surgery. These findings should be considered when developing and managing an intervention program to prevent and reduce the incidence of unplanned reintubation.
{"title":"Risk Factors and Clinical Outcomes of Unplanned Reintubation after Planned Extubation in Adult Patients admitted to the Intensive Care Unit after Cardiac Surgery","authors":"Ju-Hee Lee, H. Choi","doi":"10.34250/jkccn.2022.15.3.88","DOIUrl":"https://doi.org/10.34250/jkccn.2022.15.3.88","url":null,"abstract":"Purpose : This study aimed to identify risk factors for unplanned reintubation after planned extubation and to analyze the clinical outcomes in patients admitted to the intensive care unit after cardiac surgery.Methods : The study examined patients who underwent intubation and planned extubation admitted to the intensive care unit after cardiac surgery between January 1, 2017, and December 31, 2021. The reintubation group comprised 58 patients underwent unplanned reintubation within 7 days of planned extubation. The maintenance group comprised 116 patients who did not undergo reintubation and were matched with the reintubation group using the rational for matching criteria. Data were collected retrospectively from electronic medical records. We used the independent t-test, Mann-Whitney U test, χ2-test, Fisher’s exact test, and logistic regression analysis with SPSS/WIN 27.0.Results : The multivariate logistic regression analysis demonstrated that albumin (odds ratio [OR]=0.38, 95% confidence interval [CI]=0.20-0.72), surgery time (OR=1.54, 95% CI=1.20-1.97), PaO2 before extubation (OR=0.85 per 10 mmHg, 95% CI=0.75-0.97), postoperative arrhythmia (OR=2.82, 95% CI=1.22-6.51), reoperation due to bleeding (OR=4.65, 95% CI=1.27-17.07), and postoperative acute renal failure (OR=2.97, 95% CI=1.09-8.04) were risk factors for unplanned reintubation. The reintubation group had a higher in-hospital mortality rate (χ2=33.74, p＜.001), longer intensive care unit stay (Z=-7.81, p＜.001), and longer hospital stay than the maintenance group (Z=-8.29, p＜.001).Conclusion : These results identified risk factors and clinical outcomes of unplanned reintubation after planned extubation after cardiac surgery. These findings should be considered when developing and managing an intervention program to prevent and reduce the incidence of unplanned reintubation.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86435589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.34250/jkccn.2022.15.3.51
Ji Hyun Lee, Sujae Choi
Purpose : This study aimed to verify the effectiveness of the clinical ladder system (CLS) by identifying the perception of the CLS, professional self-concept, self-efficacy, and organizational commitment among intensive care unit (ICU) nurses.Methods : Data were collected through a questionnaire survey of 173 nurses working in 11 ICUs at a tertiary hospital in Seoul.Results : The perception of the CLS, self-efficacy, and organizational commitment showed significant difference according to the CLS level. As a result of the partial Spearman correlation analysis after adjusting for demographic difference according to CLS (age, marital status, education, and clinical career), CLS positively correlated with the perception of the CLS (r=.16, p=.045), professional self-concept (r=.24, p=.001), and self-efficacy (r=.21, p=.007). On the contrary, organizational commitment negatively correlated with the perception of the CLS (r=-.43, p＜.001) and self-efficacy (r=-.32, p＜.001).Conclusion : The CLS is effective for professional self-concept and self-efficacy. However, specialists 2 nurses, who had high professional self-concept and self-efficacy, showed low level of organizational commitment. Thus, it is necessary to examine the factors of work burden and career plateau that are imposed after promotion and improve experience and planning according to the growth needs. Moreover, regular evaluation of the CLS will require hospital support to ensure that ICU nurses appreciate and actively participate in the support.
目的:本研究旨在通过对重症监护病房(ICU)护士临床阶梯系统(CLS)的认知、专业自我概念、自我效能感和组织承诺的研究，验证临床阶梯系统(CLS)的有效性。方法:对首尔某三级医院11个icu的173名护士进行问卷调查。结果:在不同的CLS水平上，CLS知觉、自我效能感和组织承诺存在显著差异。根据CLS(年龄、婚姻状况、教育程度和临床职业)调整人口统计学差异后的部分Spearman相关分析结果显示，CLS与CLS感知呈正相关(r=)。16, p=.045)，职业自我概念(r=。24, p=.001)，自我效能感(r=. 001)。21日,p = .007)。反之，组织承诺与组织安全感知呈负相关(r=-)。43, p<.001)和自我效能感(r=-。32 p <措施)。结论:CLS量表对职业自我概念和自我效能感有显著影响。专科护士具有较高的职业自我概念和自我效能感，但其组织承诺水平较低。因此，有必要研究晋升后的工作负担和职业平台因素，并根据成长需要改进经验和规划。此外，定期评估CLS需要医院的支持，以确保ICU护士欣赏并积极参与支持。
{"title":"Perception of Clinical Ladder System, Professional Self-Concept, Self-Efficacy, and Organizational Commitment by the Level of Clinical ladder among Intensive Care Unit Nurses","authors":"Ji Hyun Lee, Sujae Choi","doi":"10.34250/jkccn.2022.15.3.51","DOIUrl":"https://doi.org/10.34250/jkccn.2022.15.3.51","url":null,"abstract":"Purpose : This study aimed to verify the effectiveness of the clinical ladder system (CLS) by identifying the perception of the CLS, professional self-concept, self-efficacy, and organizational commitment among intensive care unit (ICU) nurses.Methods : Data were collected through a questionnaire survey of 173 nurses working in 11 ICUs at a tertiary hospital in Seoul.Results : The perception of the CLS, self-efficacy, and organizational commitment showed significant difference according to the CLS level. As a result of the partial Spearman correlation analysis after adjusting for demographic difference according to CLS (age, marital status, education, and clinical career), CLS positively correlated with the perception of the CLS (r=.16, p=.045), professional self-concept (r=.24, p=.001), and self-efficacy (r=.21, p=.007). On the contrary, organizational commitment negatively correlated with the perception of the CLS (r=-.43, p＜.001) and self-efficacy (r=-.32, p＜.001).Conclusion : The CLS is effective for professional self-concept and self-efficacy. However, specialists 2 nurses, who had high professional self-concept and self-efficacy, showed low level of organizational commitment. Thus, it is necessary to examine the factors of work burden and career plateau that are imposed after promotion and improve experience and planning according to the growth needs. Moreover, regular evaluation of the CLS will require hospital support to ensure that ICU nurses appreciate and actively participate in the support.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"296 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79667920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.34250/jkccn.2022.15.2.27
Min Young Kim, Jeong Hye Kim, Sujin Choi
Purpose : The purpose of this study was to identify the mediating effect of role clarity in the relationship between clinical decision-making abilities and job stress among advanced practice nurses at tertiary hospitals.Methods : The participants were 137 advanced practice nurses. The assessment tools were clinical decisionmaking in nursing scale, role ambiguity scale, and Korean occupational stress scale (KOSS-26). Data were analyzed with the SPSS/24.0 program and mediation analysis was performed according to the Baron and Kenny methods.Results : There were significant relationships between clinical decision-making abilities and job stress (r=-.33, p<.001), and role clarity and job stress (r=-.29, p=.001). Role clarity showed partial mediating effects in the relationship between clinical decision-making abilities and job stress (Z=2.02, p=.043).Conclusion : Therefore, to reduce advanced practice nurses’ job stress, it is necessary to develop a program and strategies to increase their clinical decision-making abilities.
{"title":"Mediating Effects of Role Clarity between Clinical Decision-Making Abilities and Job Stress for Advanced Practice Nurses at Tertiary Hospitals","authors":"Min Young Kim, Jeong Hye Kim, Sujin Choi","doi":"10.34250/jkccn.2022.15.2.27","DOIUrl":"https://doi.org/10.34250/jkccn.2022.15.2.27","url":null,"abstract":"Purpose : The purpose of this study was to identify the mediating effect of role clarity in the relationship between clinical decision-making abilities and job stress among advanced practice nurses at tertiary hospitals.Methods : The participants were 137 advanced practice nurses. The assessment tools were clinical decisionmaking in nursing scale, role ambiguity scale, and Korean occupational stress scale (KOSS-26). Data were analyzed with the SPSS/24.0 program and mediation analysis was performed according to the Baron and Kenny methods.Results : There were significant relationships between clinical decision-making abilities and job stress (r=-.33, p<.001), and role clarity and job stress (r=-.29, p=.001). Role clarity showed partial mediating effects in the relationship between clinical decision-making abilities and job stress (Z=2.02, p=.043).Conclusion : Therefore, to reduce advanced practice nurses’ job stress, it is necessary to develop a program and strategies to increase their clinical decision-making abilities.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"303 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74106095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.34250/jkccn.2022.15.2.64
Kyeong-Ok Kim, Youngrye Park
Purpose : This study aimed to verify the validity and reliability of the Korean version of the nurses’ attitude scale toward advance directives of patients.Methods : We translated and back-translated the original tool consisting of 20 questions and tested and verified its content validity. Questions for which its content validity has been verified, a preliminary investigation was conducted among 20 nurses working in ICU, followed by the actual investigation. Data were analyzed using SPSS version 24.0 for Windows and Mac and AMOS version 24.0. To verify the validity, an item analysis was conducted for all 398 samples, and then an exploratory factor analysis for 200 samples that were randomly selected, followed by a confirmatory factor analysis for the remaining 198 samples.Results : Korean version of advance directives attitude scale (K-ADAS) consisting of 14 questions – 7 questions on ‘patient rights,’ 4 questions on ‘role of a nurse,’ and 3 questions on ‘ethical judgment’ – was verified its validity and reliability.Conclusion : In this study, the validity and reliability of the K-ADAS have been verified. We expect the verified tool to be useful in various fields that measuring the nurses’ attitude toward advance directives of patients.
{"title":"Validity and Reliability of the Korean Version of Advance Directives Attitude Scale of Nurses’","authors":"Kyeong-Ok Kim, Youngrye Park","doi":"10.34250/jkccn.2022.15.2.64","DOIUrl":"https://doi.org/10.34250/jkccn.2022.15.2.64","url":null,"abstract":"Purpose : This study aimed to verify the validity and reliability of the Korean version of the nurses’ attitude scale toward advance directives of patients.Methods : We translated and back-translated the original tool consisting of 20 questions and tested and verified its content validity. Questions for which its content validity has been verified, a preliminary investigation was conducted among 20 nurses working in ICU, followed by the actual investigation. Data were analyzed using SPSS version 24.0 for Windows and Mac and AMOS version 24.0. To verify the validity, an item analysis was conducted for all 398 samples, and then an exploratory factor analysis for 200 samples that were randomly selected, followed by a confirmatory factor analysis for the remaining 198 samples.Results : Korean version of advance directives attitude scale (K-ADAS) consisting of 14 questions – 7 questions on ‘patient rights,’ 4 questions on ‘role of a nurse,’ and 3 questions on ‘ethical judgment’ – was verified its validity and reliability.Conclusion : In this study, the validity and reliability of the K-ADAS have been verified. We expect the verified tool to be useful in various fields that measuring the nurses’ attitude toward advance directives of patients.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79149232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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