Il Young Yoo

Effects of nurse staffing, work environments, and education on patient mortality: an observational study.

BACKGROUND While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea. OBJECTIVE To examine the effects of nurse staffing, work environment, and education on patient mortality. METHODS This study linked hospital facility data with staff nurse survey data (N=1024) and surgical patient discharge data (N=76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission. RESULTS Risk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00-1.10; OR 0.52, 95% CI 0.31-0.88; and OR 0.91, CI 0.83-0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in nurses having Bachelor of Science in Nursing Degree is associated with a 9% decrease in patient deaths. CONCLUSIONS Nurse staffing, nurse work environments, and percentages of nurses having Bachelor of Science in Nursing Degree in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of nurses having Bachelor of Science in Nursing Degree would help reduce the number of preventable in-hospital deaths.

Construct validity and reliability of the Korean version of the practice environment scale of nursing work index for Korean nurses

PURPOSE To develop and test the validity and reliability of the Korean version of PES-NWI measuring nursing work environments in hospitals. METHODS The Korean version of the PES-NWI was developed through forward-backward translation techniques, and revision based on feedback from focus groups. An internal consistency reliability and construct validity using confirmatory factor analysis were conducted using SPSS WIN (16.0) and AMOS (18.0). Survey data were collected from 733 nurses who worked in three acute care hospitals in Seoul, South Korea. RESULTS The Korean version of PES-NWI showed reliable internal consistency with a Cronbachs alpha for the total scale of .93. Factor loadings of the 29 items on the five subscales ranged from .28 to .85. The five subscales model was validated by confirmatory factor analysis (RMR<.05, CFI>.9). CONCLUSION The findings of this study demonstrate that the Korean version of PES-NWI has satisfactory construct validity and reliability to measure nursing work environments of hospitals in Korea.

Factors associated with needlestick and sharp injuries among hospital nurses: A cross-sectional questionnaire survey

BACKGROUND The current status of needlestick or sharp injuries of hospital nurses and factors associated with the injuries have not been systematically examined with representative registered nurse samples in South Korea. OBJECTIVE To examine the incidence to needlestick or sharp injuries and identify the factors associated with such injuries among hospital nurses in South Korea. DESIGN, SETTINGS AND PARTICIPANTS A cross-sectional survey of hospital nurses in South Korea. Data were collected from 3079 registered nurses in 60 acute hospitals in South Korea by a stratified random sampling method based on the region and number of beds. METHODS The dependent variable was the occurrence of needlestick or sharp injuries in the last year, and the independent variables were protective equipment, nurse characteristics, and hospital characteristics. This study employed logistic regression analysis with generalized estimating equation clustering by hospital to identify the factors associated with needlestick or sharp injuries. RESULTS The majority (70.4%) of the hospital nurses had experienced needlestick or sharp injuries in the previous year. The non-use of safety containers for disposal of sharps and needles, less working experience as a registered nurse, poor work environments in regards to staffing and resource adequacy, and high emotional exhaustion significantly increased risk for needlestick or sharp injuries. Working in perioperative units also significantly increased the risk for such injuries but working in intensive care units, psychiatry, and obstetrics wards showed a significantly lower risk than medical-surgical wards. CONCLUSIONS The occurrence of needlestick or sharp injuries of registered nurses was associated with organizational characteristics as well as protective equipment and nurse characteristics. Hospitals can prevent or reduce such injuries by establishing better work environments in terms of staffing and resource adequacy, minimizing emotional exhaustion, and retaining more experienced nurses. All hospitals should make safety-engineered equipment available to registered nurses. Hospitals as well as specific units showing higher risk for needlestick and sharp injuries should implement organizational strategies to prevent such injuries. It is also necessary to establish a monitoring system of needlestick and sharp injuries at a hospital level and a reporting system at the national level in South Korea.

Factors associated with resilience of school age children with cancer

Aim:  To identify factors associated with resilience of school age children with cancer.

만성질환아의 극복력(Resilience) 측정도구 개발

PURPOSE The purpose of this study was to develop and evaluate a Korean questionnaire to measure resilience in children with chronic illness. METHODS Item construction was drawn from an extensive review of the literature, existing questionnaires and interviews with parents. Content validity was tested by experts. To further refine the questionnaire and test its reliability and validity, data were collected from the 202 children with asthma, diabetes mellitus or nephrotic syndrome. Corrected items were used to total correlation coefficient and test-retest reliability. Questionnaire testing was conducted using factor analysis, Cronbachs alpha, and correlation coefficients. Validity of the questionnaire was tested using internal consistency, construct validity, and criterion-related validity. RESULTS Components of the questionnaire were in three domains; interpersonal characteristics, characteristics of coping, and intrapersonal characteristics. Factor analysis is showed five factors; positive self-understanding, self-reliance, resourcefulness, perception of positive family relationships, and intimacy. The questionnaire showed a high internal consistency. A significant positive correlation with the Numerical Rating Score and negative correlation with the Child Depression Inventory support the validity of the questionnaire. CONCLUSION This instrument demonstrated high reliability and validity. Therefore, this instrument can contribute to the evaluation of resilience of chronically ill children and to any subsequent intervention as well as to develop a theory for resilience.

Fourier-feynman transform, convolution and first variation of functional on abstract wiener

Park, Skoug and Storvick examined various relationships among the first variation, the Fourier-Feynman tranform, and the convolution product for functionals, on classical Wiener space(C o[0,1],m), which belong to some Banach algebra S.In this paper, we extend the above concepts to an abstract Wiener space(B,ν)and the first variation for functionals in the Fresnel Class F(B)which corresponds to S. Since the Fresnel class F(B)is the abstracat Wiener space setting of the Banach algebra S, our result inclued the above results as special cases

Relationships involving generalized fourier–feynman transform, convolution and first variation

Huffman, Park and Skoug introduced a generalized Fourier–Feynman transform (GFFT) and a generalized convolution product (GCP) and they obtained the relationships between the GFFT and GCP for functionals in the Banach algebra 𝒮 introduced by Cameron and Storvick. In this paper, we investigate various relationships among the GFFT, GCP and generalized first variation for functionals in 𝒮.

Conditional Fourier-Feynman Transform and Convolution Product Over Wiener Paths In Abstract Wiener Space

In this paper, we define the conditional Fourier-Feynman transform and the conditional convolution product over Wiener paths in abstract Wiener space. Using a simple formula, we obtain conditional Feynman integrals of Fourier-Feynman transform and convolution product of cylinder type functions. For these functions, we evaluate the conditional Fourier-Feynman transforms and the conditional convolution products, and show that the conditional Fourier-Feynman transform of the conditional convolution product is a product of the conditional Fourier-Feynman transforms.

Fourier-Feynman transform, convolution and first variation

We examine several interesting relationships and expressions involving Fourier-Feynman transform, convolution product and first variation for functionals in the Fresnel class F(B) of an abstract Wiener space B. We also prove a translation theorem and Parsevals identity for the analytic Feynman integral.

Resilience in families of children with Down syndrome in Korea

This study aims to identify the factors related to resilience of the families of children with Down syndrome (DS). Data were collected from 126 parents of children with DS in Korea, using a self-administered questionnaire. The age of the child, developmental level of the child, parental depression, and stress and strain were negatively related with family adaptation, whereas health of parents, family cohesiveness, flexibility, communication skills, supportive family/relatives, and quality of community service were positively related. Parental depression, family cohesiveness and communication skills were the factors that were strongly related to family resilience and adaptation. It is suggested that nursing interventions to decrease parental depression and increase family cohesiveness and communication skills should be included to increase resilience of the families of children with DS.This study aims to identify the factors related to resilience of the families of children with Down syndrome (DS). Data were collected from 126 parents of children with DS in Korea, using a self-administered questionnaire. The age of the child, developmental level of the child, parental depression, and stress and strain were negatively related with family adaptation, whereas health of parents, family cohesiveness, flexibility, communication skills, supportive family/relatives, and quality of community service were positively related. Parental depression, family cohesiveness and communication skills were the factors that were strongly related to family resilience and adaptation. It is suggested that nursing interventions to decrease parental depression and increase family cohesiveness and communication skills should be included to increase resilience of the families of children with DS.