Ji-Su Kim

Korean nurses’ ethical dilemmas, professional values and professional quality of life

Background: In the changing medical environment, professional stress continuously increases as the individual’s quality of life suffers. Of all the healthcare professions, nursing is especially prone to burnout, compassion fatigue and reduced compassion satisfaction, due to the tensions resulting from the physical and psychological stress of caring for extremely ill patients. Objectives: This study examined the professional quality of life of clinical nurses in Korea and the relationship between their experiences in ethical dilemmas and professional values. Methods: This was a cross-sectional study of a convenience sample consisting of 488 clinical nurses. We used four questionnaires to measure the participants’ demographic characteristics, experiences in ethical dilemmas, professional nursing values and professional quality of life (ProQOL assessment, Version 5). Ethical considerations: This study received approval from the Institutional Review Board of Bronco Memorial Hospital. Written informed consent was given by all participants. Results: The nurses’ professional quality of life was affected by ethical dilemmas and professional nursing values. The factors influencing compassion satisfaction were age, client domain of ethical dilemmas, social awareness, professionalism of nursing and the roles of nursing services in professional values. The factors influencing burnout were marital status (married), religion (yes), human life domain, professional work domain of ethical dilemmas, social awareness and the role of nursing services in nursing professional values. The factors influencing secondary traumatic stress were human life domain, client domain and the professional work domain of ethical dilemmas. Conclusion: Intervention to help nurses increase their professional quality of life will have a greater chance of success if they are based on the nurses’ values and beliefs about the ethical dilemmas they face and foster the establishment of positive professional values.

Factors Influencing Quality of Life in Adult End-Stage Renal Disease Patients Undergoing Hemodialysis

Background:The population of individuals with end-stage renal disease (ESRD) in Korea is increasing rapidly, yet comprehensive research on the quality of life (QOL) of this population undergoing hemodialysis is scarce. Purpose:The purpose of this study was to identify the factors influencing QOL of Korean hemodialysis patients with ESRD. Methods:This study was a cross-sectional survey. Data were drawn from a convenience sample of 141 patients aged >18 years receiving maintenance hemodialysis in a general hospital. Data were collected by a self-administrated survey conducted from June 15 to July 25, 2012. The questionnaire included basic subject data, QOL, fatigue, perceived health status, and emotional status. Results:The mean QOL score was 3.09 or “above average” as measured by the World Health Organization’s (1993) Quality of Life Assessment. Significant differences were observed for basic subject data including educational level, occupation, monthly income, medical expense assistance, and family living situation. Significant negative correlations were found between QOL and fatigue and between anxiety and depression, but a significant positive correlation was found with perceived health status. The factors influencing QOL were fatigue and depression, marital status (married), and medical expense assistance (from self or parents). Conclusions/Implications for Practice:The results of this study indicate that, to improve the QOL in patients with ESRD, comprehensive intervention is necessary to assess and manage depression and fatigue. Social mediation is needed to enhance the QOL of patients with ESRD who lack familial and economic support, those who are single, or those who cannot afford medical expenses either by themselves or with the help of their parents.

Meta-analysis of complication as a risk factor for early ambulation after percutaneous coronary intervention.

Purpose: This study systematically examined previous studies on the effect of early ambulation on vascular complications in subjects who had just undergone a percutaneous coronary intervention (PCI), and analyzed the effects of early ambulation on both hemorrhage and hematoma formation at the puncture site. Methods: Study data were analyzed using the R (version 2.13.1) program. Publication bias was verified via regression analysis, using the logarithm of the odds ratio (OR) and sample size, and a funnel plot using sample size. The risk ratio of the incidence of bleeding and hematoma formation at the puncture site, relative to early ambulation, was confirmed using ORs and the forest plot. Results: The PCI recipients’ bed rest time had no significant effect on the risk ratio of hematoma formation (OR = 0.89; 95% CI = 0.68–1.17) nor the incidence of bleeding (OR = 1.14; 95% CI = 0.77–1.7) at the puncture site. Conclusions: This retrospective study’s findings show that early ambulation following PCI had no effect on the incidence of either hematoma formation nor bleeding at the puncture site; however, differences in demographic factors should be considered carefully, in order to avoid interpreting the results too broadly.

Development and validation of a nursing professionalism evaluation model in a career ladder system

Background The clinical ladder system categorizes the degree of nursing professionalism and rewards and is an important human resource tool for managing nursing. Aim We developed a model to evaluate nursing professionalism, which determines the clinical ladder system levels, and verified its validity. Methods Data were collected using a clinical competence tool developed in this study, and existing methods such as the nursing professionalism evaluation tool, peer reviews, and face-to-face interviews to evaluate promotions and verify the presented content in a medical institution. Reliability and convergent and discriminant validity of the clinical competence evaluation tool were verified using SmartPLS software. The validity of the model for evaluating overall nursing professionalism was also analyzed. Results Clinical competence was determined by five dimensions of nursing practice: scientific, technical, ethical, aesthetic, and existential. The structural model explained 66% of the variance. Clinical competence scales, peer reviews, and face-to-face interviews directly determined nursing professionalism levels. Conclusions The evaluation system can be used for evaluating nurses’ professionalism in actual medical institutions from a nursing practice perspective. Implications for nursing management A conceptual framework for establishing a human resources management system for nurses and a tool for evaluating nursing professionalism at medical institutions is provided.

Symptom Experience, Self-Care Adherence, and Quality of Life Among Heart Transplant Recipients in South Korea

Among heart transplant recipients, the perceived quality of life (QOL) is a key indicator of successful transplantation. QOL is affected by posttransplant treatments, including immunosuppressive therapy or self-care. However, few studies have evaluated QOL after heart transplantation in South Korea. This study aimed to investigate posttransplant symptoms associated with immunosuppressant, self-care adherence, and QOL in 105 heart transplant recipients in South Korea. Educational status (β = −1.05, p = .013), symptoms (β = −3.98, p = .004), and diet (β = 0.38, p < .001) were found to affect subjects’ overall QOL. In addition to these factors, caregivers and the duration of heart disease (years) were found to be influencing factors, depending on the individual QOL subdimension. These findings highlight the importance of controlling symptoms and managing medications as well as of self-care (particularly dietary compliance). Educational programs targeting beneficial changes in lifestyle, including diet, are needed.