Purpose This study examined how nurse staffing and parental caregiving burden influence patient experiences in pediatric wards. Methods: The sample included 326 parents of pediatric patients at a tertiary children’s hospital. Nurse staffing was measured using parent-perceived staffing adequacy (4-point scale) and registered nurse hours per patient day (RN HPPD). Parent experiences were evaluated using the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS), with items rated on 3-, 4-, or 11-point scales and subsequently converted to scores on a 0–100 scale. Parents also reported their caregiving burden experienced during their child’s hospitalization. Results: Among the Child HCAHPS domains, nurse–parent communication received the highest score, while lower scores were reported in child-specific domains, including teen involvement, quietness, and child comfort. Most parents (80.4%) stayed at the hospital either all or nearly all the time, and 63.5% perceived caregiving as burdensome. Commonly reported burdens included economic and work-related challenges, physical and psychological stressors, and responsibilities related to caring for other children. Higher levels of parent-perceived staffing adequacy and greater RN HPPD were significantly associated with better patient experiences. Conclusion: Improving nurse staffing may alleviate parental caregiving burden and improve patient and parent experiences in pediatric wards.
Purpose This study aimed to examine the relationships among self-leadership, role conflict, practice environment, and patient safety competency, and to identify factors influencing patient safety competency in clinical practice nurses. Methods: A total of 152 clinical practice nurses from four university hospitals participated in this cross-sectional study. Data were collected using a structured questionnaire and analyzed to identify key predictors of patient safety competency. Results: Patient safety competency was positively associated with self-leadership, the practice environment, and the presence of regular educational programs tailored for clinical practice nurses. Self-leadership and the practice environment were identified as significant predictors, explaining 30% of the variance in patient safety competency. Conclusion: The findings underscore the importance of fostering self-leadership and enhancing the practice environment to improve patient safety competency among clinical practice nurses. Tailored education and training programs aimed at strengthening self-leadership skills should be developed. Additionally, organizational efforts to optimize the clinical practice environment are essential to support safe and effective nursing practice.
Purpose This study investigates the mediating effect of job embeddedness in the relationship between nursing professionalism and turnover intention among clinical nurses. Methods: A nationwide online survey was conducted using a structured questionnaire. Participants included 204 clinical nurses from tertiary hospitals in South Korea. Data on general characteristics, nursing professionalism, job embeddedness, and turnover intention were collected through self-reported questionnaires from March 19 to March 22, 2024. The analysis involved descriptive statistics, independent t-tests, one-way analysis of variance, Scheffé test, Pearson's correlation coefficients, multiple linear regression analysis, and bootstrapping, using SPSS/WIN version 29.0 and the SPSS PROCESS macro 4.2 version programs. Results: The mean score of nursing professionalism was 3.48±0.45 out of 5, job embeddedness was 3.13±0.52 out of 5, and turnover intention was 2.80±1.00 out of 5. Nursing professionalism did not directly impact turnover intention (B=-0.07, p=.649). Job embeddedness acted as a mediating factor in the relationship between nursing professionalism and turnover intention (B=-0.46, p<.05). Conclusion: These findings suggest that increasing job embeddedness can reduce nurses' turnover intention. Therefore, to decrease nurses' turnover intention, it is essential to enhance nursing professionalism while simultaneously promoting job embeddedness.
Purpose This study aimed to examine the predictors of nurses’ incident reporting by dividing the level of patient safety incident (near miss, no harm, harmful incident) reporting into upper and lower level groups. Methods: Data were collected from 208 nurses working in a hospital from March 29 to April 6, 2022. Logistic regression analysis was used to determine the predictors of nurses’ reporting level. Results: Predictors of the upper level group of near miss reporting were belief in improvement (odds ratio [OR], 2.40; 95% confidence interval [CI], 1.27-4.53), reporting intention (OR, 2.00; 95% CI, 1.15-3.47), patient safety knowledge (OR, 2.16; 95% CI, 1.16-4.01). Predictors of the upper level group no harm incidents reporting were reporting training (OR, 1.38; 95% CI, 1.01-1.90), belief in improvement (OR, 2.00; 95% CI, 1.01-3.95), patient safety knowledge (OR, 2.41; 95% CI, 1.17-4.98). In the case of harmful incident reporting, the predictor was patient safety attitude (OR, 9.32; 95% CI, 2.77-31.38). Conclusion: The reporting level varies depending on the type of patient safety incidents. Managing nurses' individual characteristics, such as their beliefs in improvement, patient safety knowledge, and attitude is a key strategy for enhancing incident reporting level. Nursing managers should be aware that not all harmful incidents are being reported.
Purpose To evaluate the effectiveness of a Silver Hour End-Of-Life (SHEOL) program in enhancing end-of-life care performance among new nurses. Methods: A nonequivalent control group pre-post test design was adopted. A total of 34 new nurses working at a tertiary general hospital participated in the study. The experimental group (n=17) participated in the SHEOL program, which was delivered through hybrid simulation (180 minutes), while the control group (n=17) received a theoretical lecture on end-of-life care (90 minutes). The intervention and data collection were conducted from August 8 to September 30, 2024. Results: Compared to the control group, the experimental group showed a significant reduction in fear of death (χ2=11.69, p=.003) and significant improvements in attitudes toward end-of-life care (χ2=6.99, p=.030), self-efficacy of end-of-life care (χ2=6.51, p=.039), and performance of end-of-life care (χ2=20.07, p<.001) both immediately and 4 weeks after the intervention. Conclusion: These findings suggest that the SHEOL program can be effectively used to alleviate fear of death, improve attitudes and self-efficacy regarding end-of-life care, and enhance end-of-life care performance among new nurses.
Purpose This study aimed to explore the mediating role of self-transcendence in the relationship between job stress and wellness among nurses based on self-transcendence theory. Methods: A descriptive cross-sectional design was adopted, and data were collected via an online survey using Google Forms from July 22 to August 20, 2024. This study analyzed data from 290 nurses working in 10 hospitals. Correlation and multiple regression analyses were conducted, alongside simple mediation analysis with bootstrapping, to evaluate the mediating role of self-transcendence. All statistical analyses were performed using Jamovi software. Results: Positive correlations were identified among job stress, self-transcendence, and wellness in nurses. Regression analyses revealed that self-transcendence was positively associated with wellness (β=.62, p<.001), while job stress had no significant association with wellness. Mediation analysis demonstrated that self-transcendence significantly mediated the relationship between job stress and wellness (β=.22, p<.001). Conclusion: The findings highlight the influence of self-transcendence on the relationship between job stress and wellness among nurses. This underscores the importance of designing interventions to enhance self-transcendence as a strategy to promote wellness among nurses.
Purpose This study aimed to conduct a systematic review to explore leadership-related variables among nurses in the novice and advanced beginner stages, identify research trends, and analyze effect sizes to provide evidence for developing a nursing leadership program. Methods: A systematic review and meta-analysis were conducted according to PRISMA(Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and NECA (National Evidence based Healthcare Collaborating Agency) guidelines. Literature was searched from February 26 to April 26, 2024 using databases including KISS, KMbase, RISS, KoreaMed, Science ON, CINAHL, CENTRAL, Embase, PubMed, Web of Science, and Korean nursing journals. Meta-analysis was performed using R version 3.6.2. Results: From 589 articles, five studies were selected. Self-leadership was most frequently studied topic (80.0%). Leadership antecedents with k≥2 included preceptor’s clinical teaching behavior (correlation effect size [ESr], 0.34). For leadership outcomes, effect size analyses for cases with k≥2 indicated resilience (ESr, 0.72), nursing performance (ESr, 0.69), and organizational socialization (ESr, 0.31), with resilience demonstrating the largest effect. Conclusion: Preceptor’s clinical teaching behavior, resilience, nursing performance, and organizational socialization were identified as critical factors in leadership of the nurses at novice and advanced beginner stage. Enhancing leadership requires preceptor support, which can improve resilience and help early-career nurses overcome challenges. Therefore, strategies for leadership development must include specific measures to ensure preceptor support.
Purpose This study investigated the effect of new nurses' metacognition on their retention intention and the dual mediating effect of job satisfaction and organizational commitment in the relationship between those two variables. Methods: Participants included 154 new nurses with 12 months or less of clinical experience working in general hospitals in Seoul. Using a structured questionnaire, data were collected from September 30 to October 29, 2024 and analyzed using IBM SPSS version 29.0 and the Process Macro 4.2 program. Results: Metacognition had a positive effect on job satisfaction (B=0.60, p<.001). Job satisfaction had significant positive effects on organizational commitment (B=0.84, p<.001) and retention intention (B=1.31, p<.001), while organizational commitment had a significant positive effect on retention intention (B=0.65, p=.016). The sequential mediating effect of job satisfaction and organizational commitment was confirmed within the relationship between metacognition and retention intention in new nurses (effect=0.33, 95% confidence interval: 0.03-0.71). Conclusion: The results of this study suggest the presence of a causal structure in which higher metacognition is associated with greater job satisfaction in new nurses; this leads them to commit to the organization, eventually increasing their retention intention.
Purpose The study was to develop a Clinical Nurses' Job Crafting Scale (CN-JCS) and examines its validity and reliability. Methods: Data were collected from 423 clinical nurses working in general hospitals. The CN-JCS was developed according to DeVellis’s step sclae development guidelines. The CN-JCS was assessed for content validity, construct validity, item convergence/discrimination, convergent validity, and internal consistency. Results: In the exploratory factor analysis, five factors and 20 items were selected. Construct validity was examined using confirmatory factor analysis, and the model fit was good. The Conceptual reliability was greater than .70 and average variance extracted value was greater than .50, indicating discriminant validity. Convergent validity was confirmed through correlations between the CN-JCS, psychological empowerment and work engagement. The scale’s reliability was established with a Cronbach's alpha of .90. The CN-JCS employs a 5-point Likert scale across 20 questions, gauging aspects such as giving meaning to work, changing the structure of work, exploring and communicating, pursuing relationship change, and positive attitude toward change. Conclusion: The CN-JCS can be used to accurately assess the job craft of clinical nurses, and the measured level can be used as baseline data to improve awareness and education of nurses’ job craft.
Purpose This study explored the lived experiences of physician assistants (PAs) in Korea during the 2024 medical workforce shortage, focusing on how they perceived and adapted to their rapidly changing roles. The study investigated both the challenges PAs faced and the professional growth they experienced throughout the adaptation process. Methods: A phenomenological qualitative design was applied using Colaizzi’s method. In-depth interviews were conducted with 15 PAs at a tertiary hospital in Seoul between September 25, 2024 and February 1, 2025. Data were analyzed thematically. Results: Four major theme clusters emerged: changes in work environment and quality of life, role conflict and ambiguity in professional identity, dual aspects of role expansion including autonomy and burnout, and coping strategies and structural policy demands. Participants reported physical and emotional strain, but also described greater involvement in care decisions, improved patient relationships, and a stronger sense of professional identity. Conclusion: Amid the medical staffing crisis, PAs adapted to their expanded responsibilities and became key healthcare providers. While facing substantial burdens, they simultaneously experienced personal and professional growth. Institutional and legal support is essential to stabilize their roles and improve long-term healthcare outcomes.
Purpose This study examined the effects of role conflict, work environment, and meaning of work on job embeddedness among physician assistants to provide foundational data for their retention and professional development. Methods: A descriptive survey was conducted with 180 physician assistants from six tertiary hospitals in Seoul and Chungcheong Province. Data were collected from July to November 2022. Role conflict, work environment, meaning of work, and job embeddedness were measured using validated scales. Data were analyzed using SAS Enterprise Guide 7.1 with descriptive statistics, the independent t-test, ANOVA, Pearson correlation coefficients, and multiple regression analysis. Results: Job embeddedness correlated positively with meaning of work (r=.28, p<.001) and work environment (r=.22, p=.002) and weakly with role conflict (r=.14, p=.045). Multiple regression identified meaning of work (B=0.32, p<.001), role conflict (B=0.13, p=.005), work environment (B=0.14, p=.018), and work type (B=-3.95, p=.004) as significant predictors (Adj. R²=19.8%). Meaning of work had the greatest impact. Conclusion: Enhancing job embeddedness among physician assistants requires improving the work environment, clarifying professional roles, and strengthening professional recognition and organizational support.
Purpose This study aimed to explore the effects of presenteeism, burnout, and nursing performance on intention to retention among nurses of an intensive care unit in one tertiary hospital.
Method The data were collected from from July 1 to July 31, 2023, from 172 nurses at intensive care units. Data were analyzed using the SPSS/WIN 26.0 program.
Results A four-step hierarchical regression model, including control variables, presenteeism, burnout, and nursing performance, accounted for 44.9% of the factors influencing intention to retention. Burnout (β=-.54, p<.001), nursing performance (β=.21, p=.002), health problem (β=-.07, p=.040), and experience of turnover (β=-.16, p=.008) were identified as the significant predictor of intention to retention. Model III, which adds burnout, has a significant 23.5%p increase in explanatory power over Model II, indicating that burnout has the strongest impact on intention to retention.
Conclusion For enhancing the intention to retention of the intensive care nurses, it is necessary to provide a systematic strategy and support to increase the performance of nurses and to try to reduce the burnout and health problems of nurses.
Purpose This study explored how Generation Z characteristics—specifically work–life balance, growth needs, and individualism—along with work environment, emotional labor, and interpersonal skills, affect job embeddedness among newly graduated nurses. It also examined whether job embeddedness mediates the relationship between these factors and turnover intention. Methods: A correlational descriptive study was conducted by analyzing survey data collected from 131 clinical nurses born between 1995 and 2000, who had less than three years of nursing work experience in South Korea. Hierarchical multiple regression analysis was employed to identify the independent effects of Generation Z characteristics on job embeddedness, over and above the effects of work environment, emotional labor, and interpersonal skills. Path analysis using bootstrapping method was conducted to examine the mediating role of job embeddedness in turnover intention. Results: Needs for growth and work environment were significant predictors of job embeddedness among newly graduated nurses. Furthermore, the effects of needs for growth and work environment on turnover intention were significantly mediated by job embeddedness. Conclusion: Understanding the characteristics of Generation Z, particularly their needs for growth, along with the work environment, is essential for enhancing job embeddedness among newly graduated nurses. Strengthening job embeddedness can effectively reduce their turnover intention.
Purpose This study aimed to identify the impact of clinical nurses’ grit and nursing work environment on job enthusiasm and provide basic data for system improvement to maintain and secure nursing personnel. Methods: Data were collected online from July to August 2022 targeting 210 clinical nurses at three general hospitals located in Jeollabuk-do. Data analysis was performed using the IBM SPSS 26.0 program. Results: Job enthusiasm exhibited statistically significant differences according to age (F=5.20, p=.006) and presence of children (F=0.95, p<.001). Furthermore, job enthusiasm showed statistically significant positive correlations with grit (r=.64, p<.001) and the nursing work environment (r=.49, p<.001). The following factors were found to affect job enthusiasm: having children (β=.26, p<.001), grit (β=.46, p<.001), nursing work environment (β=.33, p<.001), and age over 40 (β=.16, p<.001). Conclusion: Based on the results of this study, it is recommended that an internal motivation strengthening program that promotes grit should be developed and applied to increase work enthusiasm among clinical nurses. Additionally, hospital organizations should prepare various policies to improve the nursing work environment.
Purpose To identify the factors influencing the perception of “decent work” by nurses. Methods: Data were collected from 208 nurses who had worked in hospitals for over six months, from January 23 to February 11, 2024. The collected data were analyzed using descriptive statistics, t-tests, analysis of variance, Pearson's correlation, and hierarchical multiple regression analysis using IBM SPSS Statistics 29.0. Results: Statistically significant positive correlations were observed among “decent work,” “work volition,” “living a calling,” and “social comparison orientation.” The core factors that significantly affected the perception of “decent work” by nurses were ‘work volition” (β=.30, p<.001), shift type (β=-.28, p<.001), aged in their 40s (β=-.22, p=.003), “living a calling” (β=.18, p=.012), and “social comparison orientation” (β=.14, p=.021). These variables explained 32% of the variance in the perception of “decent work.” Conclusion: The study results confirmed that, in addition to “work volition” and “living a calling’,” “social comparison orientation” also plays a significant role in how nurses perceive “decent work.” To understand the “decent work” conditions in nursing, it is necessary to explore the relationship between these factors and the variables that reflect professionalism or social recognition.
Purpose This study employs Giorgi's descriptive phenomenological approach to explore the experiences of retired military nurse officers transitioning to civilian hospitals and to identify the essential meanings and underlying structures of this transition.
Methods Eleven participants with over two years of military hospital experience, now employed in civilian hospitals, were recruited via snowball sampling. Data were collected through in-depth interviews conducted between December 2023 and March 2024.
Results Analysis using Giorgi’s four-stage method identified 257 meaning units, 37 central meanings, 12 themes, and six general structures: 1) Positive perceptions of the nursing profession, 2) Confusion due to lack of information, 3) Difficulty in adapting due to differences between military and civilian hospitals, 4) Self-blame for a lack of competence, 5) Struggles in finding a position suitable for one’s career, and 6) Satisfaction with freedom and a stable life.
Conclusion These findings emphasize the need for tailored transition programs, including job placement support, skill development, and cultural adaptation training. Socialization and communication programs can further aid integration and contribute to the professional growth. Additionally, a positive perception of nursing significantly influenced the decision to return to the workforce, highlighting the importance of fostering professional identity and confidence among transitioning military nurses.
Purpose This concept analysis aimed to deepen the understanding of Quiet Quitting among nurses by identifying its antecedents, defining attributes, and consequences.
Methods This study employed Walker and Avant’s conceptual analysis framework.
Results Quiet Quitting among nurses is defined as “a state in which individuals pursue harmony between their work and personal lives by performing only the minimum required tasks, rejecting workplace initiatives, and expressing passive resistance to organizational and job dissatisfaction.” Key antecedents include “fatigue resulting from changes in the healthcare environment”, “lack of managerial competence”, “role stress”, “toxic organizational culture”, “financial problem” and “Generation Z’s evolving perspective on work”. The analysis highlight five primary concerns: a decline in nursing care quality, increased likelihood of job turnover, conflicts with colleagues and supervisors, reduced job satisfaction, and a diminished personal competency.
Conclusion This study provides a clear definition of Quiet Quitting among nurses and establishes a theoretical basis for addressing the issue. Additionally, it underscores the need for further research, including the development of measurement tools, to better understand and mitigate this phenomenon.
Purpose To examine the impact of reading the text of the Nightingale Pledge aloud at the beginning of the shift on nursing workplace spirituality, organizational commitment, and job satisfaction among hospital nurses.
Methods We used a non-randomized controlled trial design. Forty-four nurses from four wards with similar work environments at M General Hospital in B City were enrolled. The data were analyzed using a x2 test, t-test, and generalized estimating equations.
Results In both groups, we observed a significant group and time interaction effect for nursing workplace spirituality (Wald x2=4.50, p=.015) and organizational commitment (Wald x2=11.33, p=.001). Nursing workplace spirituality was significantly higher in the experimental group than in the control group at eight weeks after the intervention (t=-3.41, p=.001). Likewise, organizational commitment was significantly higher in the experimental group than in the control group at four and eight weeks after the intervention (Z=-1.97, p=.049; Z=-2.71, p=.007, respectively). Job satisfaction did not significantly before and after the intervention.
Conclusion Despite the short time commitment, reading aloud the text of the Nightingale Pledge at the beginning of shift had positive effects on hospital nurses’ nursing workplace spirituality and organizational commitment.
Purpose This study investigated the effects of newly graduated nurses’ perceived readiness for nursing practice, resilience, and preceptors’ teaching behaviors on turnover intention.
Methods A survey was conducted among 168 newly graduated nurses between August 7 and 31, 2023. The data were analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis.
Results The factors that significantly affected turnover intention included preceptors' teaching behavior (β=-.29, p=.001) and resilience (β=-.21, p=.026). This model explained 32.0% of the variance.
Conclusion Newly graduated nurses’ resilience and their initial training environment are key factors influencing turnover intention. Therefore, nursing managers should develop strategies to enhance the resilience of newly graduated nurses and improve training systems. Additionally, efforts should be made to promote positive teaching behaviors among the educators responsible for training newly graduated nurses.
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Purpose This study aimed to investigate the relationship between socio-cognitive mindfulness, job stress, social support, and turnover intention among general hospital nurses and identify the factors influencing nurses’ turnover intention.
Methods A descriptive survey was conducted among 218 nurses from five general hospitals located in G metropolitan city. The participants completed a questionnaire measuring the study variables, and the data were analyzed using t-tests, ANOVA, Pearson’s correlation coefficient, and hierarchical multiple regression analysis in SPSS/WIN 28.0.
Results Significant differences were found in turnover intention by gender (t=-2.12, p=.036), family type (t=-3.09, p=.002), work department (F=7.01, p<.001), and work type (t=2.55, p=.011). Socio-cognitive mindfulness was positively related to social support (r=.331, p<.001), and turnover intention was positively related to job stress (r=.347, p<.001). The factors influencing nurses’ turnover intention included job stress (β=.317, p<.001), work department (artificial kidney room: β=-.287, p=.004; emergency room: β=-.219, p=.015), social support (β=-.183, p=.005), and work type (shift work: β=.170, p=.036), respectively. These factors explained 23.4% of the variance.
Conclusion The findings indicate the need to develop programs to effectively cope with job stress and implement mentoring systems or psychological support programs to reduce turnover intention among nurses at the organizational level.
PURPOSE This study was done to identify the mediating effect of resilience on the relationship between nurse's character and happiness for nurses in general hospitals. METHODS Participants were 139 nurses working in general hospitals. A survey was used and data were collected in April 2019. Data were analyzed using the IBM SPSS/WIN 22.0 program. RESULTS The significant predictors for the happiness of nurses were nurse's character (β=.56) and resilience (β=.80). These variables explained 67% of the variance in happiness of nurses. Also, resilience had a total mediating effect on the relationship between nurse's character and happiness. CONCLUSION Findings indicate that nurse's character and resilience are important factors for the happiness of nurses in general hospitals.
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PURPOSE The aim of this study was to evaluate the effectiveness of interventions for workplace bullying among nurses. METHODS First, risk factors of workplace bullying were categorized in order to create analysis criteria. A search of 8 databases, and manual searching resulted in the identification of 3,096 relevant articles. Three of the authors did article selection, data extraction, and quality assessment using the Risk of Bias (RoB) and the Risk of Bias for Nonrandomized studies (ROBANS). RESULTS Interventions in workplace bullying were classified as individual, interactions, and organizational approach. Twelve intervention studies (10 individual interventions, 1 team approach, 1 multi-level approach) were selected. Four of the individual interventions decreased bullying, but three had no effect. One multi-level intervention reported that bullying did not occur. Individual interventions improved bullying awareness in four articles, decreased turnover intention in two articles, and increased skill and knowledge of bullying management in five articles. One team approach increased nurse interactions and group cohesion. The quality of selected articles was low overall. CONCLUSION Individual interventions have a possibility to improve awareness and knowledge about bullying, but there is a lack of evidence on preventing bullying. Further research is required on multi-levels interventions with well-designed controlled trials.
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