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 validate the Korean version of the Attitudes towards Men in Nursing Questionnaire (K-AMnQ) using a sample of Korean nurses.
Methods To measure the perceptions of male nurses, this study translated and adapted the AMnQ developed in India to the Korean context and collected data from 319 nurses. Item analysis, exploratory factor analysis, and confirmatory factor analysis were conducted on the collected data to verify convergent validity and discriminant validity, and the Korean version of the male nurse recognition scale was finalized with three factors and nine questions.
Results The analysis showed that the scale had both validity and reliability.
Conclusion This tool can be used to improve attitudes and interventions among male nurses.
Hyunjung Ko, Nara Han, Seulki Jeong, Jeong A Jeong, Hye Ryoung Yun, Eun Sil Kim, Young Jun Jang, Eun Ju Choi, Chun Hoe Lim, Min Hee Jung, Jung Hee Kim, Dong Hyu Cho, Seok Hee Jeong
J Korean Acad Nurs Adm 2024;30(5):529-542. Published online December 31, 2024
Purpose This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.
The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.
Purpose This study aimed to develop a colleague solidarity scale for nurses and to verify its validity and reliability. Methods Initial items were extracted through an extensive literature review and in-depth interviews with twelve clinical nurses. These items were subjected to content validity testing by ten experts and face validity testing by five nurses.
Subsequently, the final tool was developed using a validity and reliability test comprising 53 preliminary items. Survey data were collected from 548 hospital nurses. Results In the exploratory factor analysis, four factors and 33 items were selected, yielding a total cumulative variance ratio of 66.7%. Through the confirmatory factor analysis, the final tool consisting of 4 factors and 31 items was developed. The factors were as follows: “mutually beneficial community,” “nurse identity.” “rigid organizational experience,” and “supportive interaction.” These factors were verified through convergent and discriminant validity testing. The internal consistency reliability was acceptable (Cronbach’s ⍺= .94). Conclusion This tool can serve as the basis for developing programs and strategies to strengthen solidarity among nurses by identifying the current level of colleague solidarity among hospital nurses and enhancing their understanding of it.
Purpose This study aimed to identify factors influencing nursing professionalism among outpatient nurses. Methods Data were collected through a self-evaluation survey of 157 nurses from general and tertiary hospitals in Seoul and Gyeonggi-do, Korea. Data were analyzed using independent t-tests, one-way ANOVA, Importance-Performance Analysis, Pearson correlation coefficients, and multiple regression analysis. Results The mean scores were as follows: importance, 3.29 out of 5; performance, 2.50 out of 4; role conflict, 3.23 out of 5; and nursing professionalism, 3.23 out of 5. There were statistically significant positive correlations between the importance (r=.32, p<.001) and performance (r=.38, p<.001) of nursing activities and professionalism. There were statistically significant negative correlations between role conflict and nursing professionalism (r=-.20, p=.014). Stepwise multiple regression analysis showed that the importance of nursing activities, performance of nursing activities, role conflict, working department, and sex explained 33.0% of outpatient nurses’ professionalism (F=8.66, p<.001). Conclusion The findings indicate educational system about important and highly accomplished tasks would be useful to improve nursing professionalism of outpatient nurses. Furthermore, reducing role conflicts by clearly distinguishing tasks is necessary to increase nursing professionalism.
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Purpose This study aimed to identify the effects of the nursing practice environment and reciprocity among hospital nurses on their intent to leave, and to investigate the mediating effect of reciprocity in this process. Methods This study was conducted with 218 full-time nurses working for more than 6 months at four general hospitals located in two cities in South Korea. Data were collected using questionnaires from July 26 to August 12, 2022, and analyzed using IBM SPSS/WIN 23.0 and SPSS Process Macro. Results The nursing practice environment (r=-.38, p<.001) and reciprocity (r=-.33, p<.001) were negatively related to the intention to leave. The nursing practice environment and reciprocity affected intent to leave, reciprocity had a partial mediating effect between the nursing practice environment and intent to leave. Conclusion Nursing managers should strengthen the nursing work environment and reciprocity levels to reduce nurses’ intention to leave. Additionally, nursing managers need to effectively manage the organizational culture so that nursing services can be provided in a friendly medical culture that values fair and equal cooperation.
Purpose This conceptual analysis aimed to reveal the “role conflict of physician assistants with nursing licenses in Korea” by defining and organizing its concept. Methods This study used the conceptual analysis process of Walker and Avant. Results The role conflict of Korean physician assistant nurses can be defined by the following attributes: “Confusion of identity,” “Psychological burden of work,” “Anxiety and fear of legal responsibility,” “Anxiety about an uncertain future,” “Relative deprivation,” “Sense of neglect,” and a “Lack of sense of belonging.” The antecedents identified were: “unclear work boundaries,” “absence of work guidelines,” “excessive work and poor environment,” “Absence of regulations and administrative regulation,” “Exclusion from unfair treatment and promotion,” “Difficulty measuring job performance,” “Absence of job autonomy,” and “Physician group interest pursuit.” The consequences were: “Decreased job satisfaction,” “Decreased sense of achievement,” “Decreased self-esteem,” “Limited growth,” “Increased turnover intentions,” “Exhaustion of mind and body,” “Career identity crisis,” and “Frustrations.” Conclusion: This study provides basic data for constructing a theory concerning role conflict among Korean dedicated nurses and promotes the development of measurement tools. Furthermore, it meaningfully presents both theoretical grounds for reducing the role conflict of dedicated nurses and evidence for legalization.
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Purpose This study aimed to determine the mediating effect of leader-member exchange (LMX) on the relationship between nursing unit managers’ethical leadership and nurses’turnover intentions. Methods A cross-sectional nationwide survey was performed using structured questionnaires. A total of 225 clinical nurses working in general tertiary hospitals were recruited through proportional quota sampling; the quota used represented the location of working hospitals in South Korea. Data were collected through an online survey and snowball sampling from June to September 2022 and analyzed using the SPSS 25.0 program. A mediation analysis was performed using a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval. Results In bootstrapping, the indirect effect (X→M→Y) was statistically significant (B=-0.77, 95% CI:-1.02 to -0.50). LMX showed a mediating effect on the relationship between nursing unit managers’ethical leadership and clinical nurses’ turnover intention. In this model, the total effect was B=-0.93 (p<.001). Conclusion These findings suggest that LMX must be considered when making a strategy for nursing retention in the hospital setting. Nursing unit managers with ethical leadership could decrease nurses’ turnover intention by improving the LMX.
Purpose The purpose of this study was to develop and validate the Job Competency Scale (JCS) for insurance review nurses working in hospitals. Methods The initial items were generated through a literature review and interviews with 10 experts. The content validity of the items was evaluated through content validity and face validity tests. Data from 301 insurance review nurses working in hospitals were analyzed using item analysis, exploratory and confirmatory factor analysis, and convergent validity; reliability was tested using Cronbach’s ⍺. Results The final JCS consisted of 25 items and five factors (knowledge integration, professional ethics, communication and interpersonal relationship, information literacy and problem solving, self-development) that explained 72.4% of the variance. Confirmatory factor analysis indicated that the theoretical model comprising 25 items satisfied all goodness-of-fit parameters. Convergent validity was confirmed by the Task Performance Scale for insurance review nurses (r=.53, p<.001). The total Cronbach’s ⍺ score for scale was .94. Conclusion The JCS was found to be a reliable and valid instrument that can be used to measure the job competency of insurance review nurses working in hospitals.
Purpose This study investigated the effects of job embeddedness and resilience on the relationship between job rotation stress and nursing work performance among clinical nurses. Methods: We conducted a nationwide online survey with 205 nurses employed at advanced general or general hospitals. Data were collected from August 17 to October 5, 2021. We analyzed the data using various descriptive statistics, independent t-tests, one-way analysis of variance, Scheffé test, Welch test, Games-Howell test, Pearson's correlation coefficients, multiple regression, and the PROCESS macro with a 95% bias-corrected bootstrap confidence interval. These analyses were conducted using SPSS Windows Software version 23.0 and SPSS PROCESS macro version 3.5.2. Results: Nurses' job embeddedness mediated the relationship between job rotation stress and nursing work performance (B=-0.02, p<.05). Furthermore, their resilience moderated this mediated relationship, also known as moderated mediation, with job embeddedness as the mediating factor (B=-0.02, p<.05). Conclusion: These findings imply that, when devising a strategy to improve the nursing work performance of nurses undergoing job rotation, their resilience levels should be considered. Reducing job rotation stress while concurrently enhancing job embeddedness is essential for enhancing the nursing work performance of nurses with high levels of resilience.
Purpose This study investigated the effects of nursing unit managers' authentic, transformational, and transactional leadership styles on positive psychological capital and turnover intention in advanced beginner-stage nurses (ABNs). Methods The study included 157 nurses with clinical experience ranging form more than one year to less than 3 years in three general hospitals. Data analysis was conducted using the SPSS/WINdows software version 26.0. Results Authentic, transformational, and transactional leadership styles of nursing unit managers increased the positive psychological capital of ABNs, thereby lowering their turnover intention. Additionally, the turnover intention of ABNs was negatively correlated with the authentic, transformational, and transactional leadership styles of a nursing unit manager and positive psychological capital. Positive psychological capital showed a mediating effect in the relationship between authentic, transformational, and transactional leadership styles of nursing unit manager and turnover intention of ABNs. Conclusion To reduce ABNs turnover, medical institutions and nursing organizations should focus on enhancing nursing unit managers’ transformational and authentic leadership styles. Moreover, as transactional leadership has been found to decrease the turnover intention among ABNs, nursing unit managers should carefully consider their responsibilities and resources allocation to provide conditional compensation support to nurses.
Purpose A descriptive survey-based study was undertaken to determine how emotional intelligence mediates the relationship between social support and resilience by clinical nurses, thereby providing primary data for improving resilience. Methods This study involved a descriptive survey of 202 nurses working in four general hospitals. Using SPSS/WIN 26.0, frequency analysis, descriptive statistics, and multiple regression analyses were conducted. Results Social support had a statistically significant positive correlation with emotional intelligence (β=.49, p<.001) and resilience (β=.47, p<.001). Emotional intelligence showed a statistically significant positive correlation with resilience (β=.66, p<.001). Emotional intelligence was found to have a partial mediation effect on the relationship between social support and resilience (z=5.76, p<.001). Conclusion The study also discovered that social support and emotional intelligence are factors influencing clinical nurses' resilience. Furthermore, it evident that emotional intelligence has a partial mediating effect on the relationship between social support and resilience. Therefore, it is necessary to consider nurses’ emotional intelligence at the individual level to effectively improve resilience through social support.
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Purpose This study aimed to clarify and analyze the concept of a career plateau among clinical nurses. Methods Using Walker and Avant’s concept analysis framework, 20 articles on the career plateau of clinical nurses were selected for this study. Results The attributes of the clinical nurses’ structural career plateau were “unmet need for vertical movement” and “accepting of promotion restrictions”. The attributes of the clinical nurses’ content career plateau were “job repetition”, “involuntary job fixation”, “work lethargy”, “low expectations for nursing professional development,” and “indifference to care recipients”. The antecedent factors for the nurses’ career plateau were “lack of organizational support”, “lack of respect from the organization, bosses, and colleagues”, “personal problems arising or remaining unresolved”, “limited autonomy”, and “absence of role models”. As a consequence of the career plateau, job satisfaction, nursing competency, and nursing quality decreased, while burnout and turnover intention increased. Conclusion This study is significant in that it clarified the concept and attributes of the clinical nurses’ career plateau by reflecting the characteristics and purpose of nursing.
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Purpose This study aimed to identify the occupational performance and development needs, and specifically the priority needs, of general hospital nurses according to their career levels so as to help create an effective nursing management competency development program.
Methods: This is a cross-sectional study conducted with 203 nurses working at three advanced general hospitals in G metropolitan city and C province. The participants completed a questionnaire about behavioral indicators which measured their nursing management performance and development needs. Their career levels were divided into four. Data were analyzed using t-test, ANOVA, Borich need, and the Locus for Focus model.
Results: The mean levels of nursing management performance and competency development needs were 2.78±0.75 and 4.07±0.58, respectively. There was a significant difference in nursing management performance and development needs according to career level (F=6.18, p<.001, F=12.35, p<.001). Priority need analysis showed that level 1, level 2, level 3, level 4 nurses had higher demands for self-development and adaptation to new changes/organization/nursing work performance and information management role/creativity development, respectively.
Conclusion: The findings provide a basis for training systems that differentiate between contents and degrees of nursing management competency based on career level to develop nursing human resources.
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Purpose This study analyzed news titles related to nurses in Korea before and after the Coronavirus disease 2019 (COVID 19) pandemic, and aimed to identify the implications of media reports.
Methods: Data from January 2019 to December 2020 were collected from BIGKINDS regarding Korean nurses. Text mining and CONCOR analysis were conducted on the top 30 keywords using TEXTOM and Ucinet 6.
Results: From the findings of this study, keywords were related to Taewom and Newborn death in 2019. Additionally, because of COVID-19 and the controversy over the encouragement of President Moon Jae-in, Taewom was included in 2020. Using CONCOR analysis, 6 clusters (characteristics and results of major incidents, the issue related target, Newborn abuse, Taewom, drugs, nursing education) were generated in 2019, and 6 clusters (emergency room, hero, controversy, Taewom, COVID-19, hospital infection) were generated in 2020.
Conclusion: Before and after the COVID-19 pandemic, most of the news headlines of nurses consisted of negative keywords, while there were few positive news headlines. In order to improve the image of nurses, it is necessary to continuously analyze media trends and establish strategies accordingly.
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Purpose This study was explored the current nursing issues in the COVID-19 era by analyzing newspaper articles.
Methods: The search term “nurse” was used to collect newspaper articles from 2020. Pre-processing and semantic network analysis and topic group clustering were conducted using the NetMiner program to analyze the collected articles.
Results: A total of 256 articles were identified, and four topics were extracted. The core keywords were “medical care”, “hospital”, “COVID-19” and “medical workforce”. The extracted topics were “work environment related to response to infectious diseases”, “utilization of nursing resources”, “excessive nursing work”, and “shortage of nursing workforce”.
Conclusion: Our findings provide useful information for understanding social perspectives of critical nursing issues in the COVID-19 era. Most of the extracted topics are the actual problems that nurses have faced for a long time. Now, nurses must proactively address current nursing issues to respond to national disasters and provide quality nursing care.
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Purpose This study conducted a systematic review and meta-analysis to identify trends in nursing ethics education research for Korean nursing students and nurses.
Methods: The data search was conducted in July 2020; domestic and foreign academic journals were targeted for the search. A combination of search terms was entered into major databases, and the year of publishing was limited to the last 10 years (2010~2020).
Results: The systematic review analyzed 25 experimental and 13 non-experimental studies, and education methods included lectures, discussions, role play, film-use classes related to nursing ethics, action learning, and case-based learning. The meta-analysis of 12 studies revealed that ethical education has significant differences in effect size of biomedical ethics, critical thinking, moral judgment, and moral sensitivity. A subgroup analysis of education methods showed that in addition to traditional lecture and discussion education methods, there were significant differences in the effect size of sense of biomedical ethics between the following two methods: lecture and discussion including additional methods and lecture and discussion only.
Conclusion: Ethics education for nursing students and nurses has been found to be effective in improving ethics-related competencies, and various teaching methods other than lectures and discussions must be utilized.
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Methods: A total of 10 nurses working in a COVID-19 ward of a public hospital in South Korea were recruited using purposeful sampling. Individual telephone interviews were conducted and then transcribed verbatim. Data were analyzed using qualitative content analysis.
Results: Two categories of nurses’ experience in caring for COVID-19 patients emerged; “unstable psychological status” and “adaptation and self-esteem”. “Shortage of staff due to the increase in infected people”, “poor environment due to the urgent construction of a COVID-19 ward”, “unstable operating system”, and “excessive demands and verbal abuse from patients” were “obstacles”, while “cooperation and consideration between colleagues” and “interest and support from the manager” were found to be “sources to boost morale” for nurses in caring for COVID-19 patients.
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Purpose This study aimed to identify the job characteristics of the integrated nursing care wards.
Methods: For 388 nurses working in the integrated nursing wards of 30 hospitals, the importance, performance frequency, and difficulty of nursing tasks were analyzed using 31 job categories (678 items). Nursing tasks were analyzed using ImportancePerformance Analysis by hospital type.
Results: Tertiary hospitals and general hospitals were analyzed using Importance-Performance Analysis, and the categories of general nursing intervention, spiritual and end of life nursing, and nursing during examination differed by hospital type. Other tasks into the same categories. 'Keep up the Good Work' includes 12 tasks: nursing assessment, medication and blood transfusion, admission or discharge management, and cooperation and coordination. 'Concentrate Here' had three tasks: emergency care, education to nurses, self-development. 'Possible Overkill' included supportive contact, environmental management, and product management. 'Low Priority' has ten tasks, including administration and organization management, facility management.
Conclusion: Nurses had different perceptions of importance and difficulty according to the tasks.
Nursing during the examination, general nursing intervention, spiritual nursing, and end-of-life nursing were placed in different domains according to hospital type. Therefore, it is necessary to establish the nursing tasks and plan to improve workforce management, reflecting these differences.
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Purpose This study aimed to define and clarify the concept of colleague solidarity experienced by nurses during the COVID-19 pandemic.
Methods: A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical phase, 20 articles selected through literature review by including nursing and related disciplines were analyzed. For the fieldwork phase, in-depth interviews were conducted with nine nurses who took care of infected patients with COVID-19 at Infectious Diseases Specialized Hospital.
Results: The dimensions identified were consistently observed in the field phase, however, more attributes were found newly from the fieldwork phase. In the final phase, the concept of colleague solidarity among the nurses was found to have three dimensions with nine attributes. The interaction dimension had four attributes as voluntary support, mutual respect, open communication, and virtuous circle. The motivation dimension had two attributes of sense of communion and calling. Lastly, the relationship dimension had three attributes of unity, mutually equal relationship, and comradeship.
Conclusions: This study is meaningful in observing how the concept of colleague solidarity, which is relatively unfamiliar to domestic nurses, appears in the clinical field during a national crisis and analyzing the concept.
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Purpose This study was done to determine whether the Korean version of the cyberbullying scale developed for adolescents is applicable to newly graduated nurses. Methods: This scale was composed of 14 items with the one-factor structure to measure the degree of cyberbullying and 1 item with multiple responses the media used for cyberbullying. Online survey data were collected from 279 newly graduated nurses who worked in hospital. Internal consistency reliability and construct validity using confirmatory factor analysis were conducted using SPSS/WIN 26.0 and AMOS 26.0. Results: The one-factor structure was validated through confirmatory factor analysis (x 2 =360.22, df=77, Normed Fit Index (NFI)=.91, Tucker Lewis index (TLI)=.92, Comparative Fit Index (CFI)=.93, and Root Mean-Squared Error of Approximation (RMSEA)=.12). The correlation coefficient between cyberbullying and workplace bullying was .50 (p<.01), confirming the criterion-related validity. The Korean version of the cyberbullying scale showed reliable internal consistency with a Cronbach’s ⍺ for the total scale of .97. Conclusion: Findings from this study demonstrate that the Korean version of the cyberbullying scale has satisfactory construct validity and reliability to measure cyberbullying experience among newly graduated nurses. The use of this scale will be valuable for future practice and research related to cyberbullying.
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Purpose This study was done using quantile regression to identify the factors affecting nurses’ turnover intention.
Methods: A sample of 163 nurses, who had worked in hospitals for more than 6 months, was recruited from two online nursing communities. Data were collected through self-report questionnaires, which included turnover intention, workplace bullying, empowerment, and sociodemographic and job characteristics. Collected data were analyzed using ANOVA, Kruskal-Wallis test, Mann-Whitney U test, Spearman correlation coefficients, and quantile regression.
Results: The factors affecting turnover intentions by quantile were partially different, but the predicting factors over 50% quantile were workplace bullying (Q50, b=0.15, p=.002; Q75, b=0.10, p=.025; Q90, b=0.12, p=.012), structural empowerment (Q50, b=-0.64, p<.001; Q75, b=-0.55, p=.005) and experience in current unit (Q75, b=-0.04, p=.013; Q90: b=-0.05, p=.002).
Conclusion: Different factors have an influence on nurses’ turnover intention level. Nursing organizations need to develop customized management strategies to address nurses' turnover intention levels based on policies that reduce workplace bullying and strengthen structural empowerment.
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Purpose This study was done to identify the mediating effect of biomedical ethics awareness in the relationship between moral sensitivity and perceived ethical confidence among nursing students.
Methods Participants were 211 nursing students from 7 universities in G city. A self-report questionnaire was used to measure moral sensitivity, biomedical ethics awareness, and perceived ethical confidence. The data were analyzed with descriptive statistics, Pearson correlation coefficient analysis, and multiple regression analysis using Baron and Kenny's method.
Results Moral sensitivity was significantly positively correlated with biomedical ethics awareness (r=.52, p<.001) and perceived ethical confidence (r=.60, p<.001). Biomedical ethics awareness was also significantly correlated with perceived ethical confidence (r=.50, p<.001). Also, biomedical ethics awareness (β=.25, p<.001) showed a partial mediating effect on the relationship between moral sensitivity and perceived ethical confidence.
Conclusion The impact of moral sensitivity on perceived ethical confidence in nursing students was mediated by biomedical ethics awareness. Therefore, it is suggest that strategies for improving biomedical ethics awareness in nursing students should be considered when developing an educational program for enhancing their perceived ethical confidence.
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