Earticle

Objectives : Cash Flows from operating activities is the most important part of the cash flow statement and it serves as an important financing source. Accordingly, the purpose of this study is to examine the influence of the contents of cash flows from operating activities on the changes in borrowings. Methods : In this study financial data from 2011 to 2014 were used to analyz 36 general hospitals and 85 hospitals according to the index displaying variation against the previous year. Results : For general hospitals, borrowings in cash flow from financing activities increased as net income decreased; while depreciation etc increased in cash flow from operating activities. For hospitals, borrowings in cash flow from financing activities increased as the gain on disposition of tangible assets in cash flow from operating activities decreased. Conclusions : General hospitals need to control the management of borrowings and depreciation at the level of funding management; whereas hospitals need to manage of future cash forecasts for stability of operational funds.

최근 IT 기술이 발달함에 따라 병원에서 사용되고 있는 의료 장비도 고사양의 성능을 요구하고 있다. 그러나, 사용 자는 사용자의 상황에 따라 서로 다른 병원을 내원하기 때문에, 병원에서 진료 받은 의료 정보가 병원마다 분산되어 있다. 본 논문에서는 서로 다른 병원에 내원한 사용자의 헬스케어 정보 수집을 위해서 병원에 저장되어 있는 사용자의 헬스케어 정보를 효율적으로 통합하기 위한 모델을 제안한다. 제안모델은 사용자 중심의 헬스케어 정보 수집을 위해서 개인 웨어러블 장치로부터 수집된 사용자의 헬스케어 정보를 서로 동기화한다. 또한, 제안 모델은 헬스케어 서비스 센터와 데이터 공유를 원활하게 수행하기 위해서 클라우드 환경에 존재하는 데이터베이스에서 사용자의 헬스케어 정보와 관련된 무결성 및 유효 성 검사를 수행한다. 특히, 제안모델은 모바일 플랫폼으로부터 수집된 사용자의 헬스케어 정보를 원활하게 관리하기 위해서 트리기반의 데이터 처리를 수행할 수 있도록 하였다.

As IT technology develops recently, medical equipment used in hospitals is demanding high performance. However, since the user visits different hospitals depending on the user's situation, the medical information treated at the hospital is distributed among the hospitals. In this paper, we propose a model to efficiently integrate the health care information of the users stored in the hospital in order to collect the healthcare information of the users who visited the different hospitals. The proposed model synchronizes users' healthcare information collected from personal wearable devices to collect user - centered healthcare information. In addition, the proposed model performs integrity and validity check related to user 's healthcare information in a database existing in a cloud environment in order to smoothly share data with the healthcare service center. In particular, the proposed model enables tree - based data processing to smoothly manage healthcare information collected from mobile platforms.

본 연구의 목적은 녹색경영 평가기준을 실제 의료기관에 적용해 봄으로서 향후 의료기관의 녹색경영 인증 에 필요한 전반적인 전략도출과 녹색경영평가제도의 개선방향을 제시하는 데 있다. 조사는 전국 44개 병원을 대상으 로 실시하였으며, 평가도구는 2012년 보건ㆍ의료서비스분야 녹색경영 평가기준을 사용하였다. 분석결과 44개 병원 중 11개 병원만이 녹색경영 인증을 받는 것으로 나타났다. 유형별로는 400병상 이상병원, 서울ㆍ경기지역병원(≥ 400), 사립병원(≥400)들이 상대적으로 높은 평가점수를 획득하였다. 인증점수의 평균차이의 분석결과 400병상 이상 과 미만의 병원군 간 차이만이 통계적으로 유의하였다. 획득점수가 부족한 병원들의 인터뷰 결과, 경영진과 직원의 의식변화, 비전/전략/목표 수립, 비교적 적은 규모의 활동부터 추진, 장기계획 수립 등이 중요할 것으로 판단되었다. 녹색경영평가제도의 개선은 평가영역의 재설정, 배점과 가중치 조정, 인증등급의 신설, 가점항목 조절 등이 필요하다 고 판단된다.

We sought to derive an overall strategy for green business certification of medical institutions and to propose the improvement directions for green management evaluation systems through applying the criteria to medical institutions. A self-assessment survey was conducted at 44 targeted hospitals across the country, and the 2012 green management evaluation criteria for healthcare services were used as assessment tools. As a result, only 11 of the 44 hospitals were eligible for green business certification. By type, hospitals with more than 400 beds, hospitals in Seoul and the Gyeonggi area (≥ 400 beds) and private hospitals (≥ 400 beds) received relatively high scores. In an analysis of the mean score, only the difference between the hospitals with ≥ 400 beds and < 400 beds was statistically significant. When we analyzed the interviews of the hospitals with lower scores, it is important to change the awareness of executives and employees, to establish vision/strategy/objective, to promote relatively small-scale activities, and to establish long-term plans. To improve green management evaluation systems, it is necessary to reset the assessment area, to control scoring and weights, to create certification grades, and to adjust additional points.

Objectives : The objective of this study was to examine preceding variables that affect the dual commitment of outsourced employees working at hospitals and to analyze the influence of these variables on job performance. Methods : Data were collected from 461 outsourced employees, working at 7 general hospitals, which had introduced the outsourcing system, using a structured, self-administered questionnaires. Frequency, validity/reliability, correlation and path analyses were done for data analysis. Results : The results of the path analyses showed that both commitment to the hiring company and commitment to the client company (hospital) had statistically significant positive effects on job performance. Additionally, when the 'single measurement' approach was used, dual commitment had a larger positive effect, compared with the 'parallel approach.' Among the preceding variables, 'satisfaction for the job itself' was found to be the most important variable affecting dual commitment and job performance. Conclusions : In conclusion, to enhance the job performance of outsourced employees, it is important for management to examine and improve the various factors related to job satisfaction. Additonally, for outsourced employees to have organizational commitments to the hiring and client companies simultaneously, management should emphasize a sense of unity and share organizational values.

본 연구는 병원의 비정규직 사무직을 대상으로 차별과 직무만족의 관계를 분석하였다. 2017년 12월 1일부터 12월 31일 사이에 전국의 7개 대학병원에 근무하는 비정규직 사무직 128명을 대상으로 설문조사를 실시하였다. 분석 방법은 일반적 특성에 따른 차별경험, 직무만족 차이분석을 위한 t-검정, ANOVA 분석, 상관관계분석, 다중회귀분석을 적용하였다. 연구의 주요 결과를 보면, 환경불공정성, 지위불공정성 및 고용불안정성이 유의한 음(-)의 영향력을 보였고, 일반적 특성은 성별, 교육, 소득이 유의한 음(-)의 영향력이 있는 것으로 나타났다. 특히 병원의 경우 여성이 남성에 비해 차별이 높고, 직무만족도가 떨어지는 것으로 분석되었다. 이에 따라 병원에서는 비정규직 여성을 위한 친화적 직장 분위기를 만들기 위한 적극적인 노력이 필요함을 시사해 주고 있다.

The purpose of this study was to analyze the association between discrimination and job satisfaction among non-regular office workers. The data was collected from 128 employees of 7 university hospitals using a standardized questionnaire. In research methodology, the data was analyzed with descriptive statistics, t-test, ANOVA, pearson's correlation, multiple regression analysis. The results of the study are as follows. Unjust working environment, position unfairness, employment instability were found to have a negative(-) effect on job satisfaction. Gender, education, income in general characteristics had a significant negative(-) effect on job satisfaction. The discrimination of non-regular office woman workers was higher and job satisfaction was lower than that man workers. These results showed that hospitals need active efforts to create friendly work environment for non-regular woman workers.

본 연구는 난임센터에서 근무하는 간호사들이 자신의 전문직 경력에서 그릿을 어떻게 이해하고 경험하는지 탐색하고자 하였다. 난임센터에서 근무하는 간호사 10명을 대상으로 심층 면담을 진행하였고, 연구 참여자들은 어려움의 극복, 동기 부여 유지, 그리고 지속적인 헌신에 대한 개인적 경험을 공유하였다. 난임센터 간호사의 그릿은 인내, 동기 부여, 대처 전략, 전문직적 성장 등 투지의 의미와 역할을 반영하는 주요 주제로 도출되었다. 본 연구는 난임센터 간호사의 그릿이 직무 만족도, 회복탄력성, 재직 유지에 미치는 구체적인 영향력을 파악하였으며, 이는 향후 간호 인력 관리 방안을 모색하는 데 도움이 될 수 있다.

Background/Objectives: This study aims to explore how nurses understand and experience grit in theirprofessional lives. Methods/Statistical analysis: We conduct in-depth interviews with 10 nurses who practice in infertility settings. The participants shared their personal stories about overcoming challenges, staying motivated, and sustaining commitment throughout their nursing careers. Findings: The interview data will be organized into themes reflecting the meaning and role of grit, such as perseverance, motivation, coping strategies, and professional growth. Application/Improvements: The findings are expected to provide valuable insights into how grit shapes nurses’ job satisfaction, resilience, and retention.

본 연구는 병원 간호사의 자기효능감에 대한 개념과 속성을 분석하는 것으로 간호학에서의 병원 간호사의 자기효능감 개념과 관련된 이론적 기초를 마련하는 것이다. Walker 와 Avant의 개념분석 방법을 적용하여 병원 간호사의 자기효능감에 대한 개념 분석을 하였다. 간호사로 하여금 스스로 임상 환경에서 오는 스트레스와 역경, 그로부터 수반되는 부정적 감정을 이겨낼 수 있다는 믿음과 기대를 갖게 하는 것, 간호사 자신에게 간호업무 수행 능력이 있다고 믿게 하여 명확한 방향성을 가질 수 있게 하는 것, 임상에서 일어나는 여러 상황을 통제할 적합한 판단력이 있다고 믿게 하여 업무를 속행 할 수 있게 하는 것, 간호 업무에 대한 적극적 참여를 통해 도전적인 목표 의식을 갖게 하고 미래를 위한 동기를 부여하는 것, 간호사 개인적 측면에서부터 환자나 병원 조직까지 다방면에 연쇄적으로 영향을 끼치는 것의 다섯 가지 속성으로 규명되었다. 본 연구를 통하여 자기 효능감 개념이 간호사 개인의 발전에서 끝나는 것이 아니라 직무 성과와 조직 몰입을 이끌어 내 병원이라는 조직에 영향을 미친다는 점, 임상에서 가장 중요한 환자 안전에 영향을 미치는 요인을 공고히 하기 위한 추가적인 연구가 필요할 것으로 생각 된다.

This study was done clarify the concept of clinical nurse’s self-efficacy. This study was conducted using Walker & Avant’s concept analysis framework, There were five aspects of the concept of Clinical Nurse’s Self-Efficacy: To have faith and expectation that nurses can overcome stress and adversity in the clinical environment, To have a clear direction by believing that nurses themselves have the ability to perform nursing tasks, Allowing nurses to continue their work by believing that they have appropriate judgment to control various situations in clinical practice, Having a challenging sense of goal and motivating for the future through active participation in nursing work, and influencing various aspects from individual nurses to patients and hospital organizations. This conceptual analysis of clinical nurses' self-efficacy can recognize the need to prepare an educational system to improve nurses' self-efficacy and conduct related research.

본 연구는 종합병원에 근무하는 암병동 간호사와 일반병동 간호사의 직무스트레스와 신체화 증상간의 관계를 알아보기 위한 조사연이다. 참가자는 종합병원에 근무하는 114명의 간호사로 일반적 특성에 따른 직무스 트레스와 신체화 증상을 확인하고 두 변수들의 상관관계를 분석하였다. 연구결과 암병동 간호사는 일반병동 간 호사보다 직무스트레스와 신체화 증상이 모두 높았으며, 암병동 간호사와 일반병동 간호사 모두 직무스트레스와 신체화 증상은 양의 상관관계가 있는 것으로 나타났다. 암병동 간호사에 대한 안전한 근무환경 및 호스피스 간호 와 관련한 심리적 지원을 통하여 암병동 간호사의 직무스트레스를 완화시시키고 나타날 수 있는 신체화 증상을 예방하는 의료기관의 적극적 지원이 필요하다.

The purpose of this study was to compare the stress from nursing care between nurses in cancer unit and nurses in the general unit. A total 114 of nurses were recruited from a general hospital. The job stress level of the nurses and the somatic symptoms level of the nurses working in cancer unit was significantly higher than the level of the nurses working in general unit. It is important to eusure the methods that contrive to perform care efficiently by generating hospice nurses.

본 연구는 임상간호사의 바람직한 간호 인성의 본질과 내용을 확인하여 임상간호사로서 간호역량 확보와 양질의 간 호 제공을 위한 기초 자료를 제공하고자 한다. 임상 간호현장에서 기대하는 바람직한 간호사의 인성에 대해 포괄적으로 탐구 하기 위하여 포커스그룹 인터뷰 분석을 시행한 질적 연구이다. 2019년 11월 30일~ 2020년 1월 20일까지 경력 5년 이상 D 지역 대학병원의 경력 간호사 6명을 대상으로 총 4회 진행하였으며, 내용 분석 방법을 통해 분석하였다. 임상 간호사에게 요 구되는 인성은 ‘환자 간호를 위한 자기 통제와 노력의 과정’, ‘인간 중심의 간호를 위한 구성요인’, ‘건강한 인간관계를 만드는 영향력’, 간호‘조직을 구성하고 운영케 하는 영향력’, ‘조직의 변화와 성과를 이끌어내는 영향력’ 총 5개의 주제와 17개의 하 위 주제로 분석되었다. 본 연구를 통해 간호현장에서 바람직한 인성의 요소를 확인하였으며, 추후 전문직 간호역량 확보와 양 질의 간호 제공을 위한 간호사 대상의 임상간호 인성 교육 프로그램 개발 연구를 제언한다.

This study aims to identify the nature and content of the desired nursing personality of clinical nurses and provide basic data for securing nursing competencies and providing quality nursing as clinical nurses. This is a qualitative study with a focused group analysis to comprehensively explore the desirable nurse personality expected in clinical nursing settings. From November 30, 2019 to Jan 20, 2020, 6 nurses with more than 5 years of clinical experiences and working in a regional university hospital participated in the four focus group interviews. The collected qualitative data was analyzed by the content analysis method. The personality required of clinical nurses is `process of self-regulation and effort for patient care', `components for human-centered nursing', `influence to create healthy interpersonal relationships', and `nursing'. Configure and operate the organization. It was analyzed into a total of five main themes and 17 sub-themes: “Influence to make changes” and “Influence to bring about organizational change and results.” This study confirms the desirable elements of personality in nursing practice, and proposes the application and effect verification research of clinical nursing education programs for nurses in order to secure the nursing competence of professionals and provide high-quality nursing care in the future.

Objectives : This study was conducted to measure the effects of healthcare accreditation (HA) on the changes in infection control (IC). Methods : Questionnaires were e-mailed to 60 hospitals from 23 October to 23 December, 2011. Data were analyzed by SPSS 12.0. Results : Finally 50 hospitals (83.0%) were enrolled in the study: Seoul area (40.0%), tertiary (76.0%), and >500 beds (98.0%). Nine hospitals (18.0%) had a full time infection control nurse[ICN] with 300 beds. Among various factors, ICN (36.0%), hospital facilities (66.0%), instruments (32.0%) and supplies (88.0%) all improved. Hand hygiene increased (53.1% vs 83.2%, p<.001), but it was continued only in 34.1% of hospitals. Healthcare-associated infection (68.4%), multi drug resistant organisms (42.1%) and outbreaks (26.3%) decreased. Reasons for difficulties in satisfying the HA standards were inadequate support which included hospital facilities, instruments, budget, and a shortage of ICNs and healthcare workers (HCWs). Conclusions : HA had effects on the IC, but they were transient. Staffing in ICN and HCW staffing, hospital facilities, instruments, and supplies all need to be improved.

Purpose: In Japan, about 80% of deaths occur in hospitals, especially long-term care beds. The purpose of this study was to clarify the nursing practices used for such older patients at the end-of-life stage in longtermcare wards via the modified grounded theory approach (M-GTA). Methods: Data were obtained through semi-structured interviews of nineteen nurses working in cooperating long-term care wards, acute care wards, or hospice services (to allow for constant comparison between these types of wards) in western Japan in 2014. We analyzed the transcribed data using M-GTA. Results: The core category that emerged from the analysis was “Balancing enhancement of patients' daily life quality and life-sustaining care in the face of uncertainty about the patients' character.” Eleven categories emerged, such as Seeking older patients' character with their family, Supporting families' decision making, Rebuilding patients' daily life in the ward, and Sustaining patients' life span through medical care. Conclusions: Nurses experienced uncertainty about the care needs of older patients, the ethical problems of Enhancing the patients' QOL by using risky care, and the evaluation criteria used to judge their own nursing care after the patients' death. All nurses had the goal of ensuring a natural death for all patients. Nurses' acceptance and evaluation of their own care was critically influenced by the patient's family's responses to their care after patients' death. Further research is necessary to develop evaluation criteria and educational programs for end-of-life nursing care of older adults.

Purpose The rising rate of violence and abuse in health care centers has become a major problem for nurses. The purpose of this cross-sectional study was to explore the prevalence of assaults during nurses’ careers in the Islamic Republic of Iran. Methods Self-report questionnaires were filled out by 1,317 nurses. Results Verbal abuse was experienced by 87.4% of the population during a 6-month period, and physical violence by 27.6% during the same period of time. No physical harm was reported in 66.4% of cases. Only 35.9% cases of verbal abuse and 49.9% cases of physical violence were actually reported. The majority of cases reported that abuse was followed by either inaction or by actions which failed to satisfy the victim. According to the findings, men were exposed to more abuse than women, and the risk of experiencing abuse was higher in nurses with more job experience or who worked more hours. Also, nurses who are responsible for first aid were subjected to more abuse than those in other positions. Conclusion The findings showed a noticeable trend of a rising number of assaults against nurses. The findings of this study may help hospital staff and nurses to avoid, reduce and control violence and abuse. [Asian Nursing Research 2008;2(3):184?193]

Purpose: To examine levels of teamwork and its relationships with clinical error reporting among Korean hospital nurses. Methods: The study employed a cross-sectional survey design. We distributed a questionnaire to 674 nurses in two teaching hospitals in Korea. The questionnaire included items on teamwork and the reporting of clinical errors. We measured teamwork using the Teamwork Perceptions Questionnaire, which has five subscales including team structure, leadership, situation monitoring, mutual support, and communication. Using logistic regression analysis, we determined the relationships between teamwork and error reporting. Results: The response rate was 85.5%. The mean score of teamwork was 3.5 out of 5. At the subscale level, mutual support was rated highest, while leadership was rated lowest. Of the participating nurses, 522 responded that they had experienced at least one clinical error in the last 6 months. Among those, only53.0% responded that they always or usually reported clinical errors to their managers and/or the patient safety department. Teamwork was significantly associated with better error reporting. Specifically, nurses with a higher team communication score were more likely to report clinical errors to their managers and the patient safety department (odds ratio = 1.82, 95% confidence intervals [1.05, 3.14]). Conclusions: Teamwork was rated as moderate and was positively associated with nurses' error reporting performance. Hospital executives and nurse managers should make substantial efforts to enhance teamwork, which will contribute to encouraging the reporting of errors and improving patient safety.

PurposeThis study examined levels of compassion competence, professional self-concept, and nursing organizational culture among nurses in long-term care hospitals (LTCHs) and analyzed their influence on person-centered care (PCC) in South Korea. The aim was to provide foundational data to support strategies for improving PCC. MethodsA cross-sectional descriptive survey was conducted with 201 nurses from 10 LTCHs in Busan, South Korea. Validated instruments were used to assess compassion competence, professional self-concept, nursing organizational culture, and PCC. Data were analyzed using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression using SPSS version 25.0. ResultsThe mean PCC score was 3.44 out of 5, indicating a moderate level. The levels of compassion competence (M = 3.87 out of 5) and professional self-concept (M = 5.97 out of 8) were also moderate. PCC was positively correlated with compassion competence, professional self-concept, and specific subdomains of organizational culture. Hierarchical regression identified compassion competence (β = 0.43, p < .001), innovation-oriented culture (β = 0.19, p = .006), and satisfaction with work (β = 0.13, p = .042) as significant predictors of PCC, accounting for 48.0% of the variance. ConclusionCompassion competence, innovation-oriented nursing organizational culture, and satisfaction with work significantly influenced PCC among nurses in LTCHs. Healthcare institutions should actively implement strategies to enhance nurses’ compassion competence and promote a supportive, innovative workplace culture and environment to improve PCC.

Purpose To explore the levels of continuing education management in hospitals according to their size, and to investigate problems in the management of continuing education of nurse midwives by chief nurses in community hospitals. Methods The target population was 128 chief nurses, 103 of whom (80.47%) returned the questionnaires. Data were collected using a questionnaire that had been tested for its content validity by three experts (content validity index was .80 and the Cronbach’s alpha was .83). Descriptive statistics and ANOVA were used to investigate if differences existed among groups. Results The mean score of the level of continuing education management in nurse midwives for the chief nurses was low. The levels of education management for chief nurses according to hospital size (10-bed, 30-bed, and 60-bed hospitals) were not significantly different (p > .05). The problems for chief nurses in the management of continuing education in nurse midwives in the community hospitals were: lack of manpower (70%); financial problems (45%); lack of lecturers in advanced nurse midwifery (38%); insufficient number of courses in advanced nurse midwifery (29%); length of time for study leave taken for training(21%); and safety problems in the unrest areas in the southern provinces (21%). Conclusion The levels of continuing education management by chief nurses in all the community hospitals were low, primarily due to a lack of manpower and budgetary constraints. Therefore, the Nursing Council of Thailand should provide training and funds to support advanced nurse midwifery education programs in all parts of the country. [Asian Nursing

Purpose : Many developed countries have already accepted the indispensable role of clinical pharmacist (CP) in health care system. In past few years, Ministry of Health in China has also worked efficiently to regularize and implement clinical pharmacy services (CPSs). In our study, we opted to access the perception, satisfaction and expectation of patients towards the services provided by CP in hospitals in China. Method : The study was conducted in 10 general hospitals located in 8 different cities in China. Questionnaire was composed of four main parts: 1) Demographics of patients, 2) General awareness about CP, 3) Response regarding CP’s professional capabilities, 4) Satisfaction and expectations regarding different CPSs. The chi-test was performed to examine the statistical significance of association between independent variables and dependent variables. Results : Out of 350 distributed questionnaires, 289 were retrieved giving a response rate of 82%. Most of the respondents know about clinical pharmacist and 39.79% had experienced CPSs before. 75% believed that clinical pharmacist is a drug expert, whereas mostly all agreed that CP is an important member of health care team and should be encouraged to participate in patient therapy. More than 75% of respondents perceive that CP can improve quality and safety of treatment. Among those who had previously experienced CPSs, more than 75% showed satisfaction with CP providing individualized patient care, participating in ward rounds, taking medication history, providing drug information and counseling. And approximately 80% of the remaining, who never experienced, expects CP to execute these tasks except for performing physical examination. Conclusion : Most people in China understand, accept and encourage the role of CP in health care. As patients who experienced CPSs were less, it triggers the need of hiring more clinical pharmacist and allowing them to perform additional interactive roles, so that effective CPSs can be delivered to masses.

Purpose: This study was done to evaluate the effects of a fluid intake intervention on increasing fluid intake and ameliorating dehydration status in elders admitted to long-term care hospitals. Methods: A nonequivalent control group, pretest and posttest design was used. The experimental group of 39 participants received the 4-week intervention while the control group of 38 participants received routine care. Outcome variables were daily fluid intake and physiological indexes such as blood urea nitrogen and creatinine ratio (BUN/Cr), urine specific gravity (USG), and urine color. Results: After the intervention to increase fluid intake, there were statistically significant increases in daily fluid intake, normal BUN/Cr, and USG in the experimental group. However, a statistically significant improvement in normal urine color was not found for either group. Conclusion: The findings of this study demonstrated that the fluid intake intervention improved hydration status of the experimental group participants. Consequently, it was confirmed that the intervention is considered to be effective in preventing dehydration which occurs frequently in older adults in long-term care facilities and, thus this intervention may contribute to preventing various health issues resulting from dehydration.

Purpose The purpose of this study was to compare the validity of three fall risk assessment scales including the Morse Fall Scale (MFS), the Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS),and the Johns Hopkins Hospital Fall Risk Assessment Tool (JHFRAT). Methods This study was a prospective validation cohort study in five acute care hospitals in Seoul and Gyeonggi-Do, Korea. In total, 356 patients over the age of 18 years admitted from December 2009 to February 2010 participated. The three fall risk assessment scales listed above were tested for sensitivity,specificity, positive predictive and negative predictive values. A receiver-operating characteristic (ROC)curve was generated to show sensitivities and specificities for predicting falls based on different threshold scores for considering patients at high risk. Results Based on the mean scores of each scale for falls, the MFS at a cut-off score of 50 had a sensitivity of 78.9%, specificity of 55.8%, positive predictive value of 30.8%, and negative predictive value of 91.4%, which were the highest values among the three fall assessment scales. Areas under the curve of the ROC curves were .761 for the MFS, .715 for the BMFRAS, and .708 for the JHFRAT. Conclusions Accordingly, of the three fall risk assessment scales, the highest predictive validity for identifying patients at high risk for falls was achieved by the MFS. [Asian Nursing Research 2011;5(1):28?37]

Purpose: The purpose of the study was to investigate the effects of laughter therapy on depression and sleep among patients at two long-term care (LTC) hospitals. Methods: Forty-two residents from two LTC hospitals participated in this study. Twenty-one residents at one LTC hospital received the laugher therapy treatment and 21 at the other LTC hospital received no treatment as a comparison group. The laugher therapy protocol consisted of singing funny songs, laughing for diversion, stretching, playing with hands and dance routines, laughing exercises, healthy clapping, and laughing aloud. The participants engaged in the protocol 40 minutes twice a week (Monday/Thursday) for a total of eight sessions held in the patients’ lounge. Results: Findings showed that depression and sleep improved in the treatment group compared to the comparison group (t=-7.12, p<.001; Z=-4.16, p<.001). Conclusion: To improve depression and sleep among patients at LTC hospitals, offering laughter therapy strengthening physical activities might be beneficial to patients.

Purpose: The purpose of this study was to develop and validate a tool to evaluate slow nursing performance for older adults in long-term care hospitals. Methods: The search period was set from March 2013, when the term "slow nursing" was first used in the literature, to October 2021. A slow nursing tool was developed in two phases: development and verification. In the tool development phase, 29 items were developed through an extensive literature review and in-depth interviews with seven long-term care hospital nurses. Construct validity testing was performed by a 10-member expert panel, and a pilot survey was conducted on long-term care hospital nurses. In the tool validation phase, the construct validity, criterion validity, and reliability of the tool were tested by applying it to 181 nurses in long-term care hospitals. Results: The final tool comprised five factors and 23 items, with an overall explanatory power of 56.8%. Construct validity was examined using confirmatory factor analysis, and the model fit was good. Known-group validity was established by the observation of a significant difference in the slow nursing score between intensive care unit and long-term care hospital nurses, and criterion validity was established by a significant correlation between the slow nursing and person-centered assessment scores. Internal consistency reliability was shown by a Cronbach's α coefficient of .781. Conclusion: The concept of slow nursing has been clarified, improving the understanding and implementation of slow nursing care by nurses in long-term care hospitals. The Slow Nursing Tool for Long-term Care Hospital Nurses (SNT-LCHN) is expected to increase interest in and contribute to the effectiveness of slow nursing practices. It will serve as a valuable tool for improving nursing performance in these settings.