Earticle

The purpose of this study was to understand experiences of successful aging of community-dwelling elderly living in the Korean community using mixed methods. This study is a mixed methods research using convergent parallel design. 483 elderly people living in the 2 cities were selected as subjects to collect quantitative data. For qualitative data collection, 6 elderly people participated. The level of successful aging for elderly people living at home scored an average of 4.30 ± .59 out of 5 points (4.46 ± .64 for self-efficacy, 4.31 ± .65 for good self-control, 4.29 ± .70 for satisfaction with children’s success, and 4.26 ± .61 for partnership with spouses). The main themes of successful aging derived by interview were as follows: 1) fulfill responsibilities of raising children as parents, 2) establish a stable life to overcome difficulties, 3) accept the body being different from the past, and 4) live in harmony with people around them. Based on these results, it is necessary to provide useful health care services that can be used in the local community and to provide service utilization information through various routes in order to achieve a successful aging.

Purpose: This study aimed to investigate the factors affecting nursing students' learning flow in COVID- 19 pandemic situations through mixed-method research. Method: Of the 245 nursing students participating in the survey, 20 participated in a focus group interview. Quantitative data were analyzed using stepwise multiple regression analysis. Qualitative data were analyzed using content analysis. Results: The factors affecting the learning flow of nursing students during the COVID-19 pandemic were their self-regulated learning ability (b ¼ .24, p ¼ .001); learning motivation (b ¼ .23, p ¼ .001); selfefficacy in clinical practice (b ¼ .14, p ¼ .014); and lecture type, or a mixture of recorded and realtime video lectures (b ¼ .13, p ¼ .022). As a result of the qualitative study, eight categories and 22 subcategories were derived. The eight categories are: a lack of preparation in the starting of virtual classes, adapting and growing in a new learning environment, enhancing nursing knowledge and skills through virtual clinical training, self-regulation difficulties when studying alone due to social distancing, difficulty concentrating when learning online, disadvantages of virtual learning, concerns about academic performance, and missing opportunities to enjoy college life. Conclusion: Students attempted to discover their own learning expertise through virtual learning while concerned that they would be unable to fully establish their competence to work as actual hospital nurses due to a lack of clinical practice. In such a learning environment, systematic support and strategies are needed to increase the learning flow of nursing students.

This study aimed to evaluate the agreement between a two-step in vitro digestion procedure and in vivo apparent total tract digestibility across three life stages in mixed-breed dogs. Eighteen dogs were divided into three groups: puppies (n = 6; < 1 year; initial body weight [iBW]: 10.68 ± 1.55 kg), adults (n = 6; 2?7 years; iBW: 8.34 ± 0.38 kg), and seniors (n = 6; > 8 years; iBW: 8.87 ± 0.98 kg). An extruded diet based on oat, turkey, and chicken breast meal was used for both in vitro and in vivo digestibility determinations of dry matter, organic matter, crude protein, gross energy, crude fiber, and ether extract. In vitro digestibility values were consistently higher than in vivo values across all nutrients and life stages (p < 0.05). Linear regression revealed strong in vitro?in vivo agreement for gross energy across all life stages (r² = 0.87?0.98), for organic matter in adult dogs (r² = 0.96), and for ether extract and dry matter in senior dogs (r² = 0.91?0.93), as well as for crude fiber in puppies and adults (r² = 0.85?0.87) and for ether extract in puppies (r² = 0.91), whereas agreement was weaker for crude protein across life stages (r² = 0.55?0.66) and for organic matter in puppies (r² = 0.40). These findings indicate that the two-step in vitro digestion method can serve as a practical screening tool for energy and macronutrient digestibility in mixed-breed dogs of the body-size range studied here, with predictive accuracy that depends on both the nutrient and the life stage.

Providing services using kiosks is actively carried out between suppliers and consumers. These service processes have recently begun to play a dominant role in transactions. However, previous self-service technology (SST) studies or kiosks have not fully reflected the changing environment surrounding these different technologies. To cover the updated business environments, we combined qualitative and quantitative research methods. Through qualitative research and a review of previous studies, the variables emphasized as motivations and constraints for kiosks use and those that can be newly illuminated were selected for this study. We then applied the variables to the research model to assess their influence. In terms of the motivations for using kiosks, the results suggest that perceived usefulness and compatibility as service quality, forced use, and perceived service providers’ efficiency as provider polices, absorptive capacity, and habit as an individual characteristic and social influence as a subjective norm have a significant effect on the attitude toward kiosks. In terms of constraints, difficult to use and need for interaction predicts the attitude toward kiosks. Attitude toward kiosks, perceived behavioral control, and social influence are directly related to the intention to use kiosks. Lastly, intention to use kiosks plays a significant role as an antecedent of revisit intention. Using these empirical results, we propose both academic and practical implications for future kiosks use.

본 연구는 장애인조직생활능력에 관한 고용주인식이 고용만족도에 미치는 영향을 파악하고, 이 관계안에서 특히 조직몰입의 매개효과와 교육훈련지원의 조절효과를 검증하는 것이다. 이 연구는 통합방법론을 적용하여 양적조사와 질적조사를 병행하였다. 양적조사는 ‘기업체장애인고용실태조사(2014)’ 데이터 4,337개를 연구에 맞게 재구성하여 활용하였으며, 질적조사는 장애인고용기업체 고용주 및 담당자 등 장애인근로자 총14명을 선정하여 장애인고용경험을 심층분석하였다. 양적조사의분석방법은 다중회귀분석을 수행하였으며, 질적조사의 분석방법은 현상학적 질적연구 중 Colaizzi (1978)의 방법을 따랐다. 연구결과, 장애인조직생활능력에 관한 고용주인식은 고용만족도에 유의미한 영향을 미치는 것으로(β=.186, p<.001) 나타났으며, 조직몰입은 이 둘 간의 매개영향을 갖고 있는것으로 나타났다. 반면, 질적 분석에서는 조직몰입이 높은 이유로 장애인이 선택할 수 있는 기업체가적기 때문인 것으로 확인되었으며, 교육훈련지원도 고용주 및 담당자의 장애인조직생활능력에 대한인식이 낮으면 업무 및 교육환경조성에 부(-)적 영향을 갖는 것으로 확인되었다.

This study aims to investigate the effects of employers’ attitude toward persons with disabilities regarding their satisfaction with employment and to verify the mediating effect of organizational commitment and the moderating effect of education and training support. The mixed method was applied to this study, including a quantitative analysis of the data from the Survey on the Employment of the Disabled (2014) on 4,337 businesses that employed the disabled and a qualitative analysis based on the in-depth interviews of 14 people such as business owners, managers, and disabled workers. The data were analyzed by a multiple regression and the Colaizzi's research method. The quantitative analyses found that employer’s attitude had a significant effect on their satisfaction with employment (β=.186, p<.001) and education and training supports had a direct effect on employer's satisfaction with employment (β=.112, p<.001). The qualitative analysis reveals that the employers’ positive perception toward persons with disabilities was critical to facilitate educational training environment.

Amazon Go is a cashierless convenience store concept, which is seen as a disruption in the grocery retail segment. Although Amazon Go has the ability to disrupt the retail segment, there are speculations on how Amazon Go will be perceived by users. Existing studies have not utilized user-generated content to understand the factors that affect customer behaviour in case of Amazon Go. Additionally, in case of phygital retail, studies have not attempted at understanding the effect of emotions and gratifications on user behaviour. To address the gap of exploring user perspectives based on their experience, we have examined the impact of gratifications and emotions on the acceptance of phygital retail using user-generated-content. A mixed-method approach has been utilized using only user-generated content. Utilizing topic-modelling based content analysis and emotion analysis on 30 articles related to Amazon Go, we found themes like, convenience, technology, experience, personalization, enjoyment and emotions like, bad, good, annoyance, success. In the empirical analysis, we have utilized 522 reviews about Amazon Go from the cognition and emotion theory stance, and found that hedonic gratifications have a positive impact on challenge emotions. We also found a significant impact of emotions on customer’s favourite behaviour.

본 연구는 스포츠 훈련에서의 개인 혁신성을 고려하여 VR 자기훈련에 대한 태도와 수용 과정의 선행 요인을 탐색한다. 구조방정식모형과 질적 인터뷰를 결합한 혼합방법 접근법(mixed method approach)을 활용해 골프 훈련에서의 VR‑HMD 수용을 분석하였다. 분석 결과, 기대 성과와 지각된 즐거움은 VR 훈련에 대한 태도에 직접적인 영향을 미치며, 이는 VR‑HMD 사용의도로 이어졌다. 반면 지각된 사용용이성은 태도에 직접효과를 보이지 않았고, 개인 혁신성이 낮은 집단에서는 기대 성과에도 유의한 영향을 주지 않았다. 다만 사용용이성은 지각된 즐거움을 매개로 간접효과를 보였다. 이러한 결과는 개인 혁신성 수준에 따라 수용 메커니즘이 상이함을 보여주는 VR 수용의 이중 경로를 시사한다. 본 연구는 자기주도 훈련 맥락에서의 VR 수용에 대한 통찰을 제공하여 학계와 실무가 잠재적 훈련참여자의 행동을 더 잘 이해하도록 돕고, 보다 효과적인 VR 훈련 전략의 개발에 기여한다.

본 연구는 소아암 환아 가족을 위한 건강돌봄교사파견사업의 성과를 규명하여 실천적 함의를 제공하는데 목적이 있다. 본 연구는 혼합연구방법론을 적용하였다. 양적연구에서 사전검사는 2019년 2월부터 건강돌봄교사 최초 파견시 실시하였고, 사후검사는 참여자별로 해당 서비스(20회기)가 종료된 후에 하였다. 양적자료분석방법은 대응표본 t 검정을 실시하였다. 소아암 환아(N=34)의 사전 레질리언스의 평균은 96.79이며, 사후 레질리언스의 평균은 108.68이었다. 보호자(N=58)의 사전 양육스트레스의 평균은 43.90이며, 사후 양육스트레스의 평균은 42.14로 나타났다. 질적연구에 있어서는 소아암 환아 6명, 보호자 6명이 심층 인터뷰에 참여하였다. 질적연구결과에서는 양적연구결과에서 나타난 ‘소아암 환아의 레질리언스의 증가’와 ‘보호자의 양육스트레스 감소’가 동일하게 나타났고 이 밖에도 다차원적인 성과가 다음과 같이 나타났다. 첫째, 건강돌봄교사파견사업에 참여한 소아암 환아가 ‘투병생활에 활기를 주는 특별한 만남’을 갖게 되었으며, 개인 내적 특성 관련 성과로 긍정적 정서 향상 및 긍정적 자기이해가 나타났다. 소아암 환아의 대처 양상 특성 관련 성과로는 자립성 향상과 자원동원성 향상이 나타났다. 소아암 환아의 대인관계 특성 관련 성과로는 관계기술 및 사회성 향상이 나타났다. 둘째, 보호자의 자기돌봄 및 가족돌봄시간이 확보되었으며, 환아에 대한 양육환경이 개선되었고, 환아의 형제관계가 향상된 것으로 나타났다. 이러한 연구결과를 토대로 실천적 함의를 제언하였다. 본 혼합연구는 건강돌봄교사파견사업 수행이 갖는 개입의 효과성을 규명하고 사업의 방향성을 제시한 점에 연구의 의의가 있다.

The purpose of the present study was to evaluate the effect of the health care teacher dispatch project for families with pediatric cancer patients and identify the outcomes of the project in order to present practical implications. The present study used mixed methodology. In the quantitative research, the prior inspection had been carried out when dispatching a health care teacher for the very first time from February 2019. Regarding the post-inspection, it had been done after the concerned service (20 sessions) by the participant ended. And, regarding the quantitative data analysis method, a correspondence sample t-test (a matched pair t-test) had been carried out. The average of the pre-resilience of the children with cancer (N=34) was 96.79. And the average of the post-resilience was 108.68. The average of the pre-rearing stress of the protectors (N=58) was 43.90. And the average of the post-rearing stress appeared as being 42.14. For the qualitative approach, 6 children and 6 parents participated in the interviews. As a result of the qualitative research, the ‘increase in resilience of children with cancer’ and ‘reduction in rearing stress of protectors’, which were identically observed even in those of the quantitative research, were found. In addition, the multidimensional outcomes were shown as follows. First, children with cancer who participated in the health care teacher dispatch project had a ‘special meeting that energizes their lives of struggling against illness, thereby showing positive emotional improvement and positive self-understanding as outcomes related to personal intrinsic characteristics. Moreover, there were improvements in self-reliance and resource mobilization as outcomes related to the coping-pattern characteristics of the children, and improvements in relationship skills and sociality as outcomes related to their interpersonal characteristics. Second, the self-care and family-care time of their protectors was secured. In addition, the nurturing environment for the children and their sibling relationship were improved. Based on the findings, this study suggested practical implications. Therefore, this mixed method study has significance in that it identifies the effectiveness of the health care teacher dispatch project and suggests the direction of the project.

Purpose: This study investigated the difficulties in end-of-life care and end-of-life care competency in nurses who take care of cancer patients. Methods: In the mixed method, a structured questionnaire on end-of-life care stress and competency was conducted on 115 nurses caring for cancer patients, and 19 were interviewed for qualitative research. For the collected quantitative data, descriptive statistics were used. For the qualitative study, the contents of the interview were summarized and systematized using the content analysis method to derive the main themes. Results: The mean end-of-life care stress was 4.08 points (out of 5) and the mean end-of-life care competency was 3.43 points (out of 5). Four themes and 11 sub-themes for the difficulties in end-of-life care were identified, and the four themes are as follows: (1) regret over limited end-of-life nursing, (2) different aspects of persistent emotional distress, (3) overloaded duty at the end-of-life (4) conflicts encountered in decision-making for life-sustaining treatment. Four themes and eight sub-themes for end-of-life care competency were identified, and the four themes are as follows: (1) empathy and listening skills, (2) communication skills, (3) clinical nursing experience and education, (4) clinical nursing competency. Conclusion: It was confirmed that nurses caring for cancer patients had a high level of end-of-life care stress, and it is necessary to develop a program to reduce difficulties in end-of-life care and increase end-of-life care competency.

Purpose: This study is for comparing gender egalitarianism and sexual harassment experienced by gender and providing a basis for the solution of sexual harassment. Methods: A mixed method design was used. Quantitative data were collected from 198 university and college students, and qualitative data were collected from 154 university and college students from an open-ended question on resolutions of sexual harassment. Results: The quantitative data represent that the average score of gender egalitarianism of female students and male students was 104.88±7.32 and 87.20±13.13, respectively. The average score of sexual harassment of female students and male students was 50.89±16.75 and 42.09±10.83 respectively. The Qualitative data indicated that the common resolutions of sexual harassment in female and male categories were classified by 4 main topics of education, regulation, improving awareness and personal behavior. Conclusions: Accordingly, it would be effective to prevent sexual harassment problem by subdividing the sexual education program systematically and strengthening the laws and regulations of punishment for offenders. It is needed to figure out sexual harassment occurrences, especially in each university and college, and make an effort to develop strict punishment regulations and organized manuals in advance.

Purpose: This study explored the care experience of persons assisting the disabled people with their activities. Methods: Concurrent triangulation mixed methods design was used. The quantitative data on care experience were collected from 370 personal assistants for the disabled persons from May 10 to June 30, 2017, while qualitative data were collected through focus group interviews with 11 personal assistants in August 2017. Results: The participants experienced unfair treatment including requests for doing work for the client's family or unrelated work (35.2%), violence or assault (23.6%), sexual harassment or interest (7.1%), and infection risk (7.1%). Many of them suffered from health problems such as work-related muscular pain, headache, or fatigue. There was low satisfaction with the psychosocial work environment and 16.2% participants experienced depression. The participants' care experience was classified into four categories of “feeling like giving up because of emotional difficulty”, “work overload and tough working condition”, “expectation to improve work confidence through practical skill training”, and “hope for systematic support”. Conclusion: The results suggest that need-based emotional competence building programs are required to prevent their physical and emotional exhaustion among the personal assistants along with strengthening their job capacity. Furthermore, the decision makers need to pay attention to their work environment to ensure their emotional competence.

목적 : 본 연구는 통합방법론을 이용하여 고엽제 환자의 우울 및 삶의 질을 심층적으로 알아보고자 하였다. 연구방법: D병원에 입원한 고엽제 환자 29명을 대상으로 일반적인 특성, 우울, 삶의 질과 29명의 대상자 중 17명을 대상으로 포커스그룹 면담을 실시하였다. 통합방법론은 모형 중 Teddlie와 Tashakkori(2003)가 제시한 순차적 통합설계를 사용하였다. 분석방법으로는 일반적인 특성은 빈도 및 백분율로 산출하고 우울 및 삶의 질은 기술통계 분석, 포커스그룹 면담은 내용분석방법을 사용하였다. 고엽제 환자의 우울 및 삶의 질은 순차적 통합설계 방법을 통해 심층적으로 분석하였다. 결과: 고엽제 환자의 연령은 75세~79세(58.6%)가 가장 많았고, 70~74세(34.3%), 85세 이상(3.4%), 65~69세(3.4%) 순이었다. 고엽제 환자의 우울은 19.24점, 삶의 질은 평균 57.66점으로 나타났다. 포커스그룹 면담 결과 3가지의 주제와 7개의 구성 요소, 14개의 하위구성 요소로 3가지의 주제는 “파병 경로”, “고엽제 노출 경로”, “고엽제 노출 이후의 삶”으로 나타났다. 결론: 본 연구는 통합방법론을 이용하여 선행연구들과는 차별되게 고엽제 환자의 우울 및 삶의 질을 심층적으로 분석할 수 있었다. 향후 고엽제 환자의 우울 및 삶의 질을 개선할 수 있는 신체활동이 포함된 집단작업치료 프로그램을 개발하고 적용하는 연구와 사회적 관심과 제도적 지원도 적극적으로 이루어져야 할 것이다.

Objective: This study used a mixed methods analytical approach to analyze the level of depression in and quality of life of patients who had been exposure to Agent Orange. Methods: Data on the general characteristics, depression level, and the quality of life of 29 patients who were hospitalized because of exposure to Agent Orange were collected. Focus group interviews were conducted with 17 of these 29 patients. Regarding mixed methods, the sequential integrated design model proposed by Teddlie and Tashakkori (2003) was employed. The analytical methods were as follows: (1) general characteristics were examined using frequencies and proportional distributions; (2) depression scores and quality of life scores were assessed using descriptive statistical analysis; and (3) content analysis was used to examine the focus group interview data. Results: The average K-GDS depression score was 19.24 points, and the average WHOQOL-BREF quality of life score was 57.66 points. The focus group interview data yielded 3 topics were named “deployment route”, “the manner of exposure to Agent Orange”, and “life after Agent Orange exposure”. Conclusion: There is an urgent need to increase public awareness, develop a public policy response, and conduct additional research on ground occupational therapy programs that include physical therapy.

Purpose: Although many studies have reported the high-stress levels of clinical nurses, there are few studies regardingthe stress of clinical nurses who are concurrently working and studying as graduate students. This study investigatedthe stress, self-efficacy, and context of stress experienced by clinical nurses in graduate school. Methods:Explanatory sequential strategy of mixed method was used. Stress and self-efficacy were quantitatively analyzedby general and academic characteristics of 61 nurses. The effect of self-efficacy on stress and the conditional effectof the years employed were investigated through conditional process analysis. Stress and related contextual aspectswere explored through focus group interviews, differentiated by the number of years employed, with 22 nurses inJune of 2018. Results: The average score of self-efficacy was 3.42±0.53, and stress was 2.88±0.60, out of 5 points. There were no differences in self-efficacy and stress according to demographics and academic characteristics. Themoderation effect of the number of years employed on stress was present for those nurses with under 8.88 yearsof experience. Nurses who had under 9 years of work experience endured a busy schedule full of study and work. On the other hand, participants with more than 9 years of work experience reported having household chores orchildcare, so their academic career was less of a priority, and they faced incrementally increasing physical illnessor strain in their family life. Conclusion: Since graduate school provides clinical nurses with the opportunity to furtheradvance within the nursing field, a supportive environment is imperative.

Purpose: This study was conducted to confirm the provision standards and appropriateness of functional recovery training services performed on residents in long-term care facilities. Methods: Twenty-eight service providers working in four long-term care facilities applied the functional recovery training services to 63 older residents for 15 days, integrating them with their existing daily tasks. The contents recorded by the service providers on checklists were analyzed, and the experiences of applying functional recovery training services by the service providers were examined through focus group interviews. Results: Training for activities of daily living, excluding bathing, five items such as dressing and undressing are performed 2 to 4 times per day. The duration for one session is approximately 16 minutes for meals, around 10 minutes for bathing, and about 5 to 7 minutes for the remaining activities. Movement and walking training, covering five items like standing, occurs 2 to 3 times per day, with session durations ranging from 3 to 10 minutes. Physical activity training is conducted 1 to 2 times per day, with each session lasting about 5 to 7 minutes. Cognitive activity training is performed 1 to 2 times per day, with each session lasting approximately 4 to 7 minutes. Conclusion: For functional recovery training to be established in long-term care facilities, it is crucial to share an accurate understanding of the concept of training. Prior to the provision of training services, appropriate personnel such as nurses need to comprehensively assess the individuals and plan the training accordingly.

Purpose: This study investigated the patient safety culture (PSC), the perception of importance on patient safety management (PIPSM) and the patient safety management activities (PSMA) of care workers in nursing homes. This was a descriptive study that attempted to provide basic data for the patient safety education program of care workers. Methods: Data were collected using questionnaires and interviews from July 1 to 31 in 2020. One hundred and seventy-four care workers participated in quantitative research. The collected data were analyzed by the SPSS/WIN 25.0 program using descriptive statistics, t-test, ANOVA, Bonferroni, and Pearson’s correlation. The qualitative data were collected through semi-structured, audio-recorded interviews with six representatives and six care workers from six nursing homes. Content analysis was performed to analyze the data. Results: Positive correlations were observed between PSC and PIPSM, and between PIPSM and PIPSM. Care workers' experience in patient safety management was in the following six categories: "Safety accident risk factors", "Type of safety accidents", "How to prevent safety accidents", "Effective safety management education", "Emphasis on occupational ethics of care workers", and "Needs for standard protocol" Conclusion: These findings indicate that considering the care workers’ age and facility size, nurses should enhance patient safety education for care workers and establish a management activity system.

소아청소년암 생존자 어머니들은 자녀의 진단과 치료의 과정에서 마주하는 어려움들로 인해 심각한 정신적 스트레스를 경험하였다. Bright IDEAS 문제해결기술훈련 개입은 이들의 문제해결기술을 향상시키고 정서적 스트레스를 완화하는 데 효과적인 근거기반의 개입이다. 본 연구는 소아청소년암 생존자 어머니 14명을 대상으로 5회기의 Bright IDEAS 개입을 실행하였고, 혼합연구 방법론을 활용하여 효과성을 평가하였다. 윌콕슨의 부호순위 검정 결과, 개입 이후 우울 증상, 외상후스트레스, 양육스트레스가 통계적으로 유의미하게 감소하였고, 사회적 문제해결 정도는 긍정적으로 개선되었지만 통계적으로 유의미한 차이는 없었다. 질적 인터뷰 결과 프로그램에 참여한 이후 연구 참여자들의 유익과 관련된 3개의 대주제와 8개의 하위주제를 도출하였다. 본 연구는 국내에서 소아청소년암 생존자의 어머니를 대상으로 Bright IDEAS의 적용과 실행에 대한 실증적 근거를 제공하였다. 본 연구결과를 통해 이들의 문제해결기술을 증진하여 정신건강을 도모할 수 있는 근거기반의 개입이 확대될 수 있을 것으로 기대한다.

Mothers of survivors of childhood and adolescent cancer often report psychological stress due to many challenges associated with children’s diagnosis and treatment. Bright IDEAS (BI) problem-solving skills training is an effective evidence-based intervention for improving problem-solving skills and alleviating psychological distress in caregivers of survivors of childhood and adolescent cancer. This study aimed to implement and evaluate the effectiveness of BI for mothers of survivors of childhood and adolescent cancer using mixed method approaches. Five sessions of BI were implemented individually with 14 mothers of survivors of childhood and adolescent cancer. Results of Wilcoxon’s signed ranks test showed that participants who completed the BI program reported significant decreases in depression, posttraumatic stress, and parenting stress after the intervention. Although not statistically significant, problem solving skills improved. Through qualitative interviews, 8 subthemes within 3 themes related to benefits of participation in BI were identified. This study provided an empirical evidence for the adaptation and implementation of BI for mothers of survivors of childhood and adolescent cancer in South Korea. The findings of study proposed to expand evidence-based intervention that enhance problem-solving skills, which can lead to improved their mental health.