This study aimed to investigate the factors affecting nursing students' learning flow in COVID-19 pandemic situations through mixed-method research. 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. The factors affecting the learning flow of nursing students during the COVID-19 pandemic were their self-regulated learning ability (β = .24, p = .001); learning motivation (β = .23, p = .001); self-efficacy in clinical practice (β = .14, p = .014); and lecture type, or a mixture of recorded and real-time video lectures (β = .13, p = .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. 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.

Many firefighters suffering from traumatic events while on duty participate in the work force. However, the impact of work-related traumatic events on work performance is unclear. To address this issue, we administered a work-related traumatic event experience survey, the health-related work limitations questionnaire, the Korea Depression Scale, and the World Health Organization quality of life assessment to firefighters from four cities in Korea. The health-related work limitations questionnaire measured limitations in their ability to perform three specific work demands—physical, psychosocial, and environmental. Of 685 firefighters enrolled in the study, 618 (90.2%) were included in the final analyses. Their mean age ± standard deviation (SD) was 41.1 ± 8.0 years and mean employment period ± SD was 163.0 ± 101.2 months. A large percentage of participants reported they had experienced work-related traumatic events. Among the firefighters, the total work limitation prevalence was 21.5%, 16.8% of them were limited in their abilities to perform physical work demands, 15.5% were limited in performing psychosocial work demands, and 13.8% were limited in their abilities to function without difficulty within the ambient work environment. Based on multivariable logistic regression, with having work-related traumatic event experience of a threat or injury to self, the odds ratio (OR) of having work limitations in physical (OR = 3.32, 95% CI = 1.17–9.41), psychosocial (OR = 3.05, 95% CI = 1.08–8.61), environmental (OR = 4.89, 95% CI = 1.66–14.40) work demands, and total work limitation (OR = 3.73, 95% CI = 1.44–9.68) increased significantly. With experiences of treating fatalities or injured patients, the OR of total work limitation increased significantly (OR = 2.07, 95% CI = 1.09–3.91). We demonstrated a relationship between the firefighters’ exposure to work-related traumatic events and their work limitations. A professional care management system for firefighters to prevent and manage work-related traumatic events should be developed in order to protect and improve their performance ability.

This study clarifies the concept of illness intrusiveness in patients with a chronic disease using the hybrid model method. To clarify the dimension, attributes, and definition of illness intrusiveness in chronic disease, three phases of analysis were conducted. In the theoretical phase, a working definition was devised through a systematic review. In the fieldwork phase, individual in-depth interviews were conducted with nine participants with chronic diseases. In the final analytic phase, the results were integrated through comparison and review. There are four domains and eleven attributes of illness intrusiveness in chronic disease. The domains include physical, psychological, social/contextual, and spiritual. The physical domain consists of four attributes: pain, fatigue, physical malfunction, and change of body image. The psychological domain consists of three attributes: psychological weakness, uncertainty, and stigma. The social/contextual domain is made up of three attributes: withdrawal of role play, limit of daily life, and burden of changing health habits. Finally, the spiritual domain had one attribute: unstable spiritual state. Thus, based on the study findings, it is necessary to develop a suitable illness intrusiveness in chronic disease assessment scale to assess chronic disease patients.

Background: The generic competency domains of advanced nursing practice have been reported on in numerous countries, but rather few studies have examined competencies specific to pediatric nurse practitioners (PNPs). Objectives: We identified the core clinical competencies of PNPs in South Korea and related these identified competencies to the five patterns of knowing in nursing. Design: Focus group interviews were conducted with five PNP students and four PNPs using two thematic questions, one on clinical competencies required for PNPs and the other on competencies specific to Korean PNPs. A purposive sampling method was used to choose nurses with varying work experience and age from different hospital units. The inclusion criterion for PNP students was having at least two years of clinical experience and that for PNPs was having at least two years of clinical experience as a PNP in pediatric units in tertiary hospitals. The verbatim transcriptions of these interviews were analysed by two researchers using inductive content analysis. Results: Six clinical competency domains were identified including advanced pediatric-specific knowledge and clinical skills, education and counseling, utilization and engagement in research, professional identity development, clinical and professional leadership, and holistic care. Some competencies identified were related to empirical and ethical knowledge that could be taught in nursing, whereas others were based on esthetic and personal knowledge, which can be mastered through professional experience. Conclusions: To provide holistic care for children and families, PNPs must acquire all necessary patterns of knowing through continuing education and individual reflection on personal practice.