Background and PurposeThe ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model enables educators to create programs using a systematic approach designed to meet learner's needs. The purpose of this study was to develop and evaluate a clinical ethics education program for nurses to improve their ethical confidence, ethical competence, and moral sensitivity.MethodsThe study was conducted in three steps. In the first step, a seven-session ethics program was developed using the ADDIE model. The themes of each session were as follows: (a) sharing individual ethical issues in clinical settings; (b) understanding a process involved in ethical decision-making; (c) identifying ethical issues in end-of-life care; (d) identifying ethical issues in family caregiving; (e) learning communication skills; (f) developing ethical leadership skills; and (g) reflecting to build self-awareness of the significance of practicing clinical ethics. The second step involved the delivery of the program. In the third step, using a mixed methods design, the effects of the program were evaluated through a quantitative survey administered both before and after completion of the program and focus group interviews.ResultsThe seven-session ethics program based on the ADDIE model improved ethical confidence, ethical competence, and moral sensitivity in nurses.Implications for PracticeThe ADDIE model can be an effective tool in nursing education, offering an established structure for developing educational programs. In order to validate the effectiveness of the ethics program, it is necessary to conduct repeated measure studies and further studies at the institutional level.

Nurses face both practical and existential ethical issues that require rapid solution each day. There is a need for ethical counselling to prevent compassion fatigue and identify means via which nurses reflect on their daily lives in their own fields. In-house training should be provided for each unit, to improve ethical competence and facilitate the development of pragmatic, sensible solutions.

According to a survey of older people in 2014, 54.6% of survey participants reported feeling uncomfortable in their daily life because of swallowing disorders. The purpose of this study was to identify factors that influence swallowing quality of life in community dwelling elders. Methods: A cross-sectional descriptive study was conducted with a sample of 150 community dwelling older people. Data were collected using self-administered questionnaires consisting of the MMSE-K(Mini-Mental State Examination-Korean), GDSSF-K (Geriatric Depression Scale Short Form Korea Version), Life Stress, and SWAL-QOL (Swallowing-Quality of Life). For data analysis, descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression were performed using SPSS/WIN 21.0 for Windows. Results: There was a significant correlation between swallowing quality of life and mental state (r=.27, p=.001), depression (r=-.47, p<.001) and life stress (r=-.60, p<.001). The factors influencing swallowing quality of life were having experienced aspiration (β=.29, p<.001), and life stress (β=-.38, p<.001). These variables explained 43.0% of swallowing quality of life. Conclusion: The findings indicate that the experiencing aspiration and life stress are variables that influence swallowing quality of life. Based on these results, nurses should educate older people about chronic disease management and eating habits to prevent aspiration.

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