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Volume 43(1); February 2013
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Original Articles
Analysis of the Characteristics of the Older Adults with Depression Using Data Mining Decision Tree Analysis
Myonghwa Park, Sora Choi, A Mi Shin, Chul Hoi Koo
J Korean Acad Nurs 2013;43(1):1-10.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.1
AbstractAbstract PDF
Purpose

The purpose of this study was to develop a prediction model for the characteristics of older adults with depression using the decision tree method.

Methods

A large dataset from the 2008 Korean Elderly Survey was used and data of 14,970 elderly people were analyzed. Target variable was depression and 53 input variables were general characteristics, family & social relationship, economic status, health status, health behavior, functional status, leisure & social activity, quality of life, and living environment. Data were analyzed by decision tree analysis, a data mining technique using SPSS Window 19.0 and Clementine 12.0 programs.

Results

The decision trees were classified into five different rules to define the characteristics of older adults with depression. Classification & Regression Tree (C&RT) showed the best prediction with an accuracy of 80.81% among data mining models. Factors in the rules were life satisfaction, nutritional status, daily activity difficulty due to pain, functional limitation for basic or instrumental daily activities, number of chronic diseases and daily activity difficulty due to disease.

Conclusion

The different rules classified by the decision tree model in this study should contribute as baseline data for discovering informative knowledge and developing interventions tailored to these individual characteristics.

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Influence of Childbirth Experience and Postpartum Depression on Quality of Life in Women after Birth
Jung Hee Yeo, Nami Chun
J Korean Acad Nurs 2013;43(1):11-19.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.11
AbstractAbstract PDF
Purpose

The purpose of this study was to identify influence of childbirth experience and postpartum depression on quality of life in women after birth.

Methods

Two hundred and eleven postpartum women were asked to complete the questionnaires on their childbirth experience during their admission and on their postpartum depression and quality of life between one to three weeks after birth. Initial data were collected from February 1 to May 30, 2011 at two obstetric hospitals in Busan, Korea. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and hierarchical multiple regression.

Results

The women's childbirth experience and postpartum depression were identified as factors influencing quality of life after birth. The model explained 50% of the variables.

Conclusion

Results suggest that childbirth educators should include strategies to increase a positive childbirth experience and to decrease postpartum depression in their education programs in order to improve women's quality of life.

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Structural Equation Modeling on Nursing Productivity of Nurses in Korea
Se Young Kim, Eun-Kyung Kim, Heon Man Lim, Mi Young Lee, Kwang-Ok Park, Kyoung A Lee
J Korean Acad Nurs 2013;43(1):20-29.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.20
AbstractAbstract PDF
Purpose

The purpose of this study was to propose and test a predictive model that could explain and predict nursing productivity.

Methods

A survey using a structured questionnaire was conducted with 360 nurses in Korea. The data were analyzed using SPSS Windows 18.0 and AMOS 19.0 program.

Results

Based on the constructed model, burnout and organizational commitment were found to have direct effects on nurses' turnover intention and nursing productivity. While nursing work environment was found to have indirect effects on nurses' turnover intention and nursing productivity.

Conclusion

This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with nursing productivity. Comprehensive organizational interventions to improve nursing productivity should focus on improving the nursing work environment. Findings from this study can be used to design appropriate strategies to decrease nurse turnover in Korea. Further studies are needed to prospectively verify these causal relationships with larger samples.

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pH, Temperature, Hydration of the Stratum Corneum of the Dorsal Hand and the Cord Area, and Acid Mantle Formation during Early Days of life in High-risk Newborns
Youngmee Ahn, Min Sohn, Sangmi Lee, Mijin Lee
J Korean Acad Nurs 2013;43(1):30-38.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.30
AbstractAbstract PDF
Purpose

The study was done to explore variations in physiologic parameters of the stratum corneum (SC) of the dorsal hand and cord area during early days of life in high-risk newborns.

Methods

In this longitudinal study, a total of 77 high-risk newborns were assessed for pH, temperature and hydration of the SC of the dorsal hand and the cord area on the 1st, 2nd, 3rd, 5th and 7th days of life.

Results

Results showed that an acid mantle (AM) was formed in 57.1% for dorsal hand and 35.1% for cord area, implying significant delay regardless of decrease in pH (F=103.60, p<.001), and hydration (F=4.00, p=.003) across days in both areas. Peripheral hypothermia with low hydration level was also observed in both areas. There was a positive relation between hydration and temperature (.14<r<.27, p<.010), and negative relation between hydration and pH in both areas (-.23<r<-.15, p<.010). Antibiotics may play a positive role in AM formation.

Conclusion

High-risk newborns may experience delay in acid mantle formation on SC, hypothermia and decreases in hydration on peripheral sites during the first 7 days of life.

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Structure of Nurse Labor Market and Determinants of Hospital Nurse Staffing Levels
Bohyun Park, Sukyung Seo, Taejin Lee
J Korean Acad Nurs 2013;43(1):39-49.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.39
AbstractAbstract PDF
Purpose

To analyze the structure of Korean nurse labor market and examine its effect on hospital nurse staffing.

Methods

Secondary data were obtained from Statistics Korea, Education Statistics, and Health Insurance Review & Assessment Service and Patient Survey. Intensity of monopsony in the nurse labor market was measured by Herfindahl Hirshman Index (HHI). Hospital nurse staffing level was divided into high and low. While controlling for confounding factors such as inpatient days and severity mix of patients, effects of characteristics of nurse labor markets on nurse staffing levels were examined using multi-level logistic regressions.

Results

For characteristics of nurse labor markets, metropolitan areas had high intensity of monopsony, while the capital area had competitive labor market and the unemployed nurse rate was higher than other areas. Among hospital characteristics, bed occupancy rate was significantly associated with nurse staffing levels. Among characteristics of nurse labor markets, the effect of HHI was indeterminable.

Conclusion

The Korean nurse labor market has different structure between the capital and other metropolitan areas. But the effect of the structure of nurse labor market on nurse staffing levels is indeterminable. Characteristics such as occupancy rate and number of beds are significantly associated with nurse staffing levels. Further study in support of the effect of nurse labor market is needed.

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Measurement Properties of Self-report Questionnaires Published in Korean Nursing Journals
Eun-Hyun Lee, Chun-Ja Kim, Eun Jung Kim, Hyun-Ju Chae, Soo-Yeon Cho
J Korean Acad Nurs 2013;43(1):50-58.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.50
AbstractAbstract PDFSupplementary Material
Purpose

The purpose of this study was to evaluate measurement properties of self-report questionnaires for studies published in Korean nursing journals.

Methods

Of 424 Korean nursing articles initially identified, 168 articles met the inclusion criteria. The methodological quality of the measurements used in the studies and interpretability were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. It consists of items on internal consistency, reliability, measurement error, content validity, construct validity including structural validity, hypothesis testing, cross-cultural validity, and criterion validity, and responsiveness. For each item of the COSMIN checklist, measurement properties are rated on a four-point scale: excellent, good, fair, and poor. Each measurement property is scored with worst score counts.

Results

All articles used the classical test theory for measurement properties. Internal consistency (72.6%), construct validity (56.5%), and content validity (38.2%) were most frequently reported properties being rated as 'excellent' by COSMIN checklist, whereas other measurement properties were rarely reported.

Conclusion

A systematic review of measurement properties including interpretability of most instruments warrants further research and nursing-focused checklists assessing measurement properties should be developed to facilitate intervention outcomes across Korean studies.

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Development of a Mother-Preschool Child Interaction Scale
Sung-Hee Park, Kyung-Sook Bang
J Korean Acad Nurs 2013;43(1):59-68.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.59
AbstractAbstract PDF
Purpose

This study was done to develop the self-report Mother-Preschool Child Interaction Scale (MPIS) for mothers of preschool children.

Methods

The scale was based on items derived from literature review and in-depth interviews. A methodological study was used to check reliability and validity and participants were 334 mothers of preschool children enrolled in kindergarten or nursery. Data were analyzed using principal component factor analysis for construct validity, t-test for contrasted group validity, Pearson correlation for criterion related validity and test-retest reliability and Cronbach's α for reliability.

Results

In the final MPIS 34 items identified through factor analysis were included, 6 constructs were derived, and explanatory power was 64.2%. Items on the MPIS were verified through correlation with the interaction observation scale of Kim & Mahoney and MPIS. Results were significant as mothers in the normal group exhibited MPIS scores that were significantly higher than those of mothers in the depressed group. Reliability of MPIS was .96 and test-retest reliability was .92.

Conclusion

MPIS has the advantage of being easy to use, economical, and useful. Consequently, it is expected to be used as a screening tool for promptly and simply identifying the mother-preschool child interaction in diverse nursing practice and research.

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Effects of an Integrated Self-Management Program on Self-Management, Glycemic Control, and Maternal Identity in Women with Gestational Diabetes Mellitus
HeeSook Kim, Sue Kim
J Korean Acad Nurs 2013;43(1):69-80.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.69
AbstractAbstract PDF
Purpose

The purpose of the study was to investigate the effects of an integrated self-management program on self-management, glycemic control, and maternal identity in women with gestational diabetes mellitus (GDM).

Methods

A non-equivalent control group non-synchronized quasi-experimental design was used. A total of 55 women with GDM were recruited from Cheil General Hospital, Seoul, Korea and were assigned to an experimental (n=28) or control group (n=27). The participants were 24-30 weeks pregnant women who had been diagnosed with GDM as of July 30, 2010. The program was conducted as a 1 hour small group meeting 3 out of 5 times and by telephone-counseling 2 out of 5 times. The integrated self-management program was verified by an expert panel.

Results

Although there was no significant reduction in HbA1c (U= -1.17, p=.238), there were statistically significant increases in self-management (U= -3.80, p<.001) and maternal identity (U= -4.48, p<.001), and decreased 2-h postprandial glucose levels (U= -2.43, p<.015) in the experimental group compared to the control group.

Conclusion

These findings suggest that an integrated self-management program for women with GDM improves self-management, maternal identity, and glycemic control. Further studies are needed to identify the effects of an integrated self-management program on pregnancy and neonatal outcomes.

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Structural Equation Modeling On Health-related Quality of Life in Patients with Obstructive Sleep Apnea
Su Jung Choi, Keum Soon Kim
J Korean Acad Nurs 2013;43(1):81-90.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.81
AbstractAbstract PDF
Purpose

This study was done to test structural equation modeling of health-related quality of life (QOL) of men with obstructive sleep apnea in order to identify parameters affecting QOL and provide guidelines for interventions and strategies to improve QOL in these patients.

Methods

Model construction was based on 'The conceptual model of patient outcome in health-related QOL' by Wilson and Cleary, using the variables; age, physiological factors, social support, cognitive appraisal, symptoms and QOL. Participants were 201 adult male patients recruited at a tertiary university hospital in Seoul. Data were collected via questionnaires, polysomnography, and clinical records.

Results

Age and symptoms directly influenced QOL. Social support and cognitive appraisal about sleep did not have a direct influence on QOL, but indirectly affected it via symptoms. QOL was lower in patients who were younger and had more severe symptoms. Symptoms were more severe for patients with lower social support and more dysfunctional cognitive appraisal. When social support was lower, cognitive appraisal was more dysfunctional.

Conclusion

These results suggest it is necessary to not only manage symptoms, but also apply interventions to increase social support and cognitive appraisal about sleep in order to increase QOL in patients with obstructive sleep apnea.

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Effects of Logotherapy on Life Respect, Meaning of Life, and Depression of Older School-age Children
Kyung-Ah Kang, Shin-Jeong Kim, Mi-Kyung Song, Mi-Jeong Kim
J Korean Acad Nurs 2013;43(1):91-101.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.91
AbstractAbstract PDF
Purpose

This study was done to identify effects of a life-esteemed education applied logotherapy on life respect, meaning of life, and depression on older elementary school students.

Methods

A nonequivalent control group and non-synchronized design was conducted with a convenience sample of 142 students. The program named 'My Precious Life'. consisted of one session per week for five weeks. Students were assigned to the experimental group (n=70) or the control group (72). Data were analyzed using descriptive statistics, Chi-square, Fisher's exact test, t-test, and repeated measured ANOVA with the SPSS/PC 18.0 program.

Results

Meaning of life and life respect increased significantly and depression decreased significantly for participants in the experimental group.

Conclusion

The results of the study indicate that life-esteemed education applied logotherapy is effective in improving meaning of life and life respect and in decreasing depression in elementary school students. It can also be used to prevent existential distress and to intervene as a motif for having hope in life.

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Transcultural Self-efficacy and Educational Needs for Cultural Competence in Nursing of Korean Nurses
Sun-Hee Kim
J Korean Acad Nurs 2013;43(1):102-113.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.102
AbstractAbstract PDF
Purpose

This study was done to investigate the level of transcultural self-efficacy (TSE) and related factors and educational needs for cultural competence in nursing (CCN) of Korean hospital nurses.

Methods

A self-assessment instrument was used to measure TSE and educational needs for CCN. Questionnaires were completed by 285 nurses working in four Korean hospitals. Descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression were used to analyze the data.

Results

Mean TSE score for all items was 4.54 and score for mean CCN educational needs, 5.77. Nurses with master's degrees or higher had significantly higher levels of TSE than nurses with bachelor's degrees. TSE positively correlated with English language proficiency, degrees of interest in multi-culture, degree of experience in caring for multi-cultural clients, and educational needs for CCN. The regression model explained 28% of TSE. Factors affecting TSE were degree of interest in multi-culture, degree of experience in caring for multi-cultural clients, and educational needs for CCN.

Conclusion

The results of the study indicate a need for nurse educators to support nurses to strengthen TSE and provide educational program for TSE to provide nurses with strategies for raising interests in cultural diversity and successful experiences of cultural congruent care.

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Analysis of Burnout and Job Satisfaction among Nurses Based on the Job Demand-Resource Model
Young-Hee Yom
J Korean Acad Nurs 2013;43(1):114-122.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.114
AbstractAbstract PDF
Purpose

The purpose of this study was to examine burnout and job satisfaction among nurses based on Job Demand-Resource Model.

Methods

A survey using a structured questionnaire was conducted with 464 hospital nurses. Analysis of data was done with both SPSS Win 17.0 for descriptive statistics and AMOS 18.0 for the structural equation model.

Results

The hypothetical model yielded the following Chi-square=34.13 (p = <.001), df=6, GFI=.98, AGFI=.92, CFI=.94, RMSR=.02, NFI=.93, IFI=.94 and showed good fit indices. Workload had a direct effect on emotional exhaustion (β = 0.39), whereas supervisor support had direct effects on emotional exhaustion (β = -0.24), depersonalization (β = -0.11), and low personal accomplishment (β = -0.22). Emotional exhaustion (β = -0.42), depersonalization (β = -0.11) and low personal accomplishment (β = -0.36) had significant direct effects on job satisfaction.

Conclusion

The results suggest that nurses' workload should be decreased and supervisor's support should be increased in order to retain nurses. Further study with a longitudinal design is necessary.

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Validity and Reliability of Korean Version of the Family Management Measure (Korean FaMM) for Families with Children having Chronic Illness
Dong Hee Kim, Yeo Jin Im
J Korean Acad Nurs 2013;43(1):123-132.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.123
AbstractAbstract PDF
Purpose

To develop and test the validity and reliability of the Korean version of the Family Management Measure (Korean FaMM) to assess applicability for families with children having chronic illnesses.

Methods

The Korean FaMM was articulated through forward-backward translation methods. Internal consistency reliability, construct and criterion validity were calculated using PASW WIN (19.0) and AMOS (20.0). Survey data were collected from 341 mothers of children suffering from chronic disease enrolled in a university hospital in Seoul, South Korea.

Results

The Korean version of FaMM showed reliable internal consistency with Cronbach's alpha for the total scale of .69-.91. Factor loadings of the 53 items on the six sub-scales ranged from 0.28-0.84. The model of six subscales for the Korean FaMM was validated by expiratory and confirmatory factor analysis (χ2<.001, RMR<.05, GFI, AGFI, NFI, NNFI>.08). Criterion validity compared to the Parental Stress Index (PSI) showed significant correlation.

Conclusion

The findings of this study demonstrate that the Korean FaMM showed satisfactory construct and criterion validity and reliability. It is useful to measure Korean family's management style with their children who have a chronic illness.

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Effects of the Family Resilience Enhancement Program for Families of Patients with Chronic Schizophrenia
HeeSu Lim, KuemSun Han
J Korean Acad Nurs 2013;43(1):133-142.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.133
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the effects of the Family Resilience Enhancement Program (FREP) on family hardiness, family sense of coherence, family problem solving communication, family crisis oriented personal evaluation, and adaptation in families of patients with chronic schizophrenia.

Methods

The study design was a nonequivalent control group prepost test design. Study participants were 17 families in the experimental group and 17 in the control group. Ten sessions of FREP were provided over 5 weeks. The data were analyzed using SPSS 15.0.

Results

There were statistically significant differences in family hardiness, family sense of coherence, family problem-solving communication, family crisis-oriented personal evaluation, social resources, and family adaptation between the experimental group and the control group.

Conclusion

FREP based on the family resilience model developed in this study, shows the effect of leading the families to positive family adaptation.

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Corrigenda
Corrigendum
J Korean Acad Nurs 2013;43(1):143-143.   Published online February 12, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.143
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Corrigendum: The Effects of a Cognitive Enhancement Group Training Program for Community-dwelling Elders
Young Ran Han, Mi Sook Song, Ji Young Lim
J Korean Acad Nurs 2013;43(1):144-144.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.144
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