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Volume 49(1); February 2019
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Original Articles
Development and Validation of the Communication Behavior Scale for Nurses Caring for People with Dementia
Jihye Lee, Moonhee Gang
J Korean Acad Nurs 2019;49(1):1-13.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.1
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to develop and validate the Communication Behavior Scale for nurses caring for people with Dementia (CBS-D).

Methods

Based on communication accommodation theory, the initial items were generated through a literature review and interviews with 20 experts. Content and face validity of the initial items were assessed. Data from 486 nurses caring for people with dementia were analyzed using item analysis, exploratory and confirmatory factor analysis, criterion-related validity, and internal consistency.

Results

The final scale consisted of 18 items and four factors (discourse response management, interpersonal control, emotional expression, and interpretability) that explained 57.6% of the variance. Confirmatory factor analysis indicated that the theoretical model with 18 items satisfied all goodness-of-fit parameters. Criterion-related validity was shown by the Global Interpersonal Communication Competence Scale (r=.506, p<.001). Cronbach's alpha for the total scale was .88.

Conclusion

The CBS-D can be used to measure the communication behavior of nurses caring for people with dementia.

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Development of an Aging Anxiety Scale for Middle-Aged Women
Haejin Lee, Mi-Ae You
J Korean Acad Nurs 2019;49(1):14-25.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.14
AbstractAbstract PDF
Abstract Purpose

This was a methodological study that aimed to develop a measurement scale for aging anxiety among middle-aged women.

Methods

In this study, construct factors were extracted, and a conceptual framework was established through an extensive literature review and in-depth interviews with middle-aged women. Under the conceptual framework, 44 preliminary items were constructed, and a preliminary scale of 25 items was completed after two rounds of expert validation and item review. For this study, data were collected from 201 women aged 40∼59 years, and the construct validity and reliability of the preliminary scale were verified.

Results

To verify the construct validity, exploratory factor analysis was conducted. Four factors containing 19 items were extracted. Concurrent validity of the developed scale was verified with Pearson's correlation analysis. The final scale comprised 4 factors (“Social valueless”, “Physical weakness”, “Concern about changes in appearance”, and “Expectations of old age”) and 19 items. The Cronbach's α value was .91.

Conclusion

The scale for measuring aging anxiety in middle-aged women developed in this study validly reflected the peculiarities of aging anxiety in middle-aged women, who experience many physical, emotional, and social changes. The scale can be said to reflect the cultural background, as it reflected real experiences gained through in-depth interviews with middle-aged women.

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Evaluation of Validity of the Korean Triage and Acuity Scale
Heejung Choi, Jong Sun Ok, Soo Young An
J Korean Acad Nurs 2019;49(1):26-35.   Published online February 28, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.26
AbstractAbstract PDF
Purpose

The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS).

Methods

This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value.

Results

In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively.

Conclusion

The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

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Risk Factors of Medical Device-Related Pressure Ulcer in Intensive Care Units
MiJee Koo, YoungA Sim, InSoon Kang
J Korean Acad Nurs 2019;49(1):36-45.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.36
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify the characteristics of and risk factors for medical-device-related pressure ulcer (MDRPU) development in intensive care units.

Methods

A prospective cohort study design was used, and the participants were 253 adult patients who had stayed in medical and surgical intensive care units. Data were collected regarding the application of medical devices and MDRPU-related characteristics over a period of six months from June to November, 2017. Data were analyzed using independent t-test, χ 2-test, Fisher's exact test, and binary logistic regression analysis with the SPSS 21.0 program.

Results

Among the 253 participants, MDRPUs occurred in 51 (19.8%) participants. The results of the logistic regression analysis showed that the risk factors for MDRPUs were the use of endotracheal tubes (OR=5.79, 95% CI: 1.66~20.20), having had surgery (OR=2.95, 95% CI: 1.11~7.77), being in a semi-coma/coma (OR=5.79, 95% CI: 1.04~32.05), and sedation (OR=5.54, 95% CI: 1.39~22.19).

Conclusion

On the basis of the study results, it is effectively facilitated by nurses when they care for patients with MDRPUs in intensive care units and the results are expected to be of help in preventive education for MDRPU development as well as preparing the base data for intervention studies.

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Experiencing Coercive Control in Female Victims of Dating Violence
Jinsook Kwon, Sihyun Park
J Korean Acad Nurs 2019;49(1):46-58.   Published online February 28, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.46
AbstractAbstract PDF
Background

Dating violence refers to violence occurring between people in an intimate relationship. Forms of dating violence are often categorized into physical, psychological, and sexual violence, and most existing literature has followed this frame. However, few studies have focused on the phenomenon of living under the perpetrator's coercive control in victims of dating violence, although those experiences are known to be signs of severe forms of violence later on.

Purpose

The purpose of this study was to explore the experiences of being coercively controlled in female victims who had experienced dating violence.

Methods

For this study, in-depth interviews were conducted with a total of 14 female victims, and all interviews were audio-recorded and transcribed. The data were analyzed using the phenomenological analysis method suggested by Colaizzi.

Results

Three themes were derived in chronological order: idealizing the relationship (period of potential control), facing severer tyranny (period of coercive control), and escaping from the unending trap (period of post-control). The results showed that the victims experienced perpetrators' control with specific patterns. The perpetrators' controlling behaviors were invisible, literally benevolent, at the beginning; however, severe forms of violence seemed to appear as their relationship deepened and the perpetrators failed to control the victims.

Conclusion

Findings from this study presented vivid experiences of female victims who needed help and care. Hopefully, the results can benefit in terms of developing evidence-based prevention strategies for victims as well as assessing the risks of severe forms of dating violence, such as physical attack or murder.

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Validity and Reliability of a Korean Version of Yale Food Addiction Scale for Children (YFAS-C)
Jung Ho Kim, Ji Hyun Song, Ran Kim, Mi Young Jang, Hyon Joo Hong, Hyun Ji Kim, Sung Hee Shin
J Korean Acad Nurs 2019;49(1):59-68.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.59
AbstractAbstract PDF
Abstract Purpose

This study evaluated the psychometric properties of the Korean version of Yale Food Addiction Scale for Children (YFAS-C).

Methods

Participants were 419 young adolescent students (11~15 years old). The content validity of the expert group was calculated as the content validity index (CVI) after the translation and reverse translation process of the 25 items of the YFAS-C. The multitrait-multimethod matrix (MTMM) method was used to verify the construct validity; the generalized linear model (GLM) was used to evaluate the concurrent and incremental validity. Reliability was calculated as Kuder-Richardson-20 (KR-20) and Spearman-Brown coefficients.

Results

The CVI of the 25 items was greater than the item-level CVI .80 and the scale-level CVI .90. The Korean version of YFAS-C had verified convergent validity in emotional eating and external eating and discriminant validity in restrained eating. In addition, it had verified concurrent validity in emotional eating and external eating. Finally the incremental validity of the Korean version of YFAS-C was statistically significant on BMI. Reliability was KR-20 a=.69 and the Spearman-Brown coefficient was .64.

Conclusion

The Korean version of YFAS-C is a valid and reliable scale for measuring the severity of food addiction; it can be a useful scale for preventing obesity by predicting food addiction early.

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The Longitudinal Relationships between Depression and Smoking in Hardcore Smokers Using Autoregressive Cross-Lagged Modeling
Jeong Won Han, Hanna Lee
J Korean Acad Nurs 2019;49(1):69-79.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.69
AbstractAbstract PDF
Abstract Purpose

This study aimed to identify the directionality of the causal relationship and interaction between depression and amount of smoking over time in hardcore smokers using longitudinal descriptive analysis.

Methods

Secondary data from the Korean Welfare Panel Study were analyzed using autoregressive cross-lagged modeling. Participants included 342 hardcore smokers who participated in the 8th to 11th waves of the panel study.

Results

Analyses revealed that change(s) in depression levels according to time had a significant positive relationship with the total amount of smoking per day (β=.29, β=.19, β=.17, p<.001), while change(s) in total amount of smoking per day according to time had a significant positive relationship with depression (β=.43, β=.50, β=.38, p<.001). Analysis of the cross-lagged effect between depression and total amount of smoking per day showed that depression at one time point had a significantly positive relationship with the total amount of smoking per day at the next time point (β=.14, β=.13, β=.13, p=.021), and that the total amount of smoking per day at one time point had a significant positive relationship with depression at the next time point (β=.04, β=.04, β=.03, p=.044).

Conclusion

The findings in the present study confirmed a cross-interaction between depression and total amount of smoking per day in hardcore smokers. The present findings could be used to develop appropriate smoking-related interventions.

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Development of the Patient Caring Communication Scale
Myoung Lyun Heo, Sook Bin Im
J Korean Acad Nurs 2019;49(1):80-91.   Published online February 28, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.80
AbstractAbstract PDF
Purpose

This study attempted to develop a scale that measures the level of patients' recognition of the nurses' care, based on Watson's caring theory, and confirmed its reliability and validity.

Methods

The items were developed through a literature review and an expert content validity test. The questionnaires were administered to 285 inpatients of internal medicine and surgical units at two general hospitals. Construct validity was tested using exploratory and confirmatory factor analysis, and reliability was tested using Cronbach's alpha.

Results

This process resulted in a preliminary scale composed of 34 items; We used item analysis and five exploratory factor analyses, and consequently selected 14 items composed of three factors (respect, genuineness, and relationality). The confirmatory factor analysis verified the model fit and convergent and discriminant validity of the final items; criterion validity was confirmed with the positive correlation with the measurement scale of the patient-perceived quality of nursing . The overall scale reliability had a Cronbach's alpha of .92, which indicated internal consistency and reliability.

Conclusion

The developed scale showed content, construct, and criterion validity, and reliability, as well as convergent validity for each item and discriminant validity between the factors. This makes it suitable for use in a diverse range of future studies on nurse communication using structural equation models.

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A Comparative Study on Learning Outcomes according to the Integration Sequences of S-PBL in Nursing Students: Randomized Crossover Design
So Young Yun, Ja Yun Choi
J Korean Acad Nurs 2019;49(1):92-103.   Published online February 28, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.92
AbstractAbstract PDF
Purpose

This study aimed to compare the effects of simulation integrated with problem based learning (S-PBL) according to the sequences of problem-based learning (PBL) and high fidelity simulation training (HFS) on knowledge, clinical performance, clinical judgment, self-confidence, and satisfaction in fourth-grade nursing students.

Methods

In this randomized crossover design study, four S-PBLs on medical-surgical nursing were applied alternatively to two randomly-assigned groups of 26 senior nursing students for 8 weeks. The collected data were analyzed using an independent t-test.

Results

The method of administering PBL prior to HFS led to significantly higher scores on knowledge (t=2.28, p=.025) as compared to the method of administering HFS prior to PBL. However, the latter method led to significantly higher scores on clinical performance (t=−6.49, p<.001) and clinical judgment (t=−4.71, p<.001) as compared to the method of administering PBL prior to HFS. There were no differences in the effect of the two methods on self-confidence (t=1.53, p=.128) and satisfaction (t=1.28, p=.202).

Conclusion

The integration sequences of S-PBL was associated with different learning outcomes. Therefore, when implementing S-PBL, it is necessary to consider the educational goal to executes an appropriate sequence of integration.

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Latent Class Analysis for Health-Related Quality of Life in the Middle-Aged Male in South Korea
Youngsuk Cho, Dong Moon Yeum
J Korean Acad Nurs 2019;49(1):104-112.   Published online February 28, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.104
AbstractAbstract PDF
Purpose

This study aimed to identify types of quality of life (QoL) based on the 5 dimensions of EQ-5D and predict factors affecting types of QoL.

Methods

This study was a secondary analysis using data from the Korean Health Panel Survey- II(2012). Participants were 2,071 middle-aged men who had completed the additional survey in 2012 and the data were analyzed using SPSS 20.0 and Mplus 5.21 for latent analysis.

Results

Three latent classes of QoL were identified: serious (2.4% of the sample), threatened (15.5%), and stable types (82.0%). The types and characteristics of QoL among the latent classes differed. On comparing latent type 1 with latent type 2, the socioeconomic status (p<.05), employment status (p<.05), and subjective health status (p<.001) were found to be significant. On comparing latent type 1 with latent type 3, the socioeconomic status (p<.05), current smoking status (p<.001), and subjective health status (p<.001) were found to be significant. On comparing latent type 2 with latent type 3, the socioeconomic status (p<.05), subjective health status (p<.001), stress (p<.001) were found to be significant.

Conclusion

The results showed significant heterogeneity in types of QoL and the predictors of QoL by types were different. These findings provide basic information for developing nursing interventions to improve QoL. Specific characteristics depending on the subtypes should be considered during the development of interventions.

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