Journal of Korean Academy of Nursing

Fourth Industrial Revolution and Nursing Research: Lee, Young Whee; J Korean Acad Nurs 2022;52(1):1-3. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.52101

Abstract PDF: No abstract available.

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Effect of Auriculotherapy on Musculoskeletal Pain: A Systematic Review and Meta-Analysis: Choi, Sun Yeob , Kim, Yeo Ju , Kim, Bomi; J Korean Acad Nurs 2022;52(1):4-23. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21121

Abstract PDF: Purpose
The aim of this study was to evaluate the effect of auriculotherapy on musculoskeletal pain in adults.
Methods
A total of 885 studies were retrieved from nine databases (PubMed, Scopus, CINAHL, Web of Science, Ovid Medline, Cochrane Library, RISS, KMbase, and KISS). Sixteen studies were selected for meta-analysis, which satisfied the inclusion criteria and the evaluation of risk of bias. Demographic data, auriculotherapy types, intervention characteristics, auricular points, and outcomes related to pain (subjective pain scale, and amount of analgesic) were extracted from all included studies. The effect size of auriculotherapy was analyzed through comprehensive meta analysis 3.0, and the presence of publication bias was analyzed through a funnel plot and Egger’s regression.
Results
The results of the meta-analysis (n = 16) revealed that the auriculotherapy was significantly superior to the control group on present pain in adults (Hedges’ g = - 0.35, 95% Confidence Interval [CI] = - 0.55~- 0.15). According to the results of subgroup analysis, the effect size of auricular acupuncture therapy (Hedges’ g = 0.45, 95% CI = - 0.75~- 0.15) was higher than the auricular acupuncture (Hedges’ g = 0.27, 95% CI = - 0.53~0.00): the longer the intervention period, the greater the effect size.
Conclusion
In this study, auriculotherapy demonstrates a significant reduction in musculoskeletal pain in adults. Therefore, it is necessary to refine the curriculum to include auriculotherapy as a nursing intervention to relieve musculoskeletal pain in adults and encourage its use in clinical settings.

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Incidence and Predictors of Cataract among People with Type 2 Diabetes Mellitus: Using Secondary Data Analysis from the Ansan Cohort of the Korean Genome and Epidemiology Study: Jeong, Ihn Sook , Lee, Eun Joo , Kim, Myo Sung , Yu, Jung Ok , Yun, Hae Sun , Jeong, Jeong Hee , Hwang, Youn Sun 6; J Korean Acad Nurs 2022;52(1):24-35. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21081

Abstract PDF: Purpose
This study investigated the incidence and risk factors of cataract in people with diabetes mellitus (DM) using data from Ansan cohort of the Korean Genome and Epidemiology Study (KoGES).
Methods
Data from a total of 329 patients with type 2 DM without cataract who participated in Ansan cohort of the KoGES from baseline survey (2001–2002) to fifth follow-up visit (2011–2012) were examined. The characteristics of the subjects were analyzed with frequency and percentage, and mean and standard deviation. Cataract incidence was measured as incidence proportion (%). For risk factors of cataract, hazard ratio (HR) and 95% confidence interval (CI) were obtained using the Cox proportional hazard model.
Results
The cataract incidence over a 10-year follow-up period was 19.1% (15.1 in males and 25.8 in females), and mean age at the incidence of cataract was 63.48 years (61.58 years in males and 65.31 years in females). Age (HR=1.09, 95% CI=1.05–1.13) and HbA1c (HR=1.21, 95% CI=1.07–1.37) or the duration of DM (HR=1.05, 95% CI=1.00–1.09) were found to be independently associated with cataract development.
Conclusion
Cataract development in people with DM is common, and its likelihood increases with age, HbA1c, and the duration of DM. Considering negative effect of cataract on their quality of life and economic burden, nurses should identify people with DM at a higher risk of cataract development, and plan individual eye examination programs to detect cataract development as early as possible.

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Effects of Electroencephalogram Biofeedback on Emotion Regulation and Brain Homeostasis of Late Adolescents in the COVID-19 Pandemic: Park, Wanju , Cho, Mina , Park, Shinjeong; J Korean Acad Nurs 2022;52(1):36-51. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21155

Abstract PDF: Purpose
The purpose of this study was to examine the effects of electroencephalogram (EEG) biofeedback training for emotion regulation and brain homeostasis on anxiety about COVID-19 infection, impulsivity, anger rumination, meta-mood, and self-regulation ability of late adolescents in the prolonged COVID-19 pandemic situation.
Methods
A non-equivalent control group pretest-posttest design was used. The participants included 55 late adolescents in the experimental and control groups. The variables were evaluated using quantitative EEG at pre-post time points in the experimental group. The experimental groups received 10 sessions using the three-band protocol for five weeks. The collected data were analyzed using the Shapiro-Wilk test, Wilcoxon rank sum test, Wilcoxon signed-rank test, t-test and paired t-test using the SAS 9.3 program. The collected EEG data used a frequency series power spectrum analysis method through fast Fourier transform.
Results
Significant differences in emotion regulation between the two groups were observed in the anxiety about COVID-19 infection (W = 585.50, p = .002), mood repair of meta-mood (W = 889.50, p = .024), self-regulation ability (t = - 5.02, p < .001), self-regulation mode (t = - 4.74, p < .001), and volitional inhibition mode (t = - 2.61, p = .012). Neurofeedback training for brain homeostasis was effected on enhanced sensory-motor rhythm (S = 177.00, p < .001) and inhibited theta (S = - 166.00, p < .001).
Conclusion
The results demonstrate the potential of EEG biofeedback training as an independent nursing intervention that can markedly improve anxiety, mood-repair, and self-regulation ability for emotional distress during the COVID-19 pandemic.

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The Development of a Tool for Assessment of Spiritual Distress in Cancer Patients: Kim, Jin Sook , Ko, Il-Sun , Koh, Su Jin; J Korean Acad Nurs 2022;52(1):52-65. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21120

Abstract PDF: Purpose
This study was conducted to develop a scale to measure spiritual distress in cancer patients.
Methods
A total of 69 preliminary items for the spiritaul distress assessment tool (SDAT) were compiled, based on a literature review, selection of empirically relevant items through concept analysis of hybrid models, confirmation of content validity by experts, cognitive interviews, and a pretest. Self-administered questionnaires were collected between April 1 and July 31, 2018, from 225 cancer patients at four medical institutions and one nursing home. The data were analyzed using item analysis, exploratory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity. Reliability was tested by Cronbash’s α coefficient.
Results
The final version of the SDAT consisted of 20 items. Five-factors, loss of peace, burden of family, avoidance of confronting death, guilt and remorse, regret for not being able to apololgize and forgive were extracted, and showed 62.8% of total variance. The factors were confirmed through convergent and discriminant validity. Criterion validity was confirmed by functional assessment chronic illness therapy spiritual well-being scale 12 (FACIT-Sp12). The overall Cronbach’s α was .91, and the coefficients of each subscale ranged from .78~.83.
Conclusion
The SDAT for cancer patients is valid and reliable. It is suggested that the tool can be used to measure spiritual distress in cancer patients.

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Experience of Nurses in Charge of COVID-19 Screening at General Hospitals in Korea: Ha, Boo Young , Bae, Yun-Sook , Ryu, Han Sol , Jeon, Mi-Kyeong; J Korean Acad Nurs 2022;52(1):66-79. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21166

Abstract PDF: Purpose
The purpose of this study was to understand and describe the experiences of nurses in charge of COVID-19 screening at general hospitals in South Korea.
Methods
Data were collected through individual in-depth interviews with 14 nurses who had been working for more than a month at a screening clinic operated by two general hospitals from May 11 to July 20, 2021. Verbatim transcripts were analyzed using Colaizzi’s phenomenological analysis.
Results
As a result of analysis, four theme clusters were extracted from nurses’ experiences, as follow: the role of the hospital gatekeeper entrusted with managing the COVID-19 pandemic, struggling to maintain the protective barrier, boundlessness like a Mobius strip, and driving force to endure as a nurse in charge of COVID-19 screening.
Conclusion
The results of this study provide a deeper understanding of the lives of screening clinic nurses who are struggling with the COVID-19 situation. The results are expected to be useful in providing basic data for improving the infection control system and response strategies that can be applied to nursing practice in other pandemic situations.

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Development and Evaluation of Health Empowerment Scale for North Korean Women Defectors: Lim, Semi , Kang, Younhee; J Korean Acad Nurs 2022;52(1):80-91. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21174

Abstract PDF: Purpose
This study developed an instrument to evaluate the health empowerment of North Korean women refugees and examined its validity and reliability.
Methods
Through literature review and focused group interviews, 66 preliminary items with three constructs, including perceived control, perceived competence, and goal internalization were selected based on Menon’s psychological health empowerment model. A questionnaire survey was conducted with 239 North Korean women refugees in the community from August 31 to September 4, 2020. Content, construct, convergent, and discriminative validity were evaluated. Cronbach’s α was used to evaluate the reli-ability of scale.
Results
The final instrument consisted of 31 items with three factors that were identified through confirmatory factor analysis. The convergent validity showed that the correlation coefficient was .52 (p < .001), which confirmed the validity of the developed measurement tool. Cronbach’s α for all the items was .94, and Cronbach's α for the factors was .76~.91.
Conclusion
This health empowerment scale has been developed to include aspects of health empowerment, provide a conceptual framework, and offer objective indicators to evaluate the effectiveness of a health education program.

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Relationships among Knowledge and Skills about Suicide Prevention, Attitudes toward Suicide, and Burnout of Suicide Prevention Work of Nurses at Mental Health Welfare Centers: A Mixed Methods Study: Dong, Hee-Ra , Seo, Ji Min; J Korean Acad Nurs 2022;52(1):92-104. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21189

Abstract PDF: Purpose
This study aimed to identify relationships among knowledge and skills about suicide prevention, attitudes toward suicide, and burnout of suicide prevention work of nurses at mental health welfare centers.
Methods
An explanatory sequential mixed-method research was conducted. For the quantitative study, the subjects (nurses) were 133 nurses executing suicide prevention work. The data were analyzed using the SPSS 25.0 program. For the qualitative research, 13 nurses with high burnout scores were interviewed. The data were analyzed using theme analysis method.
Results
Quantitative results showed the average burnout of suicide prevention work was 54.62 ± 12.51. The burnout of suicide prevention work had significant correlations with attitudes toward suicide (r = .30, p < .001) and suicide prevention skills (r = - .18,p = .037). Qualitative results showed six themes related to burnout of suicide prevention work. They were ‘feeling a lack of confidence in one’s suicide counselling skills’, ‘feeling of the limits of one’s ability to cope with a suicide crisis’, ‘feeling regret for not being able to help the clients’, ‘being over-empathetic to the clients’, ‘Not being able to understand the clients because the subjects (nurses) opposes committing suicide’, and ‘thinking that the suicidal thoughts of suicide attempters do not improve’.
Conclusion
To reduce burnout of nurses’ suicide prevention work at mental health welfare centers, there is a need to develop an educational program considering nurses' attitudes toward suicide and one to enhance their confidence in suicide prevention skills.

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Willingness to Use and Appropriate Payable Cost for Visiting Nurse Service for the Elderly in the Community: Seo, Soyoung , Jang, Soong-nang; J Korean Acad Nurs 2022;52(1):105-119. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21193

Abstract PDF: Purpose
This study aimed to measure willingness to use (WTU) and appropriate payable cost of visiting nurse service for the elderly and explore their impact factors.
Methods
The study included 752 participants selected from data that were completed in 2017 for the elderly aged over 60 nationwide. Logit and Tobit regression analysis were performed to confirm the influencing factors.
Results
The study found that 39.1% of the elderly in the community were WTU the visiting nurse service, and they reported that the cost per visit was 12,650 Korean Won. The factors influencing WTU were having less than moderate subjective health status (OR = 1.63, p = .011), being part of a social participating groups (OR = 1.50, p = .046), or participation in senior health promotion programs (SHPPs) (OR = 1.96, p = .003). The cost was also influenced by less than moderate subjective health status (β = 4.37, p = .021), being part of a social participating groups (β = 4.41, p = .028), or participation in SHPPs (β = 4.87, p = .023). Additionally, elderly people living alone who were used as covariates were highly WTU (OR = 2.20, p = .029).
Conclusion
This study provides evidence to predict demand for visiting nurse service and reflects consumer value in setting the service cost. This is the first study to derive cost from consumers' perspective regarding the service for the elderly. As it is the result of an open-ended survey, follow-up studies are needed to estimate more reliable and reasonable results.

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