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Volume 46(2); April 2016
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Invited Article
Psychological and Physical Health in Family Caregivers of Intensive Care Unit Survivors: Current Knowledge and Future Research Strategies
JiYeon Choi, Michael P. Donahoe, Leslie A. Hoffman
J Korean Acad Nurs 2016;46(2):159-167.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.159
AbstractAbstract PDF
Purpose

This article provides an overview of current knowledge on the impact of caregiving on the psychological and physical health of family caregivers of intensive care unit (ICU) survivors and suggestions for future research.

Methods

Review of selected papers published in English between January 2000 and October 2015 reporting psychological and physical health outcomes in family caregivers of ICU survivors.

Results

In family caregivers of ICU survivors followed up to five years after patients' discharge from an ICU, psychological symptoms, manifested as depression, anxiety and post-traumatic stress disorder, were highly prevalent. Poor self-care, sleep disturbances and fatigue were identified as common physical health problems in family caregivers. Studies to date are mainly descriptive; few interventions have targeted family caregivers. Further, studies that elicit unique needs of families from diverse cultures are lacking.

Conclusion

Studies to date have described the impact of caregiving on the psychological and physical health in family caregivers of ICU survivors. Few studies have tested interventions to support unique needs in this population. Therefore, evidence for best strategies is lacking. Future research is needed to identify ICU caregivers at greatest risk for distress, time points to target interventions with maximal efficacy, needs of those from diverse cultures and test interventions to mitigate family caregivers' burden.

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Original Articles
Experience of Role Adaptation from Nurse to Member of the Nursing Faculty
Kwang-Ok Park, Jong Kyung Kim, Mi Yu
J Korean Acad Nurs 2016;46(2):168-182.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.168
AbstractAbstract PDF
Purpose

The purpose of this qualitative study was to evaluate the experience of role adaptation from nurse to member of the nursing faculty.

Methods

Data were collected from 13 members of a nursing faculty through in-depth interviews. The main question asked was "Could you describe your experience from being a nurse to becoming a member of the nursing faculty?" Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology.

Results

The core experiential category of role adaptation from nurse to member of the nursing faculty was 'striving for survival from culture shock'. The participants used the following three interactional strategies: 'recognizing everything and entering the school environment', 'self-reflection on being a professor and integration of experiences', and 'finding a way of adapting'.

Conclusion

The participants tried to adapt to life as a professor and reflected on and integrated their experiences into their new life on the faculty. College faculty need to understand the impact of changes and challenges faced by new professors during role adaptation and to support this adaptation through mentorship and organized orientation programs.

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Development and Effects of a Drinking Prevention Program for Preschool Children
Younkyoung Kim, Chong Mi Lee, Jong Park
J Korean Acad Nurs 2016;46(2):183-193.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.183
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the effects of the program to promote drinking knowledge, attitudes, and coping behavior in preschool children.

Methods

A quasi-experimental with non-equivalent control group pretest-posttest design was conducted. The participants were 123 five year old children from G city. They were assigned to the experimental group (n=77) or the control group (n=46). A pretest and posttest were conducted to measure main variables. For the experimental group, the drinking prevention program was given for 6 weeks. Data were analyzed using χ2-test, t-test, and ANCOVA.

Results

After the intervention, preschool children in the experimental group reported significant differences in drinking knowledge (F=9.25, p=.003), drinking attitudes (F=19.57, p<.001), and coping behavior (F=16.38, p<.001) compared to preschool children in the control group.

Conclusion

The results of this study indicate that a drinking prevention program for preschool children is effective in increasing drinking knowledge, attitudes, and coping behavior. This drinking prevention program is recommended as an effective intervention for preschool age children to postpone an early introduction to drinking.

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The Effect of K-MBSR Program on Stress, Stress Coping Style, Depression, Anger and Sleep of Middle Aged Women
Jeong Min Park, In-Ryoung Choi
J Korean Acad Nurs 2016;46(2):194-206.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.194
AbstractAbstract PDF
Purpose

The purpose of this study was to examine a Korean Mindfulness Based Stress Reduction (K-MBSR) program for middle aged women and to verify the program's effectiveness on stress, stress coping style, depression, anger and sleep.

Methods

Fifty-two women aged from 40 to 59 (26 in the experimental group and 26 in the control group) from G city participated in the study. Data were collected from February 13 to April 3, 2013. The experimental group received 8 sessions, scheduled once a week, with each session lasting two and a half hours. Outcome variables included stress, stress coping style, depression, anger, sleep and a physiological measure (EEG).

Results

There were significant decreases for stress (t=-2.14, p=.037), depression (t=-2.64, p=.011), state trait anger (t=-3.79, p<.001) in the experimental group compared to the control group.

Conclusion

The findings in this study indicate that the K-MBSR program is an effective program to decrease stress, depression, and state trait anger in middle aged women.

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A Validation Study of the Korean Version of the Jefferson Empathy Scale for Health Professionals for Korean Nurses
Hye-Ran Ryu, Kyung-Sook Bang
J Korean Acad Nurs 2016;46(2):207-214.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.207
AbstractAbstract PDF
Purpose

To validate the Korean Version of the Jefferson Empathy Scale for Health professionals (K-JSE-HP) in a sample of Korean nurses.

Methods

Internal consistency reliability, construct and criterion validity were calculated using SPSS (22.0) and AMOS (22.0). Data were collected from 253 nurses (230 women, 23 men) working at one university hospital in Seoul, South Korea.

Results

The Korean version of JSE-HP showed reliable internal consistency with Cronbach's alpha for the total scale of .89, and .74~.84 for subscales. The model of three subscales for the K-JSE-HP was validated by confirmatory factor analysis (χ2=864.60, Q=6.55, p<.001, CFI=.94, NNFI=.92). Criterion validity compared to the Interpersonal Reaction Index (IRI) showed significant correlation.

Conclusion

The findings of this study demonstrate that the Korean JSE-HP shows satisfactory construct and criterion validity and reliability. It is a useful tool to measure Korean nurses' empathy.

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Life Experience following Suicide Attempt among Middle-aged Men
Eun-Young Chin, Hyun Kyung Kim
J Korean Acad Nurs 2016;46(2):215-225.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.215
AbstractAbstract PDF
Purpose

This study was performed to identify the meaning of life experience following suicide attempt among middle-aged men.

Methods

A qualitative research design was adopted using van Manen's hermeneutic phenomenological approach. The participants were six middle-aged men who had attempted suicide at least one time. Data were collected in 2013 through in-depth interviews. Individual interviews were recorded; and literary, art works and phenomenological literature were searched to identify the meaning of the experience.

Results

The five essential themes of the life experience of middle-aged men who attempted suicide were 'Bitter reality confronted again', 'Anger buried deep inside', 'Broken family, inescapable fetters', 'Blocked relationships, closed world' and 'A step towards a new life'.

Conclusion

The meaning of lived experience found in this study provides deep insight into the experience following suicide attempt in middle-aged men and crucial information to give directions to appropriate support and nursing interventions.

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A Grounded Theory Approach on Nurses’ Experience with Workplace Bullying
Jiyeon Kang, Seonyoung Yun
J Korean Acad Nurs 2016;46(2):226-237.   Published online April 17, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.226
AbstractAbstract PDF
Abstract Purpose:

The purpose of this qualitative study was to explore the workplace bullying experience of Korean nurses.

Methods:

Participants were twenty current or former hospital nurses who had experienced workplace bullying. Data were collected through focus group and individual in-depth interviews from February to May, 2015. Theoretical sampling method was applied to the point of theoretical saturation. Transcribed interview contents were analyzed using Corbin and Strauss’s grounded theory method.

Results:

A total of 110 concepts, 48 sub-categories, and 17 categories were identified through the open coding process. As a result of axial coding based on the paradigm model, the central phenomenon of nurses’ workplace bullying experience was revealed as ‘teaching that has become bullying’, and the core category was extracted as ‘surviving in love-hate teaching’ consisting of a four-step process: confronting reality, trial and error, relationship formation, and settlement. The relationship formation was considered to be the key phase to proceed to the positive settlement phase, and the participants utilized various strategies such as having an open mind, developing human relationships, understanding each other in this phase.

Conclusion:

The in-depth understanding of the workplace bullying experience has highlighted the importance of effective communication for cultivating desirable human relationships between nurses.

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Clinical Work Experience of Korean Immigrant Nurses in U.S. Hospitals
Kumsook Seo, Miyoung Kim
J Korean Acad Nurs 2016;46(2):238-248.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.238
AbstractAbstract PDF
Purpose

The purpose of this qualitative study was to explore the meaning of the experience of Korean immigrant nurses working in US hospitals.

Methods

Purposive sampling yielded 15 Korean immigrant nurses who had more than one year of clinical experience in US hospitals. Data were collected from March to August 2012 through in-depth interviews and thematic analysis was conducted using van Manen's hermeneutic phenomenological approach.

Results

The findings were classified into eight themes: 'struggling from staff at workplace being territorial to outsiders', 'feeling oppressed due to language barrier', 'accepting rational and horizontal relationships at work', 'staying alert in the environment where lawsuits are rife', 'feeling a sense of stability from the social system that values human dignity', 'maintaining self-confidence from prominent nursing practices and senior Korean nurses' professional reputation', 'performing essential comprehensive nursing care', 'promoting self-development to be equipped with professionalism.'

Conclusion

The findings indicate that the Korean immigrant nurses were able to excel in their workplace when their clinical experience at US hospitals was combined with the lived space in US politics and environment, lived time of patience, lived body to be alert, and lived others with multi cultural characteristics.

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Effects of Auricular Acupressure on Obesity in Women with Abdominal Obesity
Hyun Su Cha, Hyojung Park
J Korean Acad Nurs 2016;46(2):249-259.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.249
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the effects of auricular acupressure on reducing obesity in adult women with abdominal obesity.

Methods

The study design was a non-equivalent control group pretest-posttest design. Participants were 58 women, aged 20 years or older, assigned to the experimental group (n=30) or control group (n=28). Auricular acupressure using vaccaria seeds was administered to the experimental group. The sessions continued for 8 weeks. Outcome measures included body weight, abdominal circumference, and body mass index, body fat mass, body fat percentage, triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and serum glucose.

Results

Women in the experimental group showed significant decreases in body weight (t=6.19, p<.001), abdominal circumference (t=4.01, p<.001), and body mass index (t=2.58, p=.006) after 8 weeks compared with those in the control group.

Conclusion

Results show that auricular acupressure using vaccaria seeds was effective in decreasing body weight, abdominal circumference, body mass index, and triglyceride levels in adult women with abdominal obesity.

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Development and Application of an Overcoming Compassion Fatigue Program for Emergency Nurses
Yeong Ah Kim, Jeong Sook Park
J Korean Acad Nurs 2016;46(2):260-270.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.260
AbstractAbstract PDF
Purpose

This study was conducted to develop a program to help emergency nurses overcome compassion fatigue, and to analyze the effects of the program.

Methods

A nonequivalent control group pretest-posttest design was used. There were 14 participants in the experimental group and 18 subjects in the control group. The program was comprised of five, weekly 80-minute sessions including understanding and assessment of compassion fatigue, enhancing positive affect, balancing work-life, planning self care, training in relaxation techniques and cognitive restructuring, and getting social support. Research variables were ego-resiliency, compassion satisfaction and compassion fatigue of the ProQOL 5, and salivary cortisol. Data were analyzed using Chi-square test, independent t-test, and paired t-test.

Results

The first hypothesis, "There will be a difference in scores for ego resiliency between the experimental group and the control group". was not supported. The second hypothesis, "There will be a difference in scores for compassion satisfaction between the experimental group and the control group" was supported (t=2.15, p=.046). The third hypothesis, "There will be a difference in scores for compassion fatigue between the experimental group and the control group" was not supported.

Conclusion

The first program for emergency nurses to overcome compassion fatigue in Korea was effective in increasing emergency nurses' compassion satisfaction and decreasing salivary cortisol level in the experimental group. Therefore, this program for overcoming compassion fatigue is useful to increase emergency nurses' compassion satisfaction. However replication studies of short-term intensive program reflecting emergency nurses' opinion are needed.

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Adaptation Experience of Living Kidney Donors after Donation
Da-Hai-Som Kang, Jinhyang Yang
J Korean Acad Nurs 2016;46(2):271-282.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.271
AbstractAbstract PDF
Purpose

This study was done to explore adaptation experience of living kidney donors after donation. Specific aims were to identify challenges donors face in the process of adaptation following surgery and how they interact with recipients and other people.

Methods

Grounded theory methodology was utilized. Participants were 13 living kidney donors at six months or more after donation. Data were collected by in-depth interviews with individual participants. Data were analyzed using constants comparative method with theoretical saturation.

Results

A core category emerged as 'keeping the fences of my family in spite of vulnerability'. The adaptation process after donation was manifested in four phases: exploration, balance, maintenance, and acclimatization. Phenomenon was perception of vulnerability. Strategies to manage the vulnerability were assessing changes of body awareness, tailoring regimen to one's own body condition, coping with health problems, keeping restoration of health, and ruminating on the meaning of one's kidney donation. Consequences were reestablishing family well-being, realizing the values of one's kidney donation, and living with uncertainty.

Conclusion

Findings of the study indicate that there is a need for health professionals to understand the vulnerability of living kidney donors and help their family system maintain a healthy and productive life. The results of this study can be used to develop phase-specific, patient-centered, and tailored interventions for living kidney donors.

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Effects of Self-directed Feedback Practice using Smartphone Videos on Basic Nursing Skills, Confidence in Performance and Learning Satisfaction
Seul Gi Lee, Yun Hee Shin
J Korean Acad Nurs 2016;46(2):283-292.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.283
AbstractAbstract PDF
Purpose

This study was done to verify effects of a self-directed feedback practice using smartphone videos on nursing students' basic nursing skills, confidence in performance and learning satisfaction.

Methods

In this study an experimental study with a post-test only control group design was used. Twenty-nine students were assigned to the experimental group and 29 to the control group. Experimental treatment was exchanging feedback on deficiencies through smartphone recorded videos of nursing practice process taken by peers during self-directed practice.

Results

Basic nursing skills scores were higher for all items in the experimental group compared to the control group, and differences were statistically significant ["Measuring vital signs" (t=-2.10, p=.039); "Wearing protective equipment when entering and exiting the quarantine room and the management of waste materials" (t=-4.74, p<.001) "Gavage tube feeding" (t=-2.70, p=.009)]. Confidence in performance was higher in the experimental group compared to the control group, but the differences were not statistically significant. However, after the complete practice, there was a statistically significant difference in overall performance confidence (t=-3.07. p=.003). Learning satisfaction was higher in the experimental group compared to the control group, but the difference was not statistically significant (t=-1.67, p=.100).

Conclusion

Results of this study indicate that self-directed feedback practice using smartphone videos can improve basic nursing skills. The significance is that it can help nursing students gain confidence in their nursing skills for the future through improvement of basic nursing skills and performance of quality care, thus providing patients with safer care.

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Development and Psychometric Evaluation of the Transcultural Self-efficacy Scale for Nurses
Won-Oak Oh, Eun Sook Park, Min Hyun Suk, Yeo Jin Im
J Korean Acad Nurs 2016;46(2):293-304.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.293
AbstractAbstract PDF
Purpose

This methodological study was conducted to develop and psychometrically test the Transcultural Self-efficacy scale (TCSEscale) for nurses.

Methods

Initial 41 items for the TCSE-scale were generated based on extensive literature reviews and in-depth interviews with 18 nurses who had experience in caring for foreign patients. Cultural Competence and Confidence model was used as a conceptual framework. Content validity was evaluated by an expert panel. Psychometric testing was performed with a convenience sample of 242 nurses recruited from four general hospitals in the Seoul metropolitan area and Gyeonggi-do province of South Korea. To evaluate the reliability of TCSE-scale, a test-retest reliability and an internal consistency reliability were analyzed. Construct validity, concurrent validity, criterion validity, convergent validity and discriminative validity were used to evaluate the validity.

Results

The 25-item TCSE-scale was found to have three subscales-Cognitive, Practical, and Affective domain-explaining 91.5% of the total variance. TCSE-scale also demonstrated a concurrent validity with the Cultural Competence Scale. Criterion-related validity was supported by known-group comparison. Reliability analysis showed an acceptable-to-high Cronbach's alpha-.88 in total, and subscales ranged from .76 to .87. The ICC was .90, indicating that the TCSE-scale has internal consistency and stability of reliability.

Conclusion

This preliminary evaluation of the psychometric scale properties demonstrated an acceptable validity and reliability. The TCSE-scale is able to contribute to building up empirical and evidence based on data collection regarding the transcultural self-efficacy of clinical nurses. We suggest further testing of the applicability of TCSE-scale in different settings and community contexts.

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Factors Influencing Quality of Life of Alcoholics Anonymous Members in Korea
Jae-Soon Yoo, Jongeun Lee, Woo-Young Park
J Korean Acad Nurs 2016;46(2):305-314.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.305
AbstractAbstract PDF
Purpose

The purpose of this study was to determine quality of life (QOL) related factors in Alcoholics Anonymous (AA) members based on PRECEDE Model.

Methods

A cross sectional survey was conducted with participants (N =203) from AA meeting in 11 alcohol counsel centers all over South Korea. Data were collected using a specially designed questionnaire based on the PRECEDE model and including QOL, epidemiological factors (including depression and perceived health status), behavioral factors (continuous abstinence and physical health status and practice), predisposing factors (abstinence self-efficacy and self-esteem), reinforcing factors (social capital and family functioning), and enabling factors. Data were analyzed using t-test, one way ANOVA, Tukey HSD test and hierarchical multiple regression analysis with SPSS (ver. 21.0).

Results

Of the educational diagnostic variables, self-esteem (β=.23), family functioning (β=.12), abstinence self-efficacy (β=.12) and social capital (β=.11) were strong influential factors in AA members' QOL. In addition, epidemiological diagnostic variables such as depression (β= - .44) and perceived health status (β=.35) were the main factors in QOL. Also, physical health status and practice (β=.106), one of behavioral diagnostic variables was a beneficial factor in QOL. Hierarchical multiple regression analysis showed the determinant variables accounted for 44.0% of the variation in QOL (F=25.76, p<.001).

Conclusion

The finding of the study can be used as a framework for planning interventions in order to promote the quality of life of AA members. It is necessary to develop nursing intervention strategies for strengthening educational and epidemiological diagnostic variables in order to improve AA members' QOL.

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