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Volume 48(2); April 2018
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Review Article
Effectiveness of Non-Pharmacologic Interventions in Chemotherapy Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis
Pok-Ja Oh, You Lim Kim
J Korean Acad Nurs 2018;48(2):123-142.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.123
AbstractAbstract PDF
Abstract Purpose

This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN).

Methods

PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses.

Results

Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; I2=19%).Exercis-es were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN.

Conclusion

Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

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Original Articles
Predictors of Behavioral and Psychological Symptoms of Dementia: Based on the Model of Multi-Dimensional Behavior
Jeong Eun Yang, Gwi-Ryung Son Hong
J Korean Acad Nurs 2018;48(2):143-153.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.143
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify factors predicting behavioral and psychological symptoms of dementia (BPSD) in persons with dementia. Factors including the patient, caregiver, and environment based on the multi-dimensional behavioral model were tested.

Methods

The subjects of the study were 139 pairs of persons with dementia and their caregivers selected from four geriatric long-term care facilities located in S city, G province, Korea. Data analysis included descriptive statistics, inverse normal transformations, Pearson correlation coefficients, Spearman's correlation coefficients and hierarchical multiple regression with the SPSS Statistics 22.0 for Windows program.

Results

Mean score for BPSD was 40.16. Depression (β=.42, p<.001), exposure to noise in the evening noise (β=-.20, p=.014), and gender (β=.17, p=.042) were factors predicting BPSD in long-term care facilities, which explained 25.2% of the variance in the model.

Conclusion

To decrease BPSD in persons with dementia, integrated nursing interventions should consider factors of the patient, caregiver, and environment.

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Actor and Partner Effects of Health Status, Marital Satisfaction and Self Efficacy on Retirement Preparation of Middle Aged Couples: Actor-Partner Interdependence Model Analysis
Eun Hee Jung, Sung Hee Shin
J Korean Acad Nurs 2018;48(2):154-166.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.154
AbstractAbstract PDF
Abstract Purpose

This study aimed to identify the actor and partner effects of health status, marital satisfaction, and self efficacy on retirement preparation in middle aged couples using the Actor-Partner Interdependence Model.

Methods

Participants were 121 middle aged couples living in Seoul, Gyeonggi-do and Daegu City, Korea. All measures were self-administered. The collected data were analyzed using SPSS 20.0 and AMOS 20.0.

Results

1) Wife's self efficacy and marital satisfaction showed direct actor and partner effects on retirement preparation in middle aged couples. Wife's health status showed an indirect actor effect through wife's self efficacy and marital satisfaction on wife's retirement preparation, and showed an indirect partner effect through husband's self efficacy on husband's retirement preparation. 2) Husband's self efficacy and marital satisfaction showed only direct actor effect on retirement preparation. Health status among the husbands showed an indirect actor effect on husband's retirement preparation through their self efficacy and marital satisfaction, and an indirect partner effect through wife's marital satisfaction on wife's retirement preparation. 3) The actor effect size of health status on self efficacy and marital satisfaction was larger among husband's than wife's. Additionally, the partner effect size of health status on self efficacy and marital satisfaction was different between the two groups; however, the actor and partner effect size of self efficacy and marital satisfaction on retirement preparation was the same for husband and wife.

Conclusion

The results of this study indicate that nursing intervention strategies for improving self efficacy and marital satisfaction are strongly needed to enhance retirement preparation of middle aged couples in Korean community.

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Development and Effects of a Coping Skill Training Program for Caregivers in Feeding Difficulty of Older Adults with Dementia in Long-Term Care Facilities
Hyun Hwa Hong, Mee Ock Gu
J Korean Acad Nurs 2018;48(2):167-181.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.167
AbstractAbstract PDF
Abstract Purpose

We developed and tested the effects of a coping skill training program for caregivers in feeding difficulty among older adults with dementia in long-term care facilities.

Methods

A non-equivalent control group pretest-posttest design was used. The subjects comprised 34 caregivers (experimental group: 17, control group: 17) and 40 older adults with dementia (experimental group: 20, control group: 20). The developed program was delivered in 4-hour sessions over 6 weeks (including 2 weeks of lectures and lab practice on feeding difficulty coping skills, and 4 weeks of field practice). Data were collected before, immediately after, and 4 weeks after the program (January 3 to April 6, 2016). The data were analyzed using t-test and repeated measures ANOVA using SPSS/WIN 20.0.

Results

Compared to their counterparts in the control group, caregivers in the experimental group showed a significantly greater improvement in feeding knowledge and feeding behavior, while older adults with dementia showed greater improvements in feeding difficulty and Body Mass Index.

Conclusion

The study findings indicate that this coping skill training program for caregivers in feeding difficulty is an effective intervention for older adults with dementia in long-term care facilities.

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The Effects of a Health Mentoring Program in Community-dwelling Vulnerable Elderly Individuals with Diabetes
Ki wol Sung, Hye Seung Kang, Ji Ran Nam, Mi Kyung Park, Ji Hyeon Park
J Korean Acad Nurs 2018;48(2):182-194.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.182
AbstractAbstract PDF
Abstract Purpose

This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes.

Methods

A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0.

Results

Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups.

Conclusion

These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population.

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Testing a Model to Predict Problem Gambling in Speculative Game Users
Hyangjin Park, Suk-Sun Kim
J Korean Acad Nurs 2018;48(2):195-207.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.195
AbstractAbstract PDF
Abstract Purpose

The purpose of the study was to develop and test a model for predicting problem gambling in speculative game users based on Blaszczynski and Nower's pathways model of problem and pathological gambling.

Methods

The participants were 262 speculative game users recruited from seven speculative gambling places located in Seoul, Gangwon, and Gyeonggi, Korea. They completed a structured self-report questionnaire comprising measures of problem gambling, negative emotions, attentional impulsivity, motor impulsivity, non-planning impulsivity, gambler's fallacy, and gambling self-efficacy. Structural Equation Modeling was used to test the hypothesized model and to examine the direct and indirect effects on problem gambling in speculative game users using SPSS 22.0 and AMOS 20.0 programs.

Results

The hypothetical research model provided a reasonable fit to the data. Negative emotions, motor impulsivity, gambler's fallacy, and gambling self-efficacy had direct effects on problem gambling in speculative game users, while indirect effects were reported for negative emotions, motor impulsivity, and gambler's fallacy. These predictors explained 75.2% problem gambling in speculative game users.

Conclusion

The findings suggest that developing intervention programs to reduce negative emotions, motor impulsivity, and gambler's fallacy, and to increase gambling self-efficacy in speculative game users are needed to prevent their problem gambling.

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The Effects of Neurofeedback Training on Physical, Psychoemotional Stress Response and Self-Regulation for Late Adolescence: A Non-Randomized Trial
Moon-Ji Choi, Wan-Ju Park
J Korean Acad Nurs 2018;48(2):208-220.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.208
AbstractAbstract PDF
Abstract Purpose

The aim of this study was to analyze the effects of neurofeedback training for reducing stress and enhancing self-regulation in late adolescence to identify the possibility of use for nursing intervention.

Methods

A nonequivalent control group pre-post quasi-experimental design was used. Participants were 78 late adolescents assigned to the experimental group (n=39) that received the neurofeedback training and the control group (n=39). Data were collected on heart rate variability (HRV) and skin conductance level (SCL) to assess stress-biomarker response. The questionnaire contained 164 items from: Positive and Negative Affect Schedule (PANAS), Symptom Checklist-90-Revised (SCL-90-R) and Self-regulatory Ability scale. The neurofeedback training was based on the general adaptation syndrome and body-mind medicine. The intervention was conducted in a total of 10 sessions for 30 minutes per session with high-beta, theta and sensory motor rhythm training on scalp at central zero.

Results

There were significant difference in standard deviation of normal to normal interval (p=.036) in HRV and SCL (p=.029) of stress-biomarker response between the two groups. Negative affect (p=.036) in PANAS and obsessive compulsive (p=.023) and depression (p<.001) in SCL-90-R were statistically significant. Self-regulation mode (p=.004) in self-regulation ability scale showed a significant difference between the two groups.

Conclusion

The results indicated that the neurofeedback training is effective in stress-biomarkers, psy-choemotional stress response and self-regulation. Therefore, neurofeedback training using neuroscientific approach based on brain-mind-body model can be used as an effective nursing intervention for late adolescents in clinics and communities for effective stress responses.

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The Effect of Pain Relieving Intervention During Infiltration among Gamma Knife Surgery Patients for Stereotactic Frame Fixation
Young Jun Jang, Hyeon Ok Kim
J Korean Acad Nurs 2018;48(2):221-231.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.221
AbstractAbstract PDF
Abstract Purpose

This study aimed to compare the effects of three interventions on pain, blood pressure, and pulse rate during infiltration anesthesia in patients about to undergo gamma knife surgeries.

Methods

The three interventions employed in a university-affiliated Hospital in J City, South Korea were as follows: EMLA cream plus Vapocoolant spray (Vapocoolant, n=30), EMLA cream plus 10.0% Lidocaine spray (Lidocaine, n=30), and EMLA cream only (EMLA, n=30). The equivalent control-group pre test - post test study design was used. Pain was assessed subjectively using the numeric rating scale (NRS) and objectively using a Galvanic Skin Response (GSR) tester. NRS scores were assessed after infiltration anesthesia and the GSR was assessed during infiltration anesthesia. Blood pressure and pulse rate were assessed twice: before and after infiltration anesthesia. Data were collected between August 3, 2016 and March 24, 2017.

Results

NRS scores after infiltration anesthesia and the GSR during infiltration anesthesia were significantly lower in the Vapocoolant group than in the Lidocaine and EMLA groups (F=13.56, p<.001 and F=14.43, p<.001, respectively). The increase in systolic blood pressure (F=4.77, p=.011) and in pulse rates (F=4.78, p=.011) before and after infiltration anesthesia were significantly smaller in the Vapocoolant group than in the Lidocaine and EMLA groups; however, no significant differences were observed in diastolic blood pressures (F=1.51, p=.227).

Conclusion

EMLA cream plus Vapocoolant spray was the most effective intervention to relieve pain and to lower increase in systolic blood pressure and pulse rate caused by infiltration anesthesia for stereotactic frame fixation. Thus, application of Vapocoolant spray in addition to EMLA cream is highly recommended as a nursing intervention for patients undergoing gamma knife surgeries.

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Latent Class Analysis of Gambling Activities among Korean Adolescents
Kyonghwa Kang, Hyeongsu Kim, Ae Ran Park, Hee-Young Kim, Kunsei Lee
J Korean Acad Nurs 2018;48(2):232-240.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.232
AbstractAbstract PDF
Abstract Purpose

The aim of this study is to identify the types of gambling among adolescents and provide basic prevention information regarding adolescents’ gambling problems.

Methods

Secondary data from representative national survey on 2015 Youth Gambling Problems of Korea Center on Gambling Problems were used. Using latent class analysis (LCA), 13 gambling types such as offline and online games of 14,011 adolescents were classified, and gambling experiences and characteristics were analyzed.

Results

The subgroups of adolescent gambling were identified as four latent classes: a rare group (84.5% of the sample), a risk group (1.0%), an offline group (11.9%), and an expanded group (2.6%). The types and characteristics of gambling among the latent classes differed. In the risk group, adolescents participated in online illegal sports betting and internet casino, and gambling time, gambling expenses, and the number of gambling types were higher than other groups.

Conclusion

Gambling frequently occur among adolescent, and the subtypes of gambling did not reveal homogeneous characteristics. In order to prevent adolescent gambling problems, it is a necessary to develop tailored prevention intervention in the nursing field, which is appropriate to the characteristics of adolescent gambling group and can help with early identification.

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Symptom Distress and Coping in Young Korean Breast Cancer Survivors: The Mediating Effects of Social Support and Resilience
Ji Hyun Lee, Hye Young Kim
J Korean Acad Nurs 2018;48(2):241-253.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.241
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to test the mediating effect of social support and resilience on the relationship between symptom distress and coping in young Korean breast cancer survivors.

Methods

A purposive sample of 209 young breast-cancer survivors (mean age 39.9) was recruited for a cross-sectional survey, and the data were collected between June and October 2015. The instruments used in this study were the Memorial Symptom Assessment Scale-Short Form, the Multidimensional Scale of Perceived Social Support, 10-item Connor-Davidson Resilience Scale, and Cancer Coping Questionnaire. The collected data were then analyzed using the SPSS 23.0 and AMOS 23.0 programs.

Results

Symptom distress was found to have a significant indirect effect on coping (beta=-.32, p=.002), but not a significant direct effect (beta=.06, p=.577). Additionally, based on the values obtained for the squared multiple correlation, symptom distress, social support, and resilience were found to explain 46.4% of the total variance of coping.

Conclusion

Based on the results of this study, it can be suggested that in order to enhance young breast cancer survivors’ ability to cope with the distress they commonly feel, intervention methods that strengthen resilience and provide social support should be developed and made available to them.

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