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Volume 47(3); June 2017
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Original Articles
Illness Experience of Married Korean Women with Epilepsy
Young-Min Shon, Woo Joung Joung
J Korean Acad Nurs 2017;47(3):289-304.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.289
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to understand and describe the illness experience of married Korean women with epilepsy.

Methods

Data were collected during 2015~2016 through individual in-depth interviews with 12 married women with epilepsy. Verbatim transcripts were analyzed using Giorgi's phenomenological analysis to uncover the meaning of the illness experience of the participants.

Results

The study results showed that the illness experience of married Korean women with epilepsy was clustered into a specific description of situated structure and a general description of situated structure. Six themes from 20 meaning units were identified: 1) Undermined self-esteem with stigma of being epileptic; 2) Limited social interaction; 3) Suffering sorrow as a ‘disqualified being’; 4) Shuttling back and forth across the boundary between healthy and epileptic; 5) Desperate struggle to meet the expectation of given role; 6) Self-empowering through self-restriction and realization.

Conclusion

The findings from this study show that both the enacted and felt stigma of epilepsy impact on the life of married Korean women with epilepsy. Although the participants face social and interpersonal restriction and prejudices, they try their best to fulfill their role rather than to be cared for as patients. As the stigma and hardships of the participants are related to lack of knowledge, health professionals should focus not just on clinical intervention but also on providing targeted educational programs and counseling for these women to dispel the stigma of the disease and to increase their quality of life.

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Development and Effects of an Instructional Coaching Program Regarding Children with Attention Deficit Hyperactivity Disorder for Elementary School Teachers
Shin Jeong Park, Wan Ju Park
J Korean Acad Nurs 2017;47(3):305-318.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.305
AbstractAbstract PDF
Abstract Purpose

The aim of this study was to identify the effects of a newly developed instructional coaching program regarding Attention Deficit Hyperactivity Disorder (ADHD) for teachers.

Methods

Seventy teachers participated in this study involving a nonequivalent control group and a pretest-posttest design. The instructional coaching program consisted of eight 60-minute sessions. The program was developed through a theoretical development program involving six steps. To evaluate the effects of the program, data were collected through self-report questionnaires including the Knowledge Scale of Attention Deficit Disorder, Attitude Scale of Primary School Teachers Experiencing Students with ADHD, Practice Scale of Educational Intervention Activity, and the Korean ADHD Rating Scale. Data were analyzed with an independent t test, a chi-square test, and an ANCOVA using SPSS WIN version 20.

Results

The intervention program consisted of 3 sectors, 8 subjects, and 24 content items. The experimental group showed a significant improvement in attitudes toward ADHD (F=22.83, p<.001). In addition, teacher's knowledge regarding ADHD (F=7.16, p=.010) and the implementation of instructional interventions (F=4.29, p=.043) improved. Further, teachers reported a reduction in children's ADHD-related behavior (F=4.34, p=.041). Results showed that the coaching program made a positive contribution to teaching skills and understanding of school-age children with ADHD.

Conclusion

The instructional coaching program was well structured and significantly improved not only teachers'attitudes, knowledge, and teaching skills but also the behavior of children with ADHD in class. Therefore, the program is recommended as a means of facilitating teaching and managing children with ADHD in class.

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Development and Validation of the Cancer-Specific Posttraumatic Growth Inventory
Young-Mi Jung, Jin-Hee Park
J Korean Acad Nurs 2017;47(3):319-331.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.319
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to develop a scale to evaluate posttraumatic growth in patients with cancer and to examine the validity and reliability of the scale.

Methods

A literature review, semi-structured patient interviews and an expert panel consultation produced a 27 preliminary item questionnaire. Participants were 150 cancer patients recruited to test the reliability and validity of the preliminary scale. Data were analyzed using item analysis, exploratory factor analysis, convergent validity and internal consistency.

Results

Item reduction and exploratory factor analysis led to 23 items, grouped into five subscales which were labelled new possibilities (6 items), coping skills (5 items), preciousness of life (5 items), relating to others (4 items), and personal strength (3 items). Convergent validity was evaluated by total correlation with the Functional Assessment of Cancer Therapy-General (r=.45, p<.001). The final scale demonstrated satisfactory internal consistency (Cronbach's a =.94).

Conclusion

Findings from this study indicate that the Cancer-Specific Posttraumatic Growth Inventory has validity and reliability and is considered to be appropriate for assessing posttraumatic growth in patients with cancer.

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The Effects of Violence Coping Program Based on Middle-Range Theory of Resilience on Emergency Room Nurses’ Resilience, Violence Coping, Nursing Competency and Burnout
Seung Min Lee, Kyung Mi Sung
J Korean Acad Nurs 2017;47(3):332-344.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.332
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to examine the effects of a violence coping program (VCP) based on Polk's middle-range theory of resilience on nursing competency, resilience, burnout, and the ability to cope with violence in nurses working in emergency rooms.

Methods

A quasi-experimental study, with a nonequivalent control group and a pretest-posttest design, was conducted. Participants were 36 nurses who worked in emergency rooms and had experienced violence; 18 nurses from D hospital and 18 nurses from C hospital were assigned to the experimental and control groups, respectively. The experimental group received the VCP twice per week for 8 weeks.

Results

Levels of resilience, F=59.41, p<.001, active coping behavior, c2=33.09, p<.001, and nursing competency, F=59.41 p<.001, increased significantly and levels of passive coping behavior, c2=22.92, p<.001, and burnout, F=52.74, p<.001, decreased significantly in the experimental group.

Conclusion

The results suggest that the VCP could be an effective strategy for reducing burnout and improving resilience, active coping behavior, and nursing competency. Therefore, it would be a useful intervention for improving the quality of nursing care provided in emergency rooms.

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The Effect of a Movie-Based Nursing Intervention Program on Rehabilitation Motivation and Depression in Stroke Patients
Hye Kyung Kwon, Sook Ja Lee
J Korean Acad Nurs 2017;47(3):345-356.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.345
AbstractAbstract PDF
Abstract Purpose

The aim of this study was to develop and measure the effect of a movie-based-nursing intervention program designed to enhance motivation for rehabilitation and reduce depression levels in stroke patients.

Methods

The study used a quasi-experimental, nonequivalent control group and a pretest-posttest design. The 60 research subjects were assigned to the experimental (n=30) or control group (n=30). The movie-based nursing intervention program was provided for the experimental group during 60-minute sessions held once per week for 10 weeks. The program consisted of patient education to strengthen motivation for rehabilitation and reduce depression, watching movies to identify role models, and group discussion to facilitate therapeutic interaction.

Results

After 10 weeks of participation in the movie-based nursing intervention program, the experimental group's rehabilitation motivation score was significantly higher, F=1161.54 (within groups df=49, between groups df=1), p<.001, relative to that observed in the control group. In addition, the experimental group's depression score was significantly lower relative to that observed in the control group, F=258.97 (within groups df=49, between groups df=1), p<.001.

Conclusion

The movie-based nursing intervention program could be used for stroke patients experiencing psychological difficulties including reduced motivation for rehabilitation and increased depression during the rehabilitation process.

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Multiple Factors in the Second Trimester of Pregnancy on Preterm Labor Symptoms and Preterm Birth
Jeung-Im Kim, Mi-Ock Cho, Gyu-Yeon Choi
J Korean Acad Nurs 2017;47(3):357-366.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.357
AbstractAbstract PDF
Abstract Purpose

The aim of this study was to determine the influence of various factors on preterm labor symptoms (PLS) and preterm birth (PB).

Methods

This prospective cohort study included 193 women in the second stage of pregnancy. Multiple characteristics including body mass index (BMI), smoking, and pregnancy complications were collected through a self-report questionnaire. Pregnancy stress and PLS were each measured with a related scale. Cervical length and birth outcome were evaluated from medical charts. Multiple regression was used to predict PLS and logistic regression was used to predict PB.

Results

Multiple regression showed smoking experience, pregnancy complications and pregnancy specific stress were predictors of PLS and accounted for 19.2% of the total variation. Logistic regression showed predictors of PB to be twins (OR=13.68, CI=3.72~50.33, p<.001), shorter cervix (<25mm) (OR=5.63, CI=1.29~24.54, p<.05), BMI >25 (kg/m2) (OR=3.50, CI=1.35~9.04, p<.01) and a previous PB (OR=4.15, CI=1.07~16.03, p<.05).

Conclusion

The results of this study show that the multiple factors affect stage II pregnant women can result in PLS or PB. And preterm labor may predict PB. These findings highlight differences in predicting variables for pretrm labor and for PB. Future research is needed to develop a screening tool to predict the risk of preterm birth in pregnant women.

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Hermeneutic Phenomenological Study on Caring Experience of Spouses of Elderly People with Dementia at Home
Hye-Young Jang, Myungsun Yi
J Korean Acad Nurs 2017;47(3):367-379.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.367
AbstractAbstract PDF
Abstract Purpose

This study aimed to understand and describe the caring experiences of spouses of elderly people with dementia.

Methods

The hermeneutic phenomenological method was used and participants were 12 spouses aged 65 and over who were taking care of their husbands or wives with dementia at home. Data were collected from individual in-depth interviews on participants’ actual caring experiences. Additionally, novels, movies, and memoirs on elderly couples with partner who had dementia were included as data for the analysis. The qualitative data analysis software program was used to manage and process the collected qualitative data. Data were analyzed using hermeneutic phenomenological analysis based on four fundamental existentials including lived body, lived space, lived time, and lived others.

Results

Five essential themes emerged from the analysis: 1) body moving like an old machine, 2) swamp of despair filling with hope, 3) sweet time after bitterness, 4) disappointed elderly couple in the empty nest, and 5) unappreciation vs. empathetic feelings. These essential themes were comprehensively summarized as “the road leading to the maturation of life with dedication and hope while bearing the weight of caring based on the couple's relationship.”

Conclusion

The findings indicate that the nature of the caring experience of spouses of elderly individuals with dementia is filled with many dynamic and paradoxical dimensions. Thus, results of the study would help with developing interventions tailored specifically for elderly spouse caregivers to support their role adaptation and ultimately improving their quality of life.

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The Effect of Health Coaching Programs on Self-Efficacy, Health Behaviors, and Quality of Life in Hypertensive People Living in Poverty
Sun Ok Eom, Insook Lee
J Korean Acad Nurs 2017;47(3):380-391.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.380
AbstractAbstract PDF
Abstract Purpose

This study was designed to determine the effects of health coaching and mediating variables on quantitative aspect of health in low-income hypertensive people.

Methods

The experimental group for the current study consisted of 21 clients who received health coaching services, and the control group consisted of 22 clients who received home-visiting nursing services. Two groups received health coaching or home-visiting nursing services once a week for 8 weeks. The evaluation variables were self-efficacy, nutrition management, health behaviors, self-rated health, and quality of life.

Results

The results revealed that the level of nutrition management was significantly higher in the experimental group than the control group (F=10.33, p=.005).

Conclusion

These results confirm that health coaching is a useful strategy that encourages clients to continuously maintain their own health behaviors. Thus, the findings of the current study provide useful data for establishing measures for the health management of those afflicted with chronic disease, such as hypertension. Furthermore, health coaching may be developed into useful intervention strategies for dealing with chronic diseases and improving home-visiting nursing.

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Development and Evaluation of a Self-Reflection Program for Intensive Care Unit Nurses Who Have Experienced the Death of Pediatric Patients
Hyun-Ju Kang, Kyung-Sook Bang
J Korean Acad Nurs 2017;47(3):392-405.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.392
AbstractAbstract PDF
Abstract Purpose

This study aims to develop a self-reflection program for nurses who have experienced the death of pediatric patients in the intensive care unit and to evaluate its effectiveness.

Methods

The self-reflection program was developed by means of the following four steps: establishment of the goal through investigation of an initial request, drawing up the program, preliminary research, and implementation and improvement of the program. The study employed a methodological triangulation to evaluate the effectiveness of the program. Participants were 38 nurses who had experienced the death of pediatric patients (experimental group=15, control group=23); they were recruited using convenience sampling. The self-reflection program was provided over 6 weeks (6 sessions). Data were collected from April to August, 2014 and analyzed using t-tests and content analysis.

Results

The quantitative results showed that changes in personal growth (t=-6.33, p<.001) and burnout scores (z=-2.76, p=.005) were better in the experimental group compared to the control group. The qualitative results exhibited two themes, namely “personal growth” and “professional growth”, and ten sub-themes.

Conclusion

The self-reflection program developed by this study was effective in helping nurses who had experienced the death of pediatric patients to achieve personal growth through self-reflection, and it was confirmed that the program can be applied in a realistic clinical nursing setting. Furthermore, it can be recommended as an intervention program for clinical nurses.

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Development and Evaluation of a Motivational Interviewing Program for Exercise Improvement in Persons with Physical Disabilities
Jeong Hee Jeong, Ihn Sook Jeong
J Korean Acad Nurs 2017;47(3):406-419.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.406
AbstractAbstract PDF
Abstract Purpose

The aims of this study were to develop a motivational interviewing program for exercise improvement in persons with physical disabilities and to examine the effect of this motivational interviewing intervention.

Methods

The study employed a nonequivalent control group pretest and posttest design. A total of 62 persons with physical disabilities (30 in the experimental group, 32 in the control group) were recruited from 2 community rehabilitation centers. The experimental group received 8 sessions of a group motivational interviewing program, scheduled once a week, with each session lasting 60 minutes. Test measures were completed before the intervention, immediately after the end of the intervention, 2 weeks later, and 6 weeks after the end of the intervention. Measures included self-efficacy for exercise, decisional balance for exercise, stage of change for exercise, regularity of exercise, exercise maintenance, and independent living ability. Data were analyzed using the c2-test, Fisher's exact test, Independent samples t-test, and repeated measures ANOVA, conducted using IBM SPSS Statistics version 18.

Results

The experimental group showed a significant increase in self-efficacy for exercise (F=50.98, p<.001), benefit (pros) of exercise (F=24.16, p<.001), and independent living ability (F=50.94, p<.001), and a significant decrease in loss (cons) of exercise (F=26.50, p<.001). There were significant differences between the two groups in stages of change for exercise (p<.001), regularity of exercise (p<.001), and exercise maintenance (c2=26.61, p<.001).

Conclusion

The motivational interviewing program has the potential to improve exercise levels in persons with physical disabilities.

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Characteristics and Risk Factors for Falls in Tertiary Hospital Inpatients
Eun-Ju Choi, Young-Shin Lee, Eun-Jung Yang, Ji-Hui Kim, Yeon-Hee Kim, Hyeoun-Ae Park
J Korean Acad Nurs 2017;47(3):420-430.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.420
AbstractAbstract PDF
Abstract Purpose

The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls.

Methods

Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis.

Results

Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls.

Conclusion

The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.

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Effects of a Memory and Visual-Motor Integration Program for Older Adults Based on Self-Efficacy Theory
Eun-Hwi Kim, Soon-Rim Suh
J Korean Acad Nurs 2017;47(3):431-444.   Published online June 30, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.431
AbstractAbstract PDF
Purpose

This study was conducted to verify the effects of a memory and visual-motor integration program for older adults based on self-efficacy theory.

Methods

A non-equivalent control group pretest–posttest design was implemented in this quasi-experimental study. The participants were 62 older adults from senior centers and older adult welfare facilities in D and G city (Experimental group=30, Control group=32). The experimental group took part in a 12-session memory and visual-motor integration program over 6 weeks. Data regarding memory self-efficacy, memory, visual-motor integration, and depression were collected from July to October of 2014 and analyzed with independent t-test and Mann-Whitney U test using PASW Statistics (SPSS) 18.0 to determine the effects of the interventions.

Results

Memory self-efficacy (t=2.20, p=.031), memory (Z=-2.92, p=.004), and visual-motor integration (Z=-2.49, p=.013) increased significantly in the experimental group as compared to the control group. However, depression (Z=-0.90, p=.367) did not decrease significantly.

Conclusion

This program is effective for increasing memory, visual-motor integration, and memory self-efficacy in older adults. Therefore, it can be used to improve cognition and prevent dementia in older adults.

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