Journal of Korean Academy of Nursing

Volume 49(3); June 2019

Review Article

Effects of Reminiscence Therapy on Depressive Symptoms in Older Adults with Dementia: A Systematic Review and Meta-Analysis: Kyungsoo Kim, Jia Lee; J Korean Acad Nurs 2019;49(3):225-240. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.225

Abstract Purpose

The purpose of this study was to evaluate the effects of reminiscence therapy on depressive symptoms in older adults with dementia using a systematic review and meta-analysis.

Methods

Randomized controlled trials (RCTs) published from January 2000 to January 2018 were searched through Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), Korean Medical Database (KMbase), KoreaMed, PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Ovid MEDLINE. Two researchers independently performed the search, selection, and coding. Comprehensive Meta-Analysis 3.0 was used for meta-analysis, and Review Manager program 5.3 was used for quality assessment.

Results

Out of the 1,250 retrieved articles, 22 RCTs were selected for analysis. The overall effect size of reminiscence therapy for mitigating depressive symptoms in older adults with dementia was -0.62 (95% Cl: -0.92 to -0.31). The effect size was greater in older adults under 80, those with less disease severity, and those for whom the therapy session lasted less than 40 minutes.

Conclusion

Reminiscence therapy is an effective non-pharmacological therapy to improve depressive symptoms in older adults with dementia. Because its effectiveness is also influenced by age, disease severity, and application method, it is necessary to consider treatment designs based on individual characteristics as well as methodological approaches.

Citations

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Group reminiscence therapy interventions in non-clinical older adults: A systematic review
Ali Eryılmaz, Emre Yıldırım, Hacer Yıldırım Kurtulus, Murat Yıldırım
Geriatric Nursing.2025; 63: 35. CrossRef
Evaluation of the Influence of Garden Therapy on Memory Decline and Depression in Older Adults with Cognitive Impairments
Chohye Youn, Minji Kang, Hyejin Kim, Hyeyoon Kim, Jiyun Choi, Suyeon Lee, Juyoung Lee
Journal of Environmental Science International.2025; 34(3): 125. CrossRef
Effects of reminiscence interventions on depression and anxiety: a meta-analysis of randomized controlled trials
Martin Pinquart
Aging & Mental Health.2024; 28(5): 717. CrossRef
Effects of reminiscence therapy on quality of life and life satisfaction of the elderly in the community: a systematic review
Eunyoung Shin, Myeongshin Kim, Seyoon Kim, Sohyune Sok
BMC Geriatrics.2023;[Epub] CrossRef
Transcultural Pilot Study of the Efficacy of Reminiscence Therapy for Mexican and Spanish Older Adults with Different Levels of Cognitive Decline
Alba Villasán-Rueda, Antonio Sánchez-Cabaco, Manuel Mejía-Ramírez, Rosa Marina Afonso, Eduardo Castillo-Riedel
Journal of Cross-Cultural Gerontology.2023; 38(4): 371. CrossRef
Cross-cultural effects of reminiscence therapy on life satisfaction and autobiographical memory of older adults: a pilot study across Mexico and Spain
Alba Villasán Rueda, Antonio Sánchez Cabaco, Manuel Alejandro Mejía-Ramírez, Rosa Marina Afonso, Eduardo Castillo-Riedel
Alzheimer's Research & Therapy.2023;[Epub] CrossRef
Efficacy of group reminiscence therapy based on Chinese traditional festival activities (CTFA-GRT) on loneliness and perceived stress of rural older adults living alone in China: a randomized controlled trial
Shasha Li, Yanyan Dai, Yuqiu Zhou, Jiayuan Zhang, Chiteng Zhou
Aging & Mental Health.2022; 26(7): 1377. CrossRef
Behavioral and Psychological Symptoms and Associated Factors in Community-Dwelling Persons at the First Time of Dementia Diagnosis
Gijung Jung, Jia Lee
International Journal of Environmental Research and Public Health.2022; 19(13): 7765. CrossRef

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Original Articles

A Structural Equation Model for Happiness in Mothers with Young Children: Mijung Yeom, Soo Yang; J Korean Acad Nurs 2019;49(3):241-253. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.241

Abstract PDF

Abstract Purpose

This study aimed to develop and test a model of the happiness of mothers with young children based on the stress-coping-adaptation model of Lazarus and Folkman.

Methods

The data collection period was from May to July 2016. A self-report questionnaire was used to collect data from 210 mothers with children under 5 years of age living in Seoul, Gyeonggi, and Gangwon provinces. The exogenous variable was parenting stress, and the endogenous variables were parenting alliance, depression, optimism, ways of coping, and happiness. Data from 201 questionnaires were analyzed using the SPSS 22.0 and AMOS 20.0 programs. Data analyses included descriptive statistics, factor analysis, and structural equation modeling.

Results

The final modified model showed a reasonable fit to the data, and out of 25 paths, 13 were statistically significant. This model explained 78.4% of the variance in the happiness of mothers with young children and confirmed that depression, optimism, parenting alliance, and social support-focused coping have a direct effect on the subject's happiness. Parenting stress also influenced happiness through parenting alliance, depression, and optimism.

Conclusion

In order to bolster the happiness of mothers with young children, positive psychological interventions that can minimize psychological vulnerabilities, such as depression, and that can enhance their strengths, such as optimism, may serve as effective ways of coping with and adapting to stress.

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Environment Factors Affecting Childhood Obesity: Voices from Students, Parents, and Teachers with Photograph: Eunok Park, Hyo Young Lee; J Korean Acad Nurs 2019;49(3):254-262. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.254

Abstract PDF

Abstract Purpose

This study aimed to explore the environmental factors affecting childhood obesity using photovoice from the perspectives of students, parents, and teachers in the community.

Methods

Six school students, seven parents, and seven school teachers completed an assignment requiring them to take 24 pictures and participate in group discussions. After training session, the participants were asked to take pictures associated with food and physical activity environments related to childhood obesity at home, school, and within their communities for two weeks and to submit the pictures with records. Each group had four sessions for discussion.

Results

School cafeteria, convenience stores near schools, instant food and fast food joints, food delivery, and high-calorie snacks comprised the food environmental factors. Lack of physical activity classes at school, commuting by car, barriers to physical activity, and use of smart-phone were environmental factors that inhibited physical activity.

Conclusion

To reduce childhood obesity, the creation of a supportive environment for encouraging the consumption of healthy foods and enhancing physical activity should be considered. Modifications of and improvement to the obesogenic environment might be a good strategy to prevent and reduce childhood obesity.

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A Qualitative Study on Interpersonal Relationships of Patients with Facial Burn Injuries: Phenomenological Study: Myungsook Kil, Yongmi Lee; J Korean Acad Nurs 2019;49(3):263-273. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.263

Abstract PDF

Abstract Purpose

The purpose of the study was to explore the experience of patients with facial burn injuries regarding their interpersonal relationships.

Methods

The phenomenological research method was used. Participants of the study consisted of five males and three females. Data were collected through individual in-depth interviews from November, 2014 to February, 2015 and analyzed using Colaizzi's method.

Results

Five theme clusters were extracted that described patients’ experiences. They are “being a lonely foreigner,” “closing my mind toward the world,” “hiding hurt feelings,” “companion of my face,” and “communicating with the world”.

Conclusion

The results of this study provide a deep understanding and insight into the experience of interpersonal relationships among facial burn patients. The development of a comprehensive program including physical, psychological, and social aspects is recommended to address the problems facial burn patients encounter in interpersonal relationships and to facilitate interaction.

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Living With Stigma and Low Self-esteem Among Individuals With Burn Injuries: A Cross-sectional Study
Xiaoxue Wu, Yueyun Hu, Ailing Hu
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Effects of Mobile Navigation Program in Colorectal Cancer Patients based on Uncertainty Theory: Kyengjin Kim, Wanju Park; J Korean Acad Nurs 2019;49(3):274-285. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.274

Abstract PDF

Abstract Purpose

This study aimed to examine the effects of a mobile navigation program on uncertainty, resilience, and growth through uncertainty in colorectal cancer patients.

Methods

To verify the effectiveness of the mobile navigation program, 61 participants diagnosed with colorectal cancer undergoing surgery were selected. A nonequivalent control group nonsynchronized design was used to evaluate the program. Uncertainty was measured using the Korean version of the Uncertainty in Illness Scale, resilience was measured using the Korean version of the Connor-Davidson Resilience Scale, and growth through uncertainty was measured using the Growth through Uncertainty Scale.

Results

Compared with the control group, patients in the mobile navigation program group showed significant differences in scores for uncertainty (F=7.22, p=.009) and resilience (F=4.31, p=.042), but not for growth through uncertainty (F=2.76, p=.102).

Conclusion

These results suggest that the mobile navigation program has positive effects on decreasing uncertainty and increasing resilience among colorectal cancer patients. The mobile navigation program could play a significant role in assisting colorectal cancer patients in regard to the continuity and usability of the program.

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The Effect of Nurse's Emotional Labor on Turnover Intention: Mediation Effect of Burnout and Moderated Mediation Effect of Authentic Leadership: Soo Yang Na, Hanjong Park; J Korean Acad Nurs 2019;49(3):286-297. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.286

Abstract PDF

Abstract Purpose

To investigate the effect of nurses’ emotional labor on their turnover intention that was mediated by burnout and to examine the moderated mediation effect of authentic leadership.

Methods

A total of 227 nurses working at two general hospitals in Seoul were recruited from March 21 to May 6 in 2016. Emotional labor including surface acting and deep acting; burnout factors such as emotional exhaustion and personal accomplishment; and turnover intention were assessed. The data were analyzed using SPSS 22.0 and SPSS PROCESS macro.

Results

Surface acting significantly increased emotional exhaustion and reduced personal accomplishment. Deep acting significantly increased personal accomplishment. Emotional exhaustion significantly increased turnover intention. Conversely, personal accomplishment significantly reduced turnover intention. Surface acting had an indirect effect on turnover intention that was mediated by emotional exhaustion. Deep acting had an indirect effect on turnover intention that was mediated by personal accomplishment. Authentic leadership had a moderated mediation effect on the relationship between surface acting and turnover intention that was mediated by emotional exhaustion.

Conclusion

The findings of this study indicate that the establishment of strong authentic leadership by head nurses would help nurses reduce their burnout and turnover intention. Conducting intervention studies would be also important to promote better work environments that would enable nurses to fortify the positive aspect of emotional labor and to reduce their burnout levels.

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Mediation Effect of Self-Efficacy on the Relationship between Perceived Self-Management Support and Health-Related Quality of Life among Cancer Survivors: Bo Gyeong Lee, Tae Sook Lee, Soo Hyun Kim; J Korean Acad Nurs 2019;49(3):298-306. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.298

Abstract PDF

Abstract Purpose

This study aimed to examine the levels of perceived self-management support, self-efficacy for self-management, and health-related quality of life (HRQoL) in cancer survivors, and to identify the mediating effect of self-efficacy in the relationship between perceived self-management support and HRQoL.

Methods

This study used a descriptive correlational design. Two hundred and four cancer survivors who had completed treatment participated in the study. Measurements included the Patient Assessment of Chronic Illness Care Scale, the Korean version of the Cancer Survivors’ Self-Efficacy Scale, and the Medical Outcomes Study Short Form-36. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and multiple regression analysis using Baron and Kenny's method for mediation.

Results

The mean score for perceived self-management support was 3.35 out of 5 points, self-efficacy was 7.26 out of 10 points, and HRQoL was 65.90 out of 100 points. Perceived self-management support was significantly positively correlated with self-efficacy (r=.29, p<.001) and HRQoL (r=.27, p<.001). Self-efficacy was also significantly correlated with HRQoL (r=.59, p<.001). Furthermore, self-efficacy (β=.55, p<.001) had a complete mediating effect on the relationship between perceived self-management support and HRQoL (Z=3.88, p<.001).

Conclusion

The impact of perceived self-management support on HRQoL in cancer survivors was mediated by self-efficacy for self-management. This suggests that strategies for enhancing self-efficacy in cancer survivors should be considered when developing self-management interventions for improving their HRQoL.

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Psychosocial Well-Being of Clinical Nurses Performing Emotional Labor: A Path Analytic Model Approach: Yoonjeong Lee, Hyunli Kim; J Korean Acad Nurs 2019;49(3):307-316. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.307

Abstract PDF

Abstract Purpose

This study was conducted to investigate the influence of emotional expressivity, emotional intelligence, affectivity, job autonomy, social support, and emotional labor on clinical nurses’ individual well-being and to provide guidelines for interventions and strategies for its improvement.

Methods

The sample consisted of 207 nurses recruited from a general hospital in Korea. The participants completed a structured self-report questionnaire comprising measures of emotional expressivity, emotional intelligence, positive affectivity, negative affectivity, job autonomy, supervisor support, coworker support, deep acting, surface acting, emotional exhaustion, and job satisfaction. Data were analyzed using SPSS statistics 22.0 and AMOS 22.0.

Results

The final model was a good fit for the data based on the model fit indices. In the path analysis, surface acting, negative affectivity, supervisor support, and coworker support had statistically significant effects on emotional exhaustion, explaining 29.0% of the variance. Deep acting, emotional exhaustion, positive affectivity, and emotional intelligence had statistically significant effects on job satisfaction, explaining 43.0% of the variance.

Conclusion

Effective strategies to improve clinical nurses’ individual well-being should focus on surface acting, deep acting, affectivity, social support, and emotional intelligence. The results of this study can be utilized as base data to manage emotional labor and improve clinical nurses’ individual well-being.

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Validity and Reliability of the Korean version of the Wong and Law Emotional Intelligence Scale for Nurses
Hye-Ja Park, Soyoung Yu
Sage Open.2021;[Epub] CrossRef

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Effect of Ghrelin on Memory Impairment in a Rat Model of Vascular Dementia: Jong-Min Park, Youn-Jung Kim; J Korean Acad Nurs 2019;49(3):317-328. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.317

Abstract PDF

Abstract Purpose

The purpose of this study was to identify the effect of ghrelin on memory impairment in a rat model of vascular dementia induced by chronic cerebral hypoperfusion.

Methods

Randomized controlled groups and the posttest design were used. We established the representative animal model of vascular dementia caused by bilateral common carotid artery occlusion and administered 80 μg/kg ghrelin intraperitoneally for 4 weeks. First, behavioral studies were performed to evaluate spatial memory. Second, we used molecular biology techniques to determine whether ghrelin ameliorates the damage to the structure and function of the white matter and hippocampus, which are crucial to learning and memory.

Results

Ghrelin improved the spatial memory impairment in the Y-maze and Morris water maze test. In the white matter, demyelination and atrophy of the corpus callosum were significantly decreased in the ghrelin-treated group. In the hippocampus, ghrelin increased the length of hippocampal microvessels and reduced the microvessels pathology. Further, we confirmed angiogenesis enhancement through the fact that ghrelin treatment increased vascular endothelial growth factor (VEGF)-related protein levels, which are the most powerful mediators of angiogenesis in the hippocampus.

Conclusion

We found that ghrelin affected the damaged myelin sheaths and microvessels by increasing angiogenesis, which then led to neuroprotection and improved memory function. We suggest that further studies continue to accumulate evidence of the effect of ghrelin. Further, we believe that the development of therapeutic interventions that increase ghrelin may contribute to memory improvement in patients with vascular dementia.

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M.L. Perea Vega, M.S. Sanchez, G. Fernández, M.G. Paglini, M. Martin, S.R. de Barioglio
Neurobiology of Learning and Memory.2021; 179: 107409. CrossRef

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Reversals in Decisions about Life-Sustaining Treatment and Associated Factors among Older Patients with Terminal Stage of Cardiopulmonary Disease: Jung-Ja Choi, Su Hyun Kim, Shin-Woo Kim; J Korean Acad Nurs 2019;49(3):329-339. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.329

Abstract PDF

Abstract Purpose

The purpose of this study was to investigate the frequency, patterns, and factors of reversals in decisions about life-sustaining treatment (LST) among older patients with terminal-stage chronic cardiopulmonary disease.

Methods

This was a retrospective correlational descriptive study based on medical chart review. De-identified patient electronic medical record data were collected from 124 deceased older patients with terminal-stage cardiopulmonary disease who had made reversals of LST decisions in an academic tertiary hospital in 2015. Data were extracted about the reversed LST decisions, LST treatments applied before death, and patients’ demographic and clinical factors. Multivariate logistic regression analysis was used to identify the factors associated with the reversal to higher intensity of LST treatment.

Results

The use of inotropic agents was the most frequently reversed LST treatment, followed by cardiopulmonary resuscitation, intubation, ventilator therapy, and hemodialysis. Inconsistency between the last LST decisions and actual treatments occurred most often in hemodialysis. One-third of the reversals in LST decisions were made toward higher intensity of LST treatment. Patients who had lung diseases (vs. heart diseases); were single, divorced, or bereaved (vs. married); and had an acquaintance as a primary decision maker (vs. the patients themselves) were significantly more likely to reverse the LST decisions to higher intensity of LST treatment.

Conclusion

This study demonstrated the complex and turmoil situation of the LST decision-making process among older patients with terminal-stage cardiopulmonary disease and suggests the importance of support for patients and families in their LST decision-making process.

Citations

Citations to this article as recorded by

Characteristics of Life-Sustaining Treatment Decisions: National Data Analysis in South Korea
Jiyeon Choi, Heejung Jeon, Ilhak Lee
Asian Bioethics Review.2024; 16(1): 33. CrossRef
Decision and Practice of End-of-Life Care in Lung Disease Patients with Physicians Orders for Life Sustaining Treatment
Yu Mi Oh, Yoon Na Kang, Soo Jung Han, Jeong Hye Kim
The Korean Journal of Hospice and Palliative Care.2023; 26(1): 7. CrossRef
Same, same, but different? A longitudinal, mixed-methods study of stability in values and preferences for future end-of-life care among community-dwelling, older adults
Malin Eneslätt, Gert Helgesson, Carol Tishelman
BMC Palliative Care.2021;[Epub] CrossRef
Preferences for life-sustaining treatment in Korean adults: a cross-sectional study
HyunChul Youn, Suk-young Lee, Han-yong Jung, Shin-Gyeom Kim, Seung‑Hyun Kim, Hyun-Ghang Jeong
BMJ Open.2021; 11(1): e039470. CrossRef
Life-Sustaining Treatment in End-Stage Liver Disease Patients: Patients’ Decisions and Results
Hyun Jung Jung, Jeong Yun Park
The Korean Journal of Hospice and Palliative Care.2020; 23(2): 85. CrossRef

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Nutritional Status of Liver Transplantation Recipients and Factors Influencing Nutritional Status: SinYoung Hwang, Smi Choi-Kwon; J Korean Acad Nurs 2019;49(3):340-348. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.340

Abstract PDF

Abstract Purpose

This study aimed to investigate the nutritional status of liver transplantation (LT) recipients and explore certain factors that influence nutritional status, including dietary patterns and physical activities.

Methods

This was a cross-sectional, descriptive study. The subjects included 211 LT recipients at a medical center outpatient clinic located in Seoul, Korea. The nutritional status, dietary patterns, and physical activities of each subject were measured using the body mass index (BMI), Mini Dietary Assessment (MDA), and Global Physical Activity Questionnaire. Independent t-test, one-way analysis of variance, and multiple linear regression analysis were used to analyze the data.

Results

The percentages of living and deceased donor LTs were 81.0% and 19.0%, respectively. The mean BMIs pre- and post-LT were 23.88 and 23.16 kg/m², respectively, and the average MDA score was 36.55. More than 60.0% of the subjects had a moderate or high level of physical activity. In multivariate analysis, a higher BMI before LT (β=.72, p<.001), a lower Model for End-stage Liver Disease (MELD) score (β=-.18, p<.001), and being male (β=-.10, p=.024) contributed to better nutritional status post-LT. Patients within six months of LT were less engaged in muscle exercises than those post six months of LT (p=.020).

Conclusion

LT recipients in Korea have good nutritional status and a good level of physical activity. To improve recipients’ post-LT nutritional status, the pre-LT nutritional status should be considered, particularly in those with a higher MELD score. In addition, physical activity including muscle-strengthening exercises should be encouraged from an earlier stage.

Citations

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Nutritional Intake after Liver Transplant: Systematic Review and Meta-Analysis
Lynsey N. Spillman, Angela M. Madden, Holly Richardson, Fumiaki Imamura, Danielle Jones, Marilyn Nash, Hong Kai Lim, Holly N. Hellawell, Kirsten L. Rennie, Linda M. Oude Griep, Michael Allison, Simon J. Griffin
Nutrients.2023; 15(11): 2487. CrossRef
Impact of Self-esteem and Social support on Self-care Performance in Liver Transplantation Recipients
Hyun Jung Jung, Young-Ju Kim
The Korean Journal of Rehabilitation Nursing.2020; 23(2): 132. CrossRef

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Experiences of Ego Integrity Recovery in Elderly Cancer Patients: Grounded Theory Approach: Han-Gyo Choi, Hye-Ah Yeom; J Korean Acad Nurs 2019;49(3):349-360. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.349

Abstract PDF

Abstract Purpose

This study was conducted to derive a substantive theory on lived experiences of elderly cancer patients.

Methods

The data were collected from February to March 2018 through in-depth personal interviews with 14 elderly cancer patients. The collected data were analyzed based on Corbin and Strauss's grounded theory.

Results

The core category was “the journey to find balance in daily lives as a cancer patient by recovering disturbed ego integrity.” The core phenomenon was “shattered by suffering from cancer,” and the causal conditions were “physical change” and “limitations in daily life.” The contextual conditions were “decreased self-esteem,” “feelings of guilt toward the family,” and the sense of “economic burden.” The participants’ action and interaction strategies were “maintaining or avoiding social relations,” “seeking meaning of the illness,” “falling into despair,” and “strengthening the willingness to battle the cancer.” The intervening conditions were “support from health care providers and family,” “dissatisfaction with health care providers,” “spiritual help from religion,” and “the improvement or worsening of health conditions.” The consequences were “having a new insight for life,” “living positively along with cancer illness,” and “the loss of willingness to live.” A summary of the series of processes includes the “crisis stage,” “reorganizing stage,” and the “ego integration stage.”

Conclusion

This study explored the holistic process of ego integrity impairment and the recovery experience of elderly cancer patients. This study is expected to be used as a basis for the development of nursing interventions that can support patients when coping with all stages of their cancer illness trajectory.

Citations

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Yong Hwan Hyeon, Kyoung Ja Moon
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Geriatric Nursing.2021; 42(6): 1349. CrossRef
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Miseon Bang, Suhye Kwon, Seonnyeo Kim, Haeyun Shin, Eunyoung Seo
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