Journal of Korean Academy of Nursing

Effects of the Advanced Practice Nurse-Led Psychoeducational Program for Colorectal Cancer Survivors: Kim, Hye Kyung , Yoo, Yang-Sook; J Korean Acad Nurs 2022;52(3):245-260. Published online June 30, 2022; DOI: https://doi.org/10.4040/jkan.21207

Abstract PDF: Purpose
This study aimed to investigate the effects of an advanced practice nurse-led psychoeducational program on distress, anxiety, depression, coping with cancer (CWC), health promotion behavior (HPB), and quality of life (QOL) among colorectal cancer survivors.
Methods
This study was designed as a quasi-experimental study with a non-equivalent control group pretest-posttest. The participants were survivors of colorectal cancer who underwent follow-up care. There were 39 survivors: 19 in the experimental group and 20 in the control group. The experimental group performed a psychoeducational program for 120 minutes per session, once a week for a total of six weeks, while the control group received routine education and counseling. Distress, anxiety, depression, CWC, HPB, and QOL were investigated before, immediately after, and 4 weeks after the intervention. The data were analyzed with SPSS/WIN ver. 24.0, using repeated measures ANOVA.
Results
There were significant interactions between time and group for distress and anxiety. In addition, CWC interacted with the total of CWC and interpersonal coping, and QOL interacted with the total of QOL and functional status. However, there were no significant differences in the depression or HPB scores.
Conclusion
Based on the results of this study, we expect that this program can be used as an effective intervention for colorectal cancer survivors.

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Development and Evaluation of an Integrated Health Management Program for Psychiatric Patients with Metabolic Syndrome: Kwak, Yun Bock , Kim, Ji Young; J Korean Acad Nurs 2022;52(3):261-277. Published online June 30, 2022; DOI: https://doi.org/10.4040/jkan.21222

Abstract PDF: Purpose
This study developed an integrated health management program for metabolic syndrome in psychiatric patients and examined its effects on self-efficacy, healthy lifestyle, physiological indicators, knowledge of metabolic syndrome, attitudes toward healthy behavior, and social support.
Methods
A non-equivalent control group pretest posttest design was used. The participants were 65 psychiatric patients with metabolic syndrome in psychiatric rehabilitation centers, with 33 in the experimental group and 32 in the control group. The experimental group participants engaged in daily mobile application and walking exercises three times a week for more than 40 minutes over 8 weeks, while those in the control group were provided education booklets. The outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. Intervention effects were analyzed using the independent t-test, Mann—Whitney U test, ANCOVA, and Ranked ANCOVA.
Results
The experimental group showed a significant increase in self-efficacy (F = 8.85, p = .004, η_p2 = .13) and knowledge of metabolic syndrome (t = 2.60, p = .012, d = 0.60) compared to the control group. Additionally, the experimental group demonstrated a significant decrease in waist circumference (Z = - 2.34, p = .009, d = 0.58) and body mass index (Z = - 1.91, p = .028, d = 0.47) compared to the control group.
Conclusion
The integrated health management program for psychiatric patients with metabolic syndrome is effective in improving self-efficacy and knowledge of metabolic syndrome and decreasing physiological indicators such as waist circumference and body mass index.

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Influence of Learning Presence of Non-Face-to-Face Class Experience in Nursing Students on Academic Achievement: Mediating Effect of Learning Flow and Moderated Mediation of Digital Literacy: Ryu, Eui Jeong , Jang, Keum Seong , Kim, Eun A; J Korean Acad Nurs 2022;52(3):278-290. Published online June 30, 2022; DOI: https://doi.org/10.4040/jkan.21241

Abstract PDF: Purpose
This study aimed to identify the mediating effect of learning flow and the moderated mediation effect of digital literacy on the effect of the learning presence of non-face-to-face class experience in nursing students on academic achievement.
Methods
Participants were 272 nursing students from six universities in two different cities. A self-report questionnaire was used to measure learning presence, learning flow, digital literacy, and academic achievement. Analysis was performed using SPSS 26.0 and SPSS PROCESS Macro (4.0).
Results
The mediating effect of learning flow on the effect of learning presence on academic achievement was 0.42, and the moderated mediation index of digital literacy was 0.17. Learning flow showed a mediating effect on the relationship between learning presence and academic achievement. Digital literacy had a moderated mediation effect on the relationship between learning presence and academic achievement that was mediated by learning flow.
Conclusion
The intensity of the mediating effect of nursing students’ learning presence on academic achievement through learning flow increases as the level of digital literacy increases. These results suggest that educational programs considering the level of learning presence, learning flow, and digital literacy are required to promote the academic achievement of nursing college students.

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Images of Nurses Appeared in Media Reports Before and After Outbreak of COVID-19: Text Network Analysis and Topic Modeling: Park, Min Young , Jeong, Seok Hee , Kim, Hee Sun , Lee, Eun Jee; J Korean Acad Nurs 2022;52(3):291-307. Published online June 30, 2022; DOI: https://doi.org/10.4040/jkan.22002

Abstract PDF: Purpose
The aims of study were to identify the main keywords, the network structure, and the main topics of press articles related to nurses that have appeared in media reports.
Methods
Data were media articles related to the topic “nurse” reported in 16 central media within a one-year period spanning July 1, 2019 to June 30, 2020. Data were collected from the Big Kinds database. A total of 7,800 articles were searched, and 1,038 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4.
Results
The number of media reports related to nurses increased by 3.86 times after the novel coronavirus (COVID-19) outbreak compared to prior. Pre- and post-COVID-19 network characteristics were density 0.002, 0.001; average degree 4.63, 4.92; and average distance 4.25, 4.01, respectively. Four topics were derived before and after the COVID-19 outbreak, respectively. Pre-COVID-19 example topics are “a nurse who committed suicide because she could not withstand the Taewoom at work” andf “a nurse as a perpetrator of a newborn abuse case,” while post-COVID-19 examples are “a nurse as a victim of COVID-19,” “a nurse working with the support of the people,” and “a nurse as a top contributor and a warrior to protect from COVID-19.” Conclusion: Topic modeling shows that topics become more positive after the COVID-19 outbreak. Individual nurses and nursing organizations should continuously monitor and conduct further research on nurses’ image.

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Structural Equation Modeling for Quality of Life of Mothers of Children with Developmental Disabilities: Focusing on the Self-Help Model: Yang, Mi Ran , Yu, Mi; J Korean Acad Nurs 2022;52(3):308-323. Published online June 30, 2022; DOI: https://doi.org/10.4040/jkan.22013

Abstract PDF: Purpose
This study aimed to construct and test a predictive model for the quality of life (QOL) in mothers of children with developmental disabilities (DB). The hypothesized model included severity of illness, distress, uncertainty, self-help, and parenting efficacy as influencing factors, QOL as a consequence based on the Braden’s Self-Help Model.
Methods
The data were collected through a direct and online surveys from 206 mothers in 8 locations, including welfare or daycare centers, developmental treatment centers, and The Parents’ Coalition for the Disabled located in two provinces of Korea. Data were analysed using SPSS/WIN 23.0 and AMOS 21.0 program.
Results
The fit indices of the predictive model satisfied recommended levels; χ² = 165.79 (p < .001), normed χ² (χ² /df) = 2.44, RMR = .04, RMSEA = .08, GFI = .90, AGFI = .85, NFI = .91, TLI = .93, CFI = .95. Among the variables, distress (β = - .46, p < .001), parenting efficacy (β = .22, p < .001), and self-help (β = .17, p = .018) had direct effects on QOL. Severity of illness (β = - .61, p = .010) and uncertainty (β = - .08, p = .014) showed indirect effects. The explanatory power of variables was 61.0%.
Conclusion
The study results confirm the utility of Braden’s Self-Help Model. They provide a theoretical basis for improving QOL in mothers of children with DB. Nursing intervention strategies that can relieve mothers’ distress and uncertainty related to disease and enhance parenting efficacy and self-help behavior should be considered.

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Effect of Acculturative Stress on Multicultural Adolescents’ Life Satisfaction: Sequential Multiple Mediating Effects of Bicultural Acceptance Attitude, Self-Esteem, and Social Withdrawal -Using the 2016 Multicultural Adolescents Panel Study-: Kim, Soo Mi , Kim, Hyeon Ok; J Korean Acad Nurs 2022;52(3):324-340. Published online June 30, 2022; DOI: https://doi.org/10.4040/jkan.22030

Abstract PDF: Purpose
This study determined acculturative stress’ effect on the life satisfaction of multicultural adolescents based on Roy’s Adaptation Model and some earlier studies. Further, it examined the sequential multiple mediating effects of bicultural acceptance attitude, self-esteem, and social withdrawal on life satisfaction.
Methods
Participants included 1,163 multicultural adolescents who participated in the sixth Multicultural Adolescents Panel Study. A hypothesis test was conducted using Hayes’ Process Macro Model 81.
Results
Life satisfaction increased with a decline in acculturative stress. Each of bicultural acceptance attitude, self-esteem, and social withdrawal had a single mediating effect on the relationship between acculturative stress and life satisfaction in multicultural adolescents. The sequential multiple mediating effects of bicultural acceptance attitude and self-esteem were confirmed significant after their impact on the relationship between acculturative stress and life satisfaction was analyzed. Bicultural acceptance attitude and social withdrawal were found to have a significant sequential multiple mediating effect on the relationship, as well.
Conclusion
This study’s results demonstrate that acculturative stress reduction is critical to improving multicultural adolescents’ life satisfaction. Bicultural acceptance attitude, self-esteem, and social withdrawal have a single mediating or sequential multiple mediating effect on the relationship between multicultural adolescents’ acculturative stress and life satisfaction. The findings, which highlight mediating effects, indicate that by increasing bicultural acceptance attitude and self-esteem, and reducing social withdrawal, multicultural adolescents’ life satisfaction can be improved.

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Development and Effects of a Person-Centered Fall Prevention Program for Older Adults with Dementia in Long-Term Care Hospitals: For Older Adults with Dementia and Caregivers in LongTerm Care Hospitals: Lim, Jeong Ok , Gu, Mee Ock; J Korean Acad Nurs 2022;52(3):341-358. Published online June 30, 2022; DOI: https://doi.org/10.4040/jkan.21230

Abstract PDF: Purpose
This study examined the effects of a person-centered fall prevention program for older adults with dementia in long-term care hospitals.
Methods
A nonequivalent control group pretest-posttest design was used. The study sample included 42 older adults with dementia (experimental group: 21, control group: 21) and 42 caregivers (experimental group: 21, control group: 21). The program comprised 48 sessions held over 12 weeks and included exercise intervention with resistance and balance, dance walking (45~60 min, three times/week), cognitive and emotional intervention (35~50 min, once per week), and person-centered fall prevention education (10 min, once per week). The program for caregivers consisted of six educational sessions (i.e., fall prevention competency enhancement and person-centered care strategy education, 80 min, once per week) for six weeks. Data were collected before participation and 12 weeks after program completion from February 18 to May 12, 2019. Data analysis was conducted using the chi-square test, t-test, and Mann―Whitney U test with SPSS/WIN 21.0.
Results
The experimental group of older adults with dementia showed significant improvement in physical and cognitive functions, and a decrease in depression, and behavioral and psychological symptoms, when compared with the control group. caregivers in the experimental group exhibited significant improvement in fall-related knowledge and person-centered care of older adults with dementia compared to the control group.
Conclusion
The study findings indicate that this program was effective as a nursing intervention for fall prevention among older adults with dementia in long-term care hospitals.

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