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Volume 48(4); August 2018
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Review Article
Effectiveness of Telemonitoring Intervention in Children and Adolescents with Asthma: A Systematic Review and Meta-Analysis
Youjin Jung, Jimin Kim, Dong Ah Park
J Korean Acad Nurs 2018;48(4):389-406.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.389
AbstractAbstract PDF
Abstract Purpose

This review aimed to evaluate the effectiveness of telemonitoring (TM) in the management of children and adolescents with asthma.

Methods

We searched Ovid-MEDLINE, Ovid-EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and 5 domestic databases to identify randomized controlled trials (RCTs) published through December 2017. Two reviewers independently selected relevant studies, assessed methodological quality and extracted data. We performed a meta-analysis of TM versus usual care and summarized the intervention characteristics of included studies.

Results

Of the 3,095 articles identified, 8 RCTs (9 articles) were included in this review. The type of TM intervention of included studies was varying across studies (transmitted data, transmission frequency, data review, etc.). The pooled asthma control score was not significantly different between TM and usual care (standardized mean difference 0.04, 95% confidence interval (CI) -0.20~0.28). Another pooled analysis demonstrated no statistically significant difference in asthma exacerbation between TM and usual care (odds ratio 0.95, 95% CI 0.43~2.09). Overall, the pooled results from these studies revealed that TM did not lead to clinically significant improvements in health outcomes, but some studies in our analysis suggested that TM increased patient medication adherence and intervention adherence.

Conclusion

The current evidence base does not demonstrate any differences between TM intervention and usual care, but TM intervention might be considered a promising strategy for the delivery of self-management support for children and adolescents with asthma. Further well-designed studies are needed to assess the effects on clinical outcomes.

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Original Articles
Development and Effects of Social Learning Theory Based Eye-Health Program for Preschoolers
Sunghwa Lee, Haejung Lee, Hyungsik Seo, Jaeho Jung
J Korean Acad Nurs 2018;48(4):407-418.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.407
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to develop an eye-health program based on social learning theory (EPST) of preschoolers and evaluate its effectiveness.

Methods

A nonequivalent control group pre-post test design was utilized and 141 six-year-old preschoolers and their parents participated (experimental group=69, control group=72) in the study. The EPST in this study included eye-health education and eye exercises. Attention, memory, replay, motivation, reinforcement, and self-efficacy were used as interventional strategies. To examine the effectiveness of EPST, proficiency in eye-health activities, refractive power, and visual acuity were measured before and after the intervention. Data were analyzed with SPSS WIN 21.0 using the Shapiro-Wilk test, χ 2-test, Mann-Whitney U test and Wilcoxon signed rank test.

Results

Following the intervention, eye-health activities, refractive power, and visual acuity significantly improved in the experimental group compared to the control group.

Conclusion

The results of this study suggest that EPST is effective in improving eye-health activities, refractive power, and visual acuity in preschoolers, and its wider implementation in educational institutions will promise improved eye-health among preschoolers.

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Development and Psychometric Testing of the Clinical Nursing Competency Scale for Clinical Preceptor Use (CNCS-CP)
Eunmi Kwak, Heeyoung Oh
J Korean Acad Nurs 2018;48(4):419-431.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.419
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to develop and establish the psychometric properties of a clinical nursing competency evaluation tool to be utilized by clinical preceptors.

Methods

The initial items were identified through in-depth literature review and field interviews based on a hybrid model. Content validation of the items was evaluated through three rounds of content validity testing. Participants were 34 clinical preceptors and 443 nursing students participating in clinical practice. Data were analyzed using exploratory and confirmatory factor analysis, convergence and discriminant validity, internal consistency and inter-rater reliability.

Results

The final scale consisted of 23 items and four factors, fundamental nursing skills performance, critical thinking skills based on the nursing process, basic nursing knowledge, and professional attitude; these factor explained 69.7% of the total variance. The analysis with multi-trait/multi-item matrix correlation coefficients yielded 100.0% and 95.7 % convergence and discriminant validity, respectively. Cronbach's alpha for the total items was .95. The four subscale model tested by confirmatory factor analysis was satisfactory. Inter-rater reliability ranged from .912 to .967.

Conclusion

This scale was found to be a reliable and valid instrument that clinical preceptors can apply for evaluating the clinical nursing competency of nursing students in clinical settings.

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Effects of Group Rational Emotive Behavior Therapy on the Nurses’ Job Stress, Burnout, Job Satisfaction, Organizational Commitment and Turnover Intention
Hye-Lyun Kim, Sook-Hee Yoon
J Korean Acad Nurs 2018;48(4):432-442.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.432
AbstractAbstract PDF
Abstract Purpose

This study aimed to develop a Group REBT program with group counseling for nurses and test the effect of group counseling on their job stress, burnout, job satisfaction, organizational commitment, and turnover intention.

Methods

A quasi-experimental study with nonequivalent control group design was employed to identify the effect of the Group REBT program on nurses’ job stress, burnout, job satisfaction, organizational commitment, and turnover intention. Data were collected from 47 participants from two hospitals. The data from the experimental (n=23) and control (n=24) groups were analyzed from January 5 to April 3, 2015. The Group REBT program was conducted eight tmes in all, once a week, with each session lasting 180 minutes. The effect of experimental intervention was measured for each group using a series of structured questionnaires at each of the phases: Pre-intervention, post-intervention (immediately after intervention), and post-intervention (four weeks after intervention). Following this, the significance of the changes in the scores was tested.

Results

The scores of the experimental group, which received the Group REBT program, were compared with those of the control group; the hypotheses were supported in terms of job stress (F=8.85, p<.001), burnout (F=5.62, p=.022), job satisfaction (F=2.70, p=.042), organizational commitment (F=2.97, p=.048), and turnover intention (F=4.60, p=.012).

Conclusion

The Group REBT program was shown to be an effective intervention that could reduce nurses’ job stress and burnout and increase job satisfaction and organizational commitment. Therefore, the Group REBT program can be adopted by nursing organizations to strategically decrease nurses’ turnover intention.

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The Effects of an Acceptance-Commitment Therapy Based Stress Management Program on Hospitalization Stress, Self-Efficacy and Psychological Well-Being of Inpatients with Schizophrenia
Jae Woon Lee, Jae Hyun Ha
J Korean Acad Nurs 2018;48(4):443-453.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.443
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to construct an acceptance-commitment therapy (ACT)-based stress management program for inpatients with schizophrenia and to examine its effects on hospitalization stress, self-efficacy, and psychological well-being.

Methods

A non-equivalent control group pretest-posttest design was used. Participants were 44 inpatients with a diagnosis of schizophrenia. The experimental group (n=22) received the ACT-based stress management program twice a week for a total of four weeks. The control group (n=22) received the usual care from their primary health care providers. The study was carried out from August 7 to September 1, 2017, and data were analyzed using IBM SPSS/WIN 22.0 with a Chi-square test, Fisher's exact test, and an independent t-test.

Results

The experimental group showed a significant decrease in hospitalization stress (t=5.09, p<.001) and an increase in self-efficacy (t=2.44, p=.019). However, there was no significant difference in psychological well-being between the two groups (t=0.13, p=.894).

Conclusion

The results of this study suggest that the ACT-based stress management program can be used as an effective mental health nursing intervention for hospitalization stress and self-efficacy for inpatients with schizophrenia.

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Factors Influencing Psychosocial Well-Being in Family Caregivers of People with Amyotrophic Lateral Sclerosis
Hyeon Sik Chu, Young Ran Tak, Seung Hyun Kim
J Korean Acad Nurs 2018;48(4):454-464.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.454
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify factors influencing psychosocial well-being in family caregivers of patients with amyotrophic lateral sclerosis (ALS).

Methods

A descriptive correlational design was used. The transactional model of stress and coping was used to investigate the psychosocial well-being of 137 family caregivers of patients with ALS. Data were collected through self-reported questionnaires from January to November 2016. Data were analyzed using an independent t-test, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis with the SPSS WIN 21.0 program.

Results

The regression model had an adjusted R2 of .49, which indicated that meaning-focused coping, social support, ALS patient-family caregiver relationship (especially a spousal relationship), and tracheostomy were significant predictors of caregivers’ psychosocial well-being.

Conclusion

Meaning-focused coping and social support significantly influenced caregivers’ psychosocial well-being. Therefore, interventions to improve caregivers’ psychosocial well-being must focus on increasing meaning-focused coping and social support resources.

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The Effects of Hand Massage in Patients Who Underwent Transradial Percutaneous Coronary Intervention
Eun Sil Shin, Myung-Hee Kim
J Korean Acad Nurs 2018;48(4):465-474.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.465
AbstractAbstract PDF
Abstract Purpose

This study aimed to determine the effect of hand massage in patients who underwent transradial percutaneous coronary intervention.

Methods

This was a quasi-experimental study with a nonequivalent control group and non-synchronized design. The study included 30 patients in the experimental group and 30 in the control group. Hand massage was performed 2 times for 5 minutes each in the experimental group and the control group only received usual nursing interventions. Pain, level of discomfort, and vital signs were defined as key outcome measures, and the data were analyzed using the chi-square test, an independent t-test, Mann-Whitney U test, repeated-measures analysis of variance, and Friedman test.

Results

Significant differences were observed between the 2 groups in the pain score (F=7.91, p=.003), discomfort score (F=18.15, p<.001), pulse (F=12.92, p<.001), and respiration rate (χ 2=19.35, p<.001).

Conclusion

Hand massage can be a helpful nursing intervention for transradial percutaneous coronary intervention by reducing pain and discomfort to a considerable degree.

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Differences in Factors Associated with Depressive Symptoms between Urban and Rural Female Adolescents in Korea
Gyuyoung Lee, Ok Kyung Ham, Bo Gyeong Lee, Abuan Micah Kim
J Korean Acad Nurs 2018;48(4):475-484.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.475
AbstractAbstract PDF
Abstract Purpose

To examine the prevalence of depressive symptoms and differentiate factors associated with them in urban and rural areas by applying the Ecological Models of Health Behavior.

Methods

We employed a cross-sectional design and convenience sample of 460 female adolescents. The instruments included the Adolescent Mental-Health Problem-Behavior Questionnaire (AMPQ-II) and the Beck Depression Inventory (BDI).

Results

Depressive symptoms were confirmed in 15.7% of urban adolescents and 22.9% of rural adolescents (p<.05). In the urban group, perception of health and stress associated with school performance were significantly associated with depressive symptoms. In the rural group, aca-demic/internet related problems and rule violations were significantly associated with depressive symptoms (p<.05). General life happiness, worry/ anxiety, and mood/suicidal ideation were common factors in both urban and rural areas (p<.05).

Conclusion

Multiple factors were associated with depressive symptoms, and those significant factors differed between urban and rural female youths. Accordingly, tailored approaches are required considering urban and rural differences. The approaches should include intrapersonal, interpersonal, and organizational levels of interventions.

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Impact of Uncertainty on the Anxiety of Hospitalized Pregnant Women Diagnosed with Preterm Labor: Focusing on Mediating Effect of Uncertainty Appraisal and Coping Style
Eun Mi Kim, Sehoon Hong
J Korean Acad Nurs 2018;48(4):485-496.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.485
AbstractAbstract PDF
Abstract Purpose

This study aimed to test the mediating effect of uncertainty appraisal and coping style in the relation between uncertainty and anxiety in hospitalized pregnant women diagnosed with preterm labor.

Methods

The participants were 105 pregnant women diagnosed with preterm labor in hospitals in Korea. Data were collected from July to October 2017. The measurements included the Uncertainty in Illness Scale, Uncertainty Appraisal Scale, Coping Style Scale, and State Anxiety Inventory. Data were analyzed using descriptive statistics, an independent t-test, correlation, and multiple regression following the Baron and Kenny method and Sobel test for mediation.

Results

The mean score for anxiety was 2.29 out of 4.00 points and for uncertainty it was 2.46 out of 5.00 points. There were significant correlations among uncertainty, uncertainty danger appraisal, uncertainty opportunity appraisal, problem-focused coping, emotion-focused coping, and anxiety. Uncertainty danger appraisal (β=.64, p<.001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=4.54, p<.001). Uncertainty opportunity appraisal (β=-.45, p<.001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=3.28, p<.001). Emotion-focused coping (β=-.23, p=.021) had a partial mediating effect in the relation between uncertainty and anxiety (Z=2.02, p=.044).

Conclusion

Nursing intervention programs focusing on managing uncertainty appraisal and improving emotion-focused coping are highly recommended to decrease anxiety in hospitalized pregnant women diagnosed with preterm labor.

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