Journal of Korean Academy of Nursing

Volume 47(5); October 2017

Review Article

An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group: Dasom Kim, Insook Lee; J Korean Acad Nurs 2017;47(5):577-588. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.577

Abstract Purpose

This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review.

Methods

We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers.

Results

Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach.

Conclusion

As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements.

Citations

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Prenatal nursing intervention studies published in Korean nursing journals: a scoping review
Seo Yun Kim, Hae Won Kim
Korean Journal of Women Health Nursing.2020; 26(2): 109. CrossRef
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Su Hyun Kim, Hyang-In Cho Chung
Journal of Korean Academy of Nursing.2019; 49(6): 677. CrossRef
An Integrative Review of Intervention for School-bullying Perpetrators
Yul-mai Song, Moonju Song, Sunah Kim
Journal of Korean Academy of Psychiatric and Mental Health Nursing.2018; 27(4): 355. CrossRef

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Original Articles

Development of the Transition Shock Scale for Newly Graduated Nurses: Eun-Young Kim, Jung Hee Yeo, Kyeong Im Yi; J Korean Acad Nurs 2017;47(5):589-599. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.589

Abstract PDF

Abstract Purpose

The purpose of this study was to develop a scale to assess the transition shock experienced by newly graduated nurses, and test the validity and reliability of the scale.

Methods

The initial items were identified through a review of literature and in-depth interviews with nine newly graduated nurses. Content validation of the items was evaluated by five nurse professors and three nurses. Participants were 269 newly graduated nurses who worked at six acute care hospitals in Busan, Ulsan, and Yangsan, South Korea. Data were analyzed using item analysis, exploratory and confirmatory factor analysis, criterion related validity, and internal consistency.

Results

The final scale consisted of 18 items and six factors (conflict between theory and practice, overwhelming workload, loss of social support, shrinking relationship with co-workers, confusion in professional nursing values, and incongruity in work and personal life), which explained 71.3% of the total variance. The six subscale model was validated by confirmatory factor analysis. Cronbach's alpha for the total items was. 89. Convergent validity was evaluated by analyzing total correlation with burnout (r=.71, p<.001) and turnover intention (t=5.84, p<.001).

Conclusion

This scale can be used in the development of nursing interventions to reduce the transition shock experienced by newly graduated nurses.

Citations

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A Comparison of Hospice Care Research Topics between Korea and Other Countries Using Text Network Analysis: Eun-Jun Park, Youngji Kim, Chan Sook Park; J Korean Acad Nurs 2017;47(5):600-612. Published online October 31, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.600

Abstract PDF

Purpose

This study aimed to identify and compare hospice care research topics between Korean and international nursing studies using text network analysis.

Methods

The study was conducted in four steps: 1) collecting abstracts of relevant journal articles, 2) extracting and cleaning keywords (semantic morphemes) from the abstracts, 3) developing co-occurrence matrices and text-networks of keywords, and 4) analyzing network-related measures including degree centrality, closeness centrality, betweenness centrality, and clustering using the NetMiner program. Abstracts from 347 Korean and 1,926 international studies for the period of 1998–2016 were analyzed.

Results

Between Korean and international studies, six of the most important core keywords-“hospice,” “patient,” “death,” “RNs,” “care,” and “family”-were common, whereas “cancer” from Korean studies and “palliative care” from international studies ranked more highly. Keywords such as “attitude,” “spirituality,” “life,” “effect,” and “meaning” for Korean studies and “communication,” “treatment,” “USA,” and “doctor” for international studies uniquely emerged as core keywords in recent studies (2011~2016). Five subtopic groups each were identified from Korean and international studies. Two common subtopics were “hospice palliative care and volunteers” and “cancer patients.”

Conclusion

For a better quality of hospice care in Korea, it is recommended that nursing researchers focus on study topics of patients with non-cancer disease, children and family, communication, and pain and symptom management.

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Effects of Education about Action Plans according to Self-Monitoring on Self-Management Adherence, Knowledge, Symptom Control, and Quality of Life among Adult Asthma Patients: A Randomized Controlled Trial: Ja Yun Choi, Young-Ran Kweon; J Korean Acad Nurs 2017;47(5):613-623. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.613

Abstract PDF

Abstract Purpose

This study was conducted to identify the effects of education regarding action plans according to a self-monitoring program on self-management adherence, knowledge, symptom control, and health-related quality of life (HRQoL) among adults with asthma.

Methods

Thirty-four patients were randomly assigned to the intervention group and thirty-two to the control group in this study. A tailored 50-minute intervention based on the contents of self-monitoring and action plans developed by the National Heart Lung and Blood Institute was provided to the intervention group. Structured and well developed questionnaires were used to measure the dependent variables.

Results

There were no differences in all general and clinical characteristics, and the dependent variables between two groups in the pre-test. In the post-test, there were differences in the level of self-management adherence (t=4.41, p<.001), knowledge (t=2.26, p=.027), symptom control (t=-2.56, p=.013), and total HRQoL (t=2.14, p=.036) between the two groups, although there was a difference only in the sub-domain of emotion (t=2.03, p=.047) in HRQoL.

Conclusion

This study found that action plans according to self-monitoring that enhance a participatory interaction in the treatment and care could help patients with moderate to severe asthma to engagead equately in self-care, to control their symptoms, and to improve their HRQoL. Further studies are still needed to identify longitudinal effects of this program.

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Optimizing asthma care in the elderly: A guidelines-based therapeutic approach for enhanced diagnosis and management
Shivshankar M. Nagrik, Shatrughna U. Nagrik, Durgesh B. Thakur, Sanjana R. Bali, Mayuri G. Zore, Satish Shelke
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Structural Equation Modeling on Health-Related Quality of Life in Adults with Epilepsy: Jeong Ok Ko, Myung Ha Lee; J Korean Acad Nurs 2017;47(5):624-637. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.624

Abstract PDF

Abstract Purpose

This study aimed to identify variables influencing the health-related quality of life (HRQoL) of adults with epilepsy in order to establish a structural model and design an intervention strategy to improve patients’ HRQoL.

Methods

The selected subjects were 212 patients with epilepsy aged between 18 and 70 years who were currently receiving treatment from hospital, general hospital, and clinic. They were surveyed using a structured questionnaire.

Results

The goodness of fit measures of the final hypothetical model were as follows: c²/df=2.51, GFI=.91, AGFI=.90, CFI=.96, SRMR=.04, NFI=.93, and RMSEA=.08. The major variables influencing the HRQoL of adults with epilepsy were epilepsy self-efficacy, depression, social support, and side effects of anti-epileptic drugs (AEDs), which were significant in the mentioned order, whereas the duration of AEDs use and perceived stigma did not show any effects. Six variables accounted for 75.6% of HRQoL. Variables having a direct and total effect on the HRQoL of adults with epilepsy were the side effects of AEDs, social support, epilepsy self-efficacy, and depression, and those with an indirect effect were the side effects of AEDs and social support.

Conclusion

It is necessary to accurately identify the side effects of AEDs in adults with epilepsy and accurately observe the physical changes caused by depression. In addition, it is imperative to establish an active and effective nursing intervention program to strengthen the self-efficacy of the patients and to improve their quality of life through social support provided by family members and medical professionals.

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Effects of a Positive Psychotherapy Program on Positive Affect, Interpersonal Relations, Resilience, and Mental Health Recovery in Community-Dwelling People with Schizophrenia: Jinhee Kim, Hyunjoo Na; J Korean Acad Nurs 2017;47(5):638-650. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.638

Abstract PDF

Abstract Purpose

Recently, the interest in positive psychotherapy is growing, which can help to encourage positive relationships and develop strengths of people. This study was conducted to investigate the effects of a positive psychotherapy program on positive affect, interpersonal relations, resilience, and mental health recovery in community-dwelling people with schizophrenia.

Methods

The research was conducted using a randomized control group pretest-posttest design. A total of 57 adults with schizophrenia participated in this study. The study participants in experimental group received a positive psychotherapy program (n=28) and the participants in control group received only the usual treatment in community centers (n=29). The positive psychotherapy program was provided for 5 weeks (of 10 sessions, held twice/week, for 60 minutes). The study outcomes included positive affect, interpersonal relations, resilience, and mental health recovery. The collected data were analyzed using repeated measures ANOVA for examining study hypothesis.

Results

Results showed that interpersonal relations (F=11.83, p=.001) and resilience (F=9.62, p=.003) significantly increased in the experimental group compared to the control group. Although experimental group showed a slight increase in positive affect, it was not significant.

Conclusion

The study findings confirm that the positive psychotherapy program is effective for improving interpersonal relations and resilience of community-dwelling people with schizophrenia. Based on the findings, we believe that the positive psychotherapy program would be acceptable and helpful to improve recovery of mental health in schizophrenia.

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Effects of a Sleep Improvement Program Combined with Aroma-Necklace on Sleep, Depression, Anxiety and Blood Pressure in Elderly Women: Nami Chun, Myoungsuk Kim, Gie ok Noh; J Korean Acad Nurs 2017;47(5):651-662. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.651

Abstract PDF

Abstract Purpose

The purpose of this study was to evaluate the effectiveness of a sleep improvement program combined with an aroma-necklace on sleep, depression, anxiety, and blood pressure in elderly women living at home.

Methods

A program consisting of a four-week (one hour per week) sleep improvement intervention plus use of an aroma-necklace, was developed based on Cox's Interaction Model of Client Health Behavior. 70 elderly women were assigned to the experimental (n=35) or control group with no intervention (n=35). Data from 62 participants (32 in the experimental and 30 in the control) were analyzed using the SPSS 21.0 program. Women in the experimental group were instructed to constantly wear the aroma necklace filled with marjoram and orange oil until the program was completed. Sleep quality, sleep duration, sleep satisfaction, depression, anxiety, and blood pressure were measured to identify the effectiveness of the program.

Results

Significant group differences were found in sleep quality (t=-5.10, p<.001), sleep duration (z=-3.10, p=.002), sleep satisfaction (z=-4.13, p=<.001), depression (t=2.53, p=.015), and anxiety (z=-2.47, p=.014). No differences were found in the systolic or diastolic blood pressure.

Conclusion

The results indicate that a sleep improvement program combined with an aroma-necklace was effective in improving sleep disturbances in elderly women living at home. Nurses may contribute to improving sleep among elderly women by applying this program to aged women living in various environments.

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Structural Equation Modeling of Self-Management of Liver Transplant Recipients: Mi-Kyeong Jeon, Yeon-Hwan Park; J Korean Acad Nurs 2017;47(5):663-675. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.663

Abstract PDF

Abstract Purpose

The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory.

Methods

Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers’ autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program.

Results

The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers’ autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers’ autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management.

Conclusion

The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients.

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Patterns and Influential Factors of Inter-Regional Migration of New and Experienced Nurses in 2011~2015: Bohyun Park, Se Young Kim; J Korean Acad Nurs 2017;47(5):676-688. Published online October 31, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.676

Abstract PDF

Purpose

The purpose of this study was to analyze the migration patterns of new nurses and experienced nurses and to identify the factors influencing inter-regional migration for solving regional imbalances of clinical nurses in South Korea.

Methods

This study involved a secondary analysis of data from the Health Insurance Review and Assessment Service (HIRA). Data were analyzed using descriptive statistics and multiple logistic regression analysis.

Results

New nurses tended to migrate from Kyunggi to Seoul. However, experienced nurses tended to migrate from Seoul and Chungchung to Kyunggi. Significant predictors of inter-regional migration among new nurses were location and nurse staffing grade of hospitals. Significant predictors of inter-regional migration among experienced nurses were location, hospital type, nurse staffing grade, ownership of hospitals and age of nurses.

Conclusion

Inter-regional migration occupied a small portion of total hospital movement among clinical nurses. The regional imbalances of nurses were not caused by the migration from non-metropolitan areas to Seoul. Nurse shortage problems in the small and medium hospitals of the non-metropolitan area can be solved only through improvement of work environment.

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Effects of a Cognitive Rehearsal Program on Interpersonal Relationships, Workplace Bullying, Symptom Experience, and Turnover Intention among Nurses: A Randomized Controlled Trial: Jiyeon Kang, Jeung-Im Kim, Seonyoung Yun; J Korean Acad Nurs 2017;47(5):689-699. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.689

Abstract PDF

Abstract Purpose

This research aimed to investigate the effects of a cognitive rehearsal program (CRP) on workplace bullying among nurses.

Methods

A randomized controlled trial was performed. Participants were 40 nurses working in different university hospitals in B city, South Korea. The experimental group was provided with a 20-hour CRP comprising scenarios on bullying situations, standard communication, and role-playing. To evaluate effects of the CRP, we measured interpersonal relationships, workplace bullying, symptom experience, and turnover intention at pre-and post-intervention. Follow-up effect was measured in the experimental group only at 4 weeks after the intervention.

Results

After the intervention, there were significant differences in interpersonal relationships (F=6.21, p=.022) and turnover intention (F=5.55, p=.024) between experimental and wait-list groups. However, there was no significant difference in workplace bullying or symptom experience between the 2 groups. The beneficial effects on interpersonal relationships and turnover intention lasted at least up to 4 weeks after CRP.

Conclusion

The CRP for workplace bullying improves interpersonal relationships and decreases turnover intention. So it can be utilized as one of the personal coping strategies to reduce the the turnover among nurses. Further studies on the effects of unit- or hospital-based CRP and on the long-term effects of CRP are necessary.

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Effects of Bullying Experience on Psychological Well-Being Mediated by Conflict Management Styles and Psychological Empowerment among Nursing Students in Clinical Placement: A Structural Equation Modeling Approach: Liping Ren, Hyunli Kim; J Korean Acad Nurs 2017;47(5):700-711. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.700

Abstract PDF

Abstract Purpose

This study aimed to test a proposed structural equation model in which bullying experience, conflict management styles and psychological empowerment predict psychological well-being among Chinese nursing students in clinical placement.

Methods

Three hundred and sixty-six nursing students recruited from five hospitals in J city and Y city were assessed with self-report questionnaires on bullying experience, conflict management styles, psychological empowerment and psychological well-being including depression, self-esteem, and academic major satisfaction. Data were analyzed using SPSS version 20.0 and AMOS version 22.0.

Results

The evaluation parameters included the comparative fit index at .90, the goodness of fit index at .93, the root mean square error of approximation at .07, and c²/df ratio at 2.66, indicating that the proposed structural equation model provided a good fit to the data. Experience of being bullied during clinical placement, conflict management styles and psychological empowerment explained 93.0% of the variance and had significant effects on psychological well-being, with conflict management styles and psychological empowerment mediating the association between bullying and psychological well-being.

Conclusion

The findings indicated that mediation by conflict management styles and psychological empowerment alleviated the negative influence of bullying on psychological well-being. To limit bullying and its negative effects, development of effective guidelines to deal with bullying will be a critical tool for both Chinese nursing students and their instructors. Further research should incorporate conflict management styles and psychological empowerment into the specific intervention strategies for handling bullying behaviors among nursing students and staff nurses and promoting nursing students’ psychological well-being.

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Corrigendum

Corrigendum: Evolutionary Concept Analysis of Spirituality: Il Sun Ko, So Young Choi, Jin Sook Kim; J Korean Acad Nurs 2017;47(5):712-712. Published online October 31, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.712

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Proposing a conceptual framework of spiritual care competence for Chinese nurses
Yuling Cao, Wipada Kunaviktikul, Marcia Petrini, Acharaporn Sripusanapan
Nursing & Health Sciences.2020; 22(3): 498. CrossRef

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