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Volume 39(6); December 2009
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Original Articles
The Effects of Logotherapy on Meaning in Life and Quality of Life of Late Adolescents with Terminal Cancer
Kyung-Ah Kang, Jeoung-Sook Shim, Dae-Geun Jeon, Myung-Suk Koh
J Korean Acad Nurs 2009;39(6):759-768.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.759
AbstractAbstract PDF
Purpose

To evaluate the effects of a logotherapy program entitled 'Finding meaning in my life' for adolescents with terminal cancer.

Methods

A nonequivalent control group, non-synchronized design was conducted with a convenience sample of 44 late adolescents with terminal cancer. The experimental group (n=22) participated in the 'Finding meaning in my life' program which consisted of five-day sessions for one week. The control group (n=22) received the usual nursing care. The effects were measured using adolescent meaning in life (AMIL), and quality of life (QOL) scales. The collected data were analyzed by descriptive statistics, Chi-square, and t-test using SPSS/PC 17.0 program.

Results

There were significant differences in AMIL (t=3.36, p<.05) and QOL (t=2.67, p<.05) between the experimental and control groups.

Conclusion

Logotherapy is effective in improving the meaning in life and quality of life of late adolescents with terminal cancer, and can be used to prevent existential distress.

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Effects of an Educational Program for the Reduction of Physical Restraint Use by Caregivers in Geriatric Hospitals
Keumbong Choi, Jinsun Kim
J Korean Acad Nurs 2009;39(6):769-780.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.769
AbstractAbstract PDF
Purpose

The purposes of this study were to develop an educational program to reduce the use of physical restraints for caregivers in geriatric hospitals and to evaluate the effects of the program on cargivers' knowledge, attitude and nursing practice related to the use of physical restraints.

Methods

A quasi experimental study with a non-equivalent control group pretest-posttest design was used. Participants were recruited from two geriatric hospitals. Eighteen caregivers were assigned to the experimental group and 20 to the control group. The data were collected prior to the intervention and at 6 weeks after the intervention through the use of self-administered questionnaires. Descriptive statistics, χ2 test, Fisher's exact probability test, and Mann-Whitney U test were used to analyze the data.

Results

After the intervention, knowledge about physical restraints increased significantly in experimental group compared to the control group. However, there were no statistically significant differences between the groups for attitude and nursing practice involving physical restraints.

Conclusion

Findings indicate that it is necessary to apply knowledge acquired through educational programs to nursing practice to reduce the use of physical restraints. User friendly guidelines for physical restraints, administrative support of institutions, and multidisciplinary approaches are required to achieve this goal.

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Computerized Measurement for Asthma-Specific Quality of Life: Comparison with a Conventional Paper-and-Pencil Questionnaire
Eun-Hyun Lee
J Korean Acad Nurs 2009;39(6):781-787.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.781
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate a computerized touch-screen version of the asthma-specific quality-of-life (cA-QOL) questionnaire against the conventional paper-and-pencil version (pA-QOL) for equivalence, time for completion, user preference, and ease of use.

Methods

A total of 261 patients were recruited. A randomized cross-over design was used. Patients in group A completed the cA-QOL first while waiting to see a physician, and completed the pA-QOL version after seeing the physician. Patients allocated in group B completed these questionnaires in the reverse order. The patients were asked questions about user preference and ease of use of the cA-QOL. The time taken to complete both versions of the questionnaire was measured.

Results

Weighted kappa coefficients of all items showed almost perfect agreement. The time required to complete the pA-QOL is faster than the time for cA-QOL. The patients who preferred the cA-QOL were 37.5%, while those who preferred the pA-QOL were 29.9%. Most patients reported that the cA-QOL was "easy" or "very easy" to complete.

Conclusion

The cA-QOL is the computerized equivalent of the pA-QOL. The findings herein demonstrate that the cA-QOL can be helpful to nurses in busy practices for assessing, collecting, and evaluating their patients' health related quality of life.

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Concept Analysis of Resilience in Patients with Cardiovascular Diseases
Su-Jin Shin, Duk-Yoo Jung, Eun-Hee Hwang
J Korean Acad Nurs 2009;39(6):788-795.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.788
AbstractAbstract PDF
Purpose

The purpose of this study was to define and clarify the concept of 'resilience' in patients with cardiovascular diseases.

Methods

A hybrid model was used to develop the concept of resilience. The model included a field study carried out in Cheonan, Korea. The participants in this study were 9 patients with cardiovascular diseases who underwent a percutaneous coronary intervention.

Results

The concept of resilience was found to be a complex phenomenon having meanings in two dimensions: the personal-dispositional and interpersonal dimensions. Four attributes and seven indicators were defined.

Conclusion

A resilient person was defined as one who has a positive attitude toward restoration, the power to reconstruct and control his/her disease (personal dimension), and support from a supportive system with supportive persons (interpersonal dimension). In the clinical setting, resilience plays an important role in managing the care plans of cardiovascular patients. Therefore, nurses who work closely with patients suffering from cardiovascular diseases should be aware of the attributes and indicators of resilience to enhance the resilience of their patients.

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Effects of an Early Nursing Intervention Program for Infants' Development and Mother's Child Rearing in Poverty
Kyung-Sook Bang
J Korean Acad Nurs 2009;39(6):796-804.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.796
AbstractAbstract PDF
Purpose

This quasi-experimental study was performed to evaluate the effectiveness of an early nursing intervention program to support mothers of children aged 0-3 yr living in poverty.

Methods

In this study, mothers who received financial support from the government were recruited from one city and assigned to an intervention group (24) and comparison group (18). They completed a baseline questionnaire about depression, child rearing burden, agreement on physical punishment, and child temperament. Also, Denver II screening of the children was performed by the researcher. Mothers in the intervention group received a home visit intervention every two weeks for three months. At 3-months post-baseline, questionnaire and Denver II screening were reused to compare these two groups.

Results

Mother's depression, child rearing burden, agreement on physical punishment, and child temperament were not significantly different between the two groups. However, the percentage of depression declined only in the intervention group. Mothers in the intervention group showed higher Home Observation for Measurement of the Environment (HOME) scores than mothers in the comparison group.

Conclusion

The findings of the study show that this nursing intervention is an effective parenting program. The early nursing program for mothers with infant and toddlers in poverty is effective in promoting HOME, the child rearing home environment.

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Qualitative Research Investigating Patterns of Health Care Behavior among Korean Patients with Chronic Hepatitis B
Jin-Hyang Yang, Myung-Ok Cho, Hae-Ok Lee
J Korean Acad Nurs 2009;39(6):805-817.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.805
AbstractAbstract PDF
Purpose

This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems.

Methods

The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods.

Results

Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered.

Conclusion

Participants' health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one's symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.

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Development of a Cell Phone Addiction Scale for Korean Adolescents
Hyun Young Koo
J Korean Acad Nurs 2009;39(6):818-828.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.818
AbstractAbstract PDF
Purpose

This study was done to develop a cell phone addiction scale for Korean adolescents.

Methods

The process included construction of a conceptual framework, generation of initial items, verification of content validity, selection of secondary items, preliminary study, and extraction of final items. The participants were 577 adolescents in two middle schools and three high schools. Item analysis, factor analysis, criterion related validity, and internal consistency were used to analyze the data.

Results

Twenty items were selected for the final scale, and categorized into 3 factors explaining 55.45% of total variance. The factors were labeled as withdrawal/tolerance (7 items), life dysfunction (6 items), and compulsion/persistence (7 items). The scores for the scale were significantly correlated with self-control, impulsiveness, and cell phone use. Cronbach's alpha coefficient for the 20 items was .92. Scale scores identified students as cell phone addicted, heavy users, or average users.

Conclusion

The above findings indicate that the cell phone addiction scale has good validity and reliability when used with Korean adolescents.

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Effects of Music Therapy and Rhythmic Exercise on Quality of Life, Blood Pressure and Upper Extremity Muscle Strength in Institution-Dwelling Elderly Women
Eun Young Jeon, Sook Young Kim, Hyun Suk Yoo
J Korean Acad Nurs 2009;39(6):829-839.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.829
AbstractAbstract PDF
Purpose

The purpose of this study was to determine the effects of music therapy and rhythmic exercise on health related quality of life, blood pressure and upper extremity muscle strength in the institution-dwelling elderly women.

Methods

The study was designed using a nonequivalent control group pretest-posttest design. The participants consisted of 35 elders (18 in the experimental group and 17 in the control group). The music therapy and rhythmic exercise were developed by the investigators. The experimental group took part in this program twice a week for 8 weeks. The Short Form 36 health survey questionnaire, blood pressure and grasp power scale were used as instruments. The data were analyzed using SPSS 14.0.

Results

Repeated measures ANOVA revealed that music therapy and rhythmic exercise had positive effects on quality of life, especially on vitality, general health and mental health. Also, there were statistically significant differences in diastolic blood pressure and upper extremity muscle strength between the pretest and posttest in the experimental group.

Conclusion

The study suggests that this program can be applied for older women in long-term facilities to improve quality of life, blood pressure and upper extremity muscle strength.

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Critical Thinking Disposition and Clinical Competence in General Hospital Nurses
Jin-Ah Park, Bog-Ja Kim
J Korean Acad Nurs 2009;39(6):840-850.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.840
AbstractAbstract PDF
Purpose

This study was done to investigate the relationship between critical thinking disposition and clinical competence among nurses in general hospitals.

Methods

This study was a descriptive-correlational study with a convenience sample of 560 nurses from 5 general hospitals. The data were collected by self-administered questionnaires. Critical thinking disposition was measured using the Critical Thinking Disposition Scale for Nursing Students. Clinical competence was measured using the Standardized Nurse Performance Appraisal Tool.

Results

The mean score for critical thinking disposition and clinical competence was 3.37 and 4.10 respectively on a 5 point scale. A statistically significant correlation was found between critical thinking disposition and clinical competence. A regression model explained 72.8% of clinical competence. Prudence is the most significant predictor of clinical competence (R2=.728).

Conclusion

Study findings suggest that nurses with a higher level of critical thinking disposition would have a higher level of clinical competence. Furthermore, prudence might be the most important predictor of clinical competence. In order to strengthen clinical competence in nurses, the development and enhancement of critical thinking should be emphasized at the college level and nurses should be encouraged to make a clinical decision with greater prudence.

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Effects of Core Competency Support Program on Depression and Suicidal Ideation for Adolescents
Hyun Sook Park
J Korean Acad Nurs 2009;39(6):851-859.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.851
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the effects of a core competency support program on depression and suicidal ideation in adolescents.

Methods

A quasi-experimental design was employed in this study. Participants for the study were high school students, 27 in the experimental group and 29 in the control group. Data were analyzed using the SPSS/WIN. 14.0 program with χ2 test, t-test, and ANCOVA.

Results

Participants in the core competency support program reported decreased depression scores significantly different from those in the control group. Participants in the core competency support program reported decreased suicidal ideation scores, also significantly different from those in the control group.

Conclusion

The core competency support program was effective in decreasing depression and suicidal ideation for adolescents. Therefore, this approach is recommended as a suicide prevention strategy for adolescents.

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Factors Predicting Patient Discomfort after Coronary Angiography
Ae Ran Park, Ja Yun Choi
J Korean Acad Nurs 2009;39(6):860-867.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.860
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the factors that predict discomfort after coronary angiography or percutaneous coronary intervention (PCI) among hospitalized patients.

Methods

A total of 203 patients who underwent coronary angiography or PCI were recruited from C hospital located in S city, J province, from June through August 2008. The level of discomfort was measured and standardized by two instruments, discomfort questionnaire and the Visual Analogue Scale (VAS).

Results

Stepwise multiple regression showed that the factors predicting the level of discomfort were type of angiography, gender, previous angiography, dysuria, pre-information, and sleep satisfaction, which together explained 30.6% of the total variance of the level of discomfort.

Conclusion

Patients who had previous experience with these procedures, received a pre-information about the upcoming procedure, had no dysuria, and had slept well after the procedure were less likely to complain discomfort. Pre-informed education should be given by nurses to patients who will have an angiography or PCI to reduce their physical and emotional discomforts.

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Effects of Koryo Hand Therapy on Menopausal Symptoms and FSH, LH, and Estradiol in Climacteric Women
Young A Song, Hye Sook Shin
J Korean Acad Nurs 2009;39(6):868-877.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.868
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the effects of Koryo Hand Therapy (KHT) on menopausal symptoms and hormone levels (Follicle Stimulating Hormone [FSH], Luteinizing Hormone [LH], and estradiol [E2]) in climacteric women.

Methods

The research design was a nonequivalent control group pretest-posttest design. Data were collected from November 28, 2005 to February 28, 2006. The 45 participants were assigned to either the experimental group (23) or control group (22). KHT was applied three times a week, for a total of 8 weeks to the women in the experimental group.

Results

There was a statistically significant decrease in menopausal symptoms (F=42.49, p=.000), FSH level (F=26.98, p=.000) and LH level (F=5.31, p=.026) between the experimental and control groups. There was an increase of the estradiol level in the experimental group but the difference between the two groups was not statistically significant.

Conclusion

KHT can be applied as a supportive nursing intervention to climacteric women. KHT is expected to be a complementary alternative intervention for health management of the climacteric women.

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New Nurse Turnover Intention and Influencing Factors
Sang Sook Han, In Soon Sohn, Nam Eun Kim
J Korean Acad Nurs 2009;39(6):878-887.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.878
AbstractAbstract PDF
Purpose

The study was done to identify turnover intention in new nurses according to characteristics of the nurses and other factors affecting turnover and to provide data to set up a strategy to reduce the turnover.

Methods

Data were collected from 1,077 new nurses who had less than 12 months employment experience and worked in one of 188 hospitals. Eight research instruments were used. Data analysis was done using SPSS WIN 15.0 program.

Results

Several factors influence new nurse turnover intention. The average score for turnover intention was 2.12. The scores for subscales were self efficacy, 3.76, nursing performance, 3.90, job satisfaction, 2.09, organization commitment, 1.28, stress, 1.32, burnout, 2.82 and nursing organizational culture, 3.29. Turnover intention was related to self efficacy, nursing performance, job satisfaction, organization commitment, stress, burnout, nursing organizational culture, duration of in-class training, duration of on the job training, number of hospital beds, length of employment and duration of employment in current workplace. The predicting factors for turnover intention were burnout, stress, duration of employment in the current workplace, self efficacy and nursing performance. Those factors explained 51.6% of turnover intention.

Conclusion

New nurse turnover intention can be reduced by mitigating the factors affecting this intention.

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Comparison of Clinical Manifestations and Treatment-Seeking Behavior in Younger and Older Patients with First-time Acute Coronary Syndrome
Seon Young Hwang
J Korean Acad Nurs 2009;39(6):888-898.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.888
AbstractAbstract PDF
Purpose

This study was conducted to examine and compare clinical manifestations and predicting factors for treatment-seeking delay among patients <65 and ≥65 yr with first-time acute coronary syndrome (ACS).

Methods

A total of 288 patients who were diagnosed with ACS were individually interviewed at C university hospital in G-city from November 2007 to December 2008.

Results

Median pre-hospital delays for younger and older patients were 5 and 12 hr, respectively. Younger patients were more likely to be current smokers, heavy drinkers, obese, stressed, and have an unhealthy diet and family history, and to complain of chest pain, left shoulder and arm pain, perspiration, and nausea. Older patients were more likely to have hypertension and diabetes, and to complain syncope and dyspnea. Logistic regression analyses showed that after adjustment for age, gender and education, progressive onset of symptom and no attribution to cardiac problem significantly predicted pre-hospital delay >3 hr in both younger and older patients. Low perceived health status was a significant independent predictor in older patients only.

Conclusion

Health care providers should be concerned with different manifestations between younger and older adults, and educate people at risk for heart attack about symptoms and actions to get immediate help.

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Social Support and Acculturative Stress in Migrant Workers
Soon-Hee Lee, Young-Joo Lee, Sook-Young Kim, Shin-Jeong Kim
J Korean Acad Nurs 2009;39(6):899-910.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.899
AbstractAbstract PDF
Purpose

The purpose of this study was to collect basic data on social support and acculturative stress in migrant workers.

Methods

Between August, 2007 and January, 2008 171 immigrant workers completed data collection using a questionnaire. Workers were recruited from 2 churches, one in Seoul and the other in Gyeonggi Province. Mean and standard deviation, t-test, ANOVA, Pearson correlation coefficients and Stepwise multiple regression were used to analyze the data.

Results

The average score for social support was 3.73 (±0.65) and for acculturative stress, 2.52 (±0.65). There were significant differences acculturative stress according to gender (t=2.152, p=.033), kind of job (t=2.597, p=.040), and have community or not (t=2.899, p=.005). There was a significant negative correlation between social support and acculturative stress (r=-.270, p=.001). Factors influencing acculturative stress were existence of participants having a community of people from their home country or not (R2=.151, p=.002).

Conclusion

More studies are needed to identify the variables that influence acculturative stress in immigrant workers.

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