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32 "Adaptation"
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Research Papers
A Structural Equation Model for Posttraumatic Growth among Cured Patients with COVID-19
An, Soo Young , Choi, Heejung
J Korean Acad Nurs 2023;53(3):309-323.   Published online June 30, 2023
DOI: https://doi.org/10.4040/jkan.22118
AbstractAbstract PDF
Purpose
This study aimed to develop and test a model for posttraumatic growth among cured patients with COVID-19. This model was based on Calhoun and Tedeschi’s Posttraumatic Growth model and a literature review.
Methods
The participants comprised 223 patients cured from COVID-19 who were ≥ 19 years of age. The data were collected through an online questionnaire from March 21 to 24, 2022. The assessment tools included the Impact of Event Scale: Revised Korean version, the Connor-Davidson Resilience Scale, the Distress Dis-closure Index, the Multidimensional Scale of Perceived Social Support, the Korean version of the Event-related Rumination Inventory, and the Korean version of the Post-traumatic Growth Inventory. Data were analyzed using the IBM SPSS version 24.0 and IBM AMOS 26.0.
Results
The modified model showed appropriate goodness of fit (χ 2 = 369.90, χ 2 /degree of freedom = 2.09, SRMR = .09, RMESA = .07, CFI = .94, TLI = .93). The post-traumatic growth of cured patients with COVID-19 was explained through distress perception, self-disclosure, and deliberate rumination, with the explanatory power being 70.0%.
Conclusion
This study suggests preparing a disaster psychology program involving experts who can activate deliberate rumination is necessary. Further, this study may serve as basic data for developing a program to enhance the post-traumatic growth of patients cured from COVID-19.
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Actor and Partner Effects of Couple’s Daily Stress and Dyadic Coping on Marital Satisfaction
Won, Su Kyung , Seol, Kyoung Ok
J Korean Acad Nurs 2020;50(6):813-821.   Published online December 31, 2020
DOI: https://doi.org/10.4040/jkan.20162
AbstractAbstract PDF
Purpose
This study aimed to identify the actor and partner effects of daily stress and dyadic coping on marital satisfaction using the Actor-Partner Interdependence Mediational Model (APIeM).
Methods
Participants were 314 couples who met the study’s eligibility criteria. Data were collected from March to April 2016 through apartment and cooperative company communities in Seoul. Two APIeMs of positive and negative dyadic coping were analyzed using SPSS 20.0 and Mplus 7.4. All measures were self-administered.
Results
Daily stress and positive and negative dyadic coping in both spouses had direct actor effects on their marital satisfaction. Daily stress in both spouses had an indirect actor effect on marital satisfaction through their positive and negative dyadic coping. The husband’s daily stress had an indirect partner effect on the wife’s marital satisfaction through his positive dyadic coping, while the wife’s positive dyadic coping had a direct partner effect on the husband’s marital satisfaction. The husband’s daily stress had an indirect partner effect on the wife’s marital satisfaction through his negative dyadic coping, while the wife’s negative dyadic coping had a direct partner effect on the husband’s marital satisfaction.
Conclusion
Dyadic coping is an effective way to deal with couple’s daily hassles as it increase their satisfaction in marriage.
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Original Articles
Adaptation to Motherhood in Central Asian-Korean Immigrants to Korea: A Grounded Theory Study
Su Hyun Kim, Hyang-In Cho Chung
J Korean Acad Nurs 2019;49(6):677-689.   Published online December 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.677
AbstractAbstract PDF
Purpose

This qualitative study aimed to develop a substantive theory of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea.

Methods

Individual, in-depth interviews were conducted from July to September 2017, with 18 women who emigrated of Korean ethnicity from Central Asia to Korea, and took care of their baby for at least a year after their first delivery in Korea. The interviews were audio-recorded and transcribed verbatim. Data from the transcriptions were analyzed through Strauss and Corbin's grounded theory method, and data analysis was conducted simultaneously with data collection.

Results

As a result of categorizing the interview data through the process of open coding, 10 categories, with 31 subcategories and 102 concepts were drawn, and “growth as a Central Asian-Korean mother in an unfamiliar, historical hometown” was found to be the core category of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea.

Conclusion

A characteristic of the process of adaptation to motherhood in Central Asian-Korean immigrants to Korea, drawn from this study, is that it differs according to the level of initiative to carry out interaction strategies, and the use of various supportive social resources. The findings indicate the need for Medicare eligibility adjustment for antenatal care, the extension of the visa renewal period during childbirth, the development of web- or mobile application-based educational programs in Russian language, and the establishment of integrated visiting healthcare services, community service resources, and policy support to enable these women to utilize various supportive social resources.

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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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Reliability and Validity of the Korean Version of the Coping and Adaptation Processing Scale–Short-Form in Cancer Patients
Chi Eun Song, Hye Young Kim, Hyang Sook So, Hyun Kyung Kim
J Korean Acad Nurs 2018;48(3):375-388.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.3.375
AbstractAbstract PDF
Abstract Purpose

This study was conducted to assess the reliability and validity of the Korean version of the Coping and Adaptation Processing Scale-Short-Form in patients with cancer.

Methods

The original scale was translated into Korean using Brislin's translation model. The Korean Short-Form and the Functional Assessment Cancer Therapy-General were administered to 164 Korean patients with cancer using convenience sampling method. The collected data were analyzed using SPSS 23.0 and AMOS 23.0. Construct validity, criterion validity, test-retest reliability, and internal consistency reliability of the Korean Coping and Adaptation Processing Scale-Short-Form were evaluated.

Results

Exploratory factor analysis supported the construct validity with a four-factor solution that explained 60.6% of the total variance. Factor loadings of the 15 items on the four subscales ranged .52~.86. The four-subscale model was validated by confirmatory factor analysis (Normed χ 2=1.38 (p=.013), GFI=.92, SRMR=.02, RMSEA=.05, TLI=.94, and CFI=.95), and criterion validity was demonstrated with the Functional Assessment Cancer Therapy-General. Cronbach's alpha for internal consistency of the total scale was .83 and ranged .68~.81 for all subscales, demonstrating sufficient test-retest reliability.

Conclusion

The Korean version showed satisfactory construct and criterion validity, as well as internal consistency and test-retest reliability.

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A Companison Study of Stress, Coping and Adaptation between Fathers and Mothers of Mentally Retarded Children
Young Im Moon, Hyung Young Koo
Journal of Nurses Academic Society 1996;26(1):165-176.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.1.165
AbstractAbstract PDF

The purpose of this study was to contribute to family nursing in the areas of reducing stress and improving coping for parents of mentally retarded children. Data were collected through self-report questionnaires during a period of 2 months between November 1994 and January 1995 in the Kyoung-in area. The subjects consist of 176 parents (88 mothers and 88 fathers) of mentally retarded children attending schools for the handicapped. The levels of general stress and of parental role stress were measured with the General stress scale and the Parental role stress scale, respectively. The coping scale developed by Folkman and Lazarus was adopted to measure the level of coping, and the patterns of adaptation scale developed by Damrosch and Perry was adopted to measure the patterns of adaptation. The data were analyzed by a SAS program using Fisher's exact test, paired t-test, and oneway ANOVA. The results are as follows: 1. The level of general stress was significantly higher in mothers than in fathers. Mothers experienced a significantly greater level of parental role stress than fathers did. No significant difference in the level of coping was observed between mothers and fathers. There were differences in maternal and paternal patterns of adaptation. 2. The adaptation pattern of fathers was different according to their level of general stress, parental role stress and coping. The adaptation pattern of mothers was not different according to their level of general stress and parental role stress, but was according to their level of coping. 3. General stress experienced by fathers was different according to education, health status and support from their spouses. Satisfaction with family life, satisfaction with spouse and the support from spouse influenced coping used by fathers. Their level of parental role stress was not associated with any of their general characteristics. 4. In mothers, the level of general stress was different according to their health status, the level of parental role stress was related to satisfaction with family life and satisfaction with spouse. Their level of coping was associated with the support from spouse. The above findings indicate that mothers did not have more coping strategies than fathers did, despite the results which showed that mothers experienced greater stress than fathers did. Especially, the adaptation pattern of mothers was different according to their level of coping. Hence, nursing interventions directed at managing stress and improving coping should be used with mothers who use adaptation pattern 1. In particular, fathers should actively participate in parenting, and support their spouses.

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The Clinical Experiences of Adaptation as a New Nursing Staff
Haeng Mi Son, Moon Hee Koh, Chun Mi Kim, Jin Ha Moon
Journal of Korean Academy of Nursing 2001;31(6):988-997.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.6.988
AbstractAbstract PDF

PURPOSE: This study aimed at uncovering the experience of adaptation of the new nursing staff in hospital setting.
METHODS
For this study, 15 new graduate nurses participated. The data was collected through the in-dept interviews and analysed in terms of Strauss and Corbin's grounded theory methodology.
RESULTS
The core category was identified with "entering orbit". The new graduate nurses, who experienced the taeoom because of their unskilled professions, tried to enter orbit by overcoming difficult situations through reducing stress, maintaining good interpersonal relationship, grasping, compensating, persisting, and introspecting. Noticeably, in the process of adaptation, negative image of nursing, conflict of interpersonal relationship and the educational program for the new nursing staff had effect on the intervening factors. Finally, this study confirmed that the processes of new nurses' adaptation are confusing, confrontating, becoming a member and settling in hospital setting.
CONCLUSION
Therefore, the educational programs reflecting new nursing staffs' experiences should be developed.

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Influencing Factors on Social Adaptation of Chronic Mental Illness
Pyoung Sook Lee, Kuem Sun Han
Journal of Korean Academy of Nursing 2001;31(2):340-340.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.2.340
AbstractAbstract PDF

The purpose of this study was to investigate the factors influencing social adaptation of chronic mental illness. The subjects of this study were 190 patients, over the age of 20 with chronic mental illness diagnosed by a physician, and living in Seoul, Korea during May, 2000 to December 2000. The instruments for this study were the social adaptation scale by Wallace (1979), the self-esteem scale by Rogenberg (1965), social support scale by ParkJiWon (1985), coping behavior scale by Shirley Zeitlin (1978), self efficacy scale by Sherer et. al (1982), and Rand mental health inventory(1979). The data were analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. The results of this study are as follows: 1. The level of social adaptation showed moderate (M=3.43). 2. The social adaptation showed significant positive correlation with self-esteem (r=0.39, p=0.00), self-efficacy (r=0.31, p=0.00), social support (r=0.47, p=0.00), self-productive coping (r=0.14, p=0.05), self-flexible coping (r=0.22, p=0.00), environment-active coping (r=0.21, p=0.00), and environment-flexible coping (r=0.14, p=0.04). The social adaptation showed significant negative correlation with anxiety (r=-0.16, p=0.02), and emotional problems (r=-0.18, p=-0.00). 3. The stepwise multiple regression analysis revealed that the most powerful predictor of social adaptation was social support (21%). A combination of social support, depression, behavioral controllability, self-efficacy, and environmental coping behavior accounted for 39% of the variance in social adaptation in chronic mental illness. From the results of this study, it is suggested to develop and apply a social adaptation training program for chronic mental illness.

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The Predictive Model of Adolescent Women's Depression
Young Joo Park, Hee Kyung Kim, Jung Nam Sohn, Suk Hee Cheon, Hyun Jung Shin, Young Nam Chung
Journal of Korean Academy of Nursing 1999;29(4):829-840.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.4.829
AbstractAbstract PDF

This study was condicted to construct a hypothetical model of depression in Korean adolescent women and validate the fit of the model to the empiricla data. The data were collected from 345 high school girls in Seoul, from May 1 to June 30, 1998. The instruments were the Body Mass Index, Physical Satisfaction Scale, Family Adaptatibility and Cohesion Evaluation Scale III, Family Satisfaction Scale, CES-D and School Adaptation Scale. The data were analyzed using descriptive statistics with the pc-SAS program. The Linear Structural Relationship(LISREL) modeling process was used to find the best fit model which would predict the causal relationships among the variables. The overall fit of the hypothetical model to the data was moderate [X2=69.6(df=17, p=.000), GFI=0.95, AGFI=0.90, RMR=0.087, NNFI=0.86, NFI=0.90]. The predictable variables, especially menstrual symptoms, physical symptoms and family function, had a significant direct effect on depression, but school life adaptation did not have a significant direct effect. These variables explained 18.1% of the total variance.

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Stress and Adaptation in Family with Physical Disabled Children
Sook Ja Yang
Journal of Korean Academy of Nursing 1999;29(2):238-248.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.2.238
AbstractAbstract PDF

The purpose of this study was to describe the relationship between family stress and adaptation in families with a disabled child through literature review using McCubbin's Double ABCX family crisis framework. The literature review focused on (1) family stress and factors affecting family stress, (2) the critical individual, familial and social resources which families acquire and employ over time in managing crisis situation, (3) the changes in definition and meaning families develop in an effort to make sense out of their predicament, (4) the coping strategies families employ, and (5) the range of outcomes of these family efforts The results showed that families reported financial difficulties and the burden of care-giving demands as major family stressors. Siblings of disabled children manifested depressive symptoms and social isolation, but was not consistent study results. The parents' views of the cause of the disabling condition fundamentally affected their behavior toward their disabled child. Especially, the fathers' views of the child's characteristics made the greatest contribution to positive changes in the mothers' perceptions. The term perceived social support refers to the cognitive appraisal by individuals that they are cared for and valued, that significant others are available to them if needed, and that they are satisfied with their interpersonal relationships. The perceived social support was more protective than social support source, network size and network density. Parental adaptation was found to be related to the child's communication competence rather than family coping strategies proposed by Lazarus and Folkman. One study results showed that there was no difference in depressive symptoms and physical health between mothers with a disabled child and those without all though mothers with a disabled child had negative attitudes and perceived themselves as having significantly less social support and lower family functioning. But a longitudinal study revealed decreases in the negative impact of the child and increases in sibling and overall family adaptation.

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Influencing Factors on Family Stress, Family Meaning and Family Adaptation in Families with High Risk Neonates
Joung Ae Lee, In Sook Park, Young Sook Moon, Nam Hyeong Lee
Journal of Korean Academy of Nursing 2007;37(4):431-441.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.4.431
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the relationship among family stress, family meaning and family adaptation of families with high risk neonates.

Method

The date was collected on the basis of self- report questionnaires (August 2004 to March 2005); Tow-hundred twelve parents, who had high risk neonates in C hospital's neonatal intensive care unit, participated on request.

Results

Family sense of coherence, family meaning, social support, family stress, marital communication and patient condition had a significant, direct effect on family adaptation. Family cohesion, religion, confidence in the health professional, and length of stay had a significant, direct effect on family meaning.

Conclusion

The results of this study suggest the consequences associated with high risk neonates may be alleviated by a family support intervention designed to improve parental communication skills as well as to maintain family cohesiveness. Medical care could also encourage more emotional support of parents towards their neonate.

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Factors Predicting Depression in Hemodialysis Patients
Sang Sook Han, Young Hee Kim
Journal of Korean Academy of Nursing 2005;35(7):1353-1361.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.7.1353
AbstractAbstract PDF
Purpose

This study was done to provide fundamental data for developing a depression prediction model by discovering main factors that affect depression in patients who do maintenance hemodialysis.

Methods

The subjects were 191 patients doing maintenance hemodialysis selected from outpatient dialysis clinics at 9 major general hospitals, The Instrument tools utilized in this study were adapted from depression, fatigue, sleep disturbance, stress, adaptation,symptoms, daily activities, and role limitation and thoroughly modified to verify reliability and validity. The collected data was analyzed with a SPSS-PC 11.0 Window Statistics Program for real numbers, percentage, average, standard deviation, and multiple regression.

Results

The correlation factor for depression was (M=2.54) fatigue(M=3.12), sleep disturbance (M=2.82), stress(M=3.04), adaptation(M=2.53), daily activities(M=2.24), symptoms(M=2.37), and role limitation(M=2.24). The strongest factor that affected depression was explained by symptoms of the patients who performed hemodialysis. The analysis of the factors that affected depression revealed a 58.4% prediction in symptoms, stress, role limitation, and adaptation.

Conclusion

It has been confirmed that the regression equation model(Depression=7.351 + .266*symptoms + .260*stress -.189*adaptation + .057*fatigue) of this research may serve as a prediction factor for depression in Hemodialysis Patients.

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The Role Adaptation Process of Head Nurses in the General Hospitals
Sung Rye Kang
Journal of Korean Academy of Nursing 2004;34(8):1416-1426.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1416
AbstractAbstract PDF
Purpose

The purpose of this study is to identify the role adaptation process experienced by head nurses.

Methods

Data were collected from 10 head nurses with in-depth interviews about their actual experiences. All the interviews were recorded and transcribed. The collected data were analyzed by the grounded theory methodology of Strauss and Corbin.

Results

The core category was identified as “weighing and balancing,” and the role adaptation process was divided into six stages by time sequence: inquiring, approaching to others, bringing people into their fold, working with conviction, avoiding conflicts, and settling.

Conclusion

The results of this study yield useful information for top mangers of nursing to identify, by stages, the demands of the head nurses in their role adaptation process. The findings of this study contributes to developing programs that facilitates the head nurses' role adaptation.

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Family Resiliency Facto for the Adaptation of Family who have a Congenital Heart Disease
Young Ran Tak, E Hwa Yun, Ji Yeon An, Sang Hwa Kim
Journal of Korean Academy of Nursing 2004;34(7):1298-1306.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.7.1298
AbstractAbstract PDF
Purpose

The purpose of this study was to explore the relationships of family strain, perceived social support, family hardiness, and family adaptation and identify the family resiliency factors for the adaptation of families who have a child with congenital heart disease.

Method

The sample consisted of 90 families who had a child diagnosed with congenital heart disease and completed surgical treatment. Data was collected from parents using a questionnaire.

Results

Results from path analyses revealed that family strain had a direct effect on both perceived social support and family hardiness, and an indirect effect on family adaptation. Also, the findings revealed that perceived social support had a direct effect on both family hardiness and family adaptation, and family hardiness had a direct effect on family adaptation. Thus, these results indicated that perceived social support and family hardiness had a mediating effect on family strain.

Conclusion

Findings provide the evidence for the theoretical and empirical significance of perceived social support and family hardiness as family resiliency factors for family adaptation. Clinical implications of these findings might be discussed in terms of family-centered nursing interventions for the families who have a child with congenital heart disease based on an understanding of family resiliency for adaptation.

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Health Problems and Psychosocial Adaptation of Children with Cancer
Ka Sil Oh, Mi Kyung Sim, Sun Young Son
Journal of Korean Academy of Nursing 2003;33(2):293-300.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.2.293
AbstractAbstract PDF
Purpose

The purpose of this study was to describe health problems and psychosocial adaptation in children with cancer and to determine the relationship between these two variables.

Method

The data were collected from parents of 61 children with cancer, aged 4-11 years at one university hospital in Seoul. The instruments for this study were the Korea Child Behavior Check List (KCBCL) and a physical symptom checklist developed by the researchers.

Result

The major health problems were coughing, sleeping disturbances, fatigue and weakness. The total behavior problem score for children in the cancer group was higher than the score for those in the norm group. The scores on the scales for withdrawal, somatic complaints, social immaturity, and internalizing problems were higher in the children with cancer compared to normative findings. Scores on social and school competence in the cancer group were lower than the norms for healthy children. The relationship between health problems and psychosocial adaptation was significant in the subscales of withdrawal, anxiety/depression, internalizing problems and social involvement in the off therapy group.

Conclusions

This study shows the various areas that need further study in caring for children with cancer.

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The Male Nurses' Experiences of Adaptation in Clinical Setting
Haeng Mi Son, Moon Hee Koh, Chun Mi Kim, Jin Ha Moon, Myung Sun Yi
Journal of Korean Academy of Nursing 2003;33(1):17-25.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.1.17
AbstractAbstract
Purpose

The purpose of this study was to identified the male nurses' encounter in adapting themselves in the hospital settings dominated by the female nurses in number.

Method

Data were collected through the in-depth interview of 16 male nurses and analysed through the grounded theory methodology.

Result

The behaviors of male nurses for job-adaptation can be summarized as a series of struggles to consolidate their own ground. They have made tremendous efforts to hold their own ground in the nursing profession composed of a large numbers of female nurses, while they have experienced many difficulties and problems as minorities. They have struggled to adapt themselves professionally through efforts such as; challenging the social and professional barriers, identifying the job identity, empowering themselves through self-development and dedication, expanding their influence among colleagues. In spite of these efforts, they had the perception that nursing is not a lifelong occupation for them. Thus, they had tendency to find outlets of change to occupations.

Conclusion

A specific strategy is needed to provide an environment that is helpful for males in integrating into and adapting to the nursing profession.

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The Effects of Violence Coping Program Based on Middle-Range Theory of Resilience on Emergency Room Nurses’ Resilience, Violence Coping, Nursing Competency and Burnout
Seung Min Lee, Kyung Mi Sung
J Korean Acad Nurs 2017;47(3):332-344.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.332
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to examine the effects of a violence coping program (VCP) based on Polk's middle-range theory of resilience on nursing competency, resilience, burnout, and the ability to cope with violence in nurses working in emergency rooms.

Methods

A quasi-experimental study, with a nonequivalent control group and a pretest-posttest design, was conducted. Participants were 36 nurses who worked in emergency rooms and had experienced violence; 18 nurses from D hospital and 18 nurses from C hospital were assigned to the experimental and control groups, respectively. The experimental group received the VCP twice per week for 8 weeks.

Results

Levels of resilience, F=59.41, p<.001, active coping behavior, c2=33.09, p<.001, and nursing competency, F=59.41 p<.001, increased significantly and levels of passive coping behavior, c2=22.92, p<.001, and burnout, F=52.74, p<.001, decreased significantly in the experimental group.

Conclusion

The results suggest that the VCP could be an effective strategy for reducing burnout and improving resilience, active coping behavior, and nursing competency. Therefore, it would be a useful intervention for improving the quality of nursing care provided in emergency rooms.

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Development and Validation of the Cancer-Specific Posttraumatic Growth Inventory
Young-Mi Jung, Jin-Hee Park
J Korean Acad Nurs 2017;47(3):319-331.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.319
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to develop a scale to evaluate posttraumatic growth in patients with cancer and to examine the validity and reliability of the scale.

Methods

A literature review, semi-structured patient interviews and an expert panel consultation produced a 27 preliminary item questionnaire. Participants were 150 cancer patients recruited to test the reliability and validity of the preliminary scale. Data were analyzed using item analysis, exploratory factor analysis, convergent validity and internal consistency.

Results

Item reduction and exploratory factor analysis led to 23 items, grouped into five subscales which were labelled new possibilities (6 items), coping skills (5 items), preciousness of life (5 items), relating to others (4 items), and personal strength (3 items). Convergent validity was evaluated by total correlation with the Functional Assessment of Cancer Therapy-General (r=.45, p<.001). The final scale demonstrated satisfactory internal consistency (Cronbach's a =.94).

Conclusion

Findings from this study indicate that the Cancer-Specific Posttraumatic Growth Inventory has validity and reliability and is considered to be appropriate for assessing posttraumatic growth in patients with cancer.

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Adaptation Process to Group Home Living by Older Adults
Hee Sook Yoon, Sohyune Sok
J Korean Acad Nurs 2016;46(6):858-870.   Published online December 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.6.858
AbstractAbstract PDF
Purpose

The purpose of the study was to explore and describe the adaptation process of older people to group homes.

Methods

Participants were twenty older adults aged 65 or older who were living in group homes. Data were collected from January to April, 2015. In-depth unstructured interviews were conducted with individual participants. Data were analyzed using Strauss and Corbin's grounded theory method.

Results

From open coding, 100 concepts, 38 sub-categories, and 14 categories were identified. Analysis showed that the central phenomenon of the adaptation process of older people to group homes was ‘gradually giving up’. Causal conditions were ‘good-for-nothing body’, contextual conditions were ‘pushed’, ‘beleaguered’. Intervening conditions were ‘reliable pillar: children’, ‘having affection (情) more than having it from family: facility workers’, ‘comfort - like feeling at home’, ‘relieved: system’. Action/interaction strategies were ‘facing the unfamiliar reality’, ‘building relationships with other people’, ‘accepting reality’. Consequences were ‘a good place, more than expected’, ‘hope for the remaining days’, ‘waiting for a peaceful death’.

Conclusion

The results of this study provide an in-depth understanding of the experience of the adaptation process of older people to group homes. The findings from this study can be used as basic data to establish policies to increase the number of small scale facilities which can help older adults adapt easily to the facilities.

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Factors Influencing Posttraumatic Growth in Survivors of Breast Cancer
Jin-Hee Park, Yong-Sik Jung, Youngmi Jung
J Korean Acad Nurs 2016;46(3):454-462.   Published online June 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.3.454
AbstractAbstract PDF
Purpose

Posttraumatic growth (PTG) is defined as 'positive psychological change experienced as a result of a struggle with highly challenging life circumstances'. The purpose of this study was to identify the level of PTG and its correlates in Korean patients with breast cancer.

Methods

A sample of 120 participants was recruited from outpatients, who had successfully completed primary treatment of breast cancer at a university hospital., Data were collected from June to December, 2014 using Posttraumatic Growth Inventory, lllness Intrusiveness Rating Scale, Cancer Coping Questionnaire, Revised Life Orientation Test and The Multidimensional Scale of Perceived Social Support.

Results

Total score for the PTG was 79.18±17.54 in patients surviving breast cancer. Bivariate analyses indicated that PTG was positively associated with having a religion, perceived social support, greater optimism, cancer coping, and illness intrusiveness. Results of the regression analysis showed that cancer coping (β=.29, p=.001), optimism (β=0.28, p=.001) and illness intrusiveness (β=0.17, p=.037) were statistically significant in patients' PTG.

Conclusion

The research findings show that the variables of cancer coping, optimism and illness intrusiveness significantly explain PTG and these psychological variables can be used to provide improvement in PTG for patients with breast cancer

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Adaptation Experience of Living Kidney Donors after Donation
Da-Hai-Som Kang, Jinhyang Yang
J Korean Acad Nurs 2016;46(2):271-282.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.271
AbstractAbstract PDF
Purpose

This study was done to explore adaptation experience of living kidney donors after donation. Specific aims were to identify challenges donors face in the process of adaptation following surgery and how they interact with recipients and other people.

Methods

Grounded theory methodology was utilized. Participants were 13 living kidney donors at six months or more after donation. Data were collected by in-depth interviews with individual participants. Data were analyzed using constants comparative method with theoretical saturation.

Results

A core category emerged as 'keeping the fences of my family in spite of vulnerability'. The adaptation process after donation was manifested in four phases: exploration, balance, maintenance, and acclimatization. Phenomenon was perception of vulnerability. Strategies to manage the vulnerability were assessing changes of body awareness, tailoring regimen to one's own body condition, coping with health problems, keeping restoration of health, and ruminating on the meaning of one's kidney donation. Consequences were reestablishing family well-being, realizing the values of one's kidney donation, and living with uncertainty.

Conclusion

Findings of the study indicate that there is a need for health professionals to understand the vulnerability of living kidney donors and help their family system maintain a healthy and productive life. The results of this study can be used to develop phase-specific, patient-centered, and tailored interventions for living kidney donors.

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Experience of Role Adaptation from Nurse to Member of the Nursing Faculty
Kwang-Ok Park, Jong Kyung Kim, Mi Yu
J Korean Acad Nurs 2016;46(2):168-182.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.168
AbstractAbstract PDF
Purpose

The purpose of this qualitative study was to evaluate the experience of role adaptation from nurse to member of the nursing faculty.

Methods

Data were collected from 13 members of a nursing faculty through in-depth interviews. The main question asked was "Could you describe your experience from being a nurse to becoming a member of the nursing faculty?" Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology.

Results

The core experiential category of role adaptation from nurse to member of the nursing faculty was 'striving for survival from culture shock'. The participants used the following three interactional strategies: 'recognizing everything and entering the school environment', 'self-reflection on being a professor and integration of experiences', and 'finding a way of adapting'.

Conclusion

The participants tried to adapt to life as a professor and reflected on and integrated their experiences into their new life on the faculty. College faculty need to understand the impact of changes and challenges faced by new professors during role adaptation and to support this adaptation through mentorship and organized orientation programs.

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The Psychosocial Adaptation Process of Psychiatric Nurses Working in Community Mental Health Centers
So-Young Min
J Korean Acad Nurs 2015;45(6):868-878.   Published online December 31, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.6.868
AbstractAbstract PDF
Purpose

The aim of this study was to verify psychosocial issues faced by psychiatric and community mental health nurse practitioners (PCMHNP) working in community mental health centers, and to identify the adaptation processes used to resolve the issues.

Methods

Data were collected through in-depth interviews between December 2013 and August 2014. Participants were 11 PCMHNP working in community mental health centers. Analysis was done using the grounded theory methodology. The first question was "How did you start working at a community mental health center; what were the difficulties you faced during your employment and how did you resolve them?"

Results

The core category was 'regulating within relationships.' The adaptation process was categorized into three sequential stages: 'nesting,' 'hanging around the nest,' and 'settling into the nest.' Various action/interaction strategies were employed in these stages. The adaptation results from using these strategies were 'psychiatric nursing within life' and 'a long way to go.'

Conclusion

The results of this study are significant as they aid in understanding the psychosocial adaptation processes of PCMHNP working in community mental health centers, and indicate areas to be addressed in the future in order for PCMHNP to fulfill their professional role in the local community.

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Adaptation in Families of Children with Down Syndrome: A Mixed-methods Design
Hyunkyung Choi
J Korean Acad Nurs 2015;45(4):501-512.   Published online August 31, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.4.501
AbstractAbstract PDF
Purpose

The purpose of this study, which was guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation, was twofold: (a) to explore family and parental adaptation and factors influencing family adaptation in Korean families of children with Down syndrome (DS) through a quantitative methodology and (b) to understand the life with a Korean child with DS through a qualitative method.

Methods

A mixed-methods design was adopted. A total of 147 parents of children with DS completed a package of questionnaires, and 19 parents participated in the in-depth interviews. Quantitative and qualitative data were analyzed using stepwise multiple regression and content analysis respectively.

Results

According to the quantitative data, the overall family adaptation scores indicated average family functioning. Financial status was an important variable in understanding both family and parental adaptation. Family adaptation was best explained by family problem solving and coping communication, condition management ability, and family hardiness. Family strains and family hardiness were the family factors with the most influence on parental adaption. Qualitative data analysis showed that family life with a child with DS encompassed both positive and negative aspects and was expressed with 5 themes, 10 categories, and 16 sub-categories.

Conclusion

Results of this study expand our limited knowledge and understanding concerning families of children with DS in Korea and can be used to develop effective interventions to improve the adaptation of family as a unit as well as parental adaptation.

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Role Adaptation Process of Elementary School Health Teachers: Establishing Their Own Positions
Jeong Hee Lee, Byoung Sook Lee
J Korean Acad Nurs 2014;44(3):305-316.   Published online June 30, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.3.305
AbstractAbstract PDF
Purpose

The purpose of this study was to explore and identify patterns from the phenomenon of the role adaptation process in elementary school health teachers and finally, suggest a model to describe the process.

Methods

Grounded theory methodology and focus group interviews were used. Data were collected from 24 participants of four focus groups. The questions used were about their experience of role adaptation including situational contexts and interactional coping strategies. Transcribed data and field notes were analyzed with continuous comparative analysis.

Results

The core category was 'establishing their own positions', an interactional coping strategy. The phenomenon identified by participants was confusion and wandering in their role performance. Influencing contexts were unclear beliefs for their role as health teachers and non-supportive job environments. The result of the adaptation process was consolidation of their positions. Pride as health teachers and social recognition and supports intervened to produce that result. The process had three stages; entry, growth, and maturity.

Conclusion

The role adaptation process of elementary school health teachers can be explained as establishing, strengthening and consolidating their own positions. Results of this study can be used as fundamental information for developing programs to support the role adaptation of health teachers.

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Adaptation Experiences in South Korea of Men defecting from North Korea
Kyoung Mi Kim, Miyoung Kim
J Korean Acad Nurs 2013;43(3):431-441.   Published online June 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.3.431
AbstractAbstract PDF
Purpose

The study was done to explore meanings and essence of the experience in South Korea of men defectors from North Korea.

Methods

Data were collected from March, 2011 to May, 2012, through in-depth interviews with ten men defectors. Data analysis was conducted using the process of hermeneutic phenomenological reflection.

Results

Eight essential themes were extracted; 'buoyant expectation for a new life', 'feeling guilty about family left behind in North Korea', 'inability to become acclimatized due to communication difficulties', 'inability to socialize with South Koreans due to different lifestyles', 'finding strength through trustworthy acquaintances', 'continuing reconciliation with oneself while trying to assimilate into South Korean culture', 'self-realization of one's original self', and 'continuing to feel out the possibility of a future in South Korea'.

Conclusion

The findings indicate that North Korean men who defect to South Korea shape their identity through three phases: forming self-image during escape from North Korea, trying to become accustomed to South Korean society, and finding their own identity by self-realization of their original self. Eventually, the whole process enables them to recover their identity, to feel a sense of belonging, and to discover possibilities for a better future.

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Overcoming Experiences of Family Members Caring for Elderly Patients with Dementia at Home
Mi Ra Sung, Myungsun Yi, Dong Young Lee, Hye Young Jang
J Korean Acad Nurs 2013;43(3):389-398.   Published online June 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.3.389
AbstractAbstract PDF
Purpose

The purpose of the study was to understand and describe the overcoming experiences of family members caring for elderly patients with dementia at home.

Methods

Data came from autobiographies on the overcoming experiences of caregiving from 31 participants, who had submitted the autobiographies to a public contest held by the Seoul Metropolitan Center for Dementia in 2012. Data were analyzed using qualitative content analysis.

Results

Four overcoming stages emerged from the analysis: confronting stage; challenging stage; integrating stage; and transcendental stage, representing transformation of experiences from frustration and suffering to happiness and new hope in life. The confronting stage illustrates severe negative feelings and exhaustion occurring after the diagnosis of dementia. The challenging stage signifies major driving forces in taking good care of their patients. It includes tender loving memories about the patients as well as family and social supports. The integrating stage shows genuine empathy for the patients' situation and the happiness of 'here and now', while the transcendental stage represents new hope in the future.

Conclusion

Health professionals need to support caregivers to find true meaning of caring and happiness in everyday life, while providing specific information on dementia care and relieving various negative feelings.

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Adaptation Experience to Family of Immigrant Women in Multicultural Families
Jin-Hyang Yang, Hyun-Joo Park, Song-Soon Kim, Eun-Jeong Kang, Sang-Hee Byun, Ji-Soo Bang
J Korean Acad Nurs 2012;42(1):36-47.   Published online February 29, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.1.36
AbstractAbstract PDF
Purpose

This study was to explore adaptation experience to family among women who immigrated for marriage. Specific aims were to identify problems immigrant women face as family members and how they interact with other family members.

Methods

Grounded theory methodology was utilized. Data were collected from iterative fieldwork with individual in-depth interviews from 6 immigrant women as key informants, and 2 of their husbands and 2 of their mothers-in-law as general informants.

Results

Through constant comparative analysis, a core category emerged as "tearing down the wall in communicating". Causal conditions were feeling frustrated in one's expectations, differences in language and life style, differences in recognition, and perceptions of discrimination and prejudice. Strategies were learning the Korean language, learning Korean culture, managing stress, mediating differences between family members, and introspecting. Intervening factors were support systems, burdens of child-rearing, and the condition of one's health. Consequences were rooting oneself in one's family and accepting one's life as it is.

Conclusion

Results of the study indicate that there is a need for nurses to understand differences in communication with family members among immigrant women and to provide information and emotional support to improve the adaptation of these women to their Korean families.

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The Role Adaptation Process of The Executive Director of Nursing Department
Sung-Ye Kang, Kwang-Ok Park, Jong-Kyung Kim
J Korean Acad Nurs 2010;40(6):785-798.   Published online December 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.6.785
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the role adaptation process experienced by executive directors of nursing department of general hospitals.

Methods

Data were collected from 9 executive nursing directors though in-depth interviews about their experiences. The main question was "How do you describe your experience of the process of role adaptation as an executive nursing director?" Qualitative data from field and transcribed notes were analyzed using Strauss & Corbin's grounded theory methodology.

Results

The core category of experience of the process of role adaptation as an executive nursing director was identified as "entering the center with pushing and pulling". The participants used five interactional strategies; 'maintaining modest attitudes', 'inquiring about trends of popular feeling', 'making each person a faithful follower', 'collecting & displaying power', 'leading with initiative'. The consequences of role adaptation in executive nursing directors were 'coexisting with others', 'immersing in one's new role with dedication', and 'having capacity for high tolerance'. The types of role adaptations of executive directors in nursing department were friendly type, propulsive type, accommodating type.

Conclusion

The results of this study produced useful information for executive nursing directors on designing a self-managerial program to enhance role adaptation based on interactional strategies.

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Factors Affecting Mother's Adaptation to Breastfeeding
Sun Hee Kim
J Korean Acad Nurs 2010;40(2):225-235.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.225
AbstractAbstract PDF
Purpose

The aim of this study was to identify factors which influence breastfeeding adaptation from among the following: parity and feeding behavior, social support, psychological, and demographic factors.

Methods

The respondents were 179 breastfeeding mothers. Data were collected from June 2 to 19, 2009 at two community health centers and one pediatric outpatient department. Data were analyzed using the SPSS program and included descriptive statistics, t-test, ANOVA, correlation, and multiple regression.

Results

The major findings of this study were: 1) Significant differences in the level of breastfeeding adaptation were related to number of children, current problems related to breastfeeding, and lay supporters. 2) Level of breastfeeding adaptation was significantly related to marriage satisfaction, proportion of breastfeeding, length of previous breastfeeding, planned length of breastfeeding, parenting stress, and encouragement to breastfeed given by medical personnel. 3) Regression analysis showed that parenting stress, marriage satisfaction, current problems related to breastfeeding, and proportion of breastfeeding explained 44.3% of variance for breastfeeding adaptation. Length of previous breastfeeding also explained 9.7% of breastfeeding adaptation among mothers who had breastfed an elder child.

Conclusion

Mothers with lower marriage satisfaction, breastfeeding problems, and higher parenting stress require more help from their family and nurses for breastfeeding adaptation. Future research should include variables, such as mother's and baby's behavior related to breastfeeding, knowledge about breastfeeding, and attitude toward breastfeeding.

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J Korean Acad Nurs : Journal of Korean Academy of Nursing
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