Journal of Korean Academy of Nursing

Research Papers

Factors influencing smartphone overdependence in university students: an ecological model: a descriptive study: Jeong Soon Yu, Myung Soon Kwon; J Korean Acad Nurs 2025;55(1):64-80. Published online February 20, 2025; DOI: https://doi.org/10.4040/jkan.24092

Abstract PDF ePub: Purpose
This study investigated the factors influencing smartphone overdependence in university students using an ecological model and descriptive research.
Methods
Data were collected from 482 students at 13 universities in the six regions in South Korea from October 20, 2020, to March 25, 2021. Data analysis involved descriptive statistics, the chi-square test, the independent samples t-test, analysis of variance, and hierarchical multiple regression.
Results
The significant ecological factors influencing smartphone overdependence included self-awareness of smartphone overdependence (β=.33, p<.001), autonomy (β=–.25, p<.001), average daily smartphone usage time (β=.18, p<.001), gender (β=.15, p=.001), college year (β=.15, p=.020), forming relationships with others as a motivation for smartphone use (β=–.15, p=.008), friend support (β=.14, p=.006), and age (β=–.12, p=.047). The model explained 34.9% of the variance.
Conclusion
The study emphasized the role of personal and interpersonal factors, in smartphone overdependence among university students. Tailored intervention strategies are necessary to address smartphone overdependence, considering the unique characteristics of students’ environments. A significant aspect of this study is that it provides an explanation of the multidimensional factors contributing to smartphone overdependence among university students, including intrapersonal, interpersonal, and environmental influences.

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The Effects of a Self-Efficacy Theory-Based Exercise Program for Patients Undergoing with Total Knee Arthroplasty: Kyung-Hye Park, Hee-Young Kang; J Korean Acad Nurs 2024;54(4):547-562. Published online October 22, 2024; DOI: https://doi.org/10.4040/jkan.24027

Abstract PDF Supplementary Material ePub: Purpose
This study was performed to develop a self-efficacy theory-based exercise program for total knee arthroplasty (TKA) and to test the program’s efficacy in ameliorating knee pain and restoring function as measured by lower extremity muscle strength, 3 meter walking time, Korean Western Ontario McMaster Index (WOMAC), exercise self-efficacy, and length of hospital stay for TKA patients.
Methods
This quasi-experimental study incorporating a non-equivalent control group and pretest-posttest non-synchronized design non-synchronous design was applied to assess self-efficacy reinforcement strategies based on self-efficacy theory. The exercise program consisted of the following steps: TKA, education to prevent postoperative complications, and muscle strength exercises. Respective exercise and control groups included 29 and 27 participants. The experimental group received eight sessions of the program from three weeks before TKA to four weeks after TKA. Collected data were analyzed using the chi-square test, Mann–Whitney U test, and ranked ANCOVA and t-tests using IBM SPSS Statistics 23.
Results
Experimental group showed significant improvement in lower extremity muscle strength (F = 8.63, p = .005), 3 meter walking time (z = - 5.02, p < .001), WOMAC index (z = - 2.22, p = .027), self-efficacy for exercise (z = - 3.29, p = .001), and length of hospital stay (t = - 2.11, p = .040) compared to the control group. No significant differences in knee pain and range of motion were observed.
Conclusion
These findings indicate that a self-efficacy theory-based exercise program can be an effective exercise strategy that patients undergoing TKA can easily follow at home without assistance. It is thus recommended as an exercise intervention for TKA patients.

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Review Paper

Effects of Non-Pharmacological Interventions on Major Adverse Cardiac Events in Patients Underwent Percutaneous Coronary Intervention: Systematic Review and Meta-Analysis: Jo, Sojeong , Lee, Haejung , Park, Gaeun; J Korean Acad Nurs 2024;54(3):311-328. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.24019

Abstract PDF: Purpose
In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI).
Methods
A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2).
Results
Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality.
Conclusion
Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).

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Research Papers

Influence of Illness Uncertainty on Health Behavior in Individuals with Coronary Artery Disease: A Path Analysis: Jeong, Hyesun , Lee, Yesul , Park, Jin Sup , Lee, Yoonju; J Korean Acad Nurs 2024;54(2):162-177. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.23136

Abstract PDF

Purpose
This study aimed to investigate the influence of uncertainty-related factors on the health behavior of individuals with coronary artery disease (CAD) based on Mishel’s uncertainty in illness theory (UIT).
Methods
We conducted a cross-sectional study and path analysis to investigate uncertainty and factors related to health behavior. The study participants were 228 CAD patients who visited the outpatient cardiology department between September 2020 and June 2021. We used SPSS 25.0 and AMOS 25.0 software to analyze the data.
Results
The final model demonstrated a good fit with the data. Eleven of the twelve paths were significant. Uncertainty positively affected danger and negatively affected self-efficacy and opportunity. Danger had a positive effect on perceived risk. Opportunity positively affected social support, self-efficacy, perceived benefit and intention, whereas it negatively affected perceived risk. Social support, self-efficacy, perceived benefit and intention had a positive effect on health behavior. We found that perceived benefit and intention had the most significant direct effects, whereas self-efficacy indirectly affected the relationship between uncertainty and health behavior.
Conclusion
The path model is suitable for predicting the health behavior of CAD patients who experience uncertainty. When patients experience uncertainty, interventions to increase their self-efficacy are required first. Additionally, we need to develop programs that quickly shift to appraisal uncertainty as an opportunity, increase perceived benefits of health behavior, and improve intentions.

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Association between Coping Profiles and Cardiac Health Behavior among Patients with Coronary Artery Disease: A Latent Profile Analysis
Yesul Lee, Yoonju Lee, Jeong Cheon Choe, Hyesun Jeong, Sunyoung Jung
Korean Journal of Adult Nursing.2024; 36(3): 228. CrossRef

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Development and Effectiveness Evaluation of Comprehensive Mobile-Based, Breastfeeding Promotion Program for Mothers with Gestational Diabetes: Kwak, Eunju , Park, Seungmi; J Korean Acad Nurs 2024;54(2):224-236. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.23098

Abstract PDF

Purpose
This study aimed to evaluate the effects of a mobile-based breastfeeding promotion program (M-BFGDM) that helps mothers with gestational diabetes.
Methods
Forty-seven mothers participated in the study, of whom 22 were in the experimental group and 25 in the control group. To verify the effects, a lag design before and after the non-equivalence control group was used. The data collection for the experimental group was done before and after the intervention.
Results
In the results, breastfeeding knowledge showed a significant difference in the interaction between measurement period and group (χ² = 8.14, p = .017), whereas breastfeeding intention did not show a significant difference in the interaction (χ² = 4.73, p = .094). There was no difference in self-efficacy interaction (F = 0.13, p = .856). The breastfeeding method showed no difference in interaction (F = 0.04, p = .952), whereas cross-analysis showed a significant difference in breastfeeding practice rate between the experimental group and the control group at 1 month postpartum (χ² = 7.59, p = .006).
Conclusion
A mobile-based breastfeeding promotion program was developed and applied for gestational diabetic mothers, resulting in an increase in breastfeeding knowledge and an improvement in breastfeeding practice rate one month after childbirth. In addition, M-BFGDM managed to create a breastfeeding practice environment with fewer time and place restrictions. A program study that complements motivation is needed to improve breastfeeding in pregnant diabetic mothers in the future.

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Breastfeeding and education in the puerperium
Elena Alfonso
Community and Interculturality in Dialogue.2025; 5: 129. CrossRef

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Effects of a Health Partnership Program Using Mobile Health Application for Male Workers with Cardiovascular Risk Factors in Small and Medium Enterprises: A Randomized Controlled Trial: Kim, Eun Jin , Hwang, Seon Young; J Korean Acad Nurs 2024;54(1):44-58. Published online February 29, 2024; DOI: https://doi.org/10.4040/jkan.23090

Abstract PDF: Purpose
This study aimed to apply a health partnership program using commercially available mobile health apps to improve cardiovascular risk factors in male employees and verify its effectiveness.
Methods
Using a randomized control group pretest-posttest design, male employees with cardiovascular risk factors from five small and medium-sized workplaces were randomly assigned to an experimental group (n = 32) and a control group (n = 31). The experimental group was encouraged to use three mobile health apps for 12 weeks to acquire the necessary cardiovascular disease-related information and practice strengthening training, walking, and diet management appropriate to their level. They also received feedback on their weekly activities and motivational text messages from health partners. Hypotheses were tested using the SPSS WIN 22.0.
Results
The experimental group showed a significant difference compared to the control group in terms of their perception of mobile health app (p < .05), self-efficacy for exercise and diet, self-management partnership, and cardiovascular disease prevention health behavior (p < .001). In particular, there were significant decreases in the body mass index, ratio, serum fasting blood sugar, total cholesterol, and triglyceride in the experimental group (p < .001); however, there was no significant difference in high-density lipoprotein-cholesterol.
Conclusion
Intervention using mobile apps based on partnership with health managers is effective in improving the objective cardiovascular risk index in male employees; therefore, such intervention should be continuously used as a useful lifestyle modification strategy in the workplace.

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Analysis of ROX Index, ROX-HR Index, and SpO 2 /FIO 2 Ratio in Patients Who Received HighFlow Nasal Cannula Oxygen Therapy in Pediatric Intensive Care Unit: Choi, Sun Hee , Kim, Dong Yeon , Song, Byung Yun , Yoo, Yang Sook; J Korean Acad Nurs 2023;53(4):468-479. Published online August 31, 2023; DOI: https://doi.org/10.4040/jkan.22152

Abstract PDF

Purpose
This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit.
Methods
A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ² test, Mann–Whitney U test, and area under the curve (AUC).
Results
Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption.
Conclusion
The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time.

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Can the ROX index predict high‐flow nasal cannula failure in children under 2 with lower respiratory tract infection?
Pablo Vasquez‐Hoyos, Alvaro L. Jacome‐Orozco, Andrea P. Rodriguez‐Mayorga, Leidy E. Sepulveda‐Forero, Diana P. Escobar‐Serna, Juan S. Barajas, Evelyn Obando‐Belalcazar, Claudia M. Salinas‐Jaimes, Juan J. Peralta‐Palmezano, Alexandra Jimenez‐Chavez, Rafael
Pediatric Pulmonology.2024; 59(5): 1246. CrossRef
Impact of Surgical Mask Placement Over High-Flow Nasal Cannula on Oxygenation Parameters in COVID-19 Patients Experiencing Hypoxemic Respiratory Failure
Aadila Coatwala, Mayank Dhir, Sagar Sinha, Dattatray Bhusare
Cureus.2024;[Epub] CrossRef

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Keyword Network Analysis and Topic Modeling of News Articles Related to Artificial Intelligence and Nursing: Ha, Ju-Young , Park, Hyo-Jin; J Korean Acad Nurs 2023;53(1):55-68. Published online February 28, 2023; DOI: https://doi.org/10.4040/jkan.22117

Abstract PDF

Purpose
The purpose of this study was to identify the main keywords, network properties, and main topics of news articles related to artificial intelligence technology in the field of nursing.
Methods
After collecting artificial intelligence-and nursing-related news articles published between January 1, 1991, and July 24, 2022, keywords were extracted via preprocessing. A total of 3,267 articles were searched, and 2,996 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4.
Results
As a result of analyzing the frequency of appearance, the keywords used most frequently were education, medical robot, telecom, dementia, and the older adults living alone. Keyword network analysis revealed the following results: a density of 0.002, an average degree of 8.79, and an average distance of 2.43; the central keywords identified were ’education,’ ‘medical robot,’ and ‘fourth industry.’ Five topics were derived from news articles related to artificial intelligence and nursing: ‘Artificial intelligence nursing research and development in the health and medical field,’ ‘Education using artificial intelligence for children and youth care,’ ‘Nursing robot for older adults care,’ ‘Community care policy and artificial intelligence,’ and ‘Smart care technology in an aging society.’ Conclusion: The use of artificial intelligence may be helpful among the local community, older adult, children, and adolescents. In particular, health management using artificial intelligence is indispensable now that we are facing a super-aging society. In the future, studies on nursing intervention and development of nursing programs using artificial intelligence should be conducted.

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Mapping the Landscape of AI-Driven Human Resource Management: A Social Network Analysis of Research Collaboration
Mehrdad Maghsoudi, Motahareh Kamrani Shahri, Mehrdad Agha Mohammad Ali Kermani, Rahim Khanizad
IEEE Access.2025; 13: 3090. CrossRef
The Impact of Artificial Intelligence-Assisted Learning on Nursing Students' Ethical Decision-making and Clinical Reasoning in Pediatric Care
Hyewon Shin, Jennie C. De Gagne, Sang Suk Kim, Minjoo Hong
CIN: Computers, Informatics, Nursing.2024; 42(10): 704. CrossRef
Research trends over 10 years (2010-2021) in infant and toddler rearing behavior by family caregivers in South Korea: text network and topic modeling
In-Hye Song, Kyung-Ah Kang
Child Health Nursing Research.2023; 29(3): 182. CrossRef

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Development and Evaluation of Prenatal Education for Environmental Health Behavior Using Cartoon Comics: Kim, Hyun Kyoung , Kim, Hee Kyung , Kim, Mirim , Park, Seohwa; J Korean Acad Nurs 2021;51(4):478-488. Published online August 31, 2021; DOI: https://doi.org/10.4040/jkan.21083

Abstract PDF

Purpose
This study aimed to develop and examine the effects of a prenatal program on environmental health behavior using cartoon comics among Korean pregnant women.
Methods
This study used a non-equivalent control group pre-test/post-test design. The program used cartoon comics to explore environmental health behaviors during pregnancy. The program consisted of the following four components: environmental toxicants during pregnancy, avoiding particulate matter during pregnancy, environmental toxicants during baby care, and making a healthy environment for children. In total, 35 pregnant women participated in the study: 18 in the experimental group and 17 in the control group. Data collection and program adaptation were conducted between November 3, 2020 and January 19, 2021. The effect of the prenatal education program was evaluated by t-test and repeated measures ANOVA.
Results
Learning experience (t = - 2.35, p = .025), feasibility (t = - 2.46, p = .019), satisfaction (t = - 2.23, p = .032) were higher in the experimental group than in the control group in the first post-test. Feasibility (t = - 2.40, p = .022) was higher in the experimental group than in the control group in the second post-test. Repeated-measures ANOVA showed significant interactions between time and group in environmental susceptibility (F = 9.31, p < .001), self-efficacy (F = 3.60, p = .033), and community behavior (F = 5.41, p = .007).
Conclusion
This study demonstrates the need for a prenatal education program to promote environmental health perceptions and behavior during pregnancy. We suggest a prenatal class adopting the creative cartoon comics to promote the maternal environmental health behaviors.

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Examining the Effectiveness of Interactive Webtoons for Premature Birth Prevention: Protocol for a Randomized Controlled Trial
Sun-Hee Kim, Jennie C De Gagne
JMIR Research Protocols.2024; 13: e58326. CrossRef
Development and effects of a webtoon education program on preventive self-management related to premature labor for women of childbearing age: a randomized controlled trial
Sun-Hee Kim
Korean Journal of Women Health Nursing.2022; 28(3): 250. CrossRef
The effects of environmental prenatal program on environmental health perception and behavior using internet-based intervention in South Korea: A non-randomized controlled study
Hyun Kyoung Kim, Geum Hee Jeong, Hye Young Min, George Vousden
PLOS ONE.2022; 17(11): e0277501. CrossRef

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Topic Modeling and Keyword Network Analysis of News Articles Related to Nurses before and after “the Thanks to You Challenge” during the COVID-19 Pandemic: Yun, Eun Kyoung , Kim, Jung Ok , Byun, Hye Min , Lee, Guk Geun; J Korean Acad Nurs 2021;51(4):442-453. Published online August 31, 2021; DOI: https://doi.org/10.4040/jkan.20287

Abstract PDF

Purpose
This study was conducted to assess public awareness and policy challenges faced by practicing nurses.
Methods
After collecting nurse-related news articles published before and after ‘the Thanks to You Challenge’ campaign (between December 31, 2019, and July 15, 2020), keywords were extracted via preprocessing. A three-step method keyword analysis, latent Dirichlet allocation topic modeling, and keyword network analysis was used to examine the text and the structure of the selected news articles.
Results
Top 30 keywords with similar occurrences were collected before and after the campaign. The five dominant topics before the campaign were: pandemic, infection of medical staff, local transmission, medical resources, and return of overseas Koreans. After the campaign, the topics ‘infection of medical staff’ and ‘return of overseas Koreans’ disappeared, but ‘the Thanks to You Challenge’ emerged as a dominant topic. A keyword network analysis revealed that the word of nurse was linked with keywords like thanks and campaign, through the word of sacrifice. These words formed interrelated domains of ‘the Thanks to You Challenge’ topic.
Conclusion
The findings of this study can provide useful information for understanding various issues and social perspectives on COVID-19 nursing. The major themes of news reports lagged behind the real problems faced by nurses in COVID-19 crisis. While the press tends to focus on heroism and whole society, issues and policies mutually beneficial to public and nursing need to be further explored and enhanced by nurses.

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Patent Technology Trends of Oral Health: Application of Text Mining
Hee-Kyeong Bak, Yong-Hwan Kim, Han-Na Kim
Journal of Dental Hygiene Science.2024; 24(1): 9. CrossRef
Agendas on Nursing in South Korea Media: Natural Language Processing and Network Analysis of News From 2005 to 2022
Daemin Park, Dasom Kim, Ah-hyun Park
Journal of Medical Internet Research.2024; 26: e50518. CrossRef
Analysis of issues related to nursing law: Examination of news articles using topic modeling
JooHyun Lee, Hyoung Eun Chang, Jaehyuk Cho, Seohyun Yoo, Joonseo Hyeon, Andrea Cioffi
PLOS ONE.2024; 19(8): e0308065. CrossRef
Research Trends on Cancer-Related Cognitive Impairment in Patients with Non-Central Nervous System Cancer: Text Network Analysis and Topic Modeling
Hee-Jun Kim, Sun Hyoung Bae, Jin-Hee Park
Journal of Korean Academy of Fundamentals of Nursing.2023; 30(3): 313. CrossRef
Perspectives of Frontline Nurses Working in South Korea during the COVID-19 Pandemic: A Combined Method of Text Network Analysis and Summative Content Analysis
SangA Lee, Tae Wha Lee, Seung Eun Lee
Journal of Korean Academy of Nursing.2023; 53(6): 584. CrossRef
Nurses’ Experience in COVID-19 Patient Care
Soojin Chung, Mihyeon Seong, Ju-young Park
Journal of Korean Academy of Nursing Administration.2022; 28(2): 142. CrossRef
A topic modeling analysis for Korean online newspapers: Focusing on the social perceptions of nurses during the COVID-19 epidemic period
Soo Jung Chang, Sunah Park, Yedong Son
The Journal of Korean Academic Society of Nursing Education.2022; 28(4): 444. CrossRef
Images of Nurses Appeared in Media Reports Before and After Outbreak of COVID-19: Text Network Analysis and Topic Modeling
Min Young Park, Seok Hee Jeong, Hee Sun Kim, Eun Jee Lee
Journal of Korean Academy of Nursing.2022; 52(3): 291. CrossRef
Experience of Nurses in Charge of COVID-19 Screening at General Hospitals in Korea
Boo Young Ha, Yun-Sook Bae, Han Sol Ryu, Mi-Kyeong Jeon
Journal of Korean Academy of Nursing.2022; 52(1): 66. CrossRef
An Exploratory Study on Current Nursing Issues in the COVID-19 era through Newspaper Articles: The Application of Text Network Analysis
Young Joo Lee
Journal of Korean Academy of Nursing Administration.2022; 28(3): 307. CrossRef
Analysis of Headline News about Nurses Before and After the COVID-19 Pandemic
Su-Mi Baek, Myonghwa Park
Journal of Korean Academy of Nursing Administration.2022; 28(4): 319. CrossRef
Warmth and competence perceptions of key protagonists are associated with containment measures during the COVID-19 pandemic: Evidence from 35 countries
Maria-Therese Friehs, Patrick F. Kotzur, Christine Kraus, Moritz Schemmerling, Jessica A. Herzig, Adrian Stanciu, Sebastian Dilly, Lisa Hellert, Doreen Hübner, Anja Rückwardt, Veruschka Ulizcay, Oliver Christ, Marco Brambilla, Jonas De keersmaecker, Feder
Scientific Reports.2022;[Epub] CrossRef

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An Exploratory Study on the Policy for Facilitating of Health Behaviors Related to Particulate Matter: Using Topic and Semantic Network Analysis of Media Text: Byun, Hye Min , Park, You Jin , Yun, Eun Kyoung; J Korean Acad Nurs 2021;51(1):68-79. Published online February 28, 2021; DOI: https://doi.org/10.4040/jkan.20213

Abstract PDF

Purpose
This study aimed to analyze the mass and social media contents and structures related to particulate matter before and after the policy enforcement of the comprehensive countermeasures for particulate matter, derive nursing implications, and provide a basis for designing health policies.
Methods
After crawling online news articles and posts on social networking sites before and after policy enforcement with particulate matter as keywords, we conducted topic and semantic network analysis using TEXTOM, R, and UCINET 6.
Results
In topic analysis, behavior tips was the common main topic in both media before and after the policy enforcement. After the policy enforcement, influence on health disappeared from the main topics due to increased reports about reduction measures and government in mass media, whereas influence on health appeared as the main topic in social media. However semantic network analysis confirmed that social media had much number of nodes and links and lower centrality than mass media, leaving substantial information that was not organically connected and unstructured.
Conclusion
Understanding of particulate matter policy and implications influence health, as well as gaps in the needs and use of health information, should be integrated with leadership and supports in the nurses’ care of vulnerable patients and public health promotion.

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Changes in Public Sentiment under the Background of Major Emergencies—Taking the Shanghai Epidemic as an Example
Bowen Zhang, Jinping Lin, Man Luo, Changxian Zeng, Jiajia Feng, Meiqi Zhou, Fuying Deng
International Journal of Environmental Research and Public Health.2022; 19(19): 12594. CrossRef

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Review Paper

Characteristics of Aerobic Exercise as Determinants of Blood Pressure Control in Hypertensive Patients: A Systematic Review and Meta-Analysis: Lee, Sun Hee , Chae, Young Ran; J Korean Acad Nurs 2020;50(6):740-756. Published online December 31, 2020; DOI: https://doi.org/10.4040/jkan.20169

Abstract PDF

Purpose
The purpose of this study was to evaluate the effect on blood pressure (BP) and heart rate (HR) according to aerobic exercise characteristics in adults with hypertension using a systematic review and meta-analysis.
Methods
The related researches were selected from PubMed, EMBASE, Cochrane library, CINAHL, PsycINFO, SPORTDiscus and 5 domestic databases up to September 4, 2019. To estimate the effect size, random effect models were used to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on BP and HR.
Results
A total of 37 RCTs with 1,813 samples were included. Aerobic exercise was found to significantly reduce systolic BP (WMD, - 8.29 mmHg; 95% CI, - 10.12 to - 6.46), diastolic BP (WMD, - 5.19 mmHg; 95% CI, - 6.24 to - 4.14) and HR (WMD, - 4.22 beats/min; 95% CI, - 5.36 to –3.09). In detail, systolic BP and diastolic BP were significantly decreased in all groups of exercise types, frequency and duration. Systolic BP and diastolic BP were significantly decreased in the moderate and vigorous-intensity group. Exercise characteristics with the most dramatical change in systolic BP were water-based training, moderate-intensity, 3 times a week and 8 to 11 weeks of duration. In diastolic BP, the greatest effect size was over 24 weeks of exercise.
Conclusion
Moderate aerobic exercise, especially water-based exercise can be an important part of lifestyle modification for hypertensive patients. Also, it can be recommended in a variety of clinical settings for lowering BP and HR. However, there is insufficient evidence that low-intensity exercise is effective in lowering BP.

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Effect of exercise based on ACSM recommendations on blood pressure and heart rate in hypertensive patients: A systematic review and meta-analysis of randomized controlled trials
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Physical Activity Intensity and Risk of Dementia
Angelique G. Brellenthin, Duck-chul Lee, Elizabeth C. Lefferts, Wesley K. Lefferts, Ryan J. Dougherty, Youngwon Kim
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The Western and Chinese exercise training for blood pressure reduction among hypertensive patients: An overview of systematic reviews
Kelvin Tsoi, Amy Lam, Joshua Tran, Ziyu Hao, Karen Yiu, Yook‐Chin Chia, Yuda Turana, Saulat Siddique, Yuqing Zhang, Hao‐Min Cheng, Ji‐Guang Wang, Kazuomi Kario
The Journal of Clinical Hypertension.2024; 26(12): 1327. CrossRef
Does regular exercise help significantly reduce blood pressure in adults diagnosed with hypertension within the general population?
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Physical Activity and Hypertension
Peter Hayes, Alexandra Ferrara, Aoife Keating, Kathryn McKnight, Andrew O'Regan
Reviews in Cardiovascular Medicine.2022;[Epub] CrossRef

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Original Articles

Effects of BeHaS Program on Health Behavior, Physiologic Index and Self-Esteem of the Elderly Living Alone with Metabolic Syndrome Based on Community Based Participatory Research: Kim, Jong Im , Kim, Sun Ae , Park, Keumok , Kim, Jiyoung , Lee, Lina , Choi, Si Wan , Ku, Bon Jeong; J Korean Acad Nurs 2020;50(4):571-582. Published online August 31, 2020; DOI: https://doi.org/10.4040/jkan.19261

Abstract PDF

Purpose
This study aimed to determine the effects of a 12-week metabolic syndrome BeHaS (Be Happy and Strong) program in elderly people with metabolic syndrome living alone, based on a community-based participatory research (CBPR).
Methods
A nonequivalent control group pre-posttest design was used, and the participants were 43 elderly people living alone (experimental group 24, control group 19). The experimental group received a one-hour program per week and two individual health consultations during 12 weeks. The control group received two sessions about the metabolic syndrome and two individual health consultations. The effects of health behavior, blood pressure, blood sugar levels, abdominal circumference, triglycerides, and self-esteem were evaluated. The data were analyzed using the independent t-test and Mann-Whitney U test.
Results
The health behavior with respect to the metabolic syndrome in the experimental group increased significantly (t = - 3.19, p = .002). Both diastolic blood pressure and abdominal circumference decreased in the experimental group (t = 2.00, p = .028 and t = 3.91, p < .001). No significant differences were observed between the groups in systolic blood pressure, fasting blood sugar levels, triglycerides, and self-esteem.
Conclusion
The 12-week metabolic syndrome BeHaS program using community resources improves the health of elderly people with metabolic syndrome living alone. Based on these findings, further studies on the effectiveness of the metabolic syndrome BeHaS program and the experiences of those who participated in the CBPR are warranted.

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Exploring the Impact of Smart Mobility and ICT Solutions on Older Adults’ Mobility: A Systematic Literature Review
Chengyuan An
IEEE Access.2024; 12: 159056. CrossRef
노인 대사증후군에 효과적인 중재: 체계적 문헌고찰과 메타분석
서현 이, 슬 구, 유미 서, 선화 반
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Chahwa Hong, Haejung Lee, Misoon Lee
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A Structural Equation Model of Health-Related Quality of Life among Older Women Following Bilateral Total Knee Replacement: Lee, Hyun Ok , Yoo, Jae Soon; J Korean Acad Nurs 2020;50(4):554-570. Published online August 31, 2020; DOI: https://doi.org/10.4040/jkan.19216

Abstract PDF

Purpose
This study aimed to develop and test a structural equation model of health-related quality of life among older women following bilateral total knee replacement based on a literature review and Wilson and Cleary’s model of health-related quality of life.
Methods
One hundred ninety three women who were diagnosed with osteoarthritis, were older than 65 years, and were between 13 weeks and 12 months of having a bilateral total knee replacement were recruited from an outpatient clinic. Data were collected from July 2017 to April 2018 using a structured questionnaire and medical records. Data were analyzed using SPSS/WIN 22.0, AMOS 22.0, and Smart PLS 3.2.4.
Results
The fitness of the hypothetical model was good, with coefficients of determination (R² ) ranging between .28 and .75 and predictive relevance (Q² ) between .26 and .73. The standardized root mean square residual of the model fit indices for the hypothetical model was .04; which explained 64.2% of physical and 62.5% of mental health-related quality of life. Self-efficacy, symptom status, functional status, and general health perceptions had a significant direct effect on physical health-related quality of life, while social support, symptom status, and general health perceptions had a significant direct effect on participants’ mental-health-related quality of life.
Conclusion
To improve the physical and mental quality of life of older women who receive bilateral knee replacement, nursing-based intervention strategies that reduce symptoms, improve functional status, and increase health perceptions, self-efficacy, and social support are needed. The most important factor is the symptom status.

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Health-related quality of life for older patients with chronic low back pain: A structural equation modeling study
Suin Lee, Eun-Ju Lee
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Invited Paper

Development of Caring as a Human Science: 50 Years of History of the Korean Society of Nursing Science: Kim, Jeung-Im , Suh, Eunyoung E. , Song, Ju-Eun , Im, YeoJin , Park, Jin-Hee , Yu, Soyoung , Jang, Sun Joo , Kim, Da-Hee; J Korean Acad Nurs 2020;50(3):313-332. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.20142

Abstract PDF

Purpose
This year 2020 marks the 50th anniversary of the founding of the Korean Society of Nursing Science (KSNS). This study wasaimed to explore development of caring and describe the 50 years of history of KSNS within the sociocultural context of Korea regardingacademic footsteps, meanings, and implications for the future.
Methods
This study used a historical research methodology using a literaturereview and bibliometric analysis. Relevant literature was reviewed and the published abstracts in the Journal of Korean Academy ofNursing (JKAN) were analyzed using VOSviewer.
Results
Birth control and family planning in the 1970s was the main research topic. In the1980s, the development of nursing concepts, theories, and philosophies was the mission of KSNS to extend the disciplinary boundary. In the1990s, the progress of KSNS to become one of the woman-dominant healthcare professionals was the mission in the given period. Expandingthe frontiers of KSNS to the extent of global standards was the undertaking of the nursing scholars in the 2000s. Lastly, in the 2010s,the quality and quantity improvement of KSNS and JKAN is expected to make our future even prosperous. The map visualization of the 50years of research accumulation showed the comparable opposition of quantitative vs. qualitative research methodologies, equation modeling,and instrument development.
Conclusion
These clusters of research demonstrates the efforts to make nursing evidence by Koreannursing scholars for the last five decades. The growth in the slope of KSNS and outcomes of JKAN are to carry on to an unimaginable extentin the future.

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Kyung-Sook Cho
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Original Article

Factors Influencing Health Behavior Related to Particulate Matter in Older Adults: Park, Min Kyung , Kim, Gwang Suk; J Korean Acad Nurs 2020;50(3):431-443. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.19201

Abstract PDF

Purpose
This study aimed to investigate health behavior related to particulate matter (PM) in older adults and examine the factors affectingit.
Methods
A cross-sectional survey design was used. Data were collected from 150 voluntary older adult participants from Songpa-gu inSeoul. The survey questions measured service perception and experience related to PM, risk perception related to PM, attitude toward riskof PM, and health behavior related to PM.
Results
The average score for health behavior related to PM was 79.37, ranging from 51 to 115.There was a significant positive correlation between health behavior related to PM and risk perception related to PM (r=.58, p <.001) as wellas between health behavior related to PM and attitude toward risk of PM (r=.70, p<.001). Multiple linear regression revealed that healthbehavior related to PM was predicted by levels of the existence of disease related to PM (β=.14, p=.019), service experience related to PM(b=.20, p=.021), risk perception related to PM (b=.20, p=.019), and attitude toward risk of PM (b=.44, p<.001). The model including thesevariables accounted for 47.0% of health behavior related to PM.
Conclusion
Korean older adults have the low level of health behaviorrelated to PM. The findings of this study emphasize that risk perception and attitude toward risk of PM should be evaluated, and theunderlying diseases related to PM and their service experience should be considered in developing intervention to improve health behaviorrelated to PM.

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Review Article

Parental Factors Associated with Smartphone Overuse in Preschoolers: A Systematic Review and Meta-Analysis: Lee, Gumhee , Kim, Sungjae , Yu, Heajin; J Korean Acad Nurs 2020;50(3):349-368. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.19186

Abstract PDF

Purpose
This study aimed to identify parental factors associated with smartphone overuse in preschoolers.
Methods
A systematic reviewwas conducted according to PRISMA guidelines. Relevant studies published in peer-reviewed journals from 2009 to June 2019 were identifiedthrough systematic search in 10 electronic databases (PubMed, CINAHL, Cochrane Central, EMBASE, Web of Science, NDSL, KISS, KMbase,KoreaMed, and RISS). Standardized effect sizes were calculated to quantify the associations of parental factors with smartphoneoveruse in preschoolers using meta-analysis.
Results
A total of 30 cross-sectional studies involving 7,943 participants met the inclusioncriteria. The following were negatively correlated with smartphone overuse in preschoolers: mother’s parenting self-efficacy (r =-.35),mother-child attachment (r =-.28), mother’s positive parenting behavior (r =-.28), mother’s positive parenting attitude (r =-.25), and father’sparenting involvement (r =-.15). Further, maternal factors such as smartphone addiction tendency (r =.41), parenting stress (r =.40), negativeparenting behavior (r =.35), negative parenting attitude (r =.14), smartphone usage time (r =.26), employment status (r =.18), and age(r =.12) were positively correlated with smartphone overuse in preschoolers.
Conclusion
Several parental factors influence smartphoneoveruse in preschoolers. These findings emphasize the need to assess and enhance the parental factors identified in this study to preventsmartphone overuse in preschoolers. Accordingly, we recommend the development of preventive interventions to strengthen parent-relatedprotective factors and mitigate risk factors.

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Original Articles

Effect of a Physical Activity Promoting Program Based on the IMB Model on Obese-Metabolic Health Outcomes among Obese Older Adults with Knee Osteoarthritis: Kim, Jung-Suk , Kim, Chun-Ja; J Korean Acad Nurs 2020;50(2):271-285. Published online April 30, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.2.271

Abstract PDF

Purpose
This study examined the effects of a physical activity promoting program based on the Information-Motivation-Behavioral Skills (IMB) model on physical activity and health outcomes among obese older adults with knee osteoarthritis.
Methods
This study utilized a randomized controlled trial with a convenience sample of 75 obese older adults with knee osteoarthritis in a university hospital. The older adults in the intervention group participated in a 12-week program involving weekly group sessions and monitoring calls with education booklets and video clips for exercise dances, while those in the control group received an usual care. Outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. The intervention effects were analyzed using Mann-Whitney U test and ANCOVA.
Results
The mean age of participants was 74.9 years with 84.0% women. The intervention group at 12 weeks showed significantly greater improvements in self-efficacy for physical activity (F=81.92, p <.001), physical activity amounts (Z=-2.21, p =.044), knee joint function (F=15.88, p <.001), and health-related quality of life (F=14.89, p <.001) compared to the control group. Among obese-metabolic outcomes, the intervention group at 12 weeks showed a significant decrease in visceral fat mass (F=7.57, p =.008) and improvement in high-density level cholesterol (F=9.51, p =.003) compared to the control group.
Conclusion
Study findings support the need for an IMB based physical activity program for promoting physical activity, knee function and health outcomes in obese older adults with knee osteoarthritis. Longitudinal studies are warranted to confirm the persistence of obese-metabolic effects in clinical settings.

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Development and Effects of Smartphone App-Based Exercise Program for Hemodialysis Patients: Eun Jeong Ki, Hyang Sook So; J Korean Acad Nurs 2020;50(1):52-65. Published online January 31, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.1.52

Abstract PDF

Abstract Purpose:

To examine the effects of a smartphone application-based exercise program on self-efficacy expectations (SEE) and outcome expectations regarding exercise (OEE), physical fitness, activity level, physiological indices, and health-related quality of life in a sample of hemodialysis patients.

Methods:

A quasi-experimental control group pre-test post-test design was used. Subjects were recruited from two university hospitals in G city. The subjects were assigned randomly by coin toss: 33 participants to the experimental group and 30 to the control group. A literature review and the self-efficacy theory were used to develop the smartphone program. Experts designed and verified the program to be userfriendly and in consideration of user interaction. Data were collected through a self-report pre-test post-test questionnaire and online medical records.

Results:

In the experimental group, the levels of physical fitness and physical activity were significantly improved post-test, but the scores on health-related quality of life and the physical indices did not improve. In the experimental group, the SEE and OEE post-test scores were also significantly higher than the pre-test scores, but the control group’s scores did not change.

Conclusion

The smartphone application-based exercise program based on self-efficacy theory significantly improved the level of physical fitness and activity, SEE, and OEE for hemodialysis patients. The use of this application-based exercise program for hemodialysis patients might be an effective nursing intervention tool for improving SEE, OEE, level of physical fitness, and physical activity.

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Development and Effect of a Smartphone Overdependence Prevention Program for University Students Based on Self-Determination Theory: Myung Soon Kwon, Jeong Soon Yu; J Korean Acad Nurs 2020;50(1):116-131. Published online January 31, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.1.116

Abstract PDF

Abstract Purpose:

This study aimed to develop a smartphone overdependence prevention program for college students based on the self-determination theory (SDT) and evaluate its effectiveness.

Methods:

A non-equivalent control group repeated measures design was used for the study. Participants were 64 university freshmen (experimental group: 29, control group: 35). The developed program consists of eight sessions conducted twice a week. The program was designed to promote autonomy, competence, and relatedness the three elements of the basic psychological needs of self-determination theory. The participants were assessed before the program, immediately after, and 1 and 3 months after the program. Data were collected from April 23 to September 14, 2018 and analyzed by performing a Chi-square test, Fisher’s exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 23.0.

Results:

This study showed improvement in the basic psychological needs (F=3.90, p=.010) in the experimental group compared to the control group. Specifically, competence (F=2.93, p=.035), relatedness (F=2.89, p=.045), and self-regulatory ability (F=3.11, p=.028) improved significantly.

Conclusion

Study findings indicate that the smartphone overdependence prevention program based on the Self-determination theory could be an effective intervention for improving basic psychological needs and self-regulation ability. Therefore, this program could be an efficient strategy for smartphone overdependence prevention in university students.

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Effects of a Reinforcement Program for Postpartum Care Behavioral Skills of Couples with Their First Baby: Meera Park, Kyung Min Park; J Korean Acad Nurs 2019;49(2):137-148. Published online April 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.2.137

Abstract PDF

Purpose

This study aimed to investigate the effects of a reinforcement program for behavioral skills in postpartum care for couples with their first baby.

Methods

The study used a non-equivalent control group and pretest-posttest design. It was conducted from January 14 to April 10, 2016 at a postpartum care center in D city. It analyzed 43 couples (22 in the experimental group and 21 in the control group.) For data analysis, descriptive statistics, test of homogeneity in pretest, independent t-tests, and repeated measures ANOVA were used.

Results

For maternal fulfillment of postpartum care and postpartum fatigue, there was no significant difference in the interaction between group and time. In terms of parent-newborns attachment, the interaction between group and time showed a significant difference for mothers (F=13.63, p=.001) and fathers (F=6.51, p=.001). In marital intimacy, the interaction between group and time showed a significant difference for mothers (F=14.40, p<.001) and fathers (F=9.46, p=.004). In parenting stress, the interaction between group and time showed a significant difference for mothers (F=31.8, p<.001) and fathers (F=11.69, p=.001). A significant difference was found for the mothers' postpartum sleeping hours (F=0.14 p=.004).

Conclusion

This program for behavioral skills in postpartum care, which is based on the information-motivation-behavioral skills model, improves postpartum care, parent-newborn attachment, marital intimacy, parenting stress, and maternal postpartum sleeping, by reinforcing behavioral skills required for postpartum care.

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Experiencing Coercive Control in Female Victims of Dating Violence: Jinsook Kwon, Sihyun Park; J Korean Acad Nurs 2019;49(1):46-58. Published online February 28, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.1.46

Abstract PDF

Background

Dating violence refers to violence occurring between people in an intimate relationship. Forms of dating violence are often categorized into physical, psychological, and sexual violence, and most existing literature has followed this frame. However, few studies have focused on the phenomenon of living under the perpetrator's coercive control in victims of dating violence, although those experiences are known to be signs of severe forms of violence later on.

Purpose

The purpose of this study was to explore the experiences of being coercively controlled in female victims who had experienced dating violence.

Methods

For this study, in-depth interviews were conducted with a total of 14 female victims, and all interviews were audio-recorded and transcribed. The data were analyzed using the phenomenological analysis method suggested by Colaizzi.

Results

Three themes were derived in chronological order: idealizing the relationship (period of potential control), facing severer tyranny (period of coercive control), and escaping from the unending trap (period of post-control). The results showed that the victims experienced perpetrators' control with specific patterns. The perpetrators' controlling behaviors were invisible, literally benevolent, at the beginning; however, severe forms of violence seemed to appear as their relationship deepened and the perpetrators failed to control the victims.

Conclusion

Findings from this study presented vivid experiences of female victims who needed help and care. Hopefully, the results can benefit in terms of developing evidence-based prevention strategies for victims as well as assessing the risks of severe forms of dating violence, such as physical attack or murder.

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Beatriz Víllora, María Jesús Cava, Sofía Buelga, Raúl Navarro
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Implementing expressive writing therapy in a virtual setting: A feasibility trial for survivors of intimate partner violence
Sihyun Park, Yejung Ko
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Development and Validation of the Bystander Engagement Scale for Witnessed Intimate Partner Violence: A South Korean Version
Sihyun Park, Yejung Ko
Journal of Interpersonal Violence.2024; 39(13-14): 2959. CrossRef
Development and Initial Validation of a Scale to Measure Social Abuse in Intimate Partner Relationships
Sihyun Park, Hyunji Woo, Kader Tekkas-Kerman
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Social marketing program for dating violence bystander intervention on university campus: analyzing its effectiveness and sociocultural feasibility
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Sihyun Park, Su-Hyang Bang, Jaehee Jeon
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Sihyun Park, Yejung Ko
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Hye Young Min, Jung Min Lee, Yoonjung Kim
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The Effects of Utilizing Smartphone Application Peer Support on Health Behavior and Body Mass Index among Breast Cancer Survivors: Gaeun Park, Haejung Lee, Hyun Yul Kim; J Korean Acad Nurs 2019;49(5):550-561. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.5.550

Abstract PDF

Abstract Purpose

This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS).

Methods

A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA.

Results

At the completion of SAPS significant differences were found between groups in motivation for exercise (t=-3.24, p=.005), physical activity (t=-4.15, p<.001), total calorie intake (t=3.42, p=.002), calories from fat (t=-3.01, p=.005), intake of vegetables (t=-2.83, p=.008), and BMI (t=5.21, p<.001). Significant differences in BMI (t=4.13, p<.001) remained up to 3 months after SAPS completion. No significant differences was shown between groups in self-efficacy for exercise, either immediately after or 3 months after SAPS.

Conclusion

The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.

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Suyoun Maeng, Jungok Yu
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Effects of an integrated lifestyle intervention for overweight and obese breast cancer survivors: A quasi-experimental study
Su Jin Seo, Ju-Hee Nho
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Ji-Su Kim, Minhae Kim, Yeji Seo
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Gustavo Adolfo Pimentel-Parra, M. Nelia Soto-Ruiz, Leticia San Martín-Rodríguez, Paula Escalada-Hernández, Cristina García-Vivar
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Bok Yae Chung, Sung Jung Hong
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Su-Jin Seo, Ju-Hee Nho, Youngsam Park
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A Structural Model for Quality of Life in Individuals with Rheumatoid Arthritis: Hyun Soo Oh, Young Ran Kim; Journal of Nurses Academic Society 1997;27(3):614-626. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.3.614

Abstract PDF

The main purposes of the study were to develop and test a model which explains the dynamic relationship among factors reported as affecting to the quality of life of individuals with rheumatoid arthritis and to examine the relationship between self-help response and quality of life. Data for the study were collected from March 1996 to December 1996 from 153 female patients who regularly visited a clinic for people with rheumatism. The Patients were introduced to the investigators by nurses who worked at that clinic, and then the investigator interviewed the patients for 30 to 40 minutes to collect the data. Instruments used in the study were modified self-report questionnaires from the ones which were already developed in previous studies of from related literature. Data analysis were performed using LISREL(Lineal Structural Relations) 8 Program to test whether the proposed hypothesized model fit the collected data. To test fitablity of the hypothesized model both a general fit measure and a detailed fit measure were used. Based on the test results from the various fit measures, the hypothesized model was found to be well suited to the real data. As characteristics related to illness becomes severe, the feasibility for uncertainty about the illness tend to increase, but, the direct effects from the illness characteristics(such as level of physical symptoms, sense of social-psychologic change, limitations of action) as they are related to the other intrinsic variables(self-efficacy or self-help behavior and quality of life), were found to be not significant. It was found that uncertainty had a direct effect on self-efficacy but did not have a direct effect on self-help behavior or quality of life. Also, it is noted that self-efficacy had a positive effect on self-help behavior and quality of life and there was a bilateral relationship between self-efficacy and self-help behavior. Lastly, the hypothesis proposed from the theoretical model in this study was supported basis of the results that self-help behavior provides both direct and positive effects to quality of life. Particularity, since a bilateral relationship was also found between self-help behavior and quality of life in the modified model, as self-help behavior increased, so did quality of life. And, reversely, as quality of life increased, so did self-help behavior. In conclusion, the results of this study suggest that focusing on both acquirement and reinforcement of adjustment factors or self-help behavior is more efficient than focusing on the characteristics of illness in establishing the strategies for improving quality of life of individuals with rheumatoid arthritis.

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Health-related quality of life in female patients with reumatoid arthritis: a structural equation model
Bukyung Kim, Mi-Hae Sung
Korean Journal of Women Health Nursing.2023; 29(2): 91. CrossRef
Factors Related to Quality of Life among Older Adults who Had Arthritis: Limited Daily Activities and Physical Activity
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Health-related Quality of Life in Korean Patients with Rheumatoid Arthritis: Association with Pain, Disease Activity, Disability in Activities of Daily Living and Depression
Dong Choon Uhm, Eun Sook Nam, Ho Yeon Lee, Eun Bong Lee, Young Im Yoon, Gong Ju Chai
Journal of Korean Academy of Nursing.2012; 42(3): 434. CrossRef

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A Study on the Development of a Postrartum Depression Scale: Jeung Iee Bai; Journal of Nurses Academic Society 1997;27(3):588-600. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.3.588

Abstract PDF: Postpartum depression is one of the most serious problems in maternal health because it affects not only the mother but also her family. Postpartum depression disturbs the maternal-infant interaction and attachment. However, most postpartum depression patients ignore this problem and do not seek treatment. Many clinicians and researchers realize there is a need to develop a postpartum depression scale. Thus, this study has been designed to development of a postpartum depression scale. Data were collected through a survey over a period of three months. Subjects who participated in the study were 167 Korean mothers in their postpartum period. The author used a convenience sampling method. The analysis of the data was done with SPSS PC+ for descriptive statistics, item analysis and factor analysis. Initially 62 items were generated from the interview data of eight postpartum depression patients and from a literature review. This preliminary scale was analyzed for reliability and validity. The results of this analysis are as follows. 1. Initially 62 items were analyzed through the index of Content Validity(CVI)and 48 items were selected. 2. Seven factors were extracted through the principal component analysis, and these contributed 61% of the variance in the total score. Finally 46 items in the scale loaded .41~.84 on one of seven factors. 3. Each factor was labeled. Factor 1 was labeled 'emotional phenomena-emotional upset' and included 13 items, factor 2 was labeled 'cognitive phenomena-self concept disturbance' and included seven items, factor 3 was labeled 'relationship to baby-negative feeling' and included six items, factor 4 was labeled 'relationship to baby-overload' and included eight items, factor 5 was labeled 'negative maternal identity' and included five items, factor 6 was labeled 'biophysiological phenomena-disturbance of physical functioning' and included four items, and factor 7 was labeled 'interpersonal relationship phenomena-blamed others' and included three items. 4. Cronbach Coefficient Alpha for internal consistency was .95 for the total 46 items. Finally, the author suggests that this scale could be adequately applied in assessing the postpartum depression of mothers during the postpartum period. The results of this study can contribute to designing an appropriate postpartum depression prevention strategy.

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An Exploration of the Life Experiences of Patients with Chronic Pain: Women with Rheumatoid Arthritis: Hea Kyung Hur; Journal of Nurses Academic Society 1997;27(1):13-25. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.1.13

Abstract PDF: Rheumatoid Arthritis(RA), a chronic and systemic inflammatory disorder, is characterized by joint pain, swelling and stiffness. Patients with RA suffer from joint pain and overall pain. The painful and disabling consequences of RA are accompanied by a variety of affective, cognitive, and behavioral changes. The purpose of this paper was to explore and describe the life experiences of RA patients by eliciting verbal description of their experiences. Participants were nine persons who were diagnosed with RA, and had if for more than six months. They were asked open ended and descriptive questions in order for them to talk about their experiences in their own terms. Interviews were tape recorded and transcribed verbatim. The transcripts were analyzed by Colaizzi method. From the protocols, 213 significant statements about life experience were organized into 83 formulating meanings which were then grouped into five theme clusters. The major themes that emerged from the analysis were 'Emotional Disturbances', 'Trying to Adapt to the Progress of Treatment', ' Change of Role Performances', 'Experiences related to Family'. The result of this study showed that RA patients and families need nursing care based on a deep understanding of their lived experiences in everyday life. Nurses and other health workers must develop rehabilitation programs that focus on the pain control, functional independence and psychosocial factors.

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A Study on the Postpartum Depression Experience: Q-Methodological Approach: Hye Sook Jang, Su Jin Kim, Jeong Sun Kim, Hung Kyu Kim, Euy Soon Choi; Journal of Nurses Academic Society 1996;26(4):917-929. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.4.917

Abstract PDF: The purpose of this study is to explore types of postpartum depression and to understand the nature and structure of the postpartum depression by using Q-methodological approach. As a way of research, 55 statements concerning postpartum depression were selected through individual interviews with postpartum mothers and literature review. 30 women were chosen as a subject group for the study, with opinions shown in 55 statements divided into 9 scales by forced distribution. PC QUANL Program was used for analysis and Q-factors were analyzed by using principal component analysis. As a result, postpartum depression experience was classified into 5 types. There are "Role -Strain Type", "Unattributional Depression Type", "Psychosomatic Symptoms Type", "Self-Compassion Type", and "Role-Crisis Type". Type I was named "Role-Strain Type", referring to the strain generally experienced by mothers with regard to the new role as a mother and as a social member. Type II was named "Unattributional Depression Type", referring to the symptom experienced by people who were in a state of vanity and a sense of loss. They often break into tears for no specific reasons. In case of Type III, people in a state of "Psychosomatic Symptoms Type" develop physical symptoms after suffering from inherent emotional conflict. Type IV was named "Self-Compassion Type" refers to the symptom shown by those who feel pity for their children and for themselves. And they show inability to cope with the reality properly. Type V was named "Role-Crisis Type", which is experienced by people who have a burden and a severe fear of their own job and their children in their mind, also showing serious conflict with maternal role. Futhermore, it was carried out to examine structure of postpartum depression in terms of degree of depression and adjustment ability. Type I showed mild degree of depression and relatively good adjustment ability. Type II showed broad range of degree in depression and moderate adjustment ability. Type III showed moderate depression and relatively low adjustment ability. Type IV revealed relatively serious degree of depression and the lowest adjustment ability. Type V revealed very serious degree of depression and the lowest adjustment ability. As a result, considering the structure of postpartum depression, Type I is considered to be a normal depression sympton which most mothers generally experience, followed by Type II, Type III, Type IV and Type V, each of which show increasingly worse degree of depression and lower adjustment ability. In conclusion, it seems to be it is necessary to understand distinct symptoms of postpartum depression and to examine the characteristics and structure of those types, so that it could lead to more individual nursing approach.

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An Effect of Muscle Strengthening Exercise Program on Muscle Strength, Pain, Depression, Self-efficacy, and Quality of Life of Patients with Knee Osteoarthritis: Mi Ra Lee; Journal of Nurses Academic Society 1996;26(3):556-575. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.3.556

Abstract PDF

In an attempt to investigate the effect of a muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy and quality of life of patients with knee osteoarthritis, a pre-experiment, one group pre-test and post-test design, was planned. Muscle strengthening exercise was carried out from May 22 through August 14, 1995 at isokinetic exercise room in rehabilitation department of University Hospital in Taejon. The subjects were seven female clients conveniently sampled from University Hospital located in Taejon, between 39 and 61 years of age, who had a osteoarthritis in knee. Muscle strengthening exercise program was composed of three sessions per week, one isokinetic exercise at angular velocity of 60degrees and 180degrees with Cybex isokinetic dynamometer and two resistance home exercise sessions with elastic band. Data were analyzed with frequency, percentage of change, Friedman test, Duncan test using SAS program. Results were obtained as follows: 1) Flexion and extension muscle strength at angular velocity of 60degrees and 180degrees were increased after 12weeks' exercise than those of before experiment. But exept flexion muscle strength at angular velocity of 180degrees (F=3.34, P=0.0261), there was no statistically significant difference among muscle strengths, which is measured every 3 weeks. 2) Pain was decreased after 6weeks' exercise than that of before experiment, and after 12weeks' exercise than that of 6weeks' exercise. There was statistically significant difference(F=4.28, P= 0.0396). 3) Depression was increased after 6weeks' exercise than that of before experiment, and after 12weeks' execise than that of 6weeks' exercise. There was no statistically significant difference between before experiment and after 6weeks' exercise. But, there was statistically significant difference between after 6weeks' exercise and 12weeks' exercise (F=9.38, P=0.0035). 4) Self-efficacy was decreased after 6weeks' exercise than that of before exercise. But, it was increased after 12weeks' exercise than that of before exercise and after 6weeks' exercise. But there was no statistically significant difference (F=1.46, P=0.2706). 5) Quality of life was increased after Gweeks' exercise than that of before exercise, and after 6weeks' exercise than that of 12weeks' exercise. But there was no statistically significant differ-ence(F=1.06, P=0.3816). Thus, the significant of muscle strengthening exercise for the improvement of muscle strength, pain, depression, is verified. But, this study was a preexperiment with small size subjects. So, controlled experimental study is necessary to determine the effect of this muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy, and quality of life of patients with knee osteoarthritis.

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The effects of elastic band exercises and nutritional education on frailty, strength, and nutritional intake in elderly women
Yena Bong, Wook Song
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Retracted:Effects of Exercise Program on Physical Fitness, Depression, and Self‐Efficacy of Low‐Income Elderly Women in South Korea
Kyung Rim Shin, Younhee Kang, Hyo Jung Park, Margaret Heitkemper
Public Health Nursing.2009; 26(6): 523. CrossRef

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Development of a Nursing Diagnosis System Using a Neural Network Model: Eun Ok Lee, Mi Soon Song, Myung Ki Kim, Hyeoun Ae Park; Journal of Nurses Academic Society 1996;26(2):281-289. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.2.281

Abstract PDF

Neural networks have recently attracted considerable attention in the field of classification and other areas. The purpose of this study was to demonstrate an experiment using back-propagation neural network model applied to nursing diagnosis. The network's structure has three layers; one input layer for representing signs and symptoms and one output layer for nursing diagnosis as well as one hidden layer. The first prototype of a nursing diagnosis systern for patients with stomach cancer was developed with 254 nodes for the input layer and 20 nodes for the output layer of 20 nursing diagnoses, by utilizing learning data set collected from 118 patients with stomach cancer. It showed a hitting ratio of .93 when the model was developed with 20,000 times of learning, 6 nodes of hidden layer, 0.5 of momentum and 0.5 of learning coefficient. The system was primarily designed to be an aid in the clinical reasoning process. It was intended to simplify the use of nursing diagnoses for clinical practitioners. In order to validate the developed model, a set of test data from 20 patients with stomach cancer was applied to the diagnosis system. The data for 17 patients were concurrent with the result produced from the nursing diagnosis system which shows the hitting ratio of 85%. Future research is needed to develop a system with more nursing diagnoses and an evaluation process, and to expand the system to be applicable to other groups of patients.

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Artificial intelligence, machine learning, and deep learning in women’s health nursing
Geum Hee Jeong
Korean Journal of Women Health Nursing.2020; 26(1): 5. CrossRef
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Jong Kyung Kim
Journal of Korean Academy of Nursing Administration.2010; 16(2): 121. CrossRef

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The Experience of the Postpartum Depression: A Grounded Theory Approach: Jeung Lee Bai; Journal of Nurses Academic Society 1996;26(1):107-236. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.1.107

Abstract PDF: The Purpose of this study was to build a substan tive theory about the experience of postpartum depression. The qualitative research method used was grounded theory. The interviewees were eight mothers who had experienced postpartum depression. The data were collected through in-depth interviews with audiotape recording done by the investigator over a period of twelve months. The data were analyzed simultaniously by a constant comparative method in which new data were continuously coded into categories and properties according to Strauss and Corbin's methodology. Analysis the grounded data resulted in 28 concepts being identified. Eight categories emerged from the analysis. The categories were regret, loss of freedom, isolation of oneself, heartache, loss, emotional upset, avoidance, recovery. These substantive categories are consistant with preious research results. Causal conditions included: regret, loss of freedom. Phenomena: heartache, loss, emotional upset. Context: isolation oneself. Intervention condition: avoidance. Action/interaction strategies: desire for recovery. Consequences: recovery. These categories were synthesized into the core concept-The process of filling the empty loss of self The process of the experienced postpartum depression was (1) change after delivery, (2) searching for a reason for depression, (3) effort to recover from postpartum depression, (4) recovery from postpartum depression and return to previous life. The process of recovery from postpartum depression was proceeded by (1) support from others, especially husband, (2) resolution of stressful life events, (3) reconstructing of life goals and resolution strategies, (4) acceptance of depression and seeking psychiatric treatment. Seven hypotheses were derived from the analysis. (1) Mothers who experienced stressful life event and economic problem are more depressive. (2) Mothers who have conflict with parents are more depressive. (3) The more somatic symptoms, the more depression. (4) Social support faciliates recovery from postpartum depression. (5) Mothers who have lower self-esteem are more depressive. (6) Mother's role overload disturbs recovery from postpartum depression. (7) Ideal maternal identity faciliates recovery from postpartum depression. Through this substantive theory, nurses can understand the importance of postpartum depression management.

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