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Original Articles
Relationships of Mood Disturbance, Symptom Experience, and Attentional Function in Women with Breast Cancer Based upon the Theory of Unpleasant Symptoms
Eun Hyun Lee
Journal of Korean Academy of Nursing 2005;35(4):728-736.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.4.728
AbstractAbstract
Purpose

The purpose of this study was to identify direct, mediating, and moderating relationships of mood disturbance, symptom experience, and attentional function in Korean women with breast cancer based upon a middle-range theory of unpleasant symptoms.

Methods

This study used a cross-sectional, correlational design. A convenience sample of 125 women receiving chemotherapy for breast cancer was recruited from a university hospital in South Korea. The women completed questionnaires on mood disturbance, symptom experience, and attentional function using the Linear Analogue Self-Assessment Scale, the Symptom Experience Scale, and the Attentional Function Index, respectively.

Results

Each mood disturbance and symptom experience showed a significant relationship with attentional function. Symptom experience did not act as a mediator between mood disturbance and attentional function, but it did act as a moderator: patients with a higher level of mood disturbance exhibited a lower level of attentional function when their symptoms were at the level of medium, but not when their symptoms were either high or low.

Conclusion

This suggests that clinical interventions for attenuating the influence of mood disturbance on attentional function may be effective only in women experiencing medium level of symptoms.

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Development and Effects of an Instructional Coaching Program Regarding Children with Attention Deficit Hyperactivity Disorder for Elementary School Teachers
Shin Jeong Park, Wan Ju Park
J Korean Acad Nurs 2017;47(3):305-318.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.305
AbstractAbstract PDF
Abstract Purpose

The aim of this study was to identify the effects of a newly developed instructional coaching program regarding Attention Deficit Hyperactivity Disorder (ADHD) for teachers.

Methods

Seventy teachers participated in this study involving a nonequivalent control group and a pretest-posttest design. The instructional coaching program consisted of eight 60-minute sessions. The program was developed through a theoretical development program involving six steps. To evaluate the effects of the program, data were collected through self-report questionnaires including the Knowledge Scale of Attention Deficit Disorder, Attitude Scale of Primary School Teachers Experiencing Students with ADHD, Practice Scale of Educational Intervention Activity, and the Korean ADHD Rating Scale. Data were analyzed with an independent t test, a chi-square test, and an ANCOVA using SPSS WIN version 20.

Results

The intervention program consisted of 3 sectors, 8 subjects, and 24 content items. The experimental group showed a significant improvement in attitudes toward ADHD (F=22.83, p<.001). In addition, teacher's knowledge regarding ADHD (F=7.16, p=.010) and the implementation of instructional interventions (F=4.29, p=.043) improved. Further, teachers reported a reduction in children's ADHD-related behavior (F=4.34, p=.041). Results showed that the coaching program made a positive contribution to teaching skills and understanding of school-age children with ADHD.

Conclusion

The instructional coaching program was well structured and significantly improved not only teachers'attitudes, knowledge, and teaching skills but also the behavior of children with ADHD in class. Therefore, the program is recommended as a means of facilitating teaching and managing children with ADHD in class.

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Review Article
Effects of Cognitive Behavioral Therapy on Attention Deficit Hyperactivity Disorder among School-aged Children in Korea: A Meta-Analysis
Wan-Ju Park, Shin-Jeong Park, Sung-Dong Hwang
J Korean Acad Nurs 2015;45(2):169-182.   Published online April 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.2.169
AbstractAbstract PDF
Purpose

This study was a meta-analysis designed to identify effects of Cognitive Behavioral Therapy (CBT) interventions in alleviating main symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among school-aged children in Korea.

Methods

Examination of several databases including Research Information Sharing Service, Korean Studies Information Service System, Data Base Periodical Information Academic and hand-searched article references, resulted in identification of 1,298 studies done between 2000 and 2013 of which 21 met the inclusion criteria. Comprehensive Meta-Analysis version 2.0 was used to analyze effect sizes, explore possible causes of heterogeneity, and check publication bias with a funnel plot and its trim-and-fill analysis.

Results

Overall effect size of CBT intervention was large (g=1.08) along with each outcome of self-control (g=1.26), lack of attention (g=1.02), social skills (g=0.92), and hyperactivity (g=0.92). For heterogeneity, moderator analysis was performed, but no significant differences were found between the RCT (Randomized Controlled Trials) group and the NRCT (Non RCT) group. Also, meta-regression was performed using sample size, number of sessions, and length of session as predictors, but no statistically significant moderators were found. Finally, a funnel plot along with trim-and-fill analysis was produced to check for publication bias, but no significant bias was detected.

Conclusion

Based on these findings, there is clear evidence that CBT intervention has significant positive effects on the main symptoms of school-aged children suffering ADHD. Further research is needed to target diverse age groups with ADHD along with more RCT studies to improve the effectiveness of the CBT intervention.

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Original Articles
Prevalence and Characteristics of Chemotherapy-related Cognitive Impairment in Patients with Breast Cancer
Jin-Hee Park, Sun Hyoung Bae, Yong-Sik Jung, Young-Mi Jung
J Korean Acad Nurs 2015;45(1):118-128.   Published online February 27, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.1.118
AbstractAbstract PDF
Purpose

Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy.

Methods

Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses.

Results

At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function.

Conclusion

These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.

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A Meta-analysis of Chemotherapy related Cognitive Impairment in Patients with Breast Cancer
Jin-Hee Park, Sun Hyoung Bae
J Korean Acad Nurs 2012;42(5):644-658.   Published online October 12, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.5.644
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the cognitive effects of chemotherapy in patients with breast cancer.

Methods

Using several databases, prospective studies were collected up to August 2011. Of 2,106 publications identified, 12 met the inclusion criteria, and 8 studies were used to estimate the effect size of chemotherapy on cognitive impairment.

Results

Twelve studies were done since 2005 and most of the research was performed in Europe or North America. Eight studies were used to generate effect size across the cognitive domains of attention/concentration, verbal and visual memory, executive function, visuospatial skill, language, and subjective cognitive function. Each of the cognitive domains showed small effect sizes (-0.02 ~ -0.26), indicating diminished cognitive function for the chemotherapy group compared with non-chemotherapy groups.

Conclusion

Finding suggests that breast cancer patients who undergo chemotherapy may experience mild cognitive decline. Further study is needed to generate knowledge and guideline for interventions to address chemotherapy related cognitive impairment in these patients.

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Meta Analysis of Variables Related to Attention Deficit Hyperactivity Disorder in School-Age Children
Wan Ju Park, Ji Yeong Seo, Mi Ye Kim
J Korean Acad Nurs 2011;41(2):256-268.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.256
AbstractAbstract PDF
Purpose

The purpose of this study was to use meta-analysis to examine recent domestic articles related to attention deficit hyperactivity disorder (ADHD) in school-age children.

Methods

After reviewing 213 articles published between 1990 and 2009 from and cited in RISS, KISS, and DBpia, the researchers identified 24 studies with 440 research variables that had appropriate data for methodological study. SPSS 17.0 program was used. The outcome variables were divided into five types: Inattention, hyperactive impulsive, intrinsic, extrinsic, and academic ability variables.

Results

Effects size of overall core symptoms was 0.47 which is moderate level in terms of Cohen criteria and effects size of overall negative variables related ADHD was 0.27 which is small level. The most dominant variable related to ADHD was obtained from hyperactive-impulsive (0.70). Also academic ability (0.45), inattention (0.37), and intrinsic variables (0.29) had a small effect whereas extrinsic variables (0.13) had little effect on descriptive ADHD study.

Conclusion

The results reveal that ADHD core symptoms have moderate effect size and peripheral negative variables related ADHD have small effect size. To improve the reliability of the meta-analysis results by minimizing publication bias, more intervention studies using appropriate study designs should be done.

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Analysis of Relationships between Parenting Stress, Maternal Depression, and Behavioral Problems in Children at Risk for Attention Deficit Hyperactive Disorder
Hee Sun Shin, Jeong Mee Kim
J Korean Acad Nurs 2010;40(3):453-461.   Published online June 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.3.453
AbstractAbstract PDF
Purpose

In this study differences in behavioral problems between children at risk for Attention Deficit Hyperactive Disorder (ADHD) and normally developing children were identified. Further, relationships between parental stress, depression, and child behavioral problems according to ADHD symptoms were explored.

Methods

Participants were 222 elementary school children and their parents. The ADHD risk group was determined by the Korean-ADHD Rating Scale. Data were collected using the Korean-ADHD Rating Scale, Korean version of Child Behavior CheckList (K-CBCL), Parenting Stress Index, and Beck Depression Inventory. Data were analyzed using t-test, Pearson correlation coefficients, and regression analysis.

Results

1) The ADHD risk group showed higher levels of behavioral problems, parenting stress, and maternal depression than the normal group. 2) There were significant relationships between ADHD scores and parenting stress (r=.66), maternal depression (r=.35), internal behavioral problems (r=.47), and external problems (r=.55), but, ADHD risk scores were negatively correlated with social competence (r=-.40). 3) The regression analysis revealed that ADHD levels affected the child's internal behavioral problems, mediated by maternal depression (β=.29, p<.001).

Conclusion

The study results show that higher risk scores for ADHD indicate a significant effect for behavioral problems. Also, parenting stress and depression influence child's behavioral problems. These results suggest that identification of children at risk for ADHD and development of parental education programs would contribute to the prevention of behavioral problems and aggravation of the ADHD symptoms.

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Parenting Experiences of Parents of Children with ADHD: Approaching the Normal
Won Oak Oh, Eun Sook Park
Journal of Korean Academy of Nursing 2007;37(1):91-104.   Published online February 28, 2007
DOI: https://doi.org/10.4040/jkan.2007.37.1.91
AbstractAbstract PDF
Purpose

The purpose of this study was to explore the experiences of parenting from the parents of children with ADHD and to develop a grounded theory about their experiences.

Method

This study was a qualitative research study that used a grounded theory to understand and discuss the parenting experiences of parents of children with ADHD in a greater depth. Grounded data was collected through an in-depth interview from twelve participants with ADHD children. The data was analyzed using the grounded theory method.

Results

“Approaching the normal” emerged as the core phenomenone. Parenting experiences for parents of children with ADHD referred to a process of bringing the children, back on track of normal growth development, and their functioning in the family at a normal level and establishing a new normalcy. The process of approaching the normal involved a basic social-psychological process, such as ‘living a day in hell’, ‘accepting’, ‘confronting the conflicts’, ‘lowering expectations’, and ‘making a new normalcy’.

Conclusion

The outcomes of this study, which observed the parenting process of parents of children with ADHD, could enhance nurses' understanding of ADHD and help nurses become major mental health service providers for the mental health of children with ADHD and their families.

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