The purpose of this study was to explain a structural model of posttraumatic growth among psychiatric nurses based on existing models and a literature review and verify its effectiveness.

Data were collected from psychiatric nurses in one special city, four metropolitan cities, and three regional cities from February to March 2016. Exogenous variables included hardiness and distress perception, while endogenous variables included self-disclosure, social support, deliberate rumination, and posttraumatic growth. Data from 489 psychiatric nurses were analyzed using IBM SPSS Statistics 19.0 and AMOS 20.0.

The modified model was a good fit for the data. Tests on significance of the pathways of the modified model showed that nine of the 14 paths were supported, and the explanatory power of posttraumatic growth by included variables in the model was 69.2%. For posttraumatic growth among psychiatric nurses, deliberate rumination had a direct effect as the variable that had the largest influence. Indirect effects were found in the order of hardiness, social support, and distress perception. Self-disclosure showed both direct and indirect effects.

A strategy to improve deliberate rumination is necessary when seeking to improve posttraumatic growth among psychiatric nurses. Enhancing psychiatric nurses’ hardiness before trauma would enable them to actively express negative emotions after trauma, allowing them to receive more social support. This would improve deliberate rumination and consequently help promote psychological growth among psychiatric nurses who have experienced trauma.

This study aimed to develop and test a structural model for chemotherapy-related cognitive impairment of breast cancer patients based on a literature review and Hess and Insel's chemotherapy-related cognitive change model.

The Participants consisted of 250 patients who were ≥19 years of age. The assessment tools included the Menopause Rating Scale, Symptom Experience Scale, Hospital Anxiety and Depression Scale, Everyday Cognition, and Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs.

The modified model was a good fit for the data. The model fit indices were χ ²=423.18 (p<.001), χ ²/df=3.38, CFI=.91, NFI=.91, TLI=.89, SRMR=.05, RMSEA=.09, and AIC=515.18. Chemotherapy-related cognitive impairment was directly influenced by menopausal symptoms (β=.38, p=.002), depression and anxiety (β=.25, p=.002), and symptom experiences (β=.19, p=.012). These predictors explained 47.7% of the variance in chemotherapy-related cognitive impairment. Depression and anxiety mediated the relations among menopausal symptoms, symptom experiences, and with chemotherapy related cognitive impairment. Depression and anxiety (β=-.51, p=.001), symptom experiences (β=-.27, p=.001), menopausal symptoms (β=-.22, p=.008), and chemotherapy-related cognitive impairment (β=-.15, p=.024) had direct effects on the quality of life and these variables explained 91.3%.

These results suggest that chemotherapy-related toxicity is highly associated with cognitive decline and quality of life in women with breast cancer. Depression and anxiety increased vulnerability to cognitive impairment after chemotherapy. Nursing intervention is needed to relieve chemotherapy-related toxicity and psychological factor as well as cognitive decline for quality of life in patients undergoing chemotherapy.

This study aimed to examine the effects of cognitive behavior therapy for insomnia (CBT-I) based on the mobile social networking service (SNS) on dysfunctional beliefs and attitudes about sleep, sleep quality, daytime sleepiness, depression, and quality of life among rotating-shift nurses in a hospital in Korea.

A nonequivalent control group pre-post test design was used. The participants included 55 nurses with rotating three-shift work (25 in the experimental group and 30 in the control group). For the experimental group, CBT-I using mobile SNS was provided once a week for 60 minutes over six weeks. Data were analyzed using descriptive statistics, χ²-test, independent samples t-test, and Mann-whitney U test with the SPSS 21.0 program.

In the homogeneity test of the general characteristics and study variables, there were no significant differences between the two groups. Nurses in the experimental group had significantly lower scores on dysfunctional beliefs and attitudes regarding sleep and sleepiness than nurses in the control group. Nurses in the experimental group had significantly higher scores on sleep quality and quality of life than nurses in the control group.

These findings indicate that using the mobile SNS-based CBT-I is feasible and has significant and positive treatment-related effects on rotating-shift nurses' irrational thoughts and beliefs in association with sleep, sleep quality, daytime sleepiness, and quality of life. These contribute to expanding our knowledge of rotating-shift nurses' sleep issues and their preferences for intervention.

The purpose of this study was to evaluate a cognitive behavioral anger management intervention in order to increase self-consciousness and decrease anger among Korean military men.

A quasi-experimental design was used for this study. Ninety two soldiers were screened for unhealthy anger expression using a questionnaire. Among them, 26 soldiers who showed unhealthy anger expression were selected for this study. They were matched by rank and assigned to either a treatment or control group. The treatment group received the intervention three consecutive times, once a week and for 120 minutes per session. Participants were assessed before and after the intervention for anger (the State-Trait Anger Scale) and self-consciousness (Self-consciousness Scale). Data was analyzed using descriptive statistics, χ²-test, Mann-Whitney test, and Wilcox on signed rank test.

There was no statistically significant decrease in anger or increase in self-consciousness between the two groups following treatment. However, there was a significant increase in private self-consciousness in the treatment group after the intervention(p=.006).

The cognitive behavioral anger management program improves private self-consciousness in soldiers. However, Additional research is needed to explore whether long-term intervention is more effective for anger control in the military setting. The findings from this study suggest that more attention should be given to mental health care for Korean soldiers.

This study was conducted to develop a comprehensive cognitive rehabilitation program that can be easily applied to brain injured patients by family members or nurses in community or hospital settings.

A Systemic literature review design was used. Thirty-three related studies were reviewed.

Based on the results of the literature review, the training tasks for attention were designated to enhancing 4 hierarchical areas, i.e., focused, selective, alternating, and divided attention. On the other hand, the memory rehabilitation tasks mainly consisted of mnemonic skills, such as the association method which helps patients memorize given information by linking together common attributes, the visual imagery method, and self-instruction method. The problem solving rehabilitation program included a task of games or plays which stimulated the patients' curiosity and interest. The training tasks for problem solving were to encourage the process of deriving reasonable solutions for a problematic situation resembling real problems that the patients were faced with in their everyday life.

It is expected that the cognitive rehabilitation program developed from this study could help patients having difficulty in their every day life, due to a reduced cognitive ability resulting from brain injury, to effectively adapt to every day life.

The purpose of this study was to compare the degree of cognitive level, nutritional status and depression in elderly according to living situations.

The subjects consisted of 173 elderly classifying three groups(living alone, living with spouse, living with children). Data was collected from March to June, 2003 by a structured questionnaire that included general characteristics, MMSE-K, nutritional status and depression scale. The collected data was analyzed by the SPSS program including descriptive statistics, χ²-test, ANCOVA, Scheffe test and Pearson Correlation Coefficient.

In MMSE-K, the living alone group showed suspicious dementia while the other groups were normal. The living alone group showed a high nutritional risk and all three groups showed depression. In MMSE-K, the nutritional status and depression were statistically significant by the living situation. In each group except living with spouse, MMSE-K indicated a significantly negative correlation to depression and nutritional status, while nutritional status showed a significantly positive correlation to depression.

It is necessary to develop supportive programs for decreasing the risk of bad health in the elderly and an individual approach according to their living situation. Especially, more concern and intervention is necessary for the solitary elderly.

The purpose of this study was to examine the effects of a cognitive training program on neurocognitive task performance and activities of daily living (ADL) in patients who had a stroke.

The research design for this study was a nonequivalent control group non-synchronized design. Patients were assigned to the experimental (n=21) or control group (n=21). The experimental group received a 4-week cognitive training program and usual care (i.e., rehabilitation service), while the control was received usual care only. Cognitive function was measured with a standardized neurocognitive test battery and ADL was assessed at baseline and one and two months after completion of the intervention. Repeated measures ANOVA was used to determine changes in cognitive function and ADL over 2 months.

The interaction of group and time was significant indicating that the experimental group showed improvement in attention, visuospatial function, verbal memory, and executive function compared to the control group which had a sustained or gradual decrease in test performance. A significant group by time interaction in instrumental ADL was also found between the experimental group with gradual improvement and the control group showing no noticeable change.

Findings show that the cognitive training program developed in this study is beneficial in restoring cognitive function and improving ADL in patients following a stroke. Further study is needed to investigate the long-term relationship between cognitive training participation and cognitive improvement and effective functioning in daily living.

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

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

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

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

The purpose of this study was to test a hypothetical model of chemotherapy-related cognitive impairment (CRCI) and depression in people with gastrointestinal cancer.

A purposive sample of 198 patients undergoing chemotherapy was recruited from November 2014 to July 2015. The instruments were Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module. Data were analyzed using descriptive statistics, correlation, and path analysis.

CRCI was directly affected by cancer symptoms (β=.19, p=.004) and fatigue (β=.56, p<.001)(R²=47.2%). Depression was directly affected by fatigue (β=.48, p<.001) and CRCI (β=.27, p<.001). However, The impact of cancer symptoms on depression was confirmed through the mediating effect of CRCI.

Results indicate that in patients with gastrointestinal cancer undergoing chemotherapy along with the direct physiologic effects (fatigue, symptoms) of cancer treatment may have altered cognitive function leading to depression.

This study was done to develop a internalized stigma reducing program based on cognitive-behavioral therapy and appropriate for patients with schizophrenia and to evaluate its effectiveness.

The study design was a mixed method research. Qualitative study, 13 patients with schizophrenia who had experience in overcoming stigma were purposively chosen for interviews and data were analyzed using Giorgi method. Quantitative study, 64 patients with schizophrenia (experimental group=32, control group=32) were recruited. The cognitive-behavioral therapy-based program for reducing internalized stigma in patients with schizophrenia was provided for 8 weeks (12 sessions). Data were collected from June. 20, 2013 to Feb. 14, 2014. Quantitative data were analyzed using χ²-test, t-test, repeated measures ANOVA with the SPSS program.

Qualitative results, from the experience of coping with stigma in patients with schizophrenia seventeen themes and five themes-clusters were drawn up. Quantitative results showed that internalized stigma, self-esteem, mental health recovery and quality of life were significantly better in the experimental group compared to the control group.

Study findings indicate that this program for reducing internalized stigma in patients with schizophrenia is effective and can be recommended as a rehabilitation program intervention to help patients with schizophrenia to cope with internalized stigma.

The purpose of this study was to test the mediating effect of psychological distress in the relationship between chemotherapy related cognitive impairment (CRCI) and quality of life (QOL) in people with cancer.

A purposive sample of 130 patients undergoing chemotherapy was recruited for the cross-sectional survey design. Data were collected from November 2014 to June 2015. The instruments were K-MMSE (Korean Mini-Mental State Examination), Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny steps for mediation.

The mean score for objective cognitive function was 27.95 and 69.32 for perceived cognitive decline. Overall quality of life was 91.74. The mean score was 17.52 for psychological distress. The prevalence was 56.2% for anxiety and 63.1% for depression, and 20.0% for CRCI. There were significant correlations among the variables, objective cognitive function and self-reported cognitive decline, psychological distress, and quality of life. Psychological distress was directly affected by CRCI. (R²=29%). QOL was directly affected by CRCI. Psychological distress and CRCI effected QOL (R²=43%). Psychological distress had a partial mediating effect (β= -.56, p <.001) in the relationship between self-reported cognitive decline and quality of life (Sobel test: Z= -5.08, p <.001).

Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline, and decreasing psychological distress are highly recommended to improve quality of life in cancer patients.

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.

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.

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.

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.

This study was done to evaluate the Military Mental Health Promotion Program. The program was an email based cognitive behavioral intervention.

The research design was a quasi-experimental study with a non-equivalent control group pretest-posttest design. Participants were 32 soldiers who agreed to participate in the program. Data were collected at three different times from January 2012 to March 2012; pre-test, post-test, and a one-month follow-up test. The data were statistically analyzed using SPSS 18.0. The effectiveness of the program was tested by repeated measures ANOVA.

The first hypothesis that the level of depression in the experimental group who participated in the program would decrease compared to the control group was not supported in that the difference in group-time interaction was not statistically significant (F=2.19, p=.121). The second and third hypothesis related to anxiety and self-esteem were supported in group-time interaction, respectively (F=7.41, p=.001, F=11.67, p<.001).

Results indicate that the program is effective in improving soldiers' mental health status in areas of anxiety and self-esteem.

This study was done to compare demographic characteristics, comorbidity, and health habits of elders with mild cognitive impairment (MCI) and elders with cognitively normal function (CNF).

Secondary data analysis was conducted using data from the Database of the Seoul Dementia Management Project for 5,773 adults age 60 and above.

The MCI group showed an older age distribution, but there was no significant education difference between the two groups. Elders with MCI had more diabetes and stroke than elders with CNF. In subgroups, the same findings were observed in women, but not in men. While more men with MCI had hypertension compared to men with CNF, there was no significant difference in hypertension between the two groups for women. Elders with MCI, men in particular, had a lower prevalence of obesity than men with CNF. MCI individuals did less exercise compared to individuals with CNF. While there were no significant differences in alcohol consumption and smoking between MCI and CNF groups, the over 80's subgroup with MCI reported more alcohol consumption.

Findings from this study could be helpful in designing community-based dementia prevention programs and health policies to reduce the prevalence of dementia or related cognitive impairments.

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

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.

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.

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.

This study was done to evaluate the effects of cognitive behavioral therapy in a victimized community district and to determine if the program is an effective nursing intervention to reduce posttraumatic stress disorder symptom, depression and state anxiety.

A nonequivalent control group design was used for the study. The participants, 32 elementary school students, were selected from grades 4, 5, 6 and each student was assigned to either the experimental (16) or control (16) group. Cognitive behavioral therapy was used as the experimental treatment from April 9 to May 28, 2009. The experimental group received cognitive behavior therapy intervention 8 times. Data analysis was done using ANCOVA with SPSS 17.0.

After the intervention, the experimental group showed significantly lower levels of posttraumatic stress disorder symptoms than the control group.

The findings from this study suggest that cognitive behavioral therapy is an effective nursing intervention to decrease the level of mental health problems of children in victimized district. Further research is required in order to identify the continuous effects of cognitive behavioral therapy.

The purpose of this study was to identify the prevalence of cognitive impairment, behavioral problems, and the state of mental health for elderly Korean people who have been institutionalized.

A cross-sectional, nation-wide survey was performed using an anonymous questionnaire. The participants in this study were 2,521 institutionalized elderly Korean people. A proportional stratified random sampling method was employed.

1) Elders admitted to subacute hospitals and long term care (LTC) facilities showed a higher level of cognitive impairment compared to elders admitted to acute care hospitals. 2) Elders confined in LTC facilities showed a higher level of behavioral problems compared to elders in acute or subacute hospitals. 3) Elders admitted to subacute hospitals and LTC facilities showed more serious mental health problems, such as depression or suicidal ideation, compared to elders in acute care hospitals.

The results of this study indicate that the severity of cognitive-behavioral or mental health problems do not match well with type of care setting. Therefore, health personnel working with elderly people should be provided guidance on detection and management of cognitive-behavioral and mental health problems. The necessity of a decision support system for eligibility and placement in long-term care is also discussed.

This study was conducted to analyze the factors that influence the life satisfaction of the elderly according to their cognitive impairment level.

This study was conducted by dividing 3,012 elderly residents of a regional community into three groups based on the scores of the Korean version of the Mini-Mental State Examination: a normal group without any cognitive impairment, a suspicious group with a mild level of cognitive impairment, and a high risk group with a high level of cognitive impairment. Researchers made phone calls, house calls, and personal visits to health centers and shelters for the elderly to gather the information required for this study.

The results of this study revealed that social relationships, depression, and activities of daily living had a significant impact on life satisfaction for the normal group, while social relationships and depression had a high impact on life satisfaction for the suspicious group, and social relationships had high impact on the life satisfaction of the high risk group.

Based on the results of this study, we suggest that programs that promote development of the social relationship networks of the elderly should be established to promote their life satisfaction.

The purpose of this study was to analyze the effects of a cognitive-behavioral nursing intervention on anxiety and depression of patients with breast cancer undergoing radiotherapy.

A nonequivalent control group design was used for the study. The research participants were patients with breast cancer (N=71; experimental group=35, comparison group=36) who received radiotherapy at P university hospital. The experimental group received a 6-week cognitive-behavioral nursing intervention (2 hr/week), which included nursing counseling, education about treatment choices for breast cancer and possible side effects and management strategies during radiotherapy, and rehabilitation exercise.

Following the intervention, the experimental group showed significantly lower levels of anxiety (Experimental group=34.60±6.35, Comparison group=44.63±9.93, t=3.552, p<.001) and depression (Experimental group=10.20±6.61, Comparison group=17.81±10.85, t=3.542, p<.001) than the comparison group.

The findings from this study showed that cognitive-behavioral counseling applied by nurses is very effective to reduce anxiety and depression among patients with breast cancer. Therefore, providing nursing counseling to broader spectrum of patients with cancer should be considered. Further research would warrant future clinical application of nursing counseling.

The purpose of this study was to identify the effects of an exercise program on frontal lobe cognitive function in seniors.

The participants were 42 seniors using a health center in Seoul (experimental group) and 28 seniors using a facility for elders in Seoul (control group). The exercise program was carried out for 16 weeks from April to August 2007. The frontal lobe cognitive function, which includes short term memory, attention, immediate memory, delayed memory, verbal fluency and motor function, was measured by the Digit Span Forward test, Trail Making test, Immediate recall words test, Delayed recall words, Controlled oral word association test and Finger tapping test. The collected data were analyzed by Fisher's exact test, Chi-square, t-test, and ANCOVA using the SAS program.

The major findings of this study were as follows: Attention (p=.009), immediate memory (p=.005), delayed memory (p=.009), and verbal fluency (p=.004) improved after the exercise program.

In this study, the exercise program was effective in improving frontal lobe cognitive function in elders. So it provides basic information for further nursing education on exercise programs which will be effective for prevention of early cognitive function decline in normally aging elders.

The purpose of this study was to examine cognitive functions, depression, and life satisfaction among the elderly receiving visiting nursing services.

The subjects of this study consisted of 221 elderly individuals who were receiving visiting nursing services from public health center located in Gyeonggi-do. The Mini-mental State Examination Korea version (MMSE-K), Geriatric Depression Scale-short form-Korea version (GDS-K), and Life Satisfaction Scale were utilized to determine cognitive functions, depression, and life satisfaction. Collected data was analyzed by the SPSS PC Win 12.0 program.

The prevalence of cognitive impairment (MMSE-K≤24) was 86.4%, and the proportion of severe depression (GDS-K≥10) was 22.6%. Older age, lower education, and low income were associated with cognitive impairment, and low education, no religion, and low income were associated with depression. Cognitive function negatively correlated with depression. Life satisfaction level was fairly low and was not associated with any variables.

The high prevalence of cognitive impairment and low life satisfaction status were determined among low-income elderly who were registered at a visiting health care center. Thus, in the future at visiting health care services, efficient and various programs for the elderly should be tried, to improve cognitive functions and reduce depression. Additionally, consistent evaluation studies for those programs will be required.