Journal of Korean Academy of Nursing

Research Paper

Development and Evaluation of Health Empowerment Scale for North Korean Women Defectors: Lim, Semi , Kang, Younhee; J Korean Acad Nurs 2022;52(1):80-91. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21174

Abstract PDF: Purpose
This study developed an instrument to evaluate the health empowerment of North Korean women refugees and examined its validity and reliability.
Methods
Through literature review and focused group interviews, 66 preliminary items with three constructs, including perceived control, perceived competence, and goal internalization were selected based on Menon’s psychological health empowerment model. A questionnaire survey was conducted with 239 North Korean women refugees in the community from August 31 to September 4, 2020. Content, construct, convergent, and discriminative validity were evaluated. Cronbach’s α was used to evaluate the reli-ability of scale.
Results
The final instrument consisted of 31 items with three factors that were identified through confirmatory factor analysis. The convergent validity showed that the correlation coefficient was .52 (p < .001), which confirmed the validity of the developed measurement tool. Cronbach’s α for all the items was .94, and Cronbach's α for the factors was .76~.91.
Conclusion
This health empowerment scale has been developed to include aspects of health empowerment, provide a conceptual framework, and offer objective indicators to evaluate the effectiveness of a health education program.

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Original Articles

Effects of a Relapse Prevention Program on Insight, Empowerment and Treatment Adherence in Patients with Schizophrenia: Jaewon Joung, Sungjae Kim; J Korean Acad Nurs 2017;47(2):188-198. Published online April 28, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.2.188

Abstract PDF

Purpose

The purpose of this study was to develop a relapse prevention program (RPP) and examine the effects of the RPP on insight, empowerment, and treatment adherence in patients with schizophrenia.

Methods

A non-equivalent control group pretest-posttest design was used. Participants were 54 inpatients who had a diagnosis of schizophrenia (experimental group: 26, control group: 28). The study was carried out from February 7, 2012 to February 6, 2013. Over a 10-day period prior to discharge each participant in the experimental group received three one-hour sessions of RPP a one-to-one patient-nurse interaction. Data were collected using Assess Unawareness of Mental Disorder (SUMD), Empowerment Scale, and Insight and Treatment Attitude Questionnaire (ITAQ) and analyzed using PASW 18.0 with chi-square test, independent t-test, Mann-Whitney U test, and ANCOVA.

Results

The experimental group had a significant increase in insight and treatment adherence compared to the control group. However, there was no significant difference in empowerment between the two groups.

Conclusion

Findings indicate that the RPP for patients with schizophrenia was effective in improving insight and treatment adherence. A longitudinal study is needed to confirm the persistence of these effects of RPP in patients with schizophrenia.

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An Analysis of the Concept 'Empowerment': Ok Hee Koo; Journal of Korean Academy of Nursing 1998;28(1):37-46. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.1.37

Abstract PDF: Recently the concept of 'empowerment' not only attracts attention in the area of management but also is considered as an useful concept in the areas of nursing theory, practice, education, and research. The purpose of this paper is to clarify the meaning of the concept 'empowerment'. More concretely, it is to find the concept that can be applied appropriately to the area of nursing management. This study uses Walker and Avant's(1983) process of concept analysis. The attributes of empowerment based on the concept can be defined concisely as follows: 1. a dynamic and interaction process. 2. a partnership which values self and others : power shaving. 3. mutual decision-making using resources, opportunities, and authority 4. accept autonomy and responsibility Antecedents of empowerment consist of 1) mutual trust and respect, 2) education and support, 3) participation and commitment. In regard to the consequences of empowerment, it is expected to 1) positive self-esteem, 2) ability to sex and reach goals, 3) the promotion of organization's effectiveness and productivity, 4) provide effective and high quality health-care, 5) a sense of hope for the future. The concept of empowerment is certainly believed that it will help future nurses since they needs an integrated technique that can treat acute and chronic patients' nursing, individuals, families, and communities. Therefore, it is necessary to develop the instrument including the defining attributes identified in this study. Also, it is need follow up study of this concept.

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Impact of Clinical Nurses' Power and Empowerment on Job Satisfaction and Organizational Commitment: Hyeon Hui Park, Kyung Sook Park, Young Hee Yom, Kyung Hee Kim; Journal of Korean Academy of Nursing 2006;36(2):244-254. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2006.36.2.244

Abstract PDF

Purpose

This study was performed to analyze effects of the power and empowerment on job satisfaction and organizational commitment. This study was based on the Kanter's theory of organizational empowerment.

Method

A predictive, non-experimental design was used to test the model in a sample of 688 nurses working in 7 university hospitals that have over 500 beds in Seoul, Kyunggi and Kangwon provinces. The data were collected from December, 2003 to January, 2004. It was analyzed with descriptive statistics and Pearson correlation of SPSS and with path analysis of LISREL.

Result

The formal and informal power had direct effects on empowerment. Formal power also had direct effects on informal power. Empowerment had direct effects on job satisfaction and organizational commitment. Organizational commitment had direct effects on job satisfaction. There was positive effects in all of the variables.

Conclusion

The positive changes show on personal behaviors and attitudes when the nurses who have formal and informal power are empowered. These findings would be important resource to nurse administrators for clinical implication.

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Effects of an Empowerment Program on the Burden of Mothers Having a Child with Cerebral Palsy: Yong Sook Eo; Journal of Korean Academy of Nursing 2005;35(1):154-164. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.1.154

Abstract PDF

Purpose

The purpose of this study was to develop an empowerment program as a nursing intervention for mothers who care for a child with cerebral palsy at home and to determine the effects of the program on those mothers' self efficacy, coping behavior and burden.

Method

An non-equivalent control group pretest-posttest design was used in this study. An Empowerment program was developed based on Dunst & Trivette's model. Using the program, the study was carried out from Dec. 13, 2003 to Jan. 17, 2004, mothers whose children, aged 1 to 6, were outpatients of the Dept. of Rehabilitation Medicine, at P University Hospital or registered at educational institutions for early disabled children. The experimental group of subjects were included in the new empowerment program which was held for two and half hours every week for 6 times.

Results

After treatment with the Empowerment Program, the experimental group was found to be significantly increased in score for self efficacy(t=4.55, p<.01), coping behavior(t=5.54, p<.001), objective burden(t=-3.96, p<.01) and subjective burden(t=-5.05, p<.01), in comparison to the control group.

Conclusion

The Empowerment Program is very effective in increasing self efficacy and coping behavior of mothers having a child with cerebral palsy and decreasing their burden. Finally, this study would recommend that an empowerment program should be extended to community facilities such as public health offices and welfare centers.

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Online social support and collective empowerment: Serial mediation effect on self‐efficacy among mothers of children with type 1 diabetes
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Evaluating the effectiveness of a family empowerment program on family function and pulmonary function of children with asthma: A randomized control trial
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Effects of Breastfeeding Empowerment Program on Breastfeeding Self-efficacy, Adaptation and Continuation in Primiparous Women: Seon Mi Song, Mi Kyung Park; J Korean Acad Nurs 2016;46(3):409-419. Published online June 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.3.409

Abstract PDF

Purpose

The purpose of this study was to develop a breastfeeding empowerment program and to investigate the effects of the breastfeeding empowerment program on self-efficacy, adaptation and continuation of breastfeeding for primiparous women.

Methods

The 5 session breastfeeding empowerment program was developed and a non-equivalent control group non-synchronized quasi-experiment design was used. Fifty-five participants were assigned to either the experimental group (n=27) or the control group (n=28). Effects were tested using repeated measures ANOVA and χ²-test.

Results

Scores for self-efficacy, adaptation and continuation of breastfeeding of in the experimental group after program were significantly higher than 1week, 4weeks, 8weeks scores in control group.

Conclusion

The effects of the breastfeeding empowerment program for elevating self-efficacy, adaptation and continuation of breastfeeding in primiparous women were validated. Therefore, this program can be recommended for vigorous use in clinical practice.

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Development and Validation of the Empowerment Scale for Woman with Breast Cancer: Sun Hwa Shin, Hyojung Park; J Korean Acad Nurs 2015;45(4):613-624. Published online August 31, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.4.613

Abstract PDF

Purpose

The purpose of this study was to develop a scale to evaluate empowerment in woman with breast cancer and to examine the validity and reliability of the scale.

Methods

The development process for the initial items included a literature review, interviews, and construction of a conceptual framework. The identified items were evaluated for content validity by experts, resulting in 3 factors and 48 preliminary items. Participants were 319 women with breast cancer recruited to test reliability and validity of the preliminary scale. Data were analyzed using item analysis, confirmatory factor analysis, criterion related validity, internal consistency and test-retest reliability.

Results

The final scale consisted of 30 items and 3 factors. Factors, including 'intrapersonal factor' (14 items), 'interactional factor' (8 items), and 'behavioral factor' (8 items), were drawn up after confirmatory factor analysis. Goodness of fit of the final research model was very appropriate as shown by χ²/df=1.86, TLI=.90, CFI=.92, SRMR=.06, and RMSEA=.05. Criterion validity was evaluated by total correlation with the Cancer Empowerment Questionnaire .78. Cronbach's alpha for total items was .93 and test-retest reliability was .69.

Conclusion

Findings from this study indicate that the scale can be used in the development of nursing interventions to promote the empowerment of women having breast cancer.

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Development and Evaluation of Health Empowerment Scale for North Korean Women Defectors
Semi Lim, Younhee Kang
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Reliability and Validity of the Korean Version of the Health Care Empowerment Questionnaire (K-HCEQ)
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Soo Hyun Kim, Yu Hyeon Choe, Ah Reum Han, Gwui Jeong Yeon, Gyeong Hee Lee, Bo Gyeong Lee, Young Up Cho, Seho Park, Moon Hee Lee
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Acta Oncologica.2017; 56(2): 156. CrossRef

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Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness: Chorong Park, Misoon Song, Belong Cho, Jaeyoung Lim, Wook Song, HeeKyung Chang, Yeon-Hwan Park; J Korean Acad Nurs 2015;45(2):192-201. Published online April 30, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.2.192

Abstract PDF

Purpose

The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness.

Methods

A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function.

Results

Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups.

Conclusion

The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.

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Review Article

Evidence Based Practice in Long Term Care Settings: Janet K. Specht; J Korean Acad Nurs 2013;43(2):145-153. Published online April 30, 2013; DOI: https://doi.org/10.4040/jkan.2013.43.2.145

Abstract PDF

Purpose

The purpose of this manuscript is to discuss the need for use of evidence based practice (EBP) in LTC, the current use of evidence in long term care facilities and what we know about adoption of the use of EBP in LTC.

Methods

Literature review and reporting of findings from the M-TRAIN study that was a quasi-experimental design to test the effectiveness of an intervention to increase the use of EBPs for urinary incontinence and pain in 48 LTC facilities.

Results

Barriers to adopting EBPs include lack of available time, lack of access to current research literature, limited critical appraisal skills, excessive literature to review, non-receptive organizational culture, limited resources, and limited decision-making authority of staff to implement change. Strategies to promote adoption of EBP include the commitment of management; the culture of the home; leadership; staff knowledge, time, and reward; and facility size, complexity, the extent that members are involved outside the facility, NH chain membership, and high level of private pay residents. Findings from the M-TRAIN add, stability of nurse leader and congruency between the leaders perception of their leadership and the staff's perception of the leadership.

Conclusion

There is clear evidence of the need and the benefits to residents of LTC and to the health care system yet adoption of EBP continues to be slow and sporadic. There is also evidence for the process of establishing best evidence and many resources to find the available EBPs. The urgent need now is finding ways to best get the EBPs implemented in LTC. There is growing evidence about best methods to do this but continued research is needed. Clearly, residents in LTC deserve the best care possible and EBPs represent an important vehicle by which to do this.

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Original Articles

Effects of an Empowerment Program on the Adjustment of Older Adults to Nursing Home Life: Aekyung Chang, Yeon-Hwan Park; J Korean Acad Nurs 2012;42(4):559-567. Published online August 31, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.4.559

Abstract PDF

Purpose

This study aimed to evaluate the effectiveness of the empowerment intervention on the levels of self-esteem, interpersonal relationships and adjustment to nursing home life of the Korean nursing home residents.

Methods

Participants (n=47) whose period of stay was less than one year were purposefully selected from 3 nursing homes in Korea. The experimental group (n=21) attended 10 weekly hour-long empowerment sessions. The empowerment program comprised two components; group education and group discussion. The control group (n=26) received a two-hour education about health management.

Results

Compared with the control group, the experimental group showed significantly higher mean scores of self-esteem (t=5.51, p<.001), interpersonal relationships (t=2.73, p=.009) and adjustment to nursing home life (t=2.10, p=.041).

Conclusion

Findings of this study suggest that empowerment interventions may be effective in enhancing nursing home residents' self-esteem, interpersonal relationships and adjustment to nursing home life. Future research is needed to determine if such an empowerment program could be used with newly institutionalized elders to speed as well as enhance their adjustment to nursing home life.

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Contingent Nurses' Burnout and Influencing Factors: Won Ock Kim, Sook Ja Moon, Sang Sook Han; J Korean Acad Nurs 2010;40(6):882-891. Published online December 31, 2010; DOI: https://doi.org/10.4040/jkan.2010.40.6.882

Abstract PDF

Purpose

This study was designed to identify burnout and factors influencing burnout in contingent nurses.

Methods

A cross-sectional design was conducted with a sample of 228 contingent nurses randomly selected from 25 general hospitals in Korea. The tools used for this study were scales measuring burnout (8 items), job stress (8 items), job satisfaction (9 items), self efficacy (9 items), organizational commitment (9 items), empowerment (9 items), autonomy (7 items) and social support (8 items). The data were analyzed using SPSS 15.0 employing Pearson correlation coefficients and multiple regression analysis.

Results

The mean score for burnout in contingent nurses was 3.05 points. Factors influencing burnout in contingent nurses were identified as job stress (β=.40), satisfaction level with current ward (β=-.25), organizational commitment (β=-.21), job satisfaction (β=-.19) and empowerment (β=-.16). These factors explained 65.0% of burnout reported by contingent nurses.

Conclusion

The results indicate which factors are major factors influencing burnout in contingent nurses in general hospitals. Therefore, these factors may serve as predictors of burnout in contingent nurses.

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Effects of an Empowerment Education Program in the Prevention of Internet Games Addiction in Middle School Students: Aeran Joo, Inhyae Park; J Korean Acad Nurs 2010;40(2):255-263. Published online April 30, 2010; DOI: https://doi.org/10.4040/jkan.2010.40.2.255

Abstract PDF

Purpose

The purpose of this study was to determine effects of an empowerment education program (EEP) on internet games addiction, empowerment, and stress in middle school students.

Methods

The EEP used in this study was based on the Freire's Empowerment Education Model. The research design of this study was a non-equivalent control group pretest-posttest design for 48 middle school students, who were conveniently assigned to an experimental group or a control group. The data were collected from May 29 to June 19, 2005. Data were analyzed using SPSS/PC program with frequencies, χ²-test, Fisher exact test, t-test, mean, standard deviation and ANCOVA.

Results

1) The first hypothesis that, "the experimental group would have higher empowerment scores than the control group." was supported. 2) The second hypothesis that, "the experimental group would have lower internet games addiction scores than the control group." was supported. 3) The third hypothesis that, "the experimental group would have lower stress scores than the control group." was supported.

Conclusion

We suggest, therefore, that the EEP should be used with adolescent to help them control their stress, internet games addiction and to increase their empowerment.

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Factors influencing Nurses' Organizational Citizenship Behavior: Junhee Park, Eunkyung Yun, Sangsook Han; J Korean Acad Nurs 2009;39(4):499-507. Published online August 31, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.4.499

Abstract PDF

Purpose

This study was conducted to identify the factors that influence nurses' organizational citizenship behavior.

Methods

A cross-sectional design was used, with a convenience sample of 547 nurses from four university hospitals in Seoul and Gyeonggi province. The data were collected through a questionnaire survey done from September 22 to October 10, 2008. The tools used for this study were scales on organizational citizenship behavior (14 items), self-leadership (14 items), empowerment (10 items), organizational commitment (7 items), job satisfaction (8 items) and transformational·transactional leadership (14 items). Cronbach's alpha and factor analysis were examined to test reliability and construct validity of the scale. The data collected were processed using SPSS Window 15.0 Program for actual numbers and percentages, differences in the dependent variable according to general characteristics, and means, standard deviations, correlation coefficients and multiple regression analysis.

Results

The factors influencing nurses' organizational citizenship behavior were identified as self-leadership (β=.247), empowerment (β=.233), job satisfaction (β=.209), organizational commitment (β=.158), and transactional leadership (β=.142). Five factors explained 42.0% of nurses' organizational citizenship behavior.

Conclusion

The results of this study can be used to develop further management strategies for enhancement of nurses' organizational citizenship behavior.

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The Mediator Effect of Empowerment in Relationship between Transformational Leadership and Organizational Commitment: Yun-Mi Lee, Bok-Mi Kim; J Korean Acad Nurs 2008;38(4):603-611. Published online August 31, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.4.603

Abstract PDF

Purpose

This study was to determine the mediator or moderator role of empowerment in the relationship between the head nurse's transformational leadership and organizational commitment as perceived by staff nurses.

Methods

Data was collected from 451 nurses in a tertiary hospital located in B city by means of structured questionnaires. Data was analyzed with descriptive statistics, Pearson's correlation coefficient and hierarchial multiple regression using the SPSS program.

Results

Empowerment showed mediating effects between the head nurse's transformational leadership and organizational commitment as perceived by staff nurses. However, empowerment did not show moderating effects.

Conclusion

Nurses' perception of empowerment, the head nurse's transformational leadership and organizational commitment have a strong relationship. This finding suggests the importance of empowering nurses to increase organizational commitment.

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