Journal of Korean Academy of Nursing

Review Paper

Effectiveness of non-pharmacological interventions to reduce internalized stigma in people with severe mental illness: a systematic review and meta-analysis: Soyoung Kim, Sun Hyoung Bae, Myung-Sun Hyun; J Korean Acad Nurs 2025;55(1):1-18. Published online February 25, 2025; DOI: https://doi.org/10.4040/jkan.24072

Abstract PDF ePub: Purpose
This study systematically reviewed and analyzed the effects of non-pharmacological interventions on internalized stigma among people with severe mental illness.
Methods
A systematic review and meta-analysis were conducted following the Cochrane Intervention Research Systematic Review Manual and Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. This study targeted people with severe mental illness as the population, interventions aimed at reducing internalized stigma, comparisons with control groups, and internalized stigma as the outcome. A literature search was performed across multiple databases, including PubMed, EMBASE, the Cochrane Library, CINAHL, PsycArticles, RISS, KMbase, and KoreaMed. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Effect sizes were computed using Hedges’s g, and subgroup analyses were conducted with Comprehensive Meta-Analysis software version 4.0.
Results
Of 2,388 papers, 15 were included in the meta-analysis. The overall effect size (Hedges’s g) of the intervention was –0.60 (95% confidence interval, –1.01 to –0.19), indicating a statistically significant reduction in internalized stigma (Z=–2.88, p=.004). Subgroup analyses revealed that the intervention type (p=.008) and session length (p=.011) were significant moderators influencing the effectiveness of the interventions.
Conclusion
Tailoring interventions by considering variables such as the intervention type and session length could enhance the effectiveness of non-pharmacological interventions for reducing internalized stigma among people with severe mental illness (PROSPERO: CRD42023418561).

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Research Papers

Mediating effect of grit on the influence of nurses’ silence behavior on medication safety competence: a cross-sectional study: Haengsuk Kim, Wanju Park; J Korean Acad Nurs 2025;55(1):81-92. Published online February 20, 2025; DOI: https://doi.org/10.4040/jkan.24088

Abstract PDF ePub: Purpose
This study investigated the mediating effect of grit in the relationship between silence behavior and medication safety competence among nurses.
Methods
The study included 166 nurses from four university hospitals and general hospitals in Seoul and Gyeonggi-do, South Korea. Data were collected from March 1 to 10, 2024, using self-report questionnaires. Data were analyzed using the t-test, analysis of variance, Scheffé’s test, and Pearson’s correlation coefficients with IBM SPSS Statistics ver. 23.0 (IBM Corp.). A mediation analysis was performed using Hayes’s PROCESS macro model 4 and the bootstrapping method.
Results
Medication safety competence showed significant correlations with silence behavior (r=–.21, p=.008) and grit (r=.43, p<.001). Furthermore, grit partially mediated the relationship between silence behavior and medication safety competence.
Conclusion
This study indicates that grit is a significant mediator in the relationship between silence behavior and medication safety competence. Therefore, an integrated approach that reduces silence behavior and promotes grit is essential for strengthening nurses’ medication safety competence. Ultimately, these strategies will help ensure patient safety by improving medication safety competence.

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The Mediating Role of Psychological Resilience in Chinese Nursing Students’ Professional Identity and Learning Burnout: Liu Zhang, Qin Zhang, ShuWen Li, YuHong Li, GuoCui Wu, Ying Chen, YunNa Zhou; J Korean Acad Nurs 2024;54(4):509-518. Published online November 25, 2024; DOI: https://doi.org/10.4040/jkan.24044

Abstract PDF ePub: Purpose
This study investigated whether professional identity predicts learning burnout among Chinese nursing students, and whether resilience moderates this relationship.
Methods
This cross-sectional study recruited 635 students from a nursing college at a medical university in Hefei, China. Data were collected using the professional identity questionnaire, learning burnout scale for college students, and 10-item Connor-Davidson Resilience Scale. Pearson’s correlation analysis was used to investigate the relationships between variables. The mediation effect was evaluated using linear regression and the bootstrap method in SPSS.
Results
Nursing students exhibited intermediate learning burnout levels (score: 54.95 ± 10.42). Professional identity was positively correlated with psychological resilience (r = .42, p < . 001), whereas learning burnout was negatively correlated with professional identity (r = - .54, p < . 001) and psychological resilience (r = - .57, p < . 001). Psychological resilience mediated the relationship between professional identity and learning burntout to the tune of 32.8%.
Conclusion
Psychological resilience mediates the relationship between professional identity and learning burnout. Thus, nursing educators can mitigate student burnout by developing their students' professional identities and psychological resilience.

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Exploring Traumatic Experiences and Posttraumatic Growth among Korean Veterans: A Photovoice Study: Riah Kim, Heese Choi, Minsung Kim; J Korean Acad Nurs 2024;54(4):519-533. Published online October 14, 2024; DOI: https://doi.org/10.4040/jkan.24049

Abstract PDF ePub: Purpose
This study aimed to explore traumatic experiences and posttraumatic growth among Korean veterans.
Methods
A qualitative study was conducted using photovoice. Purposive sampling strategies yielded five veterans who had experienced traumatic events. Participants engaged in three discussion sessions between August 5, 2023, and October 28, 2023. The collected data were analyzed using photovoice document analysis and thematic analysis.
Results
Study results identified the following themes: ‘The collapse of my life as a result massive trauma,’ ‘Sinking into endless isolation and disconnection,’ ‘The process of finding myself through reflection,’ and ‘My life journey moving forward together.’ Despite the irreversible damage caused by traumatic experiences during military service, the participants continuously reflected on the meaning of their trauma and posttraumatic growth, thereby recovering their authentic selves.
Conclusion
Veterans who have experienced traumatic events face severe difficulties, however through their efforts at recovery, they recognize the individuals they are now. This study suggests the need for social support and highlights the necessity of providing various opportunities and policy assistance to traumatized veterans.

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Moderating Effect of General Self-Efficacy on the Relationship between Pregnancy Stress, Daily Hassles Stress, and Preterm Birth Risk in Women Experiencing Preterm Labor: A Cross-Sectional Study: Cho, Hyun-Jeong , Kim, Jeung-Im; J Korean Acad Nurs 2024;54(3):329-339. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.24008

Abstract PDF: Purpose
This study investigated the moderating role of general self-efficacy (GSE) on how stress caused by pregnancy and daily hassle affect the risk of preterm birth (PTB) in women experiencing preterm labor.
Methods
This cross-sectional study included 196 pregnant women experiencing preterm labor before 37 weeks of gestation. We used IBM SPSS Statistics 27 and employed Hayes process macro version 4 (model 1) and hierarchical regression to analyze the moderating effect of GSE on the relationship between pregnancy stress, daily hassle stress, and PTB risk.
Results
Stress caused by pregnancy and daily hassle was positively correlated to PTB risk (r = .54, p < .001; r = .25, p < .001, respectively). While GSE did not significantly correlate with pregnancy stress, it negatively correlated with daily hassle stress (r = - .19, p = .009). GSE significantly moderated the relationship between combined stressors and PTB risk. As GSE levels increased, escalation in PTB risk in response to increasing stress levels was a more pronounced, highlighting a complex interaction between higher GSE levels and response to escalating stress levels. This model accounted for 39.5% of the variance in the PTB risk.
Conclusion
Higher GSE may amplify the impact of stress on PTB risk, rather than mitigate it, which suggests a more nuanced role of GSE in the stress response of pregnant women at risk of preterm labor. GSE should be considered in care strategies, and managing its impact on stress perception and responses in pregnant women is crucial.

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Association between Resilience, Professional Quality of Life, and Caring Behavior in Oncology Nurses: A Cross-Sectional Study: Jeon, Misun , Kim, Sue , Kim, Sanghee; J Korean Acad Nurs 2023;53(6):597-609. Published online December 31, 2023; DOI: https://doi.org/10.4040/jkan.23058

Abstract PDF

Purpose
The degree of caring behavior of oncology nurses is a crucial factor in the care provided to patients with cancer. In this study, we aimed to investigate factors related to oncology nurses’ caring behavior, including their resilience and professional quality of life.
Methods
A cross-sectional descriptive study was conducted with 107 oncology nurses at an urban tertiary hospital from May 18 to 24, 2015. We used a self-report questionnaire to measure resilience, professional quality of life, and degree of caring behavior. Data analysis included descriptive statistics, correlations, and multiple regression analysis using SPSS/WIN 20.0.
Results
Oncology nurses presented with low levels of resilience and caring behavior, and high levels of compassion satisfaction, burnout, and secondary traumatic stress. There was a statistically significant relationship between the degree of caring behavior, resilience (r = .43, p < .001), compassion satisfaction (r = .51, p < .001), and burnout (r = - .42, p < .001), as well as between secondary traumatic stress and burnout (r = .34, p < .001). Factors associated with oncology nurses’ degree of caring behavior were compassion satisfaction (t = 6.00, p < .001) and educational level (t = 3.45, p = .001).
Conclusion
This study demonstrates that oncology nurses’ degree of caring behavior is related to their professional quality of life and education. These findings suggest that enhancing oncology nurses’ healthy coping strategies at both the individual and organizational levels can further develop holistic nursing care. Additionally, it is necessary to examine the factors affecting nurses’ compassion satisfaction and to try to promote this aspect.

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Burnout among health professionals working in oncology: current evidence and challenges for future research
Javier Martinez-Calderon, Cristina García-Muñoz
Current Opinion in Oncology.2025;[Epub] CrossRef
Personal and work-related factors associated with nurse resilience: An updated systematic review using meta-analysis and narrative synthesis
Fiona Yu, Deborah Raphael, Lisa Mackay, Melody Smith, Ritin Fernandez
International Journal of Nursing Studies.2025; 166: 105054. CrossRef
Mindful self-care among oncology nurses in China: a latent profile analysis
Yan Shi, Peng Wang, Lamei Liu, Mengmeng Li
BMC Nursing.2024;[Epub] CrossRef
The mediating role of compassion fatigue between perceived organization support and caring behavior among outpatient nurses in China: a cross-sectional study
Xingxing Liu, Fang He, Tian Tian, Jun Zhang, Yuanjiao Ji, Yuexia Zhong
BMC Nursing.2024;[Epub] CrossRef

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The Impact of Self-Efficacy on Nurses’ Well-Being: Does Digital Competence Matter?: Li, Yali , Jing, Qi , Feng, Taiwen , Yang, Xiaoling; J Korean Acad Nurs 2023;53(4):385-396. Published online August 31, 2023; DOI: https://doi.org/10.4040/jkan.23037

Abstract PDF

Purpose
Drawing on person–environment fit theory and social cognitive theory, this study aimed to examine how self-efficacy affects nurses’ workplace well-being via person-job fit and the moderating role of digital competence.
Methods
A two-wave survey was conducted to collect data. Data were collected from six hundred and ninety-five nurses at three Chinese hospitals between May 2022 and September 2022. We employed hierarchical regression analysis and bootstrapping to analyze the data.
Results
Self-efficacy positively influenced person-job fit (β = .55, p < .001), which positively affected nurses’ workplace well-being (β = .32, p < .001). Person-job fit mediated the effect of self-efficacy on nurses’ workplace well-being. Additionally, digital competence strengthened the positive impact of self-efficacy on person-job fit (β = .12, p < .001).
Conclusion
Recruiting nurses with both self-efficacy and digital competence benefits hospitals. It is critical for nurses to improve their digital competence for achieving person-job fit and attaining workplace well-being in the post-coronavirus disease 2019 (COVID-19) era.

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Work-family balance mediates self-efficacy and subjective well-being among nurses in Chinese intensive care units: A cross-sectional study
Lating Zhang, Xianzhen Jin, Na Cheng, Ruhua Wang, Xinhui Liang, Haiyan Fan, Xue Jiang
Applied Nursing Research.2025; 82: 151932. CrossRef
The Effect of Digital Competence on Nurses’ Career Sustainability: A Cross‐Sectional Study
Zeyu Zhang, Shuang Zhao, Yujiao Shao, Xiaocui Duan, Ping Sun, Lingling Chen, Fei Wang, Changjiang Yuan, Xiumu Yang, Lesley Barr
Journal of Nursing Management.2024;[Epub] CrossRef

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A Structural Equation Model for Posttraumatic Growth among Cured Patients with COVID-19: An, Soo Young , Choi, Heejung; J Korean Acad Nurs 2023;53(3):309-323. Published online June 30, 2023; DOI: https://doi.org/10.4040/jkan.22118

Abstract PDF: Purpose
This study aimed to develop and test a model for posttraumatic growth among cured patients with COVID-19. This model was based on Calhoun and Tedeschi’s Posttraumatic Growth model and a literature review.
Methods
The participants comprised 223 patients cured from COVID-19 who were ≥ 19 years of age. The data were collected through an online questionnaire from March 21 to 24, 2022. The assessment tools included the Impact of Event Scale: Revised Korean version, the Connor-Davidson Resilience Scale, the Distress Dis-closure Index, the Multidimensional Scale of Perceived Social Support, the Korean version of the Event-related Rumination Inventory, and the Korean version of the Post-traumatic Growth Inventory. Data were analyzed using the IBM SPSS version 24.0 and IBM AMOS 26.0.
Results
The modified model showed appropriate goodness of fit (χ 2 = 369.90, χ 2 /degree of freedom = 2.09, SRMR = .09, RMESA = .07, CFI = .94, TLI = .93). The post-traumatic growth of cured patients with COVID-19 was explained through distress perception, self-disclosure, and deliberate rumination, with the explanatory power being 70.0%.
Conclusion
This study suggests preparing a disaster psychology program involving experts who can activate deliberate rumination is necessary. Further, this study may serve as basic data for developing a program to enhance the post-traumatic growth of patients cured from COVID-19.

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Development and Psychometric Evaluation of the Ischemic Stroke Distress Scale (ISDS): Kang, Jaejin , Yoo, Yang-Sook; J Korean Acad Nurs 2023;53(1):12-27. Published online February 28, 2023; DOI: https://doi.org/10.4040/jkan.22090

Abstract PDF: Purpose
This study aimed to develop a scale to measure distress in patients with ischemic stroke and verify its validity and reliability.
Methods
Preliminary items were developed from literature review and in-depth interviews. The final preliminary scale was confirmed through a content validity test of eight experts and a preliminary survey of 10 stroke patients. The participants for psychometric testing were 305 stroke patients in the outpatient clinic. Validity and reliability analyses included item analysis, exploratory and confirmatory factor analysis, convergent validity, known-group validity, and internal consistency of the scale.
Results
The final scale consisted of 17 items and 3 factors. The three distinct factors were ‘self-deprecation, worry about future health, and withdrawal from society’ and this structure was validated using a confirmatory factor analysis. Convergent validity was supported by comparison with the Center for Epidemiologic Studies Depression Scale (r = .54, p < .001) and Brief Illness Perception Questionnaire (r = .67, p < .001). Known-groups validity was verified by dividing groups according to ‘duration since diagnosis’ (t = 2.65, p = .009), ‘presence of sequela’ (t = 10.16, p < .001), and ‘awareness of distress’ (t = 12.09, p < .001). The internal consistency of the scale using Cronbach’s α for the total items was .93.
Conclusion
The Ischemic Stroke Distress Scale is a valid and reliable tool that reflects stroke distress effectively. It is expected to be used as a basic tool to develop various intervention strategies to reduce distress in ischemic stroke patients.

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A Predictive Model of Resilience in Mothers of Children with Developmental Disabilities: Cho, Youyoung , Kim, Hyeonok; J Korean Acad Nurs 2022;52(4):407-420. Published online August 31, 2022; DOI: https://doi.org/10.4040/jkan.21235

Abstract PDF: Purpose
This structural model study was constructed and verified a hypothetical model to examine the effects of parenting stress, social resources, family resources, and positive coping on resilience among mothers of children with developmental disabilities.
Methods
Data were collected using self‐report structured questionnaires, from October 19 to October 30, 2018, with 214 mothers caring for chil-dren with developmental disabilities under the age of 20 years.
Results
In the fitness test results of the hypothesis model, with the fit index χ ² (p) = 69.27 (< .001), and the normed fit indices (χ ² = 1.87, GFI = .94, CFI = .97, NFI = .93, and TLI = .95, RMSEA = .06, SRMR = .06), this study satisfies the good fitness in standards. There are seven statistically significant paths among the 10 paths set in the hypotheti-cal model. The explanatory power of parenting stress and social resources, which affects the family resources was 41.4%, the explanato-ry power of parenting stress, social resources, and family resources affecting the positive coping was 58.9%, and the explanatory power of parenting stress, social resources, family resources, and positive coping affecting resilience was 55.5%.
Conclusion
Positive coping, family resources, and social resources of mothers of children with developmental disabilities directly affect their resilience, and parenting stress indirectly affects it. Therefore, to improve the resilience of mothers of children with developmental disabilities, it is necessary to develop a systematic nursing intervention that considers parenting stress, social resources, family resources, and positive coping.

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Relationships among Knowledge and Skills about Suicide Prevention, Attitudes toward Suicide, and Burnout of Suicide Prevention Work of Nurses at Mental Health Welfare Centers: A Mixed Methods Study: Dong, Hee-Ra , Seo, Ji Min; J Korean Acad Nurs 2022;52(1):92-104. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21189

Abstract PDF

Purpose
This study aimed to identify relationships among knowledge and skills about suicide prevention, attitudes toward suicide, and burnout of suicide prevention work of nurses at mental health welfare centers.
Methods
An explanatory sequential mixed-method research was conducted. For the quantitative study, the subjects (nurses) were 133 nurses executing suicide prevention work. The data were analyzed using the SPSS 25.0 program. For the qualitative research, 13 nurses with high burnout scores were interviewed. The data were analyzed using theme analysis method.
Results
Quantitative results showed the average burnout of suicide prevention work was 54.62 ± 12.51. The burnout of suicide prevention work had significant correlations with attitudes toward suicide (r = .30, p < .001) and suicide prevention skills (r = - .18,p = .037). Qualitative results showed six themes related to burnout of suicide prevention work. They were ‘feeling a lack of confidence in one’s suicide counselling skills’, ‘feeling of the limits of one’s ability to cope with a suicide crisis’, ‘feeling regret for not being able to help the clients’, ‘being over-empathetic to the clients’, ‘Not being able to understand the clients because the subjects (nurses) opposes committing suicide’, and ‘thinking that the suicidal thoughts of suicide attempters do not improve’.
Conclusion
To reduce burnout of nurses’ suicide prevention work at mental health welfare centers, there is a need to develop an educational program considering nurses' attitudes toward suicide and one to enhance their confidence in suicide prevention skills.

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Influence of Self-leadership, Managers’ Authentic Leadership, and Nurses' Organizational Culture Relationships on Hospital Nurses’ Organizational Silence: A Mixed Method Study
Hyun-Ju Lee, So-Young Kang
Journal of Korean Academy of Nursing Administration.2024; 30(4): 404. CrossRef
Evaluation of Internet-Based Training in Trauma Care for Nurses in Mental Health Welfare Centers: A Cluster Randomized Controlled Trial
Sunah Kim, Go-Un Kim, Jinyoung Park
Journal of Primary Care & Community Health.2023;[Epub] CrossRef

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Effects of Second Victim Experiences after Patient Safety Incidents on Nursing Practice Changes in Korean Clinical Nurses: The Mediating Effects of Coping Behaviors: Jeong, Seohee , Jeong, Seok Hee; J Korean Acad Nurs 2021;51(4):489-504. Published online August 31, 2021; DOI: https://doi.org/10.4040/jkan.21089

Abstract PDF

Purpose
This study was investigated the mediating effect of coping behaviors in the relationship between the second victim experiences after patient safety incidents and the nursing practice changes.
Methods
A cross-sectional survey was performed using structured questionnaires. Participants were 218 clinical nurses in general tertiary hospitals in South Korea. Data were collected through an online survey and snowball sampling from August 11 to September 6 2020. Data were analyzed using SPSS 23.0 program. A mediation analysis was performed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval.
Results
The mean scores of second victim experiences was 3.41/5. Approach coping (β = .55, p < .001) and the avoidant coping (β = - .23, p = .001) showed mediation effects in the relationship between second victim experiences and constructive change in nursing practice. Avoidant coping (β = .29, p < .001) showed a mediation effect in the relationship between second victim experiences and defensive change in nursing practice.
Conclusion
Coping behaviors has a mediating effect on the relationship between second victim experiences and nursing practice changes. To ensure that nurses do not experience second victim, medical institutions should have a culture of patient safety that employs a systematic approach rather than blame individuals. They also need to develop strategies that enhance approach coping and reducing avoidant coping to induce nurses’ constructive practice changes in clinical nurses in experiencing second victims due to patient safety incidents.

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Factors influencing negative outcomes for nurses who experience patient safety incidents: An integrative review
Hanseulgi Lee, Nam‐Ju Lee, Nari Kim
International Nursing Review.2025;[Epub] CrossRef
How does just culture reduce negative work outcomes through second victim distress and demand for support in clinical nurses? A path analysis
Seohee Jeong, Sunmi Kim, Hyoung Eun Chang, Seok Hee Jeong
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Changes in Nursing Practice Among Clinical Nurses After Experiencing a Patient Safety Incident: Partial Least Squares Structural Equation Modeling
Sunmi Kim, Seohee Jeong, Seok Hee Jeong, Majd Mrayyan
Journal of Nursing Management.2025;[Epub] CrossRef
“Learn from Errors”: Post-traumatic growth among second victims
Huanhuan Huang, Tong Liu, Ying Peng, Xingyao Du, Qi Huang, Qinghua Zhao, Mingzhao Xiao, Yetao Luo, Shuangjiang Zheng
BMC Public Health.2024;[Epub] CrossRef
Nurse Leader Perspectives and Experiences on Caregiver Support Following a Serious Medical Error
Marie M. Prothero, Madeline Sorhus, Katherine Huefner
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Prevalence of the second victim phenomenon among intensive care unit nurses and the support provided by their organizations
Maria Kappes, Pilar Delgado‐Hito, Verónica Riquelme Contreras, Marta Romero‐García
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The mediating role of coping styles in the relationship between second victim experience and professional quality of life among nurses: a cross-sectional study
Xizhao Li, Chong Chin Che, Yamin Li, Ling Wang, Mei Chan Chong
BMC Nursing.2023;[Epub] CrossRef
Associations among workplace incivility, stress coping, and nursing performance in hospital nurses: A path analysis
Eun Ha Kim, Yeojin Yi
Journal of Nursing Scholarship.2023; 55(4): 834. CrossRef
Influence of Clinical Nurses’ Second-Victim Experience and Second-Victim Support in Relation to Patient Safety Incidents on Their Work-Related Outcomes
Su Jin Jung, Youngjin Lee, Sun Hyoung Bae
Journal of Korean Academy of Nursing Administration.2022; 28(4): 331. CrossRef
Profiles of second victim symptoms and desired support strategies among Korean nurses: A latent profile analysis
Eun Young Choi, Jeehee Pyo, Minsu Ock, Haeyoung Lee
Journal of Advanced Nursing.2022; 78(9): 2872. CrossRef

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Development and Evaluation of Resilience Enhancement Program Applying Mindfulness Meditation in Patients with Ileostomy: Shin, Jee Hye , Choi, Ja Yun; J Korean Acad Nurs 2021;51(3):334-346. Published online June 30, 2021; DOI: https://doi.org/10.4040/jkan.21019

Abstract PDF

Purpose
The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy.
Methods
The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients’ needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes.
Conclusion
The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.

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David W. Orme-Johnson, Vernon A. Barnes, Brian Rees, Jean Tobin, Kenneth G. Walton
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Development and Evaluation of a Healthcare Empowerment Program for Patients with Temporary Ileostomy
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Influence of Self-care on Burnout in Primary Family Caregiver of Person with Dementia: Kwon, Jeong Hwa , Hong, Gwi-Ryung Son; J Korean Acad Nurs 2021;51(2):217-231. Published online April 30, 2021; DOI: https://doi.org/10.4040/jkan.20274

Abstract PDF

Purpose
The purpose of this study was to identify the influence of self-care on burnout experienced by primary family caregivers of persons with dementia.
Methods
The subjects of the study were 156 primary family caregivers of persons with dementia at home in Korea. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression using IBM SPSS Statistics ver. 24.0 for Windows.
Results
The mean scores for self-care and burnout were 42.35 and 61.60, respectively. Self-care, subjective health status, living with a person with dementia, and behavioral and psychological symptoms of dementia were significant factors affecting burnout in family caregivers. Self-care was identified as the strongest factor affecting burnout, explaining 13.9% of burnout with controlling factors in caregivers and care receivers.
Conclusion
To prevent burnout in primary family caregivers of persons with dementia, self-care of family caregivers should be emphasized. In nursing education, family caregivers should be recognized and approached as nursing clients who are responsible for taking care of their health. In nursing practice and research, digital self-care or self-care improvement intervention programs should be designed to help family caregivers, and further studies on self-care centered on health of family caregivers should be conducted.

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Development of a Tool to Measure Slow Nursing for Older Adults in Long-term Care Hospitals: A Methodological Study
Hyeon Mi Woo
Korean Journal of Adult Nursing.2024; 36(3): 212. CrossRef
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Ja Eun Kim, Soo Jin Lee
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Su-jin Lee, Ju-Young Park, Seo-Hyeon Kim
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Won Hee Jun, Eun Ju Cho, Eun Joung Choi
Journal of Korean Academy of psychiatric and Mental Health Nursing.2022; 31(4): 458. CrossRef

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Actor and Partner Effects of Couple’s Daily Stress and Dyadic Coping on Marital Satisfaction: Won, Su Kyung , Seol, Kyoung Ok; J Korean Acad Nurs 2020;50(6):813-821. Published online December 31, 2020; DOI: https://doi.org/10.4040/jkan.20162

Abstract PDF

Purpose
This study aimed to identify the actor and partner effects of daily stress and dyadic coping on marital satisfaction using the Actor-Partner Interdependence Mediational Model (APIeM).
Methods
Participants were 314 couples who met the study’s eligibility criteria. Data were collected from March to April 2016 through apartment and cooperative company communities in Seoul. Two APIeMs of positive and negative dyadic coping were analyzed using SPSS 20.0 and Mplus 7.4. All measures were self-administered.
Results
Daily stress and positive and negative dyadic coping in both spouses had direct actor effects on their marital satisfaction. Daily stress in both spouses had an indirect actor effect on marital satisfaction through their positive and negative dyadic coping. The husband’s daily stress had an indirect partner effect on the wife’s marital satisfaction through his positive dyadic coping, while the wife’s positive dyadic coping had a direct partner effect on the husband’s marital satisfaction. The husband’s daily stress had an indirect partner effect on the wife’s marital satisfaction through his negative dyadic coping, while the wife’s negative dyadic coping had a direct partner effect on the husband’s marital satisfaction.
Conclusion
Dyadic coping is an effective way to deal with couple’s daily hassles as it increase their satisfaction in marriage.

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Original Articles

Relationship of Workplace Violence to Turnover Intention in Hospital Nurses: Resilience as a Mediator: Kang, Hyun-Jung , Shin, Jaeyong , Lee, Eun-Hyun; J Korean Acad Nurs 2020;50(5):728-736. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.20147

Abstract PDF

Purpose
This study aimed to identify the relationship between workplace violence and turnover intention, and the mediation effect of resilience on the relationship in hospital nurses.
Methods
This was a cross-sectional study. A total of 237 registered nurses were recruited from three hospitals in South Korea from April to May 2019. Participants were invited to complete self-reported questionnaires that measure workplace violence, turnover intention, resilience, and demographic information. The data obtained were analyzed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval (5,000 bootstrap resampling).
Results
After controlling demographic covariates, workplace violence significantly accounted for the variance of turnover intention. It was also demonstrated that resilience partially mediated the relationship between workplace violence and turnover intention in hospital nurses. A 73.8% of nurses had experienced workplace violence (such as attack on personality, attack on professional status, isolation from work, or direct attack). Conclusion: Workplace violence directly influences turnover intention of nurses and indirectly influences it through resilience. Therefore, hospital administrators need to develop and provide a workplace violence preventive program and resilience enhancement program to decrease nurses’ turnover intention, and leaving.

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Effect of Emotional Coaching Program for Clinical Nurses on Resilience, Emotional Labor, and Self-efficacy: Ryu, Kyung , Kim, Jong Kyung; J Korean Acad Nurs 2020;50(3):419-430. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.19194

Abstract PDF

Purpose
This study aimed to assess the effect of the emotional coaching program for hospital nurses.
Methods
The study used anon-equivalent control group pretest-posttest design, and participants included 60 nurses (30 in the experimental group and 30 in thecontrol group) who worked at a general hospital. The experimental group attended four sessions, one per week, with each session lastingtwo and a half hours. Collected data were analyzed using descriptive statistics, Fisher’s exact test, x² test, t-test, paired t-test, and repeatedmeasures ANOVA using SPSS WIN 23.0 program.
Results
Significant differences were shown between the experimental and the controlgroups regarding emotional labor (F=68.40, p<.001), resilience (F=48.77, p<.001), and self-efficacy (F=15.31, p<.001).
Conclusion
Theemotional coaching program for nurses is useful for enhancing nurses’ emotional labor management, resilience, and self-efficacy. In addition,this program may serve as a basis for providing emotional coaching to nurses in the future.

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Adaptation to Motherhood in Central Asian-Korean Immigrants to Korea: A Grounded Theory Study: Su Hyun Kim, Hyang-In Cho Chung; J Korean Acad Nurs 2019;49(6):677-689. Published online December 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.6.677

Abstract PDF

Purpose

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

Methods

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

Results

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

Conclusion

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

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Factors Affecting Clinical Practicum Stress of Nursing Students: Using the Lazarus and Folkman's Stress-Coping Model: Sung Hae Kim, JuHee Lee, MiRa Jang; J Korean Acad Nurs 2019;49(4):437-448. Published online August 29, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.4.437

Abstract PDF

Purpose

This study was conducted to test a path model for the factors related to undergraduate nursing students' clinical practicum stress, based on Lazarus and Folkman's stress-coping model.

Methods

This study utilized a path analysis design. A total of 235 undergraduate nursing students participated in this study. The variables in the hypothetical path model consisted of clinical practicum, emotional intelligence, self-efficacy, Nun-chi, and nursing professionalism. We tested the fit of the hypothetical path model using SPSS/WIN 23.0 and AMOS 22.0.

Results

The final model fit demonstrated a satisfactory statistical acceptance level: goodness-of-fit-index=.98, adjusted goodness-of-fit-index=.91, comparative fit index=.98, normed fit index=.95, Tucker-Lewis index=.92, and root mean square error of approximation=.06. Self-efficacy (β=−.22, p=.003) and Nun-chi behavior (β=−.17, p=.024) were reported as significant factors affecting clinical practicum stress, explaining 10.2% of the variance. Nursing professionalism (β=.20, p=.006) and self-efficacy (β=.45, p<.001) had direct effects on emotional intelligence, explaining 45.9% of the variance. Self-efficacy had indirect effects on Nun-chi understanding (β=.20, p<.001) and Nun-chi behavior (β=.09, p=.005) through emotional intelligence. Nursing professionalism had indirect effects on Nun-chi understanding (β=.09, p=.005) and Nun-chi behavior (β=.09, p=.005) through emotional intelligence. The variables for self-efficacy and nursing professionalism explained 29.1% of the Nun-chi understanding and 18.2% of the Nun-chi behavior, respectively.

Conclusion

In undergraduate nursing education, it is important to identify and manage factors that affect clinical practicum stress. The findings of this study emphasize the importance of Nun-chi, self-efficacy, emotional intelligence, and nursing professionalism in the development of an educational strategy for undergraduate nursing students.

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Motherhood Ideology and Parenting Stress according to Parenting Behavior Patterns of Married Immigrant Women with Young Children: So-Hyun Moon, Miok Kim, Hyeun Na; J Korean Acad Nurs 2019;49(4):449-460. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.4.449

Abstract PDF

Abstract Purpose

This study aims to provide base data for designing education and counseling programs for child-raising by identifying the types, characteristics and predictors of parenting behaviors of married immigrant women.

Methods

We used a self-report questionnaire to survey 126 immigrant mothers of young children, who agreed to participate, and who could speak Korean, Vietnamese, Chinese, Filipino, or English, at two children's hospitals and two multicultural support centers. Statistical analysis was conducted using descriptive analysis, K-means clustering, χ 2 test, Fisher's exact test, one-way ANOVA, Schéffe's test, and multinominal logistic regression.

Results

We identified three clusters of parenting behaviors: ‘affectionate acceptance group’ (38.9%), ‘active engaging group’ (26.2%), and ‘passive parenting group’ (34.9%). Passive parenting and affectionate acceptance groups were distinguished by the conversation time between couples (p=.028, OR=5.52), ideology of motherhood (p=.032, OR=4.33), and parenting stress between parent and child (p=.049, OR=0.22). Passive parenting was distinguished from active engaging group by support from spouses for participating in multicultural support centers or relevant programs (p=.011, OR=2.37), and ideology of motherhood (p=.001, OR=16.65). Ideology of motherhood was also the distinguishing factor between affectionate acceptance and active engaging groups (p=.041, OR=3.85).

Conclusion

Since immigrant women's parenting type depends on their ideology of motherhood, parenting stress, and spousal relationships in terms of communication and support to help their child-raising and socio-cultural adaptation, it is necessary to provide them with systematic education and support, as well as interventions across personal, family, and community levels.

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Review Article

Effect of Autogenic Training for Stress Response: A Systematic Review and Meta-Analysis: Eunju Seo, Soukyoung Kim; J Korean Acad Nurs 2019;49(4):361-374. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.4.361

Abstract PDF

Abstract Purpose

This study was conducted to evaluate the effectiveness of autogenic training on stress responses through a systematic review and meta-analysis.

Methods

A systematic search was conducted using eight core electronic databases (Embase, CENTRAL, Medline, CINAHL, PsycInfo, DBpia, KISS, and RISS). To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3.5 program.

Results

A total 21 studies out of 950 studies were included in the review, and 11 were included for meta-analysis. These studies showed that autogenic training decreased anxiety and depression, and increased the high frequency of heart rate variability. Calculations to understand the effect of autogenic training on anxiety, through a meta-analysis, observed a reduction effect of anxiety score by 1.37 points (n=85, SMD=-1.37: 95% CI -2.07 to -0.67), in the studies on short-term intervention targeting healthy adults. On the other hand, similar calculations to understand the effect of autogenic training on depression observed, a reduction effect on the depression score by 0.29 point (n=327, SMD=-0.29: 95% CI -0.50 to -0.07), in the studies on long term intervention targeting the patient group.

Conclusion

Autogenic training is effective for adults’ stress management, and nurses will be able to effectively perform autogenic training programs for workers’ stress relief at the workplace.

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Original Articles

Structural Equation Model for Sleep Quality of Female Shift Work Nurses: Ji Yeong Jeong, Mee Ock Gu; J Korean Acad Nurs 2018;48(5):622-635. Published online October 31, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.5.622

Abstract PDF

Purpose

This study aimed to develop and test a structural model for sleep quality in female shift work nurses. The hypothetical model was constructed on the basis of Spielman's 3P model of insomnia and previous research related to the sleep quality of shift nurses.

Methods

This cross-sectional study used structural equation modeling and recruited 285 female shift work nurses from four general and university hospitals with over 300 beds located in C and J cities in Gyeongsangnamdo. Data were collected from September 27 to October 20, 2016, and then analyzed using descriptive statistics, Pearson's correlation, and structural equation modeling. The study used SPSS/Win 18.0 and AMOS 18.0 in processing the data.

Results

The final model showed good fit to the empirical data: χ²/df=2.19, SRMR=.07, RMSEA=.07, AGFI=.85, TLI=.91, GFI=.93, GFI=.89, NFI=.87. The factors that influenced sleep quality were sleep hygiene (β=.32), perceived shift work status (β=−.16), stress response (β=.16), shift work experience (β=.15), perceived health status (β=−.14), and circadian rhythm (β=−.13) explaining 36.0% of the variance.

Conclusion

The model of sleep quality of the shift work nurses constructed in this study is recommended as a model to understand and predict the sleep quality of shift work nurses. The results suggest that strategies for improving the sleep quality of shift work nurses should focus on sleep hygiene, perceived health status, stress response, circadian rhythm, perceived shift work status, and shift work experience.

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Psychoeducational Approach to Distress Management of Newly Diagnosed Patients with Breast Cancer: Jin-Hee Park, Mison Chun, Yong Sik Jung, Sun Hyoung Bae, Young-Mi Jung; J Korean Acad Nurs 2018;48(6):669-678. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.6.669

Abstract PDF

Abstract Purpose

The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer.

Methods

A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast.

Results

Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group.

Conclusion

These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.

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Hee Sang Yoon, Eun A Hwang
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Songül Kamışlı, Bahar Gökler
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Impact of Parents’ Problem Drinking on Suicidal Ideation of Their University Student Children : The Multiple Mediating Effects of Childhood Trauma, Experiential Avoidance and Depression: Eun Sook Lee, Eun Ju Bong; J Korean Acad Nurs 2018;48(5):565-577. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.5.565

Abstract PDF

Abstract Purpose

The purpose of this study was to construct and test a hypothetical model about impact of parents’ problem drinking on suicidal ideation of their children who are university students and the multiple mediating effects of childhood trauma, experiential avoidance, and depression based on stress-vulnerability model.

Methods

A purposive sample of 400 university students was recruited from three universities in provincial areas and the data were collected between October and November 2016. The collected data were then analyzed using SPSS 20.0 and AMOS 20.0 programs. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. Multiple mediating effects analysis using phantom variable and bootstrapping were implemented to verify the mediating effect of the research model.

Results

We found no significant direct effect on depression and suicidal ideation of parents’ problem drinking, but multiple mediating effects of childhood trauma and experiential avoidance between parents’ problem drinking and depression (B=.38, p=.001). The path from parents’ problem drinking to suicidal ideation was significantly mediated by childhood trauma and depression (B=.02, p=.016) and by childhood trauma, experiential avoidance, and depression (B=.05, p=.011), but experiential avoidance did not have a significant direct effect on suicidal ideation (B=.02, p=.616). Conclusions: Based on the results of this study, it can be suggested that in order to decrease depression and prevent suicide of university students, considering of parents’ problem drinking and childhood trauma, intervention methods that decreased chronic use of experiential avoidance and strengthen acceptance should be developed and made available to them.

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Joseph Lloyd Davies, Daniel Lawrence, Ruth Bagshaw, Andrew Watt, Shane Mills, Catherine Heidi Seage
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Associations between Suicidal Ideation and Relatives’ Physical and Mental Health among Community Residents: Differences between Family Members and Lineal Consanguinity
Caifeng Li, Zhen Wei, Yifan Wang, Long Sun
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Factors Influencing Psychosocial Well-Being in Family Caregivers of People with Amyotrophic Lateral Sclerosis: Hyeon Sik Chu, Young Ran Tak, Seung Hyun Kim; J Korean Acad Nurs 2018;48(4):454-464. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.4.454

Abstract PDF

Abstract Purpose

The purpose of this study was to identify factors influencing psychosocial well-being in family caregivers of patients with amyotrophic lateral sclerosis (ALS).

Methods

A descriptive correlational design was used. The transactional model of stress and coping was used to investigate the psychosocial well-being of 137 family caregivers of patients with ALS. Data were collected through self-reported questionnaires from January to November 2016. Data were analyzed using an independent t-test, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis with the SPSS WIN 21.0 program.

Results

The regression model had an adjusted R² of .49, which indicated that meaning-focused coping, social support, ALS patient-family caregiver relationship (especially a spousal relationship), and tracheostomy were significant predictors of caregivers’ psychosocial well-being.

Conclusion

Meaning-focused coping and social support significantly influenced caregivers’ psychosocial well-being. Therefore, interventions to improve caregivers’ psychosocial well-being must focus on increasing meaning-focused coping and social support resources.

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Educational Intervention for the Management of Nonspecific Lower Back Pain in Nonprofessional Caregivers (TRANSFE Program): A Quasi-Experimental Study
Víctor Ortiz-Mallasén, Eloy Claramonte-Gual, Águeda Cervera-Gasch, Desirée Mena-Tudela, María Jesús Valero-Chillerón, Laura Andreu-Pejó, Irene Llagostera-Reverter, Víctor Manuel González-Chordá
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Ling Lian, Minying Zheng, Ruojie He, Jianing Lin, Weineng Chen, Zhong Pei, Xiaoli Yao
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Juyeon Oh, Jung-A Kim, Min Sun Chu
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Psychometric properties of the Korean version of the positive aspects of caregiving scale for family caregivers of people with amyotrophic lateral sclerosis
Hyeon Sik Chu, Young Ran Tak
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The Effects of an Acceptance-Commitment Therapy Based Stress Management Program on Hospitalization Stress, Self-Efficacy and Psychological Well-Being of Inpatients with Schizophrenia: Jae Woon Lee, Jae Hyun Ha; J Korean Acad Nurs 2018;48(4):443-453. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.4.443

Abstract PDF

Abstract Purpose

The purpose of this study was to construct an acceptance-commitment therapy (ACT)-based stress management program for inpatients with schizophrenia and to examine its effects on hospitalization stress, self-efficacy, and psychological well-being.

Methods

A non-equivalent control group pretest-posttest design was used. Participants were 44 inpatients with a diagnosis of schizophrenia. The experimental group (n=22) received the ACT-based stress management program twice a week for a total of four weeks. The control group (n=22) received the usual care from their primary health care providers. The study was carried out from August 7 to September 1, 2017, and data were analyzed using IBM SPSS/WIN 22.0 with a Chi-square test, Fisher's exact test, and an independent t-test.

Results

The experimental group showed a significant decrease in hospitalization stress (t=5.09, p<.001) and an increase in self-efficacy (t=2.44, p=.019). However, there was no significant difference in psychological well-being between the two groups (t=0.13, p=.894).

Conclusion

The results of this study suggest that the ACT-based stress management program can be used as an effective mental health nursing intervention for hospitalization stress and self-efficacy for inpatients with schizophrenia.

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

Abstract PDF

Abstract Purpose

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

Methods

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

Results

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

Conclusion

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

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No Eul Kang, Hye Young Kim, Ji Young Kim, Sung Reul Kim
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Psychometric Testing of the Chinese Version of the Coping and Adaptation Processing Scale-Short Form in Adults With Chronic Illness
Xiyi Wang, Leiwen Tang, Doris Howell, Jing Shao, Ruolin Qiu, Qi Zhang, Zhihong Ye
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Kang Sun Lee, Hye Young Kim, Myung Ha Lee
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The Effects of Laughter Therapy Program on Perceived Stress, and Psycho-Neuro-Endocrino-Immuno Responses in Obese Women: Do Young Lee, Myung Sun Hyun; J Korean Acad Nurs 2018;48(3):298-310. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.298

Abstract PDF

Abstract Purpose

The purpose of this study was to examine the effects of the laughter therapy program on perceived stress and psycho-neuro-endocrine-immune responses in obese women.

Methods

A nonequivalent control group with a pretest-posttest design was used. The participants (n=60), whose age ranged from 30 to 50 years (pre-menopausal and body mass index of over 25 kg/m²), were assigned to the experimental group (n=24) or control group (n=26). The experimental group was provided with the laughter therapy program (12 sessions) for 6 weeks.

Results

There were significant differences in perceived stress, psychological stress response, fasting blood sugar, interleukin-6, and tumor necrosis factor alpha between the two groups after the program. However, there were no significant differences in normalized low frequency (norm LF), normalized high frequency (norm HF), LF/HF ratio, and cortisol between the two groups after the program.

Conclusion

It was found that the laughter therapy program had positive effects on some variables in terms of perceived stress and psycho-neuro-endocrine-immuno responses. It is suggested that the laughter therapy in this study can provide the direction for developing a program for obese women.

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Betul Bal, Canan Demirci, Gamze Gulsum Kilicli
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Symptom Distress and Coping in Young Korean Breast Cancer Survivors: The Mediating Effects of Social Support and Resilience: Ji Hyun Lee, Hye Young Kim; J Korean Acad Nurs 2018;48(2):241-253. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.2.241

Abstract PDF

Abstract Purpose

The purpose of this study was to test the mediating effect of social support and resilience on the relationship between symptom distress and coping in young Korean breast cancer survivors.

Methods

A purposive sample of 209 young breast-cancer survivors (mean age 39.9) was recruited for a cross-sectional survey, and the data were collected between June and October 2015. The instruments used in this study were the Memorial Symptom Assessment Scale-Short Form, the Multidimensional Scale of Perceived Social Support, 10-item Connor-Davidson Resilience Scale, and Cancer Coping Questionnaire. The collected data were then analyzed using the SPSS 23.0 and AMOS 23.0 programs.

Results

Symptom distress was found to have a significant indirect effect on coping (beta=-.32, p=.002), but not a significant direct effect (beta=.06, p=.577). Additionally, based on the values obtained for the squared multiple correlation, symptom distress, social support, and resilience were found to explain 46.4% of the total variance of coping.

Conclusion

Based on the results of this study, it can be suggested that in order to enhance young breast cancer survivors’ ability to cope with the distress they commonly feel, intervention methods that strengthen resilience and provide social support should be developed and made available to them.

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Hye Young Min, Yoonjung Kim, Hae Jeong An
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Meixuan Song, Qiuyao He, Juan Yang, Jinyu Zhang
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Su‐Chih Chen, Shu‐Fang Wu, Tsae‐Jyy Wang, John Rosenberg, Yu‐Ying Lu, Shu‐Yuan Liang
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Kaina Zhou, Jin Li, Xiaomei Li
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The Effects of Neurofeedback Training on Physical, Psychoemotional Stress Response and Self-Regulation for Late Adolescence: A Non-Randomized Trial: Moon-Ji Choi, Wan-Ju Park; J Korean Acad Nurs 2018;48(2):208-220. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.2.208

Abstract PDF

Abstract Purpose

The aim of this study was to analyze the effects of neurofeedback training for reducing stress and enhancing self-regulation in late adolescence to identify the possibility of use for nursing intervention.

Methods

A nonequivalent control group pre-post quasi-experimental design was used. Participants were 78 late adolescents assigned to the experimental group (n=39) that received the neurofeedback training and the control group (n=39). Data were collected on heart rate variability (HRV) and skin conductance level (SCL) to assess stress-biomarker response. The questionnaire contained 164 items from: Positive and Negative Affect Schedule (PANAS), Symptom Checklist-90-Revised (SCL-90-R) and Self-regulatory Ability scale. The neurofeedback training was based on the general adaptation syndrome and body-mind medicine. The intervention was conducted in a total of 10 sessions for 30 minutes per session with high-beta, theta and sensory motor rhythm training on scalp at central zero.

Results

There were significant difference in standard deviation of normal to normal interval (p=.036) in HRV and SCL (p=.029) of stress-biomarker response between the two groups. Negative affect (p=.036) in PANAS and obsessive compulsive (p=.023) and depression (p<.001) in SCL-90-R were statistically significant. Self-regulation mode (p=.004) in self-regulation ability scale showed a significant difference between the two groups.

Conclusion

The results indicated that the neurofeedback training is effective in stress-biomarkers, psy-choemotional stress response and self-regulation. Therefore, neurofeedback training using neuroscientific approach based on brain-mind-body model can be used as an effective nursing intervention for late adolescents in clinics and communities for effective stress responses.

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