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13 "Social Adjustment"
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Research Paper
A Structural Equation Model on Social Re-Adjustment of Stroke Patients: Based on Roy’s Adaptation Model
Kim, Jungmi , Kim, Hwasoon
J Korean Acad Nurs 2023;53(4):480-495.   Published online August 31, 2023
DOI: https://doi.org/10.4040/jkan.22140
AbstractAbstract PDF
Purpose
This study aimed to develop and test a structural equation model on social re-adjustment of individuals with stroke based on a literature review and Roy’s adaptation model.
Methods
This study involved 321 participants who had a stroke and visited the outpatient department after discharge. The hypothetical model was developed based on Roy’s adaptation model and a comprehensive review of previous literature on the topic. The model comprised four exogenous variables (neurological damage, gender [man], age, and social support) and five endogenous variables (activities of daily living, acceptance of disability, depression, rehabilitation motivation, and social re-adjustment). The data were analyzed using SPSS Windows software version 22.0 and AMOS 23.0.
Results
Out of 28 research hypotheses, 18 were supported, and they indicated approximately 64% probability of social re-adjustment. Social re-adjustment is directly and significantly affected by age, social support, activities of daily living, and depression. Social re-adjustment is indirectly affected by neurological impairment, gender (men), age, social support, and rehabilitation motivation.
Conclusion
Continuous assistance and care should be provided for individuals with disabilities caused by sudden neurological damage to facilitate gradual improvement in their social re-adjustment. To enhance social re-adjustment, especially among older adults, newly developed interventions should focus on improving their activities of daily living, preventing depression, and enhancing support from family and healthcare personnel.
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Original Articles
Psychosocial Adjustment in Korean Colorectal Cancer Survivors
Hyejin Sun, Jia Lee
J Korean Acad Nurs 2018;48(5):545-553.   Published online October 31, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.5.545
AbstractAbstract PDF
Purpose

The increasing survival rate of colorectal cancer demands various nursing interventions and continuous care for patients to adapt to their psychosocial daily lives. The purpose of this study was to identify factors associated with psychosocial adjustment in colorectal cancer survivors.

Methods

A cross-sectional descriptive study with face-to-face interviews was conducted of 156 colorectal cancer survivors after surgery visiting an outpatient cancer clinic at a tertiary hospital in S city, Korea. Posttraumatic growth, health-promoting behavior, length of treatment, difficulty in activities of daily living, and having a stoma were entered into the linear regression model.

Results

The strongest factor influencing the level of psychosocial adjustment was health-promoting behavior (β=.33, p<.001), followed by difficulty in activities of daily living (β=-.24, p=.001), posttraumatic growth (β=.20, p=.004), and having a stoma (β=-.19, p=.004).

Conclusion

Nursing interventions for psychosocial adjustment in colorectal cancer survivors need to include the contents for posttraumatic growth, as well as health-promoting behavior, and activities of daily living.

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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
AbstractAbstract 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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The Relationship of Self Efficacy and Social Support to the Psychosocial Adjustment in People with Epilepsy
Seong Mi Moon
Journal of Korean Academy of Nursing 2000;30(3):694-708.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.3.694
AbstractAbstract PDF

The main purpose of this study was to identify the relationship of self efficacy and social support to the psychosocial adjustment in people with epilepsy. Data were collected from October 1 to October 15, 1999 from 101 people with epilepsy who were being treated regularly at one of the university hospitals located in Seoul. The research instruments were a questionnaire to gather demographic and disease-specific data, the Epilepsy Psycho- Social Effects Scale developed by Chaplin et al(1990), the Epilepsy Self Efficacy Scale developed by DiIorio et al(1992a) and translated by Park(1999), the Norbeck Social Support Questionnaire developed by Norbeck et al(1981) and translated by Oh(1985). Data were analyzed using the SPSS program. The results are as follow : 1. Of the 14 psychosocial adjustment areas, 75 of 101 subjects experienced problems in ten or more areas and 28 in all 14 areas. The severity of the psychosocial adjustment problem was moderate or more in six areas. 2. The score for self efficacy was an average of 1103.86 out of a possible 1800, for social support 117.57 for total functional out of a possible 720, and 48.21 for total network out of a possible 264. There were an average of five people on the network. The main network people were parents, brothers and sisters, spouse, friends. 3. Of the 14 psychosocial adjustment areas, six areas correlated with self efficacy and 'problems with taking medication' area had a negative correlation with social support. In conclusion, people with epilepsy have various problems in psychosocial adjustment. Nursing interventions using self efficacy should be developed to improve psychosocial adjustment in people with epilepsy. Also, instruments and interventions for regimen-specific supports which are suitable for epilepsy should be developed.

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Psychosocial Adjustment after Kidney Transplantation
Myungsun Yi
Journal of Korean Academy of Nursing 1998;28(2):291-302.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.2.291
AbstractAbstract PDF

The purpose of this phenomenological study was to understand and describe the essence and the structure of lived experience of people with kidney transplantation. Initially, nine individual interviews were conducted to gather data regarding their subjective experiences. And two focus group interviews were utilized to validate or discard the themes that were emerged from the analysis using Colaizzi's method. Among 17 participants, 13 had living related kidney donations, one living unrelated, and the remaining two cadavor donations. About 130 significant statements were extracted and these were clustered into 11 themes. All participants felt anxiety and fear toward the rejection of transplantation and the complication of immunosuppressive drugs. Although they were initially satisfied with their life after kidney transplantation most of them lost a self-confidence and experienced loneliness, depression, and despair. Most of the participants also felt guilty for not being able to accomplish their appropriate roles in the family. They also had financial difficulties and social restrictions. However, they overcame these psychosocial distress by exercising, working and sharing love with others. They also could overcome it by living a religious life and by working to help others with kidney transplantations. Most of them felt gratitude toward the donor and did not have a psychological rejection toward the kidney transplanted. The results of the study might help nurses who work with people with kidney transplantations in establishing and implementing an effective nursing intervention by understanding their lived experience.

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Scale Development of Free Nursing Home-Adjustment for the Elderly
Ga Eon Lee
Journal of Korean Academy of Nursing 2007;37(5):736-743.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.5.736
AbstractAbstract PDF
Purpose

The purpose of this study was to develop a scale of free nursing home adjustment for the elderly in Korea.

Method

The developmental processes were construction of a conceptual framework, development of preliminary items, verification of content validity, twice data gathering, verification of construct validity, and reliability of final items. The first 53 preliminary items were obtained through review of literatures about nursing home adjustment and in depth interviews with 5 staffs of nursing home. These items were reviewed by five specialists for content validity and 39 items were chosen. The first data was collected from 107 elderly residing in 3 nursing homes and the second survey was from 147 residents who were living in five nursing homes. Finally this data was analyzed for construct validity and reliability.

Result

There were 23 final items which were sorted into 5 factors. The factors were identified as ‘Relocation distress symptom’(8items), ‘Making friends’(4items), ‘Acceptance of new residence’ (6items), ‘Difficulty in group life’(3items), and ‘Having self-worth’(2items). The cumulative percent of variance was 53.466%. The reliability of the scale, Cronbach's alpha was .837.

Conclusion

The result of this study could be used for measuring nursing home adjustment of the elderly. However, for further validity and reliability, repeated researches are needed.

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Illness Experience of People with Chronic Hepatitis B in Korea
Myungsun Yi, Eun Ok Choi, Seung Woon Paik, Keum Soon Kim, Sangman Kwak, Hwa Jin Lee
Journal of Korean Academy of Nursing 2007;37(5):665-675.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.5.665
AbstractAbstract PDF
Purpose

The purpose of this study was to explore the experiences of people with chronic hepatitis B (CHB) in Korea. The specific aim was to identify major problems that people with CHB face and strategies that they are dealing with.

Methods

A grounded theory method was utilized. The data were collected by individual in-depth interviews from 12 CHB patients from one of the major hospitals in Korea.

Results

After constant comparative analysis, a core category emerged as “illness management with self-reliance and will.” Seven major strategies that were identified in dealing with the illness were maintaining receptive and positive attitudes; restraining excessive work and greed; searching for information; controlling illness information; adhering to practices for not spreading the viral disease; abstaining from alcohol and smoking and maintaining healthy eating habits; nd using alternative therapies. The outcomes that result from employing these strategies were identified as burden, depression and helplessness, stress for maintaining compliance, and dispirited interpersonal relationships.

Conclusion

The results of this study suggest that most people with CHB in Korea have problems in psychosocial area. Thus health professionals need to provide not only informational support but also emotional one to improve quality of life of the people with CHB.

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Psychosocial Adjustment Process in Adolescents with Epilepsy
Seong Mi Moon
Journal of Korean Academy of Nursing 2005;35(1):16-26.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.1.16
AbstractAbstract PDF
Purpose

The purpose of this study was to explore the psychosocial adjustment process in adolescents with epilepsy in the context of Korean society and culture.

Method

A grounded theory method was used for data collection and analysis. Participants for this study were 9 adolescents who regularly visited an epilepsy clinic in a university hospital. The data was collected through in-depth interviews during the period from November, 2002 to June, 2003. Data collection and analysis were performed simultaneously.

Result

Twenty-three categories emerged including ‘ suffering’, ‘ psychological stigma’, and ‘ social isolation from one's peers’. Categories were divided into paradigms which consisted of conditions, actions/ interactions, and consequences. ‘ Reconstructing life’ was the core category in this study. The theoretical scheme was described by organizing categories around the core category.

Conclusion

This study provides a framework for the development of individualized nursing interventions to care for adolescents with epilepsy.

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Psychosocial Adjustment of Young Adult to Hemophilia: Living like a Normal Person
Myung Sun Yi, Won Ok Kim, Hyun Sook Kang
Journal of Korean Academy of Nursing 2003;33(7):875-884.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.7.875
AbstractAbstract PDF
Purpose

To explore how young adults in their 20s adjust to hemophilia.

Method

Grounded theory method guided the data collection and analysis. A purposeful sample of 15 young adults with hemophilia participated during the period of 2000-2001. The data were collected by semi-structured individual interviews, focus group interviews, and participant observations. All interviews were audio taped and transcribed verbatim. Constant comparative analysis was employed to analyze the data.

Result

“Living like a normal person” emerged as the basic social-psychological process. Two dimensions of the self were identified: normal self and abnormal self. “Living like a normal person” means conscious effort to focus on normal self rather than abnormal self. Five subcategories were identified : 1) pretending as if he is not hemophiliac; 2) relieving the burden; 3) maintaining best physical conditions; 4) becoming independent; and 5) reconciliating with their mothers.

Conclusion

The results of this study indicate that young adults with hemophilia strive for living a life as a normal person. But there is a question whether it is good for their ultimate quality of life. The results indicate that our society needs to be more tolerant to differences that hemophiliacs have.

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The Psychosocial Adaptation Process of Psychiatric Nurses Working in Community Mental Health Centers
So-Young Min
J Korean Acad Nurs 2015;45(6):868-878.   Published online December 31, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.6.868
AbstractAbstract PDF
Purpose

The aim of this study was to verify psychosocial issues faced by psychiatric and community mental health nurse practitioners (PCMHNP) working in community mental health centers, and to identify the adaptation processes used to resolve the issues.

Methods

Data were collected through in-depth interviews between December 2013 and August 2014. Participants were 11 PCMHNP working in community mental health centers. Analysis was done using the grounded theory methodology. The first question was "How did you start working at a community mental health center; what were the difficulties you faced during your employment and how did you resolve them?"

Results

The core category was 'regulating within relationships.' The adaptation process was categorized into three sequential stages: 'nesting,' 'hanging around the nest,' and 'settling into the nest.' Various action/interaction strategies were employed in these stages. The adaptation results from using these strategies were 'psychiatric nursing within life' and 'a long way to go.'

Conclusion

The results of this study are significant as they aid in understanding the psychosocial adaptation processes of PCMHNP working in community mental health centers, and indicate areas to be addressed in the future in order for PCMHNP to fulfill their professional role in the local community.

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Late Effects, Social Adjustment, and Quality of Life in Adolescent Survivors of Childhood Leukemia
Sung Sil Hong, Ho Ran Park, Kwang Sung Kim, Sun Hee Choi
J Korean Acad Nurs 2014;44(1):55-63.   Published online February 28, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.1.55
AbstractAbstract PDF
Purpose

This study was conducted to examine the late effects, social adjustment, and quality of life in adolescents who had been completely treated for childhood leukemia and their parents.

Methods

Participants consisted of 41 pairs of adolescent survivors (13-18 years) and their parents. Parents checked for their child's physical late effects. The Korean Version of Post-Traumatic Symptoms for psychological late effects, social functioning questionnaire for social adjustment and the PedsQL 4.0 Generic Core Scales for quality of life were completed by adolescents and parents. Data were analyzed using SPSS.

Results

Twenty out of 41 adolescents had one or more physical late effects. Adolescents showed more serious psychological late effect than parents. Five children and seven parents had above cut-off scores and they were considered the high risk group for posttraumatic symptoms. Parent-reported scores were significantly higher than child-reported scores in terms of social adjustment and emotional functioning of quality of life. Low school functioning in adolescents was associated with physical late effects.

Conclusion

The results indicate that long-term and systematic management for childhood leukemia survivors affect positive social adjustment and can further improve quality of life.

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Illness Experience of Adolescents with Hematologic Malignancies
Sun Young Son
J Korean Acad Nurs 2011;41(5):603-612.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.603
AbstractAbstract PDF
Purpose

The purpose of this study was to describe the experience process of adolescents with hematologic malignancies. The question for the study was "What is the experience of adolescents with hematologic malignancies like?".

Methods

The grounded theory methodology was used for this study. The data were collected through in-depth interview from 10 adolescents with hematologic malignancies. Data collection was done from January to June 2007. Theoretical sampling was used until the data reached saturation.

Results

As a result of the analysis, "Reconstructing self-image from deviated and suspended life" was identified as the core category. And 11 subcategories were identified and they were integrated to the core category. 'Establishment of expanded and matured self' was identified as the consequence.

Conclusion

The results of the study provide a frame for effective individualized nursing intervention strategies in helping adjustment of the adolescents with hematologic malignancies.

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Psychosocial Adjustment of Low-Income Koreans with Cancer
Myungsun Yi, Eun Young Park, Dal Sook Kim, Young Sook Tae, Bok Yae Chung, Hyang Sook So
J Korean Acad Nurs 2011;41(2):225-235.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.225
AbstractAbstract PDF
Purpose

To describe psychosocial adjustment of low-income Koreans who have cancer.

Methods

Data were collected during 2008 using individual in-depth interviews with 18 Korean people with cancer. The income status of the participants was low, 11 were recipients of the National Basic Livelihood Protection program. Mean age was 58.3 yr and 11 were female. Five participants had stomach cancer, five, colorectal cancer, and four, breast cancer. Data were analyzed using grounded theory methodology.

Results

The core category emerged as 'bearing up alone with double suffering'. 'Poverty and cancer: A double suffering' emerged as a causal condition. The adjustment process consisted of three stages: 'forming a treatment will to live' ,'practicing for the cure',and 'restructuring self and repaying favors'. Each stage indicated action-interaction strategies which were employed to bear up alone with double suffering during the illness process. Self-reflection, parental responsibility, and support from the public sector played important roles in overcoming the double suffering. Two types of consequences were identified: Transcended life and strained life suppressed by poverty and cancer.

Conclusion

The results provide insights into the psychosocial adjustment process for low income Korean with cancer and can be used in developing and implementing efficient home-care services for these people.

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