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Research Paper
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
AbstractAbstract 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
Effects of Spouse-Participated Health Coaching for Male Office Workers with Cardiocerebrovascular Risk Factors
So Hee Kang, Seon Young Hwang
J Korean Acad Nurs 2019;49(6):748-759.   Published online December 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.748
AbstractAbstract PDF
Purpose

This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers.

Methods

A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers' stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email.

Results

After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention.

Conclusion

To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.

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Impact of Uncertainty on the Quality of Life of Young Breast Cancer Patients: Focusing on Mediating Effect of Marital Intimacy
Yeong Kyong Oh, Seon Young Hwang
J Korean Acad Nurs 2018;48(1):50-58.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.1.50
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients.

Methods

This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis.

Results

Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (b=-.39, p=.013) and 4 sub-scales of QoL were also affected by uncertainty. Among the 4 sub-scales of QoL, physical well-being (PWB) (b=.17, p=.026), social well-being (SWB) (b=.49, p=.010), and functional well-being (FWB) (b=.38, p=.009) were affected by marital intimacy but emotional well-being (EWB) was not affected by it. The mediating effect of marital intimacy on the impact of uncertainty on QoL was confirmed. Marital intimacy showed a significant indirect effect on PWB (b=-.07, p=.024), SWB (b=-.19, p=.008), and FWB (b=-.15, p=.005), and it means that marital intimacy has a partial mediating effect on the impact of uncertainty on PWB, SWB, and FWB.

Conclusion

Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.

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Life Experiences of Uninfected Women Living with HIV-Infected Husbands: A Phenomenological Study
Myoung Hee Seo, Seok Hee Jeong
J Korean Acad Nurs 2017;47(6):781-793.   Published online December 29, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.6.781
AbstractAbstract PDF
Purpose

This study aimed to understand the meaning and essence of the life experiences of uninfected women living with HIV-infected husbands.

Methods

This qualitative study adopted van Manen's hermeneutic phenomenological method. Study participants were 8 females whose husband had been diagnosed with HIV for longer than 6 months, who had known about their husband's infection for more than 6 months, who were in a legal or common-law marriage and were living with their husbands at the time of interview for this study, and whose HIV antibody test results were negative. Data were collected from in-depth individual interviews with the participants from May to August 2016, and from related idiomatic expressions, literature, artwork, and phenomenological references.

Results

The following essential themes were identified regarding the life experiences of uninfected women living with HIV-infected husbands: ‘experiencing an abrupt change that came out of the blue and caused confusion’, ‘accepting one's fate and making desperate efforts to maintain one's family’, ‘dealing with a heavy burden alone’, ‘experiencing the harsh reality and fearful future’, and ‘finding consolation in the ordeal’.

Conclusion

This study provided a holistic and in-depth understanding of the meaning and essence of the life experiences of uninfected women living with HIV-infected husbands. Thus, this study recognizes these unnoticed women as new nursing subjects. Further, the present findings can be used as important basic data for the development of nursing interventions and national policy guidelines for uninfected women living with HIV-infected husbands.

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Lived Experience of the Family Members of Gastric Cancer Patients
Myung Sun Yi
Journal of Nurses Academic Society 1997;27(2):275-288.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.2.275
AbstractAbstract PDF

The purpose of the study is to explore and describe the lived experience of family members with gastric cancer patients using the grounded theory methodology. The participants were ten spouses of gastric cancer patients who had some kind of treatment at the hospital. They were asked open-ended and descriptive questions in order for them to talk about their experiences in their owl terms. As the interview progressed the questions became more specific to discuss themes and working hypotheses that emerged from the analysis of previous interviews. All interviews were tape-recorded and transcribed for the analysis. Constant the core category that was emerged from the comparative analysis is "magmaggam" which can be described as a psychological distress due to a high level of uncertainty regarding the health of the patient and the future of the caregivers. Psychological distress includes several emotional feelings such as frustration, anxiety, fear, guilty, and self depreciation. Subcategories or strategies related to the core category are 1) managing illness, 2) using folk medicine, 3) giving the patient a reason to live, 4) being patient, 5) losing reality, 6) anticipatory experience on the patient's death and parting, and 7) changing interpersonal relationships. The results of this study would help clinical nurses to develop nursing intervention to help spouses of gastric cancer patients establish efficient coping strategies in dealing with the problems they face.

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Pre-post changes of sexual satisfaction and spouse support of women who have had a hysterectomy
Soon Bok Chang, Seung Eun Jeong
Journal of Nurses Academic Society 1995;25(1):173-183.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1995.25.1.173
AbstractAbstract PDF

The research questions of this study were: Will the level of sexual satisfaction of women who have had a hysterectomy 4 months before be decreased compare to the level of sexsual satisfaction before the hysterectomy?, Will the level of perceived spouse support of women who have had a hysterectomy 4 months before be decreased compare to the level before the hysterectomy?, and What is the relationship between sexual satisfaction and spouse support? This is a perspective descriptive correlational study. The number of subjects was 44. The subjects were limited to Korean women who had an abdominal or vaginal hysterectomy for non-malignant diseases, were married (living with their husbands), mentally healthy, and premenopause at the time of operation. The instrument was consisted of 4 items of demographic characteristics, 13 items of spouse support, and 10 items of sexual satisfaction. The instrument of sexual satisfaction was a component of the Derogatis Sexual Function Inventory. Data analysis was done by paired t-test to see the differences between the pre- post scores of sexual satisfaction and spouse support. The Pearson Correlation Coefficiency was calculated to see the relationship between the scores of sexual satisfaction and spouse spport of pre-post hysterectomy. Results were summerized as follow: The mean age of the subjects was 43.5 years; 72. 1% of the subjects were above middle school graduates: their mean income level was 1,453,000 Korean won and 86.4% of the subjects have had bilateral oophrectomy. 1. The scores of sexual satisfaction of women at 4 months after hysterectomy was decreased significantly compare to the score before hysterectomy (paired t=. 274, p=.009). 2. The scores of spouse support of the women at 4 months after hysterectomy was not decreased significantly compare to the score before hys-terectomy(paired t=.19, p=.847). 3. The scores of sexual satisfaction and spouse support before hysterectomy was significantly related(r=.5186, p=.000). 4. The scores of sexual satisfaction and spouse support at 4 months after hysterectomy was significantly related (r=.4110, p=.005) It can be concluded that the sexual satistaction level could be decreased 4 months after the hysterectomy, but the spouse support level may not be decreased at 4 months after hysterectomy. Further studies have to be done to identify the factors related to the decrease of sexual satisfaction and spouse support after hysterectomy.

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A Structural model for Quality of Life in Women Having Hysterectomies
Sook Nam Kim
Journal of Korean Academy of Nursing 1999;29(1):161-173.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.1.161
AbstractAbstract PDF

The purpose of this study was to develope and test the structural model for quality of life in women having hysterectomies. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around eight constructs. Exogenous variables included in this model were marital intimacy, importance of uterus, professional support, positive coping behavior and pre-operative symptoms. Endogenous variables were spouse's support sense of loss and quality of life. Empirical data for testing the hypothetical model was collected using a self-report questionnaire from 203 women having hysterectomies at the outpatient clinics of four general hospitals and a mail survey in Pusan City. The Data was collected from December, 1997 to January, 1998. Reliability of the eight instruments was tested with Cronbach's alpha which ranged from 0.639-0.915. For the data analysis, SPSS 7.5 WIN Program and LISREL 8.12 WIN Program were used for descriptive statistics and covariance structural analysis. The results of covariance structure analysis were as follows : 1. Hypothetical model showed a good fit with the empirical data. [x2=6.93(df=5, P=.23), GFI=.99, AGFI=.94, RMSR=.019, NNFI=.97, NFI=.98, CN=440, standardized residuals(-2.14-2.10)] 2. For the parsimony of model, a modified model was constructed by deleting 3 paths and adding 1 path according to the criteria of statistical significance and meaning. 3. the modified model also showed a good fit with the data. [x2=5.26(df=7, P=.63), GFI=.99, AGFI=.97, RMSR=.014, NNFI=1.02, NFI=.99, CN=710, standardized residuals(-1.46-1.70)] Results of the testing of the hypothesis were as follows : 1. Marital intimacy(gamma11=.78, t=14.37) and professional support(gamma13=.12, t=2.12) had a significant direct effect on the spouse's support. 2. Pre-operative symptoms(gamma25=.32, t=3.12) , importance of uterus(gamma22=.20, t=2.61) and spouse's support(beta21=-.19, t=-2.43) had a significant direct effect on the sense of loss. 3. Sense of loss(beta32=-.66, t=-9.83) had a direct effect on the quality of life. Marital intimacy had a direct(gamma31=.19, t=3.33), indirect(gamma31=.14, t=2.52) and total effect(gamma31=.25, t=4.41) on the quality of life. Professional support had a direct effect(gamma33=.11, t=2.07) and total effect(gamma33=.13, t=2.31) on the quality of life. The direct effect of pre-operative symptoms(gamma35=-.36, t=-4.02) and positive coping behavior(gamma34=.15, t=2.06) had the insignificant effect on the quality of life while, due to the indirect effect these variables had overall significant effect on the quality of life. The results of this study showed that the sense of loss had the most significant direct effect on the quality of life. Marital intimacy, pre-operative symptoms and spouse's support had a significant direct effect on this sense of loss. These four variables, the sense of loss, marital intimacy, pre-operative symptoms and spouse's support, were identified as relatively important variables. The results of this study suggested that there is needed to determine if nursing intervention would alleviate this sense of loss and promote a greater quality of life in women who have had hysterectomies.

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Concept Development of Grief-Focusing on the Process of Spousal Bereavement
Mi Ra Lee
Journal of Korean Academy of Nursing 2007;37(7):1119-1130.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.7.1119
AbstractAbstract PDF

PURPOSE: This study was done to develop the concept of grief focusing on the process of spousal bereavement in Korea. METHODS: The Hybrid model was used for analysis according to the 3 phases. An extensive literature review was done for the Theoretical phase. In-depth interviews were conducted with 15 participants whose spouses died within the past 3 years in the Field phase. In the Final analytic phase, the results in the Theoretical and the Field phases were compared, analyzed, and integrated according to the process of grief. RESULTS: The antecedent of the concept of spousal grief was spousal death. The dimensions of grief were classified to inner dimensions related to oneself, relational dimensions related to family and others, and existential dimensions related to the meaning of being. The attributes of grief were physical suffering, decline of cognitive ability, heartbreaking sorrow, expectations and conflicts of a new life, social stigma, dependence on or resentment towards God, etc. The empirical referent of grief was physical, psychological, social, and spiritual health status. The grieving progressed through 3 phasesshock-emancipation, suffering, and integration. CONCLUSION: Nurses should recognize the importance of their unique position as supporters for grievers, and try to assess individual characteristics and to provide tailored nursing interventions.

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Health Promoting Behavior in Pregnant Couples: Actor-Partner Interdependence Model Analysis
Ju Hee Kim, Young-A Song
J Korean Acad Nurs 2017;47(4):467-475.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.4.467
AbstractAbstract PDF
Abstract Purpose

This study aimed to identify the actor and partner effects of self-efficacy, marital adjustment, and social support on the health promoting behavior of Korean pregnant couples.

Methods

Participants were 132 couples who met the eligibility criteria. Data were collected from June to November, 2016 at a community health center. The Actor-Partner Interdependence Model was used for analyzing the actor and partner effects of self-efficacy, marital adjustment, and social support on health promoting behavior.

Results

The fitness indices for the model were GFI=0.90, NFI=0.92, CFI=0.91, TLI=0.90, and RMSEA=0.04, which satisfied the criteria. Self-efficacy had actor and partner effect on health promoting behavior of wives, but had only actor effect of on health promoting behavior of husbands. Marital adjustment showed actor and partner effect on the health promoting behavior of pregnant couples. Social support only had an actor effect on the health promoting behavior of wives. And, marital adjustment and social support had a mutual effect.

Conclusion

This study indicates that the partner involvement is needed to develop health promotion programs for pregnant couples.

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Hermeneutic Phenomenological Study on Caring Experience of Spouses of Elderly People with Dementia at Home
Hye-Young Jang, Myungsun Yi
J Korean Acad Nurs 2017;47(3):367-379.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.367
AbstractAbstract PDF
Abstract Purpose

This study aimed to understand and describe the caring experiences of spouses of elderly people with dementia.

Methods

The hermeneutic phenomenological method was used and participants were 12 spouses aged 65 and over who were taking care of their husbands or wives with dementia at home. Data were collected from individual in-depth interviews on participants’ actual caring experiences. Additionally, novels, movies, and memoirs on elderly couples with partner who had dementia were included as data for the analysis. The qualitative data analysis software program was used to manage and process the collected qualitative data. Data were analyzed using hermeneutic phenomenological analysis based on four fundamental existentials including lived body, lived space, lived time, and lived others.

Results

Five essential themes emerged from the analysis: 1) body moving like an old machine, 2) swamp of despair filling with hope, 3) sweet time after bitterness, 4) disappointed elderly couple in the empty nest, and 5) unappreciation vs. empathetic feelings. These essential themes were comprehensively summarized as “the road leading to the maturation of life with dedication and hope while bearing the weight of caring based on the couple's relationship.”

Conclusion

The findings indicate that the nature of the caring experience of spouses of elderly individuals with dementia is filled with many dynamic and paradoxical dimensions. Thus, results of the study would help with developing interventions tailored specifically for elderly spouse caregivers to support their role adaptation and ultimately improving their quality of life.

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Posttraumatic Growth, Dyadic Adjustment, and Quality of Life in Breast Cancer Survivors and Their Husbands
Seunghee Song, Eunjung Ryu
J Korean Acad Nurs 2014;44(5):515-524.   Published online October 31, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.5.515
AbstractAbstract PDF
Purpose

The purpose of this study was to identify whether the couple perceived breast cancer as a traumatic event, to evaluate the association among posttraumatic growth, dyadic adjustment, and quality of life and to explore the predictors affecting quality of life of the couple.

Methods

A cross-sectional comparative survey design was utilized. Participants were 57 couples recruited from a national cancer center in Korea. Data were analyzed using paired t-test, McNemar test and independent t-test. On the basis of variables found to be significantly associated with quality of life, multiple regression was used to examine the simultaneous influence of multiple predictors.

Results

Breast cancers survivors and spouses perceived breast cancer as a traumatic event (43.9% and 24.6%, respectively). The global quality of life was explained by perception as trauma (β=-19.79) and posttraumatic growth (β=0.46) in survivors, and perception as trauma (β=-18.81) and dyadic adjustment (β=0.53) in spouses.

Conclusion

Results suggest that future research should use qualitative methods to evaluate why contemplating reasons for cancer contributed to posttraumatic growth, examine other potential predictors of quality of life such as dyadic adjustment and intimacy, and identify links between posttraumatic growth and other psychological outcomes such as distress and well-being, using prospective analyses.

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Effects of a One Session Spouse-Support Enhancement Childbirth Education on Childbirth Self-Efficacy and Perception of Childbirth Experience in Women and their Husbands
So Ye Eom, Eun Sil Kim, Hyun Jung Kim, Yang Ok Bang, Nami Chun
J Korean Acad Nurs 2012;42(4):599-607.   Published online August 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.4.599
AbstractAbstract PDF
Purpose

This study was conducted to evaluate the effect of a one-session spouse-support enhancement childbirth education on childbirth self-efficacy and perception of childbirth experience.

Methods

The design of this study was a nonequivalent control group pretest-posttest experiment. The participants in the study were 31 couples in the experimental group and 30 in the control group. The experimental couples were provided with one session on spouse-support enhancement childbirth education the night before delivery. Data were collected at two hours after delivery using the Childbirth Self-Efficacy Inventory (CBSEI) and perception of childbirth experience scale. Data were analyzed using PASW statistics 18 program. Frequencies, percentage, mean, χ2 test, t-test were used for data analysis.

Results

Childbirth self-efficacy significantly increased in the experimental group as compared to the control group, but there was no significant difference in perception of childbirth experience in the experimental group compared to the control group.

Conclusion

The results suggest that a one-session childbirth education has beneficial effects on enhancing childbirth self-efficacy in pregnant couples. A one-session spouse-support enhancement childbirth education is recommended as an effective nursing intervention to promote couple's childbirth self-efficacy and it is also recommended that modifications of program to promote women's childbirth experience should be considered.

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Meaning of Life in Wives of Alcoholics: Autobiographical Method
Sunhee Cho
J Korean Acad Nurs 2008;38(5):758-767.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.758
AbstractAbstract PDF
Purpose

The purpose of this study was to explore and describe life-stories and meanings of life in wives of alcoholics by analyzing their autobiographies.

Methods

Autobiographies were collected from 20 participants who produced their own autobiographies in the logotherapeutic autobiography program at community alcohol counseling centers in Korea. The data were coded to identify themes of agency and communion using the manual coding system developed by McAdams, and analyzed by the existential approach.

Results

There were 214 coded episodes in twenty autobiographies. There were 128 agency themes and 86 communion themes. The most common themes were Love/Friendship. Five themes emerged from the autobiographical episodes on the existential perspective: 1) overcoming the suffering, 2) meaningful people and relationships, 3) spiritual maturation, 4) caring and helping, and 5) finding a meaning of life.

Conclusion

These results showed that the wives of alcoholics who participated in the logotherapeutic autobiography program found the meaning of life through their suffering. Furthermore, a study on existential nursing interventions for people who have meaninglessness in life needs to be done.

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Relationship among Sexual Knowledge, Frequency, Satisfaction, Marital Intimacy and Levels of Depression in Stroke Survivors and Their Spouses
Jung-Hee Kim
J Korean Acad Nurs 2008;38(3):483-491.   Published online June 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.3.483
AbstractAbstract PDF
Purpose

The purpose of this research was to examine the relationship between sexual knowledge, frequency, satisfaction, marital intimacy, and depression levels in stroke survivors and their spouses.

Methods

This study was a convenience sample of Korean men who had experienced a stroke and their spouses. The subjects were discharged from the hospital and received physical therapy. Data such as sexual knowledge, frequency, satisfaction, marital intimacy, and depression levels were collected from November 2005 to April 2006.

Results

In a comparison of stroke survivors and their spouses, the survivors showed higher mean levels of sexual knowledge and marital intimacy. The levels of knowledge, frequency, satisfaction and marital intimacy were low and depression was mild in the subjects. There were significant correlations between sexual frequency, sexual satisfaction and marital intimacy. Also, subjects with lower levels of sexual satisfaction were more depressed. The spouses who possessed greater levels of sexual knowledge reported a higher frequency of sex and greater marital intimacy. In addition, spouses who reported feeling greater levels of marital intimacy experienced fewer depressive symptoms.

Conclusion

These findings demonstrate a need for the development of sexual adaptation programs which could be effective in improving sexual knowledge, frequency, satisfaction, marital intimacy, and depression reported by stroke patients and their spouses. Ideally, these corrective programs should be administered before patients are discharged from the hospital.

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