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

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

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

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

This study aimed to develop and test a model of the happiness of mothers with young children based on the stress-coping-adaptation model of Lazarus and Folkman.

The data collection period was from May to July 2016. A self-report questionnaire was used to collect data from 210 mothers with children under 5 years of age living in Seoul, Gyeonggi, and Gangwon provinces. The exogenous variable was parenting stress, and the endogenous variables were parenting alliance, depression, optimism, ways of coping, and happiness. Data from 201 questionnaires were analyzed using the SPSS 22.0 and AMOS 20.0 programs. Data analyses included descriptive statistics, factor analysis, and structural equation modeling.

The final modified model showed a reasonable fit to the data, and out of 25 paths, 13 were statistically significant. This model explained 78.4% of the variance in the happiness of mothers with young children and confirmed that depression, optimism, parenting alliance, and social support-focused coping have a direct effect on the subject's happiness. Parenting stress also influenced happiness through parenting alliance, depression, and optimism.

In order to bolster the happiness of mothers with young children, positive psychological interventions that can minimize psychological vulnerabilities, such as depression, and that can enhance their strengths, such as optimism, may serve as effective ways of coping with and adapting to stress.

The purpose of the study was to develop and test a model for predicting problem gambling in speculative game users based on Blaszczynski and Nower's pathways model of problem and pathological gambling.

The participants were 262 speculative game users recruited from seven speculative gambling places located in Seoul, Gangwon, and Gyeonggi, Korea. They completed a structured self-report questionnaire comprising measures of problem gambling, negative emotions, attentional impulsivity, motor impulsivity, non-planning impulsivity, gambler's fallacy, and gambling self-efficacy. Structural Equation Modeling was used to test the hypothesized model and to examine the direct and indirect effects on problem gambling in speculative game users using SPSS 22.0 and AMOS 20.0 programs.

The hypothetical research model provided a reasonable fit to the data. Negative emotions, motor impulsivity, gambler's fallacy, and gambling self-efficacy had direct effects on problem gambling in speculative game users, while indirect effects were reported for negative emotions, motor impulsivity, and gambler's fallacy. These predictors explained 75.2% problem gambling in speculative game users.

The findings suggest that developing intervention programs to reduce negative emotions, motor impulsivity, and gambler's fallacy, and to increase gambling self-efficacy in speculative game users are needed to prevent their problem gambling.

This study aimed to construct and test a hypothetical model of the quality of life of school-age children with asthma based on the health-related quality of life model by Wilson and Cleary.

Data were collected from 205 pairs of pediatric outpatients diagnosed with asthma and their parents in Seoul and Gyeonggi-do from July 2016 to April 2017. The exogenous variables were asthma knowledge, number of accompanying allergic diseases, and social support. The endogenous variables were asthma self-efficacy, asthma symptom control, perceived health status, parental quality of life, and children's quality of life. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed.

Eighteen of the twenty-four hypotheses selected for the hypothetical model were attentive and supported statistically. Quality of life was explained by asthma self-efficacy, asthma symptom control, perceived health, parental quality of life, and asthma knowledge with 83.5%.

Strategies for promoting self-efficacy and enforcing asthma knowledge will be helpful for the improvement of health-related quality of life with school-aged asthmatic children.

The aims of this study were to construct a hypothetical structural model which explains premenstrual coping in university students and to test the fitness with collected data.

Participants were 206 unmarried women university students from 3 universities in A and B cities. Data were collected from March 29 until April 30, 2016 using self-report structured questionnaires and were analyzed using IBM SPSS 23.0 and AMOS 18.0.

Physiological factor was identified as a significant predictor of premenstrual syndrome (t=6.45, p<.001). This model explained 22.1% of the variance in premenstrual syndrome. Psychological factors (t=-2.49, p=.013) and premenstrual syndrome (t=8.17, p<.001) were identified as significant predictors of premenstrual coping. Also this model explained 30.9% of the variance in premenstrual coping in university students. A physiological factors directly influenced premenstrual syndrome (β=.41, p=.012). Premenstrual syndrome (β=.55, p=.005) and physiological factor (β=.23, p=.015) had significant total effects on premenstrual coping. Physiological factor did not have a direct influence on premenstrual coping, but indirectly affected it (β=.22, p=.007). Psychological factors did not have an indirect or total effect on premenstrual coping, but directly affected it (β=-.17, p=.036).

These findings suggest that strategies to control physiological factors such as menstrual pain should be helpful to improve premenstrual syndrome symptoms. When developing a program to improve premenstrual coping ability and quality of menstrual related health, it is important to consider psychological factors including perceived stress and menstrual attitude and premenstrual syndrome.

This study was designed to construct a structural model for explaining mental health status in middle - aged women.

The data was collected by self - reported questionnaires from 206 middle - aged women in Seoul. Data analysis was done with the SAS pc program for descriptive statistics and a PC - LISREL Program for finding the best fit model which assumes causal relationships among variables.

The overall fit of the hypothetical model to the data was good, but paths and variables of the model were modified by considering theoretical implications and statistical significances of parameter estimates. Thus it was modified by excluding 3 paths. The modified model showed was good fit to the data(χ²=177.55, p=.00), GFI=0.908, AGFI=0.860, RMR=0.013, NFI=0.972, NNFI=0.982). Perceived stress, anger expression method, and self -esteem were found to have direct effects on mental health status in middle - aged women. These predictive variables of mental health status explained 66.6% of the model.

Programs to enhance mental health status in middle - aged women should include stress management skill, anger expression skill, and self-esteem enhancement skills to be effective.

This study was designed to construct a structural model for symptom management of life of the patients with chronic fatigue. The hypothetical model was developed based on the literature review and Self-regulating Model.

Data were collected by questionnaires from 252 patients with chronic fatigue in the 8 community from December 2002 to April 2003 in Seoul. Data analysis was done with SAS for descriptive statistics and PC-LISREL Program for Covariance structural analysis.

The fit of the hypothetical model to the data was moderate, thus it was modified by excluding 4 path and including free parameters and 3 path to it. The modified model with path showed a good fitness to the empirical data(χ²=318.11, p=0.0, GFI= .98, AGFI= .98, NNFI= .95, RMSR= .03, RMSEA= .05). The symptoms of stress, self-efficacy, and present fatigue level were found to have significant direct effect on symptom management of the patients with chronic fatigue. The ways of coping, perceived stress, and fatigue symptom were found to have indirect effects on symptom management of the patients with chronic fatigue.

The derived model is considered appropriate in explaining and predicting symptom management of the patients with chronic fatigue. Therefore, it can effectively be used as a reference model for further studies and suggested direction in nursing practice.

This study was designed to construct a structural model for explaining negative outcomes of anger in female adolescents.

Data was collected by questionnaires from 199 female adolescents ina female high school in Seoul. Data analysis was done with SAS for descriptive statistics and a PC-LISREL Program for Covariance structural analysis.

The fit of the hypothetical model to the data was moderate, thus it was modified by excluding 7 paths and adding free parameters to it. The modified model withthe paths showed a good fit to the empirical data(χ² =5.62, p=.69, GFI=.99, AGFI=.97, NFI=.99, NNFI=1.01, RMSR=.02, RMSEA=.00). Trait anger, state anger, and psychosocial problems were found to have a significant direct effect on psychosomatic symptoms. State anger, psychosocial problems, and learning behaviorswere found to have direct effects on depression of female adolescents.

The derived modelis considered appropriate for explaining and predicting negative outcomes of anger in female adolescents. Therefore, it can effectively be used as a reference model for further studies and is a suggested direction in nursing practice.

This study was done to develop and test a structural model for caregiving experience including caregiving satisfaction and caregiving strain in families providing care for family members with a mental disorder.

The Stress-appraisal-coping model was used as the conceptual framework and the structural equation model to confirm the path that explains what and how variables affect caregiving experience in these families. In this hypothesis model, exogenous variables were optimism, severity of illness and uncertainty. The endogenous variables were self efficacy, social support, caregiving satisfaction and caregiving strain. Data were collected using structured questionnaires.

Optimism and caregiving self-efficacy had significant direct and indirect effects on caregiving satisfaction. Optimism, severity of illness and uncertainty had significant direct and indirect effects on caregiving strain. The modified path model explained effects of optimism on caregiving self-efficacy with social support in the path structure as a mediator. Also, there were direct and indirect effects of optimism and uncertainty on caregiving satisfaction with social support and caregiving self-efficacy in the path structure as a mediators.

Results suggest the need to improve caregiving self-efficacy of these families, establish support systems such as a mental health professional support programs for caregiving self-efficacy. Optimism, severity of illness and uncertainty perceived by families need to be considered in the development of support programs in order to increase their effectiveness.

The aims of this study were to construct a hypothetical structural model which explains the premenstrual syndrome (PMS) in adolescent girls and to test the fitness with collected data.

The participants were 1,087 adolescent girls from 3 high schools and 5 middle schools in B city. Data were collected from July 3 to October 15, 2012 using self-reported questionnaires and were analyzed using PASW 18.0 and AMOS 16.0 programs.

The overall fitness indices of hypothetical model were good (χ² =1555, p<.001), χ²/df=4.40, SRMR=.04, GFI=.91, RMSEA=.05, NFI=.90, TLI=.91, CFI=.92, AIC=1717). Out of 16 paths, 12 were statistically significant. Daily hassles had the greatest impact on PMS in the adolescent girls in this model. In addition, PMS in adolescent girls was directly affected by menarche age, Body Mass Index (BMI), amount of menstruation, test anxiety, social support, menstrual attitude and femininity but not by academic stress. This model explained 27% of the variance in PMS in adolescent girls.

The findings from this study suggest that nursing interventions to reduce PMS in adolescent girls should address their daily hassles, test anxiety, menstrual attitude and BMI. Also, social support from their parents, friends, and teachers needs to be increased.

The study was done to construct and test a structural model to explain primipara breastfeeding behavior.

The participants were 213 primiparas on postpartum wards. Data were analyzed using the PASW 18.0 and AMOS 19.0 programs.

Fitness statistics for the hypothetical model were appropriate (χ² =38.50, p=.070, GFI=.96, RMSEA=.05, AGFI=.93, NFI=.95, TLI=.97, CFI=.98, PNFI=.57, χ²/df=1.43). Breastfeeding behaviors were directly influenced by intention to breastfeed, perceived effectiveness of breastfeeding, and the amount of supplementary feeding. The amount of supplementary feeding had the largest direct impact on breastfeeding behavior. The largest total effect on breastfeeding behavior was intention to breastfeed. The environment of the maternity hospital indirectly influenced breastfeeding behavior. These factors explained 18.9% of variance in the primipara breastfeeding behavior.

The results of the study indicate that in order to promote primipara breastfeeding the amount of supplementary feeding immediately after the birth should be limited and an environment that encourages exclusive breastfeeding in the hospital should be provided. The results also suggest it is necessary to provide nursing interventions that increase the intention to breastfeed and the perceived effectiveness of breastfeeding.

The purpose of this study was to test a model for quality of life among infertile women. This model was based primarily on the concept of the Fertility Quality of Life by Boivin et al. (2011) and the Infertility Resilience Model by Rindenour (2009).

Fifteen measurable variables were used to estimate quality of life. They included endogenous variables such as fertility quality of life and resilience, and exogenous variables such as infertility related stress, depression, marital adjustment, and family support. Data sets (n=203) used for analysis were collected in a general hospital which had, on average, 400 assisted reproductive technologies per month.

The assessment of the modified model indicated acceptable fit, with χ²/d.f=2.07, GFI=.90, AGFI=.89, NFI=.89, CFI=.91, RMSEA=.07. Depression, infertility related stress, marital adjustment, resilience, and family support had direct influences on quality of life.

The results of this study should contribute to the development of nursing intervention programs to enhance quality of life using factors that affect fertiQol (fertility quality of life) of infertile women.

This study was designed to construct and test a structural equation modeling on specific domain health status and the Selection · Optimization · Compensation (SOC) strategy affecting successful aging in elderly people.

The model construction was based on the SOC model by Baltes and Baltes. Interviews were done with 201 elderly people aged 65 or older. Interview contents included demographics, functional health status, emotional health status, social health status, SOC strategies, and successful aging. Data were analyzed using SPSS 15.0 and AMOS 7.0.

Model fit indices for the modified model were GFI=.93, CFI=.94, and RMSEA=.07. Three out of 7 paths were found to have a significant effect on successful aging in this final model. Functional health status had a direct and positive effect on successful aging. Emotional health status influenced successful aging through SOC strategies.

This study suggests that interventions for improving functional health status and for strengthening SOC strategies are critical for successful aging. Continuous development of a variety of successful aging programs using SOC strategy is suggested.

This study was done to propose a structural model to explain and predict psychosocial adjustment in patients with early breast cancer and to test the model. The model was based on the Stress-Coping Model of Lazarus and Folkman (1984).

Data were collected from February 18 to March 18, 2009. For data analysis, 198 data sets were analyzed using SPSS/WIN12 and AMOS 7.0 version.

Social support, uncertainty, symptom experience, and coping had statistically significant direct, indirect and total effects on psychosocial adjustment, and optimism had significant indirect and total effects on psychosocial adjustment. These variables explained 57% of total variance of the psychosocial adjustment in patients with early breast cancer.

The results of the study indicate a need to enhance psychosocial adjustment of patients with early breast cancer by providing detailed structured information and various symptom alleviation programs to reduce perceived stresses such as uncertainty and symptom experience. They also suggest the need to establish support systems through participation of medical personnel and families in such programs, and to apply interventions strengthening coping methods to give the patients positive and optimistic beliefs.

This study was designed to construct and test the structural equation model on sexual satisfaction in patients with a colostomy.

The model construction was based upon Roy's adaptation model. Stoma-related discomfort (SRD), age, frequency of sexual intercourse, treatment modality, and gender affect sexual satisfaction and are mediated by physical, psychosocial, and interdependence modes. Each mode was conceptualized as sexual function, body image/depression, and marital intimacy. The patients were 112 colostomates with colorectal cancer who were asked to complete a mail-back survey on their demographic data, SRD, body image, depression, marital intimacy, sexual function, and sexual satisfaction. Data were analyzed using SPSS WIN 15.0 and AMOS WIN 7.0.

Significant variables for sexual satisfaction in the final model were body image affected by SRD, depression affected by body image and SRD, marital intimacy affected by depression, and sexual function affected by marital intimacy.

The results of this study suggest that specific guidelines for SRD are necessary to improve sexual satisfaction among colostomates. Nurses should be vigilant in monitoring depression and body image disturbance, and providing appropriate interventions to increase marital intimacy. Treatment modality, gender, and age should be considered in developing education programs pertaining to sexuality.

This study was designed to construct and test a structural equation model on sexual function in women with gynecologic cancer.

The model was constructed and tested under the hypotheses that women's physical changes in sexual function after gynecologic cancer treatment did not automatically lead to sexual dysfunctions. Women's psychosocial factors were considered to be mediating variables. Two hundred twelve women with cervical, ovarian, and endometrial cancer were recruited and asked to complete a survey on their physical factors, psychosocial factors and sexual function. Data was analyzed using SPSS WIN 12.0 and Amos WIN 5.0.

Predictors of sexual function in the final model were sexual attitude affected by physical distress and couple's age, sexual information affected by physical distress and couple's age, depression affected by physical distress, and marital intimacy affected by physical distress. Tumor stage and time since last treatment directly affected women's sexual function without any mediating psychosocial variables. However, body image did not affect women's sexual function.

Nursing professionals should develop a tailored educational program integrating both physical and psychosocial aspects, and apply it to women and their spouses in order to promote sexual function in women with gynecologic cancer.