The aim of the study was to explore nurses’ experience of person-centered relational care in the context of critical care.
Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through in-depth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data.
Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced ‘balancing emotions’ and ‘authenticity’ in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory.
The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.
The purpose of this study was to develop a relapse prevention program (RPP) and examine the effects of the RPP on insight, empowerment, and treatment adherence in patients with schizophrenia.
A non-equivalent control group pretest-posttest design was used. Participants were 54 inpatients who had a diagnosis of schizophrenia (experimental group: 26, control group: 28). The study was carried out from February 7, 2012 to February 6, 2013. Over a 10-day period prior to discharge each participant in the experimental group received three one-hour sessions of RPP a one-to-one patient-nurse interaction. Data were collected using Assess Unawareness of Mental Disorder (SUMD), Empowerment Scale, and Insight and Treatment Attitude Questionnaire (ITAQ) and analyzed using PASW 18.0 with chi-square test, independent t-test, Mann-Whitney U test, and ANCOVA.
The experimental group had a significant increase in insight and treatment adherence compared to the control group. However, there was no significant difference in empowerment between the two groups.
Findings indicate that the RPP for patients with schizophrenia was effective in improving insight and treatment adherence. A longitudinal study is needed to confirm the persistence of these effects of RPP in patients with schizophrenia.
Korean American women have twice the rate of cervical cancer than white women and demonstrate low rates in participation in cervical cancer screening. This study was to describe the perceptions about cervical cancer and factors related to cervical cancer screening among Korean American women.
Focus group methods.
Five themes emerged. First, knowledge about cervical cancer; misconceptions about cervical cancer, its causes, reproductive anatomy and the treatment Second, perceived meanings of having cervical cancer; most of the women felt that cervical cancer represented a loss of femininity and existential value of womanhood. Third, knowledge about cervical cancer screening ; regular medical check-ups were necessary for early detection and prevention of cervical cancer. Forth, experiences and perceived meanings of cervical cancer screening; the participants expressed their feelings; embarrassment, fear, shame and shyness. Fifth, practices of cervical cancer screening; various intervals in participating in cervical cancer screening. But they mentioned several deterrents, language, insurance, time constraint, embarrassment, fear of the screening results, misbelief about susceptibility, lack of health prevention behavior, and lack of information written in Korean.
Results emphasize the critical need for culturally appropriate health education to encourage participation of Korean American women in cervical cancer screening.
The aim of this study was to explore the lived experiences of women problem gamblers, focusing on the meaning of gambling to them, how and why these women continue to gamble or stop gambling, and their needs and concerns. In order to effectively help women problem gamblers, practical in-depth knowledge is necessary to develop intervention programs for prevention, treatment, and recovery among women problem gamblers.
The hermeneutic phenomenology approach was used to guide in-depth interviews and team interpretation of data. Sixteen women gamblers who chose to live in the casino area were recruited through snowball sampling with help from a counseling center. Participants were individually interviewed from February to April 2013 and asked to tell their stories of gambling. Transcribed interviews provided data for interpretive analysis.
In the study analysis one constitutive pattern was identified: moving beyond addiction by recognizing the two faces of gambling in their life. Four related themes emerged in the analysis-gambling as alluring; gambling as 'ugly'; living in contradictions; and moving beyond.
Loneliness and isolation play a critical role in gambling experiences of women gamblers in Korea. In other words, they are motivated to gamble in order to escape from loneliness, to stop gambling for fear of being lonely as they get older, and to stay in the casnio area so as not to be alone. The need for acceptance is one fo the important factors that should be considered in developing intervention program for women.
The purposes of this study were to develop a Minimal Insomnia Screening Scale for Korean adults (KMISS) and to evaluate psychometric properties and discriminant ability of the developed scale.
Data from a cross-sectional survey of 959 Korean adults were analyzed to develop the summated insomnia scale, which was evaluated in terms of reliability, validity, and discriminant ability by receiver operating characteristics (ROC) curve analysis.
Item-total correlations ranged between .71-.79 and Cronbach's α was .87. Adequate validity was also evident. ROC-curve analysis showed area under ROC was .87 (95% CI: .84-.90) and identified the optimal cut-off score as ≤ 20 (sensitivity, .83; specificity, .75; positive/negative predictive values, .40/.95). Using this cut-off score, the prevalence of insomnia in the study sample was 26.3% and most frequent among women and the oldest group.
Data supports the psychometric properties of KMISS as a possible insomnia screening instrument. KMISS also shows promise as a convenient ultra-short screening measure of insomnia for adults and epidemiological studies in community health care settings.
The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy.
A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance.
The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades.
Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.
The purpose of this study was to explore and describe healing effects of the forest on alcoholics through a forest experience program.
The qualitative data was gathered from one focus group discussion with 6 alcoholics and individual interviews with 8 alcoholics. They had all participated in a "healing forest" program. All interviews were recorded and transcribed according to thematic content analysis processes.
The four main themes on the attributes of forest were "a lively living being", "placidity and tranquility", "acceptive atmosphere", and "beautifulness as it is" which revealed the participants' perceived nature of the forest which was attributed to the healing effects. Eight other themes on participants' positive changes included "revived senses", "aspired to live", "relieved and relaxed from being tense", "gaining insight on self", "having an acceptive attitude", "becoming compliant with his/her life", "learning that life is being together" and "recognizing the value of one's existence".
The findings of the study illustrated the participants' self-healing processes through interactions with the nature of the forest. Nursing interventions utilizing healing atmospheres such as "healing forest" programs can be considered helpful in providing a venue to alcoholics to reflect on their lives affirmatively.