Journal of Korean Academy of Nursing

Research Papers

Effects of Health Education Using Virtual Reality for Adolescents: A Systematic Review and MetaAnalysis: Park, SoMi , Chung, ChaeWeon , Kim, Gaeun; J Korean Acad Nurs 2023;53(2):177-190. Published online April 30, 2023; DOI: https://doi.org/10.4040/jkan.23003

Purpose
This study aimed to evaluate the effects of health interventions using virtual reality (VR) on improving knowledge, attitudes, and skills; and inducing behavioral change among adolescents.
Methods
This study is a systematic review and meta-analysis following PRISMA guidelines. We searched Cochrane, MEDLINE, Embase, CINAHL, Scopus, Web of Science, and Korean databases between database inception and April 10, 2021. Based on heterogeneity, a random- or fixed-effects model was used, as appropriate, to calculate effect sizes in terms of the standardized mean difference (SMD) and odds ratio (OR). Studies were selected if they verified the effects of health education using VR on adolescents; there was an appropriate control group; and if the effects of education were reported in terms of changes in knowledge, attitudes, skills, or behaviors.
Results
This analysis included six studies (n = 1,086). The intervention groups showed greater responses in knowledge and attitudes (SMD = 0.57, 95% confidence interval (CI) [0.12 to 1.02]), skills related to health behavior (SMD = -0.45, 95% CI [-0.71 to -0.19]), and behavioral change after 12 months (OR = 2.36, 95% CI [1.03 to 5.41]).
Conclusion
The results confirm the effectiveness of health interventions using virtual reality (VR). Although the analysis include a small number of studies, a case can be made for health interventions using VR to be utilized as educational methods and strategies to prevent risky behaviors among adolescents.

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Development and Evaluation of a Virtual Reality Intervention for Reducing Exposure to Endocrine Disruptors in Female Adolescents: A Pilot Study
SoMi Park, Yun Jeong Hwang, ChaeWeon Chung
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Chinese nurses’ perspectives on child-friendly healthcare practice assessment: a qualitative study
Wei Xiao Huang, Mei Chan Chong, Li Yoong Tang, Xiao Xia Liu, Mei Fang, Yun Yun Shen, Xiao Li Guo
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Implementation of a Childcare-Based Obesity Prevention Program for Vulnerable Families During the COVID-19 Pandemic: Lessons for School Nurses
Jiyoung Park, Gill ten Hoor, Seohyun Won, Gahui Hwang, Sein Hwang, Siew Tiang Lau
The Journal of School Nursing.2024;[Epub] CrossRef

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Effect of Digital Health Interventions on Psychotic Symptoms among Persons with Severe Mental Illness in Community: A Systematic Review and Meta-Analysis: Oh, Eunjin , Gang, Moonhee; J Korean Acad Nurs 2023;53(1):69-86. Published online February 28, 2023; DOI: https://doi.org/10.4040/jkan.22121

Abstract PDF

Purpose
This study aimed to evaluate the effects of digital health interventions on the psychotic symptoms among people with severe mental illness in the community.
Methods
A systematic review and meta-analysis were conducted in accordance with the Cochrane Intervention Research Systematic Review Manual and PRISMA. A literature search was conducted of published randomized controlled trials (RCTs) for digital health interventions from January 2022 to April 2022. RevMan software 5.3 was used for quality assessment and meta-analysis.
Results
A total 14 studies out of 9,864 studies were included in the review, and 13 were included in meta-analysis. The overall effect size of digital health interventions on psychotic symptoms was - 0.21 (95% CI = - 0.32 to - 0.10). Sub-analysis showed that the reduction of the psychotic symptoms was effective in the schizophrenia spectrum group (SMD = - 0.22; 95% CI = - 0.36 to - 0.09), web (SMD = - 0.41; 95% CI = - 0.82 to 0.01), virtual reality (SMD = - 0.33; 95% CI = - 0.56 to - 0.10), mobile (SMD = - 0.15; 95% CI = - 0.28 to - 0.03), intervention period of less than 3 months (SMD = - 0.23; 95% CI = - 0.35 to - 0.11), and non-treatment group (SMD = - 0.23; 95% CI = - 0.36 to - 0.11).
Conclusion
These findings suggest that digital health interventions alleviate psychotic symptoms in patients with severe mental illnesses. However, well-designed digital health studies should be conducted in the future.

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A Review of Mobile App-Based Psychosocial Intervention for Personal and Clinical Recovery for People With Psychosis
Dowon You, Narae Jeong
Korean Journal of Schizophrenia Research.2024; 27(1): 1. CrossRef

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Review Paper

Effect of Auriculotherapy on Musculoskeletal Pain: A Systematic Review and Meta-Analysis: Choi, Sun Yeob , Kim, Yeo Ju , Kim, Bomi; J Korean Acad Nurs 2022;52(1):4-23. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21121

Abstract PDF

Purpose
The aim of this study was to evaluate the effect of auriculotherapy on musculoskeletal pain in adults.
Methods
A total of 885 studies were retrieved from nine databases (PubMed, Scopus, CINAHL, Web of Science, Ovid Medline, Cochrane Library, RISS, KMbase, and KISS). Sixteen studies were selected for meta-analysis, which satisfied the inclusion criteria and the evaluation of risk of bias. Demographic data, auriculotherapy types, intervention characteristics, auricular points, and outcomes related to pain (subjective pain scale, and amount of analgesic) were extracted from all included studies. The effect size of auriculotherapy was analyzed through comprehensive meta analysis 3.0, and the presence of publication bias was analyzed through a funnel plot and Egger’s regression.
Results
The results of the meta-analysis (n = 16) revealed that the auriculotherapy was significantly superior to the control group on present pain in adults (Hedges’ g = - 0.35, 95% Confidence Interval [CI] = - 0.55~- 0.15). According to the results of subgroup analysis, the effect size of auricular acupuncture therapy (Hedges’ g = 0.45, 95% CI = - 0.75~- 0.15) was higher than the auricular acupuncture (Hedges’ g = 0.27, 95% CI = - 0.53~0.00): the longer the intervention period, the greater the effect size.
Conclusion
In this study, auriculotherapy demonstrates a significant reduction in musculoskeletal pain in adults. Therefore, it is necessary to refine the curriculum to include auriculotherapy as a nursing intervention to relieve musculoskeletal pain in adults and encourage its use in clinical settings.

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Jennifer Kawi, Chao Hsing Yeh, Lauren Grant, Johannes Thrul, Hulin Wu, Paul J. Christo, Lorraine S. Evangelista
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Yuna Cho, Eunmi Cho, Eunseol Cho, Yeonju Chae, Eunkyung Choi, Hyeongyeong Yoon
Pain Management Nursing.2024;[Epub] CrossRef
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The effects of auricular acupressure on blood pressure, stress, and sleep in elders with essential hypertension: a randomized single-blind sham-controlled trial
Bomi Kim, Hyojung Park
European Journal of Cardiovascular Nursing.2023; 22(6): 610. CrossRef

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Review Articles

Trends of Concept Development in Nursing Published in Korean Journals: Lee, Sumi , Lee, Jinhae , Hwang, Yugyeong , Ko, Il Sun; J Korean Acad Nurs 2020;50(2):178-190. Published online April 30, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.2.178

Abstract PDF

Purpose
The purpose of this study was to identify trends of nursing concept development in Korean journal papers to improve accurate understanding of nursing concepts.
Methods
A systematic review of 216 concept development articles published from 1970 to 2018 that met the inclusion criteria was conducted using Research Information Sharing Service (RISS) databases.
Results
The most common method of concept development was Walker and Avant’s concept analysis method, identified in 139 (64.3%) of the 216 studies, followed by 48 examples of hybrid models (22.2%) and 15 examples of evolutionary methods (6.9%). Chinn and Kramer’s method, Norris’s clarification, Wilson’s method, and others were also used. The concepts of “spirituality” and “fatigue” were most frequently analyzed. Among the 139 studies that used Walker and Avant’s concept analysis method, 127 studies (91.4%) applied all the recommended steps; the others applied the recommended steps partially, omitting description of model cases/additional cases, antecedents/consequences, and empirical indicators. Among the studies using the hybrid model, among two (5.7%) did not describe attributes, three (8.5%) did not provide definitions, and 16 (45.7%) did not present empirical indicators in the final stage.
Conclusion
Among concept development studies published in Korean journals, Walker and Avant’s concept analysis method is most commonly used. In case of most studies using Walker and Avant’s method a suitable concept analysis process is applied, but in case of other studies using the other concept development method, a suitable concept analysis process is not applied. Therefore, a suitable concept analysis process must be applied for concept development in nursing research.

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Concept Analysis of Nurses’ Job Crafting
Sujeong Han, Eunha Jeong
Journal of Korean Academy of Fundamentals of Nursing.2022; 29(3): 375. CrossRef
Concept Analysis of Spiritual Distress in Cancer Patients Using a Hybrid Model
Jin Sook Kim, Il-Sun Ko
Korean Journal of Adult Nursing.2021; 33(2): 169. CrossRef

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Factors Related to Persistent Postoperative Pain after Cardiac Surgery: A Systematic Review and Meta-Analysis: Bae, Jaewon , Shin, Sujin; J Korean Acad Nurs 2020;50(2):159-177. Published online April 30, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.2.159

Abstract PDF

Purpose
This study aimed at identifying factors related to persistent postoperative pain after cardiac surgery and estimating their effect sizes.
Methods
The literature search and selection was conducted in four different databases (CINAHL, Cochrane Library, PubMed, and PQDT) using the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement. A total of 14 studies met the inclusion criteria and were systematically reviewed. For the meta-analysis, R was used to analyze 30 effect sizes of for both individual and operative factors as well as publication biases from a total of nine studies.
Results
The meta-analysis revealed that persistent postoperative pain after cardiac surgery was related to one individual factor (gender) and two operative factors (acute postoperative pain and use of the internal mammary artery). Operative factors (OR=5.26) had a larger effect size than individual factors (OR=1.53).
Conclusion
Female gender, acute pain after surgery, and use of the internal mammary artery are related factors to persistent postoperative pain. The development of interventions focusing on modifiable related factors, such as acute postoperative pain, may help to minimize or prevent PPP after cardiac surgery.

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P. R. D. Clephas, S. E. Hoeks, P. M. Singh, C. S. Guay, M. Trivella, M. Klimek, M. Heesen
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Regional anesthesia in coronary artery bypass grafting: a narrative review
Viktor A. Koriachkin, Maksim A. Dzhopua, Beka S. Ezugbaia, Vaagn A. Avetisian, Dmitriy V. Zabolotskiy, Vladimir A. Evgrafov
Regional Anesthesia and Acute Pain Management.2023; 17(3): 161. CrossRef

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Effects of Aromatherapy on Sleep Quality: A Systematic Review and Meta-Analysis: Mi-Eun Kim, Ji Hee Jun, Muyng-Haeng Hur; J Korean Acad Nurs 2019;49(6):655-676. Published online December 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.6.655

Abstract PDF

Purpose

The purpose of this study was to investigate the effects of aromatherapy on sleep quality.

Methods

This is a systematic review of randomized controlled trial studies (PROSPERO registration number CRD42017064519). In this study, the PICO were adults and the elderly, aromatherapy intervention, a comparative intervention with the control and placebo oil groups, and sleep. The selected articles were in English, Korean, and Chinese.

Results

The results of the meta-analysis showed that the effect sizes of the experimental group were 1.03 (n=763, SMD=1.03, 95% CI 0.66 to 1.39) (Z=5.47, p<.001). In the aromatherapy intervention group, the effect size of sleep was statistically significant (Q_B=9.39, df=2, p=.009), with a difference of 0.77 for inhalation, 1.12 for oral intake and 2.05 for massage. A post-analysis showed that the effect of massage on sleep was significantly greater than the inhalation method. The regression coefficient of the intervention period, B=0.01 (Z=1.43, p=.154), also showed that the longer the intervention period, the larger the effect size; however, it was not statistically significant.

Conclusion

A total of 23 literature analyses showed that aromatherapy is effective in improving quality of sleep, and the massage method is more effective in improving quality of sleep than the inhalation method. A meta-ANOVA showed that the aromatherapy intervention affected the high heterogeneity of the effect size. Thus, future research with stricter control in methods and experimental procedures is necessary.

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Po-Hao Wang, Ho-Wei Lin, Truc Tran Thanh Nguyen, Chaur-Jong Hu, Li-Kai Huang, Ka-Wai Tam, Yi-Chun Kuan
Journal of the American Medical Directors Association.2024; 25(11): 105199. CrossRef
Meta-analysis of the Effect Size of Lavender Essential Oil and Lavender Blended Essential Oils on Psychological Factors in Adults
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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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Effects of Aromatherapy on Menopausal Symptoms, Perceived Stress and Depression in Middle-aged Women: A Systematic Review: Shinmi Kim, Ji-Ah Song, Mi-Eun Kim, Myung-Haeng Hur; J Korean Acad Nurs 2016;46(5):619-629. Published online October 31, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.5.619

Abstract PDF

Purpose

This study was a systematic review to evaluate the effects of aromatherapy on menopausal symptoms, perceived stress and depression in middle aged-women.

Methods

Eight databases were searched from their inception September 8, 2015. Two reviewers independently performed the selection of the studies, data abstraction and validations. The risk of bias was assessed using Cochrane criteria. For analysis of the data, a meta-analysis of the studies was performed.

Results

From the electronic databases, 73 articles were selected, and 19 removed due to duplication. After two reviewers read the abstracts of 54 studies, 34 studies were selected. Complete papers for 34 original articles were read and, 12 studies which met selection criteria were reviewed and the effects of aromatherapy on menopausal symptoms, stress and depression analyzed using meta-analysis with RevMan. In the 2 studies which included Randomized Controlled Trials testing of aromatherapy on menopausal symptoms and comparison of control and placebo groups were done. Aromatherapy massage was favorably effective in reducing the menopausal symptoms compared to the control group (n=118, MD=-6.33; 95% CI -11.51 to -1.15), and compared to the placebo group (n=117, MD=-4.14; 95% CI -7.63 to -0.64). Also aromatherapy was effective in reducing stress (n=72, SMD=-0.64; 95% CI -1.12 to -0.17) and depression (n=158, MD=-5.63; 95% CI -10.04 to -1.22).

Conclusion

There is limited evidence suggesting that aromatherapy for middle-aged women may be effective in controlling menopausal symptoms, perceived stress and depression.

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Dysphagia Screening Measures for Use in Nursing Homes: A Systematic Review: Yeon-Hwan Park, Hwal Lan Bang, Hae-Ra Han, Hee-Kyung Chang; J Korean Acad Nurs 2015;45(1):1-13. Published online February 27, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.1.1

Abstract PDF

Purpose

The purpose of this study was to evaluate the psychometric quality and feasibility of measurements for screening dysphagia in older adults to identify the 'right tool' for nurses to use in nursing homes.

Methods

A systematic review was done. Electronic databases were searched for studies related to dysphagia screening measurements. A checklist was used to evaluate the psychometric quality and applicability. Tools were evaluated for feasible incorporation into routine care by nurses.

Results

29 tools from 31 studies were identified. Dysphagia screening tools with an acceptable validity and reliability had sensitivity between 68% and 100% and specificity between 52% and 100%. The Gugging Swallowing Screen (GUSS) and the Standardized Swallowing Assessment (SSA) were the tools with high psychometric quality, especially with high sensitivity, that nurses could perform feasibly to identify the risk and to grade the severity of dysphagia and aspiration of nursing home residents.

Conclusion

Results show that GUSS and SSA are reliable and sensitive tools for screening dysphagia which nurses can use in nursing homes. Further research is needed to examine feasibility of screening with identified tools, and also, to establish effective and standardized protocols for these tools so they can be effectively incorporated into routine care.

Citations

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Original Article

Effects of Foot Reflexology on Fatigue, Sleep and Pain: A Systematic Review and Meta-analysis: Jeongsoon Lee, Misook Han, Younghae Chung, Jinsun Kim, Jungsook Choi; J Korean Acad Nurs 2011;41(6):821-833. Published online December 31, 2011; DOI: https://doi.org/10.4040/jkan.2011.41.6.821

Abstract PDF

Purpose

The purpose of this study was to evaluate the effectiveness of foot reflexology on fatigue, sleep and pain.

Methods

A systematic review and meta-analysis were conducted. Electronic database and manual searches were conducted on all published studies reporting the effects of foot reflexology on fatigue, sleep, and pain. Forty four studies were eligible including 15 studies associated with fatigue, 18 with sleep, and 11 with pain. The effects of foot reflexology were analyzed using Comprehensive Meta-Analysis Version 2.0. The homogeneity and the fail-safe N were calculated. Moreover, a funnel plot was used to assess publication bias.

Results

The effects on fatigue, sleep, and pain were not homogeneous and ranged from 0.63 to 5.29, 0.01 to 3.22, and 0.43 to 2.67, respectively. The weighted averages for fatigue, sleep, and pain were 1.43, 1.19, and 1.35, respectively. No publication bias was detected as evaluated by fail-safe N. Foot reflexology had a larger effect on fatigue and sleep and a smaller effect on pain.

Conclusion

This meta-analysis indicates that foot reflexology is a useful nursing intervention to relieve fatigue and to promote sleep. Further studies are needed to evaluate the effects of foot reflexology on outcome variables other than fatigue, sleep and pain.

Citations

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RECENT LITERATURE

Focus on Alternative and Complementary Therapies.2012;[Epub] CrossRef
RECENT LITERATURE

Focus on Alternative and Complementary Therapies.2012;[Epub] CrossRef

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