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Research Paper
Experiences of Transitional Care for Medicaid Case Managers
Hwang, Yunhee , Lee, Gaeon
J Korean Acad Nurs 2023;53(5):556-569.   Published online October 31, 2023
DOI: https://doi.org/10.4040/jkan.23031
AbstractAbstract PDF
Purpose
This phenomenological study tried to understand the essence of the transitional care experience of medicaid case managers and its structural meaning. In addition, it was attempted to establish a system of transitional care and seek support measures for medicaid case managers.
Methods
The participants of this study were 7 medicaid case managers who had spent more than 1 year and 6 months in medicaid pilot project. Data were collected with individual in-depth interviews from June to December 2021. The data were analyzed by Giorgi's phenomenological analysis method.
Results
The seven constituents derived from the results of this study were 'struggle to establish a living environment', 'dedication to supporting independent living', 'anxiety about safety', 'pressure on care responsibilities', ‘distress in building the pilot project’, 'pride in role', and 'expectation for improvement'.
Conclusion
The study results provide a comprehensive understanding of the transition care reality for medicaid case managers. They also shed light on managers’ perceptions and attitudes. These findings can serve as fundamental information for establishing support measures for medicaid case managers and transitional care systems.
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Original Articles
Neglecting and Ignoring Menopause Within A Gendered Multiple Transitional Context: Low Income Korean Immigrant Women
Eun Ok Im
Journal of Korean Academy of Nursing 1999;29(6):1336-1354.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1336
AbstractAbstract PDF

Researchers have rarely explored menopausal experience in the context of the totality of women's lives, subsequently making the picture of menopause incomplete, discrete and fragmented. Respecting the totality of women's lives, this study addressed how a vulnerable group of women-low income Korean immigrant women-experience menopause within a context of multiple transitions. This is a cross- sectional study using methodological triangulation. A sample of 119 first-generation Korean immigrant women aged 40 to 60 years, who were in low-income jobs, was recruited using convenience sampling methods. From the total sample, 21 peri- or post- menopausal women were recruited for in-depth interviews following the collection of the survey data. Questionnaires, short interviews, and in- depth interviews were used to collect data. The quantitative data were analyzed using descriptive and inferential statistics. Thematic analysis was used to interpret interview data. The findings indicate that menopause was given the lowest priority amidst women's multiple and demanding roles within a gendered multiple transitional (immigration, work and menopause) context. The lack of language clarity to describe women's experience, cultural background, inadequate knowledge, and lack of social supports made menopause hidden, invisible, and inaudible. Conclusions and implications for nursing practice are guided by the goal of understanding women's experiences and meanings of menopause and supporting women through reflecting these experiences into their health care.

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Transition Model of Middle-aged Women
In Sook Cho, Young Sook Park
Journal of Korean Academy of Nursing 2004;34(3):515-524.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.3.515
AbstractAbstract PDF
Purpose

The purpose of this study was to develop and test a model to explain the transition state for Korean middle-aged women focusing on the transition concept.

Method

A hypothetical model was constructed based on the transition model of Schumacher & Meleis(1994) and tested. Thehypothetical model consisted of 5 latent variables and 11 observed variables. Exogenous variables were demographic characteristics, obstetric characteristics, and health behavior. Endogenous variables were transition state and quality of life with 6 paths. The data from 221 middle-aged women selected by convenience was analyzed using covariance structure analysis.

Result

The final model which was modified from the hypotheticalmodel improved to GFI=0.97, AGFI=0.94, NFI=0.94, and NNFI=0.95. The transition state was influenced directly by demographic characteristics, quality of life, and also indirectly by health behaviors. However, the influence of obstetric characteristics was not significant. The transition state was accountable for 68% of the variance by these factors.

Conclusion

These results suggest that enhancing health behaviors of the women are necessary to increase quality of life and it consequently contributes to improving the transition state. This model could be used to explain the health related vulnerability in these ages and to diagnosis individual women.

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Maternal Transition in Mothers with High Risk Newborns
Hyun Jeong Shin
Journal of Korean Academy of Nursing 2004;34(2):243-251.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.2.243
AbstractAbstract PDF
Purpose

The purpose of this study was a comprehensive understanding about maternal transition in mothers with high risk newborns according to the degree of situational meaning.

Method

A methodological triangulation that combines qualitative and quantitative methods was used. The situational meaning of a high risk newborn mother was identified using a Family Meaning Attribution Scale. According to the degree of situational meaning, in-depth interviews were conducted at 3 time periods postpartum : between 3-10 days after childbirth, around the time of the newborn's discharge, and between 10-12 weeks after childbirth. Quantitative data was analyzed using descriptive statistics and t-test. Qualitative data was analyzed using Tutty, Rothery, & Grinnell's methodology.

Result

The average score of the situational meaning in high the risk newborn mother was 53.57(possible score is between 0-96) and the average score of each item was 1.67. A Maternal transition process in the mother that has a positive situational meaning was conceptualized in three distinctive phases : confusion, accepting, and shaping phases. The Maternal transition process in the mother that has a negative situational meaning was also conceptualized in three distinctive phases : avoiding, conflicting, and accepting phases.

Conclusion

It is necessary that the nurses provide high risk newborn mothers with individualized care considering both the situational meaning that is attributed to them and the maternal transition phase that they are faced with.

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Transitional Care for Older Adults with Chronic Illnesses as a Vulnerable Population: Theoretical Framework and Future Directions in Nursing
Youn-Jung Son, Mi-Ae You
J Korean Acad Nurs 2015;45(6):919-927.   Published online December 31, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.6.919
AbstractAbstract PDF
Purpose

Effective transitional care is needed to improve the quality of life in older adult patients with chronic illness and avoid discontinuity of care and adverse events. The aim of this article is to provide an overview of the key features, broader implications, and the utility of Meleis' transition theory intended for the transitional care of older adults with chronic illnesses. We present the role of nurse in the context of transitional care and propose future directions to increase the quality of nursing care.

Methods

The online databases Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Science Direct were searched for relevant literature published since 1970 along with textbooks regarding nursing theory.

Results

An evaluation of the usefulness of transition theory based on transitional care in older adult patients with chronic illnesses is provided. Healthy transition should be the expected standard of nursing care for older adults across all healthcare settings.

Conclusion

Nurses need to contribute to the development of transitional care for vulnerable populations; however, transition theory needs to be enhanced through additional theoretical work and repeated evaluations of the applicability in areas of transitional care.

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Construct Validity of the Life Transition Scale for Parents of Children with Autism
Ae Ran Lee, Sun Woo Hong, Se Jin Ju
J Korean Acad Nurs 2014;44(5):563-572.   Published online October 31, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.5.563
AbstractAbstract PDF
Purpose

The study was done to identify the construct validity and reliability of the life transition scale (LTS) for parents who have children with autism.

Methods

Exploratory factor analysis (EFA) and confirmative factor analysis (CFA) were conducted to identify the most adequate measurement model for structural validity. Convergent validity and discriminant validity were also conducted for structural validity. Data were collected from 208 parents through self-reported questionnaires and analyzed with SPSS/WIN 15.0 and AMOS 20.0 version.

Results

A four factor-structure was validated (χ2=541.23, p<.001, GFI=.82, RMSEA=.07, IFI=.89, CFI=.89, PNFI=.73, Q (χ2/df)=2.20) at the 3rd order of EFA and CFA, and factors were named as denying, wandering, despairing, and accepting. Both convergent and determinant validity for LTS were 100%. Cronbach's alphas for the reliability of each structure were .77-.90 and .83 for total structure.

Conclusion

The four structures, 24-item instrument showed satisfactory reliability and validity. LTS has the potential to be appropriate for assessing the transition process of life for parents who have children with autism and provides basic directions for differentiated support and care at each stage.

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Health-Illness Transition of Patients with Young-Onset Parkinson's Disease
Sung Reul Kim, Sook Ja Lee
J Korean Acad Nurs 2013;43(5):636-648.   Published online October 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.5.636
AbstractAbstract PDF
Purpose

The purpose of this study was to explore the health-illness transition of patients with Young-Onset Parkinson's Disease (YOPD).

Methods

From June to November 2011, 17 patients with YOPD who visited a neurologic clinic in a tertiary hospital participated in the study. Data were collected through in-depth interviews and analyzed using the grounded theory of Strauss and Corbin.

Results

The core category of the participants' health-illness transition emerged as 'reshaping identity following uncontrollable changes'. The participants' health-illness transition process consisted of six phases in sequence: ego withdrawal, loss of role, frustration, change of thought, modification of life tract, and second life. Although most participants proceeded through the six phases chronologically, some returned to the frustration phase and then took up the remaining phases.

Conclusion

The study results provide an in-depth understanding of health-illness transition experiences in the participants. These findings suggest a need to develop appropriate nursing intervention strategies according to the different phases in the health-illness transition of patients with YOPD.

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Development of a Scale to Measure Life Transition Process in Parents of Children with Autism
Ae Ran Lee, Sun Woo Hong, Se Jin Ju
J Korean Acad Nurs 2012;42(6):861-869.   Published online December 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.6.861
AbstractAbstract PDF
Purpose

The purpose of this research was to develop a scale to measure the life transition process of parents of children with autism, against the backdrop of a lack of research on this topic.

Methods

Seventy preliminary items were drawn from previous qualitative research, and content validity was tested by three professors as well as three parents of children with autism. A questionnaire survey was also done between August 2011 and February 2012. Data were collected from 207 parents of children with autism and analyzed using descriptive statistics, item analysis, Cronbach's alpha, Pearson correlation coefficients, and factor analysis with the SPSS Win 15.0 program.

Results

Twenty-nine items were selected to constitute the appropriate measuring scale and categorized into 5 factors explaining 63.2% of the total variance. The 5 factors were named; stages of denial (5 items), wandering (6 items), devotion (7 items), frustration (3 items), and finally acceptance (8 items). Cronbach's alpha for the 29 items was .80.

Conclusion

The results of this study not only suggest assessment criteria for the life transition process of parents who have children with autism but also provide basic directions for program development to provide differentiated support and care at each stage.

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Life Transition of Mothers of Children with Autism
Ae Ran Lee, Sun Woo Hong, Ji Soo Kim, Se Jin Ju
J Korean Acad Nurs 2010;40(6):808-819.   Published online December 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.6.808
AbstractAbstract PDF
Purpose

While there are a number of studies on children with disabilities, there have been few studies on mothers of children with autism. The purpose of this study was to explore the process of life transition of mothers who have children with autism.

Methods

From June 2007 to May 2009, the researcher interviewed 15 mothers of children with autism living in Seoul City, Gyeonggi or Chonbuk Provinces, and then analyzed the data gathered using the constant comparative method of grounded theory.

Results

"Living together holding a string of fate" was a core category showing along the continuum of life. The basic social process of life transition encompassed 5 stages: stages of denying, wandering, devoting, mind controlling, and finally accepting. These five stages proceeded in phases, though returned back to the wandering stage occasionally.

Conclusion

This study has opened the door to understanding how mothers of children with autism experienced life transition. The findings suggest that differentiated support and care at each stage should be given and there is the need to develop transition assessment tools for mothers of children with autism.

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Development and Evaluation of a Transitional Care Program for Patients Discharged from Military Hospitals
Seun Young Joe
J Korean Acad Nurs 2010;40(4):599-609.   Published online August 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.4.599
AbstractAbstract PDF
Purpose

The purpose of this study was to develop and evaluate a transitional care program for patients discharged from military hospitals. The study consists of two phases: developing the program and evaluating its effectiveness.

Methods

The conceptual framework used to guide the development of the program was Meleis's transition theory. A quasi-experimental design was employed for this study. Participants were recruited from patients discharged from one military hospital, 72 in the control group and 56 in the experiment group. Data were analyzed using SPSS WIN 12.0 program with chi-square, Fisher's exact test, independent t-test, and mixed model.

Results

Participants in the transitional care program reported promoting a positive personal condition, and more healthy patterns of response in the first week after being discharged and a smoother discharge transition.

Conclusion

The transitional care program developed for discharge patients from military hospital promoted discharge readiness and promoted smooth discharge transition.

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