Showing papers in "Journal of Korean Academy of Nursing in 2013"

An introduction to logistic regression: from basic concepts to interpretation with particular attention to nursing domain.

Abstract: Purpose: The purpose of this article is twofold: 1) introducing logistic regression (LR), a multivariable method for modeling the relationship between multiple independent variables and a categorical dependent variable, and 2) examining use and reporting of LR in the nursing literature. Methods: Text books on LR and research articles employing LR as main statistical analysis were reviewed. Twenty-three articles published between 2010 and 2011 in the Journal of Korean Academy of Nursing were analyzed for proper use and reporting of LR models. Results: Logistic regression from basic concepts such as odds, odds ratio, logit transformation and logistic curve, assumption, fitting, reporting and interpreting to cautions were presented. Substantial shortcomings were found in both use of LR and reporting of results. For many studies, sample size was not sufficiently large to call into question the accuracy of the regression model. Additionally, only one study reported validation analysis. Conclusion: Nursing researchers need to pay greater attention to guidelines concerning the use and reporting of LR models.

A Guide on the Use of Factor Analysis in the Assessment of Construct Validity

Abstract: Purpose: The purpose of this study is to provide researchers with a simplified approach to undertaking exploratory factor analysis for the assessment of construct validity. Methods: All articles published in 2010, 2011, and 2012 in Journal of Korean Academy of Nursing were reviewed and other relevant books and articles were chosen for the review. Results: In this paper, the following were discussed: preliminary analysis process of exploratory factor analysis to examine the sample size, distribution of measured variables, correlation coefficient, and results of KMO measure and Bartlett"s test of sphericity. In addition, other areas to be considered in using factor analysis are discussed, including determination of the number of factors, the choice of rotation method or extraction method of the factor structure, and the interpretation of the factor loadings and explained variance. Conclusion: Content validity is the degree to which elements of an assessment instrument are relevant to and representative of the targeted construct for a particular assessment purpose. This measurement is difficult and challenging and takes a lot of time. Factor analysis is considered one of the strongest approaches to establishing construct validity and is the most commonly used method for establishing construct validity measured by an instrument.

Effects of a Multicultural Education Program on the Cultural Competence, Empathy and Self-efficacy of Nursing Students

Abstract: Purpose: This study was done to examine the effects of a multicultural education program on nursing students" cultural competence, empathy, and self-efficacy. Methods: In this quasi-experimental study, the participants were assigned to an experimental group (n=40) or a control group (n=40). The data were analyzed using independent t-test, Chi-square or Fisher"s exact test, and paired t-test with the SPSS windows 18.0 program. Results: After receiving the multicultural education program, the levels of cultural competence and self-efficacy in the experimental group were higher than in the control group. The level of empathy increased slightly in the experimental group while it decreased in the control group. Conclusion: The results of this study indicate that multicultural education is effective in raising the level of cultural competence and self-efficacy in nursing students. Thus, there is a need for continuous effort to integrate multicultural education programs in the nursing curriculum. Repeated study to test effects of these multicultural education programs should be also necessary.

Validity of instrument development research in korean nursing research

Abstract: Purpose: This integrative review study was done to analyze methods used for validation studies in Korean nursing research. Methods: In this study, the literature on instrument development in nursing research from Research Information Sharing Service (RISS) and major nursing journal databases in Korea were examined. The MeSH search terms included ‘nursing’, ‘instrument’, ‘instrument development’, ‘validation’ and 189 articles were included in the review. Results: The most frequently reported validity type was content validity, followed by construct validity, and criterion validity. One third reported a single type of validity, and 15% of the studies demonstrated three kinds of validity at the same time. In about 40% of the studies, both content and construct validity were examined. Conclusion: The results of the study indicate that it is necessary to provide a wider variety of evidence to establish whether instruments are valid enough to use in nursing research.

A structural model for quality of life of infertile women

Abstract: Purpose: 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). Methods: 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. Results: 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. Conclusion: 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.

Development and testing of a nurse turnover intention scale (NTIS)

Abstract: Purpose: The purpose of this study was to develop a measurement tool of nurse’s turnover intention. Methods: Data were collected from questionnaires completed by 678 nurses who worked in 3 university hospitals in South Korea and analyzed using the SPSS 18.0 and AMOS 18 programs. Thirty-seven preliminary items were selected from 161 basic items extracted via a literature review and in depth interviews with 6 hospital nurses. Three steps with factor analysis were undertaken to verify the reliability and validity of the preliminary instruments. Finally, confirmative factor analysis was carried out. Results: As a result of the analysis, 3 factors including 10 items were selected. Cronbach’s Alpha for the 10 items was .83, for job satisfaction (4 items), .78, for interpersonal relationships (3 items), .80, and for work performance (3 items), .74, which was stable. Conclusion: This study is meaningful because through it a scale reflecting Korean culture was developed to measure turnover intention in nurses. Further studies that test the psychometrics of this scale in more diverse samples are warranted.

Effect of PLISSIT Model Sexual Health Enhancement Program for Women with Gynecologic Cancer and Their Husbands

Abstract: Purpose: The purpose of this study was to examine effects of the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model sexual health enhancement program on, and development in, sexual function, sexual distress, marital intimacy, and subjective happiness of women wi...

[Development and effects of a simulation-based education program for newborn emergency care].

Abstract: PURPOSE This study was conducted to develop a simulation-based education program for newborn emergency care based on most needed topics found from the needs assessment. This study consisted of two phases: developing the program and evaluating its effectiveness. METHODS The effectiveness of the program was tested in July, 2012, with 49 junior nursing students from C Nursing College in Seoul, who did not have any clinical experience in newborn care. The experimental group was given a three-hour lecture, three hours of clinical training, and a two-hour simulation program, whereas the control group only had the three-hour lecture. RESULTS There was significant improvement in knowledge in both groups, but no significant differences according to educational methods. The experiment group was more confident of their care (4.32±.29) than the control group (3.60±.29) with the difference being significant (t=8.85, p<.001), and the experimental group was also more satisfied with the program (χ²=4.60, p=.032). CONCLUSION As the results indicate 'the neonatal emergency care program' increased learners' knowledge, confidence and satisfaction with the program, it should be integrated into clinical training in pediatric nursing curriculum and in-service programs for nurses. To increase generalization further verification studies with various learner groups are needed.

Development and testing of a pediatric nurse parent partnership scale

Abstract: Purpose: This study was done to develop and test a scale to measure the partnership between pediatric nurses and hospitalized children"s parents. Methods: Instrument development process included construct identification based on concept analysis using the hybrid model of Shuwartz-Barcott and Kim (2000), a process which generated 42 initial items. This number was reduced to 35 items through content validity tests by 5 experts and face validity tests by 5 pediatric nurses and 5 parents of hospitalized children. The preliminary Pediatric Nurse Parent Partnership Scale (PNPPS) was administered to 186 pediatric nurses and 163 parents at eleven children’s wards in four hospitals. Data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach’s alpha. Results: Thirty-four items were selected for the final scale. Seven factors evolved from the factor analysis, which explained 68.4% of the total variance. The internal consistency, Cronbach’s alpha, was .96 and reliability of the subscales ranged from .66 to .93. Conclusion: The PNPPS demonstrated acceptable validity and reliability. It can be used to assess the partnership of pediatric nurses and parents in practice and research.

Evidence based practice in long term care settings.

Abstract: Purpose: The purpose of this manuscript is to discuss the need for use of evidence based practice (EBP) in LTC, the current use of evidence in long term care facilities and what we know about adoption of the use of EBP in LTC. Methods: Literature review and reporting of findings from the M-TRAIN study that was a quasi-experimental design to test the effectiveness of an intervention to increase the use of EBPs for urinary incontinence and pain in 48 LTC facilities. Results: Barriers to adopting EBPs include lack of available time, lack of access to current research literature, limited critical appraisal skills, excessive literature to review, non-receptive organizational culture, limited resources, and limited decision-making authority of staff to implement change. Strategies to promote adoption of EBP include the commitment of management; the culture of the home; leadership; staff knowledge, time, and reward; and facility size, complexity, the extent that members are involved outside the facility, NH chain membership, and high level of private pay residents. Findings from the M-TRAIN add, stability of nurse leader and congruency between the leaders perception of their leadership and the staff’s perception of the leadership. Conclusion: There is clear evidence of the need and the benefits to residents of LTC and to the health care system yet adoption of EBP continues to be slow and sporadic. There is also evidence for the process of establishing best evidence and many resources to find the available EBPs. The urgent need now is finding ways to best get the EBPs implemented in LTC. There is growing evidence about best methods to do this but continued research is needed. Clearly, residents in LTC deserve the best care possible and EBPs represent an important vehicle by which to do this.

Analysis of Burnout and Job Satisfaction among Nurses Based on the Job Demand-Resource Model

Abstract: Purpose: The purpose of this study was to examine burnout and job satisfaction among nurses based on Job Demand-Resource Model. Methods: A survey using a structured questionnaire was conducted with 464 hospital nurses. Analysis of data was done with both SPSS Win 17.0 for descriptive statistics and AMOS 18.0 for the structural equation model. Results: The hypothetical model yielded the following Chi-square=34.13 (p= <.001), df=6, GFI=.98, AGFI=.92, CFI=.94, RMSR=.02, NFI=.93, IFI=.94 and showed good fit indices. Workload had a direct effect on emotional exhaustion (β=0.39), whereas supervisor support had direct effects on emotional exhaustion (β= -0.24), depersonalization (β= -0.11), and low personal accomplishment (β= -0.22). Emotional exhaustion (β= -0.42), depersonalization (β= -0.11) and low personal accomplishment (β= -0.36) had significant direct effects on job satisfaction. Conclusion: The results suggest that nurses’workload should be decreased and supervisor’¾s support should be increased in order to retain nurses. Further study with a longitudinal design is necessary.

Effects of a Maternal Sexuality Education Program for Mothers of Preschoolers

Abstract: Purpose: The purpose of this study was to evaluate effects of a maternal sexuality education program for mothers of preschoolers. Methods: A quasi-experimental with non-equivalent control group pretest-posttest design was conducted. The participants were 55 mothers of preschoolers in G city (Experimental group=27, Control group=28). The experimental group received the maternal sexuality education, and the control group received the program after the experiment. Data were collected during October and November 2012 through self-administered questionnaires at two times: prior to the intervention and after the intervention. Data were analyzed using χ2 -test, Fisher’s exact test and t-test. Results: After the intervention, mothers in the experimental group reported significant differences in knowledge of sex (t=3.74, p<.001), attitude toward sex (t=4.31, p<.001), parent-efficacy on child sexuality education (t=11.96, p<.001). compared to mothers in the control group. Conclusion: These results indicate that a sexuality education program for mothers of preschoolers is effective in improving knowledge of sex, attitude toward sex, and parent-efficacy on child sexuality education. Therefore further study should be done with larger and varied participants to confirm the effects of sexuality education programs for mothers of preschoolers.

[Comparison of learning effects using high-fidelity and multi-mode simulation: an application of emergency care for a patient with cardiac arrest].

Abstract: PURPOSE Simulation-based learning has become a powerful method to improve the quality of care and help students meet the challenges of increasingly complex clinical practice settings. The purpose of this study was to identify the learning effects using high-fidelity SimMan and multi-mode simulation. METHODS Participants in this study were 38 students who were enrolled in an intensive course for a major in nursing at R college. Collected data were analyzed using Chi-square, t-test, and independent t-test with the SPSS 18.0 for Windows Program. RESULTS There were no statistically significant differences in learning effects between high-fidelity SimMan and multi-mode simulation group. However, skills in clinical performance in the high-fidelity SimMan group were higher than in the multi-mode group (p=.014), communication in clinical performance in multi-mode simulation group was higher than in the high-fidelity SimMan group (p<.001). CONCLUSION Multi-mode simulation with a standardized patient is an effective learning method in many ways compared to a high-fidelity simulator. These results suggest that multi-mode simulation be offered to students in nursing colleges which cannot afford to purchase a high-fidelity simulator, or offered as an alternative.

Transcultural Self-efficacy and Educational Needs for Cultural Competence in Nursing of Korean Nurses

Abstract: Purpose: This study was done to investigate the level of transcultural self-efficacy (TSE) and related factors and educational needs for cultural competence in nursing (CCN) of Korean hospital nurses. Methods: A self-assessment instrument was used to measure TSE and educational needs for CCN. Questionnaires were completed by 285 nurses working in four Korean hospitals. Descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression were used to analyze the data. Results: Mean TSE score for all items was 4.54 and score for mean CCN educational needs, 5.77. Nurses with master"s degrees or higher had significantly higher levels of TSE than nurses with bachelor’?s degrees. TSE positively correlated with English language proficiency, degrees of interest in multi-culture, degree of experience in caring for multi-cultural clients, and educational needs for CCN. The regression model explained 28% of TSE. Factors affecting TSE were degree of interest in multi-culture, degree of experience in caring for multi-cultural clients, and educational needs for CCN. Conclusion: The results of the study indicate a need for nurse educators to support nurses to strengthen TSE and provide educational program for TSE to provide nurses with strategies for raising interests in cultural diversity and successful experiences of cultural congruent care.

[Predictors of postpartum depression: prospective cohort study].

Abstract: Purpose: This prospective cohort study was done to investigate recall bias to antepartum variables measured at postpartum periods and predictors of postpartum depression. Methods: Participants were 215 women who answered a self -administered questionnaire which included demographics, Postpartum Depression Predictors Inventory -Revised and Korean version of Edinburgh Postpartum Depression Scale at antepartum 36-40 weeks and postpartum 2 weeks and 6 weeks. Data were analyzed using kappa, and hierarchical multiple logistic regression. Results: Agreement between antepartum variables at both antepartum and two postpartum periods was relatively high (κ= .55 - .95). Postpartum depression rates were 36.3% and 36.7% at two follow -up points. In hierarchical multiple logistic regression analysis, prenatal depression (OR = 4.32, 95% CI: 1.41 -13.19; OR = 5.19, 95% CI: 1.41 -19.08), social support (OR = 1.40, 95% CI: 1.18 -1.66; OR = 1.27, 95% CI: 1.06 -1.53) and maternity blues (OR = 4.75, 95% CI: 1.89 -11.98; OR = 4.22, 95% CI: 1.60 -11.12) were commonly associated with postpartum depression at two follow -up points. Child care stress (OR = 1.85, 95% CI: 1.01 -3.37) was only associated with postpartum depression at 2 weeks postpartum and pregnancy intendedness (OR = 1.57, 95% CI: 1.09 -2.27) was only associated with postpartum depression at 6 weeks postpartum. Conclusions: The results indicate a need to apply nursing interventions such as prenatal education and counseling with families from antenatal period.

Effects of Perceived Health Status, Self-esteem and Family Function on Expectations Regarding Aging among Middle-aged Women

Abstract: Purpose: The purpose of this study was to investigate expectations regarding aging by middle-aged women in the community, and identify factors contributing to their expectations about aging. Methods: Participants in the survey for this study were 303 middle-aged women from community health centers and religious facilities in Seoul, Gyeonggi Province, and Chungcheongbuk Province. Data were collected from March 2 to April 17, 2012 using self-report structured questionnaires. The instruments were the Health Perceptions, Rosenberg Self-esteem Scale (RSES), Family APGAR, Expectations Regarding Aging (ERA-12). The data were analyzed using t-test, one-way ANOVA, Scheffe test, Pearson correlation coefficients and hierarchical multiple regression with IBM SPSS/WIN 20.0 program. Results: Perceived health status (s=0.16, p=.009) and self-esteem (s=0.20, p=.001) of middle-aged women were identified as significant predictors of expectations regarding aging, after adjusting for age, education, occupation, monthly income and menstrual status. Conclusion: These results suggest that nurses should make an effort to improve expectations about aging among middle-aged women. Ultimately, community health programs for middle aged women need to be developed to achieve successful aging.

[A meta-analysis of the effect of walking exercise on lower limb muscle endurance, whole body endurance and upper body flexibility in elders].

Abstract: Purpose: The purpose of this study was to determine whether walking exercise improved physical function in elderly people using meta-analysis. Methods: Medical and nursing literature databases were searched to identify the studies on the effectiveness of walking exercise on physical function. In the databases, there were 16 articles reporting 21 interventions. Overall effect sizes for three outcome variables, elders’ physical function in lower limb muscle endurance, whole body endurance and upper body flexibility, were calculated. Effects of study characteristics on outcome variables were analyzed. Results: The meta-analysis showed that walking exercise generally had positive effects on CST (chair stand test), 6MW (6 min walking), and SRT (standing or sitting reach test) with overall weighted effect sizes of 1.06, 0.41 and 0.29 respectively. This study also showed that the chronic disease status of the elders, intervention methods, and type of residence had different effects on CST, 6MW and SRT. Conclusion: The results indicate that walking exercise improves physical function in elders. Walking exercise which can be done at any time and any location is indeed a very effective exercise for elderly people.

Effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients after a myocardial infarction

Abstract: Purpose: This study was done to identify effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients who have had a myocardial infarction (MI). Methods: This research was a quasi-experimental design with a nonequivalent control group pretest-posttest. The participants were 48 outpatients (experimental group=24, control group=24) recruited from one university hospital. They were randomly assigned to one of two groups: (a) an experimental group with telephone counseling (once a week) and text messaging (five times a week) using stages of change, and (b) a control group with traditional telephone counseling (once a month). Efficacy of the intervention was measured by comparing the two groups on smoking-related variables at 3 weeks and 12 weeks. Results: At the 3-week and 12-week measurements, there were significant differences between the experimental and control groups on smoking cessation self-efficacy (p<.001), nicotine dependence (p<.001), CO levels (p<.001), and smoking cessation rates (p<.001). Conclusion: The results indicate that the smoking cessation program including telephone counseling and text messaging using stages of change is effective for outpatients after a MI. Further attention should be paid to the intensity of the smoking cessation program and periods for long-term follow-up.

[Effects of an integrated self-management program on self-management, glycemic control, and maternal identity in women with gestational diabetes mellitus].

Abstract: Purpose: The purpose of the study was to investigate the effects of an integrated self-management program on self-management, glycemic control, and maternal identity in women with gestational diabetes mellitus (GDM). Methods: A non-equivalent control group non-synchronized quasi-experimental design was used. A total of 55 women with GDM were recruited from Cheil General Hospital, Seoul, Korea and were assigned to an experimental (n=28) or control group (n=27). The participants were 24-30 weeks pregnant women who had been diagnosed with GDM as of July 30, 2010. The program was conducted as a 1 hour small group meeting 3 out of 5 times and by telephone-counseling 2 out of 5 times. The integrated self-management program was verified by an expert panel. Results: Although there was no significant reduction in HbA1c (U= -1.17, p=.238), there were statistically significant increases in self-management (U= -3.80, p<.001) and maternal identity (U= -4.48, p<.001), and decreased 2-h postprandial glucose levels (U= -2.43, p<.015) in the experimental group compared to the control group. Conclusion: These findings suggest that an integrated self-management program for women with GDM improves self-management, maternal identity, and glycemic control. Further studies are needed to identify the effects of an integrated self-management program on pregnancy and neonatal outcomes.

[Effects of nurses' social capital on turnover intention: focused on the mediating effects organizational commitment and organizational cynicism].

Abstract: PURPOSE The purpose of this study was to investigate the casual relationship between nurses' social capital and turnover intention and to verify the goodness of fit between a hypothetical model and actual data in order to suggest the best model. METHODS This survey was conducted with 315 nurses working in general hospitals in Seoul. Data were collected from December 1 to December 30, 2011, and analyzed using SPSS Windows 18.0 and AMOS 16.0. RESULTS Nurses' social capital was found to have a direct effect on reducting organization cynicism and increasing organizational commitment. Nurses' organizational cynicism and organizational commitment were found to have a direct effect on turnover intention, but social capital did not have a direct effect on turnover intention. However, social capital had a partial and indirect effect on turnover intention through mediating organizational cynicism and organizational commitment. CONCLUSION Results of this study indicate that nurse managers should put increased effort in reducing nurses' organizational cynicism and improving their organizational commitment, two contrary parameters. At the same time managers need to develop plans to establish social capital more efficiently so that nurses have lower turnover intention.

Analysis of the Characteristics of the Older Adults with Depression Using Data Mining Decision Tree Analysis

Abstract: Purpose: The purpose of this study was to develop a prediction model for the characteristics of older adults with depression using the decision tree method. Methods: A large dataset from the 2008 Korean Elderly Survey was used and data of 14,970 elderly people were analyzed. Target variable was depression and 53 input variables were general characteristics, family & social relationship, economic status, health status, health behavior, functional status, leisure & social activity, quality of life, and living environment. Data were analyzed by decision tree analysis, a data mining technique using SPSS Window 19.0 and Clementine 12.0 programs. Results: The decision trees were classified into five different rules to define the characteristics of older adults with depression. Classification & Regression Tree (C&RT) showed the best prediction with an accuracy of 80.81% among data mining models. Factors in the rules were life satisfaction, nutritional status, daily activity difficulty due to pain, functional limitation for basic or instrumental daily activities, number of chronic diseases and daily activity difficulty due to disease. Conclusion: The different rules classified by the decision tree model in this study should contribute as baseline data for discovering informative knowledge and developing interventions tailored to these individual characteristics.

Update on irritable bowel syndrome program of research

Abstract: Purpose: This article provides an update and overview of a nursing research program focused on understanding the pathophysiology and management of irritable bowel syndrome (IBS). Methods: This review includes English language papers from the United States, Europe, and Asia (e.g., South Korea) from 1999 to 2013. We addressed IBS as a health problem, emerging etiologies, diagnostic and treatment approaches and the importance of a biopsychosocial model. Results: IBS is a chronic, functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain and alterations in bowel habit (diarrhea, constipation, mixed). It is a condition for which adults, particularly women ages 20-45, seek health care services in both the United States and South Korea. Clinically, nurses play key roles in symptom prevention and management including designing and implementing approaches to enhance the patients’ self-management strategies. Multiple mechanisms are believed to participate in the development and maintenance of IBS symptoms including autonomic nervous system dysregulation, intestinal inflammation, intestinal dysbiosis, dietary intolerances, alterations in emotion regulation, heightened visceral pain sensitivity, hypothalamic-pituitary-adrenal dysregulation, and dysmotility. Because IBS tends to occur in families, genetic factors may also contribute to the pathophysiology. Patients with IBS often report a number of co-morbid disorders and/or symptoms including poor sleep. Conclusion: The key to planning effective management strategies is to understand the heterogeneity of this disorder. Interventions for IBS include non-pharmacological strategies such as cognitive behavior therapy, relaxation strategies, and exclusion diets.

Overcoming Experiences of Family Members Caring for Elderly Patients with Dementia at Home

Abstract: Purpose: The purpose of the study was to understand and describe the overcoming experiences of family members caring for elderly patients with dementia at home. Methods: Data came from autobiographies on the overcoming experiences of caregiving from 31 participants, who had submitted the autobiographies to a public contest held by the Seoul Metropolitan Center for Dementia in 2012. Data were analyzed using qualitative content analysis. Results: Four overcoming stages emerged from the analysis: confronting stage; challenging stage; integrating stage; and transcendental stage, representing transformation of experiences from frustration and suffering to happiness and new hope in life. The confronting stage illustrates severe negative feelings and exhaustion occurring after the diagnosis of dementia. The challenging stage signifies major driving forces in taking good care of their patients. It includes tender loving memories about the patients as well as family and social supports. The integrating stage shows genuine empathy for the patients’ situation and the happiness of ‘here and now’, while the transcendental stage represents new hope in the future. Conclusion: Health professionals need to support caregivers to find true meaning of caring and happiness in everyday life, while providing specific information on dementia care and relieving various negative feelings.

Effects of the Family Resilience Enhancement Program for Families of Patients with Chronic Schizophrenia

Abstract: Purpose: The purpose of this study was to evaluate the effects of the Family Resilience Enhancement Program (FREP) on family hardiness, family sense of coherence, family problem solving communication, family crisis oriented personal evaluation, and adaptation in families of patients with chronic schizophrenia. Methods: The study design was a nonequivalent control group prepost test design. Study participants were 17 families in the experimental group and 17 in the control group. Ten sessions of FREP were provided over 5 weeks. The data were analyzed using SPSS 15.0. Results: There were statistically significant differences in family hardiness, family sense of coherence, family problem-solving communication, family crisis-oriented personal evaluation, social resources, and family adaptation between the experimental group and the control group. Conclusion: FREP based on the family resilience model developed in this study, shows the effect of leading the families to positive family adaptation.

[Meta-analysis of psychosocial interventions to reduce pain in patients with cancer].

Abstract: Purpose: The purpose of this study was to investigate the effects of psychosocial interventions on pain in cancer patients. Methods: Eight studies published between 1980 and 2012 in Korean and ten studies published between 2002 and 2012 in English met the inclusion criteria with a total of 1539 participants. Methodological quality assessed by Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. The data were analyzed by the RevMan 5.2 program of Cochrane library. Results: Overall, study quality was moderate to high. Effect sizes were heterogeneous and subgroup analysis was done. Cognitive behavioral therapy (CBT) were effective for pain (ES = -0.35; 95% CI = -0.56, -0.13). Pain education studies measured with NRS and VAS were effective for pain (ES = -0.77; 95% CI = -1.01, -0.52). Publication bias was not detected. Conclusion: This study support the use of psychosocial interventions administered to cancer patients for their pain management. However, more well-designed studies are needed.

Effect of Kegel Exercise to Prevent Urinary and Fecal Incontinence in Antenatal and Postnatal Women: Systematic Review

Abstract: Purpose: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. Methods: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: ‘Kegel, pelvic floor exercise’. The Cochrane’s Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. Results: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. Conclusion: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.

Validity and Reliability of Korean Version of the Family Management Measure (Korean FaMM) for Families with Children having Chronic Illness

Abstract: Purpose: To develop and test the validity and reliability of the Korean version of the Family Management Measure (Korean FaMM) to assess applicability for families with children having chronic illnesses. Methods: The Korean FaMM was articulated through forward-backward translation methods. Internal consistency reliability, construct and criterion validity were calculated using PASW WIN (19.0) and AMOS (20.0). Survey data were collected from 341 mothers of children suffering from chronic disease enrolled in a university hospital in Seoul, South Korea. Results: The Korean version of FaMM showed reliable internal consistency with Cronbach’s alpha for the total scale of .69-.91. Factor loadings of the 53 items on the six sub-scales ranged from 0.28-0.84. The model of six subscales for the Korean FaMM was validated by expiratory and confirmatory factor analysis (χ2 .08). Criterion validity compared to the Parental Stress Index (PSI) showed significant correlation. Conclusion: The findings of this study demonstrate that the Korean FaMM showed satisfactory construct and criterion validity and reliability. It is useful to measure Korean family’¼s management style with their children who have a chronic illness.

Effectiveness of Enneagram Group Counseling for Self-identification and Depression in Nursing College Students

Abstract: Purpose: The purpose of this study was to examine effects of enneagram group counseling program on self-identification and depression in nursing college students. Three groups, categorized by how the students solve their conflicts, were selected to identify changes from the program. Methods: A quasi-experimental study with a non-equivalent control group and pre posttest design was used. Participants were assigned to the experimental group (n=30) or control group (n=33). The experimental group participated in enneagram group counseling program for 38 hours through eight sessions covering four different topics. Collected data were analyzed using Chi-square test, Fisher’s exact test, t-test, and Wilcoxon signed rank test. Results: Total self-identity score for the experimental group was significantly higher than the control group. However, there was no significant difference between the two groups for depression scores. The Assertive and Compliant groups demonstrated significant change in self-identification while the Withdrawn groups did not reveal any change. Conclusion: Results indicate that the enneagram group counseling program is very effective in establishing positive self-identification for nursing college students who face developmental crisis and stressful situations. It is also expected that this program would be useful to enhance the students" confidence through a deeper understanding and acceptance of themselves.

Structural Equation Modeling on Nursing Productivity of Nurses in Korea

Abstract: Purpose: The purpose of this study was to propose and test a predictive model that could explain and predict nursing productivity. Methods: A survey using a structured questionnaire was conducted with 360 nurses in Korea. The data were analyzed using SPSS Windows 18.0 and AMOS 19.0 program. Results: Based on the constructed model, burnout and organizational commitment were found to have direct effects on nurses’ turnover intention and nursing productivity. While nursing work environment was found to have indirect effects on nurses’ turnover intention and nursing productivity. Conclusion: This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with nursing productivity. Comprehensive organizational interventions to improve nursing productivity should focus on improving the nursing work environment. Findings from this study can be used to design appropriate strategies to decrease nurse turnover in Korea. Further studies are needed to prospectively verify these causal relationships with larger samples.

간호사들이 근무지에서 경험하는 무례함(incivility)에 대한 연구

Abstract: Purpose: This study was done to describe nurses' experience of incivility in hospitals and to consider nurses' work environment. Methods: Data were collected through in-depth interviews and analyzed using Colaizzi' phenomenological analysis methodology. Participants were seven experienced clinical n...