The authors regret that one of the coauthor's affiliation in this article was incorrectly printed.

PURPOSE: This study was conducted to develop and evaluate the Psychological Adaptation Improvement Program (PAIP) for international marriage migrant women in South Korea. METHODS: A total of 43 international marriage migrant women who were enrolled in six rural multicultural family support centers in South Korea were included in this study. They were randomly assigned to the intervention group (n = 21) or to the control group (n = 22). The intervention group received 10 sessions of PAIP, 1 or 2 sessions per week for 8 weeks. The dependent variables were self-esteem, depression and social problem solving ability. The data were analyzed by Fisher's exact test, t test, and repeated measures analysis of variance using SAS program. RESULTS: PAIP was effective in increasing self-esteem and reducing depression, and partially showed significant positive effects on participants' social problem solving ability, suggesting increased levels of positive problem orientation and decreased avoidance style in the social problem solving ability subscales. CONCLUSION: PAIP might be used as an effective intervention to improve psychological adaptation among international marriage migrant women in the rural community of South Korea.
Adaptation, Psychological* ; Depression ; Emigrants and Immigrants ; Female ; Humans ; Korea ; Marriage* ; Problem Solving ; Rural Population ; Self Concept ; Social Problems ; Transients and Migrants*

PURPOSE: The study was conducted to explore caregivers' experiences and perceptions of barriers to their children receiving appropriate healthcare and support at schools in Thailand. METHOD: A qualitative narrative study was conducted to achieve the aim stated above. Twenty caregivers of children living with HIV/AIDS attending schools in Bangkok were interviewed in depth. The interviews were audiotaped, transcribed and analyzed using narrative analysis. RESULTS: The analysis indicated that caregivers fear discrimination, suffer from stigma and most do not reveal their child's HIV status to schools. Obstacles to children living with HIV/AIDS getting appropriate care and support in schools are persistent. Caregivers need to collaborate with the public health sector to provide HIV education and support for themselves and for teachers; community nurses would be well placed to provide this. CONCLUSION: Our findings can inform the design of systems for educational and social support alongside adequate healthcare for children living with HIV/AIDS attending school. The Thai government needs to establish collaboration between the educational and health sectors to reduce the stigma of HIV, promote acceptance and provide support.
Asian Continental Ancestry Group ; Caregivers* ; Child* ; Cooperative Behavior ; Delivery of Health Care* ; Discrimination (Psychology) ; Education ; HIV* ; Humans ; Public Health ; Thailand

PURPOSE: The purpose of this study was to examine the relationship between perceived work environment and workplace bullying among Korean intensive care units (ICU) nurses. METHODS: This is a descriptive survey research, with 134 ICU nurses from five hospitals in Korea. The work environment was measured by the Korean Nursing Work Environment Scale. Workplace bullying was measured with the Korean version of the Negative Acts Questionnaire-Revised. RESULTS: ICU nurses reported moderate satisfaction with their work environment, with perception of the basic work system receiving the highest scores. A total of 94.0% of ICU nurses have experienced at least one negative act within the past 6 months, and the prevalence of bullying was 17.2% according to operational bullying criteria. The ICU nurses reported that they experienced more work-related bullying than other types of bullying. Significant negative correlations between the nursing work environment and workplace bullying were found. CONCLUSION: These findings indicate that the better the nursing work environment, the less workplace bullying nurses will experience. Further research needs to be done to identify factors that influence bullying in the nurses and to develop an intervention that prevents workplace bullying.
Bullying* ; Intensive Care Units* ; Korea ; Nursing ; Prevalence

PURPOSE: The aim of this study is to determine the incidence of Clostridium difficile infection (CDI) in an Australian hospital and highlight considerations for other Asian countries that are considering establishing or modifying existing CDI surveillance programs. METHODS: An observational study design with dynamic population was used. Data from all persons hospitalized for more than 48 hours over 4 years in a tertiary hospital in Australia were analyzed. Persons with healthcare associated, healthcare facility onset CDIs were identified. The calculation of the relative risk was performed to compare the occurrence of CDI in different groups. RESULTS: Of the total 58,942 admissions examined, 158 admissions had CDI. The incidence of CDI per 1,000 admissions for the entire study period was 2.68 (95% confidence interval [2.28, 3.13]). There was a statistically significant increase in the incidence of CDI in 2010 compared to that of 2007 (p < .001). The incidence of CDI increased from the 30-39-year age group onwards. CONCLUSION: Comparisons between this study and others are challenging due to the lack of standardized definitions for CDI internationally. Noting the increases of CDI internationally and the associated mortality, there is increasing importance to monitor and report the incidence of this infection worldwide.
Asian Continental Ancestry Group ; Australia ; Clostridium difficile* ; Delivery of Health Care ; Epidemiology ; Humans ; Incidence* ; Infection Control ; Mortality ; Observational Study ; Tertiary Care Centers

PURPOSE: The Fertility Problem Inventory (FPI) is a screening instrument used to identify infertility-related stress. The purpose of this study was to assess the reliability and validity of the Korean version of the FPI. METHODS: Forward-backward translation of the FPI from English to Korean was conducted. The translated instrument was pilot-tested and administered to 259 women with infertility. Test-retest reliability was conducted and the internal consistency coefficient was determined. Validity was evaluated through content validity, construct validity with confirmatory factor analysis, discriminant validity, and convergent validity. RESULTS: The internal consistencywas satisfactory (Cronbach's alpha=.92, item-total correlations=.60-.92). The overall content validity index was 96.9%, signifying that the FPI had good content validity. The model fit indexes were acceptable (goodness of fit index=.92, adjusted goodness of fit index=.91, normal fit index=.95, comparative fit index=.93, and rootmean square error of approximation=.05), indicating good construct validity. The intercorrelations were significant, although low to moderate in size (.20-.59). The correlation between the FPI and depression ranged from .32 to .51 (p < .001), while the correlation between the FPI and the fertility-related quality of life ranged from -.35 to -.58 (p < .001). CONCLUSION: The Korean version of the FPI has high reliability, and good content, construct, discriminant, and convergent validity. A validated Korean version of the FPI may help nurses identify infertility-related stress and administer appropriate nursing interventions to Korean women with infertility.
Depression ; Female ; Fertility* ; Humans ; Infertility ; Mass Screening ; Nursing ; Quality of Life ; Reproducibility of Results

PURPOSE: The purpose of this study was to validate the Actiwatch with behaviorally determined sleepe-wake state in preterm infants and to explore the influence of postmenstrual age on the accuracy of Actiwatch. METHODS: A prospective and comparative research design was used. Twenty-four preterm infants with postmenstrual age ranging from 28-38 weeks were studied. The infants were studied for 2 hours between two feedings. Infant's sleep and wake state was measured every 30 seconds using Actiwatch and the Anderson Behavioral State Scale simultaneously. RESULTS: Actiwatch demonstrated high agreement, sensitivity, and predictivity of sleep state, when validated with the Anderson Behavioral State Scale at the setting of high and automatic activity thresholds, and was not influenced by the infant's postmenstrual age. However, lower specificity and predictivity were found in the wake state, and influenced by postmenstrual age. CONCLUSION: Results of this study suggest that high activity thresholds are the most accurate for determining sleep state in preterm infants, and health care professionals must take the limitations into consideration while using the Actiwatch to assess wake states.
Delivery of Health Care ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Prospective Studies ; Research Design ; Sensitivity and Specificity

PURPOSE: Interactive multimedia education using computer technology is increasing in the area of health education. The purpose of this study was to examine the effects of interactive multimedia education on community dwelling older adults' self-efficacy and knowledge for medication and level of satisfaction with the education program. METHODS: A nonequivalent control group pretest and post-test design was used in this study. The multimedia education was designed to enhance safe medication of older adults. Education consisted of seven modules which contained the medication name, usage, side effects, interactions, and storage requirements. Computerized interactive learning activities consisted of multimedia animations and games. A total of 60 older adults from two local senior centers were recruited and assigned to the experimental and control group. Twenty-six participants in experimental group used the interactive multimedia education on laptop computers. RESULTS: Participants receiving interactive multimedia education had significantly higher self-efficacy (F = 20.03, p < .001) and knowledge (F = 36.26, p < .001) scores than the control group did at post intervention. The experimental group indicated a high degree of satisfaction with the interactive multimedia education. CONCLUSION: The study results suggest that the interactive multimedia education is an effective teaching method that empowers older adults to facilitate individual learning using computer technology.
Adult* ; Education ; Health Education ; Humans ; Learning ; Multimedia* ; Senior Centers ; Teaching

PURPOSE: This study investigated evidence for the use of relaxation therapies as interventions to decrease irritable bowel syndrome (IBS) symptoms and severity as well as reduce anxiety and improve quality of life in IBS patients. METHODS: A search of electronic bibliographic databases (e.g., Medline Ovid, Embase, KoreaMed, and National Discovery for Science Leaders) was conducted to identify randomized controlled trials that included relaxation exercise programs for adults (>18 years old) with IBS. Of the 486 publications identified, 8 studies met inclusion and exclusion criteria, and all studies were used in the meta-analysis. We used Cochrane's risk of bias to assess study quality. RESULTS: The results showed that IBS symptoms decreased significantly, 6.19 (95% confidence interval [2.74, 14.02]) and there was no heterogeneity. Symptom severity and anxiety decreased by 0.38 (95% confidence interval [-1.41, 0.65]) and -0.08 (95% confidence interval [-0.38, 0.23]) due to relaxation therapies, but theses scores were not statistically significant. CONCLUSION: This review revealed positive effects of relaxation therapy on IBS symptoms in adult patients with IBS. However, these results should be interpreted with caution due to the small number of studies examined and the associated methodological problems. Further studies are needed to ascertain the longterm effects of relaxation therapy and the underlying psychosocial mechanisms leading to anxiety reduction and improved quality of life.
Adult ; Anxiety ; Bias (Epidemiology) ; Databases, Bibliographic ; Humans ; Irritable Bowel Syndrome* ; Population Characteristics ; Quality of Life ; Relaxation ; Relaxation Therapy*

PURPOSE: Given the wide disagreement over the definition of critical thinking in different disciplines, defining and standardizing the concept according to the discipline of nursing is essential. Moreover, there is limited scientific evidence regarding critical thinking in the context of nursing in Iran. The aim of this study was to analyze and clarify the concept of critical thinking in nursing education in Iran. METHODS: We employed the hybrid model to define the concept of critical thinking. The hybrid model has three interconnected phases-the theoretical phase, the fieldwork phase, and the final analytic phase. In the theoretical phase, we searched the online scientific databases (such as Elsevier, Wiley, CINAHL, Proquest, Ovid, and Springer as well as Iranian databases such as SID, Magiran, and Iranmedex). In the fieldwork phase, a purposive sample of 17 nursing faculties, PhD students, clinical instructors, and clinical nurses was recruited. Participants were interviewed by using an interview guide. In the analytical phase we compared the data from the theoretical and the fieldwork phases. RESULTS: The concept of critical thinking had many different antecedents, attributes, and consequences. Antecedents, attributes, and consequences of critical thinking concept identified in the theoretical phase were in some ways different and in some way similar to antecedents, attributes, and consequences identified in the fieldwork phase. Finally critical thinking in nursing education in Iran was clarified. CONCLUSION: Critical thinking is a logical, situational, purposive, and outcome-oriented thinking process. It is an acquired and evolving ability which develops individually. Such thinking process could lead to the professional accountability, personal development, God's consent, conscience appeasement, and personality development.
Faculty, Nursing ; Female ; Humans ; Iran ; Male ; *Models, Theoretical ; *Nursing Education Research ; Nursing Process ; *Problem Solving ; Qualitative Research ; Students, Nursing ; *Thinking