PURPOSE: This study explores the moral distress that nursing students experience during their clinical practice in Korea. METHODS: Data were collected using focus group interviews, and analyzed using qualitative content analysis. Participants were recruited from three nursing schools in three different cities; each focus group interview lasted between one to two hours. RESULTS: Twenty-two nursing students with more than one year of clinical practice experience participated. Three categories and ten themes were extracted. The following situational categories: "unprotected patients' right and dignity," "clinical settings in which standards of care are not upheld," "disrespectful hospital culture," and "inconsistent and unsystematic clinical education" caused moral distress. Types of responses to moral distress included: "shock and confusion over the gap between reality and moral standards," "powerlessness when cannot advocate patients," "fear and doubts about nursing career," and "moral desensitization and disappointment in oneself." "Expressions of moral distress and the need for advice" and "a search for meaning and hope" were identified as coping strategies. CONCLUSION: These results demonstrate the need for systematic clinical practicum and education programs to minimize moral distress. These programs may offer opportunities for students to turn moral distress into opportunities for learning and growth in the future.
Education ; Education, Nursing ; Focus Groups ; Humans ; Korea ; Learning ; Nursing* ; Patient Rights ; Preceptorship ; Qualitative Research ; Schools, Nursing ; Standard of Care ; Students, Nursing

PURPOSE: Many family caregivers of people with early stages of dementia experience difficulty in obtaining information on dementia. In addition, adjusting to this new caregiving role is emotionally demanding, thus many family caregivers go thorough a lot of emotional stress. This study tested emotion-focused individual intervention as a way to help family caregivers of early-stage dementia patients obtain necessary information and emotional support related to caregiving. METHODS: To achieve this goal, a quasi-experimental study with a non-equivalent control group design was conducted. Emotion-focused individual intervention was administered to the experimental group (n=15), and no treatment was administered to the control group (n=21). Both groups completed a demographic profile, and also took pre- and post-test measuring their dementia-related knowledge, self-efficacy of care, preparedness of care, and coping strategies of care. Descriptive statistics were calculated, and t-test, and ANCOVA were performed to SPSS program. RESULTS: It was found that there was a statistically significant improvement in dementia-related knowledge (p<.001), self-efficacy of care (p=.030), preparedness of care (p<.001), and coping strategies of care (p<.001) after the intervention. CONCLUSION: The findings suggest that emotion-focused individual intervention was effective for family caregivers of patients with early dementia to adjust to the new caregiving role.
Caregivers* ; Dementia* ; Humans ; Non-Randomized Controlled Trials as Topic ; Stress, Psychological

PURPOSE: The purpose of this study was to systematically review the suicide prevention programs for healthcare personnel to identify contents, formats, and strategies essential for effective suicide prevention programs. METHODS: A systematic search using key words in English and Korean was conducted using 10 electronic databases, including EMBASE, MEDLINE, and RISS. Of 794 publications identified, 9 studies were finally included in this systematic review. The Scottish Intercollegiate Guidelines Network (SIGN) was used for the quality assessment. RESULTS: Of the nine experimental studies, seven studies used randomized controlled trials (RCTs), and two used quasi-experimental designs. Overall, suicide prevention programs were found to be effective in improving competencies (e.g., knowledge, communication skills, and attitudes) of healthcare personnel working in diverse settings. Limitations of these studies included a lack of rigorous research designs and reliable and universal outcome measures. Paradoxically, none of the studies were conducted in South Korea, which consistently has the highest suicide rate of all OECD countries. CONCLUSION: Suicide prevention programs for health personnel can be an effective way to improve competency of healthcare personnel in preventing suicide. These findings will serve as a foundation for the development of suicide prevention programs by Korean healthcare personnel.
Delivery of Health Care* ; Health Personnel ; Humans ; Korea ; Organisation for Economic Co-Operation and Development ; Outcome Assessment (Health Care) ; Research Design ; Suicide*

PURPOSE: The specific aims of the present study were to compare Kirogi children's mental distress and psychosocial factors between short-term (ST) and long-term groups (LT), and to identify predictors of mental distress in the two groups. METHODS: A sample of 107 Kirogi children living in the U.S. participated in this cross-sectional study and completed the following questionnaires: Center for Epidemiologic Studies Depression Scale, State-Trait Anxiety Inventory for Children, Somatic Symptom Scale, Self-Esteem Scale, Parent-Child (P-C) Relationship Satisfaction Scale, Parent-Adolescent Communication Inventory Social, Attitudinal, Familial, and Environmental Scale, and Social Support Scale. RESULTS: The LT group reported higher scores on depression and anxiety, and lower scores on self-esteem and P-C relationship than the ST group. Higher scores on somatic symptoms were found in the ST group. Problematic mother-child communication and dissatisfaction with father-child relationship were significant predictors for mental distress. Self-esteem predicted depression and anxiety in the ST group; particularly self-esteem was a significant predictor for anxiety in both groups. Discrimination and process-oriented stress were significant predictors for depression and anxiety in the ST group. CONCLUSION: Results of the present study reveal the needs for school-based mental health programs for the increasing number of Kirogi children vulnerable to mental distress.
Adolescent ; Anxiety ; Anxiety Disorders ; Child* ; Cross-Sectional Studies ; Depression ; Discrimination (Psychology) ; Father-Child Relations ; Humans ; Mental Health ; Parent-Child Relations ; Psychology ; Surveys and Questionnaires

PURPOSE: To understand the meaning of the lived experience with Person under train (PUT) for train or subway operators. METHODS: The study was built on hermeneutic phenomenological themes from individual interviews of present-day train or subway operators in South Korea. Eight participants were selected to participate in the study. All qualitative data were analyzed using the heuristic guides of Van Manen. RESULTS: Four fundamental lifeworld themes and eight sub themes emerged in the findings. The first theme of spatiality had‘the place pressed by the darkness’ and ‘the train drags me there’. The second theme, corporeality had ‘a foreboding fear’, and ‘debris of death that gets stuck in the whole body’. The temporality theme had‘distorted time in chaos’, and ‘memory trapped in time’. Finally the last existential theme of relationality had ‘intrapersonal encounter’ and ‘resentment and guilt’. CONCLUSION: The four existential lifeworld themes provided a framework for in-depth investigation of the operator's “lived experience.” This leads to clear understanding of effects of PUT experience on related individuals. The findings imply that specific active nursing intervention strategies are necessary in order to treat affected train operators, and to prevent further issues in their work and private life.
Hermeneutics ; Heuristics ; Humans ; Korea ; Nursing ; Psychological Trauma ; Qualitative Research ; Railroads

PURPOSE: The purpose of this study was to investigate the level of mental health literacy (MHL) among parents of adolescents and middle and high school teachers in Korea. METHODS: A descriptive cross-sectional survey design was used for the present study. Participants were 120 parents and 103 middle and high school teachers in Korea. In 2014-2015 participants completed a survey about two case vignettes(adolescent schizophrenia and depression) and answered questions assessing recognition of these disorders and belief about the helpfulness of interventions and resources. Descriptive analysis, t-test and chi2 test were performed. RESULTS: Schizophrenia was recognized by only 11.6% of parents and 25.2% of teachers. Depression was recognized by 32.5% of parents and 59.2% of teachers. Both parents and teachers acknowledged individual and socio-environmental factors as causes for schizophrenia and depression. However, they were less likely to recognize biological factors as potential causes for mental illness. CONCLUSION: The findings demonstrate the need for education programs for parents of adolescents and teachers to improve their mental health literacy, particularly concerning biological causes of mental illness.
Adolescent* ; Biological Factors ; Cross-Sectional Studies ; Depression ; Education ; Humans ; Korea* ; Mental Health* ; Parents* ; Schizophrenia

PURPOSE: The purpose of this cross-sectional, correlational study was to identify associations of acculturative stress, depression, and quality of life among Indonesian migrant workers living in South Korea. METHODS: A total of 91 migrant workers who were recruited in Korea completed paper-and-pencil self-administered questionnaire in September 2018. Acculturative Stress Scale, Patient Health Questionnaire-9, World Health Organization Quality of Life Instrument, Multidimensional Scale of Perceived Social Support (MSPSS), Perceived Organizational Support Scale, and demographic questionnaire were used to measure acculturative stress, depression, quality of life, social support, and organizational support, respectively. We applied descriptive statistics, Pearson's correlation coefficients, and multiple linear regression analyses with SPSS 22 program. RESULTS: A positive correlation was shown between acculturative stress and depression and a negative correlation was found between acculturative stress and quality of life. Significant factor associated with depression was acculturative stress. Significant factors associated with quality of life were acculturative stress and social support. CONCLUSION: Our study findings assist nurses to improve the quality of mental health services for Indonesian migrant workers by providing important information such as contact information for health services and counseling and to guide future studies on mental health issues among the population.
Acculturation ; Counseling ; Depression ; Health Services ; Humans ; Indonesia ; Korea ; Linear Models ; Mental Health ; Mental Health Services ; Quality of Life ; Transients and Migrants ; World Health Organization

PURPOSE: The purpose of this study was to review intervention programs designed to promote mental health in multicultural children and adolescents living in Korea. METHODS: A systematic search with key words in Korean and English was conducted using 9 electronic databases. Twelve studies were included in the sample for systematic review and the Methodological Index for Non-Randomized Study (MINORS) was used to assess methodological rigor and quality of scientific evidence. RESULTS: Randomized controlled trials (RCTs) were used in 3 and quasi-experimental designs in nine studies. Interventions utilizing art therapy were found to be effective in improving school adjustment in these children, and in decreasing levels of depression and anxiety. Learning activities and self-image were not found to be effective. In all 12 studies discussion of the theory guiding the intervention was not included and all 12 studies were rated as having a high risk of bias based on MINORS criteria. CONCLUSION: Findings provide a basis for developing intervention programs to improve mental health in multicultural children and adolescents. Core strategies for promoting mental health in these children and adolescents include access to age and situational characteristics. For intervention effects, development of programs to improve self-esteem and resilience is important.
Adolescent ; Anxiety ; Art Therapy ; Bias (Epidemiology) ; Child ; Cultural Diversity ; Depression ; Humans ; Korea ; Learning ; Mental Health

Purpose: The purpose of this study was to assess insomnia and the quality of sleep, investigate the concordance between objective and self-report sleep patterns, and identify physiological, psychological, and situational factors influencing insomnia and sleep quality among firefighters. Methods: A descriptive, cross-sectional study was conducted with 103 firefighters in Korea. The collected data were analyzed using SPSS 23.0. Descriptive statistics, the independent t-test, and hierarchical logistic regression analysis were performed. Results: Insomnia was found in 66 (64.1 %) of the total subjects, and the average quality of sleep (PSQI) was 5.65 (SD=2.57). Total sleep time (401.00 minutes) and sleep latency (21.60 minutes) measured using self-reported scales were longer than the ones measured using objective measurements by approximately 48.70 and 17.10 minutes, respectively. Factors related to insomnia included the role as a paramedic (OR=4.28, 95% CI: 1.02~17.92), anxiety (OR=1.12, 95% CI: 1.01~1.24), and sedentary lifestyle (OR=0.85, 95% CI: 0.78~0.94), and factors related to sleep quality were physical illness status (OR=5.17, 95% CI: 1.53~17.51) and social support (OR=0.86, 95% CI: 0.78~0.95). Conclusion The results show a high prevalence of insomnia, poor quality of sleep and the discrepancy between objective and subjective sleep patterns among firefighters. To promote sleep quality and health, early screening and treatment of anxiety and physical illness are required. It is necessary to conduct further studies examining the relationship between physical activity level and sleep.

Purpose: This study aimed to identify regional differences in problem drinking among adult males in single-person households and predict the determinants. Methods: This study used data from the 2019 Community Health Survey. Geographically weighted regression analysis was performed on 8,625 adult males in single-person households who had been consuming alcohol for the past year. The Si-Gun-Gu was selected as the spatial unit. Results: The top 10 regions for problem drinking among adult males in single-person households were located in the Jeju-do and Jeollanam-do areas near the southern coast, whereas the bottom 10 regions were located in the Incheon and northern Gyeonggi-do areas. Smoking, economic activity, and educational level were common factors affecting problem drinking among this population. Among the determinants of regional disparities in problem drinking among adult males in single-person households, personal factors included age, smoking, depression level, economic activity, educational level, and leisure activity, while regional factors included population and karaoke venue ratio. Conclusion Problem drinking among adult males in single-person households varies by region, and the variables affecting each particular area differ. Therefore, it is necessary to develop interventions tailored to individuals and regions that reflect the characteristics of each region by prioritizing smoking, economic activity, and educational level as the common factors.