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: 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 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: 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: 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 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 present study was conducted to develop the Life Respect Enhancement Program and test its effectiveness on suicide knowledge, suicide intervention skills, self-efficacy in suicide prevention, and gatekeeper behaviors among nursing officers. Methods: The program was developed according to the ADDIE model and finalized after practical need analysis, expert verification, and a preliminary study.The present study used a concurrent embedded mixed-method research design. To compare the effects of the Program and the control group on the outcome variables, a quantitative study was conducted using a nonequivalent control group with a pretest-posttest design.Quantitative data were analyzed using c 2 -tests, t-tests, and RM-ANOVA. A qualitative study was conducted using FGI with six members of the experimental group 3 months after intervention completion. Results: In total, 56 nursing officers participated in the 3-month follow-up test. Compared to the control group, the experimental group showed significant improvements in suicide knowledge, suicide intervention skills, and self-efficacy in suicide prevention scores at post-test. The significant group differences in suicide knowledge and suicide intervention skills were maintained at 3 months. The gatekeeper behavior scores of the experimental group were also significantly higher than those of the control group at 3 months. Qualitative analysis of the participants’ experiences with the Program yielded two themes and seven sub-themes. Conclusion The newly developed Life Respect Enhancement Program demonstrates significant effects on suicide knowledge, suicide intervention skills, and gatekeeper behaviors. Thus, this program is recommended to promote suicide prevention competencies among nursing officers in military clinical settings.

Purpose: The purpose of this study was to systematically review peer support services related to mental health services utilization by people with severe mental illness and to identify core strategies essential for effective peer support services. Methods: A systematic search was conducted using keywords in English, 4 electronic databases, including CINAHL, EMBASE, MEDLINE, and PubMed. Of the 1,305 publications identified, 14 studies were finally included in this systematic review. The Scottish Intercollegiate Guidelines Network (SIGN) was used for the quality assessment. Results: The 14 studies consisted of 8 randomized controlled trials (RCTs), 4 cohort studies, and 2 quasi-experimental studies. Overall, peer support services were found to be effective in reducing hospitalization rates, hospitalization days, number of emergency room visits, and total medical costs. There was inconsistent evidence that the services were associated with positive effects on measures of psychiatric symptoms, quality of life, and social support. Conclusion Peer support services for people with severe mental illness can be a cost-effective way to increase crisis stabilization and continuity of treatment. The core strategies of the services is the development of structured programs to cultivate professional peer providers and the establishment of a cooperative system between mental health professionals and peer providers.

Purpose: This study aimed to systematically evaluate the content and effect of using Korean mobile apps for mental health care as reported in previous studies. Methods: We conducted a systematic review according to PRISMA guidelines. Randomized controlled trials published up to May 2021 were searched in the PubMed, Cochrane Library, EMBASE, CINAHL, PsycINFO, RISS, KISS, and KoreaMed databases. We used the Cochrane risk-of-bias tool version 2 for randomized trials to evaluate the selected studies. Results: Out of 3,374 articles retrieved, 12 were selected. These studies included people with mental disorders (mood disorder, panic disorder, or obsessive-compulsive disorder), psychiatric symptoms (depression, anxiety, attention deficit, etc.), and people in specific groups (college students or nurses). The apps were based on cognitive-behavioral therapy, cognitive training, well-being cognition technique, or relaxation techniques. The apps were effective in reducing depression, anxiety, panic attacks, attention deficit, negative emotions, and dysfunctional attitudes, and boosting memory and positive emotions. Conclusion Mobile apps with well-established, theory-based content can serve as an effective intervention for managing several mental health symptoms. However, the scope of the research subjects and symptoms in Korea remains limited. Further studies with more varied populations and symptoms are required.