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PURPOSE: This study aimed to test a proposed structural equation model in which bullying experience, conflict management styles and psychological empowerment predict psychological well-being among Chinese nursing students in clinical placement. METHODS: Three hundred and sixty-six nursing students recruited from five hospitals in J city and Y city were assessed with self-report questionnaires on bullying experience, conflict management styles, psychological empowerment and psychological well-being including depression, self-esteem, and academic major satisfaction. Data were analyzed using SPSS version 20.0 and AMOS version 22.0. RESULTS: The evaluation parameters included the comparative fit index at .90, the goodness of fit index at .93, the root mean square error of approximation at .07, and χ²/df ratio at 2.66, indicating that the proposed structural equation model provided a good fit to the data. Experience of being bullied during clinical placement, conflict management styles and psychological empowerment explained 93.0% of the variance and had significant effects on psychological well-being, with conflict management styles and psychological empowerment mediating the association between bullying and psychological well-being. CONCLUSION: The findings indicated that mediation by conflict management styles and psychological empowerment alleviated the negative influence of bullying on psychological well-being. To limit bullying and its negative effects, development of effective guidelines to deal with bullying will be a critical tool for both Chinese nursing students and their instructors. Further research should incorporate conflict management styles and psychological empowerment into the specific intervention strategies for handling bullying behaviors among nursing students and staff nurses and promoting nursing students' psychological well-being.
Asian Continental Ancestry Group ; Bullying* ; Depression ; Humans ; Negotiating ; Nursing* ; Personal Satisfaction ; Power (Psychology)* ; Self Concept ; Students, Nursing*

PURPOSE: This research aimed to investigate the effects of a cognitive rehearsal program (CRP) on workplace bullying among nurses. METHODS: A randomized controlled trial was performed. Participants were 40 nurses working in different university hospitals in B city, South Korea. The experimental group was provided with a 20-hour CRP comprising scenarios on bullying situations, standard communication, and role-playing. To evaluate effects of the CRP, we measured interpersonal relationships, workplace bullying, symptom experience, and turnover intention at preand post-intervention. Follow-up effect was measured in the experimental group only at 4 weeks after the intervention. RESULTS: After the intervention, there were significant differences in interpersonal relationships (F=6.21, p=.022) and turnover intention (F=5.55, p=.024) between experimental and wait-list groups. However, there was no significant difference in workplace bullying or symptom experience between the 2 groups. The beneficial effects on interpersonal relationships and turnover intention lasted at least up to 4 weeks after CRP. CONCLUSION: The CRP for workplace bullying improves interpersonal relationships and decreases turnover intention. So it can be utilized as one of the personal coping strategies to reduce the the turnover among nurses. Further studies on the effects of unit- or hospital-based CRP and on the long-term effects of CRP are necessary.
Bullying* ; Cognitive Therapy ; Follow-Up Studies ; Hospitals, University ; Humans ; Intention* ; Korea ; Role Playing

PURPOSE: The purpose of this study was to analyze the migration patterns of new nurses and experienced nurses and to identify the factors influencing inter-regional migration for solving regional imbalances of clinical nurses in South Korea. METHODS: This study involved a secondary analysis of data from the Health Insurance Review and Assessment Service (HIRA). Data were analyzed using descriptive statistics and multiple logistic regression analysis. RESULTS: New nurses tended to migrate from Kyunggi to Seoul. However, experienced nurses tended to migrate from Seoul and Chungchung to Kyunggi. Significant predictors of inter-regional migration among new nurses were location and nurse staffing grade of hospitals. Significant predictors of inter-regional migration among experienced nurses were location, hospital type, nurse staffing grade, ownership of hospitals and age of nurses. CONCLUSION: Inter-regional migration occupied a small portion of total hospital movement among clinical nurses. The regional imbalances of nurses were not caused by the migration from non-metropolitan areas to Seoul. Nurse shortage problems in the small and medium hospitals of the non-metropolitan area can be solved only through improvement of work environment.
Geography ; Gyeonggi-do ; Health Care Rationing ; Human Migration ; Insurance, Health ; Korea ; Logistic Models ; Ownership ; Personnel Turnover ; Seoul

PURPOSE: The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory. METHODS: Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers' autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program. RESULTS: The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers' autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers' autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management. CONCLUSION: The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients.
Chronic Disease ; Delivery of Health Care ; Depression ; Education ; Health Behavior ; Health Personnel ; Humans ; Liver Transplantation ; Liver* ; Mental Competency ; Outpatients ; Self Care* ; Transplant Recipients*

PURPOSE: This study was performed to identify the experience of becoming a father of a high risk premature infant. METHODS: Grounded theory was used for this research. The participants were 12 fathers who had premature infants lighter than 2,500g of birth weight, less than 37 weeks of gestational age and having stayed 2 weeks or longer in a NICU right after birth. Theoretical sampling was done to identify participants and indepth interviews were done for the data collection. For data analysis, the process suggested by Corbin and Strauss was used. RESULTS: For these participants the core phenomenon of the experience of becoming a father of a high risk premature infant was ‘striving through with belief and patience’. The phenomenon was ‘being frustrated in an unrealistic shock’. Contextual conditions were ‘uncertainty in the health status of the premature baby’ and ‘no one to ask for help’ and intervening conditions were ‘possibility in the health recovery of the premature baby’ and ‘assistance from significant others’. Action/interaction strategies were ‘withstanding with belief in the baby’ and ‘enduring with willpower as head of the family’ and the consequence was ‘becoming a guardian of the family’. CONCLUSION: For the participants, the process of becoming the father of a high risk premature infant was striving through the situation with belief in their babies' ability to overcome the crisis and waiting for the babies' recovery with patience.
Birth Weight ; Data Collection ; Fathers* ; Gestational Age ; Grounded Theory ; Head ; Humans ; Infant, Newborn ; Infant, Premature* ; Life Change Events ; Parturition ; Qualitative Research ; Statistics as Topic

PURPOSE: The purpose of this study was to explore the recovering process of men who had abused alcohol and has lived in a therapeutic community. METHODS: Individual in-depth interviews were used to collect data from 10 of these men who has lived in the therapeutic community for more than one year. Qualitative data from field notes and transcribed notes were analyzed using the grounded theory methodology developed by Strauss and Corbin. RESULTS: The core category about the recovering process of the men who had abused alcohol and are now in the therapeutic community was identified as “reconstructing a broken life”. The recovering process of these men in the therapeutic community consisted of four phases; ‘self-awareness stage’, ‘unfreezing stage’, ‘readjustment stage’, and ‘challenging stage’. CONCLUSION: In this study “reconstructing a broken life”, as the core category vividly showed joys and sorrows of men who had abused alcohol and has lived in the recovering process of managing the yoke of life-long disease. In this process of recovery from alcoholic dependence the men gradually adjusted themselves to their given condition. Also they gained coping strategies to care for, and protect themselves. Therefore health care providers can establish supportive programs in the clinical field to empower these men by reflecting their proactive coping strategies.
Alcoholics ; Grounded Theory ; Health Personnel ; Humans ; Male ; Qualitative Research ; Therapeutic Community*

PURPOSE: The aims of this study were to construct a hypothetical structural model which explains premenstrual coping in university students and to test the fitness with collected data. METHODS: Participants were 206 unmarried women university students from 3 universities in A and B cities. Data were collected from March 29 until April 30, 2016 using self-report structured questionnaires and were analyzed using IBM SPSS 23.0 and AMOS 18.0. RESULTS: Physiological factor was identified as a significant predictor of premenstrual syndrome (t=6.45, p<.001). This model explained 22.1% of the variance in premenstrual syndrome. Psychological factors (t=-2.49, p=.013) and premenstrual syndrome (t=8.17, p<.001) were identified as significant predictors of premenstrual coping. Also this model explained 30.9% of the variance in premenstrual coping in university students. A physiological factors directly influenced premenstrual syndrome (β=.41, p=.012). Premenstrual syndrome (β=.55, p=.005) and physiological factor (β=.23, p=.015) had significant total effects on premenstrual coping. Physiological factor did not have a direct influence on premenstrual coping, but indirectly affected it (β=.22, p=.007). Psychological factors did not have an indirect or total effect on premenstrual coping, but directly affected it (β=-.17, p=.036). CONCLUSION: These findings suggest that strategies to control physiological factors such as menstrual pain should be helpful to improve premenstrual syndrome symptoms. When developing a program to improve premenstrual coping ability and quality of menstrual related health, it is important to consider psychological factors including perceived stress and menstrual attitude and premenstrual syndrome.
Dysmenorrhea ; Female ; Humans ; Models, Structural* ; Premenstrual Syndrome ; Psychology ; Single Person ; Young Adult

PURPOSE: This study was done to clarify attributes, antecedents, and consequences of spirituality. METHODS: Rodgers's evolutionary concept analysis was used to analyze fifty seven studies from the literature related to spirituality as it appears in systematic literature reviews of theology, medicine, counseling & psychology, social welfare, and nursing. RESULTS: Spirituality was found to consist of two dimensions and eight attributes: 1) vertical dimension: ‘intimacy and connectedness with God’ and ‘holy life and belief’, 2) horizontal dimension: ‘self-transcendence’, ‘meaning and purpose in life’, ‘self-integration’, and ‘self-creativity’ in relationship with self, ‘connectedness’ and ‘trust’ in relationship with others·neighbors·nature. Antecedents of spirituality were socio-demographic, religious, psychological, and health related characteristics. Consequences of spirituality were positive and negative. Being positive included ‘life centered on God’ in vertical dimension, and among horizontal dimension ‘joy’, ‘hope’, ‘wellness’, ‘inner peace’, and ‘self-actualization’ in relationship with self, ‘doing in love’ and ‘extended life toward neighbors and the world’ in relationship with others·neighbors·nature. Being negative was defined as having ‘guilt’, ‘inner conflict’, ‘loneliness’, and ‘spiritual distress’. Facilitators of spirituality were stressful life events and experiences. CONCLUSION: Spirituality is a multidimensional concept. Unchangeable attributes of spirituality are ‘connectedness with God’, ‘self-transcendence’, ‘meaning of life’ and ‘connectedness with others·nature’. Unchangeable consequences of spirituality are ‘joy’ and ‘hope’. The findings suggest that the dimensional framework of spirituality can be used to assess the current spiritual state of patients. Based on these results, the development of a Korean version of the scale measuring spirituality is recommended.
Counseling ; Humans ; Nursing ; Psychology, Social ; Spirituality* ; Theology ; Vertical Dimension

PURPOSE: The purpose of this study was to examine the effects of parental stress, social support, and coping behavior on burnout among mothers caring for children with cerebral palsy. METHODS: Participants in this cross-sectional, descriptive study were 185 mothers who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, t-test, one-way ANOVA, correlation and multiple linear regression analyses with IBM SPSS Win 22 program. RESULTS: Parental stress and coping behavior were strong predictors of burnout among mothers of children with cerebral palsy. These variables explained 50.0% of the variance in burnout. Social support was not a predictor of burnout. A higher level of burnout was associated with higher levels of parental stress and lower levels of social support and coping behavior. CONCLUSION: Mothers of children with cerebral palsy are vulnerable to burnout. These results show that effective strategies for reducing parental stress and improving positive coping behavior are needed to reduce burnout in these mothers.
Adaptation, Psychological ; Cerebral Palsy* ; Child* ; Humans ; Linear Models ; Mothers* ; Parenting ; Parents ; Stress, Psychological