PURPOSE: The purpose of this study was to explain a structural model of posttraumatic growth among psychiatric nurses based on existing models and a literature review and verify its effectiveness.METHODS: Data were collected from psychiatric nurses in one special city, four metropolitan cities, and three regional cities from February to March 2016. Exogenous variables included hardiness and distress perception, while endogenous variables included self-disclosure, social support, deliberate rumination, and posttraumatic growth. Data from 489 psychiatric nurses were analyzed using IBM SPSS Statistics 19.0 and AMOS 20.0.RESULTS: The modified model was a good fit for the data. Tests on significance of the pathways of the modified model showed that nine of the 14 paths were supported, and the explanatory power of posttraumatic growth by included variables in the model was 69.2%. For posttraumatic growth among psychiatric nurses, deliberate rumination had a direct effect as the variable that had the largest influence. Indirect effects were found in the order of hardiness, social support, and distress perception. Self-disclosure showed both direct and indirect effects.CONCLUSION: A strategy to improve deliberate rumination is necessary when seeking to improve posttraumatic growth among psychiatric nurses. Enhancing psychiatric nurses' hardiness before trauma would enable them to actively express negative emotions after trauma, allowing them to receive more social support. This would improve deliberate rumination and consequently help promote psychological growth among psychiatric nurses who have experienced trauma.
Models, Structural ; Psychiatric Nursing

OBJECTIVE: To empirically investigate the relationship of internal and external customer satisfactions, service quality, and customer loyalty in medical services. METHODS: This essay proposes an integrated model to explain the causality of internal and external customer satisfactions, service quality, and customer loyalty. To this end, a structural model was developed, consisting of the following factors: internal and external customer satisfactions, service quality, and customer loyalty. The study included 214 sets of data, with 107 sets being collected for both out-patients and in-patients. The data were analyzed using AMOS 4.0. RESULTS: We found the greater the internal customer satisfaction, the greater the out-patient quality of service quality. Secondly, the greater the service quality, the greater the external customer satisfaction of both in- and out-patients. The service quality of doctors, compared to that of the nurses, had a greater effect on external customer satisfaction. Thirdly, the service quality of doctors and nurses affected both internal and external customer satisfactions, which ultimately affected the customer loyalty. Finally the greater the external customer satisfaction, the greater the customer loyalty. CONCLUSION: This study confirms the positive relationship among the internal and external customer satisfactions, service quality, and customer loyalty, which proves the doctors quality of service is the primary factor for external satisfaction, and customer loyalty relating to medical services.
Humans ; Models, Structural ; Outpatients ; Quality of Health Care

PURPOSE: This study was designed to identify a path model that anticipates the interpersonal competence of nurses by anticipating factors that explain interpersonal competence within an organization, and analyzing the effects of these factors. A hypothetical model was formulated based on a literature review of interpersonal competence. For the study, influential factors were divided into two variables: exogenous variables including communication style, coaching leadership, and social support, and endogenous variables of self-efficacy, job satisfaction, and organizational commitment. METHODS: The sample included 202 hospital nurses. Data were collected through questionnaires and analyzed using SPSS and AMOS. RESULTS: The overall fitness was good (chi2=74.707, p<.001), d.f=19, chi2/df= 3.932, GFI=.940, AGFI=.826, RMR=.009). Social support, self-efficacy, horizontal communication and organizational commitment directly affected the interpersonal competence of the nurses, and informal type of communication, horizontal, upward communication and coaching leadership indirectly effected the interpersonal competence of the nurses. Horizontal communication, social support, self-efficacy, and organizational commitment explained 46.5% of the variance in interpersonal competence of nurses. CONCLUSION: Based on the study results, nurses in hospitals need informal types of communication, horizontal, upward communication and coaching leadership to increase their interpersonal competence.
Job Satisfaction ; Leadership ; Mental Competency* ; Models, Structural*

This study examined those problems noticed under the Asymptotically Generalized Least Squares estimator in evaluating a structural model of physical health. The problems were highly correlated parameter estimates and high standard errors of some parameter estimates. Separate analyses of the endogenous part of the model and of the metric of a latent factor revealed a highly skewed a kurtotic measurement indicator as the focal point of the manifested problems. Since the sample sizes are far below that needed to produce adequate AGLS estimates in the given modeling conditions, the adequacy of the Maximum Likelihood estimator is further examined with the robust statistics and the bootstrap method. These methods demonstrated that the ML methods were unbiased and statistical decisions based upon the ML standard errors remained almost the same, Suggestions are made for future studies adopting structural equation modeling technique in terms of selecting a reference indicator and adopting those statistics corrected for normality.
Least-Squares Analysis* ; Models, Structural ; Sample Size

PURPOSE: This study was designed to construct a model which explains the career management, career plateau and career satisfaction of the factors influencing the career commitment of nurses. METHOD: The data collection was conducted from Aug. 24, 2009 to Sep. 22, 2009 through self-reported questionaries. Participants were 441 nurses who had worked in 2 national university hospitals, 1 university hospitals, and 1 hospitals founded by business enterprises. The data was analyzed by SPSS 12.0 and AMOS 15.0 for structural model. RESULTS: Career commitment was directly impacted by career management, career plateau, career satisfaction. The predictable variables of the hypothetical model explained 28.4% of career commitment. Career commitment was significantly influenced by career management, career plateau, career satisfaction. CONCLUSION: The results of study suggest that some strategies are needed which focus on career management, career plateau and career satisfaction in order to promote the nurse's career commitment.
Commerce ; Data Collection ; Hospitals, University ; Models, Structural

PURPOSE: The aim of this study was to develop and evaluate a structural model including relevant factors to identity the variables that affect school adjustment in juvenile delinquents. On the basis of a review of the literature on school adjustment of juvenile delinquents and on Bronfenbrenner's bio-ecological model, a hypothetical model was developed by setting home environmental factors (e.g.,economic conditions, parent child communication, parenting attitudes, peer relationships, and academic stress) as exogenous variables, and personal factors (e.g., ego identity and psychological well-being) as endogenous variables. METHODS: Data were collected from January 29 to March 3, 2015 by a survey of 206 students attending junior high and high schools in City B. The collected data were analyzed using the SPSS and Amos 22.0 software. RESULTS: The verification of the hypothetical model indicated a good fit for the model: χ²=0.009 df=13, χ²/df=2.161, GFI=0.97, AGFI=0.90, RMESA=0.07, CFI=0.98, TLI=0.95, and RMR=0.01. CONCLUSION: The results suggest that ego identity and parent-child communication do not directly affect school adjustment of juvenile delinquents but influence it depending on the psychological well-being of delinquents. High levels of psychological well-being, better economic conditions, better parent-child communication, and low academic stress were abserved to contribute to better school life. Therefore, to improve the school adjustment of juvenile delinquents, appropriate measures need to be taken and programs need to be designed for improving ego identity and parent-child communication, thus promoting psychological well-being.
Child ; Ego ; Humans ; Juvenile Delinquency ; Models, Structural ; Parenting ; Parents

PURPOSE: Evaluating educational programs can improve the quality of education. The present study evaluated the undergraduate occupational health program at the Semnan University of Medical Sciences in Semnan, Iran, with a focus on the associations between alumni perceptions of the learning environment and the outcomes of the occupational health program. METHODS: A cross-sectional questionnaire survey was conducted among alumni of the undergraduate occupational health program. We asked alumni to rate their perceptions of the items using a 4-point Likert scale. The associations between alumni perceptions of the educational program and curriculum, faculty, institutional resources, and learning outcomes were modeled and described using structural equation modeling procedures. RESULTS: A descriptive analysis of alumni perceptions indicated low evaluations for the administrative system, practical and research-based courses, and the number of faculty members. We found that a structural model of the evaluation variables of curriculum, faculty qualifications, and institutional resources significantly predicted undergraduate educational outcomes. The curriculum had direct and indirect effects on learning outcomes, mediated by faculty. CONCLUSION: The findings of our study highlight the usefulness of the structural equation modeling approach for examining links between variables related to the learning process and learning outcomes. Surveys of alumni can provide data for reassessing the learning environment in the light of the professional competencies needed for occupational health graduates.
Curriculum ; Education ; Iran* ; Learning ; Models, Structural ; Occupational Health* ; Program Evaluation

PURPOSE: In this study an exploration was done of the quality of lives of patients with schizophrenia in South Korea and factors related to quality of life, and to develop a model that predicts the quality of their lives. METHODS: The participants were 225 patients with schizophrenia, aged 18 and above, residing in Seoul and Gyeonggi-Province. Collected data was analyzed using SAS 9.3 and AMOS 18.0. RESULTS: Social support and psychological well-being were the two factors that most affected the quality of life in patients with schizophrenia. Symptoms, empowerment, and internalized stigma were not found to influence the quality of the patients' lives. However, symptoms, social support, empowerment, internalized stigma affected the patients' psychological well-being, and psychological well-being was identified as an influential variable for quality of life in patients with schizophrenia. Therefore, symptoms, social support, empowerment, and internalized stigma are influential to the patients' quality of lives through psychological well-being. CONCLUSION: These results suggest that the quality of life in patients with schizophrenia should be examined through the variable of psychological well-being as many variables related to the patients' quality of life affect psychological well-being.
Humans ; Korea ; Models, Structural ; Power (Psychology) ; Quality of Life* ; Schizophrenia* ; Seoul

PURPOSE: This study was designed to construct a structural model for explaining model health-related quality of life in acquired people with physical disabilities. METHOD: The hypothetical model of this study was consisted of 6 latent variables and 14 observed variables. Exogenous variables included in this model were physical status and economical level. Endogenous variables were social attitudes, family function, self-esteem, and health-related quality of life. Data were collected from 226 acquired people with physical disabilities residing in Seoul and Kyunggi-do from January to February, 2005. The collected data were analyzed using SAS 8.2 version and LISREL 8.32 version program. RESULTS: The results of the fitness test of the modified model were follow as; chi-square=67.479 (df=50, p=.05), GFI= .959, AGFI=.914, SRMR=.049, NFI=.961, NNFI=.979, CN=249.244. Health-related quality of life was influenced directly by physical status, economic level, and social attitudes and accounted for 88.8% of the variance by these factors. CONCLUSION: These results suggest that physical status is the most significant effect on health-related quality of life, and social attitudes and economic level are important factors having influences on health- related quality of life. Therefore improving physical status and economic level, and modifying negative attitudes are necessary to increase health-related quality of life of acquired people with acquired physical disabilities.
Disabled Persons ; Gyeonggi-do ; Humans ; Models, Structural ; Quality of Life* ; Seoul

Several factors have been reported as risk factors for the development of osteoporosis. In this study, we aimed to examine the relationship among lifestyle factors, biologic factors, and bone mineral density (BMD) using structural equation modeling (SEM). The subjects in the present study consisted of 866 postmenopausal Japanese women aged between 40 and 80 years old. In the analysis by the SEM, we employed a multiple basic model. As the structural variables, lifestyle factors and biologic factors were selected. The goodness of fit index (GFI) of the final model was 0.991 and the Akaike’s information criteria (AIC) showed the lowest value in the peripheral models. The degree of association between biologic factors and BMD was −0.576 (direct association), 0.012 (indirect association), and −0.564 (total association). With regard to the correlation between lifestyle factors and BMD, the degrees of association were 0.085, −0.084, and 0.001, respectively. This study defined a pilot model for factors influencing BMD. Although is remains necessary to conduct further analyses with more valid measurements and constructs, this model indicated that the correlation between BMD and lifestyle factors was lower than that between BMD and biologic factors.
Relationship by association ; Models ; Life Style ; structural equation model ; Japanese language