Purpose: Smoking is a way of coping with anxiety and stress. This study aimed to identify the effects of forest-thermal combined therapy on anxiety and depression in smokers who desire to quit smoking. Methods: Thirty participants were included in the study, 15 in the experimental group and 15 in the control group. Those in the experimental group participated in a three-day forest-thermal combined therapy program. The program includes forest walks, meditation and thermal therapy in the charcoal kiln. Results: Before and after the program, physiological indicators such as cortisol, heart rate variability, and serotonin anxiety level using the state-trait anxiety inventory (STAI), and stress level using the psychosocial well-being index (PWI) were measured in both groups. The differences in STAI (p = .012) and PWI (p = .006) scores between the experimental and control groups were statistically significant. However, cortisol, heart rate variability, and serotonin were not significantly different between the two groups after the program. Conclusion These results show that forest-thermal combination therapy effectively reduces anxiety and stress in smokers. It suggests that forest-thermal therapy can potentially increase smoking cessation rates.

PURPOSE: To develop and test the validity and reliability of the Korean version of the Moral Distress Scale-Revised (KMDS-R) to assess its applicability to Korean hospital nurses. METHODS: The KMDS-R was articulated through forward-backward translation methods. Internal consistency reliability, construct and criterion validity was calculated using SPSSWIN(19.0). Survey data were collected from 188 nurses from a university hospital in Gangwon-do, South Korea. RESULTS: The KMDS-R showed reliable internal consistency with a Cronbach's alpha of .69-.87 and a Guttman Split-half of .69-.82 for the total scale. Factor loading of the 21 items on the five subscales ranged from .41-.80. The KMDS-R was validated by factor analysis and explained 63% of moral distress for Korean hospital nurses. Criterion validity compared to Yoo's MDS showed significant correlation. CONCLUSION: The results suggest promising evidence of the KMDS-R's reliability and validity. It is used to measure moral distress for Korean hospital nurses.
Gangwon-do ; Korea ; Reproducibility of Results*

PURPOSE: The purpose of this study was to explore the relationship between moral distress, physical symptoms, and burnout among clinical nurses. METHODS: Data were collected by self-report questionnaires targeting 140 nurses from a university hospital in Chungju. The data were analyzed by, Kruskal-Wallis, Pearson correlation coefficient, and stepwise multiple regression. RESULTS: Moral distress due to the general characteristics of the participants showed a statistically significant difference at the current working department (χ2=36.01, p<.001). Hospital nurses' moral distress had a statistically significant correlation with burnout (r=.358, p<.001) and physical symptoms (r=.440, p<.001). Factors influencing hospital nurses' burnout, pro were physical symptoms, moral distress, and marital status, accounting for 36% of the variance. CONCLUSION: The findings indicate that moral distress and physical symptoms influence burnout among hospital nurses. Therefore, interventions for burnout among hospital nurses should include an empowerment program to reduce physical symptoms and moral distress.
Burnout, Professional ; Chungcheongbuk-do ; Marital Status ; Power (Psychology)