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Development and Effects of a Cognitive-behavioral Therapy Based Program in Reducing Internalized Stigma in Patients with Schizophrenia.

Mi Young KIM ; Seong Sook JUN

Journal of Korean Academy of Nursing.2016;46(3):349-363. doi:10.4040/jkan.2016.46.3.349

PURPOSE: This study was done to develop a internalized stigma reducing program based on cognitive-behavioral therapy and appropriate for patients with schizophrenia and to evaluate its effectiveness. METHODS: The study design was a mixed method research. Qualitative study, 13 patients with schizophrenia who had experience in overcoming stigma were purposively chosen for interviews and data were analyzed using Giorgi method. Quantitative study, 64 patients with schizophrenia (experimental group=32, control group=32) were recruited. The cognitive-behavioral therapy-based program for reducing internalized stigma in patients with schizophrenia was provided for 8 weeks (12 sessions). Data were collected from June. 20, 2013 to Feb. 14, 2014. Quantitative data were analyzed using χ²-test, t-test, repeated measures ANOVA with the SPSS program. RESULTS: Qualitative results, from the experience of coping with stigma in patients with schizophrenia seventeen themes and five themes-clusters were drawn up. Quantitative results showed that internalized stigma, self-esteem, mental health recovery and quality of life were significantly better in the experimental group compared to the control group. CONCLUSION: Study findings indicate that this program for reducing internalized stigma in patients with schizophrenia is effective and can be recommended as a rehabilitation program intervention to help patients with schizophrenia to cope with internalized stigma.
Cognitive Therapy ; Humans ; Mental Health ; Methods ; Quality of Life ; Rehabilitation ; Schizophrenia* ; Social Stigma ; Stereotyping

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Influence of Nurses' Self-leadership on Individual and Team Members' Work Role Performance.

Se Young KIM ; Eun Kyung KIM ; Byungsoo KIM ; Eunpyo LEE

Journal of Korean Academy of Nursing.2016;46(3):338-348. doi:10.4040/jkan.2016.46.3.338

PURPOSE: The purpose of this study was to examine correlations between nurses' self-leadership and individual work role performance and correlations between self-leadership in nursing units and team members' work role performance. METHODS: Participants were 202 conveniently selected general nurses from 5 general hospitals in Korea. The study was carried out on 35 nursing units. Data were collected during February 2015 with self-report questionnaires. RESULTS: For factors affecting individual work role performance, self-expectation, self-goal setting, constructive thought, clinical career in the present nursing unit and marital status accounted for 44.0% of proficiency, while self-expectation, self-goal setting, constructive thought, and marital status accounted for 42.3% of adaptivity. Self-expectation, self-goal setting, constructive thought, self-reward, clinical career in the present nursing unit and position accounted for 26.4% of proactivity. In terms of team members' work role performance, self-reward and self-expectation in nursing units explained 29.0% of team members' proficiency. Self-reward and self-expectation in nursing units explained 31.6% of team members' adaptivity, and self-reward in nursing units explained 16.8% of team members' proactivity. CONCLUSION: The results confirm that nurses' self-leadership affects not only individual self-leadership but also team members' work role performance. Accordingly, to improve nurses' work role performance in nursing units of nursing organizations, improvement in nursing environment based on self-leadership education is necessary and nurses' tasks rearranged so they can appreciate work-autonomy and challenges of work.
Education ; Hospitals, General ; Korea ; Leadership ; Marital Status ; Nursing ; Patient Care Team ; Task Performance and Analysis

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The Structural Equation Model on Resilience of Breast Cancer Patients Receiving Chemotherapy.

Jeong Ha YANG ; Ok Soo KIM

Journal of Korean Academy of Nursing.2016;46(3):327-337. doi:10.4040/jkan.2016.46.3.327

PURPOSE: The purpose of this study was to construct and test a structural equation model on resilience of breast cancer patients receiving chemotherapy. METHODS: Participants were 204 patients with breast cancer who received chemotherapy treatment. They participated in a structured interview, which included social support, depression, symptom experience, self-efficacy, hope, resilience, and infection prevention behaviors. Data were analyzed using SPSS/WIN 20.0 and AMOS 18.0. RESULTS: Lower depression (γ=-.33, p=.020) and symptom experience (γ=-.31, p=.012) and higher self-efficacy (γ=.32, p=.005) and hope (γ=.48, p=.016) were influenced by higher social support. Greater resilience was influenced by lower symptom experience (β=-.18, p=.016), higher self-efficacy (β=.49, p=.023), and higher hope (β=.46, p=.012), and these predictors explained 66.7% of variance in resilience. Greater resilience (β=.54, p=.009) made an impact on greater infection prevention behaviors. Resilience mediated the relations of symptom experience (β=-.10 p=.013), self-efficacy (β=.27, p=.006) and hope (β=.25, p=.009) with infection prevention behaviors. These predictors explained 24.9% of variance in infection prevention behaviors. CONCLUSION: The findings of the study suggest that breast cancer patientsw ith greater resilience who are receiving chemotherapy participate in increased infection prevention behaviors. Further research should be conducted to seek intervention strategies that improve breast cancer patients' resilience.
Breast Neoplasms* ; Breast* ; Depression ; Drug Therapy* ; Hope ; Humans ; Infection Control ; Resilience, Psychological

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Effect of Music Intervention on Maternal Anxiety and Fetal Heart Rate Pattern During Non-Stress Test.

Myung Ok OH ; Young Jeoum KIM ; Cho Hee BAEK ; Ju Hee KIM ; No Mi PARK ; Mi Jeong YU ; Han Sol SONG

Journal of Korean Academy of Nursing.2016;46(3):315-326. doi:10.4040/jkan.2016.46.3.315

PURPOSE: The purpose of this cross-over experimental study was to examine effects of music intervention on maternal anxiety, fetal heart rate pattern and testing time during non-stress tests (NST) for antenatal fetal assessment. METHODS: Sixty pregnant women within 28 to 40 gestational weeks were randomly assigned to either the experimental group (n=30) or control group (n=30). Music intervention was provided to pregnant women in the experimental group during NST. Degree of maternal anxiety and fetal heart rate pattern were our primary outcomes. State-trait anxiety inventory, blood pressure, pulse rate, and changes in peripheral skin temperature were assessed to determine the degree of maternal anxiety. Baseline fetal heart rate, frequency of acceleration in fetal heart rate, fetal movement test and testing time for reactive NST were assessed to measure the fetal heart rate pattern. RESULTS: The experimental group showed significantly lower scores in state anxiety than the control group. There were no significant differences in systolic blood pressure and pulse rate between the two groups. Baseline fetal heart rate was significantly lower in the experimental group than in the control group. Frequency of acceleration in fetal heart rate was significantly increased in the experimental group compared to the control group. There were no significant differences in fetal movement and testing time for reactive NST between the two groups. CONCLUSION: Present results suggest that music intervention could be an effective nursing intervention for alel viating anxiety during non-stress test.
Acceleration ; Anxiety* ; Blood Pressure ; Cardiotocography ; Female ; Fetal Heart* ; Fetal Movement ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Music* ; Nursing ; Pregnancy ; Pregnant Women ; Skin Temperature

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Economic Effect of Home Health Care Services for Community-dwelling Vulnerable Populations.

Eunhee LEE ; Jinhyun KIM

Journal of Korean Academy of Nursing.2016;46(4):562-571. doi:10.4040/jkan.2016.46.4.562

PURPOSE: In this study the costs and benefits of a home health care program were examined to evaluate the economic feasibility of the program. METHODS: The study participants included 349 patients in the community who had been registered at a home health care center for 5 years. The costs and benefits of the program were analyzed using performance data and health data. The benefits were classified as the effects of pressure ulcer care, skin wound care and catheters management. The program effect was evaluated on the change of progress using transition probability. Benefits were divided into direct benefit such as the savings in medical costs and transportation costs, and indirect benefits which included saving in productivity loss and lost future income. RESULTS: Participants had an average of 1.82 health problems. The input cost was KRW 36.8~153.3 million, the benefit was KRW 95.4~279.7 million. Direct benefits accounted for 53.4%~81.2%, and was higher than indirect benefits. The net benefit was greater than 0 from 2006 to 2009, and then dropped below 0 in 2010. CONCLUSION: The average net benefit during 5 years was over 0 and the benefit cost ratoi was over 1.00, indicating that the home health care program si economical.
Catheters ; Cost-Benefit Analysis ; Delivery of Health Care* ; Efficiency ; Home Care Services ; Humans ; Income ; Pressure Ulcer ; Skin Care ; Transportation ; Vulnerable Populations* ; Wounds and Injuries

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Factors Influencing Adolescent Lifetime Smoking and Current Smoking in South Korea: Using data from the 10th (2014) Korea Youth Risk Behavior Web-Based Survey.

Seok Hyun GWON ; Suyong JEONG

Journal of Korean Academy of Nursing.2016;46(4):552-561. doi:10.4040/jkan.2016.46.4.552

PURPOSE: The purpose of this study was to investigate factors influencing lifetime smoking and current smoking among adolescents in South Korea. METHODS: Hierarchical logistic regression was conducted based on complex sample analysis using statistics from the 10th (2014) Korea Youth Risk Behavior Web-Based Survey. The study sample comprised 72,060 adolescents aged 12 to 18. RESULTS: The significant factors influencing adolescent lifetime smoking were female gender, older age, higher stress, higher weekly allowance, lower economic status, living apart from parents, parental smoking, sibling smoking, peer smoking, observation of school personnel smoking, and coed school compared to boys' school. The significant factors influencing adolescent current smoking were female gender, older age, higher stress, higher weekly allowance, both higher and lower economic status compared to middle economic status, living apart from parents, parental smoking, sibling smoking, peer smoking, observation of school personnel smoking, and coed school compared to boys' school. CONCLUSION: Factors identified in this study need to be considered in programs directed at prevention of adolescent smoking and smoking cessation programs, as well as policies.
Adolescent* ; Female ; Humans ; Korea* ; Logistic Models ; Parents ; Risk-Taking* ; Siblings ; Smoke* ; Smoking Cessation ; Smoking* ; Tobacco Use

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Effects of a Facial Muscle Exercise Program including Facial Massage for Patients with Facial Palsy.

Hyoung Ju CHOI ; Sung Hee SHIN

Journal of Korean Academy of Nursing.2016;46(4):542-551. doi:10.4040/jkan.2016.46.4.542

PURPOSE: The purpose of this study was to examine the effects of a facial muscle exercise program including facial massage on the facial muscle function, subjective symptoms related to paralysis and depression in patients with facial palsy. METHODS: This study was a quasi-experimental research with a non-equivalent control group non-synchronized design. Participants were 70 patients with facial palsy (experimental group 35, control group 35). For the experimental group, the facial muscular exercise program including facial massage was performed 20 minutes a day, 3 times a week for two weeks. Data were analyzed using descriptive statistics, χ²-test, Fisher's exact test and independent sample t-test with the SPSS 18.0 program. RESULTS: Facial muscular function of the experimental group improved significantly compared to the control group. There was no significant difference in symptoms related to paralysis between the experimental group and control group. The level of depression in the experimental group was significantly lower than the control group. CONCLUSION: Results suggest that a facial muscle exercise program including facial massage is an effective nursing intervention to improve facial muscle function and decrease depression in patients with facial palsy.
Depression ; Facial Muscles* ; Facial Paralysis* ; Humans ; Massage* ; Nursing ; Paralysis

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Effect of Observation Window at Peripheral Intravenous Catheter Site on Early Recognition of Infiltration among Hospitalized Children.

Ihn Sook JEONG ; Soon Mi PARK ; Kyung Ju PARK

Journal of Korean Academy of Nursing.2016;46(4):534-541. doi:10.4040/jkan.2016.46.4.534

PURPOSE: The aim of this study was to identify the effect of an observation window (OW) at peripheral intravenous (IV) catheter sites on early detection of IV infiltration among hospitalized children. METHODS: This was a retrospective observational study with history control group design. Participants were children who had IV infiltration after peripheral catheterization when hospitalized from January to May, 2014 and January to May, 2015 at a children's hospital located in Yangsan city, Korea. The 193 patients, who were hospitalized from January to May, 2014 formed the control group and did not have OW, and the 167 patients, who were hospitalized from January to May, 2015 formed the window group and had OW. Data were analyzed using χ²-test, independent samples t-test and multiple logistic regression. RESULTS: First stage IV infiltration was 39.5% for the window group and 25.9% for the control group, which was significantly different (p=.007). The likelihood of 2nd stage and above IV infiltration decreased by 44% in the window group, which was significantly different (p=.014). CONCLUSION: OW at the peripheral IV catheter site was found to be an effective measure in early recognition of IV infiltration. Considering the effect of OW, we recommend that nurses should make an OW with transparent dressing during stabilization of the IV catheter site in hospitalized children in clinical settings.
Bandages ; Catheterization, Peripheral ; Catheters* ; Child ; Child, Hospitalized* ; Gyeongsangnam-do ; Humans ; Infusions, Intravenous ; Korea ; Logistic Models ; Observational Study ; Retrospective Studies

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Factors Influencing Musculoskeletal Symptoms in Military Personnel during Basic Combat Training.

Jeong Min YI ; Gwang Suk KIM

Journal of Korean Academy of Nursing.2016;46(4):523-533. doi:10.4040/jkan.2016.46.4.523

PURPOSE: This study was done to examine physical, psycho-social, and individual factors influencing musculoskeletal symptoms among Korean military trainees. METHODS: Using a correlation study design, military trainees who had completed almost of all the basic combat training (BCT) days were recruited from two military training units selected by convenience sampling. Data from 415 participants were analyzed. RESULTS: Prevalence of musculoskeletal symptoms was 29.6% defined as a participant having pain or discomfort in one or more body parts during training hours for more than seven consecutive days. Back/pelvic (10.8%), knees (10.1%), shoulders (7.7%), feet/toes (5.6%), ankles (4.8%) were prone to musculoskeletal symptoms. Musculoskeletal symptoms appeared to be related to physical exertion during BCT, stress during BCT, social support from fellow trainees, or previous musculoskeletal injuries. In the logistic regression model, physical exertion during BCT (OR=2.27, 95% CI: 1.42~3.65), stress during BCT (OR=1.79, 95% CI: 1.15~2.78), and previous musculoskeletal injuries (OR=1.58, 95% CI: 1.01~2.47) were the significant factors affecting prevalence of musculoskeletal symptoms. CONCLUSION: Findings indicate that physical exertion and psycho-social stress should be managed to prevent musculoskeletal symptoms in military trainees with more attention being given to trainees having a history of musculoskeletal injuries.
Ankle ; Human Body ; Humans ; Knee ; Logistic Models ; Military Personnel* ; Musculoskeletal System ; Physical Exertion ; Prevalence ; Shoulder ; Statistics as Topic ; Stress, Psychological

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Comparison of Effects of Exhalation and Inhalation Breathing Exercises on Pulmonary Function and Complications in Elderly Patients with Upper-abdominal Surgery.

Mijee KOO ; Sunkyung HWANG

Journal of Korean Academy of Nursing.2016;46(4):514-522. doi:10.4040/jkan.2016.46.4.514

PURPOSE: The purpose of this study was to identify the effects of exhalation breathing exercises using expirometer and that of inhalation breathing exercises using incentive spirometry on pulmonary function and complications in elderly patients with upper-abdominal surgery. METHODS: The research design was a nonequivalent control group non-synchronized design. Participants were 63 patients who underwent upper-abdominal surgery under general anesthesia (32 in experiment group, 31 in control group). They were recruited at P university hospital from August 1 to November 30, 2015. Effects were evaluated by measuring pulmonary functions (Forced Vital Capacity [FVC], Forced Expiratory Volume in 1 second [FEV1]) and pulmonary complications. Data were analyzed using SPSS/WIN 18.0 program. RESULTS: There was no difference in FVC between the experimental group and the control group, but FEV1 in the experimental group increased significantly compared to the control group by time change (p=.001). Also, there were no pulmonary complications in the experimental group but there were 5 cases (16.1%)(p=.018) in the control group. CONCLUSION: Findings indicate that exhalation breathing exercises by elderly patients following upper-abdominal surgery is an effective nursing intervention in enhancing pulmonary function and preventing pulmonary complications.
Aged* ; Anesthesia, General ; Breathing Exercises* ; Exhalation* ; Forced Expiratory Volume ; Humans ; Inhalation* ; Motivation ; Nursing ; Research Design ; Respiration* ; Spirometry ; Vital Capacity

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