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

PURPOSE: This study aimed to develop and test a structural model for chemotherapy-related cognitive impairment of breast cancer patients based on a literature review and Hess and Insel's chemotherapy-related cognitive change model. METHODS: The Participants consisted of 250 patients who were ≥19 years of age. The assessment tools included the Menopause Rating Scale, Symptom Experience Scale, Hospital Anxiety and Depression Scale, Everyday Cognition, and Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs. RESULTS: The modified model was a good fit for the data. The model fit indices were χ2=423.18 (p<.001), χ2/df=3.38, CFI=.91, NFI=.91, TLI=.89, SRMR=.05, RMSEA=.09, and AIC=515.18. Chemotherapy-related cognitive impairment was directly influenced by menopausal symptoms (β=.38, p=.002), depression and anxiety (β=.25, p=.002), and symptom experiences (β=.19, p=.012). These predictors explained 47.7% of the variance in chemotherapy-related cognitive impairment. Depression and anxiety mediated the relations among menopausal symptoms, symptom experiences, and with chemotherapy related cognitive impairment. Depression and anxiety (β=−.51, p=.001), symptom experiences (β=−.27, p=.001), menopausal symptoms (β=−.22, p=.008), and chemotherapy-related cognitive impairment (β=−.15, p=.024) had direct effects on the quality of life and these variables explained 91.3%. CONCLUSION: These results suggest that chemotherapy-related toxicity is highly associated with cognitive decline and quality of life in women with breast cancer. Depression and anxiety increased vulnerability to cognitive impairment after chemotherapy. Nursing intervention is needed to relieve chemotherapy-related toxicity and psychological factor as well as cognitive decline for quality of life in patients undergoing chemotherapy.
Anxiety ; Breast Neoplasms ; Breast ; Cognition ; Cognition Disorders ; Depression ; Drug Therapy ; Female ; Humans ; Menopause ; Models, Structural ; Nursing ; Psychology ; Quality of Life

PURPOSE: The aim of this study was to develop a structural model based on Bronfenbrenner's ecology of human development theory, that illustrates relationships of happiness and associated factors among Korean college students. METHODS: Study participants were 357 college students recruited from five universities throughout the convenience sampling. Self-reported data were collected from November, 2018 to January, 2019. The data were analyzed using descriptive statistics, Pearson's correlation coefficients, and a structural equation modeling in order to identify factors associated with college students' happiness. RESULTS: The tested model demonstrated the acceptable model fit compared to the hypothesized model, that explained college students' happiness with 68.7% accuracy. Positive family function, high self esteem and ego-resilience were significant factors associated with happiness for college students. However, positive friend support was not significant in our model. CONCLUSION: Our study findings suggest that both family and individual interventions are required to reduce negative emotions and increase happiness of college students. In particular, multicomponent interventions should include the concepts of self esteem, ego-resilience, and family function in terms of assessment and intervention contents tailored to Korean college students.
Ecology ; Ecosystem ; Friends ; Happiness ; Human Development ; Humans ; Models, Structural ; Self Concept

The aim of this study was to construct and test a structural equation model for the risk factors of metabolic syndrome in Korean adults. The structural equation model hypothesizes that eating alone and feeling depressed is a risk factor for metabolic syndrome. The data of this study were obtained from the Sixth Korea National Health and Nutrition Examination Survey which was cross-sectional data from the representative national survey. A total of 4,013 subjects replied to the survey item of lifestyle and completed the physical examinations among adults aged 19 years or older in South Korea was in 2015. The structural model in this study was composed of four latent variables: eating alone, depression, negative health behavior, and metabolic syndrome. Two variables, the rate of eating alone and depression, were exogenous variables. Negative health behavior was both a mediating variable and endogenous variable, and metabolic syndrome was the final endogenous variable. The data were analyzed using the Maximum Likelihood method and bootstrapping. The structural model was appropriate for the data based on the model fit indices. The results of this study can be summarized as follows: Eating alone is a direct risk factor of metabolic syndrome in Korean women. Depression can mediate metabolic syndrome through negative health behaviors. Negative health behavior had a direct impact on metabolic syndrome in both men and women. This study may be a guideline for interventions and strategies to reduce the incidence of metabolic syndrome in Korean adults.
Adult ; Depression ; Eating ; Female ; Health Behavior ; Humans ; Incidence ; Korea ; Life Style ; Male ; Methods ; Models, Structural ; Negotiating ; Nutrition Surveys ; Physical Examination ; Risk Factors

PURPOSE: The purpose of this study was to construct a structural model that explains the factors affecting aggression among elementary school students and to verify their suitability.METHODS: The study period was from June to August 2018. The study subjects were fifth- and sixth- graders at an elementary school. In total, 291 surveys were collected, of which 259 were analyzed. Data were analyzed using SPSS version 24.0 and AMOS version 24.0.RESULTS: The fit of the final model was acceptable (χ2=160.08 [p<.001], GFI=.921, AGFI=.869, CFI=.919, SRMR=.057, and RMSEA=.086). Thus, eight of the 10 hypotheses were shown to be statistically significant.CONCLUSION: The results of this study indicate that positive and open parenting behaviors and training children to engage in self-control are needed to reduce their aggression. In addition, considerable attention and education are required in the home, school, and society so that children can learn to properly recognize and express their emotions and establish suitable beliefs regarding aggressive behavior.
Aggression ; Child ; Education ; Humans ; Models, Structural ; Parenting ; Parents ; Self-Control

PURPOSE: The purpose of this study was to develop a structural model for patient safety management activities and to identify the influencing factors of organizational and individual dimensions that promote patient safety management activities and to suggest effective intervention plans.METHODS: A structured self-report questionnaire was used to measure organizational factor, attitude, subjective norm, perceived behavior control, and patient safety management activities. The questionnaires were distributed to 300 nurses and 275 were included in the analysis. SPSS 25.0 and AMOS 21.0 were used to analyze the model fitness, indirect effect, and direct effect of the model.RESULTS: The hypothetical model for patient safety management activities was appropriate. Among the 8 pathways, 6 direct pathways were significant. Organizational factor affected individual attitudes, subjective norms, and perceived behavior control. Perceived behavior control, and subjective norm affected behavioral intention. Behavioral intention affected patient safety management activities. Perceived behavior control did not affect patient safety management activities.CONCLUSION: Organizations and individuals must change together to promote patient safety management activities. The organization should establish practical education and training, systems and regulations. Individuals should increase behavioral intention by strengthening perceived behavioral control and subjective norm.
Behavior Control ; Education ; Humans ; Intention ; Models, Structural ; Nurse Clinicians ; Patient Safety ; Safety Management ; Social Control, Formal

OBJECTIVES: While the seasonality of notified tuberculosis has been identified in several populations, there is not a descriptive epidemiological study on the seasonality of tuberculosis in Korea. This study aimed to evaluate the seasonality of tuberculosis in Korea from 2006 to 2016. METHODS: Data regarding notified cases of tuberculosis by year and month was obtained from the Infectious Diseases Surveillance Yearbook, 2017 published by the Korea Centers for Disease Control and Prevention. Seasonal decomposition was conducted using the method of structural model of time series analysis with simple moving averages. RESULTS: While the trough season was winter from 2006 to 2016, the peak season was summer between 2006 and 2012, but shifted to spring between 2013 and 2016. CONCLUSION: Notified tuberculosis in Korea also showed seasonality. It is necessary to evaluate factors related to the seasonality of tuberculosis for controlling tuberculosis.
Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Disease Management ; Epidemiologic Studies ; Korea ; Methods ; Models, Structural ; Periodicity ; Republic of Korea* ; Seasons* ; Tuberculosis* ; Vitamin D

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes. METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education. RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively. CONCLUSIONS: Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.
Blood Pressure ; Body Mass Index ; Classification ; Cohort Studies* ; Diabetes Mellitus* ; Education ; Hypertension ; Incidence* ; Iran ; Joints ; Models, Structural* ; Odds Ratio ; Prehypertension* ; Prospective Studies* ; Risk Assessment ; Smoke ; Smoking

OBJECTIVES: While the seasonality of notified tuberculosis has been identified in several populations, there is not a descriptive epidemiological study on the seasonality of tuberculosis in Korea. This study aimed to evaluate the seasonality of tuberculosis in Korea from 2006 to 2016.METHODS: Data regarding notified cases of tuberculosis by year and month was obtained from the Infectious Diseases Surveillance Yearbook, 2017 published by the Korea Centers for Disease Control and Prevention. Seasonal decomposition was conducted using the method of structural model of time series analysis with simple moving averages.RESULTS: While the trough season was winter from 2006 to 2016, the peak season was summer between 2006 and 2012, but shifted to spring between 2013 and 2016.CONCLUSION: Notified tuberculosis in Korea also showed seasonality. It is necessary to evaluate factors related to the seasonality of tuberculosis for controlling tuberculosis.
Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Disease Management ; Epidemiologic Studies ; Korea ; Methods ; Models, Structural ; Periodicity ; Republic of Korea ; Seasons ; Tuberculosis ; Vitamin D

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education.RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively.CONCLUSIONS: Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.
Blood Pressure ; Body Mass Index ; Classification ; Cohort Studies ; Diabetes Mellitus ; Education ; Hypertension ; Incidence ; Iran ; Joints ; Models, Structural ; Odds Ratio ; Prehypertension ; Prospective Studies ; Risk Assessment ; Smoke ; Smoking