BACKGROUND: Suicidal behaviors are seriously social issues among adolescents in the world. Exposed to smoking and being bullied are risk factors of suicidal behaviors. The present study was aimed to examine the interaction of smoking and being bullied on suicidal behaviors among Chinese adolescents. METHODS: A total of 18,900 students were involved in the questionnaire study, in four cities of China from November 2017 to January 2018. Suicidal behaviors, smoking, and being bullied were measured by self-reported validated instruments. Chi-square tests and logistic regression were used to analyze the associations of suicidal ideation (SI)/suicidal plan (SP)/suicidal attempt (SA), smoking, and being bullied. RESULTS: The prevalence of smoking, being bullied, SI/SP/SA, were 3.1%, 20.6%, 26.4%, 13.2%, and 5.2% respectively. Interaction analysis indicated that being bullied was associated with a greater increase in the likelihood of suicidal behaviors for adolescents with smoking than for those without smoking. CONCLUSIONS These finding suggest that smoking exacerbates the association between being bullied and suicidal behaviors. Future research should explore how and why smoking appears to more bully-victims than for those without smoking and how to mitigate it.
Adolescent ; Adolescent Behavior/psychology* ; Bullying/psychology* ; Child ; China/epidemiology* ; Cross-Sectional Studies ; Humans ; Prevalence ; Smoking/psychology* ; Students/statistics & numerical data* ; Suicidal Ideation

bullying, and low self-esteem. Recently, there have been some studies on the association of mental health problems and pediatric obesity. In the treatment of pediatric obesity, many previous studies suggest multidisciplinary treatment. However, cognitive behavioral therapy (CBT) has attracted attention because obese children are accompanied by body image distortion, emotion dysregulation, and difficulties in stimulus control. This review is a narrative summary of the recent studies on mental health problems and CBT in pediatric obesity. The relationship between depression/anxiety and pediatric obesity is still inconsistent but recent studies have revealed a bidirectional relation between depression and obesity. Additionally, some studies suggest that obese children may have eating disorder symptoms, like loss of control eating, and require therapeutic intervention for pediatric obesity treatment. Furthermore, impulsivity and inattention of ADHD symptom is thought to increase the risk of obesity. It has also been suggested that CBT can be very effective for mental health problems such as depression, impulsivity, and body image distortion, that may coexist with pediatric obesity, and use of multimedia and application can be useful in CBT.]]>
Attention Deficit Disorder with Hyperactivity ; Body Image ; Bullying ; Child ; Cognitive Therapy ; Depression ; Eating ; Humans ; Impulsive Behavior ; Mental Health ; Multimedia ; Obesity ; Pediatric Obesity ; Prevalence

PURPOSE: This descriptive study aimed to explore the effects of bullying, health promotion lifestyles, and physical symptoms on the occupational stress of new nurses in general hospitals. METHODS: The participants of this study were 157 new nurses in fivegeneral hospitals with 100 to 399 beds in Gyeonggi-do. Data were collected from January to February, 2018, using a structured questionnaire and analyzed using the SPSS software version 20. RESULTS: A total of 60.5% of the participants experienced bullying, and 38.2% experienced bullying more than 10 times a month. The perceived severity of bullying was severe (32.4%) and the nurses'first bullying experience began within the first six months (47.7%). Their occupational stress was scored 3.1. The regression model for occupational stressors was significant (F=23.86, p < .001), and the total explanatory power was 46.8%. The variables affecting occupational stress were bullying awareness (β=−.30, p < .001), preceptor satisfaction (β=−.30, p < .001), and health promotion lifestyles (β=−.26, p=.001). CONCLUSION: It is important to reduce the incidence of bullying in order to help new nurses with high occupational stress. Stress management programs are needed to improve relationships between new nurses and preceptors and to encourage their health promotion lifestyles.
Bullying ; Gyeonggi-do ; Health Promotion ; Hospitals, General ; Incidence ; Life Style

PURPOSE: The study was done to investigate the mediating effects of voice behavior on the relationships between empathy and fairness and intention in helping behavior of nursing students. METHODS: A structured self-report questionnaire was used to measure empathy, fairness, voice behavior and intention in helping behavior. During November 2018, data were collected from 128 nursing students in D and G cities. Data were analyzed using hierarchical multiple linear regression with the SPSS/WIN 24.0 program. RESULTS: Empathy, fairness and voice behavior were positively correlated with intention in helping behavior of participants and voice behavior was positively correlated with empathy, fairness and intention in helping behavior of participants respectively. Also, voice behavior had a partial mediating effect on the relationship between empathy, fairness and intention in helping behavior. CONCLUSION: Findings indicate that empathy and fairness are important factors related to the intention in helping behavior of nursing students. It is also expected that voice behavior can further promote the intention in helping behavior of nursing students.
Bullying ; Empathy ; Helping Behavior ; Humans ; Intention ; Linear Models ; Negotiating ; Nursing ; Students, Nursing ; Voice

PURPOSE: This study used a system dynamics methodology to identify correlation and nonlinear feedback structures among factors affecting adolescent cyberbullying victims (CV) in Korea and to construct and verify a simulation model. METHODS: Factors affecting CV were identified by reviewing a theoretical background in existing literature and referencing various statistical data. Related variables were identified through content validity verification by an expert group, after which a causal loop diagram (CLD) was constructed based on the variables. A stock-flow diagram (SFD) using Vensim Professional 7.3 was used to establish a CV model. RESULTS: Based on the literature review and expert verification, 22 variables associated with CV were identified and the CLD was prepared. Next, a model was developed by converting the CLD to an SFD. The simulation results showed that the variables such as negative emotions, stress levels, high levels of conflict in schools, parental monitoring, and time spent using new media had the strongest effects on CV. The model's validity was verified using equation check, sensitivity analysis for time-step and simulation with 4 CV adolescent. CONCLUSION: The system dynamics model constructed in this study can be used to develop intervention strategies in schools that are focused on counseling that can prevent cyberbullying and assist in the victims' recovery by formulating a feedback structure and capturing the dynamic changes observed in CV. To prevent cyberbullying, it is necessary to develop more effective strategies such as prevention education, counseling and treatment that considers factors pertaining to the individual, family, school, and media.
Adolescent ; Bullying ; Counseling ; Education ; Humans ; Korea ; Nonlinear Dynamics ; Parents

PURPOSE: The purpose of this study was to identify the response patterns of nursing unit managers regarding workplace bullying. METHODS: Q methodology was used to identify the response patterns. Thirty-six Q samples were selected from the Q population of 210 that included literature reviews and in-depth interviews with clinical nurses and nursing managers. Participants were 30 nursing unit managers who had experience managing workplace bullying and they classified the Q samples into a normal distribution frame measured on a nine-point scale. The data were analyzed using the PC-QUANL program. RESULTS: Five types of response patterns were identified: (1) sympathetic-understanding acceleration, (2) harmonious-team approach, (3) preventive-organizational management, (4) passive observation, and (5) leading-active intervention. The preventive-organizational management type was most frequently used by the nursing unit managers. CONCLUSION: The results of this study indicated that nursing unit managers attempted to prevent and solve workplace bullying in various ways. Therefore, it is necessary to develop and conduct leadership training and intervention programs that appropriately address the response patterns of nursing unit managers, such as those identified in this study.
Acceleration ; Bullying ; Leadership ; Nursing

BACKGROUND: Few studies have examined the association between childhood bullying and adulthood mental disorders based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria. We investigated the association of childhood peer bullying with Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) psychiatric disorders and suicidality in adults. METHODS: A total of 5,102 respondents aged 18 or over completed the Korean version of the Composite International Diagnostic Interview for DSM-IV psychiatric disorders and a questionnaire for suicidal ideas, plans, and attempts. We evaluated peer bullying using an item in the Adverse Childhood Experiences International Questionnaire. Logistic regression analyses were used to identify the association between victimization of peer bullying, adult psychiatric disorders, and suicidality. RESULTS: Around 8.8% of the general population in Korea reported the experience of being bullied when growing up. Bullying experience was associated with an increase in the adulthood prevalence of nicotine use disorders (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.75–3.49), alcohol use disorders (aOR, 1.93; 95% CI, 1.49–2.51), mood disorders (aOR, 4.23; 95% CI, 3.01–5.94), and anxiety disorders (aOR, 2.89; 95% CI, 1.89–4.43) after adjusting for sociodemographic variables. Among anxiety disorders, the OR for post-traumatic stress disorder (aOR, 9.95; 95% CI, 5.62–17.63) was notably high. Frequent victimization (many times) was significantly associated with suicidality even after adjusting for sociodemographic variables and lifetime prevalence of psychiatric disorders, whereas occasional victimization (once or a few times) was not. CONCLUSION: Childhood bullying experience was associated with adult psychiatric disorders and suicidality. The findings indicated the importance of the early detection and management of childhood peer bullying to reduce detrimental adulthood consequences.
Adult ; Anxiety Disorders ; Bullying ; Crime Victims ; Cross-Sectional Studies ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Logistic Models ; Mental Disorders ; Mood Disorders ; Odds Ratio ; Prevalence ; Stress Disorders, Post-Traumatic ; Suicide ; Surveys and Questionnaires ; Tobacco Use Disorder

OBJECTIVES: Adolescence involves a number of developmental processes, as well as unique psychological characteristics and behaviors. An increased rate of internet and game addictions, school violence, and suicide may either represent aspects of adolescence or a psychopathological phenomenon. There is an urgent need to develop software programs that can prevent and resolve adolescent behavioral problems. We applied the mentalization theory to interpret and find solutions for problems faced by adolescent characters in literature. METHODS: In Joan Rowling's novel “Casual Vacancy,” Sukhvinder is a girl with problems representative of those encountered by modern adolescents; she is a victim of bullying and engages in self-mutilation. We targeted her problematic behaviors as representative of a prementalized state. RESULTS: Born into an upper-class English family with Pakistani origins, Sukhvinder, unlike her siblings, fails her parents' expectations. Whenever she faces a psychological crisis, she regresses into the teleological mode (the most primitive pre-mentalization stage) and regains her sense of self by cutting herself. After her friend's suicide, however, she begins to communicate with her parents and moves toward mentalization. CONCLUSION: By analyzing Sukhvinder's behavior, we assessed patterns of attachment, empathy, and mentalization, and identified corrective approaches for problematic behaviors. We believe that the presented interpretation may serve as a foundation for the development of models for understanding adolescent deviant behaviors.
Adolescent Behavior ; Adolescent ; Bullying ; Empathy ; Female ; Humans ; Internet ; Parents ; Siblings ; Suicide ; Violence

PURPOSE: The purpose of this study was to investigate the relationship among nursing organizational culture, work performance, and workplace bullying of nurses, and to identify the factors that affect workplace bullying.METHODS: The design of this study was descriptive research, and the data were collected from October 26 to November 5, 2018. The research participants were 210 nurses in six general hospitals in G province. The data were analyzed by descriptive statistics, a t-test, one-way ANOVA, Scheffé post-hoc test, Pearson's correlation coefficient, and a stepwise multiple regression using SPSS 22.0.RESULTS: The workplace bullying type showed negative correlations with innovation-oriented culture, relation-oriented culture, and work performance. The workplace bullying consequence showed negative correlations with the innovation-oriented culture, relation-oriented culture, and work performance, and showed positive correlations with the workplace bullying type. The factors influencing the results of the workplace bullying consequence were workplace bullying type followed by relation-oriented culture, and unmarried status.CONCLUSION: Workplace bullying among nurses was related to the nursing organizational culture and work performance. Therefore, in order to reduce the turnover rate of nurses and to help them adapt well to the nursing organizational culture, a bullying prevention and intervention program is necessary.
Bullying ; Hospitals, General ; Humans ; Nursing ; Organizational Culture ; Single Person ; Work Performance

PURPOSE: The purpose of this study was to examine the relationships of job stress, team cohesion, organizational justice and workplace bullying among Korean general hospitals nurses.METHODS: During December 2016 and January, 2017, a survey of 198 nurses was done using structured self-administered questionnaires. Data were analyzed using descriptive statistics, t-test, one way ANOVA, Pearson correlation coefficients and multiple linear regression analysis.RESULTS: The prevalence of bullying was 12.1%. The results of the multiple linear regression analysis revealed that task cohesion (β=−.20, p=.040) as a sub-factor of team cohesion and job stress (β=.19, p=.047) were predictive of workplace bullying (Adj. R²=.11, p < .001).CONCLUSION: These results suggest that team cohesion and job stress are associated with workplace bullying by nurses. Building a well-organized management plan which reduces job stress and promotes team cohesion is recommended for the registered nurses.
Bullying ; Hospitals, General ; Humans ; Linear Models ; Nurses ; Prevalence ; Social Justice