Factors associated with Brain Function in Patients with Eating Disorders / 정신간호학회지

Purpose@#The purpose of this study was to investigate the factors associated with brain function in patients with eating disorders. @*Methods@#Patients(N=171) who visited 'M' clinic for eating disorders participated. Data were collected from June 2022 to September 2022 using self-reported questionnaires. @*Results@#Problems with brain function were observed in the deep limbic system in 84.8%, basal ganglia in 78.9%, the anterior cingulate in 74.3%, the prefrontal lobe in 55.6%, and the temporal lobe in 34.5%. Additionally, 55.6% of the participants had more than moderate anxiety, and 32.2% were suspected of having obsessive-compulsive disorder. Anxiety, obsessive-compulsion, and eating psychopathology(ineffectiveness, impulse regulation, social insecurity, body dissatisfaction, perfectionism, and bulimia) were significantly associated factors of brain function. @*Conclusion@#It was found that problems of brain function can be identified in a more convenient way by evaluating brain function through the Amen Brain System Checklist (ABSC), a self-reporting test tool, instead of brain imaging. Through brain function evaluation by the ABSC at the initial interview, more suitable interventions can be selected for patients. In future studies, it is necessary to evaluate the effect of practical interventions according to changes in brain function of patients with eating disorders.

Hermeneutic Phenomenological Study on Caring Experiences of Mental Health Nurses for the Mentally Ill Patients / 정신간호학회지

Purpose@#This study aimed at understanding the experiences of mental health nurses caring for mentally ill patients. @*Methods@#Van Manen’s hermeneutic phenomenological method was used to analyze qualitative data. The partici- pants were 8 mental health nurses who worked in hospitals, mental health welfare centers, or psychiatric reha- bilitation facilities. Data were collected through in-depth interviews from July 24, 2017, to June 20, 2018. @*Results@#Eight essential themes emerged: “A body that must endure severe symptoms”, “A hand that cares for the wound”, “Ambivalence in a closed space”, “Making them adapt to the open world”, “Being together and getting close to the patients”, “Going forward, leaning on each other”, “Time to protect even a small light”, and “Becoming a shining star by myself”. @*Conclusion@#Strategies are needed to cope with patient violence and prevent psychological trauma. Mental health nurses should be trained for empathetic competency to understand symptoms and build trusting relationships. Caring requires respect and love based on humanity. Mental health nurses learn from patients and experience mutual care that grows through self-reflection. Policy support including financial and manpower security is essential to improving the quality of care and preventing exhaustion.

Hermeneutic Phenomenological Study on Caring Experiences of Mental Health Nurses for the Mentally Ill Patients / 정신간호학회지

Purpose@#This study aimed at understanding the experiences of mental health nurses caring for mentally ill patients. @*Methods@#Van Manen’s hermeneutic phenomenological method was used to analyze qualitative data. The partici- pants were 8 mental health nurses who worked in hospitals, mental health welfare centers, or psychiatric reha- bilitation facilities. Data were collected through in-depth interviews from July 24, 2017, to June 20, 2018. @*Results@#Eight essential themes emerged: “A body that must endure severe symptoms”, “A hand that cares for the wound”, “Ambivalence in a closed space”, “Making them adapt to the open world”, “Being together and getting close to the patients”, “Going forward, leaning on each other”, “Time to protect even a small light”, and “Becoming a shining star by myself”. @*Conclusion@#Strategies are needed to cope with patient violence and prevent psychological trauma. Mental health nurses should be trained for empathetic competency to understand symptoms and build trusting relationships. Caring requires respect and love based on humanity. Mental health nurses learn from patients and experience mutual care that grows through self-reflection. Policy support including financial and manpower security is essential to improving the quality of care and preventing exhaustion.

Mediating Effect of Adult Attachment on Eating Psychopathology and Depression in Patients with Eating Disorders / 정신간호학회지

PURPOSE: The purpose of this study was to investigate the mediating effect of adult attachment in the relationship between eating psychopathology and depression among patients with eating disorders. METHODS: Patients (N=146) who visited a clinic for eating disorders participated in the study. Data were collected from December 2017 to February 2018 using the Eating Disorder Inventory (EDI-2), Revised Adult Attachment Scale (RAAS), and Beck Depression Inventory (BDI-II). RESULTS: The subjects showed high scores on eating psychopathology (drive for thinness 15.02±5.11, bulimia 11.77±5.27, and body dissatisfaction 14.16±7.82), adult attachment (attachment avoidance 37.31±6.18 and attachment anxiety 16.63±5.38), and depression (24.26±10.81), and 65.1% of the participants showed above a moderate level of depression. There were significant correlations among eating psychopathology, adult attachment, and depression. We also found that adult attachment fully mediated the association between eating psychopathology and depression. CONCLUSION: Future interventions for patients with eating disorders who have experienced insecure attachment with their primary caregiver should focus on forming a therapeutic relationship with the therapist. In addition, family therapy might contribute to lowering attachment insecurities and depression by recovering the attachment between the patients and their parents.

Impact of Childhood Trauma and Social Support on Dissociative Symptoms in Marines / 정신간호학회지

PURPOSE: The purposes of the study were to investigate childhood traumatic experiences and social support that might influence dissociative symptoms in Marine soldiers. METHODS: A cross-sectional study design was used with participants who were soldiers (n=122) assigned to one Marine corps in Ganghwa Island in the study. Data were collected on September 2015 through self-report using the Childhood Trauma Questionnaire, Social Provisions Scale (SPS), and Dissociative Experience Scale. Descriptive analysis, t-test, ANOVA, Pearson's correlation coefficients and stepwise multiple regression were performed. RESULTS: A total of 11.5% self-reported experiencing over three types of trauma; emotional neglect 34.4%, physical neglect 32.8%, emotional abuse 11.5%, physical abuse 11.5%, and sexual abuse 9.8%. For all subscales of the SPS, means of item were as high as three out of four points. A total of 9.0% were likely to be dissociative disorder. Sexual abuse, attachment, and opportunity for nurturance were found to be significant factors influencing dissociative symptoms. CONCLUSION: Future military enlistment in Marines should include assessment of childhood trauma and dissociation to identify maladaptive soldiers. Because soldiers who experienced childhood sexual abuse are likely to show dissociative symptoms, military nurses should assess their social support and try to enhance attachment in order to prevent dissociative symptoms.

Discriminating Power of Dissociation in Patients with Psychological Trauma / 정신간호학회지

PURPOSE: The purpose of the study was to identify the discriminating power of dissociation as defined by depression, obsession, and Minnesota Multiphasic Personality Inventory(MMPI; psychopathology) in patients with psychological trauma. METHODS: Participants were patients (N=114) from "S" clinic for psychological trauma. Data were collected from April to June 2014 through semi-structured interviews and self-reports using a modified Lifetime Incidence of Traumatic Events, Dissociative Experience Scale (DES), Beck Depression Inventory-2, Maudsley Obsessional Compulsive Inventory, and MMPI-2. RESULTS: Participants were grouped in to two groups depending on DES scores; dissociative (n=15) and non-dissociative (n=99). Depression, F-scale (infrequency), Ma (Hypomania), and Hs (Hypochondriasis) scale of MMPI correctly discriminated 86.8% of the sample. There were also significant differences in Obsession, K-scale (korrection), D (Depression), Hy (Hysteria), Pd (Psychopathic Deviate), Pa (Paranoia), Pt (Psychasthenia), Sc (Schizophrenia), Si (Social Introversion) scales of MMPI between two groups, but they were not significant discriminant factors. CONCLUSION: Future interventions for patients with high levels of dissociation and psychological trauma should focus on the prevention of suicide and chronic dissociation by assessing depression-related factors; suicidal behavior, impulsivity, aggression, and alexithymia. Therapists should also interpret patients' MMPI profiles carefully, especially in the presence of an extremely elevated F-scale.

Influence of Communication Competence and Burnout on Nursing Performance of Intensive Care Units Nurses / 기본간호학회지

PURPOSE: The purpose of this study was to investigate the influence of communication competence and burnout on nursing performance in intensive care units (ICU). METHOD: The participants were 209 nurses from four university hospitals. Measurements included a socio-demographic and job related survey, communication competence inventory, the Maslach burnout inventory and a nursing performance scale. Data were collected from February 6 to 24, 2012, with a self-report questionnaire. The statistical analyses were performed with SPSS 18.0 software. RESULTS: The mean scores for communication competence, burnout and nursing performance were 50.49, 84.72, and 62.18, respectively. Communication competence (r=.44, p<.001) and burn out (r=-.32, p<.001) were significantly correlated with nursing performance. In the multiple linear regression, factors influencing nursing performance were communication competence, age and burnout. These variables explained about 46% of the total variance of nursing performance. Communication competence (beta=.34, p%.001) was the most influential factor. CONCLUSION: Nurses' poor communication skills and burnout can influence the occurrences of medical errors in ICU nursing performance. The results suggest that good communication and burnout resolution skills programs should be implemented to improve nursing performance efficiency.

Impact of Childhood Trauma on Post-traumatic Stress Symptoms and Dissociation: Mediating Effect of Bullying / 정신간호학회지

PURPOSE: The purposes of the study were to determine whether specific forms of childhood traumatic experience predicts post traumatic stress symptoms and dissociation and to investigate the mediating effects of bullying experience on forms of childhood trauma and post traumatic stress symptoms or dissociation. METHODS: Participants were patients (n=90) from "S" clinic for psychological trauma. Data were collected from January 2012 to January 2013 through semi-structured interviews and self-reports using a modified Lifetime Incidence of Traumatic Events, Korean Version of Impact of Event Scale-Revised, and Dissociative Experience Scale. RESULTS: The participants showed high rates for childhood trauma and high scores on post traumatic stress symptoms and dissociation, and 38.9% of participants self-reported experiencing more than three types of trauma. Physical abuse was found to be a significant predictor of post traumatic stress symptoms and dissociation. It was also found that bullying experience partially mediated the association between physical abuse and post traumatic stress symptoms or dissociation. CONCLUSION: Future interventions for patients with childhood trauma should focus on assessing the possibility of dissociation. As boys and girls who experienced physical abuse in childhood are likely to be victims of bullying, school counselors should assess their support system and refer to mental health professionals as necessary.

Factors associated with Multi-impulsivity in Women Patients with Eating Disorders / 정신간호학회지

PURPOSE: The purpose of the study was to investigate the factors that affect multi-impulsivity in women patients with eating disorders. METHODS: The participants in the study were 170 women patients with eating disorders who visited "M" clinic for eating disorders. Data were collected from January 2010 to February 2011 through semi-structured interviews and self-report using the Revised Diagnostic Interview for Borderlines, Eating Disorders Inventory-2, and The Childhood Trauma Questionnaire. Data were analyzed using chi2-test, t-test, and multiple logistic regression. RESULTS: The multi-impulsivity group accounted for 56.5% of the patients (binge eating 90.6%, alcohol abuse 43.5%, substance abuse 37.1%, sexual promiscuity 4.7%, suicidal attempts 38.8%, and self-mutilation 58.8%), and they showed higher scores on childhood trauma and eating psychopathology than a comparison group. Significant predictors for multi-impulsivity were emotional abuse, social insecurity, interoceptive awareness, and interpersonal distrust. CONCLUSION: The results of this study suggest future interventions for multiimpulsive patients with eating disorders should focus on solving interpersonal problems by establishing trustful relationships, and not focus on eating behavior early in treatment.

Factors associated with Alcohol Problem in Patients with Eating Disorders / 정신간호학회지

PURPOSE: The purpose of the study was to investigate the psychological factors such as eating psychopathology, depression, obsessive-compulsion, sleep problem, and stressors that affect the alcohol problems in patients with eating disorders. METHODS: Patients with eating disorders (n=347) who visited "M" clinic for eating disorder were participated in the study. Data were collected from February 2008 to May 2010 using Eating Disorder Inventory-2, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Alcohol Use Disorder Identification Test-Korean. RESULTS: Of the participants, 17.3% had an alcohol problem, 9.2% of them were diagnosed with alcohol dependency. Age, history of mental disorder in family, stress for love relationship, difficulties falling asleep, and 'impulse regulation' (one of eating psychopathologies) were significant associated factors of alcohol problem, but depression and obsessive-compulsion were not significant. CONCLUSION: Future interventions for patients with eating disorders should focus on assessing alcohol problems. Assessment should be non-judgmental, especially for those patients with high levels of impulse dysregulation, difficulties falling asleep, and stress in love relationship in order to prevent their early drop-out for the treatment. Alternative treatment for sleep problem and stress management also may be helpful for the patients with alcohol problem and eating disorders.

Relationships between Myers-Briggs Type Indicator (MBTI) Psychological Type and Marital Satisfaction, Divorce Proneness, Positive Affect, and Conflict Regulation in Clinic Couples

PURPOSE: The purpose of the study was to investigate the relationships between the Myers-Briggs Type Indicator (MBTI) psychological type and marital satisfaction, divorce proneness, positive affect, and conflict regulation in couple visiting a clinic. METHODS: Couples (n=62) who visited "M" couple clinic participated in the study. Data were collected from March to June 2009 using the Marital Satisfaction Scale, Marital Status Inventory, Positive Affect Inventory, and Conflict Regulation Inventory. RESULTS: The couples showed no significant differences in marital satisfaction, positive affect, and conflict regulation according to similarities between spouses in MBTI types. However, they showed significant differences in divorce proneness of husband according to a similarity in the Sensing/Intuition indicator. They also showed significant differences in divorce proneness, positive affect, and conflict regulation between the couples for ISTJ (Introversion, Sensing, Thinking, Judging) or ESTJ (Extraversion, Sensing, Thinking, Judging) types compared to other couples. CONCLUSION: When nurses counsel couples, they should understand that differences in psychological type between spouses affects their marital relationship. In addition, nurses should educate couples on the characteristics of each type according to the couple's types and help them to understand each other, especially for couples where one spouse is the ISTJ/ESTJ type. These interventions will improve marital satisfaction and prevent the divorce in these couples.

Impact of Eating Psychopathology, Obsessive-Compulsion and Depression on Self-Harm Behavior in Patients with Eating Disorders

PURPOSE: The purpose of the study was to investigate psychological factors such as eating psychopathology, depression, and obsessive-compulsion that might influence self-harm behavior in patients with eating disorders. METHODS: Patients with eating disorders (n=135) who visited "M" clinic for eating disorders participated in the study. Data were collected from March to August 2007 using the Eating Disorder Inventory-2, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Self-Harm Inventory (SHI). RESULTS: The participants scored high on self-harm as well as on depression and obsessive-compulsion. On the SHI, a high frequency of self harm behavior such as 'torturing self with self-defeating thoughts', 'abused alcohol', 'hit self', and 'suicide attempt' were found for the participants. There were significant correlations between most eating psychopathology variables, depression, obsessive-compulsion, and self-harm behavior. 'Interoceptive awareness' (eating psychopathology), depression, and 'checking' (obsessive-compulsion) were significant predictors of self-harm behavior. CONCLUSION: Future interventions for patients with eating disorders should focus on assessing the possibility of self-harm and suicidal attempts, especially in those patients with high levels of eating psychopathology, depression, or obsessive-compulsion. Early intervention for depression and obsessive-compulsion could contribute to preventing self-harm and suicide in patients with eating disorders.

Impact of Psychological Factors on Marital Satisfaction and Divorce Proneness in Clinical Couples / 간호학회지

PURPOSE: The purpose of the study was to investigate the psychological factors that affect marital satisfaction or divorce likelihood in clinical couples. METHODS: Clinical couples (n=57) who visited "M" couple clinic participated in the study. Data was collected from September 2005 to June 2006 using a Marital Satisfaction Scale, a Marital Status Inventory, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Minnesota Multiphasic Personality Inventory. RESULTS: The couples showed high scores on depression, obsessive-compulsion, personality factors and divorce probability and a low score on marital satisfaction. The wife's obsessive-compulsion was a predictor of her marital satisfaction, and the wife's social introversion and depression, and husband's obsessive-compulsion were predictors of the wife's prospect of divorce. The husband's hypomania and depression were predictors of his marital satisfaction, and there were no predictors of the husband's prospect of divorce. CONCLUSION: Obsessive-compulsion is a significant factor in a couple's relationship, although previous studies have not been interested in obsessive-compulsion. Divorce likelihood should be evaluated for clinical couples as well as marital satisfaction, because it is more important for divorce prevention. Each spouse who has a psychological problem such as depression, obsessive-compulsion, and deviated personality needs individual therapy as well as couple therapy.

A Marital-Relationship Enhancement Program for Couples: Randomized Controlled Trial / 간호학회지

PURPOSE: This paper reports a randomized controlled trial to investigate the effects of a Marital-relationship enhancement program(MREP) for marital couples. METHODS: Volunteer couples from several well-being centers in Seoul were randomly assigned either to a treatment group (n=36), participating in a MREP based on Gottman's "sound marital house" theory, or to a control group (n=35) receiving no treatment. The content of the MREP was provided to the control group after the research was completed. Data was collected from December 2003 to May 2004 using modified versions of the inventories developed by Gottman on marital satisfaction, positive affect, conflict regulation, and communication barriers. RESULTS: Participants in the experimental group showed significant improvements in marital satisfaction, positive affects, conflict regulation, and communication-barrier scores compared to the control group. CONCLUSION: The present program for marital-relationship enhancement is helpful in enhancing marital relationships and regulating conflict between marital couples and, ultimately, may be useful to prevent divorce.

The Study for Development of Day Hospital Program of Eating Disorders / 간호학회지

PURPOSE: The purpose of this study was to develop the day hospital program for Korean eating disorders patients and to examine the effect of the day hospital program on improving frequency of binging and purging, eating disorders symptoms, self-esteem, and depression. METHOD: The subjects were 24 binge eaters visited at eating disorders clinic "M". They participated in a modified day hospital program based on the Toronto Day Hospital Program. All subjects completed the Eating Disorders Inventory(EDI)-2, Rosenberg Self-Eesteem Scale, Beck Depression Inventory(BDI) at pre and post intervention, and recorded daily food records. RESULT: In paired t-test analysis, frequency of binging and purging, self-esteem, depression, and 11 sub-scales of EDI-2(drive for thinness, bulimia, body dissatisfaction, ineffectiveness, interoceptive awareness, perfectionism, interpersonal distrust, maturity fear, asceticism, impulse regulation, social insecurity) were significantly improved after treatment. CONCLUSION: The results of this study suggest that the day hospital program for Korean eating disorders patients may be an effective initial approach to overcoming various eating disorders symptoms. Further studies should investigate longer term outcome data using a larger sample.