Experiences of traumatic events, knowledge and attitudes concerning post-traumatic stress disorder, and resilience among nurses and paramedics working in emergency department / 한국간호교육학회지

Purpose@#This study aimed to assess exposure to traumatic events, knowledge and attitudes concerning post-traumatic stress disorder (PTSD) and the level of resilience among nurses and paramedics working in emergency departments. @*Methods@#Data were collected from May 22 to June 12, 2022, using a self-administered survey questionnaire. The participants comprised 135 nurses and 80 paramedics working in emergency departments. The collected data were analyzed with descriptive statistics, a t-test, and an analysis of variance with Scheffé’s test. @*Results@#Compared with emergency room nurses, paramedics were more positive about the government’s spending on job opportunities for people with PTSD. There were no significant differences in attitude regarding government strategies and people with PTSD between nurses and paramedics. Paramedics had higher scores on the effective treatment for PTSD, while emergency room nurses showed higher scores on effective psychotherapy. General knowledge of PTSD differed according to sex (t=-2.33, p=.021) and education level (F=3.21, p=.042). Resilience scores differed significantly according to sex (t=2.02, p=.045), education level (F=4.10, p=.018), self-reported economic state (F=10.34, p<.001), and self-reported health (F=11.57, p<.001). @*Conclusion@#The findings support that emergency department nurses and paramedics are in need of self-care programs to support their mental health and indicate that intervention programs should be developed to enhance resilience in emergency department professionals.

Validity and Reliability of the Life Transition Scale in Parents of Disabled Children Across the Life Transition Process

Purpose@#The Life Transition Scale (LTS) consists of 24 items that assess the life transition process of parents of autistic children. This study aimed to examine the validity and reliability of the LTS in parents of children with a wide spectrum of disabilities. @*Methods@#Data were collected from 260 parents of children with disabilities through self-report questionnaires. Validity was examined using exploratory and confirmative factor analysis to determine the factor structures of the LTS; socio-demographic differences in LTS scores were examined using the t-test or ANOVA. Reliability was examined using Cronbach's ⍺ coefficient. @*Results@#A four-factor structure was validated (x2=640.0, p<.001, GFI=.81, RMSEA=.07, NNFI=.89, CFI=.89, PNFI=.74, Q [x2/df]=2.60). The validity of the LTS was verified by exploratory factor analysis, with factor loading ranging from .30 to .80. There were significant differences in the accepting phase according to children's and parents' age and the type of disability, and in the wandering phase according to parental gender, educational level, job, and socioeconomic status. The Cronbach's ⍺s for the reliability of each of the four structures were acceptable, within a range of .80~.90. @*Conclusion@#The LTS is a valid and reliable measurement to assess the life transition process of parents with disabled children.

Attitude and knowledge on PTSD of nursing and paramedic students in Korea / 한국간호교육학회지

Purpose@#This study aimed to identify attitude and knowledge level on post-traumatic stress disorder (PTSD) among nursing and paramedic students. @*Methods@#A questionnaire survey was conducted from December 1st to 20th in 2019. A total of 210 students participated from two universities in Korea. Data were analyzed using descriptive statistics, t-tests and one-way analysis of variance. @*Results@#Students were positive about the government's spending on PTSD treatment (91.4%), and professional training (92.4%). PTSD patients were considered to be more dangerous (68.1%) and violent (42.4%) than the general population. There were no significant differences in attitude and general knowledge on PTSD between nursing and paramedic students. However, general knowledge on PTSD differed according to education experience on PTSD (t=2.04, p=.043). Knowledge scores for PTSD treatment differed significantly according to the academic major (t=2.02, p=.044), and education experience on PTSD (t=2.87, p=.005). @*Conclusions@#The results of this study indicate nursing and paramedic students lack knowledge on PTSD. Therefore, developing curriculum regarding PTSD-related contents in undergraduate and continuing education in both departments is needed to provide better quality health care to people with PTSD.

Validity and Reliability of Korean Version of Post-traumatic Stress Disorder Scale (K-PTSD) Measuring Attitudes and Knowledge of PTSD / 한국간호교육학회지

The aim of this study was to examine the validity and reliability of the Korean version of the PTSD scale (K-PTSD) for measuring attitudes and knowledge of PTSD. Methods: A cross-sectional study design was used. The K-PTSD scale consisted of 8 items for attitudes, 8 items for general knowledge of PTSD, and 3 items for knowledge of PTSD treatment; 211 nursing students and paramedic students participated. Content validity, item analysis, and factor analysis were used to examine the construct validity. Criterion validity was tested by using educational experience with PTSD as a criterion. Cronbach's α was used to identify internal consistency reliability in the attitude scale. Results: Construct validity of the K-PTSD was verified by exploratory factor analysis, with factor loadings for attitude ranging from .59 to .84. Criterion validity in comparing knowledge of PTSD (t=2.02, p=.044) and PTSD treatment (t=3.19, p=.022) showed a significant difference according to PTSD educational experience. Cronbach's α for the attitude scale was .79 and .59. Conclusion: The findings suggest that the K-PTSD is a valid and reliable tool that can measure attitudes and knowledge of PTSD among nursing and paramedic students. However, further study is needed to retest the verification of this scale with more diverse participants.

Attitude and knowledge on PTSD of nursing and paramedic students in Korea / 한국간호교육학회지

Purpose@#This study aimed to identify attitude and knowledge level on post-traumatic stress disorder (PTSD) among nursing and paramedic students. @*Methods@#A questionnaire survey was conducted from December 1st to 20th in 2019. A total of 210 students participated from two universities in Korea. Data were analyzed using descriptive statistics, t-tests and one-way analysis of variance. @*Results@#Students were positive about the government's spending on PTSD treatment (91.4%), and professional training (92.4%). PTSD patients were considered to be more dangerous (68.1%) and violent (42.4%) than the general population. There were no significant differences in attitude and general knowledge on PTSD between nursing and paramedic students. However, general knowledge on PTSD differed according to education experience on PTSD (t=2.04, p=.043). Knowledge scores for PTSD treatment differed significantly according to the academic major (t=2.02, p=.044), and education experience on PTSD (t=2.87, p=.005). @*Conclusions@#The results of this study indicate nursing and paramedic students lack knowledge on PTSD. Therefore, developing curriculum regarding PTSD-related contents in undergraduate and continuing education in both departments is needed to provide better quality health care to people with PTSD.

Life Transition Process Effects on Depressive Symptoms in Parents of Children with Autism Spectrum Disorder

PURPOSE: The purpose of this study is to examine the association between each phase of the Life Transition Process (LTP) and depressive symptoms among parents of children with Autism Spectrum Disorder (ASD). METHODS: Using a cross-sectional study design, data pertaining to LTP and depressive symptoms were collected from 285 parents of children with ASD (101 fathers and 184 mothers). Participants were recruited through the Autism Society of Korea and a counseling center for families of children with ASD. RESULTS: Using a cut-off point of 5 or higher on the Beck Depression Inventory-Short Form, more than half of the parents (53.4%) were deemed depressed; these parents experienced moderate (27.4%) to severe (11.6%) levels of depressive symptoms. A hierarchical multiple regression using the socio-demographic characteristics of children and parents and each phase of the LTP as predictors, found that lower income (β=-.14, p=.007) and greater scores for the wandering phase (β=.59, p < .001) were significant predictors of greater levels of depressive symptoms. CONCLUSION: These findings confirm the association between LTP and depressive symptoms for parents of children with ASD, who were found to have a greater risk of depressive symptoms during wandering phase.

Validation of the Decisional Conflict Scale for Evaluating Advance Care Decision Conflict in Community-dwelling Older Adults

PURPOSE: Decisional conflict is a significant and important barrier in end-of-life care planning, and it is often encountered in health professionals' discussions with patients and their families. Little is known about the measurement of decisional conflict, and existing measures are not suitable for all contexts. In this study, psychometric properties of the Decisional Conflict Scale, which was translated for the first time into Korean [Korean version of DCS (K-DCS)], were examined. METHODS: A sample of 273 community-dwelling elders was surveyed (mean age: 77.26 years; 80.2% women). Internal consistency reliability and stability reliability were tested by calculating Cronbach α and Pearson's correlation coefficients. Exploratory factor analysis and logistic regression analyses were performed to test validity. RESULTS: Reliability of the K-DCS was acceptable with Cronbach α =.87; test-retest correlation r = .76. Factor analysis showed a two-factor structure with nine items: informed/values clarity and uncertainty. Concordance between K-DCS and the four treatment directives was significant (kappa values ≥.78). Controlling for age and gender, those with decision implementation were more likely to implement their decisions on tube feeding (odds ratio = 5.15, p = .033) and hospice care (odds ratio = 2.83, p = .017). CONCLUSION: The K-DCS appears to be a valid measure to evaluate decisional conflict about advance directives in community-dwelling Korean older adults. Further validation of the K-DCS is warranted, though caution should be exercised in using subscales because of differences in decisional contexts.

Differences in Life Transition Process of Parents Caring for Children with Autism: Based on the Socio-Demographic Characteristics

PURPOSE: This study was done to identify differences in the life transition process of parents caring for children with autism according to parents' socio-demographic characteristics. METHODS: Participants were 194 parents caring for children with autism. Data were collected from December 2013 to February 2014 through self-report questionnaires, and analyzed using descriptive statistics, t-test, ANOVA with SPSS/WIN 20.0. RESULTS: Mean scores for despairing or accepting phases were higher than those for denying or wandering phases in the life transition process. According to parents' gender, educational level, and job, there were some significant differences in the denying and wandering phases. Differences in denying phase by education (p=.033), job (p=.004) were significant. Respondents with higher educational level, and having a job showed a lower level of denying than other respondents. Wandering phase differed significantly by gender (p=.009) and job (p=.001). Mothers and those who did not have a job showed a higher level of wandering than fathers and those who had a job. However, there was no difference in the despairing or accepting phases. CONCLUSION: The life transition phase of parents with autistic children needs to be assessed to provide differentiated and intensive support program and help them move to the accepting phase.

Construct Validity of the Life Transition Scale for Parents of Children with Autism

PURPOSE: The study was done to identify the construct validity and reliability of the life transition scale (LTS) for parents who have children with autism. METHODS: Exploratory factor analysis (EFA) and confirmative factor analysis (CFA) were conducted to identify the most adequate measurement model for structural validity. Convergent validity and discriminant validity were also conducted for structural validity. Data were collected from 208 parents through self-reported questionnaires and analyzed with SPSS/WIN 15.0 and AMOS 20.0 version. RESULTS: A four factor-structure was validated (chi2=541.23, p<.001, GFI=.82, RMSEA=.07, IFI=.89, CFI=.89, PNFI=.73, Q (chi2/df)=2.20) at the 3rd order of EFA and CFA, and factors were named as denying, wandering, despairing, and accepting. Both convergent and determinant validity for LTS were 100%. Cronbach's alphas for the reliability of each structure were .77-.90 and .83 for total structure. CONCLUSION: The four structures, 24-item instrument showed satisfactory reliability and validity. LTS has the potential to be appropriate for assessing the transition process of life for parents who have children with autism and provides basic directions for differentiated support and care at each stage.

Feasibility Evaluation of Korean Advance Directives (K-AD) / 한국간호교육학회지

PURPOSE: This study evaluates the feasibility of Korean Advance Directives (K-AD) developed earlier. METHODS: From January 1 to February 28, 2013, data were collected from 330 adults through a self-reported questionnaire established by the authors based on literature review and expert consultation. The feasibility of K-AD was multi-dimensionally evaluated through four criteria: cognitive, psychological, document making and socially expecting aspects. Data were analyzed using t tests, one-way ANOVA, and Scheffe post hoc tests via the SAS 9.1.3 program. RESULTS: The feasibility of K-AD differed significantly by gender (p=.003), educational level (p<.001), religion (p=.002), and self-reported health status (p=.039). Differences in the level of easiness with K-AD by gender (p=.008) and education (p=.047) were significant. Perceived simplicity of AD differed significantly by religion (p=.005), and the necessity of AD differed significantly by gender (p=.025) and religion (p=.005). CONCLUSION: K-AD are sufficiently feasible to be tentatively utilized in practice. This is the first study to explore the feasibility of K-AD on the basis of multiple aspects. However, further studies involving diverse populations and methodologies to validate the usefulness of K-AD are warranted.

The Attitude toward Marriage, Pregnancy and Abortion among Korean Nursing Students / 한국간호교육학회지

PURPOSE: There recurred controversies related to legal allowance of abortion since newly advancing prenatal genetic testing technology. This survey was aimed to identify the attitudes toward marriage, and pregnancy (AMP) and terminating pregnancy (ATP) among Korean nursing students. METHOD: A descriptive study was performed from October to November 2012 in South Korea. 424 nursing students responded to two types of tools developed by authors. Questionnaire for ATP is consisted of 10 items with 5-points Likert Scale. Questionnaire for AMP is 12 items containing 5 categories. RESULTS: Mean score of ATP was 36.90. Students that are enrolled in bachelor degree had a significant higher ATP. Students who are currently dating with an opposite gender showed much higher level of ATP than those are not. Lower group of delayed the time of getting marriage and pregnancy showed highest score of ATP, significantly. CONCLUSION: Individual factor must be primarily considered when assessing ATP of nursing students, for example current relationship with opposite gender and educational background, attitude toward marriage and pregnancy. Further studies are needed to identify personal factors of the young adults affecting on the ATP.

Development of a Korean Version of an Advance Directive Model via Cognitive Interview / 한국호스피스완화의료학회지

PURPOSE: The purpose of the study was to develop a feasible form of a Korean version of advance directives (K-AD). METHODS: Sixteen adults participated in this study: 10 aged 20~50 years and nine aged 65 years or older. Using a draft version of the K-AD, cognitive interview was conducted on the participants to establish a culturally acceptable form of advance directives whose directions can be understood and responded accordingly by the general population. RESULTS: Cognitive interviews revealed areas of concerns for the draft version of K-AD: lack of instructions or clarity for technical and medical terms, context complexity and inadequate response categories. The draft version was revised by rewording, offering examples and rearranging the context. Editorial style was added with appropriate uses of bold fonts, bullet-points and underlines to facilitate interviewees' cognitive responses. CONCLUSION: Study results feasibility of the revised version of the K-AD. Further study should be performed with a larger number of participants to develop a K-AD with an acceptable level of reliability and validity.

Prerequisite for Korean Advance Directives: From the View of Healthcare Providers

PURPOSE: The purpose of this study was to explore the main prerequisite for Korean Advance Directives [KAD] to ensure their better use. METHODS: Data were collected from two focus group interviews and individual email responses. Study participants were 5 doctors and 6 nurses. All interview data were transcribed and analyzed using qualitative content analysis. RESULTS: Three main themes emerged; establishing a philosophy of KAD, protocol to practice KAD, and the KAD document itself. A philosophy is needed to ensure individual needs, consensus to practice AD and identify principle agents. The core of protocol was found to be as follows; 1) process, 2) premise, 3) procedure, 4) contextual preparation, 5) timing, 6) feasibility. Component and feasibility need to be established for the document itself. CONCLUSION: For a positive acceptance of KAD in Korean society, a culture sensitive, reality based, and user friendly AD needs to be developed.

Development of a Scale to Measure Life Transition Process in Parents of Children with Autism

PURPOSE: The purpose of this research was to develop a scale to measure the life transition process of parents of children with autism, against the backdrop of a lack of research on this topic. METHODS: Seventy preliminary items were drawn from previous qualitative research, and content validity was tested by three professors as well as three parents of children with autism. A questionnaire survey was also done between August 2011 and February 2012. Data were collected from 207 parents of children with autism and analyzed using descriptive statistics, item analysis, Cronbach's alpha, Pearson correlation coefficients, and factor analysis with the SPSS Win 15.0 program. RESULTS: Twenty-nine items were selected to constitute the appropriate measuring scale and categorized into 5 factors explaining 63.2% of the total variance. The 5 factors were named; stages of denial (5 items), wandering (6 items), devotion (7 items), frustration (3 items), and finally acceptance (8 items). Cronbach's alpha for the 29 items was .80. CONCLUSION: The results of this study not only suggest assessment criteria for the life transition process of parents who have children with autism but also provide basic directions for program development to provide differentiated support and care at each stage.

Ageing Experiences of Nurses with Overseas Employment: Focusing on the Korean Nurses Dispatched to Germany in the 1960s and 1970s / 산업간호학회지

PURPOSE: Global shortages in nursing and strong demand for nursing services provided Korean nurses with more overseas employment opportunities, especially in the developed countries such as the United States and Canada. The purpose of this study was to explore the ageing experiences of the Korean nurses dispatched to Germany in the 1960s and 1970s. METHODS: The researcher interviewed 10 Korean nurses living in four cities in Germany. Interviews were performed twice in January and July, 2010, and the data, in the form of field notes and interview transcripts, were analyzed using the Agar's (1980) ethnographic method. RESULTS: The ageing experiences of the participants can be summarized into three theme stages: coming upon old age, reluctantly realizing getting old, and finally accepting being old. The first stage is characterized by 'wiring money to homeland all throughout youth,' second 'still feeling like a stranger anywhere,' and finally 'burying homeland in heart.' CONCLUSION: The research findings not only suggest crucial materials for training prospective nurses overseas for their successful settlement, but also shed lights on related problems and solutions with ageing experience in overseas employment.

Job Stress and Work-Related Musculoskeletal Symptoms of 119 Emergency Medical Technicians / 산업간호학회지

PURPOSE: This study was done to investigate the prevalence of job stress and musculoskeletal symptoms, and to identify the factors that affect work-related musculoskeletal symptoms of the 119 Emergency medical technicians (EMT). METHOD: From August 26 to September 10, 2010, the data were obtained from 456 EMT working in Daejeon city or Choongnam province. For data analysis, descriptive statistics and multiple logistic regression were performed using SAS version 9.1. RESULTS: Physical environment, job demand, interpersonal conflict, and occupational climate were stressful to 119 EMT. The prevalence of musculoskeletal symptoms of female EMT was higher than those of the male EMT's. After gender and age were adjusted, there ware significant relationships between musculoskeletal symptoms and some risk factors including occupational class, hours of intensive musculoskeletal use, previous injury or work-related injury, physical burden, and job stress. Overall, a higher degree of job stress increased musculoskeletal symptoms. CONCLUSION: Job stress is a major cause of musculoskeletal symptoms. To prevent and manage musculoskeletal disease of 119 EMT, there is a need to develop a management program for musculoskeletal symptoms to reduce occupational stress, considering gender differences.

Life Transition of Mothers of Children with Autism

PURPOSE: While there are a number of studies on children with disabilities, there have been few studies on mothers of children with autism. The purpose of this study was to explore the process of life transition of mothers who have children with autism. METHODS: From June 2007 to May 2009, the researcher interviewed 15 mothers of children with autism living in Seoul City, Gyeonggi or Chonbuk Provinces, and then analyzed the data gathered using the constant comparative method of grounded theory. RESULTS: "Living together holding a string of fate" was a core category showing along the continuum of life. The basic social process of life transition encompassed 5 stages: stages of denying, wandering, devoting, mind controlling, and finally accepting. These five stages proceeded in phases, though returned back to the wandering stage occasionally. CONCLUSION: This study has opened the door to understanding how mothers of children with autism experienced life transition. The findings suggest that differentiated support and care at each stage should be given and there is the need to develop transition assessment tools for mothers of children with autism.

Recapturing the Lives and Experiences of Korean Nurses Dispatched to Germany in the 1960s and 1970s / 산업간호학회지

PURPOSE: While there exist a good number of studies on Korean nurses who were dispatched to Germany in 1960s and 1970s in sociological or labor economic perspectives, there have been few studies on their experiences from a nursing perspective. The purpose of this study is to recapture their lives and experiences from a nursing point of view. METHODS: This paper adopts an Agar's ethnographic approach which is more suitable to investigate personal qualitative experiences of those Korean nurses. The data were collected from group discussion and individual interview, and field observation with 10 dispatched Korean nurses. RESULTS: The experiences of those dispatched nurses to Germany can be summarized into three themes: challenging to life, embracing new life, and giving a meaning to life. Challenging to life involved 'hope and anxiety,' and embracing new life was reflected by 'wonderment and envy' and 'loneliness and sorrow.' Lastly, they took pride in their contributions to their mother country and also felt something lacking that they had not been properly evaluated. CONCLUSION: By rediscovering their lives and experiences from a nursing perspective, this study argues for more future studies to reexamine their impact and contribution to the nursing field in Korea.

Factors influencing Health-related Quality of Life in Korean Medicaid Beneficiaries

PURPOSE: The purpose of this study was to identify the factors which influence health-related quality of life (HRQoL) in Korean Medicaid beneficiaries. The relationships among sociodemographic factors, health status, health behavior, and HRQoL were analyzed METHODS: Data from the 2007 survey on Health Services Use and Health Status of Medicaid Beneficiaries conducted by the Ministry for Health Welfare and Family Affairs were examined. To analyze the sample survey data, descriptive statistics, correlation and hierarchical multiple survey regression analysis with SAS 9.1.3 package were used with SURVEYMEANS and SURVEYREG procedures, which incorporate the sample design into the analyses in order to make statistically valid inference for the whole Medicaid population. RESULTS: The HRQoL correlated with limitations in Activities of Daily Living (ADL) (r=-.509, p<.001), stress (r=-.387, p<.001), depression (r=-.385, p<.001), alcohol consumption (r=.216, p<.001), and exercise (r=.293, p<.001). Significant factors that affect HRQoL of Medicaid beneficiaries were gender, region, limitations in ADL, stress, depression, alcohol consumption, and regular exercise. These variables explained 44.6% of HRQoL (F= 215.00, p<.001). CONCLUSION: The results indicate that to improve the HRQoL of Medicaid beneficiaries it is important to develop nursing intervention programs that focus on psychological health and health behavior and to give consideration to differences in gender and region.

Family Caregivers' Experiences Utilizing a Nursing Home for Their Elderly Family Members / 간호학회지

PURPOSE: The purpose of this study was to explore and describe the experiences of the family caregivers using a nursing home for their elderly family members. METHOD: Participants for this study were 1 man and 9 women caregivers. Data was collected through in-depth interviews from October, 2005 to April, 2006 and analyzed using Strauss and Corbin's grounded theory methodology. RESULTS: "Finding a way to live together" emerged as a core category and it reflected expanding consciousness allowing them to see each other in a more positive view. The basic social process of "finding a way to live together" includes 3 phases: 1) recognizing the problems, 2) finding solutions to the problems, and 3) accepting the changes in their surrounding. Lack of privacy, family troubles, extreme distress, and unavailable caregivers are reflected in the process of recognizing the problems. The process of finding solutions was making a decision, obtaining family agreement, choosing the best nursing home, and enduring the financial burden. Possible outcomes of the last phase include recovering peace of mind and continuing conflict. CONCLUSION: Findings from this study offer suggestions for developing a strategy to help not only the elderly but also the family caregivers.