Development of a Monitoring Tool to Manage Unregistered Mentally Ill Patients at Community Mental Health Centers: Using a Delphi Method / 정신간호학회지

Purpose@#This study was conducted to develop a monitoring tool to manage unregistered mentally ill patients at community mental health centers (M-MUMI). @*Methods@#The Delphi method was used in this study. The participants of this study were 27 psychiatric experts. In the first Delphi round, content analysis was conducted. In the second Delphi round, Kendall’s W rank and weight rank were used. The third Delphi round was analyzed based on the content validity ratio (CVR). @*Results@#The finally developed M-MUMI consisted of 2 domains, 7 categories, and 22 items. Assessment of the present status consisted of 4 basic elements affecting daily life, 5 psychological statuses, 2 elements related to the utilization of social service, and 3 causes for the refusal of registration. The registration strategy of the individual cases consisted of 2 human resources to help registration, 2 additional social services for registration, and 4 individual needs to induce registration. @*Conclusion@#It is important to manage unregistered mentally ill patients at the community mental health centers. We hope that the developed M-MUMI will help to monitor unregistered mentally ill patients how to maintain mental health in the community.

Effect of Multidisciplinary Program for Relapse Prevention on Abstinence Self-efficacy, Impulsivity and Suicidal Ideation among Patients with Substance Use Disorder / 정신간호학회지

Purpose@#The purpose of this study was to examine the effects of a multidisciplinary program for relapse prevention on abstinence self-efficacy, impulsivity and suicidal ideation among patients with substance use disorder @*Methods@#A nonequivalent control group non-synchronized design was used. The participants were 42 substance addicted patients admitted to the addiction ward. The study variables of abstinence self-efficacy, impulsivity, and suicidal ideation were evaluated by the x2 test, Kolmogorov-Smirnov test, Shapiro-Wilk test, Mann-Whitney U test using the SPSS program. @*Results@#The experimental group showed a significant difference in abstinence self-efficacy (U=54.50, p<.001), impulsivity (U=88.00, p<.001) and suicidal ideation (U=77.50, p<.001) compare to the control group. @*Conclusion@#The multidisciplinary relapse prevention program was effective in improving abstinence self-efficacy, impulsivity, and suicidal ideation. It is essential to develop optimal nursing interventions for patients with substance use disorders to prevent relapse.

Effects of Brain Attention Biofeedback Self-regulation Training Nursing Intervention on Attention, Multidimensional Impulsivity, Emotional Response Intensity, and Self-regulated Learning Ability of School-aged Children in the COVID-19 Pandemic Situation / 정신간호학회지

Purpose@#This study examined the brain attention biofeedback self-regulation training (BABST) effects on attention, multidimensional impulsivity, emotional response intensity, and self-regulated learning ability of school-aged children in the prolonged COVID-19 pandemic. @*Methods@#A pretest-posttest nonequivalent control group design was used. There were 36 school-aged children in the experimental and control groups. The experimental groups received 10 BABSTsessions for 4 weeks. The data were analyzed using the Kolmogorov-Smirnova, Shapiro-Wilk, MannWhitney U, Wilcoxon signed-rank, and Quade Two-Way ANCOVA by ranks for non-parametric tests. @*Results@#All the variables showed homogeneity between the two groups except academic stress that was controlled as a covariate. The experimental group ranked significantly higher in attention (F=4.43, p=.043), cognitive impulsivity (F=9.70, p=.004), behavior impulsivity (F=11.21, p=.032), emotional response intensity (F=21.94, p<.001), self-regulated learning ability (F=8.71, p=.006) than the control group. @*Conclusion@#The brain attention biofeedback self-regulation program, as a brain neurocognitive-based nursing intervention, markedly improved attention, impulsivity, emotional response intensity, and self-regulated learning ability in school-aged children.

The Effects of the Combined Biofeedback and Brief Emotion Regulation Nursing Intervention Based on the Gross Model for Sexually Abused Adolescents

Purpose@#This study aimed to evaluate the effects of a combined biofeedback and brief emotion regulation (C-BABER) program for sexually abused adolescents. @*Methods@#This study employed a non-equivalent control group pretest-posttest design. The participants included 26 sexually abused adolescents from eight Sunflower Centers of South Korea–with 13 in the experimental group and 13 in the control group. The experimental group received four sessions of the individual C-BABER program, each lasting 60 minutes. @*Results@#Compared with the control group, sexually abused adolescents in the experimental group exhibited significant score differences in traumatic symptoms, including depression (Z = - 2.24, p = .025), dissociation (Z = - 2.21, p = .027), anxiety (Z = - 2.02, p = .044), and posttraumatic stress (Z = - 2.01 p = .045); and impulsivity, including positive urgency (Z = - 3.35, p = .001) and negative urgency (Z = - 2.28, v = .023). Additionally, the experimental group exhibited significant score differences in meta-mood, including emotional attention (Z = - 2.45, p = .014), emotional clarity (Z = - 2.30, p = .021), and emotional repair (Z = - 2.28, p = .022); and emotional regulation modes, including emotional suppression (Z = - 2.65,p = .008) and cognitive reappraisal (Z = - 1.98, p = .047). Regarding bio-attention, significant changes were identified in the experimental group for the bio-attention rate and attention maintenance time in the posttest compared to the pretest (p = .001). @*Conclusion@#The C-BABER program for sexually abused adolescents is effective in decreasing traumatic symptoms and impulsivity, and in improving meta-mood, emotional regulation mode, and bio-attention. Therefore, we recommend providing sexually abused adolescents the C-BABER program to help them regulate their emotions and effectively adapt to their lives.

Effects of Electroencephalogram Biofeedback on Emotion Regulation and Brain Homeostasis of Late Adolescents in the COVID-19 Pandemic

Purpose@#The purpose of this study was to examine the effects of electroencephalogram (EEG) biofeedback training for emotion regulation and brain homeostasis on anxiety about COVID-19 infection, impulsivity, anger rumination, meta-mood, and self-regulation ability of late adolescents in the prolonged COVID-19 pandemic situation. @*Methods@#A non-equivalent control group pretest-posttest design was used. The participants included 55 late adolescents in the experimental and control groups. The variables were evaluated using quantitative EEG at pre-post time points in the experimental group. The experimental groups received 10 sessions using the three-band protocol for five weeks. The collected data were analyzed using the Shapiro-Wilk test, Wilcoxon rank sum test, Wilcoxon signed-rank test, t-test and paired t-test using the SAS 9.3 program. The collected EEG data used a frequency series power spectrum analysis method through fast Fourier transform. @*Results@#Significant differences in emotion regulation between the two groups were observed in the anxiety about COVID-19 infection (W = 585.50, p = .002), mood repair of meta-mood (W = 889.50, p = .024), self-regulation ability (t = - 5.02, p < .001), self-regulation mode (t = - 4.74, p < .001), and volitional inhibition mode (t = - 2.61, p = .012). Neurofeedback training for brain homeostasis was effected on enhanced sensory-motor rhythm (S = 177.00, p < .001) and inhibited theta (S = - 166.00, p < .001). @*Conclusion@#The results demonstrate the potential of EEG biofeedback training as an independent nursing intervention that can markedly improve anxiety, mood-repair, and self-regulation ability for emotional distress during the COVID-19 pandemic.

A Meta Analysis of Impulsivity Related to Self-destructive Behavior in Korean Adolescents

Purpose@#The purpose of this study is to determine the results of a meta-analysis of impulsivity variables related to self-destructive behavior of South Korean adolescents. @*Methods@#A meta-analysis was carried out according to the Cochrane guidelines criteria and the quality of the studies was evaluated using the JBI checklist. 2,333 studies were collected through the databases of RISS, KISS, and DBpia on ‘impulsivity’ published from 2000 to 2020.Self-destructive behavior-related variables were largely categorized into three areas (addiction, violence, and delinquency), and six subgroups. @*Results@#Using the correlations with impulsivity in the final 53 papers, 231 self-destructive behavior-related variables were identified. The social delinquency showed the closest relationship with impulsivity (ES=0.34, 95% CI: 0.23~0.43, p<.001), followed by addictive behavior (ES=0.28, 95% CI: 0.24~0.32, p<.001), personal delinquency (ES=0.28, 95% CI: 0.23~0.32, p<.001), violence against others, violence against self, and substance addiction. These effects were identified as ranging from magnitudes of 0.23 to 0.27 based on the criteria of Cohen. @*Conclusion@#To improve the reliability of the results of meta-analysis, more studies on the impulsivity of adolescents should be carried o

Effects of Mobile Navigation Program in Colorectal Cancer Patients based on Uncertainty Theory

PURPOSE: This study aimed to examine the effects of a mobile navigation program on uncertainty, resilience, and growth through uncertainty in colorectal cancer patients. METHODS: To verify the effectiveness of the mobile navigation program, 61 participants diagnosed with colorectal cancer undergoing surgery were selected. A nonequivalent control group nonsynchronized design was used to evaluate the program. Uncertainty was measured using the Korean version of the Uncertainty in Illness Scale, resilience was measured using the Korean version of the Connor-Davidson Resilience Scale, and growth through uncertainty was measured using the Growth through Uncertainty Scale. RESULTS: Compared with the control group, patients in the mobile navigation program group showed significant differences in scores for uncertainty (F=7.22, p=.009) and resilience (F=4.31, p=.042), but not for growth through uncertainty (F=2.76, p=.102). CONCLUSION: These results suggest that the mobile navigation program has positive effects on decreasing uncertainty and increasing resilience among colorectal cancer patients. The mobile navigation program could play a significant role in assisting colorectal cancer patients in regard to the continuity and usability of the program.

Effects of Mobile Navigation Program in Colorectal Cancer Patients based on Uncertainty Theory

PURPOSE@#This study aimed to examine the effects of a mobile navigation program on uncertainty, resilience, and growth through uncertainty in colorectal cancer patients.@*METHODS@#To verify the effectiveness of the mobile navigation program, 61 participants diagnosed with colorectal cancer undergoing surgery were selected. A nonequivalent control group nonsynchronized design was used to evaluate the program. Uncertainty was measured using the Korean version of the Uncertainty in Illness Scale, resilience was measured using the Korean version of the Connor-Davidson Resilience Scale, and growth through uncertainty was measured using the Growth through Uncertainty Scale.@*RESULTS@#Compared with the control group, patients in the mobile navigation program group showed significant differences in scores for uncertainty (F=7.22, p=.009) and resilience (F=4.31, p=.042), but not for growth through uncertainty (F=2.76, p=.102).@*CONCLUSION@#These results suggest that the mobile navigation program has positive effects on decreasing uncertainty and increasing resilience among colorectal cancer patients. The mobile navigation program could play a significant role in assisting colorectal cancer patients in regard to the continuity and usability of the program.

Effects of Quantitative Electroencephalography Based Neurofeedback Training on Autonomous Regulations in Patients with Alcohol Use Disorder

PURPOSE: The study investigated whether neurofeedback training (NFT) can normalize the excessive high beta and low alpha waves indicative of hyperarousal and subsequently improve autonomous regulation based on the self-determination theory in alcohol use disorders. METHODS: A nonequivalent control group preteste-posttest design was used. Data were collected using self-report questionnaires from 36 Korean inpatients who met the Alcohol Use Disorder Identification Test in Korea criteria. Data were collected from quantitative electroencephalography to assess alpha (8–12 Hz) and high beta (21–30 Hz) waves for hyperarousal. The questionnaires included Basic Psychological Need Satisfaction scales that assessed autonomy, competence, and relatedness, and the Alcohol Abstinence Self-Efficacy Scale and Treatment Self-Regulation Questionnaire. The experimental group underwent 10 sessions of NFT over 4 weeks. Data were analyzed using the Chi-squared, Manne-Whitney U, and Wilcoxon signed-rank tests. RESULTS: In the experimental group, the alpha wave was increased in 15 of 19 sites and high beta waves were decreased in 15 of 19 sites, but this difference was not significant. However, high beta waves were increased in 15 of 19 sites in the control group, with seven sites (Fz, Cz, Pz, Fp2, F4, C4, and P4) showing significant increases. The experimental group showed a significant increase in basic psychological need satisfaction, alcohol abstinence self-efficacy, and self-regulation compared with the control group. CONCLUSION: NFT is recommended for improving autonomous regulation in alcohol use disorder as a nursing intervention. However, for significantly attenuating hyperarousal through brain wave correction, it may be necessary to increase the number of neurofeedback sessions.

Effects of an Abdominal Obesity Management Program on Physiological Bio-markers of Middle-aged Women in Korea: A Meta-analysis

BACKGROUND: The purpose of this study is to analyze the effects of an abdominal obesity management program in middle-aged women in Korea. METHODS: Examination of databases, including the Research Information Sharing Service, Database Periodical Information Academic, and Korean Studies Information, resulted in identification of 772 studies performed up to 2014, of which 43 satisfied the inclusion data. Data analysis was performed using R version 3.2 to calculate the effect sizes, explore possible causes of heterogeneity, and check for publication bias, using a funnel plot and its trim-and-fill analysis. RESULTS: The mean effect size of the management program was small (g=0.22), along with the anthropometric index (g=0.18), metabolism index (g=0.21), fat-distribution (g=0.36), and inflammatory index (g=0.36). Moderator analysis was performed to determine heterogeneity, but no significant differences were found between the randomized controlled trial (RCT) group and non-RCT group. In addition, the length of the session was found to be statistically significant after performing a meta-regression. Finally, a funnel plot with a trim-and-fill analysis was produced to check for publication bias, but no significant bias was detected. CONCLUSION: Based on these findings, the abdominal obesity management program affects middle-aged women in Korea. Further research is needed to target other age groups with abdominal obesity.

Effect of Symptoms of Adult Attention Deficit Hyperactivity Disorder and Negative Ideation on Interpersonal Relations / 정신간호학회지

PURPOSE: This study was done to identify variables in Attention Deficit Hyperactivity Disorder (ADHD) symptoms and negative ideation that predict interpersonal relation in adults. The focus was on thought, behavior, emotional and cognition domains. METHODS: Korean Conner's Adult ADHD Rating Scale, Anxious Thought Inventory, Interpersonal Relation Scale were used. Participants were 379 of normal adults living in B, I and U cities. The data were analyzed using frequency, F-test, t-test, ANOVA, Scheffé and Pearson's correlation coefficients. Regression analysis was done to provide understanding of the effects of each variable. RESULTS: Interpersonal relation showed significantly negative correlation with adult related ADHD symptoms and negative ideation. Significant predictive factors of interpersonal relation were social-worry (β=-.40), inattention/memory problems (β=-.22) and gender (β=-.12) in order. These variables accounted for 25% of variance in interpersonal relations. CONCLUSION: The results show that social-worry in the cognitive domain and inattention-memory problems in the thought domain have a negative impact on interpersonal relation in adults compared to the behavior or emotional domains which indicates a need for intervention strategies to reduce inattention/memory problems and social-worry and thus improve interpersonal relations.

Effects of Relational Self and Negative Ideation of Teachers on Coping Type for School-aged Attention Deficit Hyperactivity Disorder / 정신간호학회지

PURPOSE: The purpose of this study was to identify predictors influencing relational self and negative thinking on coping among teachers working with students with attention deficit hyperactivity disorder (ADHD). METHODS: A cross sectional study design was conducted with 212 teachers in six elementary schools located in D and C cities. Data were analyzed using t test, one way ANOVA, Pearson's correlation coefficients, and stepwise regression analysis with SPSS 18.0. RESULTS: The significant predictive factor for the active coping type was perceived support in relational self. Empathy care was as a significant factor for the passive coping type. Relationship avoidance and agency were significant predictive factors for negative coping with ADHD students. Active and passive coping had significant negative correlations with social worry. Significant factors for positive coping were attendance at ADHD workshops and number of years of teaching. CONCLUSION: Results suggest that it is important to focus on teachers having a positive aspect in the classroom, using new strategies, and understanding their own inner factors of perceived support and empathy care in order to provide positive coping and enhance relationships with ADHD students. To further enhance positive coping and perceived support and to reduce social worry, teachers should use community resources, especially psychiatric health nurses.

Usage Patterns of Nursing Diagnoses among Student Nurses in Psychiatric Unit: Relation with NANDA and SNOMED CT / 정신간호학회지

PURPOSE: The aim of this study was to explore how nursing diagnoses are made by undergraduate students of psychiatric unit in Korea. METHODS: Data were collected from case reports and analyzed based on NANDA (North American Nursing Diagnosis Association) nursing diagnoses and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) as reference terminology. RESULTS: The 30 different nursing diagnoses from 135 distinct nursing diagnosis statements were assessed after removing repetition of case studies from a of total of 1,140 statements of nursing diagnoses. The most frequently used NANDA diagnosis was "ineffective coping" The thirty nursing diagnoses were grouped under 10 out of the 13 NANDA domains. In addition, 98 related factors were classified into SNOMED CT hierarchies of Clinical Finding, Procedure, and Observable Entity. The content validity index for the mapping of nursing diagnoses was 0.97, indicating a relatively strong agreement. CONCLUSION: These results can help students to improve their knowledge and better formulate appropriate diagnoses. Using standardized terminology would improve competency of education and help to ratify the steps of the nursing process, especially nursing planning. Educational strategies that enhance diagnostic accuracy are recommended.

The Relationship among Teachers' Empathy, Communication Style and Coping Type for Students with Attention Deficit Hyperactivity Disorder / 정신간호학회지

PURPOSE: The purpose of this research was to identify the relationship of empathy, communication style, and coping type with students exhibiting a attention deficit disorder hyperactivity (ADHD). METHODS: Participants were 238 elementary school teachers living in 5 cities in Korea. The teacher's answered questions about their empathy level, communication style and coping type when teaching students with ADHD. Data were analyzed using t-test, one-way ANOVA, and Pearson correlation coefficients with SPSS 21.0. RESULTS: Teachers' cognitive and emotional empathy were at the same level. For communication styles used by the teachers, reception-encouragement was the most widely used and nonreception-commanding style was the least widely used. With regard to how to deal with student with ADHD, passive coping type was most widely used and active and negative coping followed in that order. Teachers with higher levels of empathy, used more active coping. For communication, the correlation between reception-encouragement and passive coping had the highest level. CONCLUSION: These result suggest the necessity of developing and providing empathy boosting programs about students with ADHD as well as special workshops to increase communication efficacy and coping skills with school-aged ADHD students.