Parental Mental Illness: An Integrative Review of Children’s Mental Health and Intervention Program / 정신간호학회지

Purpose@#To increase a comprehensive understanding of the children’s mental health who have a parent with a mental illness in Korea. @*Methods@#The integrative review method by Whittemore and Knafl was applied. Online databases were searched that focused on children of a parent with a mental illness. The JBI Critical Appraisal Tools were used to assess the quality of the selected articles. @*Results@#Fourteen articles were selected for the final data analysis. Majority of the articles addressed about the mental health issues and disadvantages that the children of a parent with a mental illness have. Compared to the mental health issues and disadvantages discussed, intervention programs were not much and the sample were not enough to achieve statistical significance. @*Conclusion@#The results of this integrative review have implications for planning and implementing appropriate intervention programs to promote mental health in children of a parent with a mental illness in future.

Parental Mental Illness: An Integrative Review of Children’s Mental Health and Intervention Program / 정신간호학회지

Purpose@#To increase a comprehensive understanding of the children’s mental health who have a parent with a mental illness in Korea. @*Methods@#The integrative review method by Whittemore and Knafl was applied. Online databases were searched that focused on children of a parent with a mental illness. The JBI Critical Appraisal Tools were used to assess the quality of the selected articles. @*Results@#Fourteen articles were selected for the final data analysis. Majority of the articles addressed about the mental health issues and disadvantages that the children of a parent with a mental illness have. Compared to the mental health issues and disadvantages discussed, intervention programs were not much and the sample were not enough to achieve statistical significance. @*Conclusion@#The results of this integrative review have implications for planning and implementing appropriate intervention programs to promote mental health in children of a parent with a mental illness in future.

The Effects of Autogenic Training on Stress Response, Self-control and Internet Addiction of Adolescent Internet Addiction Risk Group / 정신간호학회지

Purpose@#The purpose of this study was to examine the effect of using autogenic training as a intervention methodfor the adolescents Internet addiction risk group. @*Methods@#The study was a pre and post test quasi-experiment between non-equivalent control groups, conducted in four middle schools and two high schools in Seoul. Participants were 46 adolescents in schools (24 in the experimental group and 22 in the control group) belonging to the potential risk group of Internet addiction as a result of the self-diagnosed Internet addiction test. Therapy was for eight sessions (eight weeks) April-October 2016. The data collected were analyzed using the SPSS 24.0 program. @*Results@#The results of the study confirmed that the autogenic training program is an effective intervention method to reduce stress response, improve self-control, and reduce Internet addiction level of the adolescents Internet addiction risk group. @*Conclusion@#The autogenic training program is a voluntary self-initiated exercise that encourages change through physical relaxation. The study presented psychological and physical recovery as well as direction for Internet use. It is expected that the program will be effective as treatment and prevention of Internet addiction at community sites, including schools.

Parental Factors Associated with Smartphone Overuse in Preschoolers: A Systematic Review and Meta-Analysis

Purpose@#This study aimed to identify parental factors associated with smartphone overuse in preschoolers. @*Methods@#A systematic reviewwas conducted according to PRISMA guidelines. Relevant studies published in peer-reviewed journals from 2009 to June 2019 were identifiedthrough systematic search in 10 electronic databases (PubMed, CINAHL, Cochrane Central, EMBASE, Web of Science, NDSL, KISS, KMbase,KoreaMed, and RISS). Standardized effect sizes were calculated to quantify the associations of parental factors with smartphoneoveruse in preschoolers using meta-analysis. @*Results@#A total of 30 cross-sectional studies involving 7,943 participants met the inclusioncriteria. The following were negatively correlated with smartphone overuse in preschoolers: mother’s parenting self-efficacy (r =-.35),mother-child attachment (r =-.28), mother’s positive parenting behavior (r =-.28), mother’s positive parenting attitude (r =-.25), and father’sparenting involvement (r =-.15). Further, maternal factors such as smartphone addiction tendency (r =.41), parenting stress (r =.40), negativeparenting behavior (r =.35), negative parenting attitude (r =.14), smartphone usage time (r =.26), employment status (r =.18), and age(r =.12) were positively correlated with smartphone overuse in preschoolers. @*Conclusion@#Several parental factors influence smartphoneoveruse in preschoolers. These findings emphasize the need to assess and enhance the parental factors identified in this study to preventsmartphone overuse in preschoolers. Accordingly, we recommend the development of preventive interventions to strengthen parent-relatedprotective factors and mitigate risk factors.

Person-Centered Relational Care Experienced by Critical Care Nurses: An Interpretative Phenomenological Analysis Study / 간호학회지

PURPOSE: The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. METHODS: Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through in-depth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. RESULTS: Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced ‘balancing emotions’ and ‘authenticity’ in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. CONCLUSION: The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.

Interventions to Reduce the Problems of Abused Children and Adolescents in Residential Facilities in South Korea: An Integrative Review

PURPOSE: The purpose of this study was to review the literature on intervention studies for abused children and adolescent in residential facilities in South Korea (ACARF-K). The goal was to understand the problems they experience, to evaluate the content and effectiveness of interventions applied to them, and to develop evidence-based nursing intervention programs. METHODS: We used four electronic databases to search for relevant articles. 18 studies according to Whittemore and Knafl's integrative review method to synthesize the literature. RESULTS: The ACARF-K experienced problems in biophysical, psychological, and sociocultural domains related to attachment impairment. Effective intervention strategies were building trust through empathy and fulfillment of needs, encouraging ACARF-K to express themselves and helping them to clarify emotions in an unthreatening environment, and improving their self-concept through activities in which they experienced achievement. CONCLUSION: Interventions are needed to help restore attachment damage among ACARF-K. The interventions in this study utilized emotional, cognitive, relational, and behavioral therapeutic tools to improve their psychological and social capacities. Future intervention programs for ACARF-K should include these key elements.

An Integrative Review on the Contents and Effectiveness of Emotion Coaching Interventions for Parents / 정신간호학회지

PURPOSE: The purpose of this integrative literature review was to synthesize contents of emotion coaching interventions (ECI) for parents and explore unique changes in parents, parents-child, or child outcomes. METHODS: This research was conducted according to Whittemore and Knafl's integrative review method, which encompassed problem identification, literature search, data evaluation, data analysis, and presentation stages. Relevant searching terms in English and Korean were used for eight electronic databases: MEDLINE, EMBASE, Cochrane library, CINAHL, RISS, KISS, NDSL, and DBpia. RESULTS: A total of 28 studies were selected: 16 Korean and 12 non-Korean ones. Among the selected studies, the ECI for parents was found to be effective in regulating both the parent's and child's emotions. The contents of the ECI seems to be applicable and understandable using self-reflection, emotional competency improvement, and emotion coaching proficiency, especially for demonstration and maintenance of a positive attitude. CONCLUSION: The ECI was an effective intervention which is helpful for child rearing, emotional regulation, and social competence for parents. In addition, it had a positive effect in regulating behavioral problems in children through interventions provided to the parents.

Person-Centered Relational Care Experienced by Critical Care Nurses: An Interpretative Phenomenological Analysis Study

PURPOSE@#The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care.@*METHODS@#Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through in-depth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data.@*RESULTS@#Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced ‘balancing emotions’ and ‘authenticity’ in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory.@*CONCLUSION@#The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.

Adequacy of Nurse Staffing Level in Integrated Nursing Care / 간호행정학회지

PURPOSE: This study was done to evaluate the adequacy of nurse staffing in integrated nursing care. METHODS: Statistical data on integrated nursing care from the National Health Insurance Corporation was used in this study. We extracted hospital data and patient data related to patient needs for nursing care. We analyzed the differences in patient needs by staffing level of each type of medical institution. RESULTS: Approximately 70% of medical institutions provided nursing care by the mid level of nurse staffing, which was 1:6, 1:10 and 1:12 in the tertiary hospital, general hospital and semi-hospital, respectively. The patients' characteristics were significantly different by hospital type. Especially, the distribution of the main diagnosis was completely different between the tertiary hospital and semi-hospital. In the tertiary hospital, the patient needs measured by severity and activities of daily living dependency were higher at higher staffing level than at lower staffing level. However, the nurse staffing was less relevant to the patient needs in the general hospital and semi-hospital. CONCLUSION: To provide high-quality nursing care, accurate workload forecasting is required at the start, and then the standard nurse staffing level can established based on workload forecasting.

Mentoring Experience of Nursing Students Participating in a Health Promotion Program for Elementary School Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to explore the monitoring experience of nursing students and to suggest considerations when developing mentoring programs. METHODS: This qualitative study was conducted by online surveys and individual interviews with 7 nursing students who participated in the health promotion program as mentors. Data were analyzed using qualitative content analysis to identify motives for participating in mentoring and to explore their changes through mentoring. RESULTS: The results were as follows: Motives for participating were ‘inquisitiveness about children’, ‘interest in mentoring activities’ and ‘curiosity about research’. Recognition of mentor roles were ‘actively involved guide’, ‘exemplary role model’ and ‘empathetic emotional supporter’. Changes through mentoring experiences were revealed by ‘understanding the characteristics of children’, ‘improvement of interaction ability with children’, ‘understanding self and changes’ and ‘recognition of excellence in forest activities’. CONCLUSION: Nursing students had opportunities to learn the characteristics of general children and to understand themselves through natural interaction. Participation in mentoring has the potential to be a creative educational method of field learning as a form of service learning.

Policy Issues and New Direction for Comprehensive Nursing Service in the National Health Insurance / 간호행정학회지

PURPOSE: This study was done to identify issues surrounding comprehensive nursing care within the national health insurance, analyze results and problems within national health insurance and to suggest new policy directions for stability. METHODS: A literature search was performed using RISS, KISS, PUBMED databases. Eighteen studies were analyzed. RESULTS: For implementation of comprehensive nursing care, there was improvement in nursing and in facilities. By improvement of structure, this new system showed positive outcomes in term of patient satisfaction and indicators related to patient safety. However, issues related to overload, job stress and evaluation of the system remain. In order to establish this system, staffing levels for nurses and nurse aids need to be adjusted to appropriate levels that reflect requirements for nursing. In addition, range of work needs to be determined clearly. Lastly, regular and systematic evaluation is needed to provide safe quality services to patients and to prevent waste of financial resources. CONCLUSION: Comprehensive nursing care needs to be implemented in ways that patients can be provided with safe and high quality service. There is a need to resolve several issues to allow this new system to function.

The Effects of Group Motivational Interviewing Compliance Therapy on Drug Attitude, Medicine Application Self-efficacy and Medicine Application in Psychiatric Patients / 정신간호학회지

PURPOSE: This study aims to verify the effects of the Group Motivational Interviewing Compliance Therapy on drug attitude, medicine application self-efficacy and medicine application in psychiatric patients. METHODS: This was a quasi-experimental study with a non-equivalent control group pre-posttest design. Participants were 43 patients (22 in experimental group and 21 in control group) who were registered at neuro-psychiatric day care center in one university hospital, S city. The experimental group received the Group Motivational Interviewing Compliance Therapy for 6 sessions over 6 weeks. Data were collected between November, 2014 and September, 2016. Comparison of the pre-post results was performed by paired t-test and between-group effect was analyzed by ANCOVA with the SPSS/WIN 23.0 program. RESULTS: The experimental group had a significant increase in drug attitude compared to the control group. However, there was no significant difference in medicine application self-efficacy and medicine application between the two groups. CONCLUSION: The Group Motivational Interviewing Compliance Therapy is suggested as a promising program that helps psychiatric patients improve drug attitude. Further studies are needed to confirm the effects of the Group Motivational Interviewing Compliance Therapy.

Effects of a Relapse Prevention Program on Insight, Empowerment and Treatment Adherence in Patients with Schizophrenia

PURPOSE: The purpose of this study was to develop a relapse prevention program (RPP) and examine the effects of the RPP on insight, empowerment, and treatment adherence in patients with schizophrenia. METHODS: A non-equivalent control group pretest-posttest design was used. Participants were 54 inpatients who had a diagnosis of schizophrenia (experimental group: 26, control group: 28). The study was carried out from February 7, 2012 to February 6, 2013. Over a 10-day period prior to discharge each participant in the experimental group received three one-hour sessions of RPP a one-to-one patient-nurse interaction. Data were collected using Assess Unawareness of Mental Disorder (SUMD), Empowerment Scale, and Insight and Treatment Attitude Questionnaire (ITAQ) and analyzed using PASW 18.0 with chi-square test, independent t-test, Mann-Whitney U test, and ANCOVA. RESULTS: The experimental group had a significant increase in insight and treatment adherence compared to the control group. However, there was no significant difference in empowerment between the two groups. CONCLUSION: Findings indicate that the RPP for patients with schizophrenia was effective in improving insight and treatment adherence. A longitudinal study is needed to confirm the persistence of these effects of RPP in patients with schizophrenia.

The Effects of an Enneagram Program on Codependency, Anger, and Interpersonal Relationship in Wives of Alcoholics / 정신간호학회지

PURPOSE: The purpose of this study was to develop an Enneagram program (EP) and examine the effects on codependency, anger and interpersonal relationship in wives of alcoholics. METHODS: A nonequivalent control group pre-posttest design was used. Participants were 26 wives of alcoholics (experimental group: 12, control group: 14). From March 17 to August 18, 2014, six two-hour sessions of EP were provided to the experimental group over six weeks. Data were collected using the Codependency Recovery Potential Survey (CRPS), Korean State-Trait Anger Expression Inventory (STAXI-K) and Relationship Change Scale (RCS). and analyzed using PASW 18.0 with Fisher's exact test, t-test, and Mann-Whitney U test. RESULTS: The experimental group showed lower scores for codependency (Z=-2.17, p=.030) and anger (Z=-2.43, p=.015) than the control group. However, there was no significant difference in interpersonal relationship score between two groups. CONCLUSION: The EP for wives of alcoholics was effective in improving codependency and anger. A randomized clinical trial is needed to confirm the value of this EP.

Recognizing the Two Faces of Gambling: The Lived Experiences of Korean Women Gamblers

PURPOSE: The aim of this study was to explore the lived experiences of women problem gamblers, focusing on the meaning of gambling to them, how and why these women continue to gamble or stop gambling, and their needs and concerns. In order to effectively help women problem gamblers, practical in-depth knowledge is necessary to develop intervention programs for prevention, treatment, and recovery among women problem gamblers. METHODS: The hermeneutic phenomenology approach was used to guide in-depth interviews and team interpretation of data. Sixteen women gamblers who chose to live in the casino area were recruited through snowball sampling with help from a counseling center. Participants were individually interviewed from February to April 2013 and asked to tell their stories of gambling. Transcribed interviews provided data for interpretive analysis. RESULTS: In the study analysis one constitutive pattern was identified: moving beyond addiction by recognizing the two faces of gambling in their life. Four related themes emerged in the analysis-gambling as alluring; gambling as 'ugly'; living in contradictions; and moving beyond. CONCLUSION: Loneliness and isolation play a critical role in gambling experiences of women gamblers in Korea. In other words, they are motivated to gamble in order to escape from loneliness, to stop gambling for fear of being lonely as they get older, and to stay in the casnio area so as not to be alone. The need for acceptance is one fo the important factors that should be considered in developing intervention program for women.

Core Components of Interventions for Prevention of Alcoholism in Adults: An Integrative Review / 정신간호학회지

PURPOSE: The aim of this study was to describe the core components of interventions for prevention of alcoholism in adults and to present basic information for developing intervention programs for problem drinkers. METHODS: The key words, ‘alcoholism’ and ‘prevention’ were used to search peer-reviewed evidence through ten electronic databases. Six electronic databases in English and four in the Korean language were searched to identify studies done between January 2005 and December 2015. RESULTS: Examination of the fifteen articles revealed six kinds of interventions for prevention of alcoholism: Screening, Brief intervention, and Referral to Treatment (SBIRT); Brief Negotiate Interview (BNI); Motivational Enhancement Therapy (MET); Screening Interventions Program for Sensible Drinking (SIPS); Stepped Care (SC) and Alcohol Reduction Program. Interventions were mainly focused on assessment of drinking behavior, investigation of alcohol-related problems, building a motivation for change, exploring the expectancies of drinking alcohol, strengthening change of behavior and continuous monitoring using motivational interviewing, empathetic feedback and coaching strategy. CONCLUSION: Findings show that the core components of interventions for prevention of alcoholism in adults are client-tailored approaches, formation of motivation to change, and continuous monitoring of behavior change. Motivational intervention is necessary to develop practical strategies to promote motivation to change for problem drinkers.

Job Analysis and Curriculum Development for Gambling Addiction Prevention Counselors based on DACUM / 정신간호학회지

PURPOSE: Recently, gambling problem have increased in Korea and the prevalence rate is much higher than in western countries. Prevention of gambling addiction is very important at this point, but we have no accreditation or certification system for gambling addiction prevention counselors. The purpose of this study was to analyze the job and to develope a curriculum for Gambling Addiction Prevention Counselor (GAPC). METHODS: The definition of GAPC, job analysis and curriculum development were done based on developing a curriculum(DACUM) method. RESULTS: The duties performed by GAPC are categorized as planning & implementing, public education, outcome evaluation and professional development, which are classified into 8 tasks. The curriculum for training GAPC had 20 lectures covering 6 subjects: Introduction to gambling addiction, Prevention policy & institute, Methods of prevention education, Development of prevention programs, Prevention programs for target population, Empowerment for prevention counselors. Among the total 50 hours, 27 were for theory and 23 for practice. The mean of CVI (Content Validity Index) was 77 by multidisciplinary professional panels. CONCLUSION: The specific tasks for gambling addiction prevention activities can be identified and curriculum developed for utilization in training GAPCs.

Financial Projection of the Nursing Fee Differentiation Policy Improvement Proposal in the National Health Insurance: Using a Break-even Analysis Model for the Optimal Nursing Fee / 간호행정학회지

PURPOSE: This study was done to propose an improvement in the Nursing Fee Differentiation Policy to alleviate polarization of nursing staffing level among hospitals and to rectify the confusion of legally mandated standards between the Korean Medical Law and National Health Insurance Act. METHODS: The policy regulation was reconstructed related to nurse staffing standards and nurse-to-patients ratios. Data on nurse staffing grades were obtained from database of the Health Insurance Review & Assessment Service (HIRA) for the third quarter of 2010 for 44 tertiary hospitals, 274 general hospitals, and 1,262 hospitals. A break-even analysis was used to estimate financial burden of the revised policy improvement proposal. An industrial engineering method was used to calculate Nurse-to-Patients ratios per shift. RESULTS: Twelve tertiary hospitals were downgraded. 74 general hospitals and 102 hospitals were upgraded after application of the regulation. Finances for total hospitalization expenditures changed from -3.55% to +3.14%. CONCLUSION: The results indicate that the proposed policy would decrease polarization between tertiary hospitals and small hospitals, and would not put a major strain on the finances of the Korean National Health Insurance. Therefore, it is suggested that government stake-holders and many interest groups consider this policy proposal and build a consensus.

Psychometric Properties of Korean Minimal Insomnia Screening Scale

PURPOSE: The purposes of this study were to develop a Minimal Insomnia Screening Scale for Korean adults (KMISS) and to evaluate psychometric properties and discriminant ability of the developed scale. METHODS: Data from a cross-sectional survey of 959 Korean adults were analyzed to develop the summated insomnia scale, which was evaluated in terms of reliability, validity, and discriminant ability by receiver operating characteristics (ROC) curve analysis. RESULTS: Item-total correlations ranged between .71-.79 and Cronbach's alpha was .87. Adequate validity was also evident. ROC-curve analysis showed area under ROC was .87 (95% CI: .84-.90) and identified the optimal cut-off score as < or = 20 (sensitivity, .83; specificity, .75; positive/negative predictive values, .40/.95). Using this cut-off score, the prevalence of insomnia in the study sample was 26.3% and most frequent among women and the oldest group. CONCLUSION: Data supports the psychometric properties of KMISS as a possible insomnia screening instrument. KMISS also shows promise as a convenient ultra-short screening measure of insomnia for adults and epidemiological studies in community health care settings.

A Proposal to Improve Nursing Fee Differentiation Policy for General Hospitals Using Profitability-Analysis in the National Health Insurance

PURPOSE: The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. METHODS: A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. RESULTS: The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. CONCLUSION: Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.