Public Health Center Service Experiences and Needs among Immigrant Women in South Korea

Purpose@#To support implementation of comprehensive, person-centered healthcare, this study aimed to explore immigrant women's public health center (PHC) service experiences and needs while considering Photovoice's feasibility for this purpose. @*Methods@#This qualitative study included 15 marriage-based immigrant women.Participants were recruited from churches and multicultural family support centers using purposive and snowball sampling. Data were collected through four focus group interviews and were subjected to inductive content analysis. @*Results@#Five categories of experiences were identified: language barriers, hectic environment, affordable and practical primary healthcare, feeling ignored and discriminated against, and feeling frustrated. In addition, five categories of needs were identified: language assistance services, ease of access, healthcare across the lifespan, expansion of affordable healthcare, and being accepted as they are. This study provides preliminary evidence that the Photovoice approach can facilitate the interview process in a qualitative inquiry involving participants with limited ability to express their perspectives in the researchers' language. @*Conclusion@#Study findings highlight the need to implement institutional policy and procedural changes within PHCs and to provide culturally competent, personcentered care for South Korea's marriage-based immigrant women and other ethnic minority populations. The findings also provide evidence-based direction for PHC service planning.

Experience of Peer Support Work among People with Mental Illness in the Community:A Grounded Theory Approach

Purpose@#This study discovered a substantive theory of the experience and process of peer support work among people with mental illness. @*Methods@#The participants were members of community-based mental health facilities and had been working as peer supporters for more than six months. The data were collected through in-depth interviews with twelve participants and analyzed using Corbin and Strauss’s grounded theory approach. @*Results@#The core category was “becoming a healer going with patients in the journey of recovery,” and the core phenomenon was “identity confusion as a peer supporter.” The causal conditions were “starting peer support work without certainty” and “standing at the boundary between the therapist and patient.” The intervening conditions were “willingness to become a successful peer supporter,” “feeling a sense of homogeneity with the patient,” “accepting the mental illness,” and “support from people around.” The action and interaction strategies were “letting go of greed,” “being open about oneself,” “developing professional skills,” “maintaining wellness in the body and mind,” and “being with the patient.” The consequences were “becoming a useful person,” “changing attitude toward life,” “expansion of the sense of self-existence,” “recovering from mental illness,” and “discovering a role as peer supporter.” Finally, the substantive theory of “becoming a healer going with patients in the journey of recovery” was derived. @*Conclusion@#This study provides a holistic understanding of peer support work and the implications of interventions to help people with mental illness in a person-centered recovery process.

Job Retention Process among Working People with Mental Illness: A Grounded Theory Approach

Purpose@#The study was conducted to explore the experiences of job retention among working people with mental illness. @*Methods@#The participants were members with mental illness at the S Community Mental Health Center in Gyeonggi Province and who had been working for more than six months. The data were collected through in-depth interviews with 11 participants between June 27 and August 20, 2018. The data were analyzed through Corbin and Strauss’s grounded theory method. @*Results@#The core category was struggling to take root in the community as a productive member. The core phenomenon was the desire to be a productive person, and the causal condition was the willingness to change for a purposeful life. The action and interaction strategies included maintaining regular living patterns, maintaining medication, developing one’s tips for self-management, and self-approval. The intervening conditions were difficulties in forming social relationships, presence of symptoms, social resources, and acceptance of one’s mental illness. The consequences were restoration of family relationships, healthy pleasure through work, social inclusion, development of self-worth, and transition to an independent person. @*Conclusion@#Working people with mental illness are struggling to take root in the community as a productive member. This study suggests that a holistic understanding of the job retention experience among people with mental illness is required. The findings will provide the basis for developing interventions that can improve job retention among working people with mental illness.

Job Retention Process among Working People with Mental Illness: A Grounded Theory Approach

Purpose@#The study was conducted to explore the experiences of job retention among working people with mental illness. @*Methods@#The participants were members with mental illness at the S Community Mental Health Center in Gyeonggi Province and who had been working for more than six months. The data were collected through in-depth interviews with 11 participants between June 27 and August 20, 2018. The data were analyzed through Corbin and Strauss’s grounded theory method. @*Results@#The core category was struggling to take root in the community as a productive member. The core phenomenon was the desire to be a productive person, and the causal condition was the willingness to change for a purposeful life. The action and interaction strategies included maintaining regular living patterns, maintaining medication, developing one’s tips for self-management, and self-approval. The intervening conditions were difficulties in forming social relationships, presence of symptoms, social resources, and acceptance of one’s mental illness. The consequences were restoration of family relationships, healthy pleasure through work, social inclusion, development of self-worth, and transition to an independent person. @*Conclusion@#Working people with mental illness are struggling to take root in the community as a productive member. This study suggests that a holistic understanding of the job retention experience among people with mental illness is required. The findings will provide the basis for developing interventions that can improve job retention among working people with mental illness.

Agreement on Core Components of an E-Learning Cultural Competence Program for Public Health Workers in South Korea: A Delphi Study

PURPOSE: This study aimed to seek agreement on the core components of an e-learning cultural competence program for Korean public health workers (PHWs) while prioritizing educational content areas. METHODS: A two-round Delphi study was performed with 16 Korean experts from five disciplines. Data were collected between August 30 and November 24, 2017. A questionnaire was developed from literature reviews and previous focus group interviews concerning PHWs. The panel members were asked to rate the importance and urgency of educational content areas and the effectiveness of teaching–learning methods and gave opinions on their appropriate frequency, duration, and target audience. Responses were analyzed using descriptive statistics. A median of 4.0 or greater or a rate of agreement of 75% or greater was considered a “consensus” for the purposes of this study. RESULTS: All consenting participants responded to two-round surveys. Participants reached consensus on thirty-one educational content areas. Of these, the highest priorities were “necessity of cultural competence of PHWs,” “health characteristics according to race and ethnicity,” and “establishing trusting relationships with migrants.” The most effective teaching–learning method was case-based learning, with seven to eight sessions of training and duration of fewer than 30 minutes per session. CONCLUSION: Multidisciplinary experts proposed 12 prioritized educational content areas and effective teaching–learning methods as well as their frequency, duration, and target audiences, reflecting Korea-specific multicultural phenomena and the nature of the work of PHWs. These findings can contribute to preparing PHWs to provide culturally competent services to migrants in their communities.

Influence of Sexual Behavior and Emotional State on Suicidal Ideation among Female Adolescents with Sexual Intercourse Experience / 정신간호학회지

PURPOSE: This study investigated the sexual behaviors, emotional state, and suicide-related characteristics of female adolescents with sexual experience. METHODS: This is a secondary data analysis study using the data of the 11th (2015) Youth Health Behavior Online Survey. The subjects were 889 female students who had sexual intercourse experience in middle and high schools in the Republic of Korea. For data analysis, descriptive statistics, χ² test, and hierarchical logistic regression were used. RESULTS: Among the subjects, 22.2% reported having experienced homosexual or bisexual relations. The sexual debut time of 31.9% of the subjects was in elementary school or earlier, while 8.1% and 10.7% experienced pregnancy and sexually transmitted diseases, respectively. They reported negative emotional states (high stress 51.7%, unhappiness 17.8%, depressive mood 9.8%) and substantial suicide experiences (suicidal ideation 33.6%, suicidal plan 16.6%, suicidal attempt 13.2%). Through hierarchical logistic regression (Cox & Snell R²=.31), the influencing factors for suicide ideation identified included being subjected to sexual relations, experience of pregnancy, perceived stress and happiness, and depressive mood. CONCLUSION: It is important to prevent negative mental health consequences among female students with early sexual experience. Sexual education should strengthen their physical and mental safety through psychological care strategies.

Development and Effects of a Children's Sex Education Program for the Parents of Lower Elementary Grade Students

PURPOSE: This study was done to develop a children's sex education program for the parents of lower elementary grade students and to evaluate its effects on sexual knowledge, gender role attitude, parent efficacy for child's sex education, and marital consistency. METHODS: A quasi-experimental with a non-equivalent control group pretest-posttest design was used. The participants were 29 couples (58 parents, experimental group=28, control group=30) from G city. The 5-week (5-session) program was developed based on ‘A theory of protection: parents as sex educators’ and used the case-based small group learning method. Data were collected during July and August 2015. The characteristics of the program developed in the present study were a theoretical-based, client-centered, multi-method. RESULTS: After the intervention, the experimental group showed a significant improvement in sexual knowledge, gender role attitudes, parent efficacy for child's sex education, and marital consistency, compared to the control group. The effect sizes of the program were .64 (knowledge), .65 (gender role attitudes), and .68 (parent efficacy). CONCLUSION: The results of this study provided implications for the parents as effective sex educator and the role expansion of school health nurses.

Factors Influencing Pain Management Practice in Pediatric Nurses

PURPOSE: The purposes of this study were to explore knowledge, barriers, and self-efficacy in relation to pain management practice, and to identify factors influencing pain management practice in pediatric nurses. METHODS: A descriptive correlational study was conducted. The participants were 237 pediatric nurses from a metropolitan city. Data were analyzed using t-test or analysis of variance and Pearson correlation and multiple regression analyses. RESULTS: The mean percentage of correct answers on the children's pain management knowledge scale was 58.8%. Child and parent related factors were the main barriers for pain management. Self-efficacy to assess children's pain across developmental stages was particularly low. Pain management practices for assessing pain and non-pharmacological interventions were relatively low. Factors significantly affecting children's pain management practice were current conditions of work department and self-efficacy in pain management, and these factors accounted for 37.5% of the variance in pain management practice. CONCLUSION: The results suggest that an integrative education program needs to be developed to improve self-efficacy in children's pain management practice. Moreover, good communication, building cooperative relationships with children and parents, and a more active role by pediatric nurses are required to carry out more effective pain management.

Military Stress, Stress Coping, and Mental Health Status among Soldiers who Need Intensive Care / 정신간호학회지

PURPOSE: The purpose of this study was to explore the level of military stress, stress coping, and mental health status and to identify the relationships among these variables in soldiers who need intensive care. METHODS: The participants were 113 perceived maladjusted soldiers who participated in Green-camp from one army base in Gyeong-gi Province. Data were collected using self-report questionnaires and analyzed with the SPSS-WIN 20.0 program. The instruments were the Military Stress Inventory, Ways of Coping Checklist, and Symptoms Checklist- 90-Revision (SCL-90-R). RESULTS: The level of stress was 3.6+/-0.70, overall stress coping was 1.1+/-0.41, and mental health status was 1.5+/-0.93. There were significant differences in stress, stress coping, and mental health status according religion, economic status of family, prospects for the future, persons with whom one could talk about troubles. The group with higher emotion focused coping had significantly higher scores on mental health status. There were significant positive correlations among major variables. Military stress was a significant predictor of mental health status (Adjusted R2 21.0%). CONCLUSION: Based on the findings of this study, stress management and intervention programs focusing on depression are highly recommended to manage maladaptive problems in soldiers.

Insight, Self-esteem, and Coping Skills among Patients with Alcohol Addiction / 정신간호학회지

PURPOSE: This study was conducted to investigate the related factors of insight, self-esteem, and coping skills and the relationships among them in patients with alcohol addiction. METHODS: The participants enrolled in this study were 106 patients from two alcohol treatment hospitals in Gyeonggi Province. Data were collected from May, 12 to 20, 2010 using self-report questionnaires. The instruments were the Hanil Alcohol Insight Scale, Rosenberg Self-esteem Scale, and the Ways of Coping Checklist. Data were analyzed using the SPSS-Win 12.0 program. RESULTS: Among the participants, 24.5% had poor insight, 45.3% fair insight, and 30.2% good insight. Insights of participants who had experienced withdrawal symptoms (t=-3.79, p<.001) and of those not living with family (t=-2.07, p=.041) were higher than those who had not experienced the symptoms and who were not living with family. Self-esteem of participants living with family (F=3.60, p<.001) and of those with better academic backgrounds (F=3.39, p=.021) were higher than those of the other groups. Also, self-esteem showed a positive relation with active coping (r=.34, p<.001). CONCLUSION: The results of the present study suggest that mental health practitioners need to focus on insight and self-esteem enhancement, coping skill development when treating patients with alcohol addiction.

Factors Affecting on Suicidal Ideation in Maladjusted Soldiers / 정신간호학회지

PURPOSE: The purpose of this study was to explore levels of depression, anxiety, suicidal ideation in maladjusted Korean soldiers and identify factors that influence suicidal ideation. METHODS: Instruments were the CES-D (Center for Epidemiologic Studies-Depression Scale), STAI (State Trait Anxiety Inventory), and SSI (Scale for Suicidal Ideation). The participants were 94 maladjusted soldiers from one army base in Gyeong-gi Province. Data were collected using self-report questionnaires, and analyzed with the SPSS/WIN 20.0 program. RESULTS: Mean scores were; for CES-D, 42.1+/-13.10, for STAI-I (state-anxiety) and STAI-II (trait-anxiety), 60.3+/-15.05 and 61.9+/-12.14 respectfully, and for SSI, 23.1+/-9.52. There were significant differences in suicidal ideation according the general characteristics of education, prospects for the future, and having someone to talk about troubles. Major variables showing significant correlations were prospects for the future, depression, trait anxiety, state anxiety, and suicidal ideation. Depression and prospect for future were significant predictors of suicidal ideation (Adjusted R2 65%). CONCLUSION: Based on the findings of this study, it is important to assess significant mental health problems at the clinical level and provide suicidal ideation prevention in maladjusted soldiers. Active input from experts such as nursing officers and intervention programs that focus on depression are needed.

Parents' Drinking Behavior and Factors Related to Mental Health of their University Student Offspring / 정신간호학회지

PURPOSE: This study was conducted to investigate factors related to mental health of university student offspring according to their parents' drinking behavior. METHODS: A cross-sectional design was used in this study. A convenience sample of university students were recruited from three universities in Seoul and Gyeonggi Province, Korea. Data were collected using self-report questionnaires with 547 university students. The scales used for this study were the Korean version of the Children of Alcoholics Screening Test (CAST-K), Symptom Checklist-90-Revision (SCL-90-R), Rosenberg's Self-esteem Scale, and the Way of Coping Checklist. RESULTS: Participants were classified into three groups; nondrinking-parents group (53.5%), social drinking-parents group (21.8%), and problem drinking-parents group (24.7%). Participants whose parents were problem drinkers had significantly higher scores on all the subcategories of SCL-90-R compared to those of other groups. In the participants group whose parents were problem drinkers, mental health problem had a significant positive correlation to passive coping methods and a negative correlation to self-esteem. There was a significant negative relationship between self-esteem and positive coping methods. CONCLUSION: The results of this study indicate the mental health of university students may be negatively affected by their parents' drinking behaviors. Special attention and early interventions are needed for university students whose parents have drinking problems.