The Influence of Dispositional Optimism and Food-related Lifestyle on Health Promoting Behavior in Middle-Aged Early Onset Stroke Patients / 재활간호학회지

Purpose@#This study aimed to investigate the influence of the propensity for dispositional optimism and food-related lifestyle on health promotion behaviors in middle-aged early onset stroke patients. @*Methods@#With a descriptive study design, this study covered middle-aged patients aged 40 to 65 years old who were admitted to P city general hospital after the onset of hemorrhagic or ischemic stroke. Date were collected with a questionnaire including dispositional optimism, food-related lifestyle, and health promoting behaviors. Using SPSS/MIN 23.0 program, data were analyzed with descriptive statistics, frequency, t-test, one-way ANOVA, Pearson's correlation coefficients and multiple regression. @*Results@#The dispositional optimism had a significant correlation with health promotion behavior. Positive awareness and coping with life (β=.28, p<.001) showed the greatest influence on health promotion behavior. In food-related lifestyle, health type (β=.26, p<.001), foodie type (β=.20, p=.002), and stable type (β=.14, p=.027) and occupation (β=-.14, p=.037) influenced on health promotion behavior. The explanatory power value of regression model was 46.5% and it was statistically significant (F=16.73, p<.001). @*Conclusion@#An early program may help health promotion behavior by enhancing the dispositional optimism and food-related lifestyle in middle-aged early onset stroke patients.

The Effects of Brain-wave Biofeedback Training Nursing Intervention upon Self-regulation of Emotional Behavior Problem in Adolescents at School

Purpose@#The purpose of this study was to identify the effects of brain-wave biofeedback training nursing intervention (NFT) upon enhancing self-regulation response in adolescence with emotional behavior problems in school. @*Methods@#A quasi-experimental design was conducted. The participants were assigned to the experimental group (n=24) or the control group (n=24). The experimental group additionally received NFT. The NFT was conducted 10 sessions for 30 minutes per session with the band reward and inhibit training which matched their Quantitative Electroencephalography (QEEG), participant’s demand and chief complaint. Data were collected with QEEG and heart rate variability (HRV) in physiological response, self-efficacy in cognitive response, depression in emotional response, impulsivity and delay gratification in behavioral response of self-regulation. @*Results@#The general characteristics and the pre-test scores of two groups were all homogeneous. The experimental group was reported to be significantly higher in QEEG homeostasis, HRV homeostasis, self-efficacy, and delay gratification than the control group. The experimental group was reported to be significantly lower in depression and impulsivity. @*Conclusion@#The results indicate that NFT using brain cognitive neuroscience approach is effective in enhancing self-regulation response. Therefore, this nursing intervention using brain cognitive neuroscience approach can be applied as an effective self-regulation nursing intervention for adolescents with emotional behavior problems in communities for adaptive life.

Influence of Posttraumatic Stress Symptoms and Conflict Management Styles on Nursing Performance of Intensive Care Unit / 중환자간호학회지

PURPOSE: This study examined the factors influencing posttraumatic and conflict management styles for nursing performance in intensive care units (ICUs).METHOD: In this study, 250 nurses from eight general hospitals in three cities participated. Structured self-report questionnaires were used to collect data on posttraumatic, conflict management styles, and nursing performance. Finally, the data were analyzed by SAS 9.3 program.RESULTS: The mean of total sum scores was 31.29, and the high risk of posttraumatic symptoms was 61.2%. It was noted that nursing performance is significantly correlated with collaboration, compromise, accommodation styles, and intrusion. Collaboration styles (β=0.39, p < .001) and hyperarousal (β=−0.22, p=.050), ICU experience below 1 year (β=−0.21, p=.027) and that of 5–10 years (β=−0.19, p=.049), and compromise style (β=0.16, p=.049) were found to be the factors influencing nursing performance with 35.9% explanatory power value of regression model.CONCLUSION: The results of the study reveal that conflict management styles, hyperarousal, and ICU experience are factors predicting the successful performance of ICUs. These findings emphasize the need of developing interventions to reduce stress symptoms and conflicts in ICUs.

The Effects of Neurofeedback Training on Physical, Psychoemotional Stress Response and Self-Regulation for Late Adolescence: A Non-Randomized Trial

PURPOSE: The aim of this study was to analyze the effects of neurofeedback training for reducing stress and enhancing self-regulation in late adolescence to identify the possibility of use for nursing intervention. METHODS: A nonequivalent control group pre-post quasi-experimental design was used. Participants were 78 late adolescents assigned to the experimental group (n=39) that received the neurofeedback training and the control group (n=39). Data were collected on heart rate variability (HRV) and skin conductance level (SCL) to assess stress-biomarker response. The questionnaire contained 164 items from: Positive and Negative Affect Schedule (PANAS), Symptom Checklist-90-Revised (SCL-90-R) and Self-regulatory Ability scale. The neurofeedback training was based on the general adaptation syndrome and body-mind medicine. The intervention was conducted in a total of 10 sessions for 30 minutes per session with high-beta, theta and sensory motor rhythm training on scalp at central zero. RESULTS: There were significant difference in standard deviation of normal to normal interval (p=.036) in HRV and SCL (p=.029) of stress-biomarker response between the two groups. Negative affect (p=.036) in PANAS and obsessive compulsive (p=.023) and depression (p < .001) in SCL-90-R were statistically significant. Self-regulation mode (p=.004) in self-regulation ability scale showed a significant difference between the two groups. CONCLUSION: The results indicated that the neurofeedback training is effective in stress-biomarkers, psychoemotional stress response and self-regulation. Therefore, neurofeedback training using neuroscientific approach based on brain-mind-body model can be used as an effective nursing intervention for late adolescents in clinics and communities for effective stress responses.

Development and Effects of an Instructional Coaching Program Regarding Children with Attention Deficit Hyperactivity Disorder for Elementary School Teachers

PURPOSE: The aim of this study was to identify the effects of a newly developed instructional coaching program regarding Attention Deficit Hyperactivity Disorder (ADHD) for teachers. METHODS: Seventy teachers participated in this study involving a nonequivalent control group and a pretest-posttest design. The instructional coaching program consisted of eight 60-minute sessions. The program was developed through a theoretical development program involving six steps. To evaluate the effects of the program, data were collected through self-report questionnaires including the Knowledge Scale of Attention Deficit Disorder, Attitude Scale of Primary School Teachers Experiencing Students with ADHD, Practice Scale of Educational Intervention Activity, and the Korean ADHD Rating Scale. Data were analyzed with an independent t test, a chi-square test, and an ANCOVA using SPSS WIN version 20. RESULTS: The intervention program consisted of 3 sectors, 8 subjects, and 24 content items. The experimental group showed a significant improvement in attitudes toward ADHD (F=22.83, p<.001). In addition, teacher's knowledge regarding ADHD (F=7.16, p=.010) and the implementation of instructional interventions (F=4.29, p=.043) improved. Further, teachers reported a reduction in children's ADHD-related behavior (F=4.34, p=.041). Results showed that the coaching program made a positive contribution to teaching skills and understanding of school-age children with ADHD. CONCLUSION: The instructional coaching program was well structured and significantly improved not only teachers'attitudes, knowledge, and teaching skills but also the behavior of children with ADHD in class. Therefore, the program is recommended as a means of facilitating teaching and managing children with ADHD in class.

Effects of Cognitive Behavioral Therapy on Attention Deficit Hyperactivity Disorder among School-aged Children in Korea: A Meta-Analysis

PURPOSE: This study was a meta-analysis designed to identify effects of Cognitive Behavioral Therapy (CBT) interventions in alleviating main symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among school-aged children in Korea. METHODS: Examination of several databases including Research Information Sharing Service, Korean Studies Information Service System, Data Base Periodical Information Academic and hand-searched article references, resulted in identification of 1,298 studies done between 2000 and 2013 of which 21 met the inclusion criteria. Comprehensive Meta-Analysis version 2.0 was used to analyze effect sizes, explore possible causes of heterogeneity, and check publication bias with a funnel plot and its trim-and-fill analysis. RESULTS: Overall effect size of CBT intervention was large (g=1.08) along with each outcome of self-control (g=1.26), lack of attention (g=1.02), social skills (g=0.92), and hyperactivity (g=0.92). For heterogeneity, moderator analysis was performed, but no significant differences were found between the RCT (Randomized Controlled Trials) group and the NRCT (Non RCT) group. Also, meta-regression was performed using sample size, number of sessions, and length of session as predictors, but no statistically significant moderators were found. Finally, a funnel plot along with trim-and-fill analysis was produced to check for publication bias, but no significant bias was detected. CONCLUSION: Based on these findings, there is clear evidence that CBT intervention has significant positive effects on the main symptoms of school-aged children suffering ADHD. Further research is needed to target diverse age groups with ADHD along with more RCT studies to improve the effectiveness of the CBT intervention.

Predictors of Hospitalization for Alcohol Use Disorder in Korean Men

PURPOSE: This study was done to identify the patterns and significant predictors influencing hospitalization of Korean men for alcohol use disorder. METHODS: A descriptive study design was utilized. Data were collected using self-report questionnaires from 143 inpatients who met the DSM-5 alcohol use disorder criteria and were receiving treatment and 157 social drinkers living in the community. The questionnaires included Alcohol Use Disorders Identification Test (AUDIT), Alcohol Problems, Alcohol Expectancy Questionnaire (AEQ), Life Position, and The Korean version of the Children of Alcoholics Screening Test (CAST-K). Data were analyzed using descriptive statistics, t-test, chi2-test, F-test, Pearson correlation coefficients, and logistic regression with forward stepwise. RESULTS: AUDIT had significant correlations with alcohol problems, alcohol expectancy, and parents' alcoholism. In logistic regression, factors significantly affecting hospitalization were divorced (OR=4.18, 95% CI: 1.28-13.71), graduation from elementary school (OR=28.50, 95% CI: 8.07-100.69), middle school (OR=6.66, 95% CI: 2.21-20.09), high school (OR=6.31, 95% CI: 2.59-15.36), drinking alone (OR=9.07, 95% CI: 1.78-46.17), family history of alcoholism (OR=2.41, 95% CI: 1.11-5.25), interpersonal relationship problems (OR=1.28, 95% CI:1.17-1.41), and sexual enhancement of alcohol expectancy (OR=0.83, 95% CI: 0.72-0.94), which accounted for 53% of the variance. CONCLUSION: Results suggest that interpersonal relationship programs and customized cognitive programs for social drinkers in the community are needed to decreased alcohol related hospitalization in Korean men.

Effects of teachers' internal-external control and leadership type on educational intervention for School-aged Attention Deficit Hyperactivity Disorder / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify the predictors influencing on educational intervention for Attention Deficit Hyperactivity Disorder (ADHD) after analyzing the relationship among teachers' internal-external locus of control, leadership type and educational intervention for ADHD. METHODS: A cross sectional study design was conducted with 255 teachers in three schools located in D, K and Y city. The data were analyzed by t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression using SPSS 20.0. RESULTS: Internal locus of control showed significantly positive correlations with educational intervention for ADHD. Efficient leadership type, harmony-oriented leadership type showed significant differences in inefficient leadership type on educational intervention for ADHD. Significant factors of the educational intervention were efficient leadership type, harmony-oriented leadership type, task-oriented leadership type and internal locus of control that were explained by 20.0% (F=12.5, p<.001) of educational intervention for ADHD. CONCLUSION: Based on the findings of this study, it is necessary to have teacher's efficient leadership type focused on ADHD symptoms. Teachers need to enhance their positive domain of internal-external locus of control towards students with ADHD to increase the effectiveness of their educational interventions for ADHD.

Impact of Relational Self Psychology and Community Attitudes toward Mentally Ill Persons on Adjustment during Army Life / 정신간호학회지

PURPOSE: The purpose of this study was to identify predictors influencing adjustment during army life after analyzing the relationship among relational self, community attitudes toward the mentally ill (CAMI), and adjustment during army life in Korea. METHODS: A cross sectional study design was conducted with 230 soldiers from two military units located in Y and B cities. Data were analyzed using t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression with SPSS/WIN 18.0. RESULTS: Empathy-care showed significantly positive correlations with adjustment during army life. Avoidance of relationships showed significantly negative correlations with adjustment. Negative concepts in CAMI, such as authoritarianism and social restrictiveness, became were getting more negative. Positive concepts in CAMI, such as benevolence and community mental health ideology, were lacking. Significant factors were empathy-care, authoritarianism, overdependence on relations, and social restrictiveness which explained 30.1% (F=8.55, p<.001) of adjustment during army life. CONCLUSION: To improve military adjustment for soldiers, it is necessary to reduce misunderstandings of people with mentally illness as well as to make efforts towards systematic interpersonal relationship interventions for positive evaluation of self and others to enhance the mental health of soldiers.

Effects of Teachers' Knowledge and Empathy on Educational Intervention for ADHD: Focused on the Mediating Effect of Empathy / 정신간호학회지

PURPOSE: The purpose of this study was to identify how empathy mediates the relationship between teachers' knowledge of Attention Deficit Hyperactivity Disorder (ADHD) and educational interventions. METHODS: A survey for structural equation modeling was conducted with 334 teachers from 61 schools in D and Y cities in Korea. Data were collected from April 2012 to July 2012 through self-report questionnaires using standardized instruments. The data were analyzed using SPSS Win 20 and AMOS 20, and Sobel tests were conducted to determine the significance of mediation and Bootstrapping tests to construct confidence intervals. RESULTS: Teachers' empathy provided complete mediation between teachers' knowledge and educational interventions in classrooms. Results showed that empathy contributes positively to educational interventions in ADHD by increasing understanding of children with ADHD and the situation. CONCLUSION: Based on the findings of this study, teachers need to enhance their empathy towards students with ADHD to increase the effectiveness of their educational interventions for ADHD. These results suggest the importance of focusing on increasing teachers' empathy in the classroom in order to provider better education interventions for children with ADHD.

Interpersonal Relationships and Suicide Probability among Korean Adolescents / 정신간호학회지

PURPOSE: This study was done to identify predictive factors influencing suicide probability in Korean adolescents. METHODS: Participants in the study were 575 adolescents from 17 schools with quota sampling by each region in D city. The data were collected from October to November, 2010 using self-report questionnaires about interpersonal relationships and suicide probability (SPS) and analyzed using descriptive statistics, one-way ANOVA with Scheffe of Post Hoc, Pearson's correlation coefficients, and stepwise multiple regression analysis with SPSS/WIN 16.0 program. RESULTS: Suicide probability showed a significantly negative correlation for interpersonal relations with parents, friends and teachers. Interpersonal relationship with parents (p<.001) explained 32% of suicide probability, compared to relationships with peers or teachers, which together was accounted for 46% of the variance. CONCLUSION: The findings suggest that interpersonal relationships with parents should be considered when adolescents suffer from suicidal thinking. Various effective strategies to improve relationships with parents are important to reduce suicide in adolescents.

Effects of Literary Therapy Intervention on Ego Resilience and Maladaptive Behavior in Children of Broken Homes / 정신간호학회지

PURPOSE: This study was done to examine the effects of a literary therapy intervention on ego-resilience and maladaptive behavior among children of broken homes. METHODS: The intervention consisted of 16 sessions designed to achieve a positive self-concept and was constructed as an interaction between participant and certain literature including poetry, narratives, dramas, art therapy, and willingness to share it with others. The study was carried out from May 2 to July 25, 2006. The participants were 36 children resided in a vulnerable region in G city. The collected data for Ego-resilience, Korean-Children Behavior Checklist (K-CBCL), Korean-Youth Self-Report (K-YSR) were respectively analyzed using descriptive statistics, t-test, repeated measures ANOVA with Post Hoc, and ANCOVA with the SPSS/WIN version 12.0 program. RESULTS: After the intervention, there was a significant difference between the experimental and the control group for Ego-resilience, K-CBCL, and K-YSR. There were significant differences according to time process in ego-resilience and K-YSR. CONCLUSION: The results indicate that literary therapy is an effective nursing intervention for enhancing ego-resilience and reducing maladaptive behavior in children of broken homes.

Meta Analysis of Variables Related to Attention Deficit Hyperactivity Disorder in School-Age Children

PURPOSE: The purpose of this study was to use meta-analysis to examine recent domestic articles related to attention deficit hyperactivity disorder (ADHD) in school-age children. METHODS: After reviewing 213 articles published between 1990 and 2009 from and cited in RISS, KISS, and DBpia, the researchers identified 24 studies with 440 research variables that had appropriate data for methodological study. SPSS 17.0 program was used. The outcome variables were divided into five types: Inattention, hyperactive impulsive, intrinsic, extrinsic, and academic ability variables. RESULTS: Effects size of overall core symptoms was 0.47 which is moderate level in terms of Cohen criteria and effects size of overall negative variables related ADHD was 0.27 which is small level. The most dominant variable related to ADHD was obtained from hyperactive-impulsive (0.70). Also academic ability (0.45), inattention (0.37), and intrinsic variables (0.29) had a small effect whereas extrinsic variables (0.13) had little effect on descriptive ADHD study. CONCLUSION: The results reveal that ADHD core symptoms have moderate effect size and peripheral negative variables related ADHD have small effect size. To improve the reliability of the meta-analysis results by minimizing publication bias, more intervention studies using appropriate study designs should be done.

Relationship of Mothers' Recognition of Attention Deficit Hyperactivity Disorder (ADHD), Parenting Stress and Family Support in Children Diagnosed with ADHD

PURPOSE: The purpose of this study was to examine the relationship of mothers' recognition of Attention deficit hyperactivity disorder (ADHD), parenting stress and family support in mothers of children diagnosed with ADHD. METHODS: The data were collected from December 24, 2009 to July 23, 2010. The participants were 141 mothers of children diagnosed with ADHD and who lived in D city. Descriptive statistics, t-test, ANOVA, Pearson correlation coefficients with SPSS 17.0 were used to analyze the data. To determine the most effective variable (mothers' recognition, parenting stress and family support) to predict parental stress, data were analyzed using canonical correlation with SAS 9.1 TS. RESULTS: Canonical correlation analysis revealed that professional and teachers' roles of the 3 sub-domains of mothers' recognition were the most outstanding variables in predicting parenting stress. Parental distress/parent-child dysfunctional interaction of parenting stress was the most outstanding variable in predicting both mothers' recognition and family support. Spouse cooperation in family support was the most outstanding variable in predicting parenting stress. CONCLUSION: The results suggest that strengthening parents' recognition of ADHD and supporting interventions are important for reducing parenting stress. Professional and teachers' roles, parental distress/parent-child dysfunctional interaction and spouse cooperation should be included in the contents of structured programs.

The Meta Analysis of Trends and the Effects of Non-pharmacological Intervention for School Aged ADHD Children / 정신간호학회지

PURPOSE: The purpose of this study was to investigate the trends and the effects of intervention related to ADHD children by meta-analysis. METHODS: After review of 200 articles released from 1990 to 2009 from RISS, KISS, and DBpia, 26 studies was conducted to determine methodological data, 362 research variables, using SPSS/WIN 17.0 program. RESULTS: Effects size of overall intervention is 1.32 which is high level in terms of Cohen criteria. The greatest effect of intervention is obtained from cognitive behavior control training (1.79). Also art therapy (1.29) and social skill training (0.97) are highly effective whereas parents education (0.66) is only moderate effective. Duration of each session and numbers of session are influential in cognitive behavior control and social skills training. CONCLUSION: The results reveal that ADHD intervention has large effect sizes for core features and peripheral features of target outcome variables. For improving the reliability of the meta-analysis results by minimizing publication bias, more intervention studies using appropriated study design should be done.

Orphan nuclear receptor small heterodimer partner inhibits angiotensin II-stimulated PAI-1 expression in vascular smooth muscle cells

Angiotensin II is a major effector molecule in the development of cardiovascular disease. In vascular smooth muscle cells (VSMCs), angiotensin II promotes cellular proliferation and extracellular matrix accumulation through the upregulation of plasminogen activator inhibitor-1 (PAI-1) expression. Previously, we demonstrated that small heterodimer partner (SHP) represses PAI-1 expression in the liver through the inhibition of TGF-beta signaling pathways. Here, we investigated whether SHP inhibited angiotensin II-stimulated PAI-1 expression in VSMCs. Adenovirus-mediated overexpression of SHP (Ad-SHP) in VSMCs inhibited angiotensin II- and TGF-beta-stimulated PAI-1 expression. Ad-SHP also inhibited angiotensin II-, TGF-beta- and Smad3-stimulated PAI-1 promoter activity, and angiotensin II-stimulated AP-1 activity. The level of PAI-1 expression was significantly higher in VSMCs of SHP-/- mice than wild type mice. Moreover, loss of SHP increased PAI-1 mRNA expression after angiotensin II treatment. These results suggest that SHP inhibits PAI-1 expression in VSMCs through the suppression of TGF-beta/Smad3 and AP-1 activity. Thus, agents that target the induction of SHP expression in VSMCs might help prevent the development and progression of atherosclerosis.

The Effects of Aromatherapy on Depression, Sleep, Mood, and Smell in Stroke Patients and Their Caregivers

PURPOSE: The purpose of this study was to examine the effects of aroma-inhalation on depression, sleep, mood, and smell in stroke patients and their caregivers. METHOD: This study employed one group pretest-posttest repeated design. Data were collected at three time points: baseline(pre-test), 10 days and 20 days after the intervention(post-test1 and post-test2, respectively). The sample included a total of 23 subjects. Data were analyzed by SPSS 12.0 program using repeated measure ANOVA. RESULTS: Depression was not statistically significant difference among pre-test, post-test1 and post-test2. Sleep was improved after intervention: 37.61+/-7.41(pre-test), 41.22+/-8.26 (post-test1), 44.33+/-7.67(post-test2)(F=8.182, p=.001). Mood was significantly improved after intervention: 16.95+/-4.89(pre-test), 14.89+/-6.31 (post-test1), 12.11+/-5.04(post-test2). Smell including smell perception, discomfort due to smell and relation between age and smell was significantly improved after intervention: 2.63+/-1.20(pre-test). 2.00+/-1.16(post-test1), 1.63+/-.96(post-test2)(F=6.176, p=.006) in smell perception, 2.50+/-1.10 (pre-test). 1.81+/-.91(post-test1), 1.19+/-.40(post-test2) (F=12.26, p=.000) in discomfort due to smell and 3.53+/-1.18(pre-test). 2.59+/-1.46(post-test1), 2.53+/-1.33(post-test2)(F=4.148, p=.025) in relation between age and smell. CONCLUSION: The results suggest that aroma-inhalation may have an effect on sleep, mood and smell and can be effective nursing intervention to increase the relaxation in stroke patients and their caregivers.