Influence of the subfactors of self-compassion on burnout among hospital nurses: A cross-sectional study in South Korea.

AIM: This study aimed to identify the effects of the subfactors of self-compassion on hospital nurse burnout and provide basic knowledge for an intervention programme to prevent nurse burnout. BACKGROUND: Burnout in nurses has been reported to influence their own and patients' mental health and safety. Enhancing self-compassion can help to prevent burnout. METHODS: This study involved descriptive research using a cross-sectional design. Data were collected at H University Hospital in Korea, from January to March 2020. Of the 213 questionnaires collected, 208 were included in data analysis. RESULTS: Burnout was higher when nurses were younger, unmarried, in poor health, general nurses, dissatisfied with their jobs, planning to leave their jobs or receiving low social support from peers. There was a negative correlation between burnout and the self-compassion subscales. Multiple regression analysis showed that isolation and mindfulness among self-compassion, were significantly related to burnout. CONCLUSIONS: Since individual variables and self-compassion are major elements impacting nurse burnout, it is important for nursing organizations to investigate nurses' individual variables, including subfactors of self-compassion, to help them prevent burnout. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse burnout might be prevented by increasing self-compassion. Hospital and nurse managers may employ individualized strategies to enhance nurses' self-compassion.

Effects of Mindfulness-Based Stress Reduction (MBSR) on Stress, Heart Rate Variability, Affect, and Wellbeing among People with Schizophrenia.

Mindfulness-based stress reduction programs have been found to be effective in reducing the stress response and improving the psychological wellbeing of various populations. We aimed to confirm the effects of a mindfulness-based stress reduction program on perceived stress, heart rate variability, positive and negative affect, and subjective wellbeing of community-dwelling people with schizophrenia. The participants in this study were 26 people with schizophrenia (experimental group: 14, control group: 12) enrolled in two community mental health centers located in Gyeonggi Province in South Korea. In the experimental group, the mindfulness-based stress reduction program was applied once a week for 60 min over 8 weeks. The experimental group showed a significantly greater decrease in perceived stress and negative affect, as well as significantly greater improvement in heart rate variability than the control group. The mindfulness-based stress reduction program was an effective nursing intervention to reduce stress and negative affect in people with schizophrenia.

The Influence of Body Image, Insight, and Mental Health Confidence on Medication Adherence in Young Adult Women with Mental Disorders.

The aim of this descriptive study was to investigate the impact of body image, insight, and mental health confidence on medication adherence among young adult women with mental disorders. Data collection occurred from August to September 2018. The study participants were 147 young adult women aged 19 to 45 with mental disorders who were psychiatry outpatients either getting treatment in general hospitals located in Seoul and Gyeonggi Province or receiving rehabilitation therapy through local mental health welfare centers in Korea, and agreed to participate in the study. The measurement tools used were the Body Image Scale; the Scale to Assess Unawareness of Mental Disorder, Korean short-form version; the Korean version of the Mental Health Confidence Scale; and the Korean version of the Medication Compliance Scale. The collected data were analyzed using descriptive statistics, t-test, analysis of variance, Pearson correlation analysis, and multiple regression analysis in SPSS/WIN 25.0 (IBM Corp., Armonk, NY, USA). Medication adherence among the study participants differed by age (F = 2.95, p = 0.042), religion (t = -2.06, p = 0.042), level of trust in psychiatrists (F = 5.40, p = 0.006), treatment duration (F = 4.48, p = 0.005), and noncompliance to medication regimens due to weight gain (t = -2.61, p = 0.010). Multiple regression analysis demonstrated that body image (ß = -0.32, p < 0.001), insight (ß = -0.24, p = 0.002), and mental health confidence (ß = 0.24, p = 0.004) had a significant impact on the medication adherence of the participants. Body image, in particular, had the greatest influence on the medication adherence of the participants. This study found that body image, insight, and mental health confidence were important in improving medication adherence among young adult women with mental disorders. Practical, patient-centered, and individualized approaches that can improve medication adherence by seeking to understand negative perceptions regarding body image should be considered.

Mediating Effects of Anger Expression in the Relationship of Work Stress with Burnout among Hospital Nurses Depending on Career Experience.

OBJECTIVES: This study examined the mediating effects of anger expression in the relationship between work stress and burnout among nurses with more than or less than 3 years of career experience. METHODS: A cross-sectional study was conducted with 454 nurses working at three university hospitals in South Korea. Nurses completed a survey consisting of demographic questions, the Maslach Burnout Inventory, the Work Stress Scale, and the Korean version of the Anger Expression Inventory. A multiple-group mediation analysis was performed using structural equation modeling. RESULTS: In total (N = 454), work stress directly affected burnout, and all anger expressions indirectly affected the relationship of work stress with burnout. Different mediating effects of anger expression style according to career experience were shown; anger-out and anger-in in nurses with less experience (n = 184) and only anger-in in those with more experience (n = 270) partially mediated the relationship of work stress with burnout. CONCLUSIONS AND CLINICAL RELEVANCE: The indirect effect of anger-in style was higher than other anger expression styles in all nurses; suppression of anger caused by work stress can increase burnout. Anger-out played a functional role in the relationship of work stress with burnout among nurses who had less career experience. Therefore, to reduce burnout, creating a work environment with collaborative culture including authentic leadership and providing anger management programs will help to manage nurses' anger properly. For new nurses, promoting work and life balance, and creating a culturally empowering work environment to help them use anger-out expression constructively, are important to reduce burnout.

Effects of Self-Efficacy, Depression, and Anger on Health-Promoting Behaviors of Korean Elderly Women with Hypertension.

The prevalence of hypertension among women in Korea aged 65 years or older is 61.7%. Past research has emphasized the importance of health-promoting behaviors in hypertension management for the elderly. The purpose of this cross-sectional study was to identify the effects of self-efficacy, depression, trait anger, and anger expression on the health-promoting behaviors of elderly women with hypertension. Self-report questionnaires were completed by 208 women aged 65 and older (age range: 65 to 85) diagnosed with hypertension by physicians and living in the communities of G city and N city of Gyeonggi-do in South Korea. A hierarchical regression analysis revealed that exercise (ß = 0.36, p < 0.001) had the most significant effect on health-promoting behaviors, followed by depression (ß = -0.31, p < 0.001), trait anger (ß = 0.21, p = 0.002), anger control (ß = 0.20, p < 0.001), religion (ß = 0.18, p = 0.001), and self-efficacy (ß = 0.18, p = 0.003). Trait anger and anger control were identified to have a more significant effect on health-promoting behaviors than self-efficacy. Thus, health-promoting behaviors were influenced by exercise, depression, anger, religion, and self-efficacy. It is necessary to implement a nursing intervention strategy which pays attention to these factors to improve health-promoting behaviors of Korean community-dwelling elderly women.

Risk Factors of Metabolic Syndrome in Community-Dwelling People with Schizophrenia.

This study investigated the prevalence and risk factors of metabolic syndrome in 100 community-dwelling people with schizophrenia registered in mental health facilities in Seoul, Korea. This study was conducted between 12 September and 15 November 2019. This study used a cross-sectional descriptive design. The data included were general and disease-related characteristics, diagnostic tests for metabolic syndrome, lifestyles, depression, and social support. The analysis of collected data was done by using the SPSS 24.0 program. The prevalence of metabolic syndrome was 42.0%. Higher body mass index (odds ratio [OR] = 1.60, 95% CI = 1.16-2.18, p = 0.004), and depression (OR = 1.22, 95% CI = 1.06-1.42, p = 0.008) were associated with higher risks of metabolic syndrome, while physical activity and weight control (OR = 0.71, 95% CI = 0.54-0.94, p = 0.018), dietary habits (OR = 0.72, 95% CI = 0.54-0.93, p = 0.011), and medication and health management (OR = 0.52, 95% CI = 0.31-0.86, p = 0.012) were associated with lower risks. Mental health care nurses need to recognize the high prevalence of metabolic syndrome in people with schizophrenia in the community and provide differentiated, customized lifestyle improvement programs based on the body mass index and depression status of each person with schizophrenia. Furthermore, comprehensive lifestyle improvement programs and health examination services that people with schizophrenia can easily adhere to should be developed.

Role of Coping Styles in the Relationship Between Nurses' Work Stress and Well-Being Across Career.

OBJECTIVES: This study examines the mediating role of stress coping styles-problem-focused coping and emotion-focused coping-on the relationship between work stress and psychological well-being in clinical nurses according to career experience. METHODS: A cross-sectional survey design was used. Data were collected from February to March 2016. The study population was composed of 399 nurses working at two university hospitals with over 500 beds located in Seoul and Gyeonggi-do in South Korea. Self-report questionnaires were administered to measure work stress (Work Stress Scale), stress coping styles (Korean version of The Ways of Coping Checklist Scale), and psychological well-being (Ryff's Psychological Well-being Scale). A multiple-group path analysis was performed using SPSS version 21.0. RESULTS: In the path model analysis (N = 399), work stress directly influenced psychological well-being. Both problem-focused coping and emotion-focused coping were indirectly influenced in the relationship between work stress and psychological well-being. In the group of nurses with 3 years or less of career experience (n = 202), work stress was significantly related to psychological well-being. Only emotion-focused coping exerted a partial mediating effect on the relationship between work stress and psychological well-being. On the other hand, in the group of nurses with over 3 years of career experience (n = 197), work stress was not significantly related to psychological well-being. Both problem-focused coping and emotion-focused coping exerted a full mediating effect on the relationship between work stress and psychological well-being. CONCLUSIONS AND CLINICAL RELEVANCE: This study's path analysis displayed a distinct pathway in the relationships among work stress, stress coping styles, and psychological well-being between nurses with 3 years or less and nurses with over 3 years of experience. The intervention with decreasing work stress and emotion-focused coping could be effective for nurses with less career experience, whereas the intervention with focusing on improving emotion- and problem-focused coping could be effective for nurses with more career experience. The practical implications of the results suggest that nurses need different stress management programs according to their career experience, as the appropriate use of stress coping styles would improve the psychological well-being of nurses as influenced by their work stress.

The Mediating Effects of Self-Esteem and Resilience on the Relationship Between Internalized Stigma and Quality of Life in People with Schizophrenia.

PURPOSE: This study examined the mediating effects of self-esteem and resilience on the relationship between internalized stigma and quality of life in people with schizophrenia. METHODS: The participants were 123 people with schizophrenia (mean age = 41.87 years; 62.6% men) recruited from Soonchunhyang university hospital, a mental health center, and daytime rehabilitation facilities located in Seoul and Gyeonggi Province in South Korea. Using a cross-sectional survey, participants completed structured questionnaires with psychometric adequacy. The regression method of Baron and Kenny was used to test the mediating effects of self-esteem and resilience on the relationship between internalized stigma and quality of life. RESULTS: Self-esteem and resilience were found to be full and partial mediators, respectively, in the relationship between internalized stigma and quality of life. CONCLUSION: The findings of this study imply that effective future intervention strategies should target improvements in self-esteem and resilience to reduce the negative impact of internalized stigma on the quality of life of people with schizophrenia.

[The Relationship between Parental Stress and Nurses' Communication as Perceived by Parents of High-risk Newborns]. / ê³ ìœ„í—˜ ì‹ ìƒì•„ 부모가 지각한 간호사의 의사소통과 부모 ìŠ¤íŠ¸ë ˆìŠ¤ì™€ì˜ 관계.

PURPOSE: This study aimed to characterize the relationship between parental stress and nurses' communication as perceived by parents of high-risk newborns in a neonatal intensive care unit (NICU). METHODS: The participants were 54 parents of high-risk newborns in a NICU. Data were collected from January to March 2018. Parental stress and parents' perceptions of nurses' communication ability and styles were measured using a questionnaire. RESULTS: The average scores for parental stress and nurses' communication ability were 3.39 and 4.38 respectively, on a 5-point scale. Parents most commonly reported that nurses showed a friendly communication style, followed by informative and authoritative styles. Mothers and fathers reported significantly different levels of parental stress. Parental stress showed a negative correlation with nurses' perceived verbal communication ability. Higher scores for nurses' verbal communication ability and for friendly and informative communication styles were associated with lower parental stress induced by the environment, the baby's appearance and behaviors, and treatments in the NICU. CONCLUSION: The findings of this study suggest that nurses need to offer proper information for parents and to support parents by encouraging them to express their emotions of stress and by providing parents with therapeutic communication and opportunities to participate in care.

Factors Influencing Resilience of Burn Patients in South Korea.

PURPOSE: To examine and identify the factors influencing the degree of resilience among Korean burn patients. DESIGN: A cross-sectional descriptive design was employed. METHODS: The study sample consisted of 138 burn patients recovering from the acute phase in H hospital, Seoul. The male patient participants numbered 93 (67.4%) and the female participants numbered 45 (32.6%). The average age of the participants was 46.79 years. Measures used were the Beck Depression Inventory, State Trait Anxiety Inventory, self-esteem scale, family support scale, and resilience scale. FINDINGS: The analyses showed that the prediction model for resilience among burn patients was significant (F = 33.94, p < .001). The value of the adjusted R2 was 0.492, which corresponds to the explanatory power of 49.2%. The factor that was found to have the most influence on resilience among burn patients was self-esteem (ß = .35), followed by family support (ß = .29). CONCLUSIONS: This study provides preliminary evidence that self-esteem is a major and primary predictor of resilience among burn patients, next followed by family support. CLINICAL RELEVANCE: In the nursing practice, nurses need to pay attention to the burn patient's self-esteem and family support. Concrete interventions and strategies to improve the resilience of burn patients are needed.

[Body image dissatisfaction as a mediator of the association between BMI, self-esteem and mental health in early adolescents: a multiple-group path analysis across gender].

PURPOSE: This study was done to examine not only the relationships between body mass index (BMI), self-esteem, body image dissatisfaction (BID) and mental health, according to gender, but the mediating role of BID on mental health in relation to BMI and self-esteem among early adolescents. METHODS: Data from 576 (296 boys and 280 girls) elementary school students in grades 5 to 6 were collected. A multiple-group path analysis was utilized to examine the relationships between BMI, self-esteem, BID and mental health by gender. RESULTS: In the path analysis for all students, poor mental health was related directly to BID, while it was indirectly related to BMI and self-esteem. In the multiple-group path analysis of both genders, BID was found to have a significant direct and indirect effect on mental health for girls alone. CONCLUSION: The findings suggested that BID should be examined early to prevent poor mental health in early adolescent girls. This study helps to elucidate the role of early adolescent BID on mental health and provides insight for further prevention and intervention programs in school and community mental health settings.

[Effects of an infant/toddler health program on parenting knowledge, behavior, confidence, and home environment in low-income mothers].

PURPOSE: This study was conducted to evaluate the effectiveness of a mother/infant-toddler health program developed to enhance parenting knowledge, behavior and confidence in low income mothers and home environment. METHODS: A one-group pretest-posttest quasi-experimental design was used. Sixty-nine dyads of mothers and infant-toddlers (aged 0-36 months) were provided with weekly intervention for seven session. Each session consisted of three parts; first, educating to increase integrated knowledge related to the development of the infant/toddler including nutrition, first aid and home environment; second, counseling to share parenting experience among the mothers and to increase their nurturing confidence; third, playing with the infant/toddler to facilitate attachment-based parenting behavior for the mothers. RESULTS: Following the programs, there were significant increases in parenting knowledge on nutrition and first aid. A significant improvement was found in attachment-based parenting behavior, but not in home safety practice. Nurturing confidence was not significantly increased. The program led to more positive home environment for infant/toddler's health and development. CONCLUSION: The findings provide evidence for mother-infant/toddler health program to improve parenting knowledge, attachment-based parenting behavior and better home environment in low income mothers. Study of the long term effectiveness of this program is recommended for future research.

Gender differences in associations between parental problem drinking and early adolescents' internet addiction.

PURPOSE: The purpose was to examine gender differences between parental problem drinking (PPD) and early adolescents' Internet addiction (IA). DESIGN AND METHODS: This was a cross-sectional, correlational design with 519 (266 boys and 253 girls) early adolescents. RESULTS: PPD had a significant direct effect on IA in boys but not in girls. Significant indirect effects of PPD on IA were evidenced via anxiety-depression and aggression for boys and via family function and aggression for girls. PRACTICE IMPLICATIONS: Findings suggest that tailored interventions for the prevention of IA should consider gender.

[Risk factors influencing probability and severity of elder abuse in community-dwelling older adults: applying zero-inflated negative binomial modeling of abuse count data].

PURPOSE: This study was conducted to identify risk factors that influence the probability and severity of elder abuse in community-dwelling older adults. METHODS: This study was a cross-sectional descriptive study. Self-report questionnaires were used to collect data from community-dwelling Koreans, 65 and older (N=416). Logistic regression, negative binomial regression and zero-inflated negative binomial regression model for abuse count data were utilized to determine risk factors for elder abuse. RESULTS: The rate of older adults who experienced any one category of abuse was 32.5%. By zero-inflated negative binomial regression analysis, the experience of verbal-psychological abuse was associated with marital status and family support, while the experience of physical abuse was associated with self-esteem, perceived economic stress and family support. Family support was found to be a salient risk factor of probability of abuse in both verbal-psychological and physical abuse. Self-esteem was found to be a salient risk factor of probability and severity of abuse in physical abuse alone. CONCLUSION: The findings suggest that tailored prevention and intervention considering both types of elder abuse and target populations might be beneficial for preventative efficiency of elder abuse.

Influences of parental problem drinking on internet addiction among early adolescents: a multiple-mediation analysis.

This study was designed to describe the relationship between Internet addiction and parental problem drinking among early adolescents. Specific aims were to identify indirect, direct, and total influence of parental problem drinking on Internet addiction; to determine relative magnitudes of specific mediating effects of self-esteem, family function, anxiety-depression, and aggression in the total sample and the Internet addiction subgroup. The target population for this correlational study was early adolescents aged 11-12 years (n = 743) who attended elementary school in J City, South Korea. Study variables included the Internet addiction self-test scale, the Rosenberg Self-Esteem Scale, the Children of Alcoholics Screening Test, the Family Adaptability and Cohesion Evaluation Scale III, and the Korean version of the Child Behavior Checklist. Multiple-mediation analyses were performed. A significant association was observed between parental problem drinking and adolescents' Internet addiction. Only aggression significantly mediated the relationship between parental problem drinking and adolescents' Internet addiction in the total sample. When the Internet addiction group was analyzed separately as a subgroup, the mediation effect of aggression disappeared, and parental problem drinking had neither indirect nor direct association. However, the significant association of aggression with Internet addiction in the Internet addiction subgroup was two times as much as in the total sample. The findings suggested that parental problem drinking and aggression should be examined early to prevent development of Internet addiction in early adolescents. For those who already have developed Internet addiction, aggression should be the focal point for more effective intervention strategies.

[Aggression and related factors in elementary school students].

PURPOSE: This study was done to explore the relationship between aggression and internet over-use, depression-anxiety, self-esteem, all of which are known to be behavior and psychological characteristics linked to "at-risk" children for aggression. METHODS: Korean-Child Behavior Check List (K-CBCL), Korean-Internet Addiction Self-Test Scale, and Self-Esteem Scale by Rosenberg (1965) were used as measurement tools with a sample of 743, 5th-6th grade students from 3 elementary schools in Jecheon city. Chi-square, t-test, ANOVA, Pearson's correlation and stepwise multiple regression with SPSS/Win 13.0 version were used to analyze the collected data. RESULTS: Aggression for the elementary school students was positively correlated with internet over-use and depression-anxiety, whereas self-esteem was negatively correlated with aggression. Stepwise multiple regression analysis showed that 68.4% of the variance for aggression was significantly accounted for by internet over-use, depression-anxiety, and self-esteem. The most significant factor influencing aggression was depression-anxiety. CONCLUSION: These results suggest that earlier screening and intervention programs for depression-anxiety and internet over-use for elementary student will be helpful in preventing aggression.