Development and evaluation of a post-traumatic growth promotion programme for North Korean refugees.

North Korean refugees exposed to traumatic events often experience a high recurrence of post-traumatic stress disorder symptoms. However, a post-traumatic growth programme has the potential to transform these traumatic events into increasing post-traumatic growth, reduced emotional stress and enhanced well-being. This study investigated the effects of a post-traumatic growth promotion programme on post-traumatic stress disorder recovery among North Korean refugees. Using a non-equivalent control group non-synchronised pretest-posttest design, 60 North Korean refugees who have been in South Korea for 6-8 or 12-13 years were assigned to the experimental (post-traumatic growth promotion programme; n = 30) or control group (post-traumatic growth promotion education brochure; n = 30). The programme comprised group sessions and discussions, each lasting 120 min/session, conducted twice a week for 5 weeks. Mindfulness, anxiety, depression, blood cortisol and post-traumatic growth were assessed at baseline, immediately after intervention and 4 weeks after intervention. The findings showed the programme was effective in significantly increasing post-traumatic growth and decreasing anxiety, depression and cortisol level. The two-way analysis of variance showed a significant interaction between groups and time. Consequently, this post-traumatic growth promotion programme can be utilised as a non-invasive, cost-effective and safe intervention for promoting post-traumatic growth and well-being among North Korean refugees.

The impact of aromatherapy-based oral care on oral conditions, salivary pH, and halitosis in older adults with dementia: Pilot study.

Inadequate oral care and poor oral health in older adults are known to increase the risk of dementia. Dementia patients residing in long-term care facilities are especially vulnerable to oral diseases due to their care-resistant behavior. This study aimed to investigate the effects of a 7-day oral care program based on an aroma solution in 58 dementia patients (29 each in the experimental and control groups) admitted to a long-term care hospital in South Korea. The experimental group received oral care with a solution containing peppermint, tea tree, and lemon essential oils, and the control group with a saline solution. The effectiveness of oral care was assessed by the participants' oral condition, salivary pH, and halitosis. The experimental group showed significant improvements (P<.001) in all three outcomes, indicating that oral care with an aroma solution can improve the oral health of older dementia patients residing in long-term care facilities.

The effect of nurse-led digital health interventions on blood pressure control for people with hypertension: A systematic review and meta-analysis.

PURPOSE: Nurse-led digital health interventions (DHIs) for people with chronic disease are increasing. However, the effect of nurse-led DHIs on blood pressure control and hypertension self-management remains unclear. This study aimed to identify the characteristics of nurse-led DHIs for people with hypertension and compared the effect size of nurse-led DHIs with that of usual care to establish evidence for the development of effective nursing interventions using technologies. DESIGN: Systematic review and meta-analysis. METHODS: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews of Intervention (PRISMA) guidelines and registered the protocol in PROSPERO. Studies published from 2000 to August 5, 2021, were searched using the international databases: PubMed; Embase; Cochrane Central Register of Controlled Trials; Web of Science; CINAHL; Korean databases: RISS, KISS, KMBASE; and NDSL. Risk of bias 2.0 was used for evaluating the quality of studies. The primary outcome was blood pressure control. The secondary outcomes were self-management, medication adherence, and diet adherence. Publication bias was assessed using the funnel plot and Egger's regression tests. FINDINGS: The systematic review included 26 studies. A meta-analysis of 21 studies was conducted to calculate the effect size and identify heterogeneity among the included studies. In our meta-analysis, we observed that nurse-led DHIs reduced systolic blood pressure by 6.49 mmHg (95% confidence interval [CI]: -8.52 to -4.46, I2  = 75.4%, p < 0.05) and diastolic blood pressure by 3.30 mmHg (95% CI: -4.58 to -2.01, I2  = 70.3%, p < 0.05) when compared with usual care. Concerning secondary outcomes, the effect size on self-management, medication adherence, and diet adherence was 0.98 (95% CI: 0.58 to 1.37, I2  = 63.2%, p < 0.05), 1.05 (95% CI: 0.41 to 1.69, I2  = 92.5%, p < 0.05), and 0.80 (95% CI: 0.17 to 1.42, I2  = 80.5%, p < 0.05), respectively. CONCLUSION: Nurse-led DHIs were more effective in reducing blood pressure and enhancing self-management than usual care among people with hypertension. Therefore, as new technologies are being rapidly developed and applied in healthcare systems, further studies and policy support are needed to utilize the latest digital innovations with nursing interventions. CLINICAL RELEVANCE: This study could be used to identify that nurse-led interventions may take advantage of real-time communication by employing digital technologies for improving blood control and self-management behaviors such as medication adherence and diet adherence. Using nurse-led DHIs allows nurses to provide patient-centered interventions such as reflecting on patients' needs and shared decision-making without space constraints and limited treatment time.

Verbal violence and turnover intention among new nurses in Korea: A time-lagged survey.

AIM: To test a model examining the impact of verbal violence against new nurses on their turnover intention and the mediating effects of emotional reaction and burnout based on affective events theory. BACKGROUND: In Korea, turnover rate of nurses, especially new nurses, is at a serious level. It is important to verify the paths by which nurses reach a turnover intention after experiencing verbal violence, which is the most common form of workplace violence. In particular, research on new nurses who are vulnerable to exposure to verbal violence and have a high turnover rate is insufficient. METHODS: Data were collected using time-lagged online surveys from 212 Korean new nurses. Structural equation modelling was used to test the hypothesized model. RESULTS: The level of the turnover intention of new nurses was almost 4 out of 5. Verbal violence not only has a direct effect on turnover intention but also has an indirect effect through burnout. Emotional reactions and burnout sequentially mediated the relationship between verbal violence and turnover intention; these variables explained approximately 57% of turnover intention. CONCLUSIONS: To decrease negative emotional reactions and burnout caused by verbal violence may benefit to reduction of turnover intention of new nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Our finding highlight the critical need for new nurses' violence interventions that focus on emotional reactions and burnout, and thereby improving desirable patient-co-worker-nurse relationships and quality of life for new nurses.

Predictors of Weight-Control Behavior in Healthy Weight and Overweight Korean Middle-Aged Women.

Although obesity level is considered to influence weight-control behavior, few studies have examined how predictors of weight-control behavior differ according to obesity level. We compared the predictors of weight-control behavior in healthy weight and overweight middle-aged Korean women. This study used a comparative cross-sectional design. In total, 352 middle-aged women (131 overweight and 221 healthy) who visited community centers in eight Korean cities participated in the study. Participants completed self-report questionnaires concerning perceived health, body dissatisfaction, health-related concerns, self-esteem, and weight-control behavior. Scores for weight-control behavior in the overweight group were higher than those in the healthy weight group. Stepwise multiple regression showed that health-related concerns, body dissatisfaction, socioeconomic status, and self-esteem predicted weight-control behavior in the overweight group. Perceived health, socioeconomic status, meal regularity, health-related concerns, and age predicted weight-control behavior in the healthy weight group. The findings indicate that nursing strategies should differ according to obesity level to improve weight-control behavior in middle-aged women. In community or clinical settings, nurses are advised to develop customized weight control programs based on obesity levels in middle-aged women.

Factors Affecting Diet-Related Quality of Life Among Hemodialysis Patients According to Age-group.

This study identified factors influencing diet-related quality of life (QoL) among hemodialysis patients by age. In a cross-sectional correlational study in South Korea, 175 participants from two age groups-20-59 years and 60 years and above-completed self-report questionnaires assessing demographic and health-related characteristics, eating status, subjective health status, disease-related factors, dietary knowledge, and xerostomia severity. Findings indicated that the predictors of diet-related QoL included subjective health status and regular eating status (20-59 years) and self-efficacy, attitude toward hydration behaviors, and exercise (60 years and above). In order to improve the diet-related quality of life of dialysis patients, young adults need to focus on their physical health and regular meals, and the elderly need a differentiation strategy that considers psychological factors such as self-efficacy and attitude toward pollination.

Predictors of posttraumatic growth of intensive care unit nurses in Korea.

AIM: Nurses working in intensive care units are repeatedly exposed to trauma (e.g., verbal or physical abuse by confused patients, and unexpected death). However, after experiencing traumatic events, not all intensive care unit nurses develop psychopathological issues, including posttraumatic stress disorder. Therefore, this study aims to examine the level of posttraumatic growth and psychosocial factors such as posttraumatic stress symptoms, deliberate rumination, wisdom, and self-compassion to predict posttraumatic growth in Korean intensive care unit nurses. METHODS: A total of 156 intensive care unit nurses participated in this cross-sectional survey. Posttraumatic growth, posttraumatic stress symptoms, deliberate rumination, wisdom, and self-compassion were measured using validated self-report scales, and data were analyzed by descriptive statistics. RESULT: Posttraumatic growth was found to be comparatively low in intensive care unit nurses, while multiple regression showed that positive self-compassion was the most significant predictor for posttraumatic growth, followed by wisdom, age, and deliberate rumination. All together four variables explained 30% of the variance in posttraumatic growth. CONCLUSION: Findings from this study suggest that intensive care unit nurses' posttraumatic growth may be enhanced by increasing positive self-compassion, wisdom, and deliberate rumination. Therefore, a paradigm shift focusing on possible positive pathways, such as development of mental health programs to improve posttraumatic growth for intensive care unit nurses is required rather than focusing on management of posttraumatic stress disorder. The results of this study could provide theoretical guidance to seek more effective and integrated intervention strategies for intensive care unit nurses.

Socioecological Factors Affecting Fluid Restriction Adherence Among Korean Patients Receiving Hemodialysis: A Qualitative Study.

Introduction: To reduce morbidity and mortality rates, hemodialysis patients are advised to restrict their fluid intake. However, fluid restriction is the biggest stressor for the patients. This study explored the barriers and facilitators of fluid restriction among Korean hemodialysis patients. Method: This qualitative descriptive study was guided by the ecological model of health behavior. This study involved five focus group (23 patients) and individual interviews (4 patients) at two hospitals in Korea. Audio-recorded transcripts were analyzed using qualitative content analysis. Results: Six intrapersonal, three interpersonal, and four organization factors affecting fluid restriction adherence were identified. Barriers included physiological symptoms, lack of self-control, social relationships, social stigma, lack of practical education, Korean food culture, and lack of public health and policy support. Facilitators included risk perception, self-assessment, knowledge, stimulated sweating, and social support. Discussion: The findings suggest that socioecological factors should be considered when designing fluid restriction programs for hemodialysis patients.

Effects of Auricular Acupressure in Patients on Hemodialysis.

BACKGROUND: Although studies on the effectiveness of self-management in limiting fluid intake in patients on hemodialysis have been conducted extensively, xerostomia, which is a powerful stimulus of fluid intake, has received scarce attention. PURPOSE: The purpose of this study was to examine the effects of a 4-week auricular acupressure treatment on xerostomia, salivary flow rate, interdialytic weight gain, constipation, and diet-related quality of life in patients on hemodialysis in Korea. METHODS: This was a randomized controlled trial. Sixty patients on hemodialysis were randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received an auricular acupressure intervention, which included the application of skin tape with a Semen vaccariae seed on the five auricular acupoints, including the large intestine (CO7), San Jiao (CO17), middle triangular fossa (TF3), spleen (CO13), and upper tragus (TG1), for 4 weeks. The control group received only the application of skin tape without a seed on the same auricular acupoints for the same period. The outcome variables were as follows: xerostomia, measured using the visual analog scale; salivary flow rate, measured using the unstimulated whole saliva absorbed in oral cotton; interdialytic weight gain; the constipation assessment scale score; and the Quality of Life Related to Dietary Change Questionnaire results. RESULTS: The experimental group scored significantly better than the control group in terms of xerostomia (p = .004), salivary flow rate (p = .010), constipation (p = .009), and diet-related quality of life (p < .001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Auricular acupressure may be an important tool for alleviating the negative symptoms of xerostomia and for improving quality of life in patients on hemodialysis. Nurses caring for patients on hemodialysis with both xerostomia and constipation may teach auricular acupressure to help patients self-manage their discomfort.

Factors Associated With Blood Pressure Classification in Korean University Students: A Descriptive Survey.

BACKGROUND: The prevalence of hypertension in young adults has increased. Hypertension is known to be a leading contributor to many diseases. PURPOSE: The study aimed to identify factors influencing blood pressure (BP) classification in university students and to establish a basis for the prevention and management of hypertension in young adults. METHODS: Four hundred three university students in South Korea were analyzed to determine the factors that influence BP classification. Data were analyzed using the chi-square test, analysis of variance, and multinomial logistic regression. RESULTS: The reference group for the logistic regression analysis included students with normal BP. The odds of being male and of having an overweight or obese body mass index were significantly higher in the prehypertension group than in the normal BP group. The odds of regular (≥ 6 months) exercise habits, having subcutaneous and borderline visceral fat types, and social support were significantly lower in the prehypertension group than in the normal BP group. The odds of being male, being overweight or obese, and having more exercise barriers were significantly higher in the hypertension group than in the normal BP group. The odds of having a high or low economic status were higher and lower in the hypertension group, respectively. Finally, the odds of having subcutaneous or borderline visceral fat types and a vigorous physical activity level were significantly lower in the hypertension group than in the normal BP group. CONCLUSIONS: Interventions that address the factors related to BP in young adults are necessary to prevent the occurrence and progression of hypertension in young adults.

Effects of a Physical Activity and Sedentary Behavior Program on Activity Levels, Stress, Body Size, and Sleep in Sedentary Korean College Students.

This study examined the effects of a physical activity and sedentary behavior program on physical activity, sedentary behavior, stress, body size, and sleep in 63 Korean college students. This study used a quasiexperimental approach with a nonequivalent control group pretest-posttest design. The results showed that the program increased physical activity and step counts and reduced sedentary behavior, waist circumference, and stress levels.

Predictors of Sleep Quality Among Young Adults in Korea: Gender Differences.

This study was performed to identify the factors influencing gender differences in sleep quality between men and women. A cross-sectional survey was conducted using a convenience sample of 300 young adults from three Korean universities. Participants were 20-40 years of age, used smartphones, and took no sleep medication. Participants completed questionnaires on sleep quality, exercise, stress, depression, and smart phone addiction. The predictors of sleep quality in men were coffee consumption, napping, depression, failure to engage in light exercise at least three times per week, being overweight, being in the potential smart phone addiction group, and being employed, which explained 30.2% of the variance. The predictors of sleep quality in women were education to college level or higher, smoking, and stress, which explained 30.5% of the variance. To improve sleep quality in this population, future intervention should contain life style modification strategies containing smartphone addiction prevention.

Predictors of Sedentary Behavior in Elderly Koreans With Hypertension.

BACKGROUND: The older adults are the most sedentary of all age groups. Sedentary behavior is associated with the onset and exacerbation of hypertension and the deterioration of health in hypertensive patients. PURPOSE: The aims of this study were to examine the level of sedentary behavior and to identify the factors predicting sedentary behavior in elderly Koreans with hypertension. METHODS: A cross-sectional descriptive design was used. Three hundred six hypertensive elderly subjects who visited three public health centers in Korea for regular medical checkups completed self-report questionnaires on sedentary behavior, physical activity, empowerment, perceived health, depression, self-efficacy for physical activity, and social support for physical activity. RESULTS: The participants spent an average of 8.59 hours a day in sedentary behavior. The stepwise multiple regression analysis showed that sedentary behavior was significantly predicted by empowerment level, perceived health, time since diagnosis of hypertension, vigorous-intensity physical activity, and depression. These variables explained 42.6% of the variance in sedentary behavior. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: To reduce sedentary behavior in this population, future interventions should improve empowerment and perceived health, increase the intensity of physical activity, and alleviate depression while considering the duration of disease.

Sex differences in social cognitive factors and physical activity in Korean college students.

[Purpose] This study examined sex differences in physical activity and social cognitive theory factors in Korean college students. [Subjects and Methods] A cross-sectional survey of 688 college students (285 men and 403 women) in Korea was conducted using a self-reported questionnaire. [Results] There was a significant difference in the level of physical activity between male and female students. The significant predictors of physical activity for male students were physical activity goals, physical activity self-efficacy, and sitting time. Meanwhile, those for female students were perceived weight, physical activity goal, physical activity outcome expectations, and sitting time. [Conclusion] Sex differences should be considered when developing interventions to increase physical activity.

Factors influencing BMI classifications of Korean adults.

[Purpose] This study aimed to identify factors influencing the BMI classifications of 3,583 Korean adults using data from the fifth Korean National Health and Nutrition Examination Survey. [Subjects and Methods] Measures included lifestyle factors, physiologic factors, perceived health state, stress, subjective body recognition, health-related quality of life, and weight control behavior. [Results] Body perception scores were lower with underweight and higher with overweight and obesity than with a healthy weight. There was a lower proportion of underweight men and a higher proportion of overweight or obese men than women. Instances of Alcohol Use Identification Scores (AUDIT) ≥ 9 were proportionately lower with underweight and more with overweight or obesity relative to an AUDIT score < 9 with healthy weight. Hemoglobin A1c and systolic blood pressure were higher with obesity than with healthy weight. The total cholesterol level was greater with overweight and obesity than with healthy weight. [Conclusion] These results suggest that obesity intervention for adults should be based on age and sex and should include drinking habits and physical activity.

A family involvement and patient-tailored health management program in elderly Korean stroke patients' day care centers.

PURPOSE: This study aimed to examine the effects of a family involvement and functional rehabilitation program in an adult day care center on elderly Korean stroke patients' perceived health, activities of daily living, instrumental activities of daily living, and cost of health services, and on family caregivers' satisfaction. DESIGN: Using one-group pre- and posttest design, dyads consisting of 19 elderly stroke patients and family caregivers participated in 12-week intervention, including involvement of family caregivers in day care services and patient-tailored health management. FINDINGS: Outcomes of patients and caregivers were significantly improved (all p < .001). However, the cost of health services did not decrease significantly. CONCLUSIONS: This program improved functional levels and health perception of elderly stroke patients and caregivers' satisfaction. However, results must be interpreted with caution, because this was only a small, single-group pilot study. CLINICAL RELEVANCE: This program may be effective for elderly stroke patients and their caregivers.

Factors affecting self-care in elderly patients with hypertension in Korea.

The objective of this study was to test nine variables which derived from the model of self-care in chronic illness and previous studies on elderly patients with hypertension. A descriptive research design was employed in this study. Totally, 306 elderly patients diagnosed with hypertension were selected from three public health centres for the study. The stepwise regression analysis was conducted by analysing predictors of self-care in elderly patients with hypertension. Statistical analyses, including correlation analysis, t-test and analysis of variance tests were conducted for seven variables. The results indicated that only four variables were significant, and the model explained 57% of the variance in self-care. Among these predictors, empowerment was the strongest predictor, followed by social support, depression and perceived severity. These findings demonstrate the significance of assessing predictors of self-care behaviour when examining patients' health behaviours and planning intervention strategies.

Use of the 5E learning cycle model combined with problem-based learning for a fundamentals of nursing course.

The 5E learning cycle model has shown a positive effect on student learning in science education, particularly in courses with theory and practice components. Combining problem-based learning (PBL) with the 5E learning cycle was suggested as a better option for students' learning of theory and practice. The purpose of this study was to compare the effects of the traditional learning method with the 5E learning cycle model with PBL. The control group (n = 78) was subjected to a learning method that consisted of lecture and practice. The experimental group (n = 83) learned by using the 5E learning cycle model with PBL. The results showed that the experimental group had significantly improved self-efficacy, critical thinking, learning attitude, and learning satisfaction. Such an approach could be used in other countries to enhance students' learning of fundamental nursing.

Relationships among self-efficacy, depression, life satisfaction, and adaptation among older korean adults residing in for-profit professional nursing facilities.

BACKGROUND: Adapting to a new environment is especially difficult for older adults relocating into professional nursing facilities or other specialized care centers. This relocation is a prominent life stressor in older adults. PURPOSE: This study examined the self-efficacy, depression, life satisfaction, and adaptation and the relationships among these four variables of older Korean adults residing in for-profit professional nursing facilities to provide preliminary information necessary to improve nursing interventions. METHODS: This was a cross-sectional and descriptive correlation study. The 322 participants were all over the age of 65 years and resided in one of three different for-profit professional nursing facilities in Seoul and Gyeonggi-do, South Korea. Measures used included a demographic characteristics form, Self-Efficacy Instrument, Korean Simple Depression Scale, Standard Life Satisfaction Instrument, and Facility Adaption Scale. RESULTS: Results found positive self-efficacy, depression, life satisfaction, and adaptation among participants. We found significant positive correlations among self-efficacy, life satisfaction, and adaptation and significant negative correlations among depression, life satisfaction, and adaptation. Moreover, we found noticeable differences in the degree of adaptation to professional nursing facility placement in several variables, including gender, age, level of education, religious background, perceived health status, presence of a spouse, presence of a nonprofessional caregiver(s), and decision maker. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: This cross-sectional study provides preliminary evidence that older Korean adults in for-profit professional nursing facilities generally maintain a healthy level of well-being. However, nursing interventions to improve self-efficacy and life satisfaction and decrease depression in older adult residents are needed to help these older adults adapt to life in such facilities.

Sedentary behavior, physical activity, and psychological health of Korean older adults with hypertension: effect of an empowerment intervention.

The aim of this study was to determine the effect of an 8-week empowerment intervention on sedentary behavior, physical activity, and psychological health in Korean older adults with hypertension. Using a quasi-experimental design, older adults participated in either an experimental group (n = 27) or control group (n = 21). The experimental group received an empowerment intervention including lifestyle modification education, group discussion, and exercise training for 8 weeks, and the control group received standard hypertension education. After 8 weeks, participants in the experimental group had significantly decreased sedentary behavior, increased physical activity, increased self-efficacy for physical activity, and increased perceived health (p < 0.05). However, no significant group difference was found for depression. Findings from this study suggest that empowerment interventions may be more effective than standard education in decreasing sedentary behavior and increasing physical activity, self-efficacy for physical activity, and perceived health in Korean older adults with hypertension.