Couple-Oriented Interventions for Mental Health: A Scoping Review.

The purpose of this research was to systematically examine and collate evidence on couple-oriented interventions for mental health to identify trends in the literature, review research strategies, and suggest directions for future research. A systematic search included studies relating to couple-oriented interventions for preventing mental disorders and/or promoting mental health. We identified a total of 52 studies, which included 55 articles. Our findings revealed that interventions were delivered through various modes, including face-to-face, telephone, and online, with the majority of couple-oriented interventions operating in conjoint sessions. The most common intervention was for selective prevention targeting patients with cancer and their partners. This review provided evidence of the applicability of theoretical frameworks, dyad analysis, and measurements associated with couple-oriented interventions. Findings can help family nurse practitioners and health care professionals advance strategies to develop and implement evidence-based, couple-oriented interventions for primary prevention of mental disorders and the promotion of mental health.

Online coaching blended couple-oriented intervention for preventing depression among Korean middle adulthood: A feasibility study.

Depression and marital satisfaction have a reciprocal cause-and-effect relationship. Thus, couple relationships should be considered to maximize the effectiveness of couple-oriented interventions for depression. Moreover, developing culturally tailored couple-oriented interventions is critical for improving cultural acceptability and enhancing the perceived effectiveness of the interventions. A new culturally tailored MindGuide Couple intervention was developed to prevent Korean middle adulthood depression and enhance couple relationships using intervention mapping. This feasibility study used a single-arm, pre- and post-test, and 2-month follow-up design to explore the reach, acceptability, and preliminary effectiveness of this preventive intervention. Reach was assessed by recruitment, retention, and completion rates; acceptability was measured based on helpfulness, suitability, and satisfaction; and preliminary effectiveness was measured by depression (CES-D), positive and negative affect (PANAS), satisfaction with life (SWLS), couple satisfaction (CSI), and healthy relationship between spouses (FRAS). Fifteen middle-aged couples participated in four psychoeducational and asynchronous online modules and four synchronous coaching sessions via videoconferencing for 5-7 weeks. Data were analyzed using descriptive statistics and repeated measures with analysis of variance. With a 94.1% completion rate, the participants demonstrated high satisfaction with the online coaching blended intervention and reported that it was helpful and easy to use. Both husbands and wives showed significant differences over time in depression, couple satisfaction, and healthy relationships between spouses. This feasibility study demonstrated the successful reach, acceptability, and potential effectiveness of this preventive intervention. Additionally, we suggest the importance of culturally tailored and online coaching blended couple-oriented intervention for preventing depression and promoting healthy couple relationships.

Machine learning models for predicting depression in Korean young employees.

Background: The incidence of depression among employees has gradually risen. Previous studies have focused on predicting the risk of depression, but most studies were conducted using basic statistical methods. This study used machine learning algorithms to build models that detect and identify the important factors associated with depression in the workplace. Methods: A total of 503 employees completed an online survey that included questionnaires on general characteristics, physical health, job-related factors, psychosocial protective, and risk factors in the workplace. The dataset contained 27 predictor variables and one dependent variable which referred to the status of employees (normal or at the risk of depression). The prediction accuracy of three machine learning models using sparse logistic regression, support vector machine, and random forest was compared with the accuracy, precision, sensitivity, specificity, and AUC. Additionally, the important factors identified via sparse logistic regression and random forest. Results: All machine learning models demonstrated similar results, with the lowest accuracy obtained from sparse logistic regression and support vector machine (86.8%) and the highest accuracy from random forest (88.7%). The important factors identified in this study were gender, physical health, job, psychosocial protective factors, and psychosocial risk and protective factors in the workplace. Discussion: The results of this study indicated the potential of machine learning models to accurately predict the risk of depression among employees. The identified factors that influence the risk of depression can contribute to the development of intelligent mental healthcare systems that can detect early signs of depressive symptoms in the workplace.

Machine learning models for predicting risk of depression in Korean college students: Identifying family and individual factors.

Background: Depression is one of the most prevalent mental illnesses among college students worldwide. Using the family triad dataset, this study investigated machine learning (ML) models to predict the risk of depression in college students and identify important family and individual factors. Methods: This study predicted college students at risk of depression and identified significant family and individual factors in 171 family data (171 fathers, mothers, and college students). The prediction accuracy of three ML models, sparse logistic regression (SLR), support vector machine (SVM), and random forest (RF), was compared. Results: The three ML models showed excellent prediction capabilities. The RF model showed the best performance. It revealed five significant factors responsible for depression: self-perceived mental health of college students, neuroticism, fearful-avoidant attachment, family cohesion, and mother's depression. Additionally, the logistic regression model identified five factors responsible for depression: the severity of cancer in the father, the severity of respiratory diseases in the mother, the self-perceived mental health of college students, conscientiousness, and neuroticism. Discussion: These findings demonstrated the ability of ML models to accurately predict the risk of depression and identify family and individual factors related to depression among Korean college students. With recent developments and ML applications, our study can improve intelligent mental healthcare systems to detect early depressive symptoms and increase access to mental health services.

Developmental trajectories of self-esteem, the related predictors, and depression: A growth mixture modeling approach.

BACKGROUND: This study aimed to identify sub-trajectory groups of self-esteem among adults aged 19-64 years and the factors impacting latent classes, as well as to assess differences in symptoms of depression. METHODS: Research data from the Korea Welfare Panel Study were analyzed, including those from 8866 adults who participated in the 6th, 9th, 12th, and 15th waves. The growth mixture modeling analysis was used to identify latent classes of self-esteem trajectories. RESULTS: Three classes of self-esteem trajectories were identified. The majority of adults (88.0%) reported stable high self-esteem over time. A second class (low-level increasing: 7.7%) reported low levels of self-esteem, which gradually increased to high levels by the end of the study. A third group, medium-level decreasing (4.3%), reported medium self-esteem levels, which decreased to the lowest level by the end of the study. LIMITATIONS: The factors identified in previous studies as those closely associated with self-esteem, such as personality, quality of life, and life satisfaction, were not considered in this study. Additionally, although the absence or presence of chronic disease was included in the health factors, no further investigation was made to identify the effects of different chronic diseases on the dependent and outcome variables. CONCLUSIONS: These results suggest that interventions designed to prevent depression among adults who are older, unemployed, at risk of alcoholism, or dissatisfied with their health and relationships may be beneficial. This study identified a relationship between unstable self-esteem and the risk of depression.

Development of an Online-Coaching Blended Couple-Oriented Intervention for Preventing Depression in Middle Adulthood: An Intervention Mapping Study.

Background: Although middle-aged adults in Korea are vulnerable to depression, there are few preventive interventions for depression in middle adulthood. Studies consistently suggest that interventions that include both spouses are effective in decreasing depression and relationship distress. Considering the busy lives of middle-aged couples, it is essential to develop an online-coaching blended couple-oriented intervention. This study aimed to describe the development, implementation, and evaluation of an online-coaching blended couple-oriented intervention using an online program and coaching via videoconference to prevent middle-aged couples' depression; this was done using an intervention mapping (IM) protocol. Methods: Six steps of IM were used to systematically develop a tailored multi-level intervention specific to middle-aged couples' depression. These steps of the IM protocol involve needs assessment, formulation of change objectives, theory-based methods, and practical strategies for program design, program development, program implementation, and program evaluation. Results: The results of the six steps were as follows: (a) middle-aged couples' needs and mental health problems were identified through a scoping review study, mixed-method study, and expert interviews; (b) six performance objectives (POs) were formulated based on the results of Step 1, and intrapersonal, interpersonal, and temporal/transpersonal determinants were identified based on the self-transcendence theory. Change objectives were developed by combining POs with determinants; (c) self-regulated learning was chosen for theoretical teaching methods and practical strategies to change the determinants of each level; (d) four modules consisting of 16 sessions were developed based on the self-transcendence theory; (e) experts evaluated the program and coaches were trained; and (f) the evaluation plan for the program's feasibility, acceptability, usability, and preliminary effects was developed. Discussion: The systematic process using IM allowed us to develop an online-coaching blended couple-oriented intervention to prevent depression and promote couples' relationships. The primary effects of this newly developed program should be evaluated in future studies. This may lead to the increased adoption and implementation of evidence-based and tailored interventions for psychological wellbeing in middle adulthood.

[Validity and Reliability of the Korean Version of the Couple Satisfaction Index].

PURPOSE: The study aimed to translate the Couple Satisfaction Index (CSI 32) into Korean, to evaluate the reliability and validity of CSI 32 and short-form (CSI 16, 4) in the Korean context, and to determine a cut-off score for Korean couples. METHODS: Korean Versions of the Couple Satisfaction Index (K-CSI) 32 was translated, back-translated, and reviewed by five bilingual experts. Confirmatory factor analysis (CFA) was conducted with data from a sample of 218 couples (N = 436) to test construct validity. Validity and reliability were evaluated. The receiver's operating characteristics curve analysis was used to obtain the cut-off score. RESULTS: The construct validities of K-CSI 32, 16, and 4 were verified using one-factor structures. The results of CFA showed a slightly better fit for K-CSI 16 and 4 than for K-CSI 32. Convergent validity was supported by significant positive correlations of K-CSI with Kansas Marital Satisfaction Scale, Dyadic Adjustment Scale, and Family Relationship Assessment Scale. Moreover, the significant differences in K-CSI between normal and depressive group demonstrated known-group validity. Cut-off scores of 105.5 on K-CSI 32, 50.25 on K-CSI 16, and 13.25 on K-CSI 4 were validated to identify distressed couple relationships. CONCLUSION: For clinical practice, the reliable and valid K-CSI 32 has the potential to measure changes in couple satisfaction after couple therapy or interventions. Applying K-CSI 32 may facilitate research on couple and family relationships in nursing and contribute to the discussion on the role of couple satisfaction in mental health.

Feasibility and Preliminary Efficacy of a New Online Self-Help Intervention for Depression among Korean College Students' Families.

Applying innovative online approaches to interventions for preventing depression is necessary. Since depressive emotions are typically shared within the family, the development of interventions involving family members is critical. This study thus aimed to examine the feasibility, acceptability, and preliminary outcomes of a new online self-help intervention, MindGuide, among Korean college students' families. We developed MindGuide, which integrates cognitive behavioral therapy with mindfulness and an emotional regulation approach. A one-group pretest-posttest design was used to measure the changes in the Center for Epidemiological Studies Depression Scale, the Attitude Toward Suicide scale, and the Satisfaction With Life Scale before and after the intervention. Of the 34 families that began the program, completion rates were 88.2%, 85.3%, and 91.2% for fathers, mothers, and children, respectively. The findings indicated that the MindGuide program is feasible and acceptable for families of Korean college students. The results support the potential effect of MindGuide on reducing depression, improving positive attitudes toward suicide prevention, and enhancing family relationships in participants at risk of depression. However, future research is needed to thoroughly explore and evaluate the efficacy of the MindGuide program.

The Benefits of Spiritual Diaries: A Mixed-Method Study in Korea.

This mixed study examined the benefits of spiritual diaries in Korea. Quantitatively, differences in spiritual growth and psychological well-being were examined in relation to the frequency of writing spiritual diaries among 385 participating adults. The group who wrote spiritual diaries '5-7 times a week' had significantly higher scores relating to spiritual growth and psychological wellbeing than other groups across the outcome variables. Qualitatively, the study also explored the benefits of writing spiritual diaries among 37 adults. Three major themes using four focus group interviews, were identified: (a) the acquisition of godly habits, (b) a closer walk with Jesus, and (c) the fullness of God's presence. These findings are particularly important for healthcare providers who want to facilitate patient self-care.

Development and Validation of the Family Relationship Assessment Scale in Korean College Students' Families.

The nature of family relationships is a critical measure for healthcare professionals who work with families. In particular, non-Western cultural groups display a higher level of collectivism that emphasizes relationships between family members. This paper reports the development and psychometric testing of a new scale, the Korean Family Relationship Assessment Scale (FRAS). Using DeVellis' Guidelines in Scale Development, a pool of 40 items was created after a review of the literature, followed by an assessment for content validity by six experts. Both exploratory and confirmatory factor analyses were conducted with data from a sample of 217 Korean family triads (father, mother, and college-aged offspring) (N = 651). The final evaluation yielded three factors with 15 items: family support, family conflict, and family togetherness. Since the FRAS demonstrated good internal consistency and validity, it would be able to facilitate research on the relationships between family support, conflict, togetherness, and health. Applying this new instrument in theory-based research may contribute to knowledge about the role of the family in the health and well-being of family members within a Korean context. For clinical practice, this culturally sensitive and valid instrument has the potential to measure changes in family relationships after family therapy or interventions.

La índole de las relaciones familiares es una medida fundamental para los profesionales de la salud que trabajan con familias. En particular, los grupos culturales no occidentales muestran un nivel más alto de colectivismo que enfatiza las relaciones entre los miembros de la familia. Este artículo informa el desarrollo y la evaluación psicométrica de una nueva escala, la Escala de Evaluación de las Relaciones Familiares Coreanas (Korean Family Relationship Assessment Scale, FRAS). Utilizando las pautas de DeVellis en el desarrollo de escalas, se creó un grupo de 40 elementos después de una revisión de la bibliografía, seguido de una evaluación de la validez del contenido por parte de seis especialistas. Se realizaron análisis factoriales exploratorios y confirmatorios con datos de una muestra de 217 triadas de familias coreanas (padre, madre e hijos en edad universitaria) (N = 651). La evaluación final arrojó tres factores con 15 elementos: apoyo familiar, conflicto familiar y unión familiar. Como la FRAS demostró buena coherencia y validez interna, podría facilitar la investigación sobre las relaciones entre el apoyo, el conflicto, la unión y la salud de la familia. La aplicación de este nuevo instrumento en la investigación basada en la teoría puede incrementar el conocimiento acerca del papel de la familia en la salud y el bienestar de los miembros de la familia dentro de un contexto coreano. Para la práctica clínica, este instrumento culturalmente sensible y válido tiene el potencial de medir los cambios en las relaciones familiares después de la terapia o las intervenciones familiares.

Couple- or family-oriented interventions and outcomes for preventing mental health problems and promoting mental health: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to map the literature describing couple- and family-oriented interventions and outcomes to prevent mental health problems and promote mental health. INTRODUCTION: Literature involving couple- and family-focused mental health interventions has gained increased attention over the past two decades, yet little is known about the efficacy of these interventions for promoting mental health and preventing mental disorders. Despite recognition that the most sustainable method for reducing the increasing burden of mental disorders is primary prevention, there has been no systematic investigation of relevant couple- and family-focused interventions. INCLUSION CRITERIA: This scoping review will consider studies that include couples or multiple family members who have participated in couple- and family-focused interventions aimed at primary prevention of mental disorders and promotion of mental health. This study will include experimental, quasi-experimental, and observational study designs, as well as qualitative studies. Conference abstracts, posters, editorials, commentaries, and opinion papers will be excluded. METHODS: Multiple databases will be searched, including PubMed (MEDLINE), CINAHL, ERIC, PsycINFO (via EBSCO), Web of Science, Scopus, and Research Information Sharing Service (RISS). Trial registers and gray literature will also be searched. Two independent reviewers will screen the abstract/title of retrieved citations using inclusion and exclusion criteria. After screening titles and abstracts of identified citations, relevant studies will be retrieved in full. Using a data extraction instrument developed specifically for this review, eligible studies will be extracted and presented in diagrammatic or tabular form, accompanied by a narrative summary.

Journaling for self-care and coping in mothers of troubled children in the community.

AIM: This mixed method research explored the benefits of a six-week diary writing intervention, and the coping strategies utilized in a sample of affected mothers who have teenagers or adult children with emotional and/or behavioral issues. METHODS: Participants were assigned to write either a best possible self or a gratitude journal, and asked to make entries at least three times per week for six weeks. A snowball sample of 34 mothers completed the six-week journal and post-test. RESULTS: The findings of paired t-tests indicated statistically significant increases in optimism and gratitude levels after completing the writing intervention. The mothers commonly used coping methods for parental distress were emotion-and meaning-focused coping. The three themes of journal writing experience were positive thinking, emotional well-being, and mental health self-care. CONCLUSION: The current study suggests that implementing a positive writing intervention is a practical means of promoting psychological well-being as a self-care strategy for this population.

Family Interdependence, Spiritual Perspective, Self-Transcendence, and Depression Among Korean College Students.

The purpose of this study was to examine the mechanisms that might account for the effects of spirituality and self-transcendence on Korean college students' depression among 197 Korean fathers, mothers, and children. A structural equation analysis indicated that spiritual perspective related to lower depression through the mediating pathway of self-transcendence for individuals. Mothers' spiritual perspective and self-transcendence related to their children's depression through the mediating pathway of their own depression, but the same was not true for fathers. Findings help explicate the intergenerational transmission of depression and important predictors of depression related to spirituality.