The Effects of a Tripod Approach for Cancer Patients on Illness Stress, Health-Promoting Lifestyle, Hope, and Resilience.

BACKGROUND: Health-related exercise and education program for cancer patients are necessary to provide physical and emotional support to enable efficient and appropriate self-management at home. OBJECTIVE: This study aimed to investigate the effects of a tripod approach including physical exercise, education, and emotional support program on illness stress, health promotion lifestyle, hope, and resilience in cancer patients. INTERVENTIONS/METHODS: This was a quasi-experimental repeated-measures study using a pre-post design with a nonhomogeneous control group. A total of 72 cancer patients (experimental group = 37, control group = 35) who were currently receiving treatment and staying at home were enrolled. RESULTS: The experimental group showed significantly lower illness stress scores (F = 17.35, P < .001) and increase in health promotion lifestyle scores (F = 4.05, P = .048) compared with the control group, especially social relationships (t = 1.85, P = .073) and stress management (t = 2.30, P = .027). However, there were no effects on hope and resilience. Also, illness stress showed significant changes after 6 weeks (t = -3.35, P = .001) and after 10 weeks (t = -5.04, P < .001). Overall health promotion lifestyle showed changes after 10 weeks (t = 2.25, P = .030), with meaning of life (t = 2.57, P = .014), stress management (t = 2.30, P = .027), and medical behaviors (t = 2.46, P = .019) especially showing significant changes. CONCLUSIONS: The results showed that the tripod approach had positive effects on illness stress and health promotion lifestyle of cancer patients staying at home. Further study to improve positive emotions such as hope and resilience is needed. IMPLICATIONS FOR PRACTICE: Based on our findings, combining nursing intervention with physical exercise, education, and emotional support could be incorporated into cancer patients in community and early survivorship care plans in clinical practice.

The hopes of nurses who care for people diagnosed with chronic mental illness in closed wards.

PURPOSE: To identify factors influencing the hopes of mental health nurses and to explore their experiences with a sense of hope. DESIGN AND METHODS: A descriptive research survey was conducted with 113 nurses at three closed psychiatric wards in South Korea. FINDINGS: Nurses' hope, interpersonal skill competence, and professional self-concept were all found to have statistically significant correlations (r = 0.60-0.73, p < 0.01). These factors explained 62% of the variance in nurses' hope. In ten themes influencing hope, 71.1% were positive, 28.9% negative. PRACTICE IMPLICATIONS: The findings suggest that the promotion of nurses' interpersonal skill competence and professional self-concept is helpful for increasing hope levels. Both positive and negative experiences with hope are important in developing strategies of nursing roles.

Effects of an Aging Management Program for Middle-aged Women on Resilience and Successful Aging.

PURPOSE: The purpose of this study was to examine the effects of an aging management program on the resilience and successful aging of middle-aged women. METHODS: A quasi-experimental study with a non-equivalent control and pre-post test design was used. The participants were 39 middle-aged women living in urban areas in Korea. The experimental group (n=22) received the aging management program for a total of 10 weeks, 90 minutes to 120 minutes per week. The aging management program consisted of strategies to enhance the behavior, promotion conditions, and habits of the program, including various activities for middle-aged women. The data were analyzed using χ² tests, independent t-tests, and repeated measures analysis of variance with the SPSS/WIN 21.0 program. RESULTS: The resilience score of the experimental group was significantly higher level than the score of the control group in the time-to-group interactions (F=3.70, p=0.029). The successful aging score of the experimental group was significantly higher than the score of the control group in the time-to-group interactions (F=5.86, p=0.004). However, the sub-hypotheses of resilience (self-regulation and interpersonal relationships) and successful aging (physical aging adaptation and psychological age adaptation) were partially accepted. CONCLUSIONS: The aging management program for middle-aged women was identified as an effective intervention for promoting resilience and successful aging in middle-aged women. Therefore, this suggests that the aging care program could be a useful intervention program to improve the mental health of middle-aged women living in communities.

Quantitative and Qualitative Evaluations of the Enhanced Logo-autobiography Program for Korean-American Women.

This study extends Bernstein et al.'s (2016) investigation of the effects of the Enhanced Logo-autobiography Program on Korean-American women's depressive symptoms, coping strategies, purpose in life, and posttraumatic growth by analyzing quantitative and qualitative data. This study's participants significantly improved on quantitative measures of depression, coping strategies, purpose in life, and post-traumatic growth at eight weeks post-intervention and follow-up. The qualitative content analysis revealed 17 themes with five essential themes. The program's activity to promote purpose in life through posttraumatic growth facilitated participants' recovery from traumatic experiences. Standardized guidelines are needed to conduct this program in Korean community centers.

[The Effects of Violence Coping Program Based on Middle-Range Theory of Resilience on Emergency Room Nurses' Resilience, Violence Coping, Nursing Competency and Burnout].

PURPOSE: The purpose of this study was to examine the effects of a violence coping program (VCP) based on Polk's middle-range theory of resilience on nursing competency, resilience, burnout, and the ability to cope with violence in nurses working in emergency rooms. METHODS: A quasi-experimental study, with a nonequivalent control group and a pretest-posttest design, was conducted. Participants were 36 nurses who worked in emergency rooms and had experienced violence; 18 nurses from D hospital and 18 nurses from C hospital were assigned to the experimental and control groups, respectively. The experimental group received the VCP twice per week for 8 weeks. RESULTS: Levels of resilience, F=59.41, p<.001, active coping behavior, χ²=33.09, p<.001, and nursing competency, F=59.41 p<.001, increased significantly and levels of passive coping behavior, χ²=22.92, p<.001, and burnout, F=52.74, p<.001, decreased significantly in the experimental group. CONCLUSION: The results suggest that the VCP could be an effective strategy for reducing burnout and improving resilience, active coping behavior, and nursing competency. Therefore, it would be a useful intervention for improving the quality of nursing care provided in emergency rooms.

[Effects on Stress, Problem Solving Ability and Quality of Life of as a Stress Management Program for Hospitalized Schizophrenic Patients: Based on the Stress, Appraisal-Coping Model of Lazarus & Folkman].

PURPOSE: The study was done to evaluate the effects a Stress Management Program (SMP) on stress, problem solving skills, and quality of life for hospitalized patients with Schizophrenia. METHODS: A mixed method design was used: a combination of a repeated-measure design with a non-equivalent control group and qualitative data collection. The participants were 40 patients with schizophrenia admitted in three psychiatric hospitals. The experimental group (n=20) received the SMP twice a week for a total of 8 weeks. RESULTS: Study results revealed that the SMP was effective for stress (F=321.02, p<.001), problem solving ability (F=246.28, p<.001), and quality of life (F=63.35,p<.001) for hospitalized persons with schizophrenia. CONCLUSION: The results suggest that a SMP can be an effective strategy to reduce patients' hospitalization stress, and improve problem solving skills and quality of life. Therefore, it is recommended that mental health nurses use this stress management program in clinical practice to assist adaptation to hospitalization for persons with schizophrenia.

Transtheoretical Model Based Exercise Counseling Combined with Music Skipping Rope Exercise on Childhood Obesity.

PURPOSE: The purpose was to evaluate the effects of a transtheoretical model (TTM) based exercise counseling offered with music skipping rope exercise on components of the TTM (stages of change, decisional balance, and self-efficacy), body mass index, glucose, and lipid profile of overweight/obese children in Korea. METHODS: This study used a nonequivalent pretest and posttest experimental study design. A total of 75 overweight/obese children participated in the study. Eight sessions of exercise counseling combined with music skipping rope exercise for 12 weeks were offered for children in the experimental group, while one session of exercise counseling with music skipping rope exercise for 12 weeks was offered for children in the control group. Outcomes were measured at baseline, and 6 months after the intervention. RESULTS: After the intervention, self-efficacy significantly improved among children in the experimental group (p = .049), while these children maintained their baseline BMI at 6-month follow-up (p > .05). Among children in the control group, BMI significantly increased (p < .05). Fasting blood sugar significantly increased for both groups after the intervention (p < .05). However, a greater increase was observed for the control group. CONCLUSIONS: Our study partially supports the hypothesis that a TTM-based exercise intervention is effective in maintaining BMI and improving self-efficacy of overweight/obese children. The TTM-based counseling combined with exercise classes has potential to control weight among overweight/obese children, while involvement of parents and children in the development of the theory-based intervention may generate further benefits regarding health and well-being of overweight/obese children.

[Development of a measurement of stress for hospitalized schizophrenic patient].

PURPOSE: This study was done to develop a measurement for stress experienced by patients with schizophrenia during hospitalization. METHODS: The preliminary tool was developed through in-depth interviews and a validity verification test of content. For data collection, 15 inpatients with schizophrenia were selected as participants for in-depth interviews and 195 patients admitted to one of eight psychiatric hospitals in four provinces were recruited as participants to test reliability and validity of the preliminary tool. RESULTS: The questionnaire was developed as a four-point Likert-type scale in a self-report form with 28 items. Factor analysis showed 28 items in six factors. Factors were named 'Unjust human rights infringement', 'Futureless life', 'Alienation from other family members', 'Infringement of basic needs', 'Infringement of personal preference' and 'Inconvenience of shared living'. The six factors explained 63.5% of the total variance. Cronbach's alpha for the total items was .93 and for the factors ranged from .65 to .87. CONCLUSION: A tool to measure stress in patients hospitalized with schizophrenic was developed based on identified hospitalization stress experiences. Study results indicate that this tool can be used to evaluate hospitalization stress in these patients and will contribute to establishing nursing interventions for relief of hospitalization stress.

The effects on helplessness and recovery of an empowerment program for hospitalized persons with schizophrenia.

PURPOSE: The study aim was to evaluate the effects on helplessness and recovery of an empowering program for patients with chronic schizophrenia. DESIGN AND METHODS: A repeated-measure design with a control group was used. The subjects consisted of 46 patients with schizophrenia admitted in three psychiatric hospitals in South Korea. The experimental group (n = 23) received the empowering program twice a week for 60 min, with a total of 6 weeks. FINDINGS: This finding revealed that the empowering program was effective on helplessness (F = 185.218, p <.001) and recovery (F = 159.402, p <.001, F = 34.154, p <.001) of hospitalized persons with schizophrenia. PRACTICE IMPLICATIONS: This study demonstrated that the empowering program can be a useful psychiatric nursing intervention.

Factors associated with screen time among school-age children in Korea.

The purpose of this study was to investigate the association of sociodemographic, psychosocial, and behavioral characteristics with screen time among school-age children in Korea. This study employed a nonexperimental, cross-sectional study design. A total of 370 children attending four elementary schools participated in the study. Self-report method was used, and instruments included screen time (time spent on TV/video/computer/video games), sleep duration, eating behavior, pros and cons of exercise, and exercise self-efficacy. According to the results, 45.7% of the children had screen time of 1-2.9 hr/day and 8.9% had 3 or more hr/day. Increased screen time showed an association with gender (boy), higher body mass index, fast food consumption, higher cons of exercise, having a working mother, and attendance at a school in an inner city area (p < .05). Understanding the factors associated with screen time may provide useful information in the development of health promotion programs aimed at decreasing sedentary behaviors.

Management of type 2 diabetes mellitus in older adults.

In the near future, the majority of patients with diabetes will be adults aged 65 or older. Unlike young adults with diabetes, elderly diabetic people may be affected by a variety of comorbid conditions such as depression, cognitive impairment, muscle weakness (sarcopenia), falls and fractures, and physical frailty. These geriatric syndromes should be considered in the establishment of treatment goals in older adults with diabetes. Although there are several guidelines for the management of diabetes, only a few are specifically designed for the elderly with diabetes. In this review, we present specific conditions of elderly diabetes which should be taken into account in the management of diabetes in older adults. We also present advantages and disadvantages of various glucose-lowering agents that should be considered when choosing a proper regimen for older adults with diabetes.

[Effects of an elder health promotion program using the strategy of elder health leader training in senior citizen halls].

PURPOSE: This study was conducted to develop and test the effects of an elder health promotion program and apply strategies for elder health leader training sessions with elders at senior citizen halls. METHODS: A nonequivalent control group pretest-posttest design was used. Participants were 49 elders at a senior citizen hall (intervention: 27, control: 22). The elder health promotion program consisted of health education and exercise. A professional leader led the program for 4 weeks, and then an elder health leader and research assistant led for 8 weeks (total 12 weeks). Scales for elder health promoting behaviors, perceived health status, life satisfaction and senior citizen hall capability were used and physical fitness levels were measured. Data were collected between April 21 and July 28, 2010 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANOVA with SPSS/WIN 12.0. RESULTS: Health promoting behaviors, physical fitness, perceived health status, and senior citizen hall capacity were significantly better in the experimental group after the intervention compared to the control group. CONCLUSION: Study findings indicate that elder health promotion programs applying strategies of elder health leader training are effective and can be recommended as nursing interventions for health promotion of these elders.

Effects of a school-based intervention program for middle school adolescent girls with depression: as part of the school health services.

PURPOSE: The purpose of this study was to evaluate the effects of a school-based intervention program for middle school adolescent girls with depression. METHODS: The study was a pretest-posttest repeated-measure design with a nonequivalent control group. Fifty eight students with depressive symptoms were recruited from two middle schools in Seoul, Korea. The data were collected from the intervention (n=30) and the comparison group (n=28). The research instrument was Reynolds Adolescent Depression Scale. RESULTS: The intervention group greatly improved from baseline to 10 weeks and then saw a slight positive change between 10 and 13 weeks. CONCLUSION: The results of this research show that depression intervention programs are effective for young female adolescents. Thus the investigation has important school-based treatment implications, and should be integrated into school curricula by school health nurses for early intervention of depressive symptoms in middle school adolescent girls.

Self-concept and coping skills of female early adolescents in South Korea.

The purpose of the present study was to investigate the coping strategies and self-concept of Korean female early adolescents. These adolescents (n = 351) were enrolled in a middle school in Seoul. The subjects completed the Multidimensional Self-Concept Scale and Coping Responses Inventory questionnaires. The subjects exhibited the greatest positivity with regard to family self-concept and the greatest negativity with regard to academic self-concept. The subjects most frequently used the seeking guidance strategy of approach coping and the seeking alternative rewards strategy of avoidance coping. Self-concept was positively or negatively related with various coping skills. Using content analysis, seven categories including discord in family relationships were identified. The results of this study provide information that will aid school nurses working with adolescents with regard to helping the adolescents develop a positive self-concept and more effective coping strategies.

[Trends of doctoral dissertations in nursing science: focused on studies submitted since 2000].

PURPOSE: The purpose of this study was to identify the characteristics of doctoral dissertations in nursing science submitted since 2000. METHOD: Three-hundred and five dissertations of six schools of nursing published from 2000 to 2006 in Korea were analyzed with the categories of philosophy, method, body of knowledge, research design, and nursing domain. RESULT: In philosophy, 82% of all dissertations were identified as scientific realism, 15% were relativism, and 3% were practicism. Two-hundred and fifty dissertations (82%) were divided into a quantitative methodology and 55 dissertations (18%) were qualitative methodology. Specifically, 45% were experimental, 23% methodological, 13% survey and 17% qualitative designed researches. Prescriptive knowledge was created in 47% of dissertations, explanatory knowledge in 29%, and descriptive knowledge in 24%. Over 50% of all research was studied with a community-based population. In the nursing domain, dissertations of the practice domain were highest (48.2%). CONCLUSION: Dissertations since 2000 were markedly different from the characteristics of the previous studies (1982-1999) in the increase of situation-related, prescriptive and community-based population studies. A picture of current nursing science identified in this study may provide a future guideline for the doctoral education for nursing.

Psychosocial factors and coping strategies of adolescents in a rural Pennsylvania high school.

OBJECTIVES: To evaluate the coping levels of rural adolescents and gender differences of coping strategies and psychosocial factors. To identify the relationships of coping strategies with psychosocial factors of rural adolescents. DESIGN: A cross-sectional study. SAMPLE: A convenience sample of 72 students attending a rural high school in southwestern Pennsylvania. MEASUREMENTS: Subjects completed the Coping Response Inventory-Youth (CRI-Y), the State-Trait Anger Expression Inventory (STAXI), the Screen for Child Anxiety Related Emotional Disorder (SCARED), the Reynolds Adolescent Depression Scale (RADS), and the Rosenberg Self-Esteem Scale (RSES). RESULTS: Significant gender differences were found for psychosocial factors of depression, self-esteem, and anxiety. Several significant relationships were observed between coping strategies and psychosocial factors of rural adolescents. Additionally, using content analysis, seven categories were determined based on the content of the open-ended question on the CRI: familial factors, peer relationships, etc. CONCLUSIONS: These rural adolescents endorsed higher levels of avoidance coping than normative samples. Rural adolescents reported many problems needing proper coping skills in their everyday lives. This study provides information to public health professionals working with rural adolescents that could be used to help them attain more effective coping strategies.

Comparing life experiences of college students with differing courses of schizophrenia in Korea: case studies.

PURPOSE: The objective of this study was to identify how daily experiences of college students with schizophrenia reflected the course of their disease. METHODS: The sample included 8 college students with schizophrenia. Comparisons of life experiences were made across disease courses using themes established in a prior study. FINDINGS: Subjects had different themes according to the following three disease courses: recovering, deteriorating, and fluctuating. CONCLUSIONS: This finding provides support for developing intervention strategies for college students in each disease course, such as the unique ways that psychiatric nurses can help college students with difficulties due to serious mental illness.

Schizophrenia in college students in Korea: a qualitative perspective.

PURPOSE: The objective of this study was to identify the salient themes that characterize the life experiences of college students with schizophrenia. METHODS: Twenty-one schizophrenia patients enrolled in college underwent in-depth interviews employing semistructured questionnaires. The content of the interviews was analyzed for recurring themes and categories of experience. FINDINGS: Analyses revealed 25 themes and six categories of experience. Subjects reported the experiences of school life (23.6%), interactions with family (22.2%), interactions with friends (21.9%), a mental illness (20.5%), everyday life (6.1%), and social role performance (5.7%). CONCLUSIONS: This study supports the need for treatment options that meet the students' actual life experiences focusing on developmental characteristics and needs.

[Effects of a network program for preventing obesity of patients taking antipsychotics or antidepressants].

PURPOSE: This study was designed to investigate the effects of a network program to prevent obesity and improve dietary habits for patients taking antipsychotics or antidepressants. METHOD: Thirty-seven patients in two hospitals were assigned to a control group (21 patients) or an intervention group (16 patients). The intervention group was evaluated to analyze the effect of the network program for six weeks after the program. RESULT: There was a difference in the rate of increased body weight between the control group and the intervention group. Notably, the body weight of both groups before the intervention was significantly increased. However, after the intervention the body weight of the intervention group rarely increased, whereas, the body weight of the control group was significantly increased as expected. There was an observed difference in diet between the control group and the intervention group. After the intervention, caloric intake per day of the intervention group decreased. Also, the duration of the meal of the intervention group after the intervention was longer than before. CONCLUSION: The network program for preventing obesity and improving dietary habits of patients taking antipsychotics or antidepressants was effective. The study shows that a network program can be an important part of a nursing intervention in clinical practice.

[Trends of nursing science inquiry in doctoral dissertations].

PURPOSE: The purpose of this study was to identify the theoretical characteristics and direction of inquiry in the discipline of nursing by analyzing doctoral dissertations. METHOD: The materials used in this study were 277 doctoral dissertations from five universities in Korea. The framework for the study was derived from Kim's(1993) alternative linkage among philosophy, theory, and method in nursing science. RESULT: Of the 277 dissertations it was found that there were 13 types of linkages out of a possible 54 types. Most of the dissertations (128 of 277) were done within the linkage of realism/etic/quantitative/explanatory knowledge type. Of the 218 dissertations within scientific realism, 42 were within relativism, and 17 within practicism. There were 134 dissertations of the explanatory knowledge type, 112 descriptive ones, and 31 prescriptive ones. Studies done within the etic quantitative methodology included 209 dissertations and within the emic perspective, 43 with qualitative methodology, and 7 with quantitative. CONCLUSION: The results show that it is necessary to develop more alternative linkages for nursing practice and this will lead to expanding nursing knowledge.