Identifying the Risk Factors of Suicidal Ideation in Patients With Hematologic Malignancies Using a Multidimensional Approach.

BACKGROUND: Patients with hematologic malignancies have a 3.5-fold higher rate of suicide completion than the noncancer population, and the Hodgkin lymphoma has the highest suicide rate among all cancers. Although the risk factors for suicidal ideation among the cancer population are well-known, the specific risk factors contributing to the high suicide rate among patients with hematologic malignancies are elusive. OBJECTIVE: This study aimed to identify the risk factors for suicidal ideation among patients with hematologic malignancies using a multidimensional approach. METHODS: This was a cross-sectional, observational study. A total of 163 patients were recruited from the oncology department of a university hospital. We collected data on psychological and physical symptoms, social support, and suicidal ideation using the Memorial Symptom Assessment Scale-Short Form, the Multidimensional Scale of Perceived Social Support, and the Suicidal Ideation Scale. Multiple regression analysis was performed using SPSS (version 26.0) to analyze the clinical data. RESULTS: Among the 163 participants, 96 (58.9%) were male, 57 (35%) were diagnosed with acute leukemia, and 97 (59.5%) received chemotherapy. The mean age was 55.26 ± 15.75. Physical symptoms, psychological symptoms, and willingness to use mental health services accounted for 39.5% of suicidal ideation cases. CONCLUSIONS: Assessment of psychological conditions at the beginning of diagnosis, provision of appropriate interventions throughout treatment, and follow-up care to relieve psychological symptoms should be initiated in patients with hematologic malignancies to prevent suicide.

[Effect of Digital Health Interventions on Psychotic Symptoms among Persons with Severe Mental Illness in Community: A Systematic Review and Meta-Analysis].

PURPOSE: This study aimed to evaluate the effects of digital health interventions on the psychotic symptoms among people with severe mental illness in the community. METHODS: A systematic review and meta-analysis were conducted in accordance with the Cochrane Intervention Research Systematic Review Manual and PRISMA. A literature search was conducted of published randomized controlled trials (RCTs) for digital health interventions from January 2022 to April 2022. RevMan software 5.3 was used for quality assessment and meta-analysis. RESULTS: A total 14 studies out of 9,864 studies were included in the review, and 13 were included in meta-analysis. The overall effect size of digital health interventions on psychotic symptoms was -0.21 (95% CI = -0.32 to -0.10). Sub-analysis showed that the reduction of the psychotic symptoms was effective in the schizophrenia spectrum group (SMD = -.0.22; 95% CI = -.0.36 to -0.09), web (SMD = -0.41; 95% CI = -0.82 to 0.01), virtual reality (SMD = -0.33; 95% CI = -0.56 to -0.10), mobile (SMD = -0.15; 95% CI = -0.28 to -0.03), intervention period of less than 3 months (SMD = -0.23; 95% CI = -0.35 to -0.11), and non-treatment group (SMD = -0.23; 95% CI = -0.36 to -0.11). CONCLUSION: These findings suggest that digital health interventions alleviate psychotic symptoms in patients with severe mental illnesses. However, well-designed digital health studies should be conducted in the future.

Identifying the suicidal ideation risk group among older adults in rural areas: Developing a predictive model using machine learning methods.

AIMS: The aim of this study was to develop a predictive model that can identify the suicidal ideation risk group among older adults in rural areas using machine learning methods. DESIGN: This study applied an exploratory, descriptive and cross-sectional design. METHODS: The participants were older adults (N = 650) aged over 65 living in rural areas of South Korea. Self-report questionnaires were used to collect the demographics, suicidal ideation, depression, socioeconomic information and basic health information from September to October 2020. The collected data were analysed using machine learning methods with R statistical software 4.1.0. RESULTS: The predictive models indicated that depression, pain, age and loneliness were significant factors of suicidal ideation. Good performance was observed based on the area under the receiver operating characteristic curve in the decision tree, random forest and logistic regression. Finally, the evaluation of model performance indicated moderate to high sensitivity and specificity. CONCLUSION: The predictive models using machine learning methods may be useful to predict the risk of suicidal ideation. Furthermore, depression with pain, age and feelings of loneliness should be included in the initial screening to assess suicide risk among older adults in rural areas. IMPACT: Identifying suicidal risk among older adults is challenging. Thus, employing predictive models that can assess depression, pain, age and loneliness can enable public healthcare providers to detect suicidal risk groups. Particularly, the presented models from this study can facilitate healthcare providers with initiating early interventions to prevent suicide among older adults in clinical and community nursing care settings. REPORTING METHOD: The reporting of this study (Observational, cross-sectional study) conforms to the STROBE statement. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public. IMPLICATION FOR THE PROFESSION AND/OR PATIENTS CARE: Applying this model may help to prevent geriatric suicide because the nursing staff will have a greater awareness regarding the suicide ideation risk of older adults, thereby reducing the possibility of their suicide.

Development and Effect of a Salutogenic Program for Rural Elderly Women on Depression and Suicidal Ideation.

This study aimed to develop and evaluate the effects of a Salutogenic program on sense of coherence, depression, and suicidal ideation among rural older adults. Quasi-experimental, nonequivalent control group pretest-posttest design was used. Participants were female, aged 65 years and older from G and O province, South Korea. The experimental group (n = 22) received a 12-session Salutogenic program for 6 weeks, twice a week. The control group (n = 19) was put on a waiting list to receive the intervention after completing the study. Collected data were analyzed using descriptive statistics, a χ2 test, independent t-test, and repeated measure ANOVA with SPSS WIN 26.0. There were significant differences in sense of coherence (F = 19.34, p < .001), depression (F = 12.93, p < .001), and suicidal ideation (F = 4.40, p = .027) over time pretest, posttest, and follow-up test after intervention between two groups. The study discussed the effect of Salutogenic program on sense of coherence, depression, and suicidal ideation, and considered its benefits in suicide prevention for elderly women. The Salutogenic program can be recommended as useful strategies to enhance sense of coherence and to reduce depression and suicidal ideation of elderly women in community.

Nurses' Assessment of Sedation of Patients With Mental Illness: Scale Development and Validation.

The current study aimed to determine the reliability and validity of a tool for evaluating the sedation of patients with mental illness. A literature review and focus group interviews were used to develop the initial questionnaire. The scale was tested on a sample of 412 representative patients and analyzed using exploratory factor analysis, concurrent validity, and internal consistency. The final scale comprised 14 items across four factors related to sedation of patients with mental illness: arousal, affect, cognitive status, and physical performance. The scale has high sensitivity and specificity and can discriminate among levels of sedation for patients with mental illness. [Journal of Psychosocial Nursing and Mental Health Services, 58(12), 22-31.].

The Moderating Effect of Communication Behavior on Nurses' Care Burden Associated with Behavioral and Psychological Symptoms of Dementia.

This study analyzed the moderating effect of the communication behavior that impacts the care burden of nurses who care for people with behavioral and psychological symptoms of dementia (BPSD). Through the Johnson-Neyman method and SPSS PROCESS Macro, the moderating effect of communication behavior was analyzed. The results showed that communication behavior has a moderating effect on the care burden of nurses of people with BPSD. The results of this study can provide basic data for the development and evaluation of the communication behavior program to reduce the care burden of nurses.

The Effects of Self-Care Intervention Programs for Elderly with Mild Cognitive Impairment.

This study examined the effects of a self-care intervention program on self-efficacy, dementia-preventive behavior, cognitive function, depression, and quality of life in elderly with mild cognitive impairment. The study employed a quasi-experimental study design using a nonequivalent control group pre-post. Data were analyzed using the chi-square test, independent t-test, and repeated-measures ANOVA. The results of the study showed that the program reduced dementia risk and strengthened self-care ability in older adults with MCI.

[Development and Validation of the Communication Behavior Scale for Nurses Caring for People with Dementia].

PURPOSE: The purpose of this study was to develop and validate the Communication Behavior Scale for nurses caring for people with Dementia (CBS-D). METHODS: Based on communication accommodation theory, the initial items were generated through a literature review and interviews with 20 experts. Content and face validity of the initial items were assessed. Data from 486 nurses caring for people with dementia were analyzed using item analysis, exploratory and confirmatory factor analysis, criterion-related validity, and internal consistency. RESULTS: The final scale consisted of 18 items and four factors (discourse response management, interpersonal control, emotional expression, and interpretability) that explained 57.6% of the variance. Confirmatory factor analysis indicated that the theoretical model with 18 items satisfied all goodness-of-fit parameters. Criterion-related validity was shown by the Global Interpersonal Communication Competence Scale (r=.506, p<.001). Cronbach's alpha for the total scale was .88. CONCLUSION: The CBS-D can be used to measure the communication behavior of nurses caring for people with dementia.

Factors Influencing on Mental Health Help-seeking Behavior Among Korean Women: A Path Analysis.

PURPOSE: The purpose of the study was to identify factors influencing mental health help-seeking behavior among women in the community. METHODS: A cross-sectional design was used. Participants were 402 women in South Korea. Data were analyzed using descriptive statistics, Pearson's correlation coefficient, and a path analysis by IBM SPSS 21.0 and AMOS 21.0. RESULTS: There was a significant, but weak positive correlation between perceived need and help-seeking intentions for formal mental health help (r=0.09, p<0.05). In the path analysis, significant the factors influencing help-seeking intentions were perceived need, attitude, and belief toward mental illness, and the attitude of them had the greatest effect. These factors accounted for 12.2% of the total variance, and the model fit was acceptable. CONCLUSION: The findings of the study reveal that positive mental illness interpretation and consequence can predict mental health help-seeking behavior of women as well as the perceived need for mental health help.

Construct Validity and Reliability of the Beliefs Toward Mental Illness Scale for American, Japanese, and Korean Women.

PURPOSE: The aim of this study was to evaluate the psychometric properties of the Beliefs Toward Mental Illness Scale (BMI) across women from the United States, Japan, and South Korea. METHODS: A cross-sectional study design was employed. The sample was 564 women aged 21-64 years old who were recruited in the United States and Korea (American = 127, Japanese immigrants in the United States = 204, and Korean = 233). We carried out item analysis, construct validity by confirmatory factor analysis (CFA), and internal consistency using SPSS Version 22 and AMOS Version 22. RESULTS: An acceptable model fit for a 20-item BMI (Beliefs Toward Mental Illness Scale-Revised [BMI-R]) with 3 factors was confirmed using CFA. Construct validity of the BMI-R showed to be all acceptable; convergent validity (average variance extracted [AVE] ≥0.5, construct reliability [CR] ≥0.7) and discriminant validity (r = .65-.89, AVE >.79). The Cronbach's alpha of the BMI-R was .92. CONCLUSION: These results showed that the BMI was a reliable tool to study beliefs about mental illness across cultures. Our findings also suggested that continued efforts to reduce stigma in culturally specific contexts within and between countries are necessary to promote help-seeking for those suffering from psychological distress.

Korean Translation of the Barriers to Research Utilization Scale: Psychometric Testing.

PURPOSE: The purpose of this study was to assess the psychometric properties of the Barriers or Facilitators to Using Research in Practice (BARRIERS) scale for use in Korea. METHODS: A cross-sectional study design was used with 364 nurses working in clinical settings. Item analysis was conducted and convergent and discriminant validity were evaluated using confirmatory factor analysis. Internal consistency reliability was evaluated using Cronbach's alpha coefficients. RESULTS: Confirmatory factor analysis revealed a 4-factor structure with 25 items that explained 62.9% of the variance. Convergent and discriminant validity were confirmed as examining the factor loading, average variance extracted, and composite reliability. The values of factor loading for 25 items were having higher estimate than criterion and the average variance extracted value for 4 factors ranged from .575 to .667. The Cronbach's alpha was .90 for the 25 items. CONCLUSION: The Korean version of the 25-item BARRIERS scale was a reliable and valid scale to measure barriers to research use in Korean health care settings. Based on this psychometric evaluation, research barriers and its associated factors will be investigated using the Korean version of the BARRIERS scale in further study.

The Effectiveness of the Nanta-Program on Psychiatric Symptoms, Interpersonal Relationships, and Quality of Life in Forensic Inpatients with Schizophrenia.

PURPOSE: The purpose of this study was to examine the effectiveness of the Nanta-program on psychiatric symptoms, interpersonal relationships, and quality of life (QoL) in forensic inpatients with schizophrenia (SPR). METHODS: A quasi-experimental study employing a nonequivalent control group and pre-posttest design was conducted. Participants were 38 forensic inpatients with SPR from South Korea (experimental group=18, control group=20). The intervention was conducted in 12 sessions over 12 weeks, taking 90 min per session. Data were analyzed using χ2-test and t-test with SPSS 22.0 program. RESULTS: The experimental group showed significant improvements in psychiatric symptoms (t=-2.73, p=.010) and slight improvement in interpersonal relationships (t=2.23, p=.0.34) after 12 weeks of group music therapy. There was no significant difference in QoL change between the two groups. CONCLUSION: These findings indicate that the Nanta-program is an effective intervention program for improving psychiatric symptoms and interpersonal relationships of prisoners with schizophrenia.

How Menopause Symptoms and Attitude Impact Korean Women's Quality of Life After Adjuvant Treatment for Breast Cancer.

BACKGROUND: Attitudes toward menopause vary across cultures and influence women's experiences of menopausal symptoms, possibly leading to reduced posttreatment quality of life in breast cancer survivors. OBJECTIVE: The aim of this study is to examine the effects of menopausal symptoms and attitudes on health-related quality of life in breast cancer survivors who were premenopausal at the time of diagnosis. METHODS: A total of 139 women receiving chemotherapy with/without endocrine therapy were assessed with self-report questionnaires of established reliability and validity. Hierarchical regression was conducted to assess the impact of menopausal symptoms and attitudes on quality of life, while controlling for demographic characteristics. RESULTS: Overall, participants endorsed more than half of 46 symptoms, most at the level of mild symptoms, and most reported a less positive attitude toward menopause. Lower quality of life was significantly predicted by more menopausal symptoms endorsed and more negative attitudes when controlling for demographic factors associated with quality of life (R = 26.1%). Most participants experienced change from premenopause to postmenopause after the completion of adjuvant chemotherapy with or without tamoxifen. CONCLUSIONS: The results suggest that more menopausal symptoms and negative attitudes toward menopause may affect health-related quality of life considerably in chemotherapy-treated Asian breast cancer survivors. IMPLICATIONS FOR PRACTICE: Healthcare professionals should develop a better understanding of the effects of menopausal symptoms and attitudes on quality of life by using a culturally relevant perspective based on patients' sociocultural backgrounds. Furthermore, these findings help healthcare professionals communicate with their Asian clients in a more informed way and provide culturally appropriate and individualized care.

Depression moderates between physical activity and quality of life in low-income children.

PURPOSE: This study investigated the relationship between physical activity and health-related quality of life (HRQoL) as moderated by depression in low-income children. METHODS: A cross-sectional study was conducted with 149 children ages 10-12 whose families' monthly incomes were at or below 150% of Korea's minimum cost of living. Children's physical activity, depression, and HRQoL were measured with self-administered questionnaires. Multiple regression and simple slope analysis examined the moderating effect of depression between physical activity and HRQoL. RESULTS: Physical activity was significantly positively correlated with HRQoL while depression was significantly negatively correlated with physical activity and HRQoL. Physical activity, depression, and their interaction explained 39.3% of variance in low-income children's HRQoL. Simple slope analysis showed that increased physical activity was related to higher QoL among children without depressive symptoms but not significantly related to QoL for children with depressive symptoms. CONCLUSION: The moderating effect of depression between physical activity and QoL was confirmed in children from low-income families. To improve HRQoL through physical activity interventions, depression screening and symptom management should be performed so that strategies to promote QoL can be effectively applied consistent with depression screening results.

[Review of meta-analysis research on exercise in South Korea].

PURPOSE: The purpose of this study was to evaluate the quality of meta-analysis regarding exercise using Assessment of Multiple Systematic Reviews (AMSTAR) as well as to compare effect size according to outcomes. METHODS: Electronic databases including the Korean Studies Information Service System (KISS), the National Assembly Library and the DBpia, HAKJISA and RISS4U for the dates 1990 to January 2014 were searched for 'meta-analysis' and 'exercise' in the fields of medical, nursing, physical therapy and physical exercise in Korea. AMSTAR was scored for quality assessment of the 33 articles included in the study. Data were analyzed using descriptive statistics, t-test, ANOVA and χ²-test. RESULTS: The mean score for AMSTAR evaluations was 4.18 (SD=1.78) and about 67% were classified at the low-quality level and 30% at the moderate-quality level. The scores of quality were statistically different by field of research, number of participants, number of databases, financial support and approval by IRB. The effect size that presented in individual studies were different by type of exercise in the applied intervention. CONCLUSION: This critical appraisal of meta-analysis published in various field that focused on exercise indicates that a guideline such as the PRISMA checklist should be strongly recommended for optimum reporting of meta-analysis across research fields.

Effect of the Group Music Therapy on Brain Wave, Behavior, and Cognitive Function among Patients with Chronic Schizophrenia.

PURPOSE: The purpose of the study was to examine the effect of group music therapy on brain waves, behavior, and cognitive function among patients with chronic schizophrenia. METHODS: A quasi-experimental pretest-posttest design was used with nonequivalent control group. The potential participants were recruited from inpatients in a psychiatric facility in a metropolitan city, assigned either to the experimental group (n = 28) or to the control group (n = 27) according to their wards to avoid treatment contamination. The experimental group participated in the group music therapy for 13 sessions over 7 weeks while continuing their standard treatment. The control group only received a standard treatment provided in the hospitals. The outcome measures include brain wave by electroencephalography, behavior by Nurses' Observation Scale for Inpatient Evaluation, and cognitive function by Mini-Mental State Examination. RESULTS: After participating in 13 sessions of the group music therapy, alpha waves measured from eight different sites were consistently present for the experimental group (p = .006-.045) than the control group, revealing that the participants in the music therapy may have experienced more joyful emotions throughout the sessions. The experimental group also showed improved cognitive function (F = 13.46, p = .001) and positive behavior (social competence, social interest & personal neatness) while their negative behaviors was significantly less than those of the control group (F = 24.04, p < .001). CONCLUSION: The group music therapy used in this study was an effective intervention for improving emotional relaxation, cognitive processing abilities along with positive behavioral changes in patients with chronic schizophrenia. Our results can be useful for establishing intervention strategies toward psychiatric rehabilitation for those who suffer from chronic mental illnesses.

Factors associated with mammography adherence among married Chinese women in Yanbian, China.

BACKGROUND: Despite the efficacy of regular mammograms, the incidence and mortality rate of breast cancer have been increasing in China. Insufficient studies on the factors affecting mammography adherence in Chinese married women have been conducted. The purpose of the present study was to explore the factors associated with adherence to guidelines for regular mammography among Chinese married women. MATERIALS AND METHODS: The participants were recruited conveniently and included Chinese and Korean Chinese women who were married, living at Yanbian City in China. Demographic information, status regarding eight risk factors of breast cancer, health responsibility, and perceived benefits/barriers of mammography were obtained. Descriptive analyses, t-test, and multivariate analysis were performed. Hierarchical logistic regression was conducted to explore the factors associated with regular mammography adherence in Chinese and Korean Chinese subgroups. RESULTS: About 24% of the sample population was adherent in going for regular mammography. The adherent group was significantly more educated, had more children, and had a lower proportion experiencing early menarche and a greater menopausal proportion than the non-adherent group. The final model using logistic regression analysis showed that being Chinese [OR=2.199 (1.224-3.951)], having no or one child [OR=4.879 (1.835-12.976)], early menarche [OR=3.515 (1.057-11.694)], being menopausal [OR=3.120 (0.965-10.088)], aged 40-49 [OR=2.374 (1.099-5.124)], having low education [OR=0.400 (0.211-0.765)], and perceiving greater benefits in doing mammography [OR=1.080 (1.014-1.151)] were significantly associated with mammography adherence, after controlling for covariates. CONCLUSIONS: Sociocultural sensitive intervention for minorities should be emphasized when improving the adherence of regular mammography. Intervention tailored for women with lower education should be delivered and the benefits of mammography should be propagated to women in rural areas of China.