Transition from homelessness to becoming housed: A qualitative study.

AIM: To explore the transitional experiences of becoming housed from homelessness. DESIGN: A qualitative descriptive study. METHODS: Data were collected during 2017 and 2018 using a semi-structured interview method with 10 former homeless people who became housed at the time of the study. The grounded theory method was used to analyse qualitative data. RESULTS: 'Desire to keep a place to stretch out and lie down' was the basic social problem participants suffered during the transition from homeless to becoming housed. In addition, 'returning to the social world as a person living an ordinary life' was the basic social process that emerged as a core category. The process was divided into four phases: (1) being discarded from everyday life in the social world, (2) struggling to reconnect with society and (3) returning to the social world as a person living an ordinary life. CONCLUSION: The transition from homelessness to becoming housed is a significant experience for individuals that involves holistic changes. Community health nurses should consider their practical needs based on client views. IMPACT: What problem did the study address? This study explored the experiences of transitioning from homelessness to becoming housed among post-homeless individuals. What were the main findings? While moving from homelessness to becoming housed, homeless people experienced returning to the social world as a person living an ordinary life. They were also shown to go through the process of four stages. Where and on whom will the research have an impact? This study will contribute to suggesting a direction for self-reliance-based interventions among people who are homeless. Additionally, the findings will provide primary data to develop a program for social integration. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Improving interprofessional teamwork in a community mental health team: a team building circle program based on the restorative justice paradigm.

Improving teamwork among mental health practitioners is crucial. However, there have been few intervention studies on teamwork enhancement among community mental health practitioners in South Korea. We aimed to determine the effectiveness of the Team Building Circle program (TBC) based on the restorative justice paradigm, which sought to promote integration and cohesion. The TBC was developed to improve conflict interpretation mind-set, interpersonal skills, and teamwork among practitioners in community mental health centers. We conducted a quasi-experimental study using a pre and posttest design with a non-equivalent control group. The participants were 44 practitioners from four community mental health centers. Data were collected before the implementation TBC (pretest), just after (posttest), and 3 months after TBC (follow-up test). A generalized estimating equation model was used for analysis. Our findings indicate that the intervention group had improved scores in the ability to cope with interpersonal stress in a constructive way, interpersonal relationship skills, and teamwork compared to the control group. To improve teamwork among community mental health practitioners, managers are encouraged to consider providing TBC intervention.

Effects of a Brief Empowerment Program for Families of Persons with Mental Illness in South Korea: A Pilot Study.

Families of persons with mental illness (PMIs) are considered important resources for PMIs rather than as contributors to their mental illness. However, these families experience not only the burden of caregiving but also social stigma and discrimination in various aspects of their lives, and their psychosocial needs tend to be overlooked. This was a pilot study to explore the effects of a brief empowerment program on the empowerment and quality of life of families of PMIs in South Korea. A repeated-measures design with a control group and pre/post-follow-up testing was used. We enrolled 18 participants (experimental group = 9, control group = 9). The experimental group participated in an empowerment program consisting of four sessions over 4 weeks. Data were collected before and after the program, and again 4 weeks later. The χ2-test, Fisher's exact probability test, t-test, and repeated-measures analysis of covariance were used, as appropriate, to analyze data. The program significantly increased empowerment (F = 4.66, p = .020) and quality of life (F = 5.83, p = .009) among participants in the experimental group over time. Its therapeutic features, such as sharing their experiences, discussion, and presentations, can be applied to create effective psychosocial interventions for families of PMIs.

Development and psychometric testing of learning immersion scale in clinical simulation: A methodological study.

BACKGROUND: Immersion during clinical simulation has been suggested to be important for learning effects. However, no valid and reliable instruments have been available for measuring the learner's immersion during simulation experience. OBJECTIVES: To develop a Learning Immersion Scale in Simulation (LISS) and evaluate its psychometric properties. DESIGN: A methodological study design was employed to develop and validate the instrument. SETTINGS: Two universities in South Korea. PARTICIPANTS: A convenience sample of 204 nursing students. METHODS: A literature review and a focus group interview were conducted to determine the properties of learning immersion during simulation experience. Content validity was assessed by a panel of 10 experts. Nursing students who participated in high-fidelity patient simulation (n = 204) were asked to complete the preliminary LISS, after which Students Satisfaction and Self-Confidence in Learning Scale and Learning Flow Scale for Adults were administered for assessing the convergent and criterion validity. Data were analyzed using exploratory factor analyses, Pearson's correlation, and Cronbach's alpha. RESULTS: Exploratory factor analyses extracted a four-factor solution, explaining 65.2% of the total variance. The convergent and criterion validity and internal consistency and half reliability were satisfied. CONCLUSIONS: The LISS is a short multi-dimensional instrument with good psychometric validity and reliability that has potential utility for clinical simulation education and research.

Validation of the Korean Version of Nurses' Moral Courage Scale.

(1) Background: Research that examines moral courage has received a great deal of attention from scholars and practitioners in recent years due to the impact of moral distress experienced by nurses. Although it needs to identify the phenomenon related to moral courage among nurses, there has been a lack of instrumentation to investigate the quantitative aspects of moral courage among Korean nurses. This study aimed to test the validity of the Korean version of the Nurses' Moral Courage Scale. (2) Methods: A cross-sectional study was conducted through convenience sampling of 243 nurses from two general hospitals in South Korea. (3) Results: The Korean version of the Nurses' Moral Courage Scale was developed from construct validity evidence, including 12 items in four domains: 'Compassion and true presence', 'Moral integrity', 'Moral responsibility', and 'Commitment to good care'. Concurrent validity was obtained according to the significant correlation coefficients among the variables: moral courage, moral sensitivity, and professional moral courage. (4) Discussion: Our research contributes to the knowledge and understanding of moral courage in the nursing context and encourages future researchers to conduct a quantitative analysis of moral courage among Korean nurses using the validated K-NMCS.

The Need for and Perceptions of Interprofessional Education and Collaboration Among Undergraduate Students in Nursing and Medicine in South Korea.

Purpose: Interprofessional education (IPE) for undergraduate students in the healthcare disciplines facilitates the acquisition of skills required for interprofessional collaboration, which is critical for patient care. This study assesses the need for and perceptions of IPE and interprofessional collaboration among undergraduate students in nursing and medicine in South Korea. Participants and Methods: This was a cross-sectional survey of undergraduate students in nursing (n = 130) and medicine (n = 68), who had never been exposed to IPE, using a convenience sampling method. The Readiness for Interprofessional Learning Scale (RIPLS) (19 items), Interdisciplinary Education Perception Scale (IEPS) (12 items), and Interprofessional Education and Collaborative (IPEC) Competency Self-Assessment Scale (16 items) were used. Data were analyzed using descriptive statistics, χ 2 test, and independent sample t-test. Results: Students in both schools almost equally indicated the need for IPE and practice-based IPE in their clinical rotations, focusing on patients in general wards, and wanted to learn teamwork. The mean RIPLS scores were 68.5 ± 5.62 in nursing students and 67.5 ± 6.53 in medical students, and those of the IEPS were 57.0 ± 7.03 in nursing students and 58.7 ± 7.08 in medical students, without significant differences. Nursing students scored significantly higher on the positive professional identity subscale of the RIPLS, whereas medical students scored higher on the competency and autonomy and perceived need for cooperation subscales of the IEPS. The total scale scores on the IPEC Competency Self-Assessment Scale were 65.2 ± 3.35 for nursing students and 67.4 ± 2.96 for medical students, the latter having a significantly higher score. Conclusion: This study revealed differences in needs and perceptions regarding IPE and interprofessional collaboration between schools. These findings warrant further research to design IPE program goals and strategies that are reflective of students' needs.

[Experience of Peer Support Work among People with Mental Illness in the Community: A Grounded Theory Approach].

PURPOSE: This study discovered a substantive theory of the experience and process of peer support work among people with mental illness. METHODS: The participants were members of community-based mental health facilities and had been working as peer supporters for more than six months. The data were collected through in-depth interviews with twelve participants and analyzed using Corbin and Strauss's grounded theory approach. RESULTS: The core category was "becoming a healer going with patients in the journey of recovery," and the core phenomenon was "identity confusion as a peer supporter." The causal conditions were "starting peer support work without certainty" and "standing at the boundary between the therapist and patient." The intervening conditions were "willingness to become a successful peer supporter," "feeling a sense of homogeneity with the patient," "accepting the mental illness," and "support from people around." The action and interaction strategies were "letting go of greed," "being open about oneself," "developing professional skills," "maintaining wellness in the body and mind," and "being with the patient." The consequences were "becoming a useful person," "changing attitude toward life," "expansion of the sense of self-existence," "recovering from mental illness," and "discovering a role as peer supporter." Finally, the substantive theory of "becoming a healer going with patients in the journey of recovery" was derived. CONCLUSION: This study provides a holistic understanding of peer support work and the implications of interventions to help people with mental illness in a person-centered recovery process.

[Job Retention Process among Working People with Mental Illness: A Grounded Theory Approach].

PURPOSE: The study was conducted to explore the experiences of job retention among working people with mental illness. METHODS: The participants were members with mental illness at the S Community Mental Health Center in Gyeonggi Province and who had been working for more than six months. The data were collected through in-depth interviews with 11 participants between June 27 and August 20, 2018. The data were analyzed through Corbin and Strauss's grounded theory method. RESULTS: The core category was struggling to take root in the community as a productive member. The core phenomenon was the desire to be a productive person, and the causal condition was the willingness to change for a purposeful life. The action and interaction strategies included maintaining regular living patterns, maintaining medication, developing one's tips for self-management, and self-approval. The intervening conditions were difficulties in forming social relationships, presence of symptoms, social resources, and acceptance of one's mental illness. The consequences were restoration of family relationships, healthy pleasure through work, social inclusion, development of self-worth, and transition to an independent person. CONCLUSION: Working people with mental illness are struggling to take root in the community as a productive member. This study suggests that a holistic understanding of the job retention experience among people with mental illness is required. The findings will provide the basis for developing interventions that can improve job retention among working people with mental illness.

Randomized controlled trial of a cognitive-behavioral therapy for at-risk Korean male adolescents.

This study examined the effects of cognitive behavioral therapy (CBT) aimed at enhancing the resilience of high-risk adolescents with alcohol-dependent parents in Suwon, South Korea. The study used a randomized control group pretest and posttest design. The experimental group participated in 10 sessions of CBT, and the scores on resilience increased significantly after the intervention, whereas the scores of self-concept and depression did not change. In the control group, none of the scores of outcome variables changed significantly after the intervention period. The results indicate that the developed CBT program might be effective for improving the resilience of adolescents with alcohol-dependent parents.

Coping strategies, physical function, and social adjustment in people with spinal cord injury.

This descriptive study examined the role of coping strategies as predictors of physical function and social adjustment in people with spinal cord injury (SCI). A sample of 128 community-residing individuals with SCI completed the structured questionnaire that included demographic characteristics and the Ways of Coping Questionnaire (WCQ), Modified Barthel Index (MBI), and Social Adjustment Scale (SAS) to measure participants' coping, physical function, and social adjustment, respectively. Among the eight factors of the WCQ, planful problem solving was used most frequently by the participants. The remaining coping strategies, except escape-avoidance, were positively correlated with social adjustment, whereas no significant correlations were found between coping and physical function. Positive reappraisal, accepting responsibility, and distancing accounted for 33.5% of the social adjustment for people with SCI. Results highlight the importance of considering coping strategies in designing interventions to facilitate social adjustment and rehabilitation in this population.

Reynolds Adolescent Depression Scale - Second Edition: initial validation of the Korean version.

AIM: This paper is a report of a study conducted to test the validity and reliability of the Reynolds Adolescent Depression Scale - Second Edition in Korean culture. BACKGROUND: Depression is a significant mental health problem in adolescents. The Reynolds Adolescent Depression Scale - Second Edition has been shown to be a useful tool to assess depression in adolescents, with extensive research on this measure having been conducted in western cultures. Measures developed in western cultures need to be tested and validated before being used in Asian cultures. METHOD: The participants were a convenience sample of 440 Korean adolescents with a mean age of 13.78 years (sd = 0.95) from grades 7 to 9 in three public middle schools in South Korea. A cross-sectional design was used. Back-translation was used to create the Korean version, with additional testing for cultural meaning and comprehension. The data were collected at the end of 2004. RESULTS: Internal consistency reliability for the Korean version of the Reynolds Adolescent Depression Scale - Second Edition was 0.89, with subscale reliability ranging from 0.66 to 0.81. Evidence for criterion-related, convergent and discriminant validity for the Korean version of the Reynolds Adolescent Depression Scale - Second Edition was found. Confirmatory factor analysis supported the 4-factor structure of Reynolds Adolescent Depression Scale - Second Edition. CONCLUSION: Our results support the validity and reliability for the Korean version of the Reynolds Adolescent Depression Scale - Second Edition as a measure of depression and suggest that it can be used to screen students and to evaluate the effectiveness of preventive interventions in school settings.

Effects of an empowerment program for community-dwelling people with mental illness in South Korea.

PURPOSE: This study aimed to examine the effects of an empowerment program on empowerment, quality of life, and recognition of human rights of people with mental illness residing in a community in South Korea. DESIGN AND METHODS: A repeated-measures design (before, immediately after, and 4 weeks after the intervention) with a control group was used. The experimental group received an eight-session empowerment program over 8 weeks. FINDINGS: The empowerment program significantly increased empowerment and quality of life, but not recognition of human rights. PRACTICE IMPLICATIONS: Nursing interventions should be developed to enhance the recognition of human rights for people with mental illness.

Psychometric properties of the alcohol use disorders identification test: a Korean version.

OBJECTIVE: The Alcohol Use Disorders Identification Test (AUDIT) is an important screening tool but has never been administered to Korean Americans. This study was conducted to examine the psychometric properties of a Korean version of the AUDIT referred to as AUDIT-K and to determine which cutoff score of the scale would perform better in Korean Americans. METHOD: Translation and backtranslation of the AUDIT-K were conducted to obtain a measure consistent with the Korean cultural understanding of alcohol use. Following satisfactory interrater agreements on each item about its Korean translation, the AUDIT-K was administered to 118 Korean American men (Time 1) and to 93 of the men approximately 1 month later (Time 2). Data were analyzed for internal consistency reliability, test-retest reliability, and construct validity. RESULTS: Approximately 47.5% of Korean American men who participated in the study were identified as having drinking problems when using the World Health Organization's recommended cutoff score of 8, whereas approximately 20.3% were found to have problems with alcohol when using the cutoff score of 12, the one recommended for Koreans. Cronbach's alpha was .82 at Time 1 and was .80 at Time 2. Test-Retest reliability assessed via the intraclass correlation coefficient for the total AUDIT scale was .85. Principal components factor analysis with varimax orthogonal rotation revealed a two-factor solution, alcohol consumption and drinking problems, resulting in 57% of the explained variance. CONCLUSIONS: The AUDIT-K was found to be internally consistent and stable over time and should be used in primary health care settings to screen Korean American men for alcohol use disorders to facilitate early interventions.

Psychometric properties of the Korean version of the Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE) for individuals with COPD.

PURPOSE: Self-efficacy is related to the emotional functioning and coping skills of an individual and is thought to be a predictor of health behaviors, which are particularly important for pulmonary rehabilitation (PR). To our knowledge, no measure of self-efficacy has been validated to explore behavior changes in the context of PR for patients with COPD in Korea. This study aimed to evaluate the psychometric properties of the Korean version of the Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE). PATIENTS AND METHODS: The original scale, developed and validated by Vincent et al was translated into Korean through a process involving forward and back translation of the original scale, and transcultural adaptation was performed following the structured procedure. Content validity was assessed by a panel of 6 expert judges. In a convenience sample of 118 patients with COPD, exploratory factor analysis using principal axis factoring, followed by oblique rotation was conducted to identify construct validity, and the concurrent validity was evaluated by testing correlations between the PRAISE and 6-minute walking distance test and the PRAISE and Saint George Respiratory Questionnaire results. Internal consistency was examined by calculating Cronbach's alpha coefficients. RESULTS: Exploratory factor analysis confirmed the 2-dimensional structure of the scale constructed from the original 15-item scale. The final scale was composed of 14 items that cumulatively explained 60.3% of the total variance. The 2 factors in the scale were named "general self-efficacy" and "exercise self-efficacy." Significant correlations between the PRAISE, and 6-minute walking distance test and Saint George Respiratory Questionnaire showed the concurrent validity of the PRAISE. The Cronbach's alpha coefficient of the PRAISE was 0.93. CONCLUSION: The Korean version of the PRAISE showed adequate construct validity and reliability. These results suggest that the PRAISE is suitable for use in clinical settings as a predictor of PR behavior in Korean patients with COPD.

[The effects of cognitive behavioral anger management program on self-consciousness and anger in Korean military man].

PURPOSE: The purpose of this study was to evaluate a cognitive behavioral anger management intervention in order to increase self-consciousness and decrease anger among Korean military men. METHODS: A quasi-experimental design was used for this study. Ninety two soldiers were screened for unhealthy anger expression using a questionnaire. Among them, 26 soldiers who showed unhealthy anger expression were selected for this study. They were matched by rank and assigned to either a treatment or control group. The treatment group received the intervention three consecutive times, once a week and for 120 minutes per session. Participants were assessed before and after the intervention for anger (the State-Trait Anger Scale) and self-consciousness (Self-consciousness Scale). Data was analyzed using descriptive statistics, chi- square-test, Mann-Whitney test, and Wilcox on signed rank test. RESULTS: There was no statistically significant decrease in anger or increase in self-consciousness between the two groups following treatment. However, there was a significant increase in private self-consciousness in the treatment group after the intervention(p=.006). CONCLUSION: The cognitive behavioral anger management program improves private self-consciousness in soldiers. However, Additional research is needed to explore whether long-term intervention is more effective for anger control in the military setting. The findings from this study suggest that more attention should be given to mental health care for Korean soldiers.

The sociocultural context of korean american men's smoking behavior.

The purpose of this article is to explore the sociocultural context wherein Korean male immigrants learned and maintained smoking behavior. Participants were 11 current and 11 former cigarette smokers who resided in New York City. The participants attended one of four focus groups and talked about their experiences of smoking initiation, changes in smoking behavior over time, smoking in Korea and the United States, strategies used for smoking cessation, and suggestions for a smoking cessation program. The focus group interviews were audiotaped and transcribed verbatim. Themes were identified from answers to the five topic questions and then compared across the four focus groups. Smoking is a common thread in Korean men's social world and a prime component of Korean men's gender identity. In contrast, smoking in the United States is increasingly being stigmatized.

Effectiveness of a Stroke Risk Self-Management Intervention for Adults with Prehypertension.

PURPOSE: The aim of this study was to evaluate the effectiveness of a community-based intervention for prehypertensive adults, to enhance stroke risk awareness and to adopt a preventive lifestyle for primary stroke prevention. METHODS: This was a single-blinded, repeated measures quasi-experimental study with 47 participants (23 in the experimental group and 24 in the control group) recruited through convenience sampling from two urban areas. The stroke risk self-management intervention consisted of three weekly, 2-hour, face-to-face sessions and two booster telephone sessions, utilizing strategies to enhance motivation for behavioral changes based on the Self-Determination Theory. All participants completed a pretest, a 1-month and a 3-month post test of stroke risk awareness and preventive lifestyle including blood pressure self-monitoring, healthy diet, and regular physical activity. Data were analyzed using descriptive statistics, chi-square test, two sample t test, repeated measures analysis of variance, and Friedman test with PASW Statistics 18.0. RESULTS: After the intervention, significant improvements were found in the experimental group for stroke risk awareness, blood pressure self-monitoring and regular physical activity, and were sustained over time. CONCLUSIONS: Our preliminary results indicate that the stroke risk self-management intervention is feasible and associated with improvement in self-management of stroke risk factors for primary stroke prevention among a prehypertensive population.

[Characteristics and mental health of battered women in shelters].

PURPOSE: The purposes of this descriptive study were to: (a) describe the identifiable characteristics of the population of battered women; (b) examine mental health aspects by means of measuring level of anxiety, self-esteem, and depression. METHOD: A convenience sample of 96 battered women was recruited from women who were admitted to a shelter. RESULT & CONCLUSION: Data from this study supported the assertion that many battered women were exposed to severe physical abusive situations. Also the major finding was that the levels of anxiety and depression were high and the level of self-esteem was low in battered women living in shelters.

[The lived experience of stigma among mentally ill persons].

PURPOSE: The purpose of this study was to explore the subjective experiences of stigma among mentally ill persons. METHODS: Phenomenological methodology was used for the study. Participants were twelve people with mental illness enrolled at the S community mental health center in GyeongGi-Do. Data were collected via in-depth interviews from August 30 to October 1, 2010 and analyzed using Colaizzi's framework. RESULTS: Four themes and sixteen formulated meanings were identified for the stigma experiences of participants with mental illness. The four themes were 'Incapable of struggling against unfair treatment', 'Living as an outsider', 'Being constrained by oneself', 'Being in suspense over disclosure of oneself'. CONCLUSION: The results from this study underscore the need for an educational and awareness programs to reduce public stigma among the general population and self-stigma among people with mental illness. In addition, efforts are also needed to prioritize mental illness stigma as a major public health issue at the government and community level.

Korean male smokers' perceptions of tobacco control policies in the United States.

The purpose of this secondary data analysis is to report Korean male smokers' perceptions of tobacco control policies in the United States. Descriptive data from four focus groups held in New York City in 2003 are presented. Focus group interviews were used to collect data, and the two investigators independently analyzed all four recorded group sessions. Korean male immigrants living in New York City area were recruited, and 22 volunteered to participate. Exclusion criteria included immigration to the United States before age 12, no smoking history, and use of chemical substance other than tobacco. Korean men differed in perceptions of the policies based on smoking status and length of U.S. residency. Among current smokers, recent immigrants had difficulty understanding smoking restrictions, whereas longtime residents complained of price increases. Both groups suggested that policies target the tobacco industry and do not target smokers. In contrast, former smokers supported more regulation of public smoking and suggested use of more aggressive antismoking campaigns. Public policymakers should take into consideration cultural attitudes and beliefs about smoking behavior in the design and implementation of tobacco control policies that affect ethnic groups whose cultural and value orientations may differ from the mainstream.