Effectiveness of a healthy lifestyle program based on a mobile serious game for childhood cancer survivors: A quasi-randomized trial.

PURPOSE: This study aimed to develop and evaluate the effectiveness of a healthy lifestyle program based on a mobile serious game (HLP-MSG) to enhance the lifestyles of childhood cancer survivors (CCSs). METHODS: This program proceeded in two stages: development and evaluation, using a non-synchronized design with a quasi-randomized trial. The participants were CCSs aged 6-13 years whose treatment was terminated at least 12 months prior. Data were collected at baseline, and post-intervention, with a follow-up after four weeks using the Child Healthy Lifestyle Profile (CHLP). The experimental (n = 26) and control groups (n = 25) were compared. Data were analyzed using descriptive statistics, chi-squared tests, t-tests, and repeated-measures ANOVA. RESULTS: The HLP-MSG promoted a healthy lifestyle by solving 26 quests, including seven sub-elements (nutrition, exercise, hygiene, interpersonal relationships, stress management, meaning of life, and health responsibility). This study revealed significant differences in the interaction between measurement time and group assignment in the CHLP (p = .006) and physical activity (p = .013), one of the seven sub-dimensions. CONCLUSIONS: A healthy lifestyle program based on a mobile serious game is a feasible health education modality to enhance the physical, psychological, social, and spiritual health of CCSs. IMPLICATIONS TO PRACTICE: The findings add to scientific evidence on a mobile serious game for health education among CCSs. The HLP-MSG provides an evolutionary educational modality that can be delivered non-face-to-face to promote CCSs' continuous healthy behavior maintenance. Moreover, the HLP-MSG is adolescent-friendly and can be utilized as a healthcare tool for parents and children to cooperate.

Development of a chatbot for school violence prevention among elementary school students in South Korea: a methodological study.

PURPOSE: This study develops a chatbot for school violence prevention (C-SVP) among elementary school students. METHODS: Among the analysis, design, development, implementation, and evaluation (ADDIE) models, ADD phases were applied to develop a C-SVP. Students' learning needs were identified by constructing content with a design that attracted their attention. Subsequently, a formative evaluation was conducted on the developed C-SVP to test its applicability by ten elementary school students targeting the 5th and 6th grades. RESULTS: The chatbot was designed using KakaoTalk and named "School Guardian Angel." The formative evaluation revealed that the developed C-SVP was easily accessible and useful for elementary school students. CONCLUSION: The developed C-SVP is expected to be effective in preventing violence among elementary school students. However, further research involving children of various age groups is required.

Awareness of using chatbots and factors influencing usage intention among nursing students in South Korea: a descriptive study.

PURPOSE: Artificial intelligence (AI) has had a profound impact on humanity; in particular, chatbots have been designed for interactivity and applied to many aspects of daily life. Chatbots are also regarded as an innovative modality in nursing education. This study aimed to identify nursing students' awareness of using chatbots and factors influencing their usage intention. METHODS: This study, which employed a descriptive design using a self-reported questionnaire, was conducted at three university nursing schools located in Seoul, South Korea. The participants were 289 junior and senior nursing students. Data were collected using self-reported questionnaires, both online via a Naver Form and offline. RESULTS: The total mean score of awareness of using chatbots was 3.49±0.61 points out of 5. The mean scores of the four dimensions of awareness of using chatbots were 3.37±0.60 for perceived value, 3.66±0.73 for perceived usefulness, 3.83±0.73 for perceived ease of use, and 3.36±0.87 for intention to use. Significant differences were observed in awareness of using chatbots according to satisfaction with nursing (p<.001), effectiveness of using various methods for nursing education (p<.001), and interest in chatbots (p<.001). The correlations among the four dimensions ranged from .52 to .80. In a hierarchical regression analysis, perceived value (ß=.45) accounted for 60.2% of variance in intention to use. CONCLUSION: The results suggest that chatbots have the potential to be used in nursing education. Further research is needed to clarify the effectiveness of using chatbots in nursing education.

Effects of a Meaning-Centered Spiritual Care Training Program for Hospice Palliative Care Teams in South Korea: A Nonrandomized Controlled Trial.

BACKGROUND: Spiritual care is an essential part and a core component of quality palliative care, as identified by the World Health Organization. However, spiritual care training for hospice palliative care teams (HPCTs) is infrequent. OBJECTIVE: The aim of this study was to investigate the effects of a meaning-centered spiritual care training program for HPCTs (McSCTP-HPCT). METHODS: This study used a nonrandomized controlled design. The McSCTP-HPCT comprised 5 modules. The participants were HPCTs working in 15 national hospice institutions and were allocated to either the experimental group (n = 33) or the control group (n = 27) based on the participating institutions' preference. Three outcome variables were tested: spiritual care competency, spiritual care therapeutics, and compassion fatigue. Data were analyzed using descriptive statistics, χ 2 test, 1-way analysis of variance, and repeated-measures analysis of variance. RESULTS: There was a significant difference in the interaction between measurement time and group assignment in spiritual care competency ( P = .002) and spiritual care therapeutics ( P = .038), whereas no significant difference was found for compassion fatigue ( P = .716). CONCLUSION: The McSCTP-HPCT conducted in this study shows effectiveness in increasing the spiritual care competency and spiritual care therapeutics of HPCTs and may support the importance of spiritual care training. IMPLICATIONS FOR PRACTICE: The McSCTP-HPCTs adds to the scientific evidence on spiritual care and has the capacity to improve the quality of care for patients with a life-threatening illness.

Spiritual Care Expectations Among Cancer and Noncancer Patients With Life-Threatening Illnesses.

BACKGROUND: Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses. OBJECTIVE: The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses. INTERVENTIONS/METHODS: This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis. RESULTS: The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence." CONCLUSIONS: Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care. IMPLICATIONS FOR PRACTICE: Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.

Psychometric validation of the Child Healthy Lifestyle Profile in South Korea: a cross-sectional study.

PURPOSE: This study aimed to validate the Child Healthy Lifestyle Profile as an instrument for screening healthy behaviors in school-aged children in South Korea. METHODS: Self-reported questionnaires were administered to 454 students, comprising elementary-school students (n=221) and child cancer survivors (n=233). Reliability and validity were assessed using Cronbach's ⍺, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). RESULTS: Cronbach's ⍺, as a reliability test, was 0.87. Varimax rotation yielded nine factors with eigenvalues greater than 1 in the EFA, which explained 61.0% of the total variance. In the CFA, both convergent and discriminant validities were acceptable. Therefore, the Child Healthy Lifestyle Profile was validated as an assessment tool for Korean school-aged children. CONCLUSION: Based on the results of this study, the Child Healthy Lifestyle Profile was identified as a reliable and valid instrument for assessing healthy lifestyles in elementary-school children in South Korea.

Elementary school students' awareness of the use of artificial intelligence chatbots in violence prevention education in South Korea: a descriptive study.

PURPOSE: This study aimed to identify students' awareness of the use of a chatbot (A-uC), a type of artificial intelligence technology, for violence prevention among elementary school students. METHODS: The participants comprised 215 students in the fourth to sixth grades in Chuncheon, South Korea, and data were collected via a self-reported questionnaire. RESULTS: The mean A-uC score was 3.43±0.83 out of 5 points. The mean scores for the 4 sub-dimensions of the A-uC tool were 3.48±0.80 for perceived value, 3.44±0.98 for perceived usefulness, 3.63±0.92 for perceived ease of use, and 3.15±1.07 for intention to use. Significant differences were observed in A-uC scores (F=59.26, p<.001) according to the need for the use of chatbots in violence prevention education. The relationships between intention to use and the other A-uC sub-dimensions showed significant correlations with perceived value (r=.85, p<.001), perceived usefulness (r=.76, p<.001), and perceived ease of use (r=.64, p<.001). CONCLUSION: The results of this study suggest that chatbots can be used in violence prevention education for elementary school students.

Healthy lifestyles in childhood cancer survivors in South Korea: a comparison between reports from children and their parents.

PURPOSE: This study investigated childhood cancer survivors' behavior related to a healthy lifestyle during their survival period by comparing reports between childhood cancer survivors and their parents. METHODS: In this comparative descriptive study, a survey was conducted with a 33-item questionnaire and one open-ended question about areas for improvement. The participants comprised 69 childhood cancer survivors and 69 of their parents, for a total of 138. RESULTS: The total mean healthy lifestyle score, on a 4-point Likert scale, reported by childhood cancer survivors was 2.97, while that reported by their parents was 3.03. No significant differences in children's healthy lifestyles were found between childhood cancer survivors' and their parents' reports (t=0.86, p=.390). For the open-ended question, the main keywords based on the results of degree and eigenvector centrality were "exercise", "unbalanced diet", and "food". These keywords were present in both the children's and parents' responses. CONCLUSION: Obtaining information on childhood cancer survivors' healthy lifestyles based on reports from themselves and their parents provides meaningful insights into the improvement of health care management. The results of this study may be used to develop and plan healthy lifestyle standards to meet childhood cancer survivors' needs.

Effects of a Violence Prevention Education Program Using Empathy (VPEP-E) on Fifth-Grade Students in South Korea.

This study aimed to investigate the effects of a violence-prevention education program using empathy (VPEP-E) on elementary school students. This quasi-experimental design examined fifth-grade students' (a) empathy level, (b) perception of violence, and (c) permissive and negligent attitudes toward violence, using a pre- and post-test design. A total of 101 students participated: the experimental group (n = 48) received eight sessions of VPEP-E, whereas the control group (n = 53) received violence prevention education through classroom lectures. Significant differences were observed between the groups' empathy level (t = 6.81, p < .001), perception of violence (t = 2.79, p = .006), and permissive and negligent attitudes toward violence (t = -2.21, p = .030; t = -2.02, p = .046). Thus, a school-based VPEP-E may help elementary school students. Long-term studies evaluating behavioral changes from VPEP-E implementation are needed for establishing the effects on violent behavior.

Validation of the Korean version of the Body Shape Questionnaire (K-BSQ): focus on young women.

In spite of more awareness about the increased concern of women about their body image and shape, a scale measuring the level of concern about body shape has not been developed in Korea yet. The currently available Body Shape Questionnaire (BSQ) was developed and validated within a Western context. Therefore, this study created the Korean version of the BSQ (K-BSQ) to target young women with concern about body shape. This study aimed to translate the 16-item version of the BSQ and examine the reliability and validity of the resulting scale. Participants included 243 young women aged 19-39 years from South Korea. The reliability and validity were examined using Cronbach's alpha, item analysis, factor analysis, and correlation with the Eating Attitudes Test (EAT). Results showed that the reliability was high, as indicated by a Cronbach's alpha of 0.95. The factor analysis of 16 items revealed two factors. They explained 65.74 percent of the variance in the Korean version of the BSQ. In addition, K-BSQ scores were related to those of the EAT significantly (r = 0.61, p < .001). It was concluded that the K-BSQ may serve as an appropriate instrument to measure the body shape concerns of young Korean women.

Validation of a Korean Version of the Body-Appreciation Scale (K-BAS) in Young Women.

Despite concerns regarding body image in young Korean women, no measurement tool has yet been developed or is available. This study examined the validity and reliability of the Korean version of the Body-Appreciation Scale (K-BAS) to assess body image positivity among young women. For this purpose, convenience sampling was conducted using social network services. The participants were 245 women (N = 245) aged 20 to 40 years. Validity and reliability were examined using item analysis, factor analysis, and correlation with body mass index, body dissatisfaction, and Cronbach's alpha. Twelve items were selected for the study. Two factors were extracted through factor analysis, explaining 64.82% of the variance and showing a good model fit in the K-BAS. The K-BAS score was negatively correlated with body mass index (r = −0.33, p < 0.001) and body dissatisfaction (r = −0.41, p < 0.001). Reliability was high, as indicated by a Cronbach's alpha of 0.91. These results indicate that the K-BAS may serve as an appropriate instrument for measuring body image positivity among young Korean women. It may also be useful for identifying women with abnormal body perceptions.

Impact of Nurse-Physician Collaboration, Moral Distress, and Professional Autonomy on Job Satisfaction among Nurses Acting as Physician Assistants.

Although there is considerable literature on job satisfaction among nurses in various settings, there is little research about contributing factors, including moral distress to job satisfaction among a certain group of nurses, such as nurses acting as physician assistants. The purpose of this study was to verify the impact of nurse-physician collaboration, moral distress, and professional autonomy on job satisfaction among nurses acting as physician assistants. Descriptive and correlational research was conducted on a convenience sample of 130 nurses from five general hospitals in South Korea. In the final regression model, the adjusted R square was significant, explaining 38.2% of the variance of job satisfaction (F = 8.303, p < 0.001), where 'cooperativeness' (ß = 0.469, p = 0.001) from nurse-physician collaboration, 'institutional and contextual factor' from moral distress (ß = -0.292, p = 0.014), and professional autonomy (ß = 0.247, p = 0.015) were included. In hospital environments, a more cooperative inter-professional relationship between nurses and physicians led to less moral distress caused by organisational constraints. A higher level of professional autonomy among nurses acting as physician assistants is required to increase their job satisfaction.

Effects of Child Sexual Abuse Prevention Education Program Using Hybrid Application (CSAPE-H) on Fifth-Grade Students in South Korea.

The purpose of this study was to test the effects of a child sexual abuse prevention education program using a hybrid application (CSAPE-H) by examining fifth-grade students' (a) knowledge for sexual abuse prevention and (b) self-protective behaviors against sexual abuse. A quasi-experimental, pretest /posttest design was used. Sixty-eight students from two schools participated. The intervention group (n = 48) received six sessions in CSA prevention education using the hybrid app, whereas the control group (n = 35) was taught using a lecture in a classroom environment. Between the two groups, there were significant differences in self-protective behaviors against CSA (t = 2.26, p = .027). In addition, educational satisfaction was significantly higher in the experimental group than the control group (t = 2.41, p = .019). A CSAPE-H may be effective for elementary school students, especially for self-protective behaviors.

Effects of Online Learning on Nursing Students in South Korea during COVID-19.

Daily life has changed due to COVID-19. This has affected nursing education and caused a shift in online learning. This study examined the effects of online learning on nursing students' knowledge, self-regulation, and learning flow. We used a quasi-experimental design on a sample comprising 164 senior nursing students. We compared pre- and post-test scores to examine the educational effects. The pre-test was conducted a week before the educational intervention, and the post-test was conducted a week after it. We found a significant increase in knowledge (t = -14.85, p < 0.001) and learning flow (t = -2.15, p = 0.033) in the post-test. We also found an increase in self-regulation (t = -1.57, p = 0.119) from the pre- to the post-test that was not statistically significant. The results could help instructors to provide additional information in online learning. They highlight the need to assess learners' readiness for online learning and to prepare the learning environment with systematic educational planning, design, development, and evaluation for improving the effectiveness of online learning outcomes.

Associations of Symptoms of Depression, Social Support, and Quality of Life Among Korean Women Who Experience Infertility.

OBJECTIVE: To describe the quality of life (QOL) of Korean women experiencing infertility based on sociodemographic and infertility characteristics and to examine the associations among symptoms of depression, social support, and QOL. DESIGN: Cross-sectional, descriptive study. SETTING: Participants were recruited from July to August 2019 on one of the largest South Korean websites where individuals share pregnancy and parenthood experiences. PARTICIPANTS: Adult women (N = 186) who received infertility treatment. METHODS: Participants completed an online survey using the Korean version of the Patient Health Questionnaire 9 to measure symptoms of depression, the Multidimensional Scale of Perceived Social Support, and the Fertility Quality of Life (FertiQOL) scale. Data were analyzed using descriptive statistics, correlation, analysis of variance, and multiple regression. RESULTS: There was a significant negative relationship between scores on the Patient Health Questionnaire 9 and FertiQOL (r = -.56) and a significant positive relationship between scores on the Multidimensional Scale of Perceived Social Support and FertiQOL (r = .40). The length of time from diagnosis of infertility to data collection, past and current treatments, cost burden, and degree of inhibition of daily life due to infertility also significantly affected participants' FertiQOL scores. Symptoms of depression, the burden of treatment, and inhibition of daily life activities explained 46% of the variance in QOL. CONCLUSION: Women experiencing infertility and symptoms of depression had lower FertiQOL scores. Health care providers, who are most familiar with and attentive to patients, could provide a first line of defense against poor QOL in this population. By continuously assessing the levels of psychosocial stress in women with infertility, nurses could provide timely resources and design interventions to improve women's QOL.

The Effects of Group Art Therapy on the Primary Family Caregivers of Hospitalized Patients with Brain Injuries in South Korea.

This study examined the effects of group art therapy on depression, burden, and self-efficacy in primary family caregivers of patients with brain injuries. This was a quasi-experimental, nonequivalent control group and a pre- and post-test design. This study was carried out in one national rehabilitation hospital targeting 41 primary family caregivers of patients with brain injuries. Group art therapy intervention was carried out three days per week comprising 12 sessions over four consecutive weeks. The experimental group (n = 20) received group art therapy, whereas the control group (n = 21) did not. We used a time difference method to minimize the risk of contaminating the control group by sampling sequentially. For depression, although there was a significant difference after the intervention (t = 3.296, p = 0.004), the mean difference score was not statistically significant between the experimental group and the control group (t = 0.861, p = 0.395). The experimental group showed a significantly greater decrease in burden (t = 2.462, p = 0.020) and significantly greater improvement in self-efficacy (t = -6.270, p < 0.001) than the control group. Group art therapy may be an effective nursing intervention for primary family caregivers of patients with brain injuries.

A meaning-centered spiritual care training program for hospice palliative care teams in South Korea: development and preliminary evaluation.

BACKGROUND: Spirituality is a fundamental, intrinsic aspect of human beings and should be a core component of quality palliative care. There is an urgent need to train hospice palliative care teams (HPCTs) to enhance their ability to provide spiritual care. This study aimed to develop and evaluate a meaning-centered, spiritual care training program (McSCTP) for HPCTs (McSCTP-HPCTs). METHODS: The modules' content was informed by Viktor Frankl's meaning-centered logotherapy with its emphasis on spiritual resources, as well as the spiritual care model of the Interprofessional Spiritual Care Education Curriculum (ISPEC). Following development, we conducted a pilot test with four nurses. We used the results to inform the final program, which we tested in an intervention involving 13 members of HPCTs. We took measurements using self-administered questionnaires at three points before and after the intervention. Using descriptive statistics, the Mann-Whitney U test, and the Kruskal-Wallis test, we analyzed the participants' demographic and career-related characteristics, as well as the degree of variance between three outcome variables: compassion fatigue (CF), spiritual care competencies (SCCs), and spiritual care therapeutics (SCT). RESULTS: We divided the McSCTP-HPCTs into five modules. Module I: The HPCTs' SCC evaluation, understanding the major concepts of spiritual care and logotherapy; Modules II-IV: Meaning-centered interventions (MCIs) related to spiritual needs (existential, relational, and transcendental/religious); Module V: The process of meaning-centered spiritual care. The preliminary evaluation revealed significant differences in all three outcome variables at the posttest point (CF, p = 0.037; SCCs, p = 0.005; SCT, p = 0.002). At the four-week follow-up test point, we only found statistical significance with the SCCs (p = 0.006). CONCLUSIONS: The McSCTP-HPCTs is suitable for use in clinical settings and provides evidence for assessing the SCCs of HPCTs.

An integrative review of studies of condom use among Korean college students.

PURPOSE: The purpose of this study was (a) to synthesize studies of condom use among South Korean college students, and (b) to appraise the quality of each article using Gough's weight of evidence. METHODS: Studies published in English and Korean were searched in electronic databases using the terms "student or college student or university student or undergraduate", "condom", and "Korea*". RESULTS: Twenty studies met the inclusion criteria, showed appropriate quality, and were therefore selected for review. The variables related to condom use were measured in terms of condom-related factors, factors related to non-condom-related knowledge and attitudes, and other factors. Knowledge, attitudes, and self-efficacy were associated with condom use, and there were differences in condom-related factors among men and women. CONCLUSION: Based on these findings, it was confirmed that sexual education is needed for both men and women to promote condom use. Education on condom use should not only focus directly on condoms, but should also address other aspects of knowledge and attitudes to influence health beliefs. In addition, developing educational programs targeting adolescents and parents will have a positive effect on college students' condom use.

Empathy, cyberbullying, and cybervictimization among Filipino adolescents.

PURPOSE: The purpose of this study was to gain insights into empathy, cyberbullying, and cybervictimization among Filipino adolescents. METHODS: The participants were 168 junior high school students in the 7th to 10th grades at a public high school in Cavite Province, Philippines. Data were collected on demographic characteristics, the Basic Empathy Scale, and Revised Cyber Bullying Inventory-II scores. The data were analyzed in SPSS using descriptive statistics (frequency and mean), the independent t-test, bivariate correlation, and one-way analysis of variance. RESULTS: The degree of empathy did not show a statistically significant relationship with cyberbullying (r=-.07, p=.359) but did show a significant relationship with cybervictimization (r=.18, p=.025). Furthermore, cyberbullying had a statistically significant association with cybervictimization (r=.60, p<.001). CONCLUSION: Although empathy does not necessarily affect cyberbullying, higher levels of empathy were found among cyberbullying victims. However, an alarming result of this study is the possibility that victims may become cyberbullies. Therefore, we should highlight empathy as part of efforts to prevent cyberbullying and to solve various cyber-related problems. Since cyberbullying and cybervictimization are closely related, it is important to focus on this relationship and to make multilateral efforts to ensure that cyberbullying does not lead to other negative issues.