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

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

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

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

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

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

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

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

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

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

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

Cultural Context of Family Religiosity/Spirituality among Korean-American Elderly Families.

The purpose of this study is to explore the cultural context of family religiosity/spirituality among Korean-American elderly families, and how this changed after families immigrated to the USA. Fifty one first-generation Korean-Americans participated in one or two hour, in-depth interviews in Korean at a participant's home or church. These included 27 older adults and 24 family members living together or within a radius of one-hour transit time from their elders, residing in the Southeastern United States. A thematic and interpretive method was used to analyze transcribed interviews. Three themes were identified that explained the cultural context of family religiosity/spirituality: (a) traditional family religious rituals, (b) church oriented routines, and (c) family collectivism. The participants did not distinguish 'religiosity' and 'spirituality' during the interviews. The findings suggest that the family religiosity/spirituality of the participants was influenced by the traditional family religious values, which were shaped by Korean culture. The traditional religions of Shamanism, Buddhism, and Confucianism are prevalent in Asian countries. Thus, the findings of this study may help healthcare professionals identify the cultural contexts of spirituality/religiosity of Asian immigrant families in order to provide holistic care.

Effects of Static Stretching Exercise on Lumbar Flexibility and Central Arterial Stiffness.

BACKGROUND: Previous studies have demonstrated that arterial stiffness is associated with lumbar flexibility (LF). Stretching exercise targeted to improve LF may have a beneficial effect on reducing arterial stiffness. OBJECTIVES: We examined the effects of a single bout of a structured, static stretching exercise on arterial stiffness, LF, peripheral and central blood pressure (BP), and heart rate (HR) and tested the association between LF and central arterial stiffness. METHOD: The study had a pretest-posttest design without a control group. Thirty healthy women followed a video demonstration of a 30-minute whole-body stretching exercise. Carotid-femoral pulse wave velocity (cf-PWV), augmentation index, LF, peripheral and central BP, and HR were measured before and after the stretching exercise. RESULTS: One bout of a static stretching exercise significantly reduced cf-PWV (t29 = 2.708, P = .011) and HR (t29 = 7.160, P = .000) and increased LF (t29 = 12.248, P < .000). Augmentation index and peripheral and central BP also decreased but did not reach statistical significance. Despite no association found between cf-PWV and LF, the larger increase in LF the subjects had, the larger decrease in cf-PWV they had after exercise (r = 0.500, P = .005). CONCLUSIONS: Study findings highlight the potential benefit of a static stretching exercise on central arterial stiffness, an independent predictor of cardiovascular morbidity. Static stretching exercise conducted in the sitting position may be used as an effective intervention to reduce cardiovascular risk after a cardiac event or for patients whose sympathetic function should not be overly activated or whose gaits are not stable.

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

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

Family Spirituality and Family Health Among Korean-American Elderly Couples.

Spirituality has been regarded as an individual and private matter; consequently, research on spirituality as a family phenomenon has been largely neglected. In addition, most published research has been focused on Western cultures. The purpose of this study was to explore the experience of family spirituality and how it influences health among Korean-American elderly couples who are the first generation to reside in the Southeastern USA. A thematic and interpretive data analysis method was used. Thirteen elderly couples (N = 26) participated in in-depth individual interviews in Korean with the primary author. Interviews were audio-taped, transcribed, and then translated by two bilingual researchers with a background in Korean and American culture. Three main themes of family spirituality were identified: (1) family togetherness, (2) family interdependence, and (3) family coping. Also, participants reported that family spirituality strengthened family health by fostering family commitment, improving emotional well-being, developing new healthy behaviors, and providing healing experiences. This finding implies that healthcare providers need to assess family spiritual issues of elderly couples to maximize their strengths for coping with health problems. As our society becomes more culturally diverse, healthcare providers should seek to understand family spirituality from different cultural perspectives to develop a more holistic approach to care.

Self-transcendence, spiritual perspective, and sense of purpose in family caregiving relationships: a mediated model of depression symptoms in Korean older adults.

OBJECTIVES: This study used structural equation modeling to test the mediated model of late-life depression to understand the mechanisms that account for the direct and indirect effects of spiritual variables and purpose in life on depression within the context of Korean family caregiving relationships. METHOD: A secondary analysis study design used data from a study that tested a theory of family interdependence of 157 Korean elder-family caregiver dyads in Seoul, Korea. RESULTS: Both caregivers' and elders' self-transcendence was positively related to their own sense of purpose in life. However, only elders' spiritual perspective was related to purpose in life. Also, elders' purpose in life was positively associated with caregivers' purpose in life. Furthermore, there was a strong negative relationship between elders' purpose in life and their depressive symptoms, but there was not a significant negative relationship between caregivers' purpose in life and elders' depressive symptoms. Last, elders' purpose in life mediated the negative effects of elders' self-transcendence and spiritual perspective and of caregivers' self-transcendence and purpose in life on elders' depression. CONCLUSION: The findings suggest that purpose in life for both the caregiver and elder played an important role in elders' depression. Self-transcendence also was related to decreased depression in elders. It is suggested that more attention be given to caregiver and elder purpose in life in developing interventions to reduce or avoid elder depression in Korean elders.

Psychological, physical, social, and spiritual well-being similarities between Korean older adults and family caregivers.

There is a growing recognition that the similarities between older adults and family caregivers has both practical and research implications; caregivers' well-being influences older adults' well-being and vice versa. There has been a paucity of studies that explore the similarities between Korean older adults and their caregivers. This study aims to examine psychological, physical, social, and spiritual well-being similarities among 157 older adult-caregiver dyads in Seoul, Korea. There was a significant degree of similarities between older adults and their caregivers with respect to psychological, social, and spiritual well-being, but not to physical well-being. Present findings suggest that nurses and other health care professionals should be involved and collaborate with family caregivers to take care of older adults; to understand the dynamic, caring relationships between older adults and their family caregivers; and to improve the well-being of older adults as well as their family caregivers.

Validity and Reliability of the Korean Version of the Paternal Postnatal Attachment Scale.

PURPOSE: The study aimed to translate the Paternal Postnatal Attachment Scale (PPAS) into Korean and to evaluate the validity and reliability of the Korean version of the PPAS (K-PPAS). METHODS: The PPAS was translated, back-translated, and reviewed by 12 experts and 5 fathers following the World Health Organization's guideline. A convenience sample of 396 fathers with infants in their first 12 months participated in this study. For construct validity, an underlying factor structure and model fit was assessed with an exploratory and confirmatory factor analysis. Convergent and discriminant validity and reliability of the K-PPAS were evaluated. RESULTS: The construct validity of the K-PPAS with 11 items was identified by two-factor structures: healthy attachment relationship, and patience and tolerance. The final model fit was shown acceptable with the normed chi-square = 1.94, comparative fit index = .94, Tucker-Lewis index = .92, root mean square error of approximation = .07, and standardized root mean square residual = .06. This model had acceptable convergent and discriminant validity for each construct with the values of the composite reliability and heterotrait-monotrait ratio at a satisfactory level. Discriminant validity with known groups showed that fathers with no postnatal depression had significantly higher scores on the K-PPAS than those with postnatal depression. Cronbach's α and McDonald's omega coefficient of the K-PPAS was .84 and .83. CONCLUSIONS: The K-PPAS would be beneficial to measure postnatal attachment among fathers with infants aged 12 months or younger in Korea. However, further studies are suggested to evaluate the applicability of the scale considering the various family structures, such as single or foster parents and multicultural families that exist within the Korean population.

Machine learning models for predicting depression in Korean young employees.

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

Evaluation of the psychometric properties of the Korean language version of the Incontinence Quiz.

Psychometric properties of the Korean version of the Incontinence Quiz were evaluated in Korean-American women with urinary incontinence. Findings support the reliability and validity of both versions of the instrument in this population.

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

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

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

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

[The Influence of Parental Self-Esteem on Late School-Aged Children's Media Device Addiction: The Mediating Effect of Marital Conflict and Children's Self-Esteem].

PURPOSE: This study aimed to examine the effect of parental self-esteem on late school-aged children's media device addiction by mediating marital conflict and children's self-esteem. METHODS: This study used data from the 11th (2018) Panel Study on Korean Children. The participants consisted of 1,082 family triads (fathers, mothers, and children). Data were collected using the Rosenberg Self-Esteem Scale, Marital Conflict Scale, and K-Internet Addiction Scale. The data were analyzed using structural equation modeling with SPSS/WIN 27.0 and Mplus 8.7. RESULTS: The final model showed a good fit for the data. Children's media device addiction was directly related to mothers' self-esteem, mothers' marital conflict, and children's self-esteem. Fathers' self-esteem had a significant indirect effect on children's media device addiction by mediating both fathers' and mothers' marital conflict. In addition, mothers' self-esteem had a significant indirect effect on children's media device addiction by mediating mothers' marital conflict. CONCLUSION: The findings indicates that self-esteem and marital conflict for both fathers and mothers have a significant effect on children's media device addiction. It suggests that more attention might be given to fathers and mothers in developing interventions to prevent children's media device addiction.

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

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

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

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

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

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