Effects of Self-Assertive Training Applying Reality Therapy Techniques on Self-esteem and Internalized Stigma in Schizophrenia Patients / 정신간호학회지

PURPOSE: The aim of this study was to examine the effect of self-assertive training applying the reality therapy techniques (SATART) on self-esteem and internalized stigma of schizophrenia patients. METHODS: This study was a non-equivalent control group pretest-posttest design and enrolled 55 people with schizophrenia (experimental group=27, control group=28) from two community mental health centers. The SATART was offered twice a week for 6 weeks in a total 12 sessions. Data were collected from February to April, 2017, using the Korean version of the Internalized Stigma of Mental Illness Scale and Rosenberg Self-Esteem Scale. The collected data was analyzed using χ2 test, independent t-test, one-way ANCOVA, and repeated measures ANOVA with using the SPSS/WIN 22.0 program. RESULTS: The experimental group showed significant improvements in self-esteem and recudction of internalized stigma compared to the control group. However, there was no significant improvement on stigma resistance measurement among the subscales of internalized stigma between two groups. CONCLUSION: The findings indicate that the SATART program is effective and could be recommended as a psychosocial intervention for self-esteem enhancement and internalized stigma reduction of people with schizophrenia.

The Relationship between Parental Stress and Nurses' Communication as Perceived by Parents of High-risk Newborns

PURPOSE: This study aimed to characterize the relationship between parental stress and nurses' communication as perceived by parents of high-risk newborns in a neonatal intensive care unit (NICU). METHODS: The participants were 54 parents of high-risk newborns in a NICU. Data were collected from January to March 2018. Parental stress and parents' perceptions of nurses' communication ability and styles were measured using a questionnaire. RESULTS: The average scores for parental stress and nurses' communication ability were 3.39 and 4.38 respectively, on a 5-point scale. Parents most commonly reported that nurses showed a friendly communication style, followed by informative and authoritative styles. Mothers and fathers reported significantly different levels of parental stress. Parental stress showed a negative correlation with nurses' perceived verbal communication ability. Higher scores for nurses' verbal communication ability and for friendly and informative communication styles were associated with lower parental stress induced by the environment, the baby's appearance and behaviors, and treatments in the NICU. CONCLUSION: The findings of this study suggest that nurses need to offer proper information for parents and to support parents by encouraging them to express their emotions of stress and by providing parents with therapeutic communication and opportunities to participate in care.

The Mediating Effects of Self-Esteem and Resilience on the Relationship Between Internalized Stigma and Quality of Life in People with Schizophrenia

PURPOSE: This study examined the mediating effects of self-esteem and resilience on the relationship between internalized stigma and quality of life in people with schizophrenia.METHODS: The participants were 123 people with schizophrenia (mean age = 41.87 years; 62.6% men) recruited from Soonchunhyang university hospital, a mental health center, and daytime rehabilitation facilities located in Seoul and Gyeonggi Province in South Korea. Using a cross-sectional survey, participants completed structured questionnaires with psychometric adequacy. The regression method of Baron and Kenny was used to test the mediating effects of self-esteem and resilience on the relationship between internalized stigma and quality of life.RESULTS: Self-esteem and resilience were found to be full and partial mediators, respectively, in the relationship between internalized stigma and quality of life.CONCLUSION: The findings of this study imply that effective future intervention strategies should target improvements in self-esteem and resilience to reduce the negative impact of internalized stigma on the quality of life of people with schizophrenia.

Exploring Decision-Making Factors of Psychiatric Nurses in the Application of Seclusion and Restraint: Applying Focus Group Interviews / 정신간호학회지

PURPOSE: The purpose of this study was to explore psychiatric nurses' decision making in the use of seclusion and restraint (SR). METHODS: Data were collected using focus group interviews. Two focus group interviews were held with a total of 10 psychiatric nurse participants. All interviews were recorded and transcribed, and data were analyzed using qualitative content analysis. RESULTS: Eleven categories emerged from three main themes. All the themes describe factors that participants took into account when deciding whether to implement SR: 1) Personal factors area: ‘Personal attributes of nurses,’ ‘Attitude of nurses regarding SR,’ ‘Nurses’ ‘physical and emotional states,’ ‘Negative experiences of nurses related to SR’; 2) Relational factors area: ‘The level of cooperation between nurses and doctors,’ ‘Role models created by seniors and colleagues,’ ‘The level of support by nursing assistants,’ ‘Therapeutic relations with patients’; and 3) Environmental factors area: ‘Poor nursing work environment,’ ‘Atmosphere of ward regarding SR,’ and ‘Social atmosphere to raise alarm about SR.’ CONCLUSION: These findings should be considered in the evaluation of the use of SR in psychiatric hospital settings and appropriate strategies used to help minimize the use of restraint.

Gender Specific Role of Anger Expression in Association with Depression and Health Behavior in Community-Dwelling Elders / 정신간호학회지

PURPOSE: The purpose of this study was to identify the total, direct, and indirect influence of depression on health behavior (HB); to determine relative magnitudes of specific mediating effects of anger expression in gender specific subgroup among elders. METHODS: A cross-sectional correlational survey was conducted in S and G cities with 333 community-dwe1ling elders (male=170, female=163). Data were collected from September 7 to November 7, 2013. Kee's GDSSF-K for depression, Spielberger's STAXI for anger expression and Choi & Kim's health behavior assessment tool were used. Multiple-mediation analyses using Indirect SPSS macros were performed. RESULTS: Depression had a significant total, direct and indirect effect on HB in both male and female. In women, direct and indirect effect of depression on HB were higher than in men. Specific indirect effects of depression on HB were evidenced via anger-control and anger-out for men and via anger-control and anger-in for women. Among anger expression, anger-control was a more salient mediator for both male and female. CONCLUSION: Findings suggest that depression and anger-control should be addressed in tandem for promotion of HB for elders. Tailored interventions for the promotion of HB should be developed considering gender of target population.

Body Image Dissatisfaction as a Mediator of the Association between BMI, Self-esteem and Mental Health in Early Adolescents: A Multiple-group Path Analysis across Gender

PURPOSE: This study was done to examine not only the relationships between body mass index (BMI), self-esteem, body image dissatisfaction (BID) and mental health, according to gender, but the mediating role of BID on mental health in relation to BMI and self-esteem among early adolescents. METHODS: Data from 576 (296 boys and 280 girls) elementary school students in grades 5 to 6 were collected. A multiple-group path analysis was utilized to examine the relationships between BMI, self-esteem, BID and mental health by gender. RESULTS: In the path analysis for all students, poor mental health was related directly to BID, while it was indirectly related to BMI and self-esteem. In the multiple-group path analysis of both genders, BID was found to have a significant direct and indirect effect on mental health for girls alone. CONCLUSION: The findings suggested that BID should be examined early to prevent poor mental health in early adolescent girls. This study helps to elucidate the role of early adolescent BID on mental health and provides insight for further prevention and intervention programs in school and community mental health settings.

Effects of an Infant/Toddler Health Program on Parenting Knowledge, Behavior, Confidence, and Home Environment in Low-income Mothers

PURPOSE: This study was conducted to evaluate the effectiveness of a mother/infant-toddler health program developed to enhance parenting knowledge, behavior and confidence in low income mothers and home environment. METHODS: A one-group pretest-posttest quasi-experimental design was used. Sixty-nine dyads of mothers and infant-toddlers (aged 0-36 months) were provided with weekly intervention for seven session. Each session consisted of three parts; first, educating to increase integrated knowledge related to the development of the infant/toddler including nutrition, first aid and home environment; second, counseling to share parenting experience among the mothers and to increase their nurturing confidence; third, playing with the infant/toddler to facilitate attachment-based parenting behavior for the mothers. RESULTS: Following the programs, there were significant increases in parenting knowledge on nutrition and first aid. A significant improvement was found in attachment-based parenting behavior, but not in home safety practice. Nurturing confidence was not significantly increased. The program led to more positive home environment for infant/toddler's health and development. CONCLUSION: The findings provide evidence for mother-infant/toddler health program to improve parenting knowledge, attachment-based parenting behavior and better home environment in low income mothers. Study of the long term effectiveness of this program is recommended for future research.

Risk Factors Influencing Probability and Severity of Elder Abuse in Community-dwelling Older Adults: Applying Zero-inflated Negative Binomial Modeling of Abuse Count Data

PURPOSE: This study was conducted to identify risk factors that influence the probability and severity of elder abuse in community-dwelling older adults. METHODS: This study was a cross-sectional descriptive study. Self-report questionnaires were used to collect data from community-dwelling Koreans, 65 and older (N=416). Logistic regression, negative binomial regression and zero-inflated negative binomial regression model for abuse count data were utilized to determine risk factors for elder abuse. RESULTS: The rate of older adults who experienced any one category of abuse was 32.5%. By zero-inflated negative binomial regression analysis, the experience of verbal-psychological abuse was associated with marital status and family support, while the experience of physical abuse was associated with self-esteem, perceived economic stress and family support. Family support was found to be a salient risk factor of probability of abuse in both verbal-psychological and physical abuse. Self-esteem was found to be a salient risk factor of probability and severity of abuse in physical abuse alone. CONCLUSION: The findings suggest that tailored prevention and intervention considering both types of elder abuse and target populations might be beneficial for preventative efficiency of elder abuse.

Aggression and Related Factors in Elementary School Students

PURPOSE: This study was done to explore the relationship between aggression and internet over-use, depression-anxiety, self-esteem, all of which are known to be behavior and psychological characteristics linked to "at-risk" children for aggression. METHODS: Korean-Child Behavior Check List (K-CBCL), Korean-Internet Addiction Self-Test Scale, and Self-Esteem Scale by Rosenberg (1965) were used as measurement tools with a sample of 743, 5th-6th grade students from 3 elementary schools in Jecheon city. Chi-square, t-test, ANOVA, Pearson's correlation and stepwise multiple regression with SPSS/Win 13.0 version were used to analyze the collected data. RESULTS: Aggression for the elementary school students was positively correlated with internet over-use and depression-anxiety, whereas self-esteem was negatively correlated with aggression. Stepwise multiple regression analysis showed that 68.4% of the variance for aggression was significantly accounted for by internet over-use, depression-anxiety, and self-esteem. The most significant factor influencing aggression was depression-anxiety. CONCLUSION: These results suggest that earlier screening and intervention programs for depression-anxiety and internet over-use for elementary student will be helpful in preventing aggression.

A Comparative Study on Health Risk Factors between Cancer Patients and Healthy People / 성인간호학회지

PURPOSE: The purpose of this study was to provide the basic data of a comprehensive counter-plan to promote health for people by comparing various factors related to cancer outbreak factors including general characteristics, health-related lifestyles, health promoting behaviors, perceived healthy status, life event stress and health care seeking behaviors with cancer patients and health people. METHOD: The study was designed to be a retrospective- comparison-survey-study and its data was collected through 5 types of questionnaires from September 2003 to December 2003. RESULTS: Cancer patients had lower education and household income, and many of them had no occupation. Cancer patients had a higher rate of smoking and drinking periods. Exercise level was higher in healthy people. However, Cancer patients were better in sleep and rest. In comparison with health promoting behaviors, it was higher in healthy people than in cancer patients but the two groups had no significant differences statistically. The perceived health status was higher in healthy people than in cancer patients. The health care seeking behaviors were higher in healthy people than in cancer patients. Cancer patients and healthy people's life event stress had no significant differences statistically. CONCLUSION: As a result of comparative analysis of cancer patients and healthy people's health risk factors, smoking, drinking period, regular exercise and health care seeking behaviors were suggested as direct or indirect risk factors for cancer patients. These finding can be applied to health promoting behavior programs to keep and promote optimal health status as well as to prevent cancer disease.