Factors that Influence Attitudes toward Advance Directives among Hemodialysis Patients.

Purpose: Advance directives (ADs) are legal documents that outline a person's preferences or decisions regarding end-of-life care ahead of time. In Korea, there is insufficient awareness and knowledge about ADs among patients undergoing hemodialysis. This study explored the relationship between perceptions of a good death, knowledge about ADs, and attitudes toward ADs in this patient population. Methods: This cross-sectional survey enrolled 119 hemodialysis patients from a secondary hospital in 2021. The participants completed a self-administered questionnaire, and the data were analyzed using the t-test, analysis of variance, Pearson correlation coefficients, Spearman rank correlation coefficients, and multiple regression analysis. Results: The average score for perceptions of a good death among hemodialysis patients was 2.80 out of 4, with clinical symptoms identified as the most critical factor. The average scores for knowledge about ADs and attitudes toward ADs were 5.69 out of 9 and 2.79 out of 4, respectively. There was a positive correlation between perceptions of a good death and attitudes toward ADs (r=0.34, P<0.001), as well as between knowledge about Ads and attitudes toward ADs (r=0.19, P=0.037). Factors influencing attitudes toward Ads included employment status (ß=0.22, P=0.011), education level (ß=0.22, P=0.013), and perceptions of a good death (ß=0.29, P=0.001), which accounted for 24.8% of the variance in attitudes toward ADs. Conclusion: A positive perception of a good death among patients undergoing hemodialysis was associated with a positive attitude toward ADs. Educational programs are needed to improve individuals' understanding of a good death and encourage the development of end-of-life care plans.

Factors Affecting Well-Being in Korean Young Adults Facing Material Deprivation: Testing the Reserve Capacity Model.

Based on the reserve capacity model, the current study aims to explore the effect of material deprivation on well-being in Korean young adults using path analysis to investigate the mediating effects of loneliness, relationship satisfaction, perceived social support, and depression. Data from 2,041 young adults in the 2021 Youth Socio-Economic Reality Survey were included in a secondary analysis. According to the constructed path model, material deprivation, relationship satisfaction, perceived social support, and depression had significant direct effects on well-being. The indirect effect of material deprivation on well-being was statistically significant and sequentially mediated by loneliness, relationship satisfaction, and depression. Findings suggest the multidimensional effects of material deprivation on the mental health and well-being of Korean young adults through loneliness and relationship satisfaction-representing intrapersonal and interpersonal reserves, respectively. Policy support and multidimensional practical programs are needed to help materially deprived young adults build and maintain relationships and avoid feelings of loneliness and social isolation. [Journal of Psychosocial Nursing and Mental Health Services, 62(3), 29-38.].

Effect of Childhood Adversity and Positive Psychological Resources on Stress Response-Comparison Between Depressed and Nondepressed Young Adults.

Objective: The purpose of this study was to explore the relationship between stress response, childhood adversity, and positive psychological resources in young adults, to investigate the mediation effect of positive psychological resources, and to compare the moderated mediation effects between depressed and non-depressed groups. Methods: A total of 360 young adults (165 outpatients diagnosed with depression and 195 non-depressed participants) were recruited. Data were collected using the Adverse Childhood Events questionnaire, Positive Resources Test, and Stress Response Inventory. Models 4 and 14 of the PROCESS macro were used to test the mediating and moderated mediating effects. Results: In both groups, the stress response was negatively correlated with positive psychological resources and positively correlated with childhood adversity. Positive psychological resources mediated childhood adversity and depression. In the depression group, positive resources had a moderated mediation effect on the relationship between childhood adversity, positive psychological resources, and stress response. Conclusion: The findings suggest the importance of enhancing positive psychological resources, especially in patient groups, to help overcome childhood adversity and cope with stress more effectively.

Enhancing cultural competency and empathy toward foreign patients for Korean nursing students through a simulation: A quasi-experimental study.

AIM: This study aimed to develop a transcultural nursing simulation-based learning program with patients from the United Arab Emirates and evaluate its effects on cultural competence and empathy among undergraduate nursing students in South Korea. BACKGROUND: The importance of cultural competency and empathy has increased with the increased number of foreign patients in Korea. The United Arab Emirates (UAE) is one of the top Middle Eastern countries from which patients visit Korea for medical services. Because South Korea is a largely homogenous country, foreign patients often experience difficulties in their hospitalizations when Korean nurses lack cultural competency in caring for them. To improve cultural competency, a practical form of education, such as a simulation, is necessary. In addition, the simulation module based on cultural competency model allowing nursing students to provide effective and culturally responsive services to ethnically diverse patients. DESIGN: This quasi-experimental study used a non-randomized control group design with a convenience sample. METHODS: The program was administered to 53 Korean undergraduate nursing students (26 control and 27 experimental). Fourteen teams of two students practiced infection prevention training with the mother of a 7-year-old child with immunodeficiency. Participants' cultural competency and empathy were assessed before and after the TN-SBL using an online survey. The effects of cultural competency and empathy were analyzed using a generalized estimation equation. RESULTS: Nursing students in the TN-SBL group showed more positive improvement in cultural competence and had increased cognitive empathy levels than students in the control group. CONCLUSION: The simulation module developed in this study improved students' cultural competency and empathy levels. It is valuable because the scenario was developed based actual clinical cases of Emirati patients and their families. The simulation module was designed based on the cultural competency model to raise awareness of cultural diversity and allow students to directly practice culturally competent care. It can be used to educate Korean nurses and improve the quality of care provided to Arabic-speaking Muslim patients.

Sex Differences in COVID-19 Infection Fear in a Community Sample of Korean Adults Using Quantile Regression.

This study aims to explore the impact of distributional changes in coronavirus disease 2019 (COVID-19) infection fear with sex differences. A quota sampling strategy was followed and 483 Korean adults were surveyed in a community sample. Self-report questionnaires were used to assess COVID-19 infection fear, depressive symptoms, and general characteristics. Quantile regression was used to explore the regression relationship of COVID-19 infection fear and an individual's sex. There was a significant difference in COVID-19 infection fear (P = 0.001) and depression (P = 0.008) between the sexes - male and female. The differences between sexes at the 20th and 30th percentiles were significant (ß = 2.04, P = 0.006; ß = 1.5, P = 0.004, respectively). The results demonstrate that sex significantly predicts COVID-19 infection fear and women had significantly greater fear than men in the mild-level of COVID-19 infection fear.

The Mediating Role of Positive Thinking on the Relationship Between Depression and Functional Recovery in Community-Dwelling People With Schizophrenia.

Functional recovery as a consumer-centered approach is critical to recovery for community-dwelling people with schizophrenia. The current study investigated the mediating role of positive thinking in the relationship between depression and functional recovery in community-dwelling people with schizophrenia in South Korea. Depression, positive thinking, and functional recovery measures were completed by 158 people with schizophrenia in the community with self-reported questionnaires. Depression had a significantly negative influence on functional recovery. Positive thinking fully mediated the relationship between depression and functional recovery. An effective intervention strategy for functional recovery in this population may reinforce positive thinking and depression management. [Journal of Psychosocial Nursing and Mental Health Services, 61(2), 44-52.].

Effectiveness of a Mobile Application for Postpartum Depression Self-Management: Evidence from a Randomised Controlled Trial in South Korea.

This study examined the effectiveness of the Happy Mother mobile app developed for self-management of postpartum depression, based on cognitive behavioural therapy. A randomized controlled trial, with a pre- and a post-test design, was conducted in South Korea. Effectiveness was analysed using repeated measures ANOVA and Wilcoxon Signed Rank Test. We confirmed that the experimental group performed significantly more health promoting behaviours than the control group (F = 5.15, p = 0.007). However, there was no significant difference in postpartum depression, knowledge of depression, maladaptive beliefs, social support, sleep quality, and stress-coping behaviours between the two groups. The experimental group's mood score increased by 1.79 ± 2.51 points, resulting in significant differences before and after the intervention (Z = -2.81, p = 0.005). The quality of sleep score in the experimental group increased by 1.48 ± 1.70 points and was also significantly different after the intervention (Z = -3.23, p = 0.001). The activity practice rate of the experimental group significantly increased by 30.27 ± 29.27% after using the app (Z = -2.81, p = 0.005). We found the app to be effective in promoting mothers' health behaviour and improving their depressive mood.

Character Strength and Mental Health Problems among Children from Low-Income Families in South Korea.

This study was conducted to understand the association between character strength and mental health problems among children in early adolescence from low-income families in South Korea. This study used a cross-sectional and descriptive study design with 214 fifth- and sixth-grade elementary school children from low-income families enrolled in 20 community centers and receiving government financial assistance. A bivariate probit model was used to examine the association between character strength and mental health problems in the children. We found that character strength lowers the likelihood of developing hyperactivity-inattention and emotional symptoms among children from low-income families. Additionally, adverse life events were associated with increased mental health problems, whereas adverse life events were not significantly correlated with character strength in the current study. Specific interventions should be developed to cultivate character strength among children in early adolescence from low-income families who are at a high risk of mental health problems under cumulative adverse life events.

Development and Evaluation: A Behavioral Activation Mobile Application for Self-Management of Stress for College Students.

College students are at a high risk of mental health problems due to continuous exposure to considerable stress as they transition into adulthood. It is necessary to reflect on young people's needs and provide brief, personalized support interventions via mobile applications. This study aimed to (1) describe the co-design development process of a behavioral activation (BA) mobile health application called MEndorphins to help youth manage stress; and (2) evaluate the ease of use and quality of the application and its effects on psychological distress. College students aged 18-25 in South Korea participated as co-designers throughout the MEndorphins development process, which involved prototyping workshops. Thirty-five students also evaluated the application's ease of use and quality, as well as its effects on psychological distress, using a self-reported online questionnaire. In the pilot evaluation, ease of use scored 74.21 out of 100 and quality 3.72 out of 5. There were statistically significant decreases in depression, anxiety, and stress after using MEndorphins (p ≤ 0.001 for depression and anxiety, p = 0.001 for stress) for 7 days. In this developed BA based mobile application, participants could monitor their mood, plan stress self-management strategies, and gain motivation by sharing experiences.

Effectiveness of International Hospice and Palliative Care Training for Health Care Professionals in Countries of the Western Pacific Region.

As hospice and palliative care is a holistic service grounded in spirituality, training in spiritual care is essential. This study aimed to describe an international workforce training program for hospice and palliative care that emphasized spiritual care and evaluate the effectiveness of the training implementation. A quasi-experimental study was conducted with 28 health care professionals from 4 countries in the Western Pacific Region, who attended the international workforce trainings on hospice and palliative care. Data were collected before and after the trainings using a self-reported survey questionnaire. The participants' palliative care knowledge, spiritual well-being, perceived stress, and compassion competency were analyzed to evaluate the training program. Whereas the participants' knowledge of hospice and palliative care ( P < .001) and compassion competency increased ( P = .004), their perceived stress decreased post training ( P = .002). This study provided an extensive description of an international workforce training program of hospice and palliative care for potential replication of the training in other regions of the world. Because training in hospice and palliative care positively influenced health care professionals' spiritual care competency, future training and studies should consider spiritual care factors, along with intellectual aspects.

The Development of the Postpartum Depression Self-Management Mobile Application "Happy Mother".

Postpartum depression is the most common mood disorder that occurs after childbirth, rendering it a significant public health problem. Information and communication technologies hold tremendous promise for expanding the reach of quality mental healthcare and closing the treatment gap for depression. In particular, given that mobile applications are inexpensive and provide information systematically, they are suitable as a method of health management that does not require visiting a medical center. The purposes of this study were to document the process of developing a mobile application for the self-management of postpartum depression and to share usability test results. The mobile application "Happy Mother" was developed based on the first five of seven stages in the mobile application development lifecycle model. Components of cognitive behavioral therapy were adopted to guide content development for "Happy Mother." The usability of the completed mobile application was tested in the following three steps: it increased awareness of mood, promoted self-management, and implemented specific methods a mother can use in her daily life to improve mood, including modifications made based on the results of the usability test.

Mediation Effects of Compassion Satisfaction and Compassion Fatigue in the Relationships Between Resilience and Anxiety or Depression Among Hospice Volunteers.

Hospice volunteers are a high-risk group for anxiety and depression owing to their frequent exposure to patients at the end of life and their subsequent deaths. Resilience is known to be a powerful factor that affects the occurrence of anxiety and depression; however, research on this subject is scarce. We investigated the relationship of resilience with anxiety or depression in hospice volunteers. A total of 145 volunteers were included in the analysis. Participants completed self-reported scales, including the Korean version of the Connor-Davidson Resilience Scale, the State-Trait Anxiety Inventory, Patient Health Questionnaire-9, and the Professional Quality of Life Scale version 5. Pearson correlation coefficients were analyzed to identify the relationship of compassion satisfaction and compassion fatigue with anxiety or depression. A PROCESS macro mediation analysis was used to investigate the mediation effects of compassion satisfaction and compassion fatigue on the relationship between resilience and anxiety or depression. There were significant associations of compassion satisfaction and compassion fatigue with anxiety and depression. The relationship between resilience and anxiety/depression was mediated by compassion fatigue, which had indirect effects on anxiety and depression. Efforts to reduce compassion fatigue and increase resilience could help prevent anxiety and depression in hospice volunteers.

Longitudinal effects of insufficient sleep on psychological problems among adolescent bullies based on Korean Child and Youth Panel Survey.

This study was performed to investigate longitudinal effects of insufficient sleep on psychological problems among bullies and neutral students using the Korean Child and Youth Panel Survey (KCYPS) collected from 8th to 10th graders. At the first wave, 6.4% of students reported that they had bullied other students two or more times. Bullies having insufficient sleep duration at the first wave exhibited significantly higher aggression levels than bullies with sufficient sleep over time. Among neutral students, sleep insufficiency showed no longitudinal relationship with aggression. Our findings confirm that insufficient sleep was an associated factor for chronically elevated aggression among bullies.

[Effects of a Positive Psychotherapy Program on Positive Affect, Interpersonal Relations, Resilience, and Mental Health Recovery in Community-Dwelling People with Schizophrenia].

PURPOSE: Recently, the interest in positive psychotherapy is growing, which can help to encourage positive relationships and develop strengths of people. This study was conducted to investigate the effects of a positive psychotherapy program on positive affect, interpersonal relations, resilience, and mental health recovery in community-dwelling people with schizophrenia. METHODS: The research was conducted using a randomized control group pretest-posttest design. A total of 57 adults with schizophrenia participated in this study. The study participants in experimental group received a positive psychotherapy program (n=28) and the participants in control group received only the usual treatment in community centers (n=29). The positive psychotherapy program was provided for 5 weeks (of 10 sessions, held twice/week, for 60 minutes). The study outcomes included positive affect, interpersonal relations, resilience, and mental health recovery. The collected data were analyzed using repeated measures ANOVA for examining study hypothesis. RESULTS: Results showed that interpersonal relations (F=11.83, p=.001) and resilience (F=9.62, p=.003) significantly increased in the experimental group compared to the control group. Although experimental group showed a slight increase in positive affect, it was not significant. CONCLUSION: The study findings confirm that the positive psychotherapy program is effective for improving interpersonal relations and resilience of community-dwelling people with schizophrenia. Based on the findings, we believe that the positive psychotherapy program would be acceptable and helpful to improve recovery of mental health in schizophrenia.

College student engaging in cyberbullying victimization: cognitive appraisals, coping strategies, and psychological adjustments.

The study's purpose was to explore whether frequency of cyberbullying victimization, cognitive appraisals, and coping strategies were associated with psychological adjustments among college student cyberbullying victims. A convenience sample of 121 students completed questionnaires. Linear regression analyses found frequency of cyberbullying victimization, cognitive appraisals, and coping strategies respectively explained 30%, 30%, and 27% of the variance in depression, anxiety, and self-esteem. Frequency of cyberbullying victimization and approach and avoidance coping strategies were associated with psychological adjustments, with avoidance coping strategies being associated with all three psychological adjustments. Interventions should focus on teaching cyberbullying victims to not use avoidance coping strategies.

[Effects of listening to music on auditory hallucination and psychiatric symptoms in people with schizophrenia].

PURPOSE: The purpose of this study was to explore the effects of listening to music in inpatients diagnosed with schizophrenia, on their auditory hallucinations, and positive and negative symptoms. METHODS: A quasi-experimental research design with 2x2 cross-over trial and convenience sample was used. Eleven patients (Group AB) listened to music followed by a wash out period and then a usual care period, and 12 patients (Group BA) had a usual care period followed by a wash out period and then listened to music. For one week those who were in the experimental period listened to individualized music using an MP3 player whenever they heard hallucinations. RESULTS: There was a statistically significant decrease in the frequency of auditory hallucinations after listening to the music. There was a decrease in the mean scores for positive symptoms, negative symptoms, and general psychopathology after listening to music, but only negative symptoms showed a statistically significant decrease. The treatment effects on scores for positive symptoms, negative symptoms, and general psychopathology were greater in Group BA than Group AB. CONCLUSION: These findings suggest that listening to music may be useful for managing auditory hallucinations in schizophrenia inpatients.