Health-related quality of life in female patients with reumatoid arthritis: a structural equation model.

PURPOSE: This study aimed to construct a structural equation model to explain and predict factors affecting the health-related quality of life (QoL) in female rheumatoid arthritis (RA) patients based on the health-related QoL model by Ferrans et al. (2005) and a literature review. METHODS: Patients (N=243) who were either registered members of an internet cafe composed of patients with RA or rheumatology outpatients at two tertiary general hospitals in Busan, Korea, were recruited via convenience sampling. Data were collected from July 2 to September 9, 2021, and the survey was conducted using a web-based questionnaire. The data were analyzed by SPSS and AMOS 26.0. RESULTS: The goodness-of-fit statistics of the final model exhibited good results (χ2/degree of freedom=2.68, Turker-Lewis index=.94, comparative fit index=.96, standardized root mean-squared residual=.04, root mean- square error of approximation=.08), and 11 out of 14 paths of the model were supported. The squared multiple correlation, which reflected the explanatory power of the environmental characteristics, symptoms, functional status, and perceived health status on health-related QoL, was 80%. In the hypothesis model, 10 paths had significant direct effects, 6 paths had significant indirect effects, and 12 paths had significant total (direct and indirect) effects. CONCLUSION: Considering that factors directly affecting the health-related QoL of female patients with RA were social support, symptoms (fatigue and depression), resilience, and perceived health status, and that resilience was the most influential factor, clinicians can encourage resilience. Hence, to improve the health-related QoL of female patients with RA, continuing management is necessary, using various intervention methods that focus on enhancing resilience from the early stage to the end of treatment for RA.

[Do parenting stress, work-family conflict, and resilience affect retention intention in Korean nurses returning to work after parental leave?: a cross-sectional study]. / 육아휴직 후 복직 간호사의 ì–‘ìœ¡ìŠ¤íŠ¸ë ˆìŠ¤, 일-ê°€ì • 갈등, ìžì•„íƒ„ë ¥ì„±ì´ 재직의도에 미치는 영향.

Purpose: This study investigated whether parenting stress, work-family conflict, resilience affect retention intent in Korean nurses returning to work after parental leave. Methods: The participants in this study were 111 nurses recruited from 10 hospitals in Korea, who were working after formal parental leave from their hospitals. Collected data were analyzed using descriptive statistics, the t-test, analysis of variance, the Mann-Whitney U-test, Pearson correlation coefficients, and hierarchical regression. Results: Retention intention (33.80±7.78), parenting stress (101.70±17.57), and resilience (85.02±12.75) were at greater than moderate levels and a midpoint level of work-family conflict (29.63±7.00) was noted in this sample of mostly women nurses in their 30s. The factors affecting retention intent were parental leave duration, the number of times that participants had taken parental leave, health condition, work-family conflict, and resilience. The total explanatory power of these variables was 36.7%. Retention intent had a negative correlation with parenting stress and work-family conflict. Conversely, retention intent was positively correlated with resilience. Conclusion: This study supports the need for flexible adjustment of returning nurses' working hours and family-friendly policies to promote balance between work and family. It is also necessary to develop and apply measures that boost resilience and support health improvement for nurses returning to work.As nurses are often assigned to new areas of work upon return, training programs to aid their adjustment may also be helpful.

Does family support mediate the effect of anxiety and depression on maternal-fetal attachment in high-risk pregnant women admitted to the maternal-fetal intensive care unit?

Purpose: This study investigated the mediating effect of family support in the relationships of anxiety and depression with maternal-fetal attachment among pregnant women admitted to the maternal-fetal intensive care unit (MFICU) in Korea. Methods: The participants were high-risk pregnant women with a gestational age of at least 20 weeks who were admitted to MFICUs in Busan and Yangsan. The Korean versions of four measurement tools were used for the self-report questionnaire: Spielberger's State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, Cobb's family support measurement, and Cranley's maternal-fetal attachment scale. Data were collected from June 22 to September 20, 2020. Out of 124 participants, data from 123 respondents were analyzed. Descriptive statistics and regression analysis were done. Results: The average age of participants was 34.1 years. Their anxiety level was moderate (43.57±11.65 points out of 80) and 53.6% were identified as having moderate depression (average 10.13±5.48 points out of 30). Family support was somewhat high (average 43.30±5.03 points out of 55). The average score of maternal-fetal attachment was also somewhat high (73.37±12.14 points out of 96). Family support had a partial mediating effect in the relationships of anxiety and depression with maternal-fetal attachment among high-risk pregnant women admitted to the MFICU. Conclusion: Maintaining family support is challenging due to the nature of the MFICU. Considering the mediating effect of family support, establishing an intervention plan to strengthen family support can be helpful as a way to improve maternal-fetal attachment for high-risk pregnant women admitted to the MFICU.

[Influence of self-differentiation, psychological discomfort, and marital dyadic adjustment on maternal-fetal attachment in primigravida]. / 초임부의 자기분화, ì‹¬ë¦¬ì  불편감 및 ë¶€ë¶€ì ì‘ì´ íƒœì•„ì• ì°©ì— 미치는 영향.

Purpose: The purpose of this study was to identify the influence of self-differentiation, psychological discomfort, and marital dyadic adjustment on maternal-fetal attachment in primigravida. Methods: In total, 108 primigravida participated in this descriptive correlational study. The participants answered self-report questionnaires. Data were collected from January to May, 2020, and were analyzed using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression with SPSS for Windows ver. 23.0. Results: The mean age of the primigravida was 31.66 years. The mean score for the degree of maternal-fetal attachment was 76.81 out of 96 points. Participants' scores for maternal-fetal attachment differed significantly based on age (t=2.08 p=.039) and marital status (t=2.05, p=.043). Maternal-fetal attachment was significantly negatively correlated with psychological discomfort (r=-.39, p<.001), and significantly positively correlated with self-differentiation (r=.36, p<.001) and marital dyadic adjustment (r=.36, p<.001). Self-differentiation explained 24.1% of variance in participants' maternal-fetal attachment, and its effect was statistically significant (F=7.79, p<.001). Conclusion: In primigravida, more self-differentiation was associated with stronger maternal-fetal attachment. To strengthen maternal-fetal attachment in primigravida, educational program that increases the level of self-differentiation and minimizes their psychological discomfort may be helpful for first time pregnant women. Additionally, it is recommended to provide nursing interventions to encourage couples to work together throughout the gestational period.

Factors Influencing HPV Vaccination Intention in Mothers with Elementary School Daughters.

PURPOSE: The purpose of this study was to identify the impacts of human papillomavirus (HPV) vaccination-related health belief, attitudes toward HPV vaccination, and subjective norms on HPV vaccination intent targeting mothers of elementary school daughters. METHODS: The study use a correlative survey design. The subjects of the study were 121 mothers of elementary school daughters located in metropolitan city B. All subjects agreed to participate in the study. The data were collected from September 1 to October 18, 2018, and were analyzed using descriptive statistics, Independent t-test, ANOVA with a post hoc Scheffé test, Pearson's correlation coefficients, and stepwise multiple regression. RESULTS: Attitude toward HPV vaccination, subjective norms, vaccination plans for their children, and mother's vaccination status were significant factors influencing HPV vaccination intention. These factors accounted for 72% of the HPV vaccination intention. CONCLUSIONS: This study showed that factors affecting the intention of mothers of elementary school daughters to vaccinate against HPV were HPV vaccination attitudes, subjective norms, vaccination plans for their children, and mother's vaccination status. The biggest influencing factor was HPV vaccination attitudes. Therefore, in order to encourage mothers of elementary school daughters to vaccinate against HPVs, national-level policies should be implemented to create a social atmosphere of positive attitudes toward HPV vaccinations that also emphasizes how easy it is to get vaccinated against HPV. Based on this, mothers of elementary school daughters should be encouraged to have them vaccinated against HPV, thus contributing to improving the HPV vaccination rates of elementary school girls.

Effects of Irrational Parenthood Cognition, Family Support, and Resilience on Depression of Infertile Women.

PURPOSE: To determine effects of irrational parenthood cognition, family support, and resilience on depression in infertile women. METHODS: Subjects were 118 infertile women who agreed to participate in this study. Data were collected from April 16 to July 31, 2018. Collected data were analyzed using descriptive statistics, t-test, analysis of variance (ANOVA), Pearson's correlation and multiple regression with SPSS WIN 23.0 program. RESULTS: Depression significantly differed according to the burden of treatment cost and presence of people giving stress. Depression showed significantly positive correlation with irrational parenthood cognition and significantly negative correlations with family support and resilience. Factors affecting depression were irrational parenthood cognition, family support, and resilience. Irrational parenthood cognition had the greatest effect on depression. These three variables explained 35.8% of total variance. CONCLUSION: Irrational parenthood cognition, family support, and resilience affected depression of infertile women, with irrational parenthood cognition having the greatest effect. Therefore, it is important to develop and implement programs that can reduce irrational parenthood cognition and increase family support and resilience in order to lower depression of infertile women. The authors declared no conflict of interest.

Effect of Incivility, Resilience, and Social Support Experienced by Nursing Students on Burnout in Clinical Practice.

PURPOSE: The purpose of the study was to determine effect of incivility, resilience, and social support experienced by nursing students on burnout in clinical practice. METHODS: Subjects were 140 nursing students who agreed to participate in this study. Collected data were analyzed using descriptive statistics, t-test, analysis of variance, Pearson's correlation and stepwise multiple regression with SPSS WIN 23.0 program. RESULTS: Burnout showed significantly positive correlation with incivility but significantly negative correlations with resilience and social support. Factors affecting burnout were satisfaction with major-dissatisfaction, satisfaction with major-average, social support, grade, and relationship with peers. Satisfaction with major (dissatisfaction) had the greatest effect on burnout, explaining 41% of the total variance. CONCLUSION: According to this study, dissatisfaction with major was identified as the most significant factor influencing burnout of nursing students in clinical practice. Therefore, it is important to develop and implement programs that can reduce dissatisfaction with major and increase social support and relationship with peers in order to lower burnout of nursing students. In addition, a systemic management of fourth-grade students with a high level of clinical practice is necessary to reduce the level of clinical practice. The authors declared no conflict of interest.

Impact of Anxiety, Social Support, and Taegyo Practice on Maternal-Fetal Attachment in Pregnant Women Having an Abortion.

PURPOSE: The purpose of the study was to identify effects of anxiety, social support, and Taegyo practice toward maternal-fetal attachment in pregnant women having an abortion. METHOD: Participants included 99 pregnant women having an abortion, who participated in this study. Collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and multiple regression with the SPSS WIN 23.0 program. RESULTS: Maternal-fetal attachment was significantly negatively correlated with anxiety, and significantly positively correlated with social support and Taegyo practice. Spousal support and Taegyo practice, explained 43.8% of participants' maternal-fetal attachment. CONCLUSION: Results indicate that less anxiety and more social support, and Taegyo practice in pregnant women having an abortion, were associated with stronger maternal-fetal attachment. To strengthen the maternal-fetal attachment of pregnant women having an abortion experience, it would be necessary to develop and implement the Taegyo program, focusing on practicing Taegyo-related encouragement. Additionally, it is recommended that nursing intervention is provided, to encourage families to participate in the Taegyo practice together throughout the gestational period, and to maintain a positive relationship among partners.

Factors influencing Human Papillomavirus Vaccination intention in Female High School Students: Application of Planned Behavior Theory.

PURPOSE: The purpose of this study was to identify effects of attitude, subjective norm, and perceived behavior control toward Human Papillomavirus (HPV) on HPV vaccination intention in female high school students. METHODS: Subjects of this study were female students aged 16 to 17 years, the optimal age group of HPV vaccination, arbitrarily selected from three high schools in B city. A total of 140 students agreed to participate in this study. Data were analyzed using descriptive statistics, t-test, ANOVA, correlation, and stepwise multiple regression. RESULTS: Attitude, subjective norm, and perceived behavior control toward HPV were factors influencing HPV vaccination intention of subjects. Perceived behavior control toward HPV vaccination was the most influential factor. These factors accounted for 49% of HPV vaccination intention. CONCLUSION: These results suggest a need to increase perceived behavior control to increase HPV vaccination intention. The government needs to establish a national policy system such as financial support for HPV vaccines and free vaccinations so that students are aware that HPV vaccines can be easily inoculated.

Impact of Menstrual Attitudes, Premenstrual Syndrome, and Stress Response on Quality of Life among Nursing Students.

PURPOSE: To identify effects of menstrual attitude, premenstrual syndrome, and stress response on quality of life of nursing students. METHODS: Subjects were 135 nursing students who agreed to participate in this study. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and stepwise multiple regression. RESULTS: Premenstrual syndrome, younger than 20 years of age, and habit of eating bland food in everyday life were factors influencing quality of life of nursing students. These factors accounted for 17.6% of quality of life. Premenstrual syndrome toward quality of life was the most influential factor. CONCLUSION: Premenstrual syndrome is the most significant factor affecting the quality of life of nursing students. To increase their quality of life, it is important to develop and apply educational programs using factors influencing quality of life of the nursing students. Results of this study will be useful as basic data for improving quality of life of nursing students. Additional study is needed to test its effect in the future.

Effects of Music Therapy on Stress of Preterm Labor and Uterine Contraction in Pregnant Women with Preterm Labor.

PURPOSE: The purpose of this study was to test effects of music therapy on stress due to preterm labor and uterine contraction in pregnant women with preterm labor. METHODS: An experimental research design was used. Participants were 35 pregnant women with preterm labor who were between 20 to 37 weeks of pregnancy: control group (n=18) received only tocolytic drugs, while experimental group (n=17) received additional music therapy. In the experimental group, Traumerei was applied before Non-Stress Test (NST) from the second day to fifth day after admission as music therapy. RESULTS: There was a statistically significant difference in stress due to preterm labor (z=-3.368, p<.001) between the two groups. CONCLUSION: The music therapy is an effective method for reducing the stress of pregnant women with preterm labor.

Factors Influencing HPV-related Infection Preventive Behavioral Intention among Female University Students.

PURPOSE: The purpose of this study was to identify impacts of HPV-related knowledge, attitude to HPV vaccination, and health beliefs on infection preventive behavioral intention targeting female university students. METHODS: With correlational survey design, subjects of this study were 120 female students at universities located in B metropolitan city and G city. A total sample agreed to participate in the study. Data were analyzed using descriptive statistics, t-test, ANOVA, correlation, and stepwise multiple regression. RESULTS: Attitude to HPV vaccination, experience of smoking, and HPV-related health beliefs were significant factors influencing the HPV-related infection preventive behavioral intention. These factors accounted for 19.0% of the HPV-related infection preventive behavioral intention. CONCLUSION: The most significant factor for HPV infection prevention was the attitude to HPV vaccination. These findings may be useful to develop strategies to improve the HPV infection preventive behavioral intention of the female university students who have a high risk of the HPV infection.

Impacts of Health Perception, Aging Anxiety and Perception of Successful Aging on Health Promotion Behavior of Late Middle-Aged Women.

PURPOSE: The purpose of the study was to identify factors influencing health promotion behavior of late-middle aged women. METHODS: The subjects were 128 women who were attending a cultural center located in B metropolitan city. Data were collected from July 1 to July 31, 2016. Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, Pearson correlation coefficient, Stepwise multiple regression with SPSS/WIN 23.0 program. RESULTS: Health promotion behavior of later middle-aged women was different by general characteristics such as religion, exercise, economic satisfaction, life satisfaction, and leisure time activities. Health promotion behavior had a positive relationship with health perception and perception of successful aging, and a negative relationship with aging anxiety. Health perception, perception of successful aging, exercise, leisure time activities (exercise and social activity) were verified significant factors influencing health promotion behavior accounted for 38%. CONCLUSION: The results indicate that health perception and perception of successful aging influence health promotion behavior of late-middle age women. It would provide the basic data for the development of program aimed at improving health promotion behavior of late-middle age women.

Impacts of Menstrual Attitudes, Premenstrual Syndrome and Stress on Burnout among Clinical Nurses.

PURPOSE: The purpose of this study was to investigate factors which effect clinical nurses' exhaustion. METHODS: This research was conducted targeting 140 clinical nurses. Data were collected from 18 September to 30 September 2015. Data were analyzed using the program SPSS/WIN 18.0. Descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and Stepwise multiple regression analysis were used. RESULTS: Burnout was significantly different by age (F=7.99, p=.001), marital status (t=8.69, p=.004), department area (F=7.65, p<.001), frequency of night work in a month (F=7.65, p=<.001), and clinical career (F=3.68, p=.028). There was positive correlations between menstrual attitudes of participants and premenstrual syndrome (r=34, p<.001), menstrual attitudes and stress (r=.40, p<.001), and menstrual attitudes and burnout (r=.16, p=.031). There were positive correlations between premenstrual syndrome and stress (r=.46, p<.001), between premenstrual syndrome and burnout (r=.35, p<.001), and between stress and burnout (r=.36, p<.001). Factors influencing burnout were premenstrual syndrome (ß=.335) and age (ß=.216), with an explanatory power of 18.0%. CONCLUSION: There is a need to develop and apply program for reducing clinical nurses' pre-menstrual syndrome. In addition, policies are needed to allow for menstruation leave, thereby making it legal.

Effect of Light Therapy on Sleep Disturbance and Depression in Climacteric Women.

PURPOSE: The purpose of this study was to examine the effects of light therapy on sleep disturbance and depression in climacteric women with menopausal symptoms. METHODS: The research design was a nonequivalent control group pre test-post test design. Data were collected from September 29, 2013 to November 11, 2013. Participants included 17 climacteric women in an artificial light therapy group, 17 climacteric women in a sun light therapy group and 16 climacteric women in a control group. Measures consisted of the sleep disturbance, depression, melatonin, and serotonin. RESULTS: There was a statistically significant difference of Korean Sleep Scale A (F=53.87, p<.001), and melatonin (F=31.19, p<.001) among three groups. There was a statistically significant difference of Self-Rating Depression Scale (F=121.86, p<.001), and serotonin (F=102.37, p<.001) among three groups. CONCLUSION: Artificial and sun light therapy can be applied as a supportive nursing intervention to subjects with sleep disturbance and depression in climacteric women with menopausal symptoms. Artificial and sun light therapy is expected to be a complementary alternative intervention for health management of the subjects with sleep disturbance and depression in climacteric women with menopausal symptoms.

Effect of Aroma Hand Massage on Anxiety and Immune Function in Patients with Gynecology Surgery under Local Anesthesia.

PURPOSE: The purpose of this study was to examine the effects of aroma hand massage on anxiety and immune function in patients who had gynecology surgery under local anesthesia. METHODS: The research design was a nonequivalent control group with pre- and posttest design. Data were collected from June 5 to October 6, 2010. Participants included 20 patients in the aroma hand massage group, 20 patients in a hand massage group, and 20 in a control group. As an experimental treatment, hand massage was carried out following the hand massage protocol. Measures consisted of the State Trait Anxiety, Numeric Rating Scale (NRS) for anxiety, vital signs (systolic and diastolic blood pressure, pulse rate), and salivary cortisol for anxiety, and immunoglobulin A for immune function. RESULTS: Aroma hand massage and hand massage group showed lower levels in NRS for anxiety, systolic and diastolic blood pressure, and pulse rate (p<.001) compared to controls. No group differences were found for state anxiety, salivary cortisol and immunoglobulin A. CONCLUSION: The results indicate that aroma hand massage and hand massage are effective in reducing anxiety and can be complementary alternative interventions for women having gynecology surgery under local anesthesia.

Home environmental and health-related factors among home fallers and recurrent fallers in community dwelling older Korean women.

The purpose of the study was to determine home environmental and health-related factors among home fallers and recurrent fallers in community dwelling older Korean women. The study population included 438 older women aged 65 years and over. Measures included a checklist of home environments and health-related items. Risk indicators for accidental falls and recurrent falling were analysed using logistic regression. Logistic regression analysis revealed that chronic disease (odds ratio (OR) = 2.02, P = 0.007), poor night light (OR = 1.97, P = 0.032) and obstacle of door sill (OR = 1.76, P = 0.021) were predictors of accidental falls, and physical inactivity (OR = 2.34, P = 0.018) and slippery floor in the bathroom (OR = 0.41, P = 0.034) were predictors of recurrent falling. The findings have implications for strategies and suggest the need to modify home environmental context in systematic and consistent ways and the need to maintain physical activities to prevent falls and recurrent falling.

Relationships among Marital Satisfaction, Spousal Support and Practice of Taekyo in Pregnant Women.

PURPOSE: The purpose of this study was to investigate the relationships among marital satisfaction, spousal support and practice of Taekyo among pregnant women. METHODS: This study was conducted by the use of questionnaire surveys with two hundred and eighty-three pregnant women at several hospitals located in Gyeonggi province and Daejeon city from October 2008 to April 2009. Contents of questionnaire included marital satisfaction, spousal support and practice of Taekyo. Descriptive statistics, t-test, ANOVA, Pearson correlation, and stepwise multiple regression were conducted for data analysis using SPSS/WIN 17.0 program. RESULTS: Degree of marital satisfaction, spousal support, and practice of Taekyo showed the high ranking among pregnant women. There was a significant difference in order of fetus, need for Taekyo, and time in Taekyo. There was a positive relationship between marital satisfaction, spousal support, and practice of Taekyo. The significant factors influencing the practice of Taekyo was connected with marital satisfaction, order of fetus and time in Taekyo. The total explanatory range was 29.3%. CONCLUSION: There is a need for multidimensional strategy in improving marital satisfaction. This study can be used as a foundation for maternal nursing education program and can be developed for practice of Taekyo.

Type 2 diabetes in urban and rural districts in Korea: factors associated with prevalence difference.

The purpose of this study was to examine the urban-rural differences in the prevalence and associated factors with type 2 diabetes mellitus (T2DM) in Korean adults. A total of 1,060 adults >30 yr of age from urban (189 males and 331 females) and rural districts (219 males and 321 females) were recruited. Anthropometric measures, blood pressure, lipid profiles, and fasting and 2-hr after 75-g oral glucose load blood glucose were obtained. The crude- and age-standardized prevalence of T2DM was 15.4% and 14.5%, and 11.7% and 8.6% in urban and rural districts, respectively. Diabetic subjects were older and obese, and had a higher triglyceride level, and systolic blood pressure compared to non-diabetes in both population. Multivariate regression analysis revealed that older age, high triglyceride levels, central obesity, and hypertension were significantly associated with T2DM in both areas. Low monthly incomes were significantly associated with T2DM in urban population, while a family history of T2DM was significantly associated with T2DM in rural area. T2DM is more prevalent in urban than in rural population, and low economic status or genetic factor is differently associated with T2DM in both population, respectively.

Factors affecting health-promoting behaviors of community-dwelling Korean older women.

The purpose of the study was to examine a staged theoretical causal model on health-promoting behavior of community-dwelling Korean older women (N = 438). Sixty-two percent of the variance in the health-promoting behaviors of the sample was explained by the direct effect of social support (ß = 0.53), self-efficacy (ß = 0.18), perceived health status (ß = 0.16), education (ß = 0.12), and presence of a spouse (ß = 0.10). Twenty-nine percent of the variance in social support was explained by the direct effect of self-efficacy (ß = 0.31), personal control (ß = 0.10), perceived health status (ß = 0.16), age (ß = -0.31), and religion (ß = 0.15). The results indicate that self-efficacy, personal control, and perceived health status had an indirect influence on health-promoting behavior through social support. The findings of this study suggest that social support is a mediating variable on health-promoting behavior of community-dwelling older women, and further refinement of the underlying model is warranted.