Eun Sook Park

Structural model for quality of life of patients with chronic cardiovascular disease in Korea.

BackgroundHealth promotion among those with chronic illness has been proposed as a strategy to contain health care cost and enhance quality of life (QOL), but little research has been done in Korea on QOL focused on health promotion of patients with chronic cardiovascular disease (CCVD). ObjectivesThis study was designed to estimate a structural model to represent the QOL of patients with CCVD, on the basis of a literature review and Penders health promotion model (HPM). MethodsData were collected by questionnaire from 436 patients with CCVD in a university hospital in Seoul from August 2001 to July 2002. Data analysis included descriptive statistics and covariance structural analysis. ResultsAs the fit of the hypothetical model to the data was only moderate, it was modified by excluding 10 paths and including free parameters. The modified model with path showed a good fit to the empirical data (χ2 = 508.12, p = .001, GFI = .95, AGFI = .93, NFI = .98, NNFI = .98, RMSEA = .04). Health-promoting behavior (HPB) and self-efficacy were found to have a significant direct effect on QOL. Health perception, self-esteem, perceived barriers to action, and preference were found to have indirect effects on QOL. The variables of this model explain 63% of the variance in QOL. DiscussionThe modified model is considered appropriate to explain and predict QOL of patients with CCVD. Therefore, it can effectively be used as a reference model for further studies and to suggest directions in nursing practice.

Parenting of children with ADHD in South Korea: the role of socio-emotional development of children with ADHD

AIMS AND OBJECTIVES The aim was to investigate the factors affecting the self-esteem and social competence of children with attention deficit hyperactivity disorder. BACKGROUND Many studies have reported parenting variables such as parenting attitude and sense of competence have been suggested as significant determinants of socio-emotional development of children with attention deficit hyperactivity disorder. In South Korean society, the traditional culture of Confucianism is a strong influence on parenting practices and childrens behaviour. However, there have been few studies that examined the relative significance of the parenting and other associated factors for self-esteem and social competence in children with attention deficit hyperactivity disorder in Korea living in a strict parenting environment. DESIGN This study was designed as a cross-sectional and descriptive survey. METHOD The subjects were 124 pairs of mothers and their children with attention deficit hyperactivity disorder, recruited from local paediatric psychiatric clinics in South Korea. Data collection was conducted through the use of questionnaires. RESULTS Affectionate parenting attitude and co-morbid condition of the child were the most important predictors of self-esteem. Rejecting parenting attitude was the most important predictor of social competence. CONCLUSION Higher levels of affectionate parenting attitude of mothers and non-co-morbid status of children both contributed unique variance to the overall prediction of higher self-esteem of children. Higher levels of rejecting parenting attitude of mothers contributed unique variance to the overall prediction of lower social competence in children with attention deficit hyperactivity disorder. RELEVANCE TO CLINICAL PRACTICE Parenting attitude is the most important factor to contribute to the healthy socio-emotional development in children with attention deficit hyperactivity disorder. Health care providers need to develop and apply a parenting skills improvement program to improve positive parenting attitudes, which will benefit self-esteem and social competence in children with attention deficit hyperactivity disorder.

Parenting and relationship characteristics in mothers with their children having atopic disease

This study compared parental cognitions and relationship characteristics of mothers of children with atopic disease with those of mothers of children without atopic disease. These factors include child-rearing attitudes, parental locus of control, parental sense of competence, attachment security, and maternal sensitivity. Preplanned subanalyses were carried out according to specific disease, mothers’ perception of disease severity, and presence of concurrent atopic diseases. The descriptive comparative study of 233 Korean mothers included 102 mothers of children aged six years or younger with atopic dermatitis, asthma, and/or allergic rhinitis. Data were collected from 2007 to 2008 from local clinics and day care centers. Parental cognitions and relationship characteristics did not differ significantly between groups of mothers, except that mothers of children with atopic dermatitis showed less affection. However, subanalyses showed that mothers who perceived their child’s disease to be severe were less likely to encourage autonomy and had a lower sense of competence, more rejecting attitudes, and an external locus of control. Although we should be cautious in generalizing these results, special care plans are strongly recommended for mothers of children with severe atopic disease to provide support and education, help mothers develop an internal locus of control, and increase parental sense of competence.

Shared decision-making in the paediatric field: A literature review and concept analysis

AIM The concept of shared decision-making is poorly defined and often used interchangeably with related terms. The aim of this study was to delineate and clarify the concept of shared decision-making in the paediatric field. METHOD Rodgers and Knafls evolutionary concept analysis was used to delineate and clarify the concept. Following a search of the CINAHL, PubMed and MEDLINE databases and online journals between 1995 and 2016, we included a total of 42 articles that referred to shared decision-making in the paediatric field. RESULTS The attributes included active participation of the three: parents, children and health professionals; collaborative partnership; reaching a compromise; and common goal for childs health. Antecedents were existing several options with different possible outcomes; substantial decisional conflict; recognising childs health situations that decision-making is needed; and willingness to participate in decision-making. Finally, the consequences included decreased decisional conflict; mutual empowerment; improved child health status; and improved quality of paediatric health care. CONCLUSION This study provides a theoretical understanding of the concept of shared decision-making in the paediatric field; furthermore, by integrating this concept into paediatric practice, it may help to reduce the gap between theory and practice. The analysis could also provide nursing researchers with insight into paediatric decision-making and establish a foundation to develop future interventions and situation-specific theory for promoting high-quality decision-making in the paediatric field.

Development and Psychometric Evaluation of the Transcultural Self-efficacy Scale for Nurses

PURPOSE This methodological study was conducted to develop and psychometrically test the Transcultural Self-efficacy scale (TCSEscale) for nurses. METHODS Initial 41 items for the TCSE-scale were generated based on extensive literature reviews and in-depth interviews with 18 nurses who had experience in caring for foreign patients. Cultural Competence and Confidence model was used as a conceptual framework. Content validity was evaluated by an expert panel. Psychometric testing was performed with a convenience sample of 242 nurses recruited from four general hospitals in the Seoul metropolitan area and Gyeonggi-do province of South Korea. To evaluate the reliability of TCSE-scale, a test-retest reliability and an internal consistency reliability were analyzed. Construct validity, concurrent validity, criterion validity, convergent validity and discriminative validity were used to evaluate the validity. RESULTS The 25-item TCSE-scale was found to have three subscales-Cognitive, Practical, and Affective domain-explaining 91.5% of the total variance. TCSE-scale also demonstrated a concurrent validity with the Cultural Competence Scale. Criterion-related validity was supported by known-group comparison. Reliability analysis showed an acceptable-to-high Cronbachs alpha-.88 in total, and subscales ranged from .76 to .87. The ICC was .90, indicating that the TCSE-scale has internal consistency and stability of reliability. CONCLUSION This preliminary evaluation of the psychometric scale properties demonstrated an acceptable validity and reliability. The TCSE-scale is able to contribute to building up empirical and evidence based on data collection regarding the transcultural self-efficacy of clinical nurses. We suggest further testing of the applicability of TCSE-scale in different settings and community contexts.

Radiation Exposure and Cancer Mortality Among Nuclear Power Plant Workers: a Meta-analysis

OBJECTIVES We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. METHODS We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. RESULTS We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. CONCLUSIONS Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.