Kuem Sun Han

Stress and Sleep Disorder

The purpose of this study was to review potential, physiological, hormonal and neuronal mechanisms that may mediate the sleep changes. This paper investigates the literatures regarding the activity of the hypothalamic-pituitary-adrenal (HPA) axis, one of the main neuroendocrine stress systems during sleep in order to identify relations between stress and sleep disorder and the treatment of stress-induced insomnia. Sleep and wakefulness are regulated by the aminergic, cholinergic brainstem and hypothalamic systems. Activation of the HPA and/or the sympathetic nervous systems results in wakefulness and these hormones including corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), cortisol or corticosterone, noradrenaline, and adrenaline, are associated with attention and arousal. Stress-related insomnia leads to a vicious circle by activating the HPA system. An awareness of the close interaction between sleep and stress systems is emerging and the hypothalamus is now recognized as a key center for sleep regulation, with hypothalamic neurontransmitter systems providing the framework for therapeutic advances. An updated understanding of these systems may allow researchers to elucidate neural mechanisms of sleep disorder and to develop effective intervention for sleep disorder.

Effects of exercise programs on depressive symptoms, quality of life, and self-esteem in older people: A systematic review of randomized controlled trials

OBJECTIVE This study attempted to show evidence of exercise programs as intervention to decrease depressive symptoms and to improve quality of life and self-esteem in older people. DESIGN Systematic review of randomized controlled trials. DATA SOURCES Electronic databases of KoreaMed, Korea Scientific and Technological Intelligence Center, Korean Society of Nursing Science, Korean Academy of Psychiatric Mental Health Nursing, Ovid-Medline and Embase were searched up to May 25th, 2012 for relevant articles. REVIEW We searched studies of randomized controlled trials involving exercise programs administered to participants aged 65 years or over. Of 461 publications identified, 18 met the inclusion criteria for the meta-analysis. Quality assessment of the studies utilized Cochranes Risk of Bias. RESULTS Exercise therapy in older people was effective, as evidenced by a decrease in depressive symptoms [standardized mean difference (SMD) -0.36; 95% confidence interval (CI) -0.64, -0.08], and improvements in quality of life (SMD 0.86; 95% CI 0.11, 1.62) and self-esteem (SMD 0.49; 95% CI 0.09, 0.88). The changes were significant statistically, with no heterogeneity. CONCLUSIONS Exercise programs in older people are effective in improving depressive symptoms, quality of life and self-esteem. Development and efficient use of tailored exercise programs for elderly people is a prudent strategy.

Anger, Anger Expression, and Suicidal Ideation in Korean Adolescents

This study described the levels of anger, anger expression, and suicidal ideation in Korean adolescents. Data from 18,752 adolescents were collected using a self-report questionnaire. Anger, anger expression, and suicidal ideation exhibited significant differences according to school level and gender. The group with higher anger and anger expression showed a higher average suicidal ideation score than that of the group with lower anger and anger expression, suggesting that school-based programs which alleviate anger may be needed to decrease suicidal ideation among Korean adolescents.

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.

The effect of an integrated stress management program on the psychologic and physiologic stress reactions of peptic ulcer in Korea

The purpose of this study was to identify the effects of an integrated stress management program on symptoms of stress and ulcer healing in a sample of Koreans at a major medical center in Seoul. The study employed an experimental design with two treatment groups. One treatment group (n = 23) participated in an integrated stress management program (ISMP) that consisted of seven 1-hour sessions over a 4-week period. A second treatment group (n = 24) was only given a tape on progressive muscle relaxation (PMR). The ISMP treatment group reported significantly lower stress symptom scores than the PMR only group (t = 3.66, p < .001). The ISMP group also demonstrated greater improvement in ulcer healing than the PMR group (t = 1.95, p < .05). The integrated stress management program was more effective in decreasing self-reported stress symptoms and resulted in more significant ulcer healing than the progressive muscle relaxation treatment.

A Structural Equation Model on Family Strength of Married Working Women

PURPOSE The purpose of this study was to identify the effect of predictive factors related to family strength and develop a structural equation model that explains family strength among married working women. METHODS A hypothesized model was developed based on literature reviews and predictors of family strength by Yoo. This constructed model was built of an eight pathway form. Two exogenous variables included in this model were ego-resilience and family support. Three endogenous variables included in this model were functional couple communication, family stress and family strength. Data were collected using a self-report questionnaire from 319 married working women who were 30~40 of age and lived in cities of Chungnam province in Korea. Data were analyzed with PASW/WIN 18.0 and AMOS 18.0 programs. RESULTS Family support had a positive direct, indirect and total effect on family strength. Family stress had a negative direct, indirect and total effect on family strength. Functional couple communication had a positive direct and total effect on family strength. These predictive variables of family strength explained 61.8% of model. CONCLUSION The results of the study show a structural equation model for family strength of married working women and that predicting factors for family strength are family support, family stress, and functional couple communication. To improve family strength of married working women, the results of this study suggest nursing access and mediative programs to improve family support and functional couple communication, and reduce family stress.