Purpose: The purpose of this study is to investigate how sexual experience associate with the suicide ideation, suicide plan and suicide attempt among culturally diverse adolescents compared with Korean adolescents. Methods: This study used a secondary data analysis study with the data derived from the 10~12th (2014~2016) Korean Youth Risk Behavior Web-based Survey. Data of 2,201 culturally diverse adolescents and 189,278 Korean adolescents were analyzed. Descriptive statistics, x2 test, and hierarchical logistic regression were used for data analysis. Results: After controlled for individual, family and social factors as compounding variables, the suicide ideation of culturally diverse adolescents with sexual experience was higher for 1.72 (95% CI: 1.24~2.38), suicide plan for 2.24 (95% CI: 1.58~3.17) and suicide attempt for 2.71 (95% CI: 1.87~3.93) compared to Korean adolescents without sexual experience. Regardless of cultural diversity, the risk of suicide ideation, suicide plan and suicide attempt of adolescents with sexual experience was higher than adolescents without sexual experience. Conclusion: Our study findings indicate the highest need to prevent suicide ideation, suicide plan and suicide attempt among culturally diversity adolescents with sexual experience among all the other adolescents' group.

Purpose: The purpose of this study was to explore uncertainty, depression, and anxiety in isolated inpatients and to identify associations between them, with specific focus on state anxiety. Methods: Data were collected using structured questionnaires and semi-structured interviews, administered to isolated inpatients at an acute care hospital (N=92). The structured questionnaires consisted of the State-Trait Anxiety Inventory, Mishel Uncertainty in Illness Scale, and the Center for Epidemiologic Studies Depression Scale. Multiple linear regression and content analysis were conducted. Results: Isolated inpatients showed significant differences in uncertainty, depression, trait anxiety, and state anxiety according to gender, perception of sufficient information about isolation, and the type of isolation. State anxiety scores increased when sufficient information about isolation was not provided (β=.23, p=.005), with higher levels of depression (β=.24, p=.020) and trait anxiety (β=.49, p<.001). Through the content analysis, three themes were identified regarding patient's information needs about isolation specifically for disease, explanation, and environment. Conclusion: Based on the findings, it is crucial to improve the awareness of emotional responses of isolated patients experiencing uncertainty, depression, and anxiety. Our study findings are expected to support the development of nursing interventions to provide proper information and mental health support when caring for isolated inpatients.

Purpose: The purpose of this study was to test the effects on stress and depression by developing and implementing an integrated stress management program for inpatients in the psychiatric closed ward. Methods: The study was a one-group pretest-posttest design. A total of 36 patients in the closed ward participated in this study. Data were collected through self-report questionnaires to measure hospital stress and depression. Data were analyzed by using t-tests and one-way ANOVA with SPSS/WIN 21.0. Results: Integrated stress management program was designed based on Lazarus and Folkman stress-appraisal-coping model. Total of eight 1-hour sessions were delivered for four weeks in the group. There were significant differences in the inpatient stress scores before and after the intervention. However, the integrated stress management program showed some reduction in depression but did not show signifiant differences statistically. Conclusion: Our study findings confirm that the use of the integrated stress management program can reduce stress of the patients, that enable them to stabilize their minds at hospitalization. However, further study is needed to confirm the effects on depression. Thus, it would be beneficial to provide psychiatric nursing intervention tailored to psychiatric patients' symptoms, especially for reducing inpatient stress.

Purpose: The purposes of this study were to develop a self-determination improvement program for enhancing nursing students' professional competence and to evaluate effects of the intervention on nursing professionalism, communication skills, and career decision-making autonomy among nursing students. Methods: The study was in a pre-test, post-test 1, and post-test 2 for a nonequivalent control group design. The participants were 56 students enrolled a nursing school or college (experimental group: 28; control group: 28). The self-determination improvement program was provided in 12 sessions over 4 weeks. Data was collected from August to September 2018. Data were analyzed using SPSS/WIN 25.0 program with x2 test, Fisher's exact test, the independent t-test, and repeated measurement ANOVA. Results: Participants receiving the self-determination improvement program reported increased nursing professionalism, communication skills, and career decision-making autonomy that was significantly different from those in the control group. Conclusion: Our study findings suggest that the self-determination improvement program could be effective for enhancing career decision-making autonomy by strengthening nursing students' professionalism and communication skills. Nursing educational program based on self-determination may be helpful for nursing students who need to prepare themselves as competent nurses in future profession.

Purpose: The purpose of this study was to examine mediating effects of pleasurable activities on the relationship between depression and suicidal ideation among the elderly moderated by living arrangement such as those living alone (LA) versus those living with others (LWO). Methods: This study is a cross-sectional and correlational design using secondary data analysis of the 2017 Korean National Survey on the Elderly (2,416 for the LA group, and 6,106 for the LWO group). Logistic regression analysis was conducted comparing effects of pleasurable activities on suicidal ideation between the two groups. Results: For suicidal ideation, there were significant differences in suicidal ideation by sex, religion, and senior center visits in the LA group, while the LWO group had no significant differences identified. Both groups showed significantly different associations of suicidal ideation by socioeconomic status, gathering, meaningful interaction, and depression. Senior center visits were statistically significant in the LA group, while there was not significant in the LWO group. Conclusion: Visiting senior centers can reduce suicidal ideation of the LA group. To prevent suicidal ideation of the elderly living alone, mental health specialists should provide community-cooperative environments to address these issues, especially LA elderly.

Purpose: The aims of this study were to evaluate a hypothetical model explaining undergraduates' interpersonal relationship ability associated with the stress of life, self-esteem, and their communication ability and to identify the mediating effect of a smartphone addiction tendency on the identified associations. Methods: Data were collected from 201 undergraduates using a structured questionnaire from August to September 2017. Data analyses included descriptive statistics, Pearson's correlation coefficients, and structural equation modeling with SPSS AMOS 22.0. Results: The participants' interpersonal relationship ability was 65.9%, explained by the stress of life, self-esteem, communication ability, and smartphone addiction tendency. The factors of undergraduates' interpersonal relationship ability were self-esteem (β=.10, p<.01) and communication ability (β=.14, p<.001). Stress of life (β=.15, p<.01) directly affected the participants' smartphone addiction tendency, which was not associated with interpersonal relationship ability. Conclusion: Based on our study findings, self-esteem and communication ability should be considered for developing nursing interventions to improve interpersonal relationship ability. However, a smartphone addiction tendency may be managed for undergraduates who experience excessive stress of life rather than interpersonal relationship ability. Thus, a tailored approach targeting specific needs or competence should be developed based on our data-based framework.

Purpose: The aims of this study was to evaluate the effects of acceptance and commitment therapy (ACT) for chronic pain patients. Methods: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses, we searched the Cochrane Library, CINAHL, EMBASE, OVID, PubMed and Korean databases to identify randomized controlled trials published through May 2019. To estimate the effect size, a meta-analysis of the studies was performed using the R program, and the risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies. Results: A total of 11 studies were included in this study. Studies were heterogeneous, and random effects models were used in the analyses. ACT was effective for improving pain (g=-0.40, 95%CI:-0.69~-1.12, p<.001, I2=80%), pain acceptance (g=1.24, 95% CI:0.41~2.05, p<.001, I2=95%), anxiety (g=-0.47, 95% CI:-0.81~-0.13, p<.001, I2=84%), depression (g=-0.52, 95% CI:-0.85~-0.19, p<.001, I2=85%), and quality of life (g=1.14, 95% CI:0.11~2.17, p<.001, I2=95%). Conclusion: Our study findings of the ACT seems to be effective for improving pain, pain acceptance, anxiety, depression, and quality of life in patients with chronic pain. Additionally, ACT may be useful for reducing barriers to therapy, and various studies should be attempted.