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한국정신간호학회> 정신간호학회지> 간호대학생의 주관적 행복감에 대한 영향 요인: 심리사회적 요인을 중심으로

KCI등재

간호대학생의 주관적 행복감에 대한 영향 요인: 심리사회적 요인을 중심으로

Factors Influencing Subjective Happiness in Nursing Students: Focused on Psycho-social Factors

김지혜 ( Ji-hye Kim ) , 전해옥 ( Hae Ok Jeon )
  • : 한국정신간호학회
  • : 정신간호학회지 25권2호
  • : 연속간행물
  • : 2016년 06월
  • : 123-132(10pages)
정신간호학회지

DOI


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서 론
연 구 방 법
연 구 결 과
논 의
결 론
REFERENCES

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Purpose: The aim of this study was to identify the predictors of subjective happiness in nursing students. Methods: A cross-sectional design was used to survey a convenience sample of 203 nursing students in Cheongju city. Data collection was conducted through self-report questionnaires on stress, self-efficacy, ego-resilience, social support and subjective happiness. Data were analyzed using descriptive analysis, t-test, ANOVA, Pearson``s correlation coefficients and stepwise multiple regression with the SPSS/WIN 18.0 program. Results: Subjective happiness negatively correlated with stress (r=-.35, p<.001) and positively correlated with self-efficacy (r=.60, p<.001), ego-resilience (r=.44, p<.001), and social support (r=.38, p<.001). Significant predictors of subjective happiness included self-efficacy (β=.34, p<.001), ego-resilience (β=.24, p<.001), satisfaction as a nursing student (β=-.21, p<.001), stress (β=-.20, p<.001), and social support (β=.14, p=.012). The regression model explained 50% of subjective happiness. Conclusion: Based on these results, effective happiness promotion programs focusing on self-efficacy and resilience improvement, and stress management are highly recommended to promote the improved quality of life in nursing students.

UCI(KEPA)

I410-ECN-0102-2017-510-000308216

간행물정보

  • : 의약학분야  > 간호학
  • : KCI등재
  • :
  • : 계간
  • : 1225-8482
  • : 2288-4653
  • : 학술지
  • : 연속간행물
  • : 1992-2021
  • : 1092


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1임신 중 우울 경험에 관한 현상학적 연구

저자 : 이은주 ( Lee Eun Joo ) , 박정숙 ( Park Jeong Sook )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 30권 2호 발행 연도 : 2021 페이지 : pp. 89-101 (13 pages)

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Purpose: Depression during pregnancy is a public health problem because of it's negative effects on the health of mother, infant, and their family. The purpose of this study was to explore women's experiences during pregnancy. Methods: Data were collected from December 2, 2019, to February 10, 2020, through individual in-depth interviews with 8 pregnant women visiting at 2 women's hospital. Collected data were analyzed using Colaizzi's phenomenological analysis. Results: The experiences of pregnant women with depression were clustered into the following six themes form 33 meaning units; 1) Maladaptation to pregnancy; 2) A future full of anxiety; 3) Loneliness without replying on someone; 4) I disappeared due to pregnancy; 5) Loss of mind control; 6) Struggle to overcome. In particular, depressed women during pregnancy experienced abnormal and negative emotions such as feeling of inferiority, self-deprecation, self-reproach, and suicidal thoughts. Conclusion: This study show that pregnant women have significant symptoms of depression, and most of them were never given adequate treatment for their symptoms during pregnancy. To improve access to mental healthcare for depressed women during pregnancy, various aspects of strategies are needed which address individual, organizational, and sociocultural level. In addition, spouses and families must understand and empathize distress of pregnant women, and share the required role in the process of pregnancy and childbirth.

KCI등재

2Validation of the Korean Version of the Patient-Reported Outcomes Information System® Emotional Distress Measures

저자 : Choi Heeseung , Ko Heesung , Kim Chanhee

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 30권 2호 발행 연도 : 2021 페이지 : pp. 102-109 (8 pages)

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Purpose: This methodological study aimed to translate the Korean version of the Patient-Reported Outcomes Measurement Information System® item bank-emotional distress (i.e., depression, anxiety, and anger) for adults and evaluate its psychometric properties. Methods: Translation involved forward translation, back translation, expert review, harmonization and quality assurance, and cognitive testing. Psychometric properties were evaluated with a community sample of 201 adults. To assess the unidimensionality of the measures, we used factor analysis to examine construct validity. Results: All items of the Patient-Reported Outcomes Measurement Information System item bank-emotional distress measures were translated through a rigorous translation process, and semantic, conceptual, and normative equivalences between the original and Korean version were ensured. Exploratory factor analysis revealed that all items loaded on one dominant factor. The Korean Patient-Reported Outcomes Measurement Information System measures demonstrated acceptable psychometric properties and unidimensionality. Conclusion: The Korean version of the Patient-Reported Outcomes Measurement Information System item bank-emotional distress (i.e., depression, anxiety, and anger) for adults is reliable and valid. Hence, it may be utilized extensively in clinical and research settings and contribute to patient-centered care.

KCI등재

3임상간호사의 업무수행능력과 분노관리능력, 회복탄력성, 자기자비

저자 : 김영애 ( Kim Young Ae ) , 한금선 ( Han Kuem Sun )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 30권 2호 발행 연도 : 2021 페이지 : pp. 110-118 (9 pages)

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Purpose: This study is aimed to identify the influence of nurses' anger management ability, resilience, and selfcompassion on their nursing work performance. Methods: The study included 220 nurses from 5 hospitals in Gyeonggi-do who consented to participate. Data were collected from July 20 to August 20, 2019. It was conducted that Descriptive analysis, t-test, Pearson's correlation coefficient, multiple regression, ANOVA, and Scheffé test using SPSS 25.0 program. Result: The nurses' work performance showed positive correlations with anger management ability, resilience, and self-compassion. Factors affecting the work performance of nurses were resilience (β=.46, p<.001), total work experience (β=.22, p=.014), current department work experience (β=.17, p=.009), anger management ability (β=.13, p=.026), and the overall explanatory power of these factors was 54.6%. Conclusion: This study showed that resilience, total work experience, current work experience, and anger management ability were important variables that influence the work performance of nurses. To enhance the nursing performance of clinical nurses, it is necessary to develop and implement training programs that enhance resilience and educational programs that help them manage their anger management ability.

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4외상 후 스트레스 장애 환자를 위한 가상현실치료 프로그램의 체계적 문헌고찰

저자 : 이원경 ( Lee Wongyeong ) , 조영신 ( Cho Youngshin ) , 김희정 ( Kim Heejung )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 30권 2호 발행 연도 : 2021 페이지 : pp. 119-140 (22 pages)

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Purpose: The aims of this systematic review were to identify the study protocol of Virtual Reality Therapy (VRT) and review the effect of VRT among patients with Post-Traumatic Stress Disorder (PTSD). Methods: This review followed the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic literature search was conducted using 12 electronic databases including gray literature with no limit of publication year. Search terms included relevant terms regarding “PTSD”, “trauma”, and “VRT”. Among 265 studies extracted through PRISMA, 20 studies were selected and evaluated for quality assessment using the Risk of Bias tool of Cochrane's collaboration. Results: The majority of the literature focused on combat veterans and war situations (95%).Usually, each session usually took 60~120 minutes of VRT in 10~20 sessions for 5~10 weeks. The VRT equipment and contents were individually designed considering patients' traumatic experiences. Most of the studies reported the positive effects associated to reduced levels of PTSD (80%) and related symptoms, such as, depression (45%) and anxiety (25%). Conclusion: Based on our findings, further studies are required to evaluate VRT in people with PTSD, after improving study design and standardizing protocols.

KCI등재

5한국어판 종교성 및 영적경험 측정도구의 타당도와 신뢰도 검증

저자 : 김석선 ( Kim Suk-sun ) , 김다은 ( Kim Daeun ) , 문난영 ( Moon Nan Young ) , 서아영 ( Seo Ahyoung ) , 길민지 ( Gil Minji )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 30권 2호 발행 연도 : 2021 페이지 : pp. 141-152 (12 pages)

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Purpose: The purpose of this study was to translate Duke University Religion Index (DUREL) and the Daily Spiritual Experience Scale (DSES) into Korean and test the validity and reliability of the instruments. Methods: Korean version of DUREL and DSES were translated and back-translated by 6 bilingual experts and group discussions. Data analyses were performed using SPSS 26.0 and AMOS 22.0. Both exploratory and confirmatory factor analyses were conducted with two data sets of secondary analysis study to examine the factor structure and construct validity. Correlations with other variables were used to test validity and reliability. Results: For K-DUREL, the final evaluation yielded two factors with 5 items: intrinsic religiosity and institutional religious activity. K-DSES had two factors with 16 items: transpersonal spiritual experience, and interpersonal & environmental spiritual experience. Cronbach's α of K-DUREL and K-DSES were .67 and .96, respectively. Both instruments showed good reliability and validity for the translated Korean versions. Conclusion: Applying K-DUREL and K-DSES in theory-based research may contribute to knowledge about the religious activity and spiritual experiences in the health and well-being of a Korean. Also, two instruments have the potential to measure changes in religion and spirituality after spiritual or holistic nursing interventions.

KCI등재

6소방공무원을 대상으로 한 심리 중재 연구의 통합적 고찰

저자 : 임미해 ( Im Mihae ) , 곽민영 ( Kwak Minyeong )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 30권 2호 발행 연도 : 2021 페이지 : pp. 153-167 (15 pages)

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Purpose: The purpose of this study was to find core components of psychological intervention for firefighters by integrative literature review. Methods: Whittemore and Knafl's integrative review methods was used to synthesize the literature. Articles published in Korean and English were identified through seven electronic databases. Nineteen studies were ultimately selected that met the selection criteria for this review. Results: Through in-depth discussion and investigation of the relevant literature, three overarching components emerged: (a) resilience prevention for primary prevention, (b) early crisis intervention for secondary prevention, and (c) tailored recovery intervention for tertiary prevention. Conclusion: The three main components found in the results of this study can be important evidence-based data when developing a psychological intervention for firefighters.

KCI등재

7아동기 가정폭력을 경험한 성인의 도박중독 과정 경험

저자 : 최서연 ( Choi Seoyeon ) , 이미형 ( Lee Mihyoung ) , 이은진 ( Lee Eunjin ) , 박시현 ( Park Sihyun ) , 김희경 ( Kim Heekyung )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 30권 2호 발행 연도 : 2021 페이지 : pp. 168-179 (12 pages)

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Purpose: The purpose of this study was to develop a theory on the gambling addiction process in adults who experienced domestic violence in childhood. Methods: Data were collected from 20 adults from May 1st to August 30th, 2020. Data were analyzed using grounded theory methodology as suggested by Strauss and Corbin. Results: The core category of this study was revealed to be 'becoming addicted to gambling to avoid the physical and emotional pain caused by childhood domestic violence and be rewarded'. The core phenomenon was 'struggle from pain', which was derived from casual and contextual conditions: 'ruthless physical violence', 'intolerable psychological pain', and 'bystand of violence', 'family addiction problem'. 'parental immoral attitude', The action and interaction strategies were 'making money by any means', and 'gambling to forget the pain'. The intervening conditions affecting them were 'a distorted view of money', 'resignation to helpless', and 'avoiding emotional distress'. The phases abbreviated through the produced process were the trauma phase, the avoidance phase, and the addiction phase. Conclusion: Adults became addicted to gambling as a manifestation of distorted compensation mentality in an attempt to avoid the physical and emotional trauma of domestic violence in childhood.

KCI등재

8정신질환자 자녀의 정신건강과 중재 프로그램에 관한 통합적 고찰

저자 : 신소영 ( Shin Soyoung ) , 김성재 ( Kim Sungjae )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 30권 2호 발행 연도 : 2021 페이지 : pp. 180-192 (13 pages)

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Purpose: To increase a comprehensive understanding of the children's mental health who have a parent with a mental illness in Korea. Methods: The integrative review method by Whittemore and Knafl was applied. Online databases were searched that focused on children of a parent with a mental illness. The JBI Critical Appraisal Tools were used to assess the quality of the selected articles. Results: Fourteen articles were selected for the final data analysis. Majority of the articles addressed about the mental health issues and disadvantages that the children of a parent with a mental illness have. Compared to the mental health issues and disadvantages discussed, intervention programs were not much and the sample were not enough to achieve statistical significance. Conclusion: The results of this integrative review have implications for planning and implementing appropriate intervention programs to promote mental health in children of a parent with a mental illness in future.

KCI등재

9조기정신증 대상자를 위한 지역사회 기반 사례관리 경험: Social Treatment for Early Psychosis 프로그램을 중심으로

저자 : 신소연 ( Shin Soyoun ) , 최희승 ( Choi Heeseung )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 30권 2호 발행 연도 : 2021 페이지 : pp. 193-205 (13 pages)

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Purpose: The purpose of this study was to explore the experience of case management for early psychosis and identify factors influencing care management. Methods: We conducted in-depth interviews with 10 mental health professionals who implemented the Social Treatment for Early Psychosis (STEP) program. The collected data were analyzed using qualitative content analysis. Results: The findings consisted of 4 categories and 15 subcategories. Case management should develop expertise considering the desires of young adults, and grew as experts by promoting family cooperation and coping with mental crises. Administrator's support and peer support programs had a positive impact, while the absence of collaborative systems with psychiatric institution were identified as limitations in the operating system of the basic center. Consulting and monitoring of the metropolitan center provided a foundation for case management at the basic center, while the government's support policy is needed to improve of working environment and set up the youth-friendly early intervention system. Conclusion: The results suggest that case management for early psychosis requires multilateral and cooperative efforts by strengthening the capabilities of case managers, establishing an integrated case management network of basic and metropolitan centers, and expanding the government's human and physical infrastructure.

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1성인 주의력결핍과잉행동장애 관련 증상과 부정적 관념화가 대인관계에 미치는 영향

저자 : 조우제 ( Woo Jea Cho ) , 박완주 ( Wan Ju Park )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 25권 2호 발행 연도 : 2016 페이지 : pp. 71-80 (10 pages)

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Purpose: This study was done to identify variables in Attention Deficit Hyperactivity Disorder (ADHD) symptoms and negative ideation that predict interpersonal relation in adults. The focus was on thought, behavior, emotional and cognition domains. Methods: Korean Conner``s Adult ADHD Rating Scale, Anxious Thought Inventory, Interpersonal Relation Scale were used. Participants were 379 of normal adults living in B, I and U cities. The data were analyzed using frequency, F-test, t-test, ANOVA, Scheffe and Pearson``s correlation coefficients. Regression analysis was done to provide understanding of the effects of each variable. Results: Interpersonal relation showed significantly negative correlation with adult related ADHD symptoms and negative ideation. Significant predictive factors of interpersonal relation were social-worry (β=-.40), inattention/memory problems (β=-.22) and gender (β=-.12) in order. These variables accounted for 25% of variance in interpersonal relations. Conclusion: The results show that social-worry in the cognitive domain and inattention-memory problems in the thought domain have a negative impact on interpersonal relation in adults compared` to the behavior or emotional domains which indicates a need for intervention strategies to reduce inattention/memory problems and social-worry and thus improve interpersonal relations.

KCI등재

2간호대학생의 식행동에 영향을 미치는 관련 요인

저자 : 변은경 ( Eun Kyung Byun ) , 김미영 ( Mi Young Kim )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 25권 2호 발행 연도 : 2016 페이지 : pp. 81-88 (8 pages)

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Purpose: The purpose of this study was to identify the level of dietary behavior in nursing students and also, to investigate factors that influence dietary behavior. Methods: In this study, 250 nursing students who were enrolled in a university school in B city, Korea and who gave written consent completed the questionnaire. The data were collected between June 22 and 30, 2015 and analyzed using t test, one way ANOVA, Pearson correlation coefficients and multiple regression. Results: The level of dietary behavior in nursing students was 3.06±0.52. Models including the variables, health concern and dietary self efficacy explained 12% of the variance for dietary behavior. Dietary self efficacy(β=.26, p<.001) was the most influential factor. Conclusion: Based on the outcomes of this study, steps should be taken to design intervention programs that emphasize the health dietary behavior of nursing students.

KCI등재

3초등교사의 관계적 자기와 부정적 관념화가 주의력결핍 과잉행동장애 학생에 대한 대처방식에 미치는 영향

저자 : 이서현 ( Seo Hyun Lee ) , 박완주 ( Wan Ju Park )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 25권 2호 발행 연도 : 2016 페이지 : pp. 89-100 (12 pages)

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Purpose: The purpose of this study was to identify predictors influencing relational self and negative thinking on coping among teachers working with students with attention deficit hyperactivity disorder (ADHD). Methods: A cross sectional study design was conducted with 212 teachers in six elementary schools located in D and C cities. Data were analyzed using t test, one way ANOVA, Pearson``s correlation coefficients, and stepwise regression analysis with SPSS 18.0. Results: The significant predictive factor for the active coping type was perceived support in relational self. Empathy care was as a significant factor for the passive coping type. Relationship avoidance and agency were significant predictive factors for negative coping with ADHD students. Active and passive coping had significant negative correlations with social worry. Significant factors for positive coping were attendance at ADHD workshops and number of years of teaching. Conclusion: Results suggest that it is important to focus on teachers having a positive aspect in the classroom, using new strategies, and understanding their own inner factors of perceived support and empathy care in order to provide positive coping and enhance relationships with ADHD students. To further enhance positive coping and perceived support and to reduce social worry, teachers should use community resources, especially psychiatric health nurses.

KCI등재

4초기 치매 환자의 가족돌봄제공자를 위한 정서중심 개별중재의 효과

저자 : 장지은 ( Ji Eun Jang ) , 최희승 ( Hee Seung Choi )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 25권 2호 발행 연도 : 2016 페이지 : pp. 101-112 (12 pages)

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Purpose: Many family caregivers of people with early stages of dementia experience difficulty in obtaining information on dementia. In addition, adjusting to this new caregiving role is emotionally demanding, thus many family caregivers go thorough a lot of emotional stress. This study tested emotion-focused individual intervention as a way to help family caregivers of early-stage dementia patients obtain necessary information and emotional support related to caregiving. Methods: To achieve this goal, a quasi-experimental study with a non-equivalent control group design was conducted. Emotion-focused individual intervention was administered to the experimental group (n=15), and no treatment was administered to the control group (n=21). Both groups completed a demographic profile, and also took pre- and post-test measuring their dementia-related knowledge, self-efficacy of care, preparedness of care, and coping strategies of care. Descriptive statistics were calculated, and t-test, and ANCOVA were performed to SPSS program. Results: It was found that there was a statistically significant improvement in dementia-related knowledge (p<.001), self-efficacy of care (p=.030), preparedness of care (p<.001), and coping strategies of care (p<.001) after the intervention. Conclusion: The findings suggest that emotion-focused individual intervention was effective for family caregivers of patients with early dementia to adjust to the new caregiving role.

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5대학생들의 건강행태, 우울, 자아탄력성

저자 : 박금숙 ( Keum Suk Park ) , 윤해민 ( Hae Min Yoon )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 25권 2호 발행 연도 : 2016 페이지 : pp. 113-122 (10 pages)

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Purpose: The objectives of the study were to examine university students`` health behavior, depression, and ego-resilience in order to understand the relationship between these variables, and to identify factors influencing egoresilience. Methods: Data were collected from a sample of 302 students attending G University. The data collection period was from October 28, 2015 to December 21, 2015. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson``s correlation coefficients, and multiple regression with the SPSS Statistics version 23 Program. Results: The number of close friends was weakly correlated with depression and ego-resilience: specifically, the number of close friends had a weak negative correlation with depression, and a weak positive correlation with ego-resilience. Factors significantly influencing the students`` ego-resilience were depression, type of residence, frequency of exercise, and gender, with a total explanatory power of 18%. Conclusion: These findings indicate that intervention programs to improve ego-resilience should be developed. Research into ego-resilience should be replicated with students from a variety of cultural background and diverse study areas.

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6간호대학생의 주관적 행복감에 대한 영향 요인: 심리사회적 요인을 중심으로

저자 : 김지혜 ( Ji-hye Kim ) , 전해옥 ( Hae Ok Jeon )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 25권 2호 발행 연도 : 2016 페이지 : pp. 123-132 (10 pages)

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Purpose: The aim of this study was to identify the predictors of subjective happiness in nursing students. Methods: A cross-sectional design was used to survey a convenience sample of 203 nursing students in Cheongju city. Data collection was conducted through self-report questionnaires on stress, self-efficacy, ego-resilience, social support and subjective happiness. Data were analyzed using descriptive analysis, t-test, ANOVA, Pearson``s correlation coefficients and stepwise multiple regression with the SPSS/WIN 18.0 program. Results: Subjective happiness negatively correlated with stress (r=-.35, p<.001) and positively correlated with self-efficacy (r=.60, p<.001), ego-resilience (r=.44, p<.001), and social support (r=.38, p<.001). Significant predictors of subjective happiness included self-efficacy (β=.34, p<.001), ego-resilience (β=.24, p<.001), satisfaction as a nursing student (β=-.21, p<.001), stress (β=-.20, p<.001), and social support (β=.14, p=.012). The regression model explained 50% of subjective happiness. Conclusion: Based on these results, effective happiness promotion programs focusing on self-efficacy and resilience improvement, and stress management are highly recommended to promote the improved quality of life in nursing students.

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7조현병 환자 배우자의 돌봄 경험

저자 : 채공주 ( Gong Ju Chai ) , 남은숙 ( Eun Sook Nam )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 25권 2호 발행 연도 : 2016 페이지 : pp. 133-146 (14 pages)

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Purpose: The aim of this phenomenological study was to qualitatively classify the experience of spouses caring for patients with schizophrenia. Methods: Data were gathered using 2 hour in-depth, unstructured interviews with nine spouses of patients with schizophrenia. The data collection period was 2012 to 2013. Colaizzi``s phenomenological method was used to analyze the resulting data. Results: Five clusters of themes were identified. These were termed according to the experiences described by the spouses, as: suffering from falling into the abyss of despair; deepening heartbreak, clouds of misery hanging over one``s family; possibly of losing the bond between family members; getting over one``s hurt and stepping forward to the future. Participants experienced many burdens while caring for their spouse, however, they showed the ability to overcome difficulties positively and actively. Conclusion: The results of this study indicate that the spouse of a patient with schizophrenia experiences multiple sources of distress, and suggests a process to overcoming them. Recommendations include helping nurses be aware of the sufferings of both the patient and the spouse and to plan and provide for psychological interventions, such as stress management programs and informational support on social welfare programs.

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8아동청소년기 따돌림 경험 유형에 따른 대학생의 대인관계 문제와 정신건강

저자 : 현미열 ( Mi Yeul Hyun )

발행기관 : 한국정신간호학회 간행물 : 정신간호학회지 25권 2호 발행 연도 : 2016 페이지 : pp. 147-154 (8 pages)

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Purpose: The purpose of this study was to identify the interpersonal problems and mental health of college students according to their experience of bullies and of being victims of bullying in childhood and adolescence. Methods: The questionnaire was completed by 221 college students in J city. Data were collected during November and December, 2015. The data were analyzed and interpreted using descriptive statistics and ANOVA with the PASW Statistics 18.0 program. Results: Nearly 65% of participants reported having experienced bullying victimization, bullying perpetration when they were in elementary, middle or high school. Interpersonal problems were significantly different between victims or victim-perpetrator and a control group (F=13.12, p<.001). Mental health was significantly different between victims, perpetrator or victim-perpetrator and a control group, (F=13.15, p<.001). Conclusion: Participants commonly reported experiencing bullying while at school and these reports were associated with higher interpersonal problems and lower levels of mental health. Bullying experience needs further investigation as a preventable cause of interpersonal problems and mental health problems across the lifespan.

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