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Background Little research has examined the moderating influence of posttraumatic growth (PTG) on the relationship between social support and quality of life. Objectives This study examined the relationship between social support and quality of life by the level of PTG in colorectal cancer patients with ostomies. Methods Using a cross-sectional design, colorectal cancer patients with ostomies (n = 140) were recruited using convenience sampling. The City of Hope Quality of Life-Ostomy, the Multidimensional Scale of Social Support, and the Posttraumatic Growth Inventory measured quality of life, social support, and PTG, respectively. Results Social support and PTG were positively related to psychological and social well-being. Higher social support was associated with better psychological and social well-being. Posttraumatic growth moderated the relationship between psychological and social well-being. At a low and moderate level of PTG, social support was more strongly associated with psychological and social well-being, whereas at high levels, this association was not significant. Conclusions Findings highlight the significance of social support to improve the quality of life for colorectal cancer patients with an ostomy, particularly those with low levels of PTG. Implications for practice Screening for patients' positive cognitive adaptations while living with an ostomy could identify those who might need further social support to improve their quality of life. Further, intensive social support programs might promote the quality of life for colorectal patients with an ostomy, which was found to be effective for those with low levels of PTG.

To improve the quality of life and health outcomes of an increasing number of colorectal cancer patients and their caregivers, the specific needs of both should be understood across the cancer treatment trajectory. This study attempted to identify the supportive needs of patients and caregivers during each treatment phase.Using text mining, posts from a South Korean internet self-help support group for colorectal cancer were classified by assigning labels to the terms extracted according to the poster, treatment phase, and support type. The extracted terms were then classified based on term frequency, with higher term frequency indicating higher need.Both caregivers and patients showed the highest term frequencies during the treatment phase. Caregivers had more high-ranking terms that were ranked higher than patients, indicating high support needs. In addition, the terms regarding treatments and diseases were ranked high. In the pre-treatment phase, test-related needs were ranked higher for both caregivers and patients. Meanwhile, patients had more highly ranked terms in the post-treatment phase, showing their high need in this phase, especially terms related to post-treatment symptoms. Caregivers had higher term frequencies of food intake during the post-treatment phase.This study demonstrated that the needs of colorectal cancer patients and their caregivers were not always consistent in each treatment phase. Therefore, the needs of both patients and caregivers should be considered separately in each treatment phase and supportive interventions should be provided accordingly.

Background: Intimate partner violence is a serious global social problem. While intimate partner violence is highly prevalent, few studies have examined its negative outcomes among victims in South Korea. The aim was to clarify the mediating roles of interpersonal dependency and anger on the relationship between intimate partner violence victimization and suicidal ideation. Methods: In this descriptive, cross-sectional study, 301 participants (203 women and 98 men) aged 18–65 yr completed an online questionnaire on a social networking site. Data were collected between Feb and Mar 2017 in South Korea. Structural equation modeling was used to test the fitness of the conceptual model of this study. Results: We found significant correlations between intimate partner violence victimization, interpersonal dependency, state-trait anger, and suicidal ideation. Intimate partner violence victimization influenced anger and suicidal ideation only when the victims had high interpersonal dependency. Conclusion: It is necessary to develop programs for reducing interpersonal dependency and improving anger management that are specifically targeted at intimate partner violence victims to prevent suicidal ideation.

Background Physical activity (PA) has been shown to improve total mortality and colorectal-specific mortality risk; however, colorectal cancer (CRC) survivors have lower rates of PA compared with survivors with other types of cancers. Objective To examine the effect of PA interventions on CRC survivors. Methods A systematic review and meta-analysis were conducted to identify randomized controlled trials that met the inclusion criteria, which included an intervention designed to increase PA and more than 1 outcome of interest. Random effects of the meta-analyses were performed using Review Manager 5.3. Results Eight publications representing 7 randomized controlled trials of 803 participants were identified. All studies used a combination of behavioral change methods. Physical activity interventions significantly improved disease-specific quality of life, PA level, and maximum amount of oxygen and did not show significant improvements for fatigue and body mass index among CRC survivors. Conclusions We provided evidence that PA interventions were effective in improving disease-specific quality of life, PA level, and maximum amount of oxygen; however, they did not improve fatigue and body mass index. Further randomized controlled trials are needed to determine the optimal mode of delivering PA intervention for CRC survivors. Implications for practice As the survival rate of patients with CRC increases, survivors of CRC need to increase PA in a community setting after completing primary treatments. Effective and efficient modes of PA intervention delivery could improve health-related outcomes and address specific barriers for CRC survivors.

This study examined the factors associated with triage competency among school nurses in South Korea. Using a convenience sampling method, 386 school nurses employed in elementary, middle, or high schools completed a cross-sectional survey that included a modified version of the Triage Competency Scale for emergency room nurses. Information regarding experience working in schools and hospitals, education level, school types, age, emergency nursing care certifications, school locations, and serious emergency experience at school was collected. Analyses were performed using SPSS version 25.0, independent t-tests, analyses of variance, Spearman’s correlation, and ordinal logistic regression. Triage competency was higher for school nurses who were employed in metropolitan regions (odds ratio [OR] = 1.63, p = 0.017) and had serious emergency experience (OR = 1.76, p = 0.008). As the participants’ experience at schools or hospitals increased by one year, their triage competency score increased by 2% (OR = 1.02, p = 0.037) and 14% (OR = 1.14, p &lt, 0.001), respectively. These findings could be used to develop policies and educational programs that promote school nurses’ triage competency. Further, they suggest the importance of establishing an organizational support system to develop guidelines and a feedback system to improve school nurses’ triage competency.

Despite the adverse effects of negative coping after receiving a stoma, there is a lack of information on how patients cope with ostomies and on their families&rsquo, experiences throughout the coping process. We aimed to explore the coping experiences of individuals with ostomies throughout their illness, applying the Corbin and Strauss Chronic Illness Trajectory Framework, using exploratory qualitative methods involving focus group interviews. Purposive sampling was utilized to recruit 19 participants (split across three groups) through an ostomy association in South Korea. Two focus group interviews were separately conducted from March through to May 2017 until data saturation was achieved. Using qualitative content analysis, we analyzed the transcribed interviews and identified words and themes to interpret the results. The coping experiences of patients with ostomies were expressed through three interrelated themes: struggling and suffering, learning how to live with ostomy, and living with ostomy. We found gender differences in spousal support and a struggle among older patients regarding social coping. The themes identified suggest that gender should be considered when designing interventions to help patients cope with ostomies.

Little research has examined the pathways between psychological factors and fatigue in older adults with diabetes. This study explored the pathways between diet-related quality of life and depressive symptoms in predicting fatigue using a moderated-mediation model. A convenience sample of adults &ge, 65 years (n = 127) with diabetes completed a cross-sectional survey including measures of fatigue severity, diet-related quality of life, and depressive symptoms, and a moderated-mediation analysis assessed the relationships between them. Diet satisfaction was negatively related to fatigue, which was mediated by depressive symptoms. In the moderated-mediation model, diet satisfaction had a conditional effect on fatigue through the mediating effect of depressive symptoms, moderated by meal planning difficulty. At higher levels of perceived meal planning difficulty, lower diet satisfaction was indirectly associated with higher fatigue through depressive symptoms, but this pathway was non-significant at lower levels. Findings suggest that supportive care for diet therapy might improve psychological outcomes in older adults with diabetes, especially for those having difficulties with daily dietary practice. Meal planning difficulties in the dietary management of diabetes accompanied by low diet satisfaction may lead to negative psychological outcomes. Monitoring satisfaction and burdens associated with dietary practices could improve fatigue in this population.

As the number of older adults with dementia increases, early diagnosis and intervention are crucially important. The purpose of this study was to conduct dementia screening on older adults to determine whether there are differences in daily activities of living, depression, loneliness, social support, and life satisfaction between older adults at high-risk for dementia compared with low-risk older adults. We hypothesized a negative relationship between high-risk older adults and these factors. This study also hypothesized a moderating effect for social support on the relationship between daily living activities and life satisfaction. This study used a cross-sectional design with survey data. Participants were recruited at 15 public community health centers in South Korea. A total of 609 older adults (male 208, female 401) living in the community were screened for early dementia, and 113 participants (18.9 %) were assigned to the high-risk group. As hypothesized, participants in the high-risk group showed significantly more negative results ​​in terms of activities of daily living, depression, loneliness, social support, and life satisfaction compared with participants in the low-risk group. The findings of this study provide a theoretical basis for the importance of early screening for dementia and policies for effective dementia prevention.

困難に直面した新人ソーシャルワーカーは，他者の有する経験から導き出した判断や対処を，自分が直面している状況に意図的に関連づけ，実践の中での振り返りを行っていた。その過程は，新人ソーシャルワーカーの内面的変化に至る過程であり，それによって意識的に生成された知は，新たな状況に対する自己の行動様式として再構築され，より洗練された実践へと移行していることが示唆された。, Novice Social Workers with neither enough empirical knowledge nor skills were puzzled by "the deviation from the image originally held" and were unable to stand the "imposition of different values," and they thus felt frustrated with the "lack of good experience." They were trying to resolve the anxiety arising from their immaturity and weak minds by "compromising with the thoughts of different perspectives." and "relying on others." However, if they encountered difficult circumstances again without having the opportunity to compensate for the "lack of experience sharing" or the "lack of the ability to reflect" due to the "absence of someone to consult or who can be a support," they became exhausted mentally and physically, thus causing a vicious circle of "negative self-evaluation.", 論文(Article)

困難に直面した新人ソーシャルワーカーは，他者の有する経験から導き出した判断や対処を，自分が直面している状況に意図的に関連づけ，実践の中での振り返りを行っていた。その過程は，新人ソーシャルワーカーの内面的変化に至る過程であり，それによって意識的に生成された知は，新たな状況に対する自己の行動様式として再構築され，より洗練された実践へと移行していることが示唆された。, This study is in the qualitative analysis of reflection of new face social workers are difficult to overcome. New face social workers consciously connected judgments and actions acquired from other people's experiences to the problems that they were having and reconstructed these as their own behavioral patterns. In doing so, they transformed how they perceived problems and their attitude in dealing with them in practice. It was suggested that reflection in the process of overcoming difficulties is discovering a new self and working as a process that leads to realistic confidence., 論文(Article)

We aimed to examine the association between shift work types and participation in breast cancer screening (BCS) programs by comparing rates of participation for BCS among regular daytime workers and alternative shift workers using data from a nationally representative, population-based survey conducted in Korea. In addition, the results were analyzed according to sociodemographic factors, including occupation, education, income, private health insurance, age, and number of working hours a week. This secondary cross-sectional analysis used data from the 2012 Korean National Health and Nutritional Examination Survey. The target population included women aged ≥ 40 years who responded as to whether they had undergone BCS in the previous year. Accordingly, we analyzed survey data for a total of 1,193 women and used a multivariate logistic regression analysis to evaluate the differences in factors affecting BCS between regular daytime and alternative shift workers. A logistic regression analysis was performed considering private health insurance as a significant sociodemographic factor for BCS among regular daytime shift workers. In contrast, none of the tested variables could significantly predict adherence to BCS among alternative shift workers. The results of this study suggest the need for the development of comprehensive workplace breast cancer prevention programs by considering shift work types. More attention should be given to female workers with low education levels, those who are uninsured, and young workers to improve the participation rate for BCS at the workplace.

Older adults with diabetes appear more susceptible to fatigue compared to younger adults with diabetes or healthy older adults, since aging and diabetes independently and synergistically influence fatigue. Few studies have investigated fatigue in older adults with diabetes using a multidimensional approach. This study explored the influences of physical, psychological, interpersonal, and contextual factors on diabetes fatigue using a dynamic biopsychosocial model. Face-to-face surveys were administered to community-dwelling older adults with diabetes and included variables across four domains (i.e., physical, psychological, interpersonal, and contextual factors). Univariate analyses and multiple linear regression were used. The mean fatigue score was 3.94 (standard deviation (SD) = 1.81) out of 7, and the prevalence of fatigue was 48.8%. Significant differences in fatigue severity by psychological, interpersonal, and contextual factors were found. Comorbidity and psychological factors were significant predictors of fatigue in the model, explaining 31.9% of the variance. As nearly half the sample experienced moderate or severe fatigue, which was significantly influenced by both comorbidity and psychological factors, including depression, sleep quality, and diet-related psychological characteristics, assessing patients&rsquo, psychological status may be important. Awareness of fatigue could be incorporated into dietary interventions for older adults with diabetes.

Data from the Patients and Families Psychological Response to the Home Automated External Defibrillator Trial were used to examine the relationship between biopsychosocial variables and patients' coping strategies postmyocardial infarction. This study is the secondary data analysis of longitudinal observational study. A total of 460 patient-spouse pairs were recruited in January 2003 to October 2005. Hierarchical linear regression analysis examined biological/demographic, psychological and social variables regarding patients' coping scores using the Family Crisis Oriented Personal Evaluation Scale. Lower social support and social support satisfaction predicted lower total coping scores. Being younger, male gender and time since the myocardial infarction predicted lower positive coping strategy use. Higher anxiety and lower social support were related to fewer positive coping methods. Lower educational levels were related to increased use of negative coping strategies. Reduced social support predicted lower total coping scores and positive coping strategy use and greater passive coping style use. Social support from a broad network assisted with better coping; those living alone may need additional support. Social support and coping strategies should be taken into consideration for patients who have experienced a cardiac event.

Aim This study compared health-related quality of life in patients with early to mid-stage chronic kidney disease. Methods This study utilized a comparative descriptive design. Patients receiving continuous ambulatory peritoneal dialysis were recruited from a hospital in Korea. Information from patients with stage 3 and 4 chronic kidney disease was obtained from Korean national survey data. A total of 75 pairs were matched using the propensity score method. Health-related quality of life was compared using the European Quality of Life–5 Dimensions questionnaire. Results Only 4% of patients with stage 3 or 4 chronic kidney disease are aware of their disease. These patients have decreased mobility and ability to perform their usual activities (χ2 = 10.77, P = 0.001; χ2 = 7.22, P = 0.007, respectively). However, they have lower levels of anxiety and depression than patients undergoing continuous ambulatory peritoneal dialysis (χ2 = 13.37, P

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Technology enables home-based personalized care through continuous, automated, real-time monitoring of a participant&rsquo, s health condition and remote communication between health care providers and participants. Technology has been implemented in a variety of nursing practices. However, little is known about the use of home mobility monitoring systems in visiting nursing practice. Therefore, the current study tested the feasibility of a home mobility monitoring system as a supportive tool for monitoring daily activities in community-dwelling older adults. Daily mobility data were collected for 15 months via home-based mobility monitoring sensors among eight older adults living alone. Indoor sensor outputs were categorized into sleeping, indoor activities, and going out. Atypical patterns were identified with reference to baseline activity. Daily indoor activities were clearly differentiated by sensor outputs and sensor outputs discriminated atypical activity patterns. During the year of monitoring, a health-related issue was identified in a participant. Our findings indicate the feasibility of a home mobility monitoring system for remote, continuous, and automated assessment of a participant&rsquo, s health-related mobility patterns. Such a system could be used as a supportive tool to detect and intervene in the case of problematic health issues.

Studies on the relationships between health, different living arrangements, and eating behaviors across age groups are limited. Therefore, we investigated these associations, focusing on metabolic syndrome, among 16,015 South Koreans aged &ge, 19 years who completed the Korean National Health and Nutrition Examination Survey (2013&ndash, 2016). Multivariate logistic regression revealed that younger adults (&lt, 65 years) who lived and ate alone consumed more carbohydrates than those who lived and ate with others (p &lt, 0.01). The odds of metabolic syndrome in younger adults increased with eating alone (adjusted odds ratio (aOR) 2.11, 95% confidence interval (CI) 1.10&ndash, 4.02) and living and eating alone (2.39, 1.25&ndash, 4.58). Older adults (&ge, 65 years) did not differ in dietary intake or prevalence of metabolic syndrome according to their living and eating situations. Younger adults living and eating alone may benefit from customized nutrition and health management programs to reduce their risk of metabolic syndrome.

BACKGROUND Heart failure (HF) is a major health problem in the United States, affecting 5.7 million American adults. Psychosocial distress, in particular depression, contributes to morbidity and mortality in patients with HF. Little is known about the interrelationship among disease severity, social support, and depression. OBJECTIVE The aim of this study was to examine the contributions of social support and disease severity to longitudinal changes in depression and anxiety of outpatients with HF. METHODS Patients (N = 108) enrolled in the Psychosocial Factors Outcome Study completed the Beck Depression Inventory-II, the State Trait Anxiety Inventory, and the Social Support Questionnaire-6 at study entry and every 6 months for up to 2 years. RESULTS At baseline, 30% of the patients were depressed and 42% were anxious. Social support amount contributed to changes in depression (P = .044) but not anxiety (P = .856). Depression increased over time for patients who had lower initial social support amount. Depression did not increase for those with higher initial social support amount. Neither New York Heart Association class nor treatment group (placebo or implantable cardioverter defibrillator) interacted with time to predict depression, which indicates that changes in depression were parallel for patients with New York Heart Association class II and class III HF and for those who received implantable cardioverter defibrillators and those who did not. Assessment of patients with HF should include depression and social support. Interventions to enhance social support among patients with HF who have low social support may help alleviate the development of depression. CONCLUSIONS Reducing psychological distress and increasing social support may improve health outcomes among HF outpatients. It is important for studies of HF to include assessment of depression, anxiety, and social support and evaluate their contributions to health outcomes.

Evidence supports the contribution of depression, anxiety, and poor social support to mortality of hospitalized myocardial infarction (MI) patients. The contribution of depression to survival is independent of disease severity. Pet ownership, a non-human form of social support, has also been associated with one year survival of post-MI patients. The current study addresses whether pet ownership contributes independently to long term survival beyond the contributions of depression, anxiety, or low social support in post-MI patients who have already survived at least 6 months. Data from patients (N = 460) enrolled in the “Psychosocial Responses in the Home Automated External Defibrillator Trial (PR-HAT)”were used. Seventeen patients died during a median follow-up of 2.8 years. In Cox proportional hazards regression model that included depression, lack of pet ownership, and the interaction between depression and lack of pet ownership, not owning a pet was the only significant independent predictor of mortality (p = 0.036). The interaction between pet ownership and depression tended to be significant indicating that the effect of pet ownership on survival in this group of people who have supportive spouses/companions living with them may relate to depression.

Objective To compare the long-term effects of cardiopulmonary resuscitation (CPR) training and CPR/automatic external defibrillator (AED) training on anxiety and depression of patients who were medically stable after myocardial infarction (MI) and of their spouses/companions. Design Longitudinal. Participants Post-MI patients (N=460) and their spouses/companions from the Home Automatic External Defibrillator Trial. Main outcome measures Depression (Beck Depression Inventory-II scores) and anxiety (State Trait Anxiety Inventory scores). Results At study entry, 25% of the patients and 15% of their spouses were depressed and 21% of the patients and 19% of the spouses were anxious. The prevalence of depression and anxiety did not change over time in the patients or their spouses. Average depression and anxiety decreased for patients but not for spouses. An intervention group did not contribute significantly to these changes. Psychological distress, indicated by depression or anxiety of the spouse or the patient, occurred in 191 couples. Among psychologically distressed patients (N=128), depression and anxiety decreased over time; the intervention group did not contribute to these changes. The reduction in anxiety among male patients was greater than in female patients (p=0.012, 95% CI 0.002 to 0.018). Among psychologically distressed spouses (N=118), depression decreased over time independently of the intervention. Changes in spouse anxiety depended on the intervention group (p=0.012, 95% CI 0.001 to 0.012); anxiety decreased significantly in the CPR and remained high in the CPR/AED group. Conclusion There was no evidence that home AEDs caused psychological distress among patients. Even among those who were psychologically distressed when they were assigned to receive either CPR training or CPR/AEDs, home AEDs did not influence changes in patients9 depression or anxiety or spouses9 depression in comparison with CPR training. Among psychologically distressed spouses, AEDs may keep anxiety higher than it would be otherwise. Interventions to reduce anxiety of spouses who are psychologically distressed may be indicated when their partners receive an AED.

Data from the Patients and Families Psychological Response to the Home Automated External Defibrillator Trial were used to examine the relationship between biopsychosocial variables and patients' coping strategies postmyocardial infarction. This study is the secondary data analysis of longitudinal observational study. A total of 460 patient-spouse pairs were recruited in January 2003 to October 2005. Hierarchical linear regression analysis examined biological/demographic, psychological and social variables regarding patients' coping scores using the Family Crisis Oriented Personal Evaluation Scale. Lower social support and social support satisfaction predicted lower total coping scores. Being younger, male gender and time since the myocardial infarction predicted lower positive coping strategy use. Higher anxiety and lower social support were related to fewer positive coping methods. Lower educational levels were related to increased use of negative coping strategies. Reduced social support predicted lower total coping scores and positive coping strategy use and greater passive coping style use. Social support from a broad network assisted with better coping; those living alone may need additional support. Social support and coping strategies should be taken into consideration for patients who have experienced a cardiac event.

本論文は，特別養護老人ホームに従事する新人ソーシャルワーカーのネガティブな経験に対する語りに注目し，彼らはそれをどのように変容させ，自らの成長につなげているのかを明らかにすることを目的とした．新人ソーシャルワーカーが実践の中で直面するネガティブな経験の構造を概念化したうえで，それを捉え直すプロセスとそれによる成長のメカニズムを解明するため，4つの課題を立て検証を行った．, Doctor of Philosophy in Social Welfare, Doshisha University