Purpose: In this study the effects of forgiveness therapy on the resilience, self-esteem, and spirituality of wives of men suffering from alcohol abuse was examined. Methods: The study design was a quasi-experimental design. Forgiveness therapy was conducted once a week for 12 weeks. Data were obtained from March 2012 to December 2013. Participants were chosen from women in two Alcohol Counseling Centers. Of the 29 participants, 16 were assigned to the experimental group and 13 to the control group. Data were analyzed using descriptive statistics, t-test, ${\chi}^2$-test, and repeated measure ANOVA. Results: There were statistically significantly differences for resilience, self-esteem, and spirituality between the experimental and control groups. Forgiveness therapy improved the resilience, self-esteem, and spirituality in the experimental group compared to the control group (p<.05). In follow-up tests, the experimental group had a statistically significantly increase only in self-esteem. Conclusion: This study results show that forgiveness therapy is effective in improving resilience, self-esteem, and spirituality in wives of men suffering from alcohol abuse. Therefore, forgiveness therapy can be considered a useful nursing intervention to promote improvements in emotional stability and provide pain relief for these wives.

Purpose: This study was done to develop a reproductive health program to improve reproductive health of women immigrants. Methods: The participants in the study were 58 immigrant women who lived in Vietnam, China, Philippines, or Cambodia before marriage. They were assigned to the experiment group (n=29) or the control group (n=29). The reproductive health program for this study consisted of reproductive health education, health counseling, phone monitoring, and emotional support based on Cox (1982)'s Interaction Model of Client Health Behavior and was implemented for four weeks. Results: There were significant differences in reproductive health knowledge (t=9.78, p<.001), reproductive health attitude (t=6.59, p<.001), and reproductive health behavior (t=5.11, p<.001) within and between groups after the reproductive health program. But there were no significant differences in clinical indicators between the two groups. Conclusion: The results of this study indicate the that reproductive health program for the women immigrants is effective in terms of reproductive health knowledge, reproductive health attitude and reproductive health behaviors. Therefore, nurses in public and private facilities, such as multicultural centers and public health centers in each community, should develop strategies to expand and provide reproductive health programs for women immigrants.

Purpose: The purpose of this study was to construct and test a structural equation modeling on burnout of clinical nurses based on CS-CF model. Methods: A survey using a structured questionnaire was conducted with 557 clinical nurses. Data were analyzed using structural equation modeling. Results: The modified hypothetical model yielded the following ${\chi}^2=289.70$, p<.001, RMSEA=.09, GFI=.93, TLI=.91, CFI=.94, PCFI=.65, AIC=363.21, SRMR=.05 or less and showed good fit indices. Nursing work environment, patient safety culture and resilience showed indirect effects on burnout while compassion fatigue and compassion satisfaction had direct effects. Conclusion: Results of this study suggest that compassion fatigue must be decreased and compassion satisfaction has to be increased, while burnout is lowered by enhancing the clinical nursing work environment, patient safety culture and resilience. In addition, more variables and longitudinal studies are necessary to validate the clear cause-and-effect relationship between the relevant variables.

Purpose: The purpose of this study was to identify sleep disorder experience in older patients living in the community and acknowledging being depressed. Methods: For this study, 11 older patients with depression were purposively chosen. Data were collected through indepth individual interviews from July 2013 to January 2014 and analyzed in terms of by Giorgi's phenomenological methodology. Results: The study results showed that sleep disorder experience in older patients with depression consisted of sixteen themes and five themes-clusters: 1) exposure of the causes of sleep disorders; 2) life is painful; 3) harassing themselves and their family; 4) difficulty in controlling themselves; 5) trying to deal with the sleep disorder to overcome the situation. Conclusion: It is necessary to develop educational guidelines for patients with sleep disorders or nursing interventions that anyone can easily provide for elders in the communities. The first priority should be given to efforts to apply diverse methods to improve sleep hygiene and minimize the period of exposure to medication before starting medication for patients with sleep disorders.

Purpose: The study was done to develop an evidence-based enteral nutrition (EN) protocol for effective nutritional support for dysphagia in patients with acute stroke, and to evaluate effects of this protocol on clinical outcomes. Methods: A methodological study was used to develop the EN protocol and a quasi-experimental study to verify the effectiveness of the protocol. The preliminary EN protocol was drawn by selecting recommendations from previous well-designed EN guidelines, and then developing additional recommendations based on high-quality evidence. Content validation was assessed by an expert group, and clinical applicability by care providers and patients. The scale-level content validity index of the final EN protocol was 0.99. Assessment was done of differences in percentage of caloric goals achieved and presence of undernutrition, aspiration pneumonia, and gastrointestinal (GI) complications after application of the EN protocol. Results: In the EN protocol group, the percentage of caloric goals achieved ($R^2=.24$, p=.001) and the reduction of GI complications (p=.045) were significantly improved, but the presence of undernutrition (p=.296) and aspiration pneumonia (p=.601) did not differ from the usual care group. Conclusion: Results indicate that the new EN protocol for dysphagia in patients with acute stroke significantly increased their nutritional intake and reduced GI complications.

Purpose: The influence of dietary composition on blood pressure is an important subject in healthcare. Interactions between antihypertensive drugs and diet (IBADD) is the most important factor in the management of hypertension. It is therefore essential to support healthcare providers' decision making role in active and continuous interaction control in hypertension management. The aim of this study was to implement an ontology-based clinical decision support system (CDSS) for IBADD management (IBADDM). We considered the concepts of antihypertensive drugs and foods, and focused on the interchangeability between the database and the CDSS when providing tailored information. Methods: An ontology-based CDSS for IBADDM was implemented in eight phases: (1) determining the domain and scope of ontology, (2) reviewing existing ontology, (3) extracting and defining the concepts, (4) assigning relationships between concepts, (5) creating a conceptual map with CmapTools, (6) selecting upper ontology, (7) formally representing the ontology with Protege (ver.4.3), (8) implementing an ontology-based CDSS as a JAVA prototype application. Results: We extracted 5,926 concepts, 15 properties, and formally represented them using Protege. An ontology-based CDSS for IBADDM was implemented and the evaluation score was 4.60 out of 5. Conclusion: We endeavored to map functions of a CDSS and implement an ontology-based CDSS for IBADDM.

Purpose: The purpose of this study was to explore and identify patterns from the phenomenon of the role adaptation process in elementary school health teachers and finally, suggest a model to describe the process. Methods: Grounded theory methodology and focus group interviews were used. Data were collected from 24 participants of four focus groups. The questions used were about their experience of role adaptation including situational contexts and interactional coping strategies. Transcribed data and field notes were analyzed with continuous comparative analysis. Results: The core category was 'establishing their own positions', an interactional coping strategy. The phenomenon identified by participants was confusion and wandering in their role performance. Influencing contexts were unclear beliefs for their role as health teachers and non-supportive job environments. The result of the adaptation process was consolidation of their positions. Pride as health teachers and social recognition and supports intervened to produce that result. The process had three stages; entry, growth, and maturity. Conclusion: The role adaptation process of elementary school health teachers can be explained as establishing, strengthening and consolidating their own positions. Results of this study can be used as fundamental information for developing programs to support the role adaptation of health teachers.

Purpose: This study was done to compare families of boys or of girls for actor and partner effect of stress, depression and parent-adolescent communication as perceived by mother, father and adolescent on adolescents' suicidal ideation. Methods: Participants were 183 families (104 boys' families, 79 girls' families) who met eligibility criteria. All measures were self-administered. Data were analyzed using SPSS 18.0 and AMOS 18.0 program. Results: In boys' families, boys' depression and communication with father showed actor effect on boys' suicidal ideation. Boys' stress showed indirect effect on boys' suicidal ideation through communication with father and boys' depression. Mothers' depression showed indirect partner effect on boys' suicidal ideation through boys' depression. In families of girls, girls' depression and stress showed actor effects on girls' suicidal ideation. Girls' communication with mother showed indirect effects through girls' depression. Also girls' stress showed indirect effect through girls' depression. Stress in mothers and/or fathers showed partner effect on girls' suicidal ideation. Conclusion: To intervene in adolescents' suicidal ideation and promote adolescents' mental health, programs should be developed differently according to gender and based on parent's psychological states.

Purpose: This study was done to explore experiences of persons living through the periods of cancer diagnosis, treatment, and self-care. Methods: With permission, texts of 29 cancer survival narratives (8 men and 21 women, winners in contests sponsored by two institutes), were analyzed using Kang's Korean-Computerized-Text-Analysis-Program where the commonly used Korean-Morphological-Analyzer and the 21st-century-Sejong-Modern-Korean-Corpora representing laymen's Korean-language-use are connected. Experiences were explored based on words included in 100 highly-used-morphemes. For interpretation, we used 'categorizing words by meaning', 'comparing use-rate by periods and to the 21st-century-Sejong-Modern-Korean-Corpora', and highly-used-morphemes that appeared only in a specific period. Results: The most highly-used-word-morpheme was first-person-pronouns followed by, diagnosis treatment-related- words, mind-expression-words, cancer, persons-in-meaningful-interaction, living and eating, information-related-verbs, emotion-expression- words, with 240 to 0.8 times for layman use-rate. 'Diagnosis-process', 'cancer-thought', 'things-to-come-after-diagnosis', 'physician husband', 'result-related-information', 'meaningful-things before diagnosis-period', and 'locus-of-cause' dominated the life of the diagnosis-period. 'Treatment', 'unreliable-body', 'husband people mother physician', 'treatment-related-uncertainty', 'hard-time', and 'waiting-time represented experiences in the treatment-period. Themes of living in the self-care-period were complex and included 'living-as-a-human', 'self-managing-of-diseased-body', 'positive-emotion', and 'connecting past present future'. Conclusion: The results show that the experience of living for persons with cancer is influenced by each period's own situational-characteristics. Experiences of the diagnosis and treatment-period are negative disease-oriented while that of the self-care period is positive present-oriented.

Purpose: This study was done to develop a measurement for stress experienced by patients with schizophrenia during hospitalization. Methods: The preliminary tool was developed through in-depth interviews and a validity verification test of content. For data collection, 15 inpatients with schizophrenia were selected as participants for in-depth interviews and 195 patients admitted to one of eight psychiatric hospitals in four provinces were recruited as participants to test reliability and validity of the preliminary tool. Results: The questionnaire was developed as a four-point Likert-type scale in a self-report form with 28 items. Factor analysis showed 28 items in six factors. Factors were named 'Unjust human rights infringement', 'Futureless life', 'Alienation from other family members', 'Infringement of basic needs', 'Infringement of personal preference' and 'Inconvenience of shared living'. The six factors explained 63.5% of the total variance. Cronbach's alpha for the total items was .93 and for the factors ranged from .65 to .87. Conclusion: A tool to measure stress in patients hospitalized with schizophrenic was developed based on identified hospitalization stress experiences. Study results indicate that this tool can be used to evaluate hospitalization stress in these patients and will contribute to establishing nursing interventions for relief of hospitalization stress.