Yul-Mai Song

The care of justice‐involved individuals with mental illness frequently extends to general psychiatric wards because of the limited dedicated forensic infrastructure. However, the lived experience of general psychiatric nurses in navigating the complex threshold between therapeutic care and risk management remains understudied. This qualitative study explored the essential meaning of general psychiatric nurses' lived experience of caring for justice‐involved individuals with mental illness, using van Manen's hermeneutic phenomenological approach. In‐depth one‐to‐one interviews were conducted with eight registered psychiatric nurses in South Korea. Data were interpreted, guided by van Manen's four lived existentials: corporeality, temporality, spatiality and relationality. The essential meaning was disclosed through an essential structure of six categories: (1) The Body Frozen Before the Criminal History, (2) Continuing Care with a Body Weighed Down by Fear, (3) A Relationship Held at a Distance, (4) The Knot of Perception Untied by Time, (5) The Sorrow of Facing a Life with Nowhere to Stay and (6) The Ward's Order Shaken by a Single Patient. Nurses continued to provide care while bearing fear inscribed on the body and maintaining a deliberate distance. They experienced a dynamic shift, coming to re‐perceive the person as a human being over time. To sustain therapeutic care and protect nurses, standardised guidelines, mentoring by experienced nurses, peer support and institutional support must be established so that the burden of this care is not left to the individual nurse's struggle.

Objective Depression in children and adolescents is a global concern associated with adverse psychological and developmental outcomes. The Center for Epidemiologic Studies Depression Scale for Children (CES-DC) measures depressive symptoms in this population; however, evidence regarding its applicability in Korea remains limited. This study validated the Korean version of the CES-DC and examined its factor structure and associations with other psychological measures.Methods A total of 370 children and adolescents participated; 358 with complete CES-DC data were included, and 301 submitted the CES-DC retest after 2–4 weeks. Internal consistency and test–retest reliability were assessed using Cronbach’s alpha and Pearson correlations. Concurrent validity was assessed using parent-reported Child Behavior Checklist for ages 6–18 (CBCL 6–18) and self-reported Youth Self-Report (YSR) and the Revised Children’s Manifest Anxiety Scale (RCMAS). Confirmatory factor analysis (CFA) evaluated model fit; exploratory factor analysis (EFA) explored variations in factor structure.Results The Korean CES-DC demonstrated high internal consistency (Cronbach’s α=0.89) and good test–retest reliability (r=0.70), with subscale-level test–retest correlations (0.55–0.66). Significant correlations with the RCMAS and YSR, and weaker correlations with the CBCL, supported concurrent validity. CFA supported the fit of the original four-factor model.Conclusion The Korean CES-DC is a reliable and valid measure for assessing depressive symptoms in children and adolescents. Further validation in broader age and clinical samples would strengthen generalizability.

Background: Nurses in long-term care often experience moral distress. While moral distress has been reported to negatively impact nursing competence and patient outcomes, some studies suggest that it may contribute positively to nursing competence. Thus, knowledge regarding the impact of moral distress on nursing competence remains limited and inconsistent. Research aim: This study aimed to identify the mediating effects of moral sensitivity and ethical climate on the relationship between moral distress and nursing competence. Research design: This was a quantitative study with a cross-sectional descriptive correlational design. Participants and research context: A survey was conducted with 175 registered nurses working in long-term care hospitals in Korea. Data were collected in September and October 2023. The survey measured moral distress, moral sensitivity, ethical climate, and nursing competence using the Moral Distress Scale, the Moral Sensitivity Questionnaire, the Hospital Ethical Climate Survey, and an instrument for measuring nursing competence in long-term care hospitals, respectively. The collected data were analyzed using SPSS Statistics version 27.0 and the PROCESS macro program. Ethical consideration: This study was approved by the Institutional Review Board. Informed consent was obtained from participants prior to data collection. Findings: Moral distress did not have a significant direct effect on nursing competence; however, it had a positive impact on nursing competence through the mediation of moral sensitivity and ethical climate. Moral sensitivity and ethical climate demonstrated a dual mediating effect in the relationship between moral distress and nursing competence. Conclusion: The findings of this study provide insights into how moral distress can positively contribute to nursing competence. Ensuring that nurses have high moral sensitivity and that organizations foster a positive ethical climate may help moral distress enhance nursing competence.

The involvement of patients with mental health issues in their own treatment decision-making has often been overlooked. This study aimed to investigate the impact of shared decision-making between mental health nurses and patients with alcohol use disorders (AUD) on medication adherence. The provider-patient communication pathway model was utilized to examine the ways in which therapeutic communication strategies employed by mental health nurses positively influence medication adherence. The study employed a percentile bootstrap method and pairwise comparison tests in structural equation modeling. The results revealed that shared decision-making between AUD patients and mental health nurses directly enhanced medication adherence, as well as indirectly influenced adherence through the mediating factors of therapeutic alliance and alcohol abstinence self-efficacy. These findings hold both theoretical and practical implications for involving patients with AUD in therapeutic decision-making within psychiatric and mental health nursing settings, as well as for improving medication adherence among this patient population.

Background: This systematic review aimed to examine the study protocol of Digital Mental Health Interventions (DMHIs) and to review the effect of DMHIs among patients with Schizophrenia Spectrum Disorder (SSD). Methods: This review followed the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic literature search was performed using PubMed, CINAHL, Embase, and PsycINFO electronic databases to identify randomized clinical trials without any limit on the publication year. Overall, 18 studies were selected and evaluated for the quality assessment utilizing the Risk of Bias 2 tool of Cochranes' Collaboration. In the quality assessment, four studies evaluated as overall high risk of bias were excluded from the selection, and the final 14 studies were chosen. Results: No DMHIs were provided for acute schizophrenia-related symptoms, and there were some studies related to schizophrenia-related symptoms (26.4%). Some studies for improving cognitive function (42.9%) were reported, and there was a significant effect when interventions that were proven to be effective when implemented in a face-to-face manner were delivered using various online devices and sensory stimuli. Nearly half of the studies reported intervention frequency and time (57.1%), and those with unclear reports relied either on a mobile app or telemedicine and were designed to self-pace the frequency and speed of the intervention. Conclusion: Based on our findings, it will be possible to understand the characteristics of DMHIs, without physical contact, for only SSD patients, providing a basis for digital mental health services.

Purpose: To translate the Korean version of Nurses' Attitudes Towards the Forensic Psychiatric Patients Scale (NAFPPS-K) into Korean and to test validity and reliability as well.Methods: Participants were 275 psychiatric nurses in South Korea who completed the self-reported online survey of the NAFPPS-K. Twenty-five items were used for item analyses, exploratory factor analyses, and confirmatory factor analyses, as well as for examining internal consistency.Results: The four factors of “Concerns about Recidivism (seven items)”, “Social Distance (four items)”, “Burden of Providing Care (four items)” and “Willingness to Provide Care (four items)” were identified based on the results of item reduction and exploratory factor analyses. Theses factors accounted for 58.1% of the total variance of the NAFPPS-K. Fitness of the modified mode was acceptable (x2=331.56, CFI=.92, TLI=.91, GFI=.89, RMSEA=.07). Cronbach’s ⍺ of the 19 items was .83.Conclusion: This study identifies the validity and reliability of the NAFPPS-K. Four factors of the NAFPPS-K may be useful in evaluating the nurses' attitude for forensic psychiatric patients.

Background: The purpose of this study was to develop a social and emotional competence enhancement (SECE) program as an intervention for adolescents who bully, and to investigate its effects on school bullying behavior and mental health. Methods: A pre-posttest, 1-month follow-up nonequivalent control group quasi-experimental design was used. In total, 71 school bullies were included in the analysis. Results: The effects of this program were significant with regard to group-by-time interaction effects on social competence, emotional regulation, empathy, and school bullying behavior at the 1-month follow-up. Conclusions: The results indicate that the SECE program was effective at reducing school bullying behavior in adolescents who bully. School and community-based mental health professionals can provide feasible interventions that can be used in the short term to reduce school bullying behavior in adolescents who bully.

Objective This study aimed to examine personality profiles and behavioral problems of children with nail biting (NB) to gain insight into the developmental trajectory of pathological NB. Methods 681 elementary school students were divided into non NB (n=436), occasional NB (n=173) and frequent NB group (n=72) depending on the frequency of NB reported in Child Behavioral Checklist (CBCL). Children's personality was assessed using the Junior Temperament and Character Inventory (JTCI), and behavioral problems were assessed using the CBCL. Latent Profile Analysis (LPA) was performed using JTCI profiles to classify personalities of the children with NB (belonging to frequent and occasional NB group, n=245). Results For subscale scores of CBCL, the total, internalizing, externalizing, anxious/depressed withdrawn/depressed, depression, thought, rule -breaking, and aggressive behavior problems, were most severe in the frequent NB group followed by occasional NB and non NB group. LPA of personality profile in children with NB revealed four classes ("adaptiveness," "high reward dependence," "low self-directedness," and "maldaptiveness"). The four personality classes demonstrated significant group differences in all of the CBCL subscales. Children who showed low self-directedness and cooperativeness and high novelty seeking and harm avoidance personality profiles demonstrated high- est tendency for problematic behavior irrespective of the frequency of NB. Conclusion Children with NB reported significantly more problematic behaviors compared to children without NB. Children with spe- cific personality profile demonstrated higher tendency for problematic behavior irrespective of the frequency of NB. Therefore, accom- panying personality profiles should be considered when assessing behavioral problems in children with NB.

Song YM, et al. J Korean Acad Psychiatr Ment Health Nurs. 2018 Dec;27(4):355-369. https://doi.org/10.12934/jkpmhn.2018.27.4.355

α-Lipoic acid (ALA) has been reported to be effective in reducing body weight in rodents and obese patients. Our previous open trial showed that ALA may play a role in reducing weight gain in patients with schizophrenia on atypical antipsychotics. The present study evaluated the efficacy of ALA in reducing weight and BMI in patients with schizophrenia who had experienced significant weight gain since taking atypical antipsychotics. In a 12-week, double-blind randomized placebo-controlled study, 22 overweight and clinically stable patients with schizophrenia were randomly assigned to receive ALA or placebo. ALA was administered at 600-1800 mg, as tolerated. Weight, BMI, abdomen fat area measured by computed tomography, and metabolic values were determined. Adverse effects were also assessed to examine safety. Overall, 15 patients completed 12 weeks of treatment. There was significant weight loss and decreased visceral fat levels in the ALA group compared with the placebo group. There were no instances of psychopathologic aggravation or severe ALA-associated adverse effects. ALA was effective in reducing weight and abdominal obesity in patients with schizophrenia who had experienced significant weight gain since beginning an atypical antipsychotic regimen. Moreover, ALA was well tolerated throughout this study. ALA might play an important role as an adjunctive treatment in decreasing obesity in patients who take atypical antipsychotics.