Development of a Health Promotion Nursing Intervention for Post-traumatic Stress Women Based on Swanson's Theory of Caring
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Women Who Have Experienced Trauma
- Sponsor
- Yonsei University
- Enrollment
- 14
- Locations
- 1
- Primary Endpoint
- health-promoting behaviors
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
Objectives: We aimed to (1) develop a caring program for health promotion among women who experienced trauma and (2) evaluate its effect on post-traumatic stress, depression, health-promoting behaviors, and self-esteem.
Methods: We conducted a quasi-experimental study using a group pre-test/post-test design. Data were collected from 14 women recruited from a self-sufficiency support center for sexually exploited women who experienced trauma, during December 2019-May 2020. Participants were assessed at pre-test, post-test, and at a one-month follow-up. We analyzed changes in outcome variables over time using repeated-measures analysis of variance and paired t-tests.
Investigators
Eligibility Criteria
Inclusion Criteria
- •women aged over 18 years who had experienced a traumatic event, and
- •a PTS score of 64 or lower on the PTSD checklist for DSM-5 (PCL-5) developed by Weathers et al. (1993), revised by Weathers et al. (2013), and translated into Korean by Kim et al. (2017).
Exclusion Criteria
- •presence of psychiatric conditions with hallucinations and delusions, and
- •diagnosis of an intellectual disability that would make understanding the intervention procedure difficult. Although a standard cut-off was not present in the PCL-5, women who exceeded 80% (64 points) of the total score were excluded to rule out high-risk women with severe trauma.
Outcomes
Primary Outcomes
health-promoting behaviors
Time Frame: one month after the intervention
Health-promoting behaviors were measured using the Health Promoting Lifestyle Profile-II (HPLP-II), developed by Walker et al. (1995) and translated into Korean by Yun and Kim (1999). The Korean version of the HPLP-II comprises 52 items under six subscales: health responsibility (scores ranging from 9-36), physical activity (scores ranging from 8-32), nutrition (scores ranging from 9-36), spiritual growth (scores ranging from 9-36), interpersonal relations (scores ranging from 9-36), and stress management (scores ranging from 8-32). It was rated on a 4-point Likert scale (1=never, 2=sometimes, 3=often, 4=routinely). Possible scores ranged from 52 to 208, with higher scores indicating higher levels of health-promoting behaviors. Cronbach's alpha coefficients were .78, .87, .69, .77, .81, and .73 for health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management, respectively.
self-esteem
Time Frame: one month after the intervention
Self-esteem was assessed using the Rosenberg Self Esteem Scale (RSES), developed by Rosenberg (1965), and translated into Korean by Bae et al. (2014). The Korean version of the RSES (K-RSES) comprises ten items rated on a 4-point Likert scale, ranging from strongly agree to strongly disagree. Possible scores ranged from 10 to 40, with higher scores indicating higher self-esteem. Cronbach's alpha coefficient for the K-RSES was .90 among Korean adults (Bae et al., 2014) and .90 in our study.
post-traumatic stress
Time Frame: one month after the intervention
PTS was measured using the PCL-5, which was developed by Weathers et al. (1993), revised by Weathers et al. (2013) as per the revised PTSD definition in the DSM-5, and translated into Korean by Kim et al. (2017). The Korean version of the PCL for the DSM-5 (PCL-5-K) contains 20 items, and each scored from 0 (not at all) to 4 (extremely). The score depended on the severity of the symptom caused by stress related to traumatic events during the past month. Possible scores ranged from 0 to 80, with a score of 37 or above indicating a PTSD diagnosis, and higher scores suggesting severe PTSD symptoms (Kim et al., 2017). Cronbach's alpha coefficient for the PCL-5-K was .97 among Korean veterans of the Vietnam War (Kim et al., 2017) and .89 in the current study.
depression
Time Frame: one month after the intervention
Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), developed by Radloff (1977), and translated into Korean by Chon and Rhee (1992). The Korean version of the CES-D contains 20 items rated on a 4-point Likert scale (0 = rarely or never; to 3 = all the time), according to how respondents felt during the past week. Possible scores ranged from 0 to 60, with a score of 16 or above indicating depressive symptoms, and higher scores indicating higher levels of depression (Radloff, 1977). Cronbach's alpha coefficient for the Korean CES-D was .89 among Korean adults (Chon \& Rhee, 1992) and .78 in our study.