Effects of the Self-transcendence Enhancement Program among Patients with Drug Addiction: A Mixed Method Research

Younsil Kim; Suk-Sun Kim

doi:10.12934/jkpmhn.2017.26.1.1

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Kim and Kim: Effects of the Self-transcendence Enhancement Program among Patients with Drug Addiction: A Mixed Method Research

Original Article

J Korean Acad Psychiatr Ment Health Nurs 2017;26(1):1-13.

Published online: 7 March 2017

DOI: https://doi.org/10.12934/jkpmhn.2017.26.1.1

Effects of the Self-transcendence Enhancement Program among Patients with Drug Addiction: A Mixed Method Research

Younsil Kim¹, Suk-Sun Kim²

¹Department of Nursing, Doowon Technical University, Anseong ․ Graduated College, College of Nursing, Ewha Womans University, Seoul, Korea

²College of Nursing, Ewha Womans University, Seoul, Korea

Corresponding author: Kim, Suk-Sun College of Nursing, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea. Tel: +82-2-3277-2885, Fax: +82-2-3277-2850, E-mail: suksunkim@ewha.ac.kr

Received 3 August 20168 December 2016 Accepted 17 January 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this mixed method study was to examine effects of the self-transcendence enhancement program among patients with drug addiction, and to explore their experiences through the program.

Methods

For the quantitative study, a non-equivalent control group quasi-experimental design was used. The sample was 49 hospitalized patients with drug addiction. The self-transcendence enhancement program was provided twice a week for 6 weeks. Quantitative data were analyzed using x² test, t-test and ANCOVA. For the qualitative study, 12 patients in the experimental group participated in a focus group interview, and data were analyzed using the content analysis technique.

Results

After the intervention, there were significant improvements for the experimental group in self-transcendence and declines in depression compared to the control group. From the qualitative findings three themes were identified as the change process after the intervention: ‘looking back at myself’, ‘gaining confidence through small changes’, and ‘finding meaning in life’.

Conclusion

Results suggest that the self-transcendence enhancement program can be utilized as a nursing intervention program for patients with drug addiction.

Keywords: Substance-related disorders, Spirituality, Self esteem, Depression

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Figure 1.

Conceptual framework of this study.

Table 1.

Self-Transcendence Enhancement Program

Session	Topic	Stage	Contents	Homework
1	Orientation Meeting	Introduction	Introducing MC Explaining program and schedule	Writing special things in life
		Content development	Concept of self-transcendence and spirituality Structuring groups and forming relationship Sharing motivation for program Positive self-introduction
		Completion	Sharing, feedback
2	Intrapersonally Self-forgiveness	Introduction Content development	Homework sharing Understanding true meaning of forgiveness Drawing life curve, group presentation Self-forgiveness Sharing thoughts about forgiving experiences	Writing things to be tankful for
		Completion	Sharing, feedback
3	Transpersonally Forgiveness of others	Introduction Content development	Homework Sharing Understanding others anf writing forgiving letter Group presentation	Writing recent things to be tankful for
		Completion	Sharing, feedback
4	Intrapersonally Seeking thanks	Introduction Content development	Homework sharing Searching for things to be thankful for Writing gratitude note to those who were not thanked	Expressing things to be thankful for
		Completion	Sharing, feedback
5	Interpersonally Expression of thanks	Introduction Content development	Homework sharing Appreciating someone to be thankful to by presenting a little candle	Writing feelings after being thankful
		Completion	Sharing, feedback
6	Interpersonally Practicing kindness	Introduction Content development	Homework sharing Sharing recent behaviors of kindness Planning kind behaviors	Practicing kind behaviors planned
		Completion	Sharing, feedback
7	Intrapersonally Meaning of kindness	Introduction Content development	Homework Sharing Writing feelings after kind behaviors Sharing feedbacks on presenting feelings after kind behaviors	Behave kindly Making a list of self compliment
		Completion	Sharing, feedback
8	Intrapersonally Recognizing strength	Introduction Content development	Homework Sharing Seeking representative strength Group presentation on strength and giving constructive feedbacks Seeking the way to apply representative strength	Behaving on representative strength
		Completion	Sharing, feedback
9	Interpersonally Compliments	Introduction Content development	Homework Sharing Presenting activities applied with representative strength Giving feedbacks in each group on activities applied with personal strength Sharing feelings of compliment and learning how to compliment right	Complimenting others
		Completion	Sharing, feedback
10	Temporally Positive thoughts	Introduction Content development	Homework sharing Sharing positive and negative thoughts on case Positive thoughts on worries Getting positive feedback	Thinking about positive future
		Completion	Sharing, feedback
11	Transpersonally Temporally Optimism	Introduction Content development	Homework sharing Drawing the best of oneself to be able to reach in the future Presentation after discussion among participants Describing oneself in five years	Practicing an activity for happiness
		Completion	Sharing, feedback
12	Termination	Introduction	Explaining about purpose of this class
		Content development	Summarizing contents of program and activity Giving feedbacks on progression and contents of program Filling in questionnaire

Table 2.

Homogeneity of General Characteristics and Dependent Variables (N=49)

Characteristics	Categories	Total	Exp. (n=24)	Cont. (n=25)	x² or t	p
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	x² or t	p
Age (year)		43.16±8.34	44.20±8.39	42.16±8.34	0.85	.396
Marital state	Single	29 (59.2)	12 (50.0)	17 (68.0)	1.79	.408
	Have a spouse	6 (12.2)	4 (16.7)	2 (8.0)
	Divorce/separation	14 (28.6)	8 (33.3)	6 (24.0)
Religion	Having	39 (79.6)	19 (79.2)	20 (80.0)	0.00	.942
	Not having	10 (20.4)	5 (20.8)	5 (20.0)
Education	Elementary school	12 (24.5)	8 (33.3)	4 (16.0)	2.09	.351
	Middle school	22 (44.9)	10 (41.7)	12 (48.0)
	≥High school	15 (30.6)	6 (25.0)	9 (36.0)
Hospitalization on	Having	44 (89.8)	21 (87.5)	23 (92.0)	0.27	.667
	Not having	5 (10.2)	3 (12.5)	2 (8.0)
Initial doping age		21.87±8.08	22.00±9.19	21.76±7.03	0.10	.919
Hospitalization times (rate)		5.32±3.79	4.95±3.35	5.68±4.21	−0.66	.511
Self-transcendence		42.04±4.50	42.04±4.20	42.04±4.84	0.00	.999
Self-esteem		29.39±4.71	28.04±4.97	30.68±4.14	−2.02	.049
Depression		16.63±11.59	17.20±10.11	16.08±13.03	0.33	.737

Exp.=Experimental group; Cont.=Control group.

Table 3.

Differences in Dependent Variables between Experimental and Control Groups (N=49)

Variables	Groups	Pretest	Posttest	t or F^∗	p
Variables	Groups	M±SD	Posttest M±SD	t or F^∗	p
Self-transcendence	Exp. (n=24)	42.04±4.21	45.04±4.87	3.33	.002
	Cont. (n=25)	42.04±4.84	41.64±4.73
Self-esteem	Exp. (n=24)	28.04±4.97	29.88±4.73	1.41^∗	.241
	Cont. (n=25)	30.68±4.14	30.48±6.09
Depression	Exp. (n=24)	17.21±10.11	13.75±9.80	−2.96	.005
	Cont. (n=25)	16.08±13.03	17.48±12.88

Exp=Experimental group; Cont=Control group.

^∗ ANCOVA with pretest value as covariate.

Table 4.

Sub-categories, Categories, and Themes

Themes	Categories	Sub-Categories
Looking back at myself	Facing myself in the dark past	Exploring lives distorted by drugs Exploring myself who have been weak to depend on drugs
	Looking at myself through others	Exploring the lives of others who have depended on drugs Reflecting my life onto the lives of others
Gaining confidence through small changes	Positive expression	Taking one step forward for a little change Getting encouraged by being satisfied with a little change
Gaining confidence through small changes	Experience in positive relationships	Experiencing changed relationships with my changes Growing confidence that leads to reconciliations of relationships by positive changes
Finding meanings in life	Determination of cutting off drugs	Searching for the meaning of cutting off drugs for my family and myself Searching for the way to be independent from drugs
Finding meanings in life	Living together	Searching for the value of my existence on the way of helping others in trouble Dreaming of hopeful future by becoming the one who doesn't disappoint the family

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