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The Impact of Acculturation and Social Support on Mental Health among Korean-American Registered Nurses

Kumsook Seo1, Miyoung Kim2, Gunjeong Lee2, Park Jinhwa1, Jungmin Yoon1
Korean Journal of Adult Nursing 2013;25(2):157-169.
Published online: April 18, 2013

1Graduate School, Ewha Womans University, Seoul

2Division of Nursing Science, College of Health Sciences, Ewha Womans University, Seoul, Korea

Corresponding author: Kim, Miyoung Division of Nursing Science, College of Health Sciences, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-6694, Fax: +82-2-3277-2850, E-mail: mykim0808@ewha.ac.kr
• Received: April 8, 2013   • Accepted: April 22, 2013

© 2013 Korean Society of Adult Nursing

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.

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  • Purpose
    This study was to examine the impact of acculturation and social support on the mental health among Korean-American registered nurses.
  • Methods
    Data were collected with a convenience sample of 203 Korean-American registered nurses living in New York state and New Jersey state from 8th May to 25th August in 2012. The structured questionnaires measured the degree of acculturation, social support, and mental health. Data analysis was conducted using t-test, ANOVA, Pearson correlation efficient, and Stepwise multiple regression.
  • Results
    Lower level of integration and higher level of marginalization were associated with the lower mental health. Social support was also positively related to mental health and had mediating effect on the relationship between acculturation and mental health. The five variables, including participants’ educational background, work shift, integration, marginalization, and social support were significant to predict the level of mental health among Korean-American registered nurses, accounting for 41% of the variability.
  • Conclusion
    The results imply that higher level of social support and strong identity of both home and host culture will enable Korean-American registered nurses to maintain sound mental health.
  • Key Words: Acculturation; Mental health; Nurses; Korean Americans; Social support
Figure 1.
The mediation effect on the relationship between acculturation and mental health.
kjan-25-157f1.jpg
Table 1.
The Characteristics of Participants and Differences of Accumulation, Social Support, and Mental Health according to Sample Characteries (N=203)
Characteristics Categories n (%) or M±SD Assimilation Separation Integration Margination Social support Mental health
M±SD t or F p M±SD t or F p M±SD t or F p M±SD t or F p M±SD t t or F p M±SD t or F p
Age (year) ＜35 52 (25.6) 2.4±0.4 1.87 .136 2.9±0.4 0.26 . .851 3.1±0.5 2.15 .096 2.1±0.5 0.94 .421 3.4±0.3 2.38 .071 2.0±0.3 0.38 .770
35~44 59 (29.1) 2.3±0.5 3.0±0.5 3.1±0.6 2.3±0.5 3.3±0.4 2.1±0.3
45~54 58 (28.6) 2.3±0.5 2.9±0.5 3.2±0.6 2.2±0.5 3.4±0.4 2.1±0.3
≥55 34 (16.8) 2.5±0.5 3.0±0.4 3.4±0.6 2.2±0.5 3.5±0.4 2.1±0.3
  43.2±10.1            
Gender Male 4 (2.0) 2.3±0.5 -0.13 .897 3.0±0.5 0.16 .874 3.2±0.6 -0.78 .435 2.2±0.5 1.08 .280 3.4±0.4 0.37 .713 2.0±0.3 0.89 .373
Female 199 (98.0) 2.4±0.4     2.9±0.4     3.4±0.6     1.9±0.2     3.3±0.4     1.9±0.4    
Marital status Singlea 73 (36.0) 2.3±0.5 4.37 .014 3.0±0.4 0.20 . .822 3.1±0.5 0.88 .417 2.3±0.5 2.02 .136 3.3±0.4 0.85 .430 2.1±0.3 1.03 .360
Marriedb 120 (59.1) 2.4±0.5 3.0±0.4 3.2±0.6 2.2±0.5 3.4±0.4 2.0±0.3
Othersc 10 (4.9) 2.1±0.4 2.9±0.6 3.1±0.8 2.4±0.6 3.4±0.4 2.1±0.3
Religion Protestant 120 (59.1) 2.3±0.5 0.42 .741 3.0±0.4 2.67 . .049 3.1±0.6 1.05 .373 2.2±0.5 0.64 .589 3.4±0.4 1.68 .173 2.0±0.3 0.99 .400
Catholic 41 (20.2) 2.4±0.5 2.9±0.5 3.3±0.5 2.3±0.6 3.4±0.4 2.0±0.3
Buddhism 16 (7.9) 2.4±0.6 2.9±0.4 3.3±0.5 2.2±0.4 3.4±0.4 2.0±0.2
None 26 (12.8) 2.4±0.4 2.8±0.4 3.1±0.6 2.3±0.5 3.2±0.4 2.1±0.4
Educational background 3-year collegea 97 (47.8) 2.4±0.5 0.33 .806 2.9±0.5 0.43 . .735 3.2±0.6 1.99 .116 2.2±0.5 2.93 .035 3.4±0.4 0.87 .456 2.0±0.3 2.70 .047
Bachelor degreeb 67 (33.0) 2.3±0.4 3.0±0.4 3.1±0.5 2.3±0.4 c＞d 3.3±0.4 2.1±0.3 b, c＞d
≥Master degreec 24 (11.8) 2.4±0.6 3.0±0.5 3.2±0.6 2.4±0.6 3.5±0.4 2.1±0.3
NHSd 15 (7.4) 2.3±0.4 2.9±0.5 3.5±0.8 2.0±0.6 3.5±0.4 1.8±0.4
Nursing experience in Korea (year) ＜3a 54 (26.6) 2.4±0.4 0.33 .800 2.9±0.4 0.83 . .481 3.3±0.7 1.48 .220 2.1±0.5 4.20 .007 3.4±0.4 3.11 .028 2.0±0.3 1.31 .273
3~＜6b 57 (28.1) 2.4±0.5 3.0±0.4 3.2±0.5 2.2±0.5 d＞a 3.5±0.3 2.0±0.3
6~＜9c 45 (22.2) 2.3±0.5 3.0±0.5 3.1±0.5 2.3±0.5 3.3±0.4 2.1±0.3
≥9d 47 (23.2) 2.3±0.5 2.9±0.5 3.1±0.5 2.4±0.5 3.3±0.4 2.1±0.3
  6.0±5.1            

NHS=nursing high school.

Table 1.
The Characteristics of Participants and Differences of Accumulation, Social Support, and Mental Health according to Sample Characteries (Continued) (N=203)
Characteristics Categories n (%) or M±SD Assimilation Separation Integration Margination Social support Mental health
M±SD t or F p M±SD t or F p M±SD t or F p M±SD t or F p M±SD t or F p M±SD t or F p
Nursing experience in the U.S (year) ＜1a 14 (6.9) 2.4±0.3 7.01 ＜.001 2.8±0.5 1.89 .132 2.9±0.5 8.52 ＜.001 2.1±0.5 1.48 .221 3.4±0.4 0.54 .654 1.9±0.3 0.66 .576
1~＜5b 73 (36.0) 2.3±0.5 d＞c 2.9±0.4 3.1±0.5 d＞a, b, c 2.3±0.5 3.4±0.4 2.1±0.3
5~＜10c 64 (31.5) 2.2±0.5 3.0±0.5 3.1±0.5 2.2±0.5 3.3±0.4 2.0±0.3
≥10d 52 (25.6) 2.5±0.4 3.0±0.4 3.5±0.5 2.1±0.4 3.4±0.4 2.0±0.3
  8.3±8.5            
Current position GRSa 183 (90.2) 2.3±0.5 0.50 .606 3.0±0.4 0.61 . .545 3.1±0.6 8.64 ＜.001 2.3±0.5 6.00 .003 3.4±0.4 3.77 .025 2.1±0.3 2.86 .060
Nurse managerb 14 (6.9) 2.4±0.4 2.8±0.5 3.7±0.4 b＞a 1.8±0.4 3.6±0.4 1.9±0.4
Nurse practitionerc 6 (3.0) 2.5±0.3 3.0±0.4 3.6±0.5 1.9±0.4 3.6±0.3 1.8±0.2
Work shift Per daya 137 (67.5) 2.4±0.5 1.39 .247 3.0±0.5 1.66 . .176 3.2±0.5 3.98 ＜.001 2.2±0.5 2.37 .072 3.4±0.4 1.41 .240 2.0±0.3 2.97 .033
Per eveningb 12 (5.9) 2.6±0.5 2.7±0.4 3.4±0.5 2.3±0.6 3.4±0.5 2.1±0.4 d＞a, b, c
Per nightc 40 (19.7) 2.3±0.4 3.0±0.5 3.0±0.6 2.3±0.6 3.3±0.4 2.1±0.4
Rotating/Per diemd 14 (6.9) 2.4±0.6 3.1±0.3 2.9±0.7 2.4±0.5 3.2±0.4 2.3±0.2
Working hours (per week) ＜30 34 (16.8) 2.3±0.5 0.90 .410 2.9±0.4 0.23 .791 3.1±0.5 1.34 .264 2.3±0.5 1.97 .142 3.3±0.4 0.32 .730 2.1±0.3 0.61 .543
30~40 101 (49.8) 2.3±0.5 3.0±0.5 3.2±0.6 2.1±0.5 3.4±0.4 2.0±0.3
＞40 68 (33.5) 2.4±0.4 3.0±0.4 3.2±0.5 2.3±0.5 3.4±0.4 2.1±0.3
Annual income (US dollar) ＜50,000a 46 (22.7) 12.4±0.4 0.88 .455 3.0±0.4 0.36 .780 3.0±0.5 6.10 ＜.001 2.2±0.5 2.49 .061 3.4±0.4 2.07 .105 2.0±0.4 0.61 .610
50,000~＜75,000b 50 (24.6) 2.3±0.5 2.9±0.5 3.0±0.5 d＞a, b 2.3±0.5 3.4±0.4 2.1±0.3
75,000~＜90,000c 51 (25.1) 2.3±0.5 3.0±0.5 3.2±0.6 2.3±0.5 3.3±0.4 2.1±0.3
≥90,0000d 56 (27.6) 2.4±0.5 3.0±0.5 3.4±0.6 2.1±0.5 3.5±0.4 2.0±0.3
Current visa Citizena 69 (34.0) 2.4±0.5 3.44 .018 3.0±0.5 1.44 . .231 3.4±0.5 5.75 ＜.001 2.1±0.5 5.43 .001 3.5±0.4 4.73 .003 2.0±0.3 0.64 .589
Permanent residentb 69 (34.0) 2.3±0.5 a＞d 3.0±0.4 3.1±0.6 a＞d 2.3±0.5 d＞c, a 3.3±0.4 a＞d 2.1±0.3
Student/CPTc 55 (27.1) 2.4±0.3 2.9±0.4 3.1±0.4 2.2±0.5 3.4±0.4 2.0±0.3
OPTd 10 (4.9) 2.0±0.4 3.0±0.6 2.9±0.6 2.6±0.6 3.1±0.4 2.1±0.3

GRS=general registered nurse; CPT=curricular practical training; OPT=optional practical training.

Table 2.
Levels of Acculturation, Social Support, and Menta Health (N=203
Variables n (%) or M±SD Items
Acculturation    
  Assimilation 2.3±0.5 8
  Separation 3.0±0.5 7
  Integration 3.2±0.6 5
  Marginalization 2.2±0.6 9
Social support 3.4±0.4 21
Mental health 2.0±0.3 20
  ≥13 4 (2.0)  
  ＜13 199 (98.0)  
Table 3.
Correlations among Acculturation, Social Support, Mental Health (N=203)
Variables Categories Mental health Assimilation Separation Integration Marginalization
r (p) r (p) r (p) r (p) r (p)
Acculturation Assimilation -.10 (.160) 1      
Separation .10 (.136) -.30 (＜.001) 1    
Integration -.30 (＜.001) .51 (＜.001) -.24 (.001) 1  
Marginalization .56 (＜.001) -.10 (.153) .21 (.003) -0.36 (＜.001) 1
Social support   -.52 (＜.001) .22 (.001) -.12 (.078) 0.26 (＜.001) -0.43 (＜.001)
Table 4.
Levels of Health Perception and Related Variables (N=203)
Model Categories B SE β t p Collinearity statistics
Tolerance VIF Adj. R2 F (p)
Model 1   (Constant) 40.21 0.68 .05 59.15 ＜.001     .06 3.04 (.007)
  Bachelor degree 0.61 1.00 .04 0.61 .543 .85 1.18
  Master degree 0.69 1.41 -.19 0.49 .624 .91 1.10
  Nursing high school -4.58 1.74 .08 -2.63 .009 .90 1.11
  Evening shift 2.25 1.91 .05 1.18 .241 .92 1.09
  Night shift 0.82 1.11 .21 0.74 .463 .95 1.05
  Rotating/per diem 5.18 1.73   3.00 .003 .97 1.03
Model 2   (Constant) 30.36 3.37 .00 9.00 ＜.001     .32 16.65 (＜.001)
  Bachelor degree 0.11 0.85 .01 0.14 .892 .84 1.18
  Master degree -0.86 1.21 -.04 -0.71 .476 .88 1.14
  Nursing high school -2.51 1.49 -.10 -1.68 .095 .88 1.14
  Evening shift 1.38 1.63 .05 0.85 .399 .91 1.10
  Night shift -0.55 0.96 -.03 -0.57 .567 .91 1.09
  Rotating/per diem 3.06 1.49 .12 2.05 .041 .94 1.06
  Integration -0.21 0.14 -.10 -1.49 .138 .82 1.22
  Marginalization 0.70 0.09 .50 7.78 ＜.001 .81 1.23
Model 3   (Constant) 51.26 4.96 .00 10.33 ＜.001     .41 16.65 (＜.001)
  Bachelor degree 0.16 0.79 .01 0.20 .843 .84 1.18
  Master degree 0.10 1.14 .01 0.09 .929 .86 1.17
  Nursing high school -2.65 1.39 -.11 -1.90 .059 .88 1.14
  Evening shift 1.49 1.52 .06 0.98 .328 .91 1.10
  Night shift -0.67 0.90 -.04 -0.75 .457 .91 1.09
  Rotating/Per diem 2.72 1.39 .11 1.96 .052 .94 1.07
  Integration -0.14 0.13 -.06 -1.06 .290 .81 1.23
  Marginalization 0.51 0.09 .36 5.57 ＜.001 .69 1.45
  Social support -0.26 0.05 -.33 -5.45 ＜.001 .78 1.28
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      The Impact of Acculturation and Social Support on Mental Health among Korean-American Registered Nurses
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      Figure 1. The mediation effect on the relationship between acculturation and mental health.

      Figure 1.

      The Impact of Acculturation and Social Support on Mental Health among Korean-American Registered Nurses

      The Characteristics of Participants and Differences of Accumulation, Social Support, and Mental Health according to Sample Characteries (N=203)

      Characteristics Categories n (%) or M±SD Assimilation Separation Integration Margination Social support Mental health
      M±SD t or F p M±SD t or F p M±SD t or F p M±SD t or F p M±SD t t or F p M±SD t or F p
      Age (year) ＜35 52 (25.6) 2.4±0.4 1.87 .136 2.9±0.4 0.26 . .851 3.1±0.5 2.15 .096 2.1±0.5 0.94 .421 3.4±0.3 2.38 .071 2.0±0.3 0.38 .770
      35~44 59 (29.1) 2.3±0.5 3.0±0.5 3.1±0.6 2.3±0.5 3.3±0.4 2.1±0.3
      45~54 58 (28.6) 2.3±0.5 2.9±0.5 3.2±0.6 2.2±0.5 3.4±0.4 2.1±0.3
      ≥55 34 (16.8) 2.5±0.5 3.0±0.4 3.4±0.6 2.2±0.5 3.5±0.4 2.1±0.3
        43.2±10.1            
      Gender Male 4 (2.0) 2.3±0.5 -0.13 .897 3.0±0.5 0.16 .874 3.2±0.6 -0.78 .435 2.2±0.5 1.08 .280 3.4±0.4 0.37 .713 2.0±0.3 0.89 .373
      Female 199 (98.0) 2.4±0.4     2.9±0.4     3.4±0.6     1.9±0.2     3.3±0.4     1.9±0.4    
      Marital status Singlea 73 (36.0) 2.3±0.5 4.37 .014 3.0±0.4 0.20 . .822 3.1±0.5 0.88 .417 2.3±0.5 2.02 .136 3.3±0.4 0.85 .430 2.1±0.3 1.03 .360
      Marriedb 120 (59.1) 2.4±0.5 3.0±0.4 3.2±0.6 2.2±0.5 3.4±0.4 2.0±0.3
      Othersc 10 (4.9) 2.1±0.4 2.9±0.6 3.1±0.8 2.4±0.6 3.4±0.4 2.1±0.3
      Religion Protestant 120 (59.1) 2.3±0.5 0.42 .741 3.0±0.4 2.67 . .049 3.1±0.6 1.05 .373 2.2±0.5 0.64 .589 3.4±0.4 1.68 .173 2.0±0.3 0.99 .400
      Catholic 41 (20.2) 2.4±0.5 2.9±0.5 3.3±0.5 2.3±0.6 3.4±0.4 2.0±0.3
      Buddhism 16 (7.9) 2.4±0.6 2.9±0.4 3.3±0.5 2.2±0.4 3.4±0.4 2.0±0.2
      None 26 (12.8) 2.4±0.4 2.8±0.4 3.1±0.6 2.3±0.5 3.2±0.4 2.1±0.4
      Educational background 3-year collegea 97 (47.8) 2.4±0.5 0.33 .806 2.9±0.5 0.43 . .735 3.2±0.6 1.99 .116 2.2±0.5 2.93 .035 3.4±0.4 0.87 .456 2.0±0.3 2.70 .047
      Bachelor degreeb 67 (33.0) 2.3±0.4 3.0±0.4 3.1±0.5 2.3±0.4 c＞d 3.3±0.4 2.1±0.3 b, c＞d
      ≥Master degreec 24 (11.8) 2.4±0.6 3.0±0.5 3.2±0.6 2.4±0.6 3.5±0.4 2.1±0.3
      NHSd 15 (7.4) 2.3±0.4 2.9±0.5 3.5±0.8 2.0±0.6 3.5±0.4 1.8±0.4
      Nursing experience in Korea (year) ＜3a 54 (26.6) 2.4±0.4 0.33 .800 2.9±0.4 0.83 . .481 3.3±0.7 1.48 .220 2.1±0.5 4.20 .007 3.4±0.4 3.11 .028 2.0±0.3 1.31 .273
      3~＜6b 57 (28.1) 2.4±0.5 3.0±0.4 3.2±0.5 2.2±0.5 d＞a 3.5±0.3 2.0±0.3
      6~＜9c 45 (22.2) 2.3±0.5 3.0±0.5 3.1±0.5 2.3±0.5 3.3±0.4 2.1±0.3
      ≥9d 47 (23.2) 2.3±0.5 2.9±0.5 3.1±0.5 2.4±0.5 3.3±0.4 2.1±0.3
        6.0±5.1            

      NHS=nursing high school.

      The Characteristics of Participants and Differences of Accumulation, Social Support, and Mental Health according to Sample Characteries (Continued) (N=203)

      Characteristics Categories n (%) or M±SD Assimilation Separation Integration Margination Social support Mental health
      M±SD t or F p M±SD t or F p M±SD t or F p M±SD t or F p M±SD t or F p M±SD t or F p
      Nursing experience in the U.S (year) ＜1a 14 (6.9) 2.4±0.3 7.01 ＜.001 2.8±0.5 1.89 .132 2.9±0.5 8.52 ＜.001 2.1±0.5 1.48 .221 3.4±0.4 0.54 .654 1.9±0.3 0.66 .576
      1~＜5b 73 (36.0) 2.3±0.5 d＞c 2.9±0.4 3.1±0.5 d＞a, b, c 2.3±0.5 3.4±0.4 2.1±0.3
      5~＜10c 64 (31.5) 2.2±0.5 3.0±0.5 3.1±0.5 2.2±0.5 3.3±0.4 2.0±0.3
      ≥10d 52 (25.6) 2.5±0.4 3.0±0.4 3.5±0.5 2.1±0.4 3.4±0.4 2.0±0.3
        8.3±8.5            
      Current position GRSa 183 (90.2) 2.3±0.5 0.50 .606 3.0±0.4 0.61 . .545 3.1±0.6 8.64 ＜.001 2.3±0.5 6.00 .003 3.4±0.4 3.77 .025 2.1±0.3 2.86 .060
      Nurse managerb 14 (6.9) 2.4±0.4 2.8±0.5 3.7±0.4 b＞a 1.8±0.4 3.6±0.4 1.9±0.4
      Nurse practitionerc 6 (3.0) 2.5±0.3 3.0±0.4 3.6±0.5 1.9±0.4 3.6±0.3 1.8±0.2
      Work shift Per daya 137 (67.5) 2.4±0.5 1.39 .247 3.0±0.5 1.66 . .176 3.2±0.5 3.98 ＜.001 2.2±0.5 2.37 .072 3.4±0.4 1.41 .240 2.0±0.3 2.97 .033
      Per eveningb 12 (5.9) 2.6±0.5 2.7±0.4 3.4±0.5 2.3±0.6 3.4±0.5 2.1±0.4 d＞a, b, c
      Per nightc 40 (19.7) 2.3±0.4 3.0±0.5 3.0±0.6 2.3±0.6 3.3±0.4 2.1±0.4
      Rotating/Per diemd 14 (6.9) 2.4±0.6 3.1±0.3 2.9±0.7 2.4±0.5 3.2±0.4 2.3±0.2
      Working hours (per week) ＜30 34 (16.8) 2.3±0.5 0.90 .410 2.9±0.4 0.23 .791 3.1±0.5 1.34 .264 2.3±0.5 1.97 .142 3.3±0.4 0.32 .730 2.1±0.3 0.61 .543
      30~40 101 (49.8) 2.3±0.5 3.0±0.5 3.2±0.6 2.1±0.5 3.4±0.4 2.0±0.3
      ＞40 68 (33.5) 2.4±0.4 3.0±0.4 3.2±0.5 2.3±0.5 3.4±0.4 2.1±0.3
      Annual income (US dollar) ＜50,000a 46 (22.7) 12.4±0.4 0.88 .455 3.0±0.4 0.36 .780 3.0±0.5 6.10 ＜.001 2.2±0.5 2.49 .061 3.4±0.4 2.07 .105 2.0±0.4 0.61 .610
      50,000~＜75,000b 50 (24.6) 2.3±0.5 2.9±0.5 3.0±0.5 d＞a, b 2.3±0.5 3.4±0.4 2.1±0.3
      75,000~＜90,000c 51 (25.1) 2.3±0.5 3.0±0.5 3.2±0.6 2.3±0.5 3.3±0.4 2.1±0.3
      ≥90,0000d 56 (27.6) 2.4±0.5 3.0±0.5 3.4±0.6 2.1±0.5 3.5±0.4 2.0±0.3
      Current visa Citizena 69 (34.0) 2.4±0.5 3.44 .018 3.0±0.5 1.44 . .231 3.4±0.5 5.75 ＜.001 2.1±0.5 5.43 .001 3.5±0.4 4.73 .003 2.0±0.3 0.64 .589
      Permanent residentb 69 (34.0) 2.3±0.5 a＞d 3.0±0.4 3.1±0.6 a＞d 2.3±0.5 d＞c, a 3.3±0.4 a＞d 2.1±0.3
      Student/CPTc 55 (27.1) 2.4±0.3 2.9±0.4 3.1±0.4 2.2±0.5 3.4±0.4 2.0±0.3
      OPTd 10 (4.9) 2.0±0.4 3.0±0.6 2.9±0.6 2.6±0.6 3.1±0.4 2.1±0.3

      GRS=general registered nurse; CPT=curricular practical training; OPT=optional practical training.

      Levels of Acculturation, Social Support, and Menta Health (N=203

      Variables n (%) or M±SD Items
      Acculturation    
        Assimilation 2.3±0.5 8
        Separation 3.0±0.5 7
        Integration 3.2±0.6 5
        Marginalization 2.2±0.6 9
      Social support 3.4±0.4 21
      Mental health 2.0±0.3 20
        ≥13 4 (2.0)  
        ＜13 199 (98.0)  

      Correlations among Acculturation, Social Support, Mental Health (N=203)

      Variables Categories Mental health Assimilation Separation Integration Marginalization
      r (p) r (p) r (p) r (p) r (p)
      Acculturation Assimilation -.10 (.160) 1      
      Separation .10 (.136) -.30 (＜.001) 1    
      Integration -.30 (＜.001) .51 (＜.001) -.24 (.001) 1  
      Marginalization .56 (＜.001) -.10 (.153) .21 (.003) -0.36 (＜.001) 1
      Social support   -.52 (＜.001) .22 (.001) -.12 (.078) 0.26 (＜.001) -0.43 (＜.001)

      Levels of Health Perception and Related Variables (N=203)

      Model Categories B SE β t p Collinearity statistics
      Tolerance VIF Adj. R2 F (p)
      Model 1   (Constant) 40.21 0.68 .05 59.15 ＜.001     .06 3.04 (.007)
        Bachelor degree 0.61 1.00 .04 0.61 .543 .85 1.18
        Master degree 0.69 1.41 -.19 0.49 .624 .91 1.10
        Nursing high school -4.58 1.74 .08 -2.63 .009 .90 1.11
        Evening shift 2.25 1.91 .05 1.18 .241 .92 1.09
        Night shift 0.82 1.11 .21 0.74 .463 .95 1.05
        Rotating/per diem 5.18 1.73   3.00 .003 .97 1.03
      Model 2   (Constant) 30.36 3.37 .00 9.00 ＜.001     .32 16.65 (＜.001)
        Bachelor degree 0.11 0.85 .01 0.14 .892 .84 1.18
        Master degree -0.86 1.21 -.04 -0.71 .476 .88 1.14
        Nursing high school -2.51 1.49 -.10 -1.68 .095 .88 1.14
        Evening shift 1.38 1.63 .05 0.85 .399 .91 1.10
        Night shift -0.55 0.96 -.03 -0.57 .567 .91 1.09
        Rotating/per diem 3.06 1.49 .12 2.05 .041 .94 1.06
        Integration -0.21 0.14 -.10 -1.49 .138 .82 1.22
        Marginalization 0.70 0.09 .50 7.78 ＜.001 .81 1.23
      Model 3   (Constant) 51.26 4.96 .00 10.33 ＜.001     .41 16.65 (＜.001)
        Bachelor degree 0.16 0.79 .01 0.20 .843 .84 1.18
        Master degree 0.10 1.14 .01 0.09 .929 .86 1.17
        Nursing high school -2.65 1.39 -.11 -1.90 .059 .88 1.14
        Evening shift 1.49 1.52 .06 0.98 .328 .91 1.10
        Night shift -0.67 0.90 -.04 -0.75 .457 .91 1.09
        Rotating/Per diem 2.72 1.39 .11 1.96 .052 .94 1.07
        Integration -0.14 0.13 -.06 -1.06 .290 .81 1.23
        Marginalization 0.51 0.09 .36 5.57 ＜.001 .69 1.45
        Social support -0.26 0.05 -.33 -5.45 ＜.001 .78 1.28
      Table 1. The Characteristics of Participants and Differences of Accumulation, Social Support, and Mental Health according to Sample Characteries (N=203)

      NHS=nursing high school.

      Table 1. The Characteristics of Participants and Differences of Accumulation, Social Support, and Mental Health according to Sample Characteries (Continued) (N=203)

      GRS=general registered nurse; CPT=curricular practical training; OPT=optional practical training.

      Table 2. Levels of Acculturation, Social Support, and Menta Health (N=203

      Table 3. Correlations among Acculturation, Social Support, Mental Health (N=203)

      Table 4. Levels of Health Perception and Related Variables (N=203)

      Table 1.

      Table 1.

      Table 2.

      Table 3.

      Table 4.

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