The Effects of ICT Enhanced Home-visit Nursing in Long-Term Care Insurance on Health-related Quality of Life among Community-Dwelling Older Adults

Purpose@#This secondary data analysis study evaluated the effects of ICT enhanced home-visit nursing in long-term care insurance on health-related quality of life among community-dwelling older adults. @*Methods@#This study included data of 131 older adults who had experienced a pilot service for ICT enhanced home-visit nursing. ICT enhanced home-visit nursing refers to a method of sharing health records and teleconference between a visiting nurse and a doctor during the home-visit nursing services to community-dwelling older adults. Health-related quality of life and influencing factors were analyzed by t-tests, logistic regression analysis using the Stata 17/SE program. @*Results@#After a pilot service for ICT enhanced home-visit nursing, their health-related quality of life increased. The teleconferencing method had a significant effect on the increase in health-related quality of life. @*Conclusion@#The findings indicate a pilot service for ICT enhanced home-visit nursing can be applied to the domestic community-based healthcare service model in terms of health management. In the future, the advanced service model of a pilot service for ICT enhanced home-visit nursing in which subjects conduct detailed for each health problem, and a well-designed evaluation system should be developed.

Influence of the Meaning in Life, Depression, and Social Support on the Suicidal Ideation of Old Adult Hemodialysis Patients

Purpose@#This study is to identify how the meaning in life, depression, and social support influences the suicidal ideation of old adult hemodialysis patients. @*Methods@#A cross-sectional design was used. A descriptive correlative study was conducted through an organized and structured self-administrated questionnaire survey for 120 sampled old adult renal dialysis patients. The collected data were analyzed by t-tests, ANOVA, Pearson's correlation coefficient, and multiple linear regression analysis using the Stata 13.0 program. @*Results@#The suicidal ideation of participants was positively correlated with the meaning in life, and social support, and the depression was negatively correlated with the suicidal ideation. Significant factors influencing the suicidal ideation included the meaning in life, depression, social support, age, caregiver, monthly income, and smoking. These factors explained 68% of the variance. @*Conclusion@#The depression of old adult hemodialysis patients was a major risk factor that increased suicidal ideation, and the meaning in life and social support was a protective factor that reduced the suicidal ideation. These results suggest that health professionals should provide old adult hemodialysis patients with proper management of suicidal ideation, and depression as well as its meaning in life, and social support.

Multilevel Effects of Community Capacity on Active Aging in Community-Dwelling Older Adults in South Korea

Purpose@#This study aimed at identifying the level of active aging in older adults and the influence of the individual and community levels of community capacity on active aging. @*Methods@#A cross-sectional survey was conducted on a stratified sample of 380 older adults living in 35 neighborhoods of five regions in Seoul, the capital of South Korea. The structured questionnaire included the Korean version of instruments that measure active aging and community capacity at the individual level. Secondary data including metropolitan statistical information, a public data portal, and a city plan were used to acquire community-capacity factors at the community level. Data were analyzed with multilevel models. @*Results@#The overall active aging mean score was 3.00 ± 0.55 out of 5; the highest mean score was in the security domain (3.46 ± 0.65) and the lowest one was in the participation domain (2.71 ± 0.66). Individual factors associated with active aging included age, education, income, and community capacity at the individual level. At the community level, two community-capacity factors (senior leisure welfare facilities and cooperative unions) were significantly associated with active aging. In active aging, 6.4% and 4.1% of total variance could be explained by 35 neighborhoods, after considering individual and community level variables, respectively. @*Conclusion@#This study showed that community capacity is important for active aging among older adults. Appropriate strategies that consider both individual and community factors, such as contextual indicators of community capacity, are necessary to improve active aging.

Influence of the Meaning in Life, Depression, and Social Support on the Suicidal Ideation of Old Adult Hemodialysis Patients

Purpose@#This study is to identify how the meaning in life, depression, and social support influences the suicidal ideation of old adult hemodialysis patients. @*Methods@#A cross-sectional design was used. A descriptive correlative study was conducted through an organized and structured self-administrated questionnaire survey for 120 sampled old adult renal dialysis patients. The collected data were analyzed by t-tests, ANOVA, Pearson's correlation coefficient, and multiple linear regression analysis using the Stata 13.0 program. @*Results@#The suicidal ideation of participants was positively correlated with the meaning in life, and social support, and the depression was negatively correlated with the suicidal ideation. Significant factors influencing the suicidal ideation included the meaning in life, depression, social support, age, caregiver, monthly income, and smoking. These factors explained 68% of the variance. @*Conclusion@#The depression of old adult hemodialysis patients was a major risk factor that increased suicidal ideation, and the meaning in life and social support was a protective factor that reduced the suicidal ideation. These results suggest that health professionals should provide old adult hemodialysis patients with proper management of suicidal ideation, and depression as well as its meaning in life, and social support.

Multilevel Effects of Community Capacity on Active Aging in Community-Dwelling Older Adults in South Korea

Purpose@#This study aimed at identifying the level of active aging in older adults and the influence of the individual and community levels of community capacity on active aging. @*Methods@#A cross-sectional survey was conducted on a stratified sample of 380 older adults living in 35 neighborhoods of five regions in Seoul, the capital of South Korea. The structured questionnaire included the Korean version of instruments that measure active aging and community capacity at the individual level. Secondary data including metropolitan statistical information, a public data portal, and a city plan were used to acquire community-capacity factors at the community level. Data were analyzed with multilevel models. @*Results@#The overall active aging mean score was 3.00 ± 0.55 out of 5; the highest mean score was in the security domain (3.46 ± 0.65) and the lowest one was in the participation domain (2.71 ± 0.66). Individual factors associated with active aging included age, education, income, and community capacity at the individual level. At the community level, two community-capacity factors (senior leisure welfare facilities and cooperative unions) were significantly associated with active aging. In active aging, 6.4% and 4.1% of total variance could be explained by 35 neighborhoods, after considering individual and community level variables, respectively. @*Conclusion@#This study showed that community capacity is important for active aging among older adults. Appropriate strategies that consider both individual and community factors, such as contextual indicators of community capacity, are necessary to improve active aging.

Differences between Perceived Readiness for Interprofessional Learning in Nursing and Other Health-related Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to investigate the level of perceived readiness for interprofessional learning and its differences between nursing and other health-related students. Methods METHODS: A web-based survey was conducted from April 25 to June 30, 2017 in one university in Korea. A total of 325 undergraduate nursing students and other health-related disciplines completed the structured questionnaire consisting of Readiness for Interprofessional Learning Scale and general characteristics. Data were analyzed by descriptive statistics, t-test, ANOVA, and multiple linear regression. RESULTS: The scores of readiness for interprofessional learning in nursing students were significantly higher than those in other health-related students (t=3.50, p=.001). Nursing students had higher collaboration, professional identity, and roles and responsibilities than other health-related students. The class experiences with other major students was a significant factor related to the readiness for interprofessional learning both in nursing (p=.001) and other health-related students (p=.001). CONCLUSION: The findings suggest that nursing educators consider the different level of readiness for interprofessional learning between nursing and other health-related students while integrating interprofessional education into nursing education curricula.

Factors Related to Emergency Department Healthcare Providers' Attitudes towards End-of-Life Care / 한국호스피스완화의료학회지

PURPOSE: The purpose of this study was to determine the factors that influence healthcare providers' attitude towards end-of-life care (EOLC) in the emergency department (ED) in hospital settings. METHODS: From June 1 through June 30, 2014, a descriptive correlational study was performed with 41 doctors and 105 nurses stationed in the ED. RESULTS: According to a regression model on the factors affecting healthcare providers' professional attitude towards EOLC, 28.1% of variance (F=15.185, P=0.000) was explained by awareness of death, gender and personal attitude towards EOLC. And 34.1% of the healthcare providers' personal attitude was related with awareness of death, experience of hospice education, occupations and professional attitude towards EOLC. CONCLUSION: This study demonstrated that attitude towards EOLC was influenced by awareness of death and personal characteristics. Healthcare providers in the ED should be provided with tailored training to improve their understanding of death. Also an educational program should be developed and provided to ED healthcare providers to improve their awareness of death.

The Effects of Communication Skills, Compassion Satisfaction, Compassion Fatigue on Burnout among Staff of Long-term Care Insurance for the Elderly in National Health Insurance Services in Korea / 한국직업건강간호학회지

PURPOSE: This study was a descriptive research to identify the effects of communication skills, compassion satisfaction, compassion fatigue on burnout among staff of long term care insurance for the elderly in National Health Insurance Services in Korea. METHODS: A descriptive cross-sectional design was used. The participants were 191 staffs of long-term care insurance in National Health Insurance Services. Data were collected via mail from the 24 branch offices which were randomly selected among the total of 226 centers of National Health Insurance Corporation. Stamm's professional quality of life (ProQOL) and Communication Skills Test tool were included in questionnaire to detect. SPSS/WIN 20.0 was used to conduct the descriptive statistics, t-test, ANOVA, correlation analysis, and multiple regression. RESULTS: Compassion fatigue had a significant positive effect on burnout, while Compassion satisfaction had a negative effect on burnout. The explained variance for burnout was 69% and compassion fatigue was the most significant factor in burnout among staff of long term care insurance services. CONCLUSION: The results indicate that the factors influencing staffs' burnout are compassion fatigue, compassion satisfaction, and education level. Therefore, strategies to decrease compassion fatigue and improve compassion satisfaction are needed to decrease burnout for staffs of long-term care insurance in National Health Insurance Services.

Global Health Competencies for Undergraduate Nursing Students in Korea / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify essential global health competencies for undergraduate nursing students in Korea. METHODS: This study used a mixed methods design including an online survey with a convenient sample of 223 nursing educators, followed by an expert discussion with four nursing educators with expertise in global health. The global health competency was measured using the Global Health Competencies for Nurses in the America, which consists of 30 competencies in 6 domains. Each competency was measured by a 4-point Likert Scale, with at least 80% of 3 or 4 point scores indicating consensus that competency was considered essential for undergraduate nursing students. RESULTS: Nursing educators most strongly agreed the competencies of the Social and Environmental Determinants of Health domain as essential global health competencies for nursing students. A total of 21 items in 5 out of 6 competency domains were initially identified with at least 80% agreement. Finally, the experts decided on 24 global health competencies through the revision and integration of several competencies. CONCLUSION: The findings indicate that nursing educators perceived that nursing students need to be prepared for responding to emerging global health needs. The proposed list of global health competencies can provide guidance to develop a framework for integrating global health into undergraduate nursing curriculums.

National Infectious Diseases Surveillance data of South Korea / 한국역학회지

The Korea Centers for Disease Control and Prevention (KCDC) operate infectious disease surveillance systems to monitor national disease incidence. Since 1954, Korea has collected data on various infectious diseases in accordance with the Infectious Disease Control and Prevention Act. All physicians (including those working in Oriental medicine) who diagnose a patient with an infectious disease or conduct a postmortem examination of an infectious disease case are obliged to report the disease to the system. These reported data are incorporated into the database of the National Infectious Disease Surveillance System, which has been providing web-based real-time surveillance data on infectious diseases since 2001. In addition, the KCDC analyzes reported data and publishes the Infectious Disease Surveillance Yearbook annually.

The Relationships between Social Determinants of Health and Health-related Quality of Life among the Community-dwelling Elderly

PURPOSE: The purpose of this study was to examine the social determinants of health (SDH) associated with health-related quality of life (HQOL) among the community-dwelling elderly, based on the conceptual framework of the Commission on Social Determinants of Health (CSDH). METHODS: A survey was conducted with 199 elders aged 65 years or older sampled through convenient sampling. Data were collected through face to face interviews by trained interviewers using a structured questionnaire, which included scales of the residential area, social support, sense of community, social network, health behaviors, and HQOL. Data were analyzed by ANOVA and stepwise multivariate regression. RESULTS: Major SDH affecting HQOL included the participants' residential area, sense of community, and health behavior. The HQOL of the elderly residing in the B area with a low rate of basic livelihood security recipients was higher than that of those residing in other areas. CONCLUSION: CSDH framework was useful to determine the factors associated with HQOL among the community-dwelling elderly. In addition to their health behavior, their sense of community was found to be a SDH of HQOL, indicating the need of health promotion programs tailored to the characteristics of residential areas and strategies to enhance involvement in community activities.

Factors Influencing Medication Adherence in Patients with Hypertension: Based on the 2008 Korean National Health and Nutrition Examination Survey

PURPOSE: The purpose of this study is to examine factors influencing medication adherence in patients with hypertension. METHODS: This study carried out a secondary analysis of data from the 2008 Korean National Health and Nutrition Examination Survey (KNHANES). Stratified sampling was used to select a participant sample that was representative of patients with hypertension throughout the country. Using the SPSS/WIN 18.0 program, data were analyzed using descriptive statistics, chi2 test, t-test, and logistic regression. RESULTS: Of the patients with hypertension, 8.8% had showed non-adherence to medication. Medication adherence was associated with age, spouse, Medicare insurance, number of other diseases, and current smoking status. The cases with older age, a spouse, Medicare insurance, higher number of other diseases, and no current smoking status showed significantly high medication adherence. CONCLUSION: Nursing interventions and further studies are needed to achieve high levels of medication adherence based on factors influencing medication adherence such as age, spouse, Medicare insurance, number of other disease, and current smoking status.

Development of the Quality Indicators in Long Term Care Service / 간호행정학회지

PURPOSE: This study was designed to develop quality outcome indicators for nursing homes and community-based home care that would contribute to an appropriate evaluation and improvement of quality of long term care in Korea. METHODS: The preliminary quality indicators of long term care were developed from a literature review and clinical expert panel. A content validity testing was done using a panel of experts who were selected from academic and clinical field of long-term care. The final quality indicators were confirmed after application in four nursing homes and four home care agencies to test clinical validity. RESULTS: The preliminary quality indicators consisted of 3 domains and 19 indicators. The final quality indicators were composed of 4 domains and 17 indicators. CONCLUSION: This study demonstrated the feasibility of outcome quality indicators in long term care. These quality indicators can be effectively used to evaluate the quality of nursing home and home care and to improve the quality of care in the Korean long-term care system.

Construct Validity and Reliability of the Korean Version of the Practice Environment Scale of Nursing Work Index for Korean Nurses

PURPOSE: To develop and test the validity and reliability of the Korean version of PES-NWI measuring nursing work environments in hospitals. METHODS: The Korean version of the PES-NWI was developed through forward-backward translation techniques, and revision based on feedback from focus groups. An internal consistency reliability and construct validity using confirmatory factor analysis were conducted using SPSS WIN (16.0) and AMOS (18.0). Survey data were collected from 733 nurses who worked in three acute care hospitals in Seoul, South Korea. RESULTS: The Korean version of PES-NWI showed reliable internal consistency with a Cronbach's alpha for the total scale of .93. Factor loadings of the 29 items on the five subscales ranged from .28 to .85. The five subscales model was validated by confirmatory factor analysis (RMR.9). CONCLUSION: The findings of this study demonstrate that the Korean version of PES-NWI has satisfactory construct validity and reliability to measure nursing work environments of hospitals in Korea.

Factors Impacting the Physical Function of Older Adults in Korean Long-Term Care Hospitals

PURPOSE: This study was conducted to examine activities of daily living (ADL) of older adults admitted to Korean long-term care hospitals (LTCHs), and to explore the patient and organizational factors that have an impact on the ADL of this population. METHODS: A secondary analysis of the Korean minimum data set (K-MDS) of patients (N=14,369) and of the profiles of LTCHs (N=358) from the Health Insurance Review and Assessment Service was done between January and July 2008. The outcome variable was ADL score 6 months after baseline assessment. Multi-level linear regression was employed to explore the patient and organizational factors that affected ADL scores. RESULTS: Of the patients, 45.4% had a baseline ADL score of between 31 and 40, with a score of 40 indicating that the patient was entirely dependent for all items. None of the organizational characteristics were significantly associated with effects on the ADLs of older adults who had been in a LTHC for at least 6 months. However, patient characteristics, such as age, baseline ADL, frequency of physical therapy, urinary incontinence, fecal incontinence, pressure ulcers, and having a tube or catheter, were significantly associated with ADL 6 months after baseline. CONCLUSION: In order to maintain and improve the ADL of older adults in LTCHs, we should develop strategies to prevent urinary and fecal incontinence, pressure ulcers, unnecessary tubes or catheters, providing adequate physical therapy. Additional studies should include more detailed information regarding nursing staff, including RN hours for direct care, education level and turnover.

Identification of Hypertension Management-related Errors in a Personal Digital Assistant-based Clinical Log for Nurses in Advanced Practice Nurse Training

PURPOSE: The purposes of this study were to develop a taxonomy for detection of errors related to hypertension management and to apply the taxonomy to retrospectively analyze the documentation of nurses in Advanced Practice Nurse (APN) training. Method: We developed the Hypertension Diagnosis and Management Error Taxonomy and applied it in a sample of adult patient encounters (N = 15,862) that were documented in a personal digital assistantbased clinical log by registered nurses in APN training. We used Standard Query Language queries to retrieve hypertension-related data from the central database. The data were summarized using descriptive statistics. Result: Blood pressure was documented in 77.5% (n = 12,297) of encounters; 21% had high blood pressure values. Missed diagnosis, incomplete diagnosis and misdiagnosis rates were 63.7%, 6.8% and 7.5% respectively. In terms of treatment, the omission rates were 17.9% for essential medications and 69.9% for essential patient teaching. Contraindicated anti-hypertensive medications were documented in 12% of encounters with co-occurring diagnoses of hypertension and asthma. CONCLUSION: The Hypertension Diagnosis and Management Error Taxonomy was useful for identifying errors based on documentation in a clinical log. The results provide an initial understanding of the nature of errors associated with hypertension diagnosis and management of nurses in APN training. The information gained from this study can contribute to educational interventions that promote APN competencies in identification and management of hypertension as well as overall patient safety and informatics competencies.

The Effects of Illumination to Experimentally Induced Refractive Errors in the Chick

The effects of different luminance levels and light sources to emmetropization in the chick were investigaed. One-day-old, forty chicks were reared under condition of unilateral visual deprivation with translucent goggle. Under normal light cycles (12-h light/12-h dark), three kinds of luminance levels and two light sources (incandescent lamp vs fluorescent lamp) were used. Three weeks after hatching, refractive error, axial length, equator diameter and corneal diameter of the eyes were measured. The deprived eyes exhibited severe myopia of -11.94 diopters (p<0.001) and refractive changes were mainly related with axial elongations. Refractive error of 1000 lux group was less myopic than 2000 lux group (p<0.05). The fellow eyes didn't show significant difference between groups. No significant changes were noted between different light source groups. The experiment suggests that different degrees of illumination under normal light/dark environment can cause different refractive changes; More studies will be needed to show that the ideal luminance condition for emmetropization in our enviroment be present.