The Impacts of Cognitive Function, Disease Severity, and Disability on Ability to Perform Activities of Daily Living after Stroke / 재활간호학회지

PURPOSE: This study aimed to examine influence of cognitive function, disease severity and disability on ability to perform activity of daily living (ADL) after ischemic stroke. METHODS: A total of 88 patients with ischemic stroke were recruited from January 1, 2008 to December 31, 2012 and assessed with the standardized cognitive test battery and self-reports about disease severity, disability, and ADL. To analyze the data, ANOVA, Pearson correlation coefficients and multiple regression were conducted using SPSS/WIN program. RESULTS: Significant correlations were found between ADL and visuospatial function, visual memory, executive function, and disability (r=.29~.38). Executive function and disability explained 17.3% of total variability in ADL performance after ischemic stroke. CONCLUSION: Executive function may be a promising target for cognitive rehabilitation after ischemic stroke. Thus, effective therapeutic interventions such as cognitive training for stroke patients should be considered to improve their ability to perform ADL.

Effects on Blood Flow Velocity, Wound Healing and Pain in Hand Microsurgery Patients Following Heating on Non-affected Side

PURPOSE: The purpose of this study was to identify the effects of heating on the non-affected hand on blood flow velocity, wound healing, and pain for hand microsurgery patients. METHODS: This study was designed using the nonequivalent control group pretest-posttest design. Thirty-nine patients were assigned either to the experimental group (20 patients) or control group (19 patients). Data were analyzed with chi2-test, Fisher's exact test, t-test, and repeated measure ANOVA using SPSS/WIN 17.0 program. RESULTS: After treatment in this program, blood flow velocity (F=5.13, p=.008) and wound healing (F=4.11, p=.020) improved significantly in the experimental group compared to the control group. But there was no significant improvement in pain in the experimental group compared to the control group (F=2.40, p=.097). CONCLUSION: Based upon these results, the non-affected side hand heating was recommended as an independent nursing intervention for the patients who need improvement in blood flow velocity and wound healing such as patients who have microsurgery. As the heating was effective even when applied on the non-affected side, it is the applicable to patients who cannot tolerate any therapy on affected side.

Prediction Model of Quality of Life in Elderly Based on ICF Model

PURPOSE: The purpose of this study was to identify from the International Classification of Functioning model, factors influencing quality of life in elderly persons and to describe the concrete pathway of influence and the power of each variable. METHODS: The sample included 334 elders who lived in 5 districts of D Metropolitan City. A structured questionnaire was used and the collected data were analyzed for fitness, using the AMOS 18.0 program. RESULTS: This model was concise and extensive in predicting the quality of life of elders. The research verified the factors influencing quality of life for elders as direct factors such as activity of daily living (ADL) (beta=.13, t=2.47), leisure activity (beta=.55, t=5.04), social disengagement (beta=-.25, t=-2.25), and depression (beta=-.62, t=-10.86). Indirect factors including economic status (gamma=.17, p=.009), type of residence (gamma=.19, p=.004), ADL (gamma=.12, p=.027) were important factors in predicting quality of life for elders. These variables explained 75.6% of variance in the prediction model. CONCLUSION: The findings indicate a need for the nursing scientific community to develop intervention programs considering these variables to improve the quality of life for elders.

The Effects of A Day Care Rehabilitation Program on Physical and Emotional Function of Patients with Job-related Injury / 재활간호학회지

PURPOSE: The purpose of this study was to examine the effects of a day care rehabilitation program managed by nurses on physical and emotional function of patients with job-related injuries. METHOD: A one group pre-test and post-test quasi-experimental design was used. Thirty patients participated in a day care rehabilitation program and 9% of those were unable to complete the 16 weeks program due to absence. The physiotherapist, occupational therapist, and clinical psychologist offered the day care rehabilitation program, 5 times a week for 16 weeks. Outcome measures included physical and emotional function. RESULTS: The program participants had significantly greater motor function (t=-2.85, p=.008) and activity of daily living (t=-5.34, p<.001), and lower depression (t=5.20, p<.001), state anxiety (t=4.71, p<.001), and trait anxiety (t=4.40, p<.001). CONCLUSION: The nurse managed day care rehabilitation program significantly improved physical and emotional function in patients with job-related injuries. The program should be further tested in a larger sample to validate the findings.

Effects of Tai Chi Exercise on Physical Fitness, Bone Mineral Density, and Fracture Risk in Institutionalized Elderly / 기본간호학회지

PURPOSE: The purpose of this study was to examine the effects of Tai Chi exercise on flexibility, balance, walking ability, muscle strength, bone mineral density, and fracture risk in institutionalized elders. METHOD: A quasi-experimental pretest-posttest design with a nonequivalent comparison group was utilized, and 53 older adults living in one institution were recruited and assigned to one of two groups, experimental group (18) or comparison (20). Both groups completed posttest measures at 6 months. There was a 31% rate of dropouts. Tai Chi exercise was provided twice a week for 24 weeks. Outcome measurements were conducted by a physiotherapist at a university hospital health promotion center who did not know the group assignment. RESULTS: At 6 months, the experimental group had significantly greater grip strength(t=2.12, p=.04), back muscle strength (t=2.42, p=.02), balance (t=5.31, p<.001), and flexibility (t=3.57, p<.001). They also showed significantly greater bone mineral density of lumbar spine and femur, and reduced fracture risk. CONCLUSION: Tai Chi exercise was safely and effectively used with institutionalized elders for 6 months and significantly improved physical fitness, bone mineral density along with a reduction in fracture risk. Whether Tai Chi exercise would lead to prevention of fall episodes and fall related fractures in this population will require further study.

Changes in Pain, Mood and Posttrauma Risk Level of Patients with Acute Hand Microsurgery / 재활간호학회지

PURPOSE: The purposes of this study were to explore changes in pain, mood and the level of posttrauma risk for 2 weeks after acute hand microsurgery and determine predictors of pain 2-week after microsurgery. METHOD: Using a sample of 84 patients with hand microsurgery, pain, mood, and posttrauma risk were measured by the Brief Pain Inventory-Korea, the modified Profile of mood states, and the Posttrauma risk checklist at 1-day, 1-week and 2-week post-microsurgery. Repeated measures ANOVA and Multiple regression analysis were conducted to evaluate changes in pain, mood, and posttrauma risk over time after the surgery and determine predictors of pain 2-week after the surgery. RESULTS: Pain significantly decreased (F=63.22, p<.001), mood significantly improved (F=41.04, p<.001) 2 weeks after microsurgery and interestingly, posttrauma risk significantly decreased from baseline to 1-week microsurgery but increased at 2-week after microsurgery (F=24.66, p<.001). Approximately 57% of the variance of pain 2-week post-microsurgery was explained by pain at 1-week post-microsurgery, mood and the numbers of injured fingers. CONCLUSION: The findings suggest the pain control for 1week after acute surgery being critical and posttrauma rehabilitation of injured finger being necessary. Developing nursing interventions is urgently needed to help individuals with impending hand microsurgery.

Relationships among Obesity, Bone Mineral Density, and Cardiovascular Risks in Post-menopausal Women / 여성건강간호학회지

PURPOSE: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. METHODS: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. RESULTS: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. CONCLUSION: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.

Relationships among Obesity, Bone Mineral Density, and Cardiovascular Risks in Post-menopausal Women / 여성건강간호학회지

PURPOSE: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. METHODS: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. RESULTS: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. CONCLUSION: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.

Concept Analysis: Deconditioning / 재활간호학회지

PURPOSE: The purpose of this study was to explore the concept of deconditioning within the field of nursing allied health sciences. METHOD: The concept analysis method described by Walker and Avant(1995) was used. Critical attributes, antecedents, consequences, and empirical referents were identified. Also model, borderline, contrary and related cases were proposed. RESULTS: The definition of concept 'deconditioning' was a decrease in the function of general system that occured after long periods of immobility and might be marked by frail upon return to normal conditions. The attributes of deconditioning were as follows; 1) the deconditioning was caused by lengthening of physical inactivity; 2) the deconditioning state was resulted by respiratory system, cardiovascular system, musculoskeletal system, hematologic system and generalized manifestation; 3) the deconditioning state could be reconditioned. 4) The reinforced functions by exercise could be compromised by physical inactivity. CONCLUSION: Deconditioning is important concept in nursing practice since it occurs commonly in any patients who lack physical activity for long time and affects many aspects of clinical outcomes, but it could be reversible by nurses' efforts.

Task Analysis of the Job Description of Rehabilitation Nurse based on DACUM / 재활간호학회지

PURPOSE: The aim of this study was to develop and to analyze the duty and the task of rehabilitation nurse in Korea. METHOD: The definition of rehabilitation nurse and job description was developed based on developing curriculum(DACUM) by panels who have experienced in DACUM analysis and rehabilitation nursing. 228 nurses who were working at rehabilitation centers and rehabilitation unit in general hospitals were participated. The questionnaire included frequency, importance, and difficulty of duties and tasks. The data were collected in March and April 2009, analyzed by descriptive statistics. RESULTS: The job description of rehabilitation nurse in Korea revealed 11 duties, and 61 tasks. On the all 11 duties, the highest duty in frequency and importance was direct nursing care (2.47+/-.31, 2.77+/-.28) and the highest duty in difficulty was self-development (2.39+/-.48). Among the tasks of duties 'direct nursing care' in 'manage medication' (2.87+/-.35) in frequency, the task 'prevent and manage bedsore' (2.91+/-.31) of duty 'direct nursing care' in importance, and 'cope emergency situations' (2.72~.49) of duty direct nursing care in difficulty showed the highest degree. CONCLUSION: The political efforts for the legislation of role and task of rehabilitation nurse were needed.

A Study about Elder Abuse Experiences of Elderly People / 재활간호학회지

PURPOSE: This study was to explore elderly people's elder abuse experiences, and the relations between the abuse experiences (direct and indirect) and their level of activities of daily living, family relations and self-integrity. METHOD: A descriptive survey was conducted, and the participants were 108 elderly people. Data were analyzed using SPSS by descriptive statistics and t-test. RESULT: It was that indirect abuse experiences of the elder was higher than direct abuse experiences. In this research, the most common kind of direct elder abuse was 'psychological abuse and negligence', and the severity was low. The largest portion of indirect abuse experiences belonged to 'physical abuse and negligence', and the severity was high. The older people who had direct abuse experiences showed lowered self-integrity and serious family problems and stress. CONCLUSION: The experiences of elder abuse showed differences in family relations and self integrity. Hence, there should be a nursing intervention improving psycho-social factors such as self integrity and family relations, and systematic and easily available supporting organizations for victims of elder abuse.

Factors Influencing Fear of Falling in Postmenopausal Women / 여성건강간호학회지

PURPOSE: The study was to identify influencing factors on fear of falling in postmenopausal women. METHODS: With a correlational survey design, 125 postmenopausal women were recruited at the D metropolitan city by a convenience sampling. Fracture risk status was assessed by bone mineral densities (BMD) at lumbar and femur with DEXA method. A structured study questionnaire was used to measure demographic variables, osteoporosis self-efficacy, and fear of falling. RESULTS: Mean age of the subjects was 59 years old and duration since menopause was 9.55 years. Twenty six percent of the subjects belonged to osteoporotic group in fracture risk status. Mean score for fear of falling was 16.10 (SD=5.18) indicating low level, and osteoporosis self-efficacy for exercise and diet was 44.76 (SD=7.41), indicating mid-range level. Factors influencing the fear of falling was longer time since menopause (beta=.30), lower score of osteoporosis self-efficacy for exercise (beta=-.26), poor health perception status (beta=-.16), and presence of chronic disease (beta=.16), and the explained variance was 20%. CONCLUSION: Although the level of fear of falling was yet low in postmenopausal women, women who had lower self-efficacy of osteoporosis for exercise and poorer health perception felt greater fear of falling. Therefore, an educational program specific to improve osteoporosis self-efficacy and reduce the fear of falling is needed for improving postmenopausal women's psychosocial well-being.

A Comparative Study on the Level of Perceived Stigma Towards Physically Disabled Between Physically Disabled and Non-disabled / 재활간호학회지

PURPOSE: The purposes were to explore and compare the level of perceived stigma toward physically disabled, and to find factors related with the perceived stigma. METHOD: Data were collected by structured questionnaire from July to September 2007. The participants consisted of 292 physically disabled and 294 non-disabled living in Daejeon, Korea. These data were analyzed using SPSS Win 12.0 by descriptive statistics, Chi-Square test, t-test, one-way ANOVA. RESULT: The perceived stigma towards physically disabled of the physically disabled was higher than non-disabled's. The physically disabled stigmatized themselves in all the subcategories of the perceived stigma. The physically disabled perceived the stigma differently according to the spouses, economic status, educational level, comorbidity and impairment sites. The non-disabled's perceived stigma was different according to gender, existence of spouses, job and economic status. Non-disabled's stigma towards physically disabled was not different by experiences related with physically disabled. CONCLUSION: For reducing the perceived stigma, nursing intervention strategies should be developed, especially for physically disabled, and further studies should be conducted to define related factors. The results of this study might be a standard to evaluate effects of nursing interventions for decreasing the stigma.

Parenting Experience of Parents with a Disabled Child / 재활간호학회지

PURPOSE: This study used a phenomenological method, which is a qualitative study, in order to understand the vivid experience of parents who have a disabled child. METHODS: The number of participants was 10. The subjects of this study were parents who are raising their disabled child who attends a special school or normal middle or high schools in D city. The period for collecting materials was from September 2005 to July 2007. The phenomenological analysis method suggested by Giorgi was used. RESULTS: The meanings of the child parenting experience of parents with a disabled child are (1) feeling of frustration of the delayed treatment, (2) difficult to accept the diagnosis of disability, (3) having eyes centered on her child, (4) accepting the disabled child, (5) giving all his energy to his disabled child, (6) making efforts for his family's unity, (7) recognizing the difficulty of parenting disabled child, (8) recognizing the difficulty of education for disabled child, (9) feeling pitiful for his their normal children, (10) planning for disabled child's future. CONCLUSIONS: All the programs for disabled child should be programed for their entire life. It is necessary to provide physical, psychological, emotional, social and economic nursing intervention to relieve or reduce the burden of parents with disabled children.

The Relationship of Powerlessness, Sense of Belonging and Nutritional Status in the Elderly / 재활간호학회지

PURPOSE: The aim of this study was to explore the relationship between powerlessness, sense of belonging and nutritional status of the elderly. METHOD: The study sample was 100 living at home and institutions. Data were collected by interview from Oct. to Dec. in 2003. The instruments were helplessness scale developed by Jung (1998), sense of belonging scale SOBI-A and nutritional initial screening. RESULT: The mean score of powerlessness was 2.71+/-.30, sense of belonging was 2.87+/-.19, and nutritional status was 4.42+/-.34. There was a statistically significant differences in powerlessness according to age (F=3.185, p=0.027), health status (F=6.945, P=0.002), religion (F=5.941, P=0.001), current spouse (t=-0.384, p=0.026), in sense of belonging according to age (F=4.40, P=0.006), length of education (F=10.64, P=<.0001) and in nutritional status according to age (F=3.34, P= 0.022), health status (F=2.86, P=0.027). There was a statistically significant correlation between powerlessness and nutritional status (r=0.219, p=0.029). CONCLUSION: Nurses are able to decrease powerlessness or increase sense of belonging and nutritional status of the elderly by developing the health promotion program, improving perceived health status and empowering social interaction of the elderly specifically living at institutions.

Comparing Clinical Usefulness of Cognitive Function Tests (CDT, K-MMSE, K-3MS, CDR) in Dementia Patient / 재활간호학회지

PURPOSE: The purpose of this study was to examine the cognitive function and degree of dementia patient by doing clock drawing test and to explore the relationship among other dementia screening test. METHOD: The study subjects were 94 dementia in patients department. The data was collected by face to face interview by clinical psychologist from January 2007 to February 2008. The tools were Clock Drawing Test, K-MMSE, K-3MS and CDR Scale. RESULTS: 1) The average score of CDT was 5.13 (2.54), of K-MMSE was 20.53 (4.85), of K-3MS was 61.66 (16.46), and of CDR was 1.2 (.72), those scores showed dementia. 2) There was a statistically the significant difference in CDT (F=2.83, p=.043) and CDR (F=2.00, p=.008) by age. CDT has shown the differences by gender (t=-2.42, p=.018) and education (F=7.66, p=.000). 3) There were significant relationships between CDT and K MMSE (r=-.294. p=.004), K-3MS (r=-.335, p=.001), and CDR (r=.286, p=.008). CONCLUSION: It is believed that using CDT which measures the visuospatial ability of dementia patients and K-MMSE which assesses an ability of language and orientation and K-3MS at the same time helps examining the beginning and the progressive degree of dementia more easily and objectively.

Effects of Tai Chi Exercise Program on Physical Fitness, Fall related Perception and Health Status in Institutionalized Elders / 간호학회지

PURPOSE: The purpose was to identify the effects of a Tai Chi exercise program on physical fitness, fall related perception and health status among institutionalized elderly. METHODS: A quasi-experimental research was carried out with a nonequivalent control group pretest-posttest design. There were 23 subjects in the experimental group and 24 in the control group. The data was gathered by structured questionnaires about fall related perception, and health status. Physical fitness was measured by an exercise therapist with a blind principle. RESULTS: At the completion of the 12 weeks Tai Chi exercise program, flexibility (F=4.50, p=.00), and ability to balance (F=3.27, p=.00) had increased significantly. Fall related perception showed significant improvement in the fear of falling (F=-3.52, p=.00). Physical functioning (F=3.38, p=.00), role limitationphysical (F=2.67, p=.01), role limitation-emotional (F=2.47, p=.02). and general health (F=3.88, p=.00) in health status showed significant differences between the two groups. CONCLUSION: The study findings revealed Tai Chi exercise as a useful nursing intervention for elderly that enhances flexibility and balance, decreases fall related perception and also increases the health status. Further research is warranted to compare the potential effects of Tai Chi exercise and its health benefits from other types of exercise or martial arts.

Effects of the Nutrition Education Program on Self-efficacy, Diet Behavior Pattern and Cardiovascular Risk Factors for the Patients with Cardiovascular Disease / 간호학회지

PURPOSE: This study examined the effects of a nutrition education program on self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease (CVD). METHOD: Sixty-four CVD subjects (37 experimental, 27 control) were recruited from a cardiac center, at a university hospital located in D city, Korea. All subjects attended a first heart camp where pretest measures were performed, and a second heart camp at 6 months for the posttest measures. During the 6 month study period, the experimental group was required to attend five monthly nutrition education sessions, while the control group received only routine outpatient follow-ups. Data were analyzed by chi-square-test and independent t-test using the SPSSWIN 11.5 program. RESULT: Group comparisons revealed that the experimental group had significantly more improved self-efficacy, frequency of food selection, gustation of salt, systolic blood pressure, and serum total-cholesterol compared to the control group. CONCLUSION: A nutrition education program may be effective in improving self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease.

Applicability and Program Effects of Tai Chi Exercise in Outpatients with Coronary Artery Disease / 성인간호학회지

PURPOSE: The study aimed to apply Tai Chi exercise to patients with coronary artery disease for 6 months, and to examine changes on body composition, physical strength, and cardiovascular risks. METHODS: Applying a quasi experimental design with a nonequivalent control group, 90 subjects with cardiovascular disease were recruited at C university hospital. For 6 months, 44 subjects performed Tai Chi exercise once a week and daily home exercise, while 46 subjects did not. Body composition was assessed by body mass index, % body fat, and waist-hip ratio; physical strength by balance, mobility, flexibility, grip strength, and back muscle strength; and cardiovascular risk checklist for fixed and modifiable risk factors. Data were analyzed by SPSS/WIN program with ANCOVA to consider group differences at the pretest. RESULTS: The subjects were 66 years old in average. In 6 months, Tai Chi group improved significantly in balance, mobility, and flexibility with decreased modifiable cardiovascular risks after adjusting for the pretest scores. CONCLUSION: Tai Chi exercise was safely applicable to individuals with coronary artery disease, and effective in some measures of physical strength and modifiable cardiovascular risks. It could be an alternative exercise for outpatient cardiac rehabilitation program in this population.

Cognitive and Physical Function by the Social Disengagement in Institution and Community Living Elderly / 재활간호학회지

PURPOSE: This study was conducted to compare the level of cognitive and physical function by the level of social disengagement in institutions and community dwelling elderly. METHOD: The study subjects were 209 people whose age ranged from 65 to 94. The data were surveyed with social disengagement index, MMSE-K, and ADL, and analysed by SPSS 11.0 using frequency, t-test, ANCOVA and ANOVA. RESULTS: 1) The level of social disengagement was 1.67 in institution and 3.25 in community elderly, and showed statistically significant difference (F=41.07, p<.001). 2) There were statistically significant difference in MMSE-K (F=15.51, p<.000), and activity of daily living (F=9.65, p=.002) between two residence after control the age, gender, religion, allowance and number of children. 3) There were statistically significant difference in MMSE-K (F=6.55, p=.002) by social disengagement in community dwelling elderly. CONCLUSIONS: Programs for successful aging to reduce social disengagement should be developed that stimulate social activities and then improve cognitive function for the elderly. For these, establishing social policies in nation and local government is needed. Especially, these policies should be conducted among the elderly with low-income living in institutions.