Family Characteristics, Family Support, Family Function and Compliance of Patient Role Behavior in Long-term Hemodialysis Patients / 재활간호학회지

PURPOSE: The purpose of this study was to examine the role of family to the compliance of patient role behavior in long-term hemodialysis patients. METHODS: In this descriptive correlational design, 103 participants recruited from 3 hemodialysis clinics at D city. They completed the self-reported questionnaire including family characteristics, family support, family function, and compliance of patient role behavior. All participants have family and are undergoing regular hemodialysis more than 1 year. RESULTS: Among patient's characteristics, compliance of patient role behavior was significantly different by standard of living, burden of treatment, marital status, experience of hospitalization, perceived health status, kidney transplantation plan, and depression. Experience of hospitalization, perceived health status and family support explained 31.9% of the variance in the compliance of patient role behavior (R2=.319, F=5.34, p=.001). CONCLUSION: Family support is important for compliance of patient role behavior in the long-term hemodialysis patients. Therefore it is recommended that the family must be included to improve compliance of patient role behaviors.

Care Dependency of Post-stroke Patients and Its Affecting Factors / 재활간호학회지

PURPOSE: This study was aimed to identify the care dependency and its affecting factors of post-stroke patients. METHODS: Cross-sectional and correlational descriptive study design was used. The subjects were 106 post-stroke patients who were in or out-patients in a rehabilitation clinic at D city. Demographic, stroke related and post-stroke status variables (paralysis, arthria, verbal expression, visual disturbance, activity intolerance, nutritional status, depression and cognition) were included as affecting factors. Multiple regression was used to identify the affecting factors. Among demographic and stroke-related variables, significant variables such as age, education level, marital status, financial status, location of treatment, and total admission days were entered with post-stroke status variables. RESULTS: Care dependency was still high regardless of disease duration or type of stroke. Overall, approximately 80.5% of total variances in care dependency was explained with all variables. Among those variables, nutritional status, cognition and activity intolerance were the significant affecting factors. CONCLUSION: To reduce the care dependency of post-stroke patients, it is recommended to improve nutritional status, cognition and activity intolerance.

Performance, Delegation, Job Importance and Education Needs for Tasks of Rehabilitation Nurses / 재활간호학회지

PURPOSE: The aim of this study was to identify performance, delegation, job importance and education needs for duties and tasks perceived by rehabilitation nurses. METHODS: Performance, delegation, job importance and education needs in regard to 11 duties and 57 tasks were surveyed 191 nurses who worked at the rehabilitation unit. RESULTS: Performance, job importance and education needs were high in most duties and tasks. Performance was significantly correlated with job importance. Job importance and education needs was also significantly correlated. Direct care was the highest duty in performance, job importance, and education needs. Psycho-social care, coordination, and self-development were high in job importance but low in performance. Psycho-social care, managing mobility disorder, and dysphagia care were most delegated duties. The most delegated person were employed caregiver/careworker, followed by nurse aid, and family members. CONCLUSION: The educational strategies and opportunities were needed for the rehabilitation nurses and delegated persons.

The Effects of Life Style Modification on Constipation of the Older Adults at a Geriatric Hospital / 재활간호학회지

PURPOSE: This study aimed to evaluate the effects of lifestyle modifications on the constipation relief, the time required to see the effects, and the effective lifestyles for constipation in older adults admitted to a geriatric hospital. METHODS: Nonequivalent control group pre-post test design was used. The subjects consisted of 25 elderly in the control group and 23 in the experimental group. Constipation was measured with symptoms of constipation, number of bowel movement and use of laxatives. Life style modification consisted of drinking water before breakfast, having a breakfast, scheduled toileting after breakfast and walking everyday for 3 weeks. RESULTS: Symptoms of constipation (t=2.23, p=.030) and number of bowel movement per week (t=-2.55, p=.014) were significantly different between two groups after 3 weeks. Drinking water, scheduled toileting and walking might contribute to the results. CONCLUSION: Lifestyle modification was effective on constipation in older adults admitted to a geriatric hospital. However, the effects were produced after 3 weeks. Nevertheless, it is recommended that nurses continuously encourage older adults for drinking water, regular trying for bowel movement and walking to relieve constipation, since the lifestyle modification does not need any special education and skill.

Psychometric Properties and Item Evaluation of Korean Version of Night Eating Questionnaire (KNEQ)

PURPOSE: The aim of this study was to develop a Korean version of Night Eating Questionnaire (KNEQ) and test its psychometric properties and evaluate items according to item response theory. METHODS: The 14-item NEQ as a measure of severity of the night eating syndrome was translated into Korean, and then this KNEQ was evaluated. A total of 1171 participants aged 20 to 50 completed the KNEQ on the Internet. To test reliability and validity, Cronbach's alpha, correlation, simple regression, and factor analysis were used. Each item was analyzed according to Rasch-Andrich rating scale model and item difficulty, discrimination, infit/outfit, and point measure correlation were evaluated. RESULTS: Construct validity was evident. Cronbach's alpha was .78. The items of evening hyperphagia and nocturnal ingestion showed high ability in discriminating people with night eating syndrome, while items of morning anorexia and mood/sleep provided relatively little information. The results of item analysis showed that item2 and item7 needed to be revised to improve the reliability of KNEQ. CONCLUSION: KNEQ is an appropriate instrument to measure severity of night eating syndrome with good validity and reliability. However, further studies are needed to find cut-off scores to screen persons with night eating syndrome.

Comparison of the Effects of Hand Massage Provided with Different Intervals and Periods on Pain and Sleep Disturbance after Orthopedic Surgery / 재활간호학회지

PURPOSE: The purpose of this study was to compare the effects of hand massage provided with different intervals and periods on pain and sleep disturbance after orthopedic surgery. METHODS: A non-equivalent control group pretest-posttest design was used. The subjects were admitted in an orthopedic hospital to get a surgery. They were divided into three groups. Group I (n=30) had hand massage every day. Group II (n=30) had hand massage every other day. Control group (n=31) had usual care. Data of all three groups were collected on the day before operation, POD (postoperative day) 6 and POD12. Hand massage was given for 2 and half minutes per hand. RESULTS: Pain on POD6 of experimental group II was reduced more than those of control group. Pains on POD12 of both experimental groups were reduced more than those of control group. On POD6, only perceived sleep disturbance (PSD) was significantly different among groups. On POD12, PSD, total sleeping time, and sleep efficiency were more improved in the experimental groups. CONCLUSION: Hand massage was effective on the reduction of pain and sleep disturbance after orthopedic surgery. Applying hand massage on alternate day was effective enough. Also the effects were more obvious after 12 days.

Effects of Letter on the Family Functioning, Fear of Death, and Depression among the Terminally Ill Cancer Patients / 재활간호학회지

PURPOSE: To improve the family functioning, fear of death and depression among the terminally ill cancer patients, the effects of letter as an independent nursing intervention were identified. METHODS: Non-equivalent control group pre and post test design was used. Subjects were 60 patients and their family members who were hospitalized at hospice units of an university-affiliated hospital. Patients and their family members were encouraged to write a letter to each other at least 4 times for 2 weeks. RESULTS: Family functioning, fear of death and depression in the experimental group were significantly more improved after intervention than those of control group, even depression of experimental group before intervention was worse than that of control group. CONCLUSION: Writing a letter to family members is worth to use as an independent nursing intervention for terminally ill patients. It is recommended that further study to identify the potential of letters as an independent nursing intervention is implemented for various patients.

Psychometric Properties of Korean Version of Modified Leeds Sleep Evaluation Questionnaire (KMLSEQ) / 재활간호학회지

PURPOSE: The Leeds Sleep Evaluation Questionnaire (LSEQ) translated into Korean was modified to easily apply and reduce respondents' confusion and was evaluated for psychometric properties and discriminant ability. METHODS: A total of 960 Korean adults aged 45 years and older participated in this cross-sectional survey. To test reliability, validity and discriminant ability, Cronbach's alpha, correlation analysis, confirmatory factor analysis, simple regression analysis and receiver operating characteristics (ROC) curve analysis were used. RESULTS: Item-total correlations ranged between .62~.85 and Cronbach's alpha was .95. Area under ROC was .86 (95% CI: .83~.90) and the optimal cutoff score was identified as < or = 66 (sensitivity, .77; specificity, .84; positive/negative predictive values, .49/.95). Using this cutoff score, the prevalence of insomnia in the study sample was 25.8% and tended to be more common in female and older groups. CONCLUSION: The data supported the psychometric properties of Korean Modified Leeds Sleep Evaluation Questionnaire (KMLSEQ) as an acceptable sleep measurement. In addition, KMLSEQ is likely to be a useful screening tool for insomnia.

Psychometric Properties of Korean Minimal Insomnia Screening Scale

PURPOSE: The purposes of this study were to develop a Minimal Insomnia Screening Scale for Korean adults (KMISS) and to evaluate psychometric properties and discriminant ability of the developed scale. METHODS: Data from a cross-sectional survey of 959 Korean adults were analyzed to develop the summated insomnia scale, which was evaluated in terms of reliability, validity, and discriminant ability by receiver operating characteristics (ROC) curve analysis. RESULTS: Item-total correlations ranged between .71-.79 and Cronbach's alpha was .87. Adequate validity was also evident. ROC-curve analysis showed area under ROC was .87 (95% CI: .84-.90) and identified the optimal cut-off score as < or = 20 (sensitivity, .83; specificity, .75; positive/negative predictive values, .40/.95). Using this cut-off score, the prevalence of insomnia in the study sample was 26.3% and most frequent among women and the oldest group. CONCLUSION: Data supports the psychometric properties of KMISS as a possible insomnia screening instrument. KMISS also shows promise as a convenient ultra-short screening measure of insomnia for adults and epidemiological studies in community health care settings.

Korean Versions of Self-reported Sleep Questionnaires for Research and Practice on Sleep Disturbance / 재활간호학회지

PURPOSE: To identify Korean versions of self-reported sleep questionnaires for cross-cultural research and practice on sleep disturbance, we searched self-reported sleep questionnaires which have been developed to measure general sleep patterns. They should be qualitative, easy to take permission, do not obligate to pay, do not need any skill or professional help for scoring and have been reported high reliability and validity. METHODS: General Sleep Disturbance Scale (GSDS), Leeds Sleep Evaluation Questionnaire (LSEQ), and Pittsburgh Sleep Quality Index (PSQI) were identified based on all criteria. Korean version of GSDS, LSEQ, and PSQI were developed according to the methods combined the guidelines for the process of cross-cultural adaptation of self-reported measures with decentering method. RESULTS: Three Korean versions of self-reported sleep questionnaires were suitable for epidemiological study. They are not full length and easy to read. It requires less than 10 minutes for each subject to complete as well as for researchers to score. CONCLUSION: Psychometric analysis study is necessary to evaluate the reliability and validity of those Korean versions of self-reported sleep questionnaires.

Analysis of Studies on Hand Massage Published in Korea: On the Effects of Sleep, Pain, Anxiety and Depression / 재활간호학회지

PURPOSE: To identify the feasibility and provide the direction for future studies regarding hand massage, studies on hand massage published in Korea were analyzed. METHODS: Using the key word of hand massage, 23 studies which identified the effects on sleep, pain, anxiety and depression were found. They were analyzed on research tendency and effects. Research tendency was analyzed in terms of published year, methods, study design, sample characteristics, and outcome variables. Effects were analyzed with hypothesis testing and effect size. RESULTS: Among 23 studies, 60%(14 studies) were about hand massage and others (9 studies) were about aroma hand massage. The most prominent outcome variables were physiological and cognitive/emotional ones. To improve sleep, hand massage over 60 minutes was necessary while pain and anxiety were improved in the studies which less than 10 minutes hand massage was applied. Aroma hand massage was more effective than hand massage. Effect size for anxiety and depression was larger than those of sleep and pain. CONCLUSION: Hand massage and aroma hand massage are recommended to improve anxiety and depression as an independent nursing intervention. More randomized clinical trials are necessary to increase the validity and identify the effects of hand massage on sleep, pain, anxiety and depression.

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.

Perceived Illness Intrusiveness by the Characteristics of Primary Caregivers in Stroke Patients / 재활간호학회지

PURPOSE: This study was implemented to investigate perceived illness intrusiveness in stroke patients by the characteristics of primary caregivers. METHOD: Retrospective cross-sectional survey design was used. The subjects were 225 stroke patients and their primary caregivers. Demographic variables, relationship variables, burden, depression and support were measured as primary caregivers' characteristics. Data were analyzed with SPSS win 14+. T-test, ANOVA and correlation test were used depending on variables. RESULT: Demographic variables such as age, gender, relation with patients, and living status were not related significantly with illness intrusiveness. But primary caregivers' burden, depression and support were related significantly with perceived illness intrusiveness of stroke patients. That is, burden, depression and quantitative support of primary caregivers were significantly positively correlated with perceived illness intrusiveness of stroke patients. On the other hand, qualitative support was negatively correlated with perceived illness intrusiveness. CONCLUSION: Primary caregivers' characteristics such as burden, depression and support were found to be correlated with stroke patients perception such as illness intrusiveness. So, it is recommended that nursing intervention targeting burden, depression and support of primary caregivers must be developed to reduce illness intrusiveness of stroke patients.

The Effects of Respiratory Rehabilitation Training on Respiratory Functions of Cervical Spinal Cord Injury Patients / 재활간호학회지

PURPOSE: This study was to investigate the effects of respiratory rehabilitation training on the respiratory functions of hospitalized cervical spinal cord injury patients. METHODS: One group pre and post test design was used. Subjects were 20 cervical spinal cord injury inpatients of the national rehabilitation center. Training program consisted of air cumulation training, manual assisted coughing training, and abdominal breathing. Trained rehabilitation nurse implemented 20 minutes program twice a day for 4 weeks. Respiratory function was measured as peak coughing flow rate, and perceived respiratory difficulty after activity on wheel chair for 30 minutes and during speaking and singing. Perceived respiratory difficulty was measured with modified Borg scale. Also content analysis was done with the result of open ended question about subjective feeling about training. All variables were measured 3 times before, 2weeks and 4 weeks after the program. RESULTS: Peak coughing flow rate significantly improved after compared to before training. Also all three perceived respiratory difficulty variables decreased significantly after training. In the content analysis, 'it's easier to cough up phlegm' was the most frequent answered subjective feeling. 'Sound at speaking and coughing became louder', 'respiratory volume increased', and 'comfortable chest feeling' were frequent answered subjective feeling, in order. CONCLUSION: Although it is preliminary since no control group, respiratory rehabilitation training was found to be effective to improve respiratory function in terms of peak coughing flow rate, perceived respiratory difficulty, and subjective feeling. It is necessary further systemic research to investigate the effects of respiratory rehabilitation training.

The Effects of Abdominal Meridian Massage on Constipation in Institutionalized Psychiatric Patients Taking Antipsychotic Drugs / 성인간호학회지

PURPOSE: It was investigated if abdominal meridian massage has effects on constipation in institutionalized psychiatric patients taking antipsychotic drugs. METHODS: According to the constipation screening tests, 22 patients were selected as subjects. One group pre and post repeated measurement design was used. Constipation was operationalized as perceived constipation, frequency of defecation, frequency of bowel sound, and number of medicine taken to relieve constipation. Abdominal meridian massage was given for two weeks, 10-15 minutes each time and 10 times in total. RESULTS: Perceived constipation, frequency of bowel sound, and number of medicine taken were significantly improved after massage. Except for number of medicine taken, the effects on perceived constipation and frequency of bowel sound were found to be persistent 2 weeks after massage. CONCLUSION: Based upon these results, abdominal meridian massage was recommended as independent nursing intervention for the relief of constipation in psychiatric patients who taking anti-psychotic drugs. Further studies to investigate the maximal duration time of effects and whether the effects of intermittent application of this method is more beneficial than the continuous application of this method are necessary.

Illness Intrusiveness by Symptoms in Patients with Rheumatoid Arthritis / 성인간호학회지

PURPOSE: Illness intrusiveness (illness induced lifestyle disruption) by symptoms was investigated in 439 patients with rheumatoid arthritis. METHOD: The cross-sectional and retrospective survey design was used. Fatigue, disability, pain, and depression were considered as symptoms of rheumatoid arthritis. RESULT: Patients were reported to perceive more illness intrusiveness than other chronic disease patients such as end stage renal disease, bipolar disorder, and peritoneal dialysis patients. They were especially intrusive into work, health, and active recreation domains. Stepwise regression analysis identified four variables counting for 26% of illness intrusiveness variances: fatigue, disability, marital status, and depression. All of the symptoms except pain were found to significantly predict illness intrusiveness. Fatigue explained 16% of illness intrusiveness variances. CONCLUSION: Fatigue and depression usually overlooked by health professionals must be carefully assessed and managed to reduce perceived illness for rheumatoid arthritis patients.

The Relationship between the Characteristics of Social Support and Post-Stroke Depression / 재활간호학회지

The effects of social support on post-stroke depression were investigated. Social support was classified into three categories: primary caregiver's. significant other's. and professional support. And primary caregiver's and significant other's support were divided into their relation, living state (which means they living together or not), frequency which they met at. and perceived satisfaction about the support, respectively. Professional support was divided into number of professionals who take care of. frequency they met at. and perceived satisfaction. The subjects were 254 stroke patients who had been discharged and were taken follow-up care at the outpatient department. The depression was measured using CES-D. Out of the primary caregiver's support. only relation and perceived satisfaction were identified to affect the post-stroke depression. The patients who primarily their spouse takes care of were less depressed than those who their adult children take care of. None of the significant other's support affects the post-stroke depression. Only perceived satisfaction of the professional support was found to affect the post-stroke depression. So it was found that the quality, not the amount, of care was important to post-stroke depression. These results also support the claim that the facilities and teaching programs for primary caregivers are necessary

The Related Factors of Self-Efficacy in Patients with Rheumatoid Arthritis / 성인간호학회지

The demographic, psychological, social and disease characteristics were analyzed to find the sources of self-efficacy(the expectation about one's ability to engage in or execute in a behavior) in the 297 patients with rheumtoid arthritis. Except for religion and client's job, the demographic characteristics such as age. sex, partner's job, income, and educatioa] level were found to be significantly related to self-efficacy. In the group of older age, female, lower income, job with less prestige, and lower educational level, the self-efficacy was lower than the other group. Depression which measured as psychological characteristics was significantly related to self-efficacy. Social characteristics, such as social support and relationship with health professionals, were positively related to self-efficacy except for social network. Getting a high score in the area of relationship with health-professionals means that the giatients perceive that they can express themselves or decide on their own activities as much as they want. Among the disease characteristics, only disease cLlration was not significantly related to self-efficccy. The self-efficacy shows a tendency to decrease with time. Pain was negatively related to self-efficacy, Possible activity level was positively related to self -efficacy. To analyze the variables which affect self-efficacy, stepwise regressicn was implemented. As a re sult, about 42% of the self-efficacy were explained by possible activity leveI, depression, social support, and pain in that order. Based upon these results, it is recommended that the nurses who are in change of or maintain the behavior of patients wth rheumatoid arthritis consider the demographic characteristics such as age, sex, et al. Also programs which decrease the pain and depression and increase the social support and activity levels are recommended to be developed.

Readjustment and Social Support of the Post Hospitalized Stroke Patients / 간호학회지

An explanatory design was employed to identify the relationship of physical, emotional & social readjustment and social support of post hospitalized stroke patients and their caregiver. A convenient sample of 254 patients who given follow-up care at the outpatient department after discharge and 225 caregivers were recruited. Mental Status Questionnaire(MSQ), Social Support Inventory Stroke Survivors(SSISS), Illness intrusiveness(II), Instument Activity of Daily Living(IADL), Center of Epidnmilogic Studies-Depression(CES-D), social activity and caregiver burden were used for measurement in this study. Results showed patient's physical level measured by IADL and psychological level measured by depression were high. But social activity was low. Cognitive function, depression & social activity were not significantly different by the posthospitalized period, but IADL was. The source of professional support was mostly the physician at the outpatient department. The family support was found significantly related to patient's depression & social activity and caregiver's subjective related to patient's IADL & depression. ILLness intrusiveness as a mediating variable was a significantly predicting power on patient's IADL & depression. The path analysis was used to identify the variables to predict the physical, emotional, and social status of patients, the physical, emotional, and cognitive function, illness intursiveness and professional support significantly predicted the level of siveness and family support significantly predicted the level of depression ; and patient's age and family support significantly predicted the level of social activity of posthospitalized stroke patients. Based upon these results, the rehabilitation programs to reduce the illness intrusiveness and improve cognitive function were recommended for the readjustment of the stroke patients. This model of the readjustment of the posthospitalized stroke patients is recommended as the framework for care of the stroke patients.

Related Factors of the Quality of Life in Stroke Patients / 재활간호학회지

The related factors of the quality of life (QOL) in stroke patients was identified empirically. The subjects were 254 stroke patients who were discharged and taken follow-up care at the outpatient department. In this model, the physical, psychological, and social status were assumed to affect the QOL. And the social support was assumed to moderate these effects. NIH stroke state, ADL, and IADL were used to measure the physical status. Using CES-D, the psychological status was measured. The social status was defined as the job change after stroke attack. The satisfaction with the care by primary caregivers, significant others, and health professionals was measured as the social support. To identify the effect of the physical, psychological, and social status on the QOL, multiple regression analysis was carried out. The psychological and social status were found to be the significant predictors of the QOL(R2=0.27, p=0.00). Next, to identify the moderating effect of the social support, the subjects were divided into two groups, that is, the low social support group and the high social support group. It is found that the predicting variance is different between these two groups. In the low social support group, the psychological, social, and physical status predicted as much as 42% of the QOL. On the contrary, the psychological status predicted only 8% of the QOL in the high social support group. So it is concluded that the social support moderates the effects of the physical, psychological, and social status on QOL. Finally, to identify the social support which moderates those effects, the social support was divided into three classes. Each social support class was divided into the low and high social support group again. In the every class of social support, the difference between two groups was also identified. So the model of the QOL is recommended for the framework of the care for the stroke patients. Also these results support the claim that the long-term facilities for stroke patients are necessary.