Influence of Resilience and Social Support on Body Image of Patients in an Acute Stage Following Traffic Accidents / 기본간호학회지

Purpose@#The purpose of this study was to identify the relationships between resilience, social support, and body image in patients in an acute stage following traffic accidents and to investigate factors affecting body image. @*Methods@#Data were collected from 86 patients at local hospitals from January 2019 to February 2020. To measure the variables, the body image scale, Conner-Davidson Resilience Scale, and Multidimensional Scale of Perceived Social Support were used. Data were analyzed using descriptive statistics, independent t-tests, analysis of variance, Pearson correlation coefficient, and multiple regression. @*Results@#Mean age of participants was 43.40±14.75 and the proportion of men was 73.3%. The average score for resilience, social support, and body image were 65.16±16.89, 72.93±8.11, and 12.24±6.63, respectively. The highest item on the body image scale was “Are you dissatisfied with the appearance of your scar?”. There were differences in scores for body image according to gender, age, and living status. Resilience (r=-.68, p<.001) and social support (r=-.65, p<.001) were negatively correlated with body image. In the regression model, resilience (β=-.41), social support (β=-.30), and gender (β=.22) accounted for 57.6% of the variance in body image. @*Conclusion@#Resilience and social support were identified in this study as significant factors protecting body image of patients during the acute stage following a traffic accident. It is recommended that psychosocial nursing interventions be conducted throughout the course of treatment.

The influence of health literacy competencies on patient-centered care among clinical nurses / 한국간호교육학회지

Purpose@#The aim of this study was to identify the relationships between health literacy competencies and patient-centered care among clinical nurses. @*Methods@#The participants of this study were 254 nurses working in two hospitals in the D region. The data were collected from July to August 2020. The health literacy competencies for registered nurses scale and individualized care scale were utilized. Descriptive statistics, independent t-test, ANOVA, Pearson’s correlation coefficient and multiple regression analysis were used for data analysis. @*Results@#The mean of health literacy competencies was 3.16±0.31 points on a four-point scale, and the average of patient-centered care was 3.69±0.50 points on a five-point scale. Regarding the nurses’ general characteristics, patient-centered care showed significant differences according to age (F=4.68, p=.010), marital status (t=-2.38, p=.018), religion (F=3.03, p=.030), total clinical experience (F=2.94, p=.021) and prior health literacy knowledge (t=3.20, p=.002). As a result of a hierarchical multiple regression analysis, health literacy competencies (β=.63) were found to significantly influence patient-centered care. The explanatory power of the model was 41.0% (F=25.58, p<.001). @*Conclusion@#The study suggests that nurse’s health literacy competencies should be developed in order to improve patient-centered care. Nursing education should include an emphasis on integrating health literacy into the nursing school curriculum.

The influence of health literacy competencies on patient-centered care among clinical nurses / 한국간호교육학회지

Purpose@#The aim of this study was to identify the relationships between health literacy competencies and patient-centered care among clinical nurses. @*Methods@#The participants of this study were 254 nurses working in two hospitals in the D region. The data were collected from July to August 2020. The health literacy competencies for registered nurses scale and individualized care scale were utilized. Descriptive statistics, independent t-test, ANOVA, Pearson’s correlation coefficient and multiple regression analysis were used for data analysis. @*Results@#The mean of health literacy competencies was 3.16±0.31 points on a four-point scale, and the average of patient-centered care was 3.69±0.50 points on a five-point scale. Regarding the nurses’ general characteristics, patient-centered care showed significant differences according to age (F=4.68, p=.010), marital status (t=-2.38, p=.018), religion (F=3.03, p=.030), total clinical experience (F=2.94, p=.021) and prior health literacy knowledge (t=3.20, p=.002). As a result of a hierarchical multiple regression analysis, health literacy competencies (β=.63) were found to significantly influence patient-centered care. The explanatory power of the model was 41.0% (F=25.58, p<.001). @*Conclusion@#The study suggests that nurse’s health literacy competencies should be developed in order to improve patient-centered care. Nursing education should include an emphasis on integrating health literacy into the nursing school curriculum.

Health-Related Quality of Life Based on Comorbidities Among Patients with End-Stage Renal Disease

ObjectivesThe aim of this study was to investigate comorbidities in patients with end-stage renal disease, and to compare health-related quality of life (HRQOL) according to the type, and number of comorbidities.MethodsA total of 250 adults undergoing hemodialysis were recruited at local clinics. HRQOL was measured using the 12-item Medical Outcomes Study Short Form questionnaire. Data were analyzed using descriptive statistics, analysis of variance, and t test.ResultsAround 70.8% of patients with end stage renal disease had 1 or more comorbidities, and the most common comorbidities were hypertension, diabetes, and cardiovascular disease. HRQOL was significantly different based on the number of comorbidities (F = 9.83, p < 0.001). The effect of comorbidities on the scores for mental health domains of the HRQOL questionnaire was not conclusive compared with the scores for the physical domain which were conclusive. Among the comorbidities, diabetes was associated with a lower quality of life.ConclusionThe customized management of diabetic and hypertensive patients is necessary for the early detection and prevention of chronic kidney disease, and slowing the progression of renal disease and managing cardiovascular risk factors is essential.

Structural Equation Modeling of Self-Management in Patients with Hemodialysis

PURPOSE: The purpose of this study was to construct and test a hypothetical model of self-management in patients with hemodialysis based on the Self-Regulation Model and resource-coping perspective. METHODS: Data were collected from 215 adults receiving hemodialysis in 17 local clinics and one tertiary hospital in 2016. The Hemodialysis Self-management Instrument, the Revised Illness Perception Questionnaire, Herth Hope Index and Multidimensional Scale of Perceived Social Support were used. The exogenous variable was social context; the endogenous variables were cognitive illness representation, hope, self-management behavior, and illness outcome. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and structural equation modeling were performed. RESULTS: The hypothetical model with six paths showed a good fitness to the empirical data: GFI=.96, AGFI=.90, CFI=.95, RMSEA=.08, SRMR=.04. The factors that had an influence on self-management behavior were social context (β=.84), hope and cognitive illness representation (β=.37 and β=.27) explaining 92.4% of the variance. Self-management behavior mediated the relationship between psychosocial coping resources and illness outcome. CONCLUSION: This research specifies a more complete spectrum of the self-management process. It is important to recognize the array of clinical resources available to support patients' self-management. Healthcare providers can facilitate self-management through collaborative care and understanding the ideas and emotions that each patient has about the illness, and ultimately improve the health outcomes. This framework can be used to guide self-management intervention development and assure effective clinical assessment.

Architecture Design of Healthcare Software-as-a-Service Platform for Cloud-Based Clinical Decision Support Service / 대한의료정보학회지

OBJECTIVES: To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. METHODS: We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used. RESULTS: The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services. CONCLUSIONS: We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs.

Factors related to Hope and Relationships between Hope, Physical Symptoms, Depressive Mood and Quality of Life in Young Adult and Prime-aged Patients with Hemodialysis / 정신간호학회지

PURPOSE: The purpose of this study was to identify the correlation among hope, physical symptoms, depressive mood, and quality of life and to examine the influence of hope on quality of life in young adults and patients in their prime who are on hemodialysis. METHODS: A secondary analysis using survey data was performed for 100 patients from 20-55 years of age treated in 10 local hemodialysis clinics. To measure hope, physical symptoms, depressive mood, and quality of life, Herth Hope Index, revised symptom scale, Hospital Anxiety and Depression Scale, and Satisfaction with Life Scale were utilized. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation coefficient, and multiple regression. RESULTS: There were differences in the scores for hope according to income, job, and religion. Statistically significant relationships were found between hope and depressive mood, and between hope and quality of life. Hope predicted quality of life with the explanatory power of 43.4%. CONCLUSION: Results indicate that hope is a protective factor which has the potential to provide a clinically useful approach to helping patients with hemodialysis, especially, in young adults and patients in their prime. Interventions that support and facilitate hope need to be developed and tested.