Pathway Analysis on the Effects of Nursing Informatics Competency, Nursing Care Left Undone, and Nurse Reported Quality of Care on Nursing Productivity among Clinical Nurses

Purpose@#Nursing informatics competency is used to manage and improve the delivery of safe, high-quality, and efficient healthcare services in accordance with best practices and professional and regulatory standards. This study examined the relationship between nursing informatics competency (NIC), nursing care left undone, and nurse reported quality of care (NQoC) and nursing productivity. A path model for their effects on nursing productivity among clinical nurses was also established. @*Methods@#Data were collected using structured questionnaires answered by 192 nurses working in a tertiary hospital located in J city, Korea, and analyzed using SPSS/WIN 23.0 and AMOS 21.0 program. @*Results@#The fit indices of the alternative path model satisfied recommended levels χ2 = .11 (p= .741), normed χ2 (χ2/df) = .11, SRMR = .01, RMSEA = .00, GFI = 1.00, NFI = 1.00, AIC = 18.11. Among the variables, NIC (β = .44, p < .001), NQoC (β = .35, p < .001) had a direct effect on nursing productivity. Due to the mediating effect of NQoC on the relationship between NIC and nursing productivity, the effect size was .14 (95% CI .08~.24). Meanwhile, nursing care left undone through NQoC in the relationship between NIC and nursing productivity, has a significant mediation effect (estimate .01, 95% CI .00~.03). The explanatory power of variables was 44.0%. @*Conclusion@#Education and training for enhancing NIC should be provided to improve nursing productivity, quality of care and to reduce missed nursing care. Furthermore, monitoring the quality of nursing care and using it as a productivity index is essential.

Living Alone, Social Isolation and Depressive Disorder Among Community-Dwelling Older Adults in an Urban Community in Korea

Efficacy of Case Management for the Community Dwelling Schizophrenia Patients : A 36-Month Prospective Follow-Up Study / 신경정신의학

OBJECTIVES: This study was conducted to observe a longitudinal course of patients with schizophrenia enrolled in a community mental health center (CMHC) in Seoul, Korea, and to evaluate the clinical efficacy of case management provided for them. METHODS: Study subjects, including 50 patients in a case-managed group, and 34 patients in the control group, were enrolled from a CMHC and followed up for 36 months. Annual length of hospitalization was compared between two groups by t-tests and time until hospitalization by Kaplan-Meier survival analysis. RESULTS: For the first year of observation, there was no significant difference in annual length of hospitalization between two groups (3.4 weeks vs. 2.9 weeks), but annual length of hospitalization of the case-managed group became significantly shorter for the second (1.7 weeks vs. 7.2 weeks) and third year (1.4 weeks vs. 7.8 weeks). In Kaplan-Meier survival analysis, no difference in time until hospitalization was observed between two groups, but time until hospitalization more than 3 months was significantly shorter in the control group. CONCLUSION: At least two years of case management was required to reduce the length of hospitalization. Reduction in length of hospitalization was achieved by preventing long-term hospitalization.

Prevalence, Work-Loss Days and Quality of Life of Community Dwelling Subjects with Depressive Symptoms

The nationwide prevalence of major depressive disorder in Korea is lower than most countries, despite the high suicide rate. To explain this unexpectedly low prevalence, we examined the functional disability and quality of life in community-dwelling subjects with significant depressive symptoms not diagnosable as depressive disorder. A total of 1,029 subjects, randomly chosen from catchment areas, were interviewed with the Center for Epidemiologic Studies Depression scale, Mini International Neuropsychiatric Interview, WHO Quality of Life scale, and the WHO Disability Assessment Schedule. Those with scores over 21 on the depression scale were interviewed by a psychiatrist for diagnostic confirmation. Among community-dwelling subjects, the 1-month prevalence of major depressive disorder was 2.2%, but the 1-month prevalence of depressive symptoms not diagnosable as depressive disorder was 14.1%. Depressive disorders were the cause of 24.7% of work loss days, while depressive symptoms not diagnosable as depressive disorder were the cause of 17.2% of work loss days. These findings support the dimensional or spectrum approach to depressive disorder in the community and might be the missing link between the apparent low prevalence of depressive disorder and high suicide rate in Korea.

Predictors for Subjective Memory Complaints in the Elderly: The Results from Korean Longitudinal Study on Health and Aging (KLoSHA) / 신경정신의학

OBJECTIVES: We investigated the predictors of subjective memory complaints in the community-dwelling normal elderly. METHODS: This study was conducted as a part of Korean Longitudinal Study on Health and Aging (KLoSHA). 747 nondemented community-dwelling elderly aged 65 years or older were recruited. All participants underwent clinical evaluation for dementia and psychiatric disorder conformed to the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) Clinical Assessment Battery and Korean version of Mini-International Neuropsychiatric Interview, respectively. Word list recall test, frontal assessment battery, Mini Mental Status Examination (MMSE-KC) and Korean version of Geriatric depression scale (GDS-K) were administered to evaluate episodic memory, frontal function, global cognition and depression, respectively. Subjective memory complaint was defined in two different ways: worse than one's past (SMC-P) and worse than others of one's age (SMC-O). RESULTS: In highly educated elderly, minor depressive disorder (OR=7.23, 95% C.I.= 2.29-22.86) and frontal dysfunction (OR=2.48, 95% C.I.=1.29-4.77) significantly increased the risk of SMC-O. However, they did not influence the risk of SMC-P. In low educated elderly, both the minor depressive disorder and frontal dysfunction did not influence the risk of SMC-O as well as that of SMC-P. CONCLUSION: SMC-O can be a sensitive subjective recognition of mild depression and/or frontal dysfunction in highly educated normal elderly.