Predictors of health-related quality of life in Koreans with cardiovascular disease

This study aimed to identify the predictors of health-related quality of life (HRQoL) in Korean adults with cardiovascular disease (CVD). Methods: This was a cross-sectional study with a stratified multistage probability sampling design. Data from the 2016 to 2019 Korea National Health and Nutrition Examination Survey (n=32,379) were used. Among the participants aged 19 years or older (n=25,995), 1,081 patients with CVD were extracted after excluding those with missing data and those who had cancer. The participants’ HRQoL was measured using the three-level EuroQoL Group’s five-dimension questionnaire (EQ-5D) scale. Data were analyzed using the t-test, one-way analysis of variance, and general linear regression for complex samples. Results: The most potent predictors of HRQoL in Korean adults with CVD were limited activity (β =−0.103, p <0.001), poor perceived health (β =−0.089, p <0.001), depression (β =−0.065, p<0.01), low household income (β=−0.033, p<0.05), unemployment (β=−0.023, p<0.05), and older age (β=−0.002, p<0.01), which explained 37.2% of the variance. Conclusion: Comprehensive interventions that address both physical and mental factors and social systems that provide financial help need to be implemented to improve the HRQoL of Korean adults with CVD.

Effectiveness of a Workplace Smoking Cessation Program based on Self-determination Theory Using Individual Counseling and Tailored Text Messaging: A Pilot Study

PURPOSE: Adverse health effects of smoking could be made worse by worker's tobacco use, and combining tobacco use with occupational hazards could enhance the likelihood of occupational disease and injury. This study was aimed to develop a workplace smoking cessation program based on self-determination theory (SDT) and then to examine the effectiveness of the program. METHODS: A quasi-experimental design with nonequivalent control group pretesteposttest design was used. An intervention group (n = 30) received a smoking cessation program using individual counseling and tailored text messaging based on SDT during 12 weeks. Participants in the control group (n = 30) received a smoking cessation leaflet and telephonic follow-up for 3 times. RESULTS: At 6 and 12 weeks, there were significant differences between the two groups on autonomous regulation, perceived competence, nicotine dependence, tobacco abstinence rate, and exhaled carbon monoxide concentration. At 12 weeks, the abstinence rate in the intervention group was 96.7%, whereas that in the control group was 12.9%. CONCLUSION: SDT-based workplace smoking cessation program using individual counseling and tailored text messaging is effective in encouraging autonomous regulation and competence for workers.

The Effects of the Korean Medicine Health Care Program on Stroke-Related Factors and Self-Care Enhancement

OBJECTIVES: This study was performed to examine the effects of the Korean medicine healthcare program on stroke-related factors and self-care enhancement. METHODS: This study was a quasi-experimental, pretest-posttest nonequivalent control group design study (N = 58 participants), with 28 in the treatment group (Korean medicine health care program) and 30 in the control group (no intervention). The program was conducted twice a week for 2 hours, for a total of 12 weeks. RESULTS: There were statistically significant differences in systolic (p = 0.005) and diastolic blood pressure (p = 0.006), cholesterol (p < 0.001), blood glucose (p < 0.001), self-esteem (p = 0.001), self-efficacy (p < 0.001), health perception (p < 0.001), and the health behavior (p < 0.001) between the experimental group and the control group. CONCLUSION: Thus, the Korean medicine healthcare program was effective in managing stroke-related factors and enhancing self-care, and should be actively used to develop community health promotion strategies to prevent strokes and prepare long-term measures.

Comparative Evaluation of Three Chromogenic Media Combined with Broth Enrichment and the Real-Time PCR-Based Xpert MRSA Assay for Screening of Methicillin-Resistant Staphylococcus aureus in Nasal Swabs

BACKGROUND: We evaluated the performance of three chromogenic media (Brilliance agar I [Oxoid, UK], Brilliance agar II [Oxoid], and ChromID MRSA [Biomerieux, France]) combined with broth enrichment and the Xpert MRSA assay for screening of methicillin-resistant Staphylococcus aureus (MRSA). METHODS: We obtained 401 pairs of duplicate nasal swabs from 321 patients. One swab was suspended overnight in tryptic soy broth; 50-microL aliquots of suspension were inoculated on the three chromogenic media. Brilliance agar I and II were examined after 24 hr, and ChromID MRSA, after 24 and 48 hr. The paired swab was processed directly using real-time PCR-based Xpert MRSA assay. RESULTS: True positives, designated as MRSA growth in any of the culture media, were detected with the prevalence of 17% in our institution. We report the sensitivity, specificity, positive predictive value, and negative predictive value of MRSA growth as follows: 92.3%, 94.0%, 75.9%, and 98.4% in Brilliance agar I (24 hr); 92.7%, 97.9%, 90.0%, and 98.5% in Brilliance agar II (24 hr); 95.6%, 95.8%, 82.3%, and 99.1% in ChromID MRSA (24 hr); 100%, 92.5%, 73.1%, and 100% in ChromID MRSA (48 hr); 92.6%, 96.7%, 85.1%, and 98.5% in Xpert MRSA assay. The agreement between the enriched culture and Xpert MRSA assay was 96.0%. CONCLUSIONS: Three chromogenic culture media combined with enrichment and Xpert MRSA assay demonstrated similar capabilities in MRSA detection. The Xpert MRSA assay yielded results comparable to those of culture methods, saving 48-72 hr, thus facilitating earlier detection of MRSA in healthcare settings.

Effects of Maximal Sterile Barrier Precaution on the Central Venous Catheter-related Infection and Cost / 성인간호학회지

PURPOSE: The purpose of this study was to examine the effect of maximal sterile barrier precaution on the central venous catheter-related infection and subsequent cost savings. METHODS: Study subjects were 462 hospitalized patients with central venous, catheter of more than 48 hours duration. Data collection period was from April 2008 to February 2009 at a tertiary university hospital in Seoul. Subjects were randomly assigned to either the treatment or the usual care group. Patients in the treatment group (n=209) were treated by staff using maximal sterile barrier precautions and the comparison group(n=253) received traditional care. RESULTS: Central venous catheter-days was2,821 in treatment group and 3,515 in comparison group. The incidence density of central venous catheter-related infection was 2.1 times higher in the comparison group (8.2 per 1,000 catheter-days) compared with the treatment group (3.9 per 1,000 catheter-days). The incidence density of central venous catheter-related bloodstream infection was 4.54 times higher than in the comparison group (3.2 per 1,000 catheter-days) compared with the treatment group (0.7 per 1,000 catheter-days). The attributable cost of central venous catheter-related infection in the treatment group was 10,174,197 won and that of the comparison group was 22,224,554 won. Attributable cost by area was also significantly lower compared with that of the comparisons. CONCLUSION: The maximal sterile barrier precaution during central venous catheter insertion was an effective intervention to reduce central venous catheter-related infection rate and provides a significant cost savings.