Effects of the Insulin Therapy Adherence Program for Patients with Type 2 Diabetes: A Randomized Controlled Trial / 임상간호연구

Purpose@#This study was conducted to evaluate the effects of the insulin therapy adherence program (INSTA GRAM) for patients with type 2 diabetes mellitus. @*Methods@#This study examined a total of 63 patients with type 2 diabetes for whom the initiation of insulin therapy is being considered or within 6 months of undergoing insulin therapy. INSTAGRAM is a stage-specific intervention consisting of strategies for motivating patients to initiate and maintain insulin therapy using the transtheoretical model on the stages of change, the process of change, and self-efficacy. The participants were randomly assigned to either the INSTAGRAM group (experimental group, n=32) or the standard diabetes education group (control group, n=31). The INSTAGRAM group received 6 sessions over 8 weeks(face-to-face education was conducted in the first and last sessions, and telephone coaching was conducted from the second to fifth sessions). The outcomes were measured by psychological insulin resistance, self-efficacy, and glycosylated hemoglobin (HbA1c). @*Results@#Psychological insulin resistance (p<.001), self-efficacy (p<.001), and HbA1c (p=.024) of the participants in the INSTAGRAM group significantly improved compared to those in the control group. @*Conclusion@#INSTAGRAM is effective in overcoming psychological insulin resistance and improving self-efficacy and HbA1c. Therefore, the INSTAGRAM can be recommended as a nursing intervention for type 2 diabetic patients who delay the initiation of insulin therapy.

Development and Evaluation of a Self-management Mobile App for Adults with Osteoarthritis

Purpose@#This study aimed to develop a self-management mobile app for adults with osteoarthritis based on a selfdetermination theory to use it as a nursing intervention tool, and to evaluate the effects of the developed mobile app on adults' basic psychological needs, indexes of osteoarthritis, self-management and quality of life. @*Methods@#The 56 participants were randomly assigned to either the experimental group (n=28) or the control group (n=28). The participants of the experimental group used a self-management mobile app for 12 weeks after the pretest, and two posttests were taken at the end of every 6 weeks. The data were analyzed using IBM SPSS/WIN 25.0 for Chi-square test, Fisher's exact test, independent t-test, and repeated measures ANOVA. @*Results@#Basic psychological needs, indexes of osteoarthritis, self-management, and quality of life score of the experimental group were significantly higher than those of the control group. @*Conclusion@#Our findings suggest that mobile app intervention can support improvements in psychological needs, symptoms of osteoarthritis and quality of life in adults with osteoarthritis. It is recommended that the developed mobile app be used as a nursing intervention tool for adults with osteoarthritis in the community.

Conditional effect of school support between learning agility and academic burnout in nursing students / 의료커뮤니케이션

Background@#The purpose of this study was to investigate the conditional effect of school support between learning agility and academic burnout in nursing students. @*Methods@#A cross-sectional descriptive study design was used. A total of 213 participants was surveyed using a self-report questionnaires including general characteristics, a learning agility, academic burnout and school support scale. The descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation, and PROCESS Macro (Model 7) and bootstrapping method. @*Results@#Educational environment support had a significant mediating effect between the learning agility and academic burnout. Professor support had a significant moderating mediation effect in the Educational environment support between the learning agility and academic burnout. And friend and senior support had only direct effect to learning agility and academic burnout. @*Conclusion@#These results highlight the importance of school support and can be used as meaningful data for intervention research to reduce the academic burnout and to learning agility for nursing students.

Structural Analysis of Variables related to Fall Prevention Behavior of Registered Nurses in Small-to-Medium Sized Hospitals / 기본간호학회지

PURPOSE: The purpose of this study was to build a model to predict the fall prevention behavior of nurses in small and medium sized hospitals. METHODS: Participants were 382 nurses from 13 hospitals who responded to the structured self-reported questionnaire. The research model was based on previous study of fall prevention, theory of planned behavior, and the health belief model. RESULTS: The modified model generally showed higher levels than recommended level of model fit indices and acceptable explanation. Of 17 hypothetical paths, 14 were supported. Predicting variables explained 51.6% of fall prevention behavior. The fall prevention behavior of nurses showed a direct influence of fall prevention expectations, fall prevent threats, perceived behavioral control for fall prevention, and intention to prevent falls and an indirect of influence of patient safety culture, attitude toward fall prevention, and the subjective norm. CONCLUSION: Findings show a need to identify a range of barrier factors to increase the benefits of fall prevention behavior and enhance the perceived control of fall prevention so that nurses will be able to promote fall prevention behavior in hospitals. Also, it is critical to increase awareness of patient safety culture among nurses.

Social Network, Self-Care Agency and Quality of Life of High-risk Beneficiaries in Case Management of Medicaid

PURPOSE: This study investigates the social network, self-care agency, and quality of life of high-risk beneficiaries in case management of Medicaid and the correlations between these variables. It also identifies influencing factors on their quality of life. METHODS: The subjects included 187 individuals chosen from the high-risk beneficiaries in case management of Medicaid in D Metropolitan City. Data was collected through direct interviews based on a structured questionnaire on home visits. RESULTS: The perceived health status was the most influential factor in their quality of life, followed by self-care agency, mutual support network, and natural support network in order. These factors explained 40.6% of their quality of life. CONCLUSION: These findings raise a need to develop a nursing intervention program to increase the self-care agency of the high-risk beneficiaries in case management of Medicaid.

Prevalence and Factors Influencing Constipation in School Age Children / 기본간호학회지

PURPOSE: The purpose of this study was to investigate prevalence and factors influencing constipation in school age children in order to help prevent and manage this problem. METHODS: The participants were 618 elementary school students (4th, 5th, and 6th grade) selected from five elementary schools. Data were gathered using questionnaires and analyzed using chi2 test, independent t-test and binary logistic regression with the PASW 18.0 program. RESULTS: The prevalence of constipation was 15.2% for these school age children. Factors influencing constipation in this population were high stress (OR: 5.77), daily intake of meat (OR: 5.42), more than 3 hours using the internet (OR: 4.50), more than 3 hours of private academy classes (OR: 2.83), obesity (OR: 2.34), and negative perceptions of school toilet environment (OR: 2.26). CONCLUSION: Psychological factors and physical activities have an important effect on constipation in school age children. Thus, there is a need to educate both children and their parents on prevention of constipation by decreasing stress, decreasing meat intake, increasing active movement and increasing positive perception of school toilet environment.

Factors Influencing Intention of Migration by Hospital Nurses in Korea / 간호행정학회지

PURPOSE: The purpose of this study was to identify the factors influencing intention of migration by Korean hospital nurses. METHODS: Using cross sectional correlational design, data were collected from 512 nurses working in 7 hospitals ranging in size from 300 to 900 beds in D city and K province of Korea. Data were analyzed by descriptive statistics, chi-square, and multiple hierarchical regression using the SPSS program. RESULTS: There were significant differences in intention of migration by age, educational background, marital status, work experience, and yearly incomes. Although there was high intention of migration of the subjects, the level of preparation for migration was relatively low. The variables that were independently associated with intention of migration were graduates of RN-BSN program, personal factors of subjects, and environmental factors. Those who had lower perception on nursing images and work condition had significantly higher intention of migration than those who had higher perception. Full model accounted for 37.3% of the variance in intention of migration. CONCLUSION: To prevent brain drain of competent nurses in Korea, appropriate strategies to enhance work condition should be developed and the effect of migration of nurses should be investigated in further studies.

Effect of Water Drinking on the Postprandial Fall of Blood Pressure in the Elderly / 기본간호학회지

PURPOSE: The purpose of this study was to examine preventive effects of water drinking on postprandial fall of blood pressure in the elderly. METHOD: Participants were 25 elders who had experienced postprandial fall of systolic blood pressure of more than 15mmHg in a previous study. Within subject repeated measures design using random order allocation was used to control extraneous variables among participants. During the experiment, each participant had to drink 400mL water before lunch, whereas when in the control, they only had their lunch. Blood pressure and heart rate were measured for both times before lunch and at 15 minutes intervals up to 90 minutes after lunch. Data were analyzed using descriptive statistics, repeated measures of ANOVA, paired t-test and Bonferroni adjustment as Post-hoc analysis. RESULTS: Water drinking before lunch elicited significant pressor effects by increasing systolic and diastolic pressure 13.9+/-4.7/5.2+/-2.2mmHg compared blood pressure during the control (p<.005, p<.022). Heart rate, however, did not change significantly at either time. CONCLUSION: Drinking water before meal is recommended for elders who experience postprandial hypotension. However, the appropriate volume of water to prevent postprandial fall in blood pressure should be further studied.

Prevalence and Risk Factors of Postprandial Hypotension in Korean Elderly People

PURPOSE: The purposes of this study were to identify the prevalence of postprandial hypotension (PPH) and risk factors for PPH in Korean elderly people. METHODS: A cross-sectional descriptive study was conducted with community dwelling and nursing home residents. The blood pressure of 162 adults aged 65 yr or older was measured before meal as a baseline and then at 15 min intervals from immediately after the meal through 90 min after the meal. Descriptive statistics and logistic regression with the SPSS WIN 14.0 program were used to analyze the data. RESULTS: The prevalence of PPH was 29% and the PPH occurred immediately after the meal continuously through 90 min after the meal. The biggest drop in systolic blood pressure occurred at 45 min after the meal. Risk factors for PPH were age, base line systolic blood pressure, and presence of cardiovascular disease. CONCLUSION: To prevent side effects of PPH such as falls and syncope, nurses should provide careful management of PPH and prohibit activities until at least 90 min after a meal. We also recommend that risk of PPH should be included in fall prevention guidelines for elderly people.

Development of Electronic Incident Reporting System to Manage Medical Errors - Focused on Nursing Related Task / 대한의료정보학회지

OBJECTIVE: Hospital and health care professionals in worldwide strive to deliver the safest care as possible. Nevertheless, medical errors that are preventable are common. Minimizing and eliminating medical errors that are preventable is vital to improve patient safety. Therefore the purpose of study is developing the electronic incident reporting system focused on nursing related task as a way to make easy to report incidents METHOD: First, we identified the types and contents of nursing errors and then developed the system under the Widow XP environment. The system was connected to the hospital information system by TCP/IP protocol and used Oracle Sybase as DBMS and Power Builder 8.0 as a program language. RESULTS: The system developed was accessible by any qualified employer who works in the hospital and easily convertible to excel file for the purposes of analyzing the data stored. The number of incident reported using the electronic incident reporting system was 85. CONCLUSION: Hospital should cultivate no blaming culture to the staffs involved in the incidents and provide a standardized education to all frontline staffs to encourage error reporting. By doing this, voluntary error reporting system can be used for system wide improvements by analyzing data stored in the system.

Effects of Discussion Centered AIDS Education on Knowledge, Prejudice, Social Interaction, and Intention for Prevention in College Students / 기본간호학회지

PURPOSE: The purposes of the study were to determine the effects of AIDS education which includes discussion on knowledge, prejudice, social interaction, and intention for AIDS prevention in college students. METHOD: A convenience sampling method was used to collect data, and 136 university students participated in the study. One group pretest-post test design was used and questionnaire for measuring knowledge about AIDS and attitude to AIDS were administered before and after 100 minutes of AIDS education, The education program consisted of a 50-minute lecture with video aids and 50 minutes of small group discussion. Means, SD, and paired t-test with the SPSS program were used to analyze the data. RESULTS: There were significant increases in knowledge (p= .000) and social interaction (p= .002) after the education, but no significant changes in prejudice (p= .832) nor in intention for AIDS prevention (p= .074). CONCLUSION: AIDS education including discussion was found to be an effective method for improving knowledge and social interaction of college students. The results suggest that education which includes discussion sessions should be used with college students to improve social interaction with people who are HIV positive and enhance knowledge about AIDS.

A Study on the Risk of Drug Use by Male Adolescents / 기본간호학회지

PURPOSE: The purpose was to identify the risk of drug use by adolescents. METHOD: The participants were 933 male students in the first grade of a high school in D city. The data were collected from Aug. 5th to Oct. 30th, 2004. The instrument was the High Risk Group Adolescent Drug User Screening Test (HIRIGADUST) developed by the Korea Adolescent Society (1996). The data were analyzed using SPSS. RESULTS: For substance use, 64.5% of the students answered that they had drunk, 40.3% that they had smoked, and 2.0% that they had tried drug use. For scores on HIRIGADUST regarding socio-demographic characteristics, there were significant differences depending on school type, personality, academic performance, economic status, and ability to talk with parents. For scores on HIRIGADUST regarding drug using-related characteristics, there were significant differences depending on drinking experience, frequency of drinking, amount of alcohol intake, smoking experience and number of cigarettes smoked. Of the students 27.2% students were in the high risk group. CONCLUSION: In schools, systematic and intensive assessment of drug use should be done, and if needed, a service system connected to clinics specializing in drug addiction should be established. Prevention education should be carried out continuously.

Analysis of RN-BSN Students' Clinical Nursing Competency / 간호학회지

PURPOSE: The purpose of this study was to investigate RN-BSN students' clinical nursing competency in order to establish baseline data for developing nursing competency based clinical education for RN-BSN students. METHOD: A survey of 1,453 RN-BSN students from 21 nursing schools was conducted using a self administered questionnaire. RESULT: The mean score of the clinical nursing competency was 2.93. The scores for competency were shown as 2.91 for nursing management, 2.94 for developing professionalism & legal implementation, 2.95 for critical thinking, 2.96 for teaching & leadership, and data collection, basic nursing care, and communication were above 3.00. The items perceived as insufficient competency were physical examination and observation & monitoring in data collection, cardiopulmonary resuscitation, psycho-social care, spiritual care, hospice in basic nursing care, application of knowledge and theory, formulating nursing diagnosis, nursing care planning in critical thinking, education material development, leadership, delegation in teaching and leadership, analysis of organization, planning, infection control, role & job description, evaluation of nursing activities in nursing management, quality improvement, and research in developing professionalism and legal implementation. CONCLUSION: This study will contribute to developing a nursing competency based on clinical education for RN-BSN students who have various education needs and clinical backgrounds.

Comparisons on Motivation for Health Behavior, Health Behaviors Practices, and Activities of Daily Living between Institutionalized and Non-institutionalized Elderly Women / 성인간호학회지

PURPOSE: The purposes of this study were to compare the motivation for health behavior, health behaviors practices, and ADL of institutionalized elderly women with those of non-institutionalized elderly women. METHODS: A cross-sectional descriptive survey was conducted in convenience samples of 144 aged women(80 institutionalized and 64 non-institutionalized) using structured questionnaires. Descriptive statistics, chi-square-test, and ANCOVA were used for data analysis with SPSS program. RESULTS: The institutionalized elderly reported significantly higher motivation than the non-institutionalized elderly. In subcategories of motivation, self-efficacy of the institutionalized elderly was significantly lower than that of the non-institutionalized elderly. The non-institutionalized elderly reported significantly lower perceived benefits and significantly higher perceived barriers than institutionalized elderly. The institutionalized elderly reported significantly lower health behaviors in exercise and nutrition than the non-institutionalized elderly. Among health behaviors of the non-institutionalized elderly women, stress management marked the lowest score. CONCLUSION: To enhance motivation of institutionalized elderly women, interventions for building self-efficacy are needed. To promote the health behavior of the non-institutionalized elderly, stress management programs are needed. All elderly women need exercise.

A Survey on Experience and Illness Management of Rural Women with Osteoarthritis / 기본간호학회지

PURPOSE: This descriptive survey was done to assess how rural women with osteoarthritis perceive their symptoms, what are their treatment preferences, and how they manage their illness. METHOD: Individual interviews were carried out with 205 women with osteoarthritis living in rural areas. Structured questionnaires were used and the interviewers were 7 trained research assistants. Descriptive statistics were used for data analysis with SPSS win 11.5 program. RESULTS: Of the respondents, 68.8% were overweight and 15.1% were obese, 86.9% reported pain in the knees, low back, and shoulders and the average pain score was 66.06. Those knowing the exact diagnosis accounted for 73.7% of the respondents but only 49.7% reported receiving medical treatments, and 40.2% who received treatment adhered to their prescription. Folk medicines were used by 14.1% of the respondents, but 65.2% among them reported that folk medicines were not effective. Exercise 2.03 times per week was reported by 17.1% of the respondents and 48.6% reported preferring to walk. CONCLUSION: Women with osteoarthritis in rural areas need a rehabilitative care program focused on exercise. The community health care system in the rural area should deliver optimal health care for this population. The results of this study can be used as a basis for planning intervention programs for women with osteoarthritis in the rural area.

The Effects of Self-Selected Music on Anxiety and Pain during Burn Dressing Changes / 간호학회지

PURPOSE: The purpose of this study was to examine the effects of music therapy on state anxiety and pain among patients undergoing burn dressing changes. METHOD: A convenience sample of 32 adult burn patients who were eligible and provided consent were included in the study which was a quasi-experimental study of a nonequivalent control group pretest-posttest design. Fifteen patients in the control group received the routine burn dressing changes but 17 patients in the experimental group listened to self-selected music through headphones connected to a CD player during burn dressing changes for three days. All subjects of the music group chose the type of music that would relax them. Before and after burn dressing changes, subjects completed the State Anxiety Inventory and self-report of pain scores. RESULT: There was a significant reduction in state anxiety before and after burn dressing changes in those who received music therapy in contrast to those who did not receive music therapy. The music group reported lower pain scores before and after burn dressing changes than did the non-music group. CONCLUSION: These findings indicate that music therapy composed of self-selected music is a valuable intervention for the treatment of pain and anxiety in patients undergoing burn dressing changes.

Comparison of Inguinal, Rectal, Axillary, and Tympanic Temperature in Newborns / 아동간호학회지

PURPOSE: In order to identify the usability of inguinal temperature in a neonatal unit, this study was done to compare inguinal temperature of newborns with rectal, axillary, and tympanic temperatures. METHOD: Fifty-one normal newborns admitted to the nursery of a university affiliated hospital participated in the study. Tympanic temperatures were taken with a tympanic thermometer. Inguinal, rectal, and axillary temperatures were taken with glass mercury thermometers, and were recorded every 1 minute until the reading remained constant for 2 times. The data were analyzed using the SPSS program. RESULT: The measurement time for inguinal temperatures in newborns was significantly longer than that for rectal temperatures, but was shorter than that for axillary temperatures. The mean temperature for the newborn's inguinal site was lower than for rectal, axillary, and tympanic temperatures (the lower side), but wasn't different from tympanic temperature (the upper side). The inguinal temperature was significantly correlated with rectal, axillary, and tympanic temperature. The inguinal temperature was not different according to general characteristics of the newborn. CONCLUSION: These findings indicate that measurement of inguinal temperature is a useful alternative to rectal temperature.

A Descriptive Survey of University Students' Prejudice toward AIDS, Social Interaction with AIDS Patients, Intention for AIDS Prevention, and Knowledge / 기본간호학회지

PURPOSE: A study of university students was conducted to explore their prejudice toward AIDS, social interaction with AIDS patients, and intention to practice AIDS preventive measures. METHOD: This study used a cross-sectional descriptive survey design. A self-reported questionnaire was completed by 145 university students. Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS 11.5. RESULT: The mean score for prejudice toward AIDS was 23.54, implying a low level of prejudice toward AIDS by the subjects. The mean score for social interaction with AIDS patients was 20.92, indicating a moderate level of intention for social interaction with AIDS patients. The mean score for intention to practice AIDS prevention was 24,74, assuming a strong intention to practice AIDS prevention. Those who had higher mean scores for AIDS Knowledge showed significantly higher mean scores for social interaction with AIDS patients and intention to practice prevention than those who had lower scores. CONCLUSION: Research findings showed that university students had a low level of prejudice toward AIDS, a moderate level of social interaction with AIDS patients and a high level of intention to practice AIDS prevention. Therefore, a specially designed AIDS education program is needed for university students so as not to provoke fear or stigma toward AIDS patients and to support AIDS patients.

Awareness of Information, Anxiety, Distress, and Perceived Value of Information in Patients undergoing Endoscopic Examination / 기본간호학회지

purpose: A descriptive study was conducted to identify awareness of information, emotional distress, behavioral distress, and perceived value of information in clients who were scheduled for endoscopic examinations, and to determine correlations between the variables. METHOD: Participants were 87 clients who were scheduled for endoscopic examinations; gastroscopy, bronchoscopy, and colonoscopy. The questionnaires were collected from September to December, 2002 by a trained nurse. Self reports, interviews, and observations were used. Data were analyzed with frequencies, percentages, means, Pearson correlation coefficients, ANOVA, and Scheffe post test using the SPSS/PC 9.0. RESULT: The score for awareness of information was 17.46, state anxiety was 47.26, emotional distress during exam was 2.90, behavioral distress was 11.18, and perceived value of information was 4.21. Clients aged above 60 showed significantly lower awareness of information than other groups. Clients undergoing broncoscopy reported significantly higher emotional distress during the exam than subjects for colonoscopy. Clients undergoing gastroscopy showed significantly higher behavioral distress than any of the others. There were no relationships between awareness of information and anxiety, but, a significant positive relationship was found between anxiety and emotional distress during exam, between emotional distress and behavioral distress, and between awareness of information and perceived value of information. CONCLUSION: Awareness of information by the clients through provision of an educational booklet was low, and clients showed moderate level of state anxiety. Research studies are needed to compare providing information with other interventions for comfortable progress of endoscopic examinations. Especially specific strategies should be established for elderly clients to facilitate awareness of information.

Factors Influencing on Quality of Life in Aged Women with Chronic Pain / 간호학회지

PURPOSE: This study was conducted to identify the pain characteristics, family support and physical functioning and to determine predictors of the quality of life in aged women with chronic pain. METHOD: The questionnaires were collected through direct interview by a trained research assistant from July 2 to August 24, 2001. Subjects were 108 women clients with chronic pain over 65 years of age. Data analyzed frequency, percentage, mean, Pearson's correlation, ANOVA and stepwise multiple regression by SAS. RESULT: Care providers were mostly spouses and daughters in law. Care providers who took care of elderly for a few hours a day had the highest percentile. Aged women had persistently had chronic pain of moderate intensity and was moderately satisfied with pain management. The mean score of disability due to pain was 3 on a 10 point scale. The mean scores of physical function and quality of life were moderate and there were negative correlations between pain characteristics, physical functioning, and quality of life at the range from r=-.46 to r=-.83. Satisfaction with care, duration of pain, disability due to pain, and physical functioning accounted for 56% of the variance in perceived quality of life for aged women with chronic pain. Disability due to pain was the most predictable variable of quality of life and physical function was the second . CONCLUSION: The results suggest that care by family, education in pain control, prevention of disability, and maintenance of physical function are important to improve and maintain quality of life in aged women with chronic pain. Therefore, there is a need for program development that enhance family support and nursing intervention that focuses on active pain control.