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.

Updates on Therapeutic Alternatives for Genitourinary Syndrome of Menopause: Hormonal and Non-Hormonal Managements

Postmenopausal atrophic vaginitis, along with vasomotor symptoms and sleep disorders, is one of the most troublesome symptoms of menopause. However, many women do not manage this symptom properly due to insufficient knowledge of the symptoms or sexual embarrassment. With appropriate treatment, many postmenopausal women can experience relief from discomforts, including burning sensation or dryness of the vagina and dyspareunia. Topical lubricants and moisturizers, systemic and local estrogens, testosterones, intravaginal dehydroepiandrosterones (DHEAs), selective estrogen receptor modulators, and energy-based therapies are possible treatment modalities. Systemic and local estrogen therapies effectively treat genitourinary syndrome of menopause (GSM), but they are contraindicated in patients with breast cancer, for whom lubricants and moisturizers must be considered as the primary treatment. Intravaginal DHEA and ospemifene can be recommended for moderate to severe GSM; however, there is insufficient data on the use of intravaginal DHEA or ospemifene in patients with breast cancer, and further studies are needed. Energy-based devices such as vaginal laser therapy reportedly alleviate GSM symptoms; however, the U.S. Food and Drug Administration warning has recently been issued because of complications such as chronic pain and burning sensations of the vagina. To summarize, clinicians should provide appropriate individualized treatment options depending on women’s past history, symptom severity, and chief complaints.

Updates on Therapeutic Alternatives for Genitourinary Syndrome of Menopause: Hormonal and Non-Hormonal Managements

Postmenopausal atrophic vaginitis, along with vasomotor symptoms and sleep disorders, is one of the most troublesome symptoms of menopause. However, many women do not manage this symptom properly due to insufficient knowledge of the symptoms or sexual embarrassment. With appropriate treatment, many postmenopausal women can experience relief from discomforts, including burning sensation or dryness of the vagina and dyspareunia. Topical lubricants and moisturizers, systemic and local estrogens, testosterones, intravaginal dehydroepiandrosterones (DHEAs), selective estrogen receptor modulators, and energy-based therapies are possible treatment modalities. Systemic and local estrogen therapies effectively treat genitourinary syndrome of menopause (GSM), but they are contraindicated in patients with breast cancer, for whom lubricants and moisturizers must be considered as the primary treatment. Intravaginal DHEA and ospemifene can be recommended for moderate to severe GSM; however, there is insufficient data on the use of intravaginal DHEA or ospemifene in patients with breast cancer, and further studies are needed. Energy-based devices such as vaginal laser therapy reportedly alleviate GSM symptoms; however, the U.S. Food and Drug Administration warning has recently been issued because of complications such as chronic pain and burning sensations of the vagina. To summarize, clinicians should provide appropriate individualized treatment options depending on women’s past history, symptom severity, and chief complaints.

Analysis of the Effects of a Health Policy Capacity Development Education Program as a Public-Private Partnership Model in Official Development Assistance for Health Policy Administrators / 한국직업건강간호학회지

Purpose@#This study analyzed the effects of a health policy capacity development education program as a publicprivate partnership (PPP) model in official development assistance (ODA) for health policy administrators. @*Methods@#Between October 2015 and September 2017, 41 participants from underdeveloped countries completed the three-week education program at K university, following the official selection process of the Korea International Cooperation Agency (KOICA) and each country’s embassy. @*Results@#The effects of the health policy capacity development education program differed significantly according to participants' age (p=.043), country region (p=.045), and academic or professional degree (p=.007). Academic or professional degree significantly predicted the effects of the program (β=.41, p=.007), explaining 21.7% of the variance in the regression model. @*Conclusion@#The current selection process for ODA program participants considers recommendations from each country’s embassy to determine eligible candidates. The hosting institution’s opinions or suggestions regarding participants’ professional expertise or work experience, country region, or demographic characteristics should also be considered in the participant selection process.

Development of the Health Promotion Program for the Auxiliary Police based on the PRECEDE Model / 한국직업건강간호학회지

Purpose@#The purpose of this study was to develop of the Health Promotion Program for the Auxiliary Police based on PRECEDE model. @*Methods@#The data were collected from the Auxiliary Police officer in the D provincial Police Agency. The program was developed through analysis of literature review, analysis on the Auxiliary Police’s demand through in-depth interview, and the content validation by an expert group. @*Results@#The program consists group education sessions (7 times, 90 minutes each) for 5 weeks. The program also reflects the concept of quality of life, health promotion behavior, self-efficacy and health knowledge, social support, and availability of resources which are important factors for assessment through PRECEDE. @*Conclusion@#The results may be crucial to develop strategy in order to decrease the disease prevalence as well as increase the participants’ overall quality of life of Auxiliary Police. This is proposed to standardize the Health Promotion Program for the Auxiliary Police.

Effects of a Reinforcement Program for Postpartum Care Behavioral Skills of Couples with Their First Baby / 간호학회지

PURPOSE: This study aimed to investigate the effects of a reinforcement program for behavioral skills in postpartum care for couples with their first baby. METHODS: The study used a non-equivalent control group and pretest-posttest design. It was conducted from January 14 to April 10, 2016 at a postpartum care center in D city. It analyzed 43 couples (22 in the experimental group and 21 in the control group.) For data analysis, descriptive statistics, test of homogeneity in pretest, independent t-tests, and repeated measures ANOVA were used. RESULTS: For maternal fulfillment of postpartum care and postpartum fatigue, there was no significant difference in the interaction between group and time. In terms of parent-newborns attachment, the interaction between group and time showed a significant difference for mothers (F=13.63, p=.001) and fathers (F=6.51, p=.001). In marital intimacy, the interaction between group and time showed a significant difference for mothers (F=14.40, p<.001) and fathers (F=9.46, p=.004). In parenting stress, the interaction between group and time showed a significant difference for mothers (F=31.8, p<.001) and fathers (F=11.69, p=.001). A significant difference was found for the mothers' postpartum sleeping hours (F=0.14 p=.004). CONCLUSION: This program for behavioral skills in postpartum care, which is based on the information-motivation-behavioral skills model, improves postpartum care, parent-newborn attachment, marital intimacy, parenting stress, and maternal postpartum sleeping, by reinforcing behavioral skills required for postpartum care.

Effects of a Reinforcement Program for Postpartum Care Behavioral Skills of Couples with Their First Baby

PURPOSE@#This study aimed to investigate the effects of a reinforcement program for behavioral skills in postpartum care for couples with their first baby.@*METHODS@#The study used a non-equivalent control group and pretest-posttest design. It was conducted from January 14 to April 10, 2016 at a postpartum care center in D city. It analyzed 43 couples (22 in the experimental group and 21 in the control group.) For data analysis, descriptive statistics, test of homogeneity in pretest, independent t-tests, and repeated measures ANOVA were used.@*RESULTS@#For maternal fulfillment of postpartum care and postpartum fatigue, there was no significant difference in the interaction between group and time. In terms of parent-newborns attachment, the interaction between group and time showed a significant difference for mothers (F=13.63, p=.001) and fathers (F=6.51, p=.001). In marital intimacy, the interaction between group and time showed a significant difference for mothers (F=14.40, p<.001) and fathers (F=9.46, p=.004). In parenting stress, the interaction between group and time showed a significant difference for mothers (F=31.8, p<.001) and fathers (F=11.69, p=.001). A significant difference was found for the mothers' postpartum sleeping hours (F=0.14 p=.004).@*CONCLUSION@#This program for behavioral skills in postpartum care, which is based on the information-motivation-behavioral skills model, improves postpartum care, parent-newborn attachment, marital intimacy, parenting stress, and maternal postpartum sleeping, by reinforcing behavioral skills required for postpartum care.

In Situ Cross-Linkable Hydrogels as a Dynamic Matrix for Tissue Regenerative Medicine

BACKGROUND: Polymeric hydrogels are extensively used as promising biomaterials in a broad range of biomedical applications, including tissue engineering, regenerative medicine, and drug delivery. These materials have advantages such as structural similarity to the native extracellular matrix (ECM), multi-tunable physicochemical and biological properties, and biocompatibility. METHODS: In situ forming hydrogels show a phase transition from a solution to a gel state through various physical and chemical cross-linking reactions. These advanced hydrogel materials have been widely used for tissue regenerative medicine because of the ease of encapsulating therapeutic agents, such as cells, drugs, proteins, and genes. RESULTS: With advances in biomaterials engineering, these hydrogel materials have been utilized as either artificial cellular microenvironments to create engineered tissue constructs or as bioactive acellular matrices to stimulate the native ECM for enhanced tissue regeneration and restoration. CONCLUSION: In this review, we discuss the use of in situ cross-linkable hydrogels in tissue engineering and regenerative medicine applications. In particular, we focus on emerging technologies as a powerful therapeutic tool for tissue regenerative medicine applications.

Association between Sleep Duration and Obesity in Young Korean Adults

BACKGROUND: The purpose of this study was to investigate the association between number of sleep hours and obesity based on body mass index (BMI) after adjusting for socioeconomic position, health behaviors, and clinical factors. METHODS: Data from subjects aged 20-64 years (n=12,688) in the Korea National Health and Nutrition Examination Survey in 2007-2009 was analyzed. Subjects were divided into two groups according to age: 20-44 (young adults) and 45-64 years (middle-aged adults). With respect to sleep time, subjects were classified as short sleepers (<6 hr/day), long sleepers (≥9 hr/day), and normal sleepers (6-8.9 hr/day). Obesity was defined as a BMI ≥25. RESULTS: The proportion of patients who were obese was 27.8%. The distribution of short sleepers, long sleepers, and normal sleepers was 6.4%, 13.7%, and 79.9%, respectively. The adjusted short sleeper and long sleeper odds ratios (OR) for obesity in young adults were significantly different from that in middle-aged adults after adjustment for confounding factors. In women, the adjusted short sleeper OR for obesity was 1.56 (95% CI, 1.02-2.37). CONCLUSION: This community-based random sample of Korean adults showed that women with short sleep duration may be at significant risk of obesity.

Effects of Sarcopenic Obesity on Metabolic Syndrome in Korean Elders: Using Data from the Korea National Health and Nutrition Examination Survey (2008-2011)

PURPOSE: This study was conducted to examine effects of sarcopenic obesity on metabolic syndrome in Korean elders. METHODS: This study is based on the analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) with 1,155 subjects (524 men, and 631 women) aged 60 or older, from 2008 to 2011. Sarcopenia was defined as an appendicular skeletal muscle (ASM), divided by weight (%) of <1 SD (standard deviation) below the sex-specific mean for young adults. Obesity was defined as a total body fat percent (men≥25%, women≥35%). RESULTS: The prevalence of SO (sarcopenic obesity) was 13.3% among men and 22.5% among women. Both sexes showed a higher total body fat percent, and the SMI (skeletal muscle index) was the lowest in the SO group. Metabolic syndrome was highly prevalent in the SO group (52.5% men, 60.4% women). The SO group showed a higher risk for metabolic syndrome (odds ratio men 6.57 [95% CI 5.19~7.27], women 3.89 [95% CI 2.41~6.29]) than the obese group (men 3.14 [95% CI 1.76~4.14], women 2.54 [95% CI 1.38~4.65]). CONCLUSION: SO is a major risk factor for metabolic syndrome in Korean elders. Therefore, a nursing program should be given to the Korean elderly SO group to prevent metabolic syndrome.

Differences in the Characteristics of Sexual Abuse Victimization between Low- and High-Grade Elementary School Children and Correlations among the Characteristics

PURPOSE: This study is attempted to figure out the characteristics of sexual abuse victimization in low- and high-grade elementary school children and furthermore to help develop appropriate preventive educational programs against sexual abuse by grade. METHODS: Data were collected from 156 sexual abuse victims who were elementary school children and visited the Child Sexual Abuse Response Center in D City during the period from 2010 to 2012. Differences in general and victimization-related characteristics between low and high graders and the correlations among the characteristics were analyzed. RESULTS: The results showed statistically significant difference between low and high graders in two variables: offender-victim relationship, and the type of sexual abuse. Offender-victim relationship was in a significant correlation with the duration of victimization (r=.576, p<.001), frequency of abuse (r=.546, p<.001), location (r=-.479, p<.001), and time (r=.435, p<.001). The type of sexual abuse was in a significant correlation with frequency (r=.175, p=.029) and time (r=.261, p=.001). CONCLUSION: Appropriate educational programs should be developed for preventing sexual assaults in consideration of difference in victimization-related characteristics between low and high graders. In addition, such programs should be applied fittingly to the learners'grade, gender, and cognitive level.

Effects of Self-esteem Improvement Program on Self-esteem and Peer Attachment in Elementary School Children with Observed Problematic Behaviors

PURPOSE: The purpose of this study was to investigate the effects of a self-esteem improvement program on self-esteem and peer attachment in elementary school children with observed problematic behaviors. METHODS: This study is a quasi-experimental study with a nonequivalent control group pretest-post-test design. A total of 47 fourth grade elementary school students participated in this study. The program was provided for 45 minutes once a week; a total of 12 sessions were completed with a group in the classroom for the experimental group. Child Problem-Behavior Screening Questionnaire was used to measure problematic behavior. Self-esteem was measured using the Rosenberg's Self-esteem Questionnaire, and peer attachment was measured using the Inventory of Parent and Attachment. Measuring was performed right after the program was done (post 1) and 1 month after the program was finished (post 2). To compare the differences in self-esteem and peer attachment between groups, repeated measures analysis of variance was used. RESULTS: Most participants in the experimental group were 10 years old (62.5%, range 10-11), male (52.0%) and with middle grade point average (64.0%). The self-esteem scores in the experimental group were significantly higher than those of the control group (F = 26.64, p < .001). The peer attachment scores in the experimental group were significantly higher than those of the control group (F = 6.48, p = .014). CONCLUSIONS: The self-esteem improvement program in this study improved the self-esteem and peer attachment in elementary school children. The self-esteem program helped acknowledge the peer's name and increased their connections. The program needs to be considered as a formal and consistent program.

A Study to Investigate the Medium- and Long-Term Developmental Directions of Mental Hospitals / 신경정신의학

OBJECTIVES: The aim of this study was to investigate medium- and long-term developmental directions of mental hospitals. METHODS: The preliminary investigation is composed of unstructured interviews with 10 psychiatrists, literature and case investigations, and development of models for medium- and long-term developmental model. The qualitative investigation consisted of constructed interviews with seven professionals. The quantitative investigation was conducted using questionnaires, which were sent to members of the Korean Neuropsychiatric Association, etc. Data were analyzed using frequency analysis. RESULTS: Through the preliminary investigation we were able to make three models : community model emphasizing linkage between mental hospitals and community, specialization model stressing specializations of mental hospitals, and extension model highlighting extensions of the roles of the mental hospital. In the qualitative investigation, two of the seven professionals gave a special preference for the community model, one for the specialization model, and two for the extension model. In the quantitative investigation, the community model and the specialization model were the most favorite models, and the extension model was the least favorite model. CONCLUSION: Three developmental models could be used in planning of the medium- and long-term developmental directions of mental hospitals, although each model needs to be embodied in order to work in practice.

Effects of Sexuality Education Coaching Program on Sex-related Knowledge and Attitude among Elementary School Students

PURPOSE: The purpose of this study was to investigate the effects of a sexuality education coaching program given to elementary school students in terms of sex-related knowledge and attitude. METHODS: The participants were elementary school students in S city (Experimental group=21, Control group=23). Data were collected and the program was conducted from Feb. 15 to Apr. 15, 2013. The experimental group of 21 elementary school students in the fifth and sixth grades who received the sexuality education coaching program, 10 sessions in the three weeks. The control group of 23 elementary school students in the fifth and sixth grades from another school received, 2 sessions in the three weeks on sexuality education including physiology and sexual abuse prevention. Data were analyzed using chi2-test, independent t-test, repeated measures ANOVA, and utilized the SPSS program. RESULTS: The experimental group showed significantly better sex-related knowledge and sex-related attitudes than the control group. CONCLUSION: Therefore, individualized approach with emphasis on the differences of their level of understanding and strengths should be considered in providing sexuality education coaching programs for elementary school students.

The Effect of a Social Support Program on Family Caregivers' Role Strain in Elderly Long-term Home Care

PURPOSE: This study was conducted to evaluate the effect of a social support program on family caregivers' role strain in elderly long-term home care. METHODS: The research adopted a non-equivalent control group pretest-posttest design. The number of participants was 25 in the experimental group and 25 in the control group sampled among family caregivers in elderly long-term home care. The experimental group participated in a 10-session social support program, which consisted of physical, emotional, informational, and material support. The effect of the program was evaluated by measuring family caregivers' role strain. RESULTS: The experimental group showed a significant decrease in family caregivers' role strain in elderly long-term home care. CONCLUSION: The result suggests that the social support program was effective in decreasing family caregivers' role strain in elderly long-term home care. There is a need to develop more effective and systematicsocial support programsfor family caregivers of elderly long-term home care.

Attunement Disorder : A Disorder of Brain Connectivity

OBJECTIVES: We reviewed cellular and synaptic dysconnectivity, disturbances in micro- and macro- circuitries, and neurodevelopmentally-derived disruptions of neural connectivity in the pathogenesis of schizophrenia. METHOD: We reviewed the selected articles about disturbances in neural circuits which had been proposed as a pathogenetic mechanism of schizophrenia. RESULTS: The literature review reveals that schizophrenia may be a disease related to disturbance in neurodevelopmental mechanism, shown as 'a misconnection syndrome of neural circuit or neural network'. In descriptive psychopathological view, definition of a disorder of brain connectivity has limitation to explain other aspects of schizophrenia including deterministic strictness in thought process. CONCLUSION: Schizophrenia is considered as a disorder of brain connectivity as well as a neurodevelopmental disorder related with genetic and environmental factors. We could make a suggestion that "JoHyeonByung (attunement disorder)" denotes the disturbances of psychic fine-tuning which correspond to the neural correlates of brain dysconnectivity metaphorically.

Factors of Depression in Korean-Chinese Elders in the Yanbian Korean Autonomous Prefecture in China: With Reference to Han-Chinese Living in the Yanbian Korean Autonomous Prefecture

PURPOSE: This study was to investigate depression in Korean-Chinese elder living in the Yanbian Korean Autonomous Prefecture in China. METHODS: A cross-sectional community-based survey was conducted using face to face private interviews for elders aged over 59, who have been dwelling in the Yanbian Korean Autonomous Prefecture. The samples consisted of 183 Korean-Chinese and 182 Han-Chinese with the latter as a reference group. Data were collected from August 25 to September 20, 2011 and analyzed with the SPSS 18.0 program. The GDS (Geriatric Depression Scale) was used to measure elderly depression in the subjects. RESULTS: In Korean-Chinese, the rate of depression was higher in those who had lower educational levels, and were economically supported by the government. And those who had depression showed lower scores in Chinese language proficiency, health status, and social supports, and had more chronic diseases. Factors having effects on Korean-Chinese elderly depression included perceived health status and subjective support. CONCLUSION: According to the results, for preventing the depression of Korean-Chinese, it is necessary to develop health management programs and social support networks, which were easy to approach.

The Correlation between Nursing Professional Values and Job Satisfaction Depending on the Types of Visiting Nurses' Personality / 산업간호학회지

PURPOSE: The purpose of this study is to identify nursing professional values and job satisfaction depending on the types of personality in visiting nurses. METHODS: Two hundred twenty six visiting nurses participated in this study. Data collection was conducted in 26 Public Health Centers in Korea. The Korean version of the Enneagram nursing professional values and job satisfaction was used to measure the nursing professional values and job satisfaction. RESULTS: The most common personality is type 9, a center of the Instinctive Center where energy tends to stress outwards. There was a significant difference in nursing professional values depending on the type of personality. The type 1, 2 and type 9 had a significant difference by depending on the type of personality. There was but no difference in job satisfaction. There was a negative correlation between nursing professional values and job satisfaction by depending on the type of personality. The nurses with the type 9 and type 1 of personality showed a significant differences with the negative correlation between professional values and job satisfaction. CONCLUSION: The findings of this study showed the necessity of a self-understanding program to improve the working efficiency by increasing the professional values and job satisfaction of visiting nurses.

The Correlation between Nursing Professional Values and Job Satisfaction Depending on the Types of Visiting Nurses' Personality / 한국직업건강간호학회지

PURPOSE: The purpose of this study is to identify nursing professional values and job satisfaction depending on the types of personality in visiting nurses. METHODS: Two hundred twenty six visiting nurses participated in this study. Data collection was conducted in 26 Public Health Centers in Korea. The Korean version of the Enneagram nursing professional values and job satisfaction was used to measure the nursing professional values and job satisfaction. RESULTS: The most common personality is type 9, a center of the Instinctive Center where energy tends to stress outwards. There was a significant difference in nursing professional values depending on the type of personality. The type 1, 2 and type 9 had a significant difference by depending on the type of personality. There was but no difference in job satisfaction. There was a negative correlation between nursing professional values and job satisfaction by depending on the type of personality. The nurses with the type 9 and type 1 of personality showed a significant differences with the negative correlation between professional values and job satisfaction. CONCLUSION: The findings of this study showed the necessity of a self-understanding program to improve the working efficiency by increasing the professional values and job satisfaction of visiting nurses.

Effects on Salivation, Xerostomia and Halitosis in Elders after Oral Function Improvement Exercises

PURPOSE: The purpose of this study was to investigate effects of Oral Function Improvement Exercises on salivation, xerostomia and halitosis in elderly people. METHODS: The participants in the study were 48 female community-dwelling elders in D city. The Oral Function Improvement Exercises were given 3 times a week, for a total of 24 times from August to October 2011. Spitting method, Visual Analogue Scale, and halimeter (mBA-21) were used to evaluate the effects of Oral Function Improvement Exercises on salivation, xerostomia, and halitosis. The data were analyzed using chi2-test and t-test with the SPSS program. RESULTS: The experimental group had significantly better salivation, and less xerostomia and halitosis than the control group. CONCLUSION: The results indicate that Oral Function Improvement Exercises were effective for salivation, xerostomia and halitosis in the elders. Therefore, it was suggested that Oral Function Improvement Exercise are applicable in a community nursing intervention program to improve the quality of life for elders.