Effects of Aroma Essential Oil Inhalation on Autonomic Nerve System Response, Electroencephalogram and Concentration / 기본간호학회지

Purpose@#This study was an experimental research study to examine the effects of aroma essential oil inhalation on autonomic nerve system response, electroencephalogram and concentration. @*Methods@#The participants were 92 healthy adults: 32 in the experimental group, 30 in the placebo group, and 30 in the control group. In the experimental group, lemon and rosemary oil were mixed in a ratio of 4: 1, and 0.1 ml was dropped on gauze and then naturally inhaled for a total of 30 minutes. The application for the placebo group was 0.9% saline solution, and for the control group, no treatment. To determine the effects, the autonomic nervous system response was measured by applying Canopy 9 Plus 4.0 before the experiment and at 10, 20, and 30 minutes after the experimental application, and an electroencephalogram was taken using QEEG-8. The computerized neurocognitive function test for measuring concentration was given before the experiment and at 30 minutes after the treatment. @*Results@#There were no significant differences in the homogeneity tests for general characteristics and for the dependent variables prior to the experiment. There was a significant difference in sympathetic nervous activity between the experimental group, placebo group, and control group (F=3.78, p=.027), and the experimental group had higher sympathetic nervous activity than the control group. There was no statistically significant difference on the electroencephalogram between the ⍺ and beta waves of the three groups. The Stroop Color-Word interference test (color) of the three groups for concentration measurement was significantly different between pre test and at 30 minutes after the treatment (F=7.40, p=.001), and the score for the experimental group increased compared to the control group. @*Conclusion@#The findings showed that the inhalation of aroma essential oil activated the sympathetic nervous system and partially increased the level of concentration.

Effects of a Thermoelectric ElementBandon Venipuncture-associatedPain and Anxiety: A RandomizedControlledTrial

Purpose@#Venipuncture is an invasive procedure for diagnosis and treatment, which is often attributed to pain and anxiety. In this study, a thermoelectric element (TEE) band was developed to apply heat therapy (40∼45°C), cold therapy (0∼10°C), or thermal grill illusion (TGI) therapy (40∼45°C, 0∼10°C) to cause an illusion of pain by simultaneously applying heat and cold. This band was subsequently used to investigate its effect on patient pain, anxiety, and satisfaction. @*Methods@#This was a randomized controlled study. Participants, who were to undergo venipuncture, were randomly assigned to the heat therapy, cold therapy, TGI therapy, or control groups. Each group had 30 participants. The interventions were employed for 10 seconds during venipuncture, and the pain, anxiety, and satisfaction were measured before and after the procedure. @*Results@#Subjective pain, anxiety, and physiological responses after TEE band intervention were not significantly different between the four groups. However, there was a significant difference in satisfaction (F = 4.21, p = .007) between the four groups, and the cold therapy group showed the highest satisfaction. @*Conclusion@#In this study, when heat, cold, and TGI therapy were applied with a TEE band, pain and anxiety relief effects were not confirmed, but satisfaction was high. TEE band is a newly developed product that can easily apply hot and cold treatments without using ice packs or hot water packs. Further studies with various individual characteristics of chronic pain or repeated venipuncture are warranted to evaluate the effect of TEE.

Effect of Resistance Exercise Program for Middle-Aged Women with Myofascial Pain Syndrome on Shoulder Pain, Angle of Shoulder Range of Motion, and Body Composition Randomized Controlled Trial, RCT

Purpose@#This study aimed to identify the effects of myofascial pain syndrome on shoulder pain, range of motion, and body composition around the shoulder in middle-aged women. @*Methods@#A total of 72 women participated in the randomized controlled trial. The subjects were grouped into an experimental group (n=39) and a control group (n=33). The experimental group received a resistance exercise program using an elastic band for 8 weeks, 3 days a week. The control group followed a normal daily for 8 weeks. Measurements were conducted three times; before the experimental treatment (pre-test), the 2nd and 8th weeks after treatment. @*Results@#Regarding the general characteristics and homogeneity of the dependent variables, there were no significant differences between the two groups, except for the thickness of the left and right muscles and the left fat. After treatment, shoulder pain was significantly different between the two groups (F=18.54, p <.001) and the range of shoulder motion was significantly different (left, F=86.70, p <.001; right, F=98.66, p <.001). Furthermore, there were a significant differences in the thickness of muscles between the two groups (left, F=40.20, p <.001; right, F=29.57, p <.001); however, the thickness of fat was not significantly different. @*Conclusion@#The resistance exercise program reduces shoulder pain and improves the range of motion of the shoulder joint and increases muscle mass on around the shoulder. It suggests to conduct a study to confirm the long-term exercise effect.

Deterioration of Sleep Quality According to Glycemic Status

Background@#Type 2 diabetes mellitus (T2DM) is a progressive disease with multiple complications. The present study aimed to determine the effects of glycemic status on sleep quality in individuals with T2DM, prediabetes, and normal glucose tolerance (NGT). @*Methods@#A total of 90 participants were categorized into three groups, T2DM (n=30), prediabetes (n=30), and NGT (n=30). @*Objective@#sleep quality was measured with the actigraph wrist-worn device over 3 nights and subjective sleep quality was evaluated with a questionnaire. @*Results@#The duration of diabetes in the T2DM group was 2.23 years and the glycosylated hemoglobin (HbA1c) levels in the T2DM, prediabetes, and NGT groups were 7.83%, 5.80%, and 5.31%, respectively. Sleep efficiency decreased across the T2DM, prediabetes, and NGT groups (86.25%, 87.99%, and 90.22%, respectively; P=0.047). Additionally, HbA1c levels revealed a significant negative correlation with sleep efficiency (r=–0.348, P=0.001). The sleep quality questionnaire results were similar among the three groups. @*Conclusion@#Although the participants in the present study were not necessarily conscious of their sleep disturbances, deterioration in sleep quality progressed according to glycemic status.

A Systematic Review of Breast Care for Postpartum Mothers / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify nursing interventions for the postpartum breast care of mothers and determine the effectiveness of interventions for breast pain and engorgement by systematic review. METHODS: Eight national and international databases were reviewed to retrieve and collect randomized controlled trial and controlled clinical trial literature published up to March 2015. Two reviewers independently selected the studies and performed data abstraction and validation. The risk of bias was assessed using Cochrane criteria. A meta-analysis of the studies was performed to analyze the data. RESULTS: The meta-analysis showed that breast massage, along with routine breast care, resulted in a 3.52-point reduction in pain on a 10-point visual analogue scale. Meta-analysis of therapy with cold cabbage leaves and routine breast care showed a pain reduction of 0.54 points. Meta-analysis of cold cabbage leaf application in the experimental group versus cold compress therapy in the comparison group showed a pain reduction of 0.44 points. Meta-analysis of cold cabbage leaf application and routine breast care showed an engorgement reduction of 0.67 points. CONCLUSION: The results of the analysis of 12 articles showed that hot and cold compresses, breast massage, and cabbage application were effective for postpartum breast pain and engorgement.

Understanding of Factors Influencing Happiness of Middle-Aged Women in Korea Based on Maslow's Hierarchy of Needs

OBJECTIVE: Middle-aged women experience a lot of events of physical changes and various mental conflicts. The purpose of this study is to determine variables related to happiness, and to make and verify the model for happiness of middle-aged women. METHODS: We constructed conceptual model for happiness of middle-aged women in Korea, based on Maslow's hierarchy of needs. This model consisted of three exogenous variables (health status, financial distress, and social support) and three endogenous variables (self-esteem, positive thinking, and happiness). For middle-aged women in Korea, we returned 442 questionnaires of 460 participants. RESULTS: Model fit of the modified model was satisfied; χ²=102.108, GFI=0.959, CMIN/DF=2.917, RMSEA=0.068, AGFI=0.922, CFI=0.977, SRMR=0.0368. Happiness was explained by 82% through health status, financial distress, social support, self-esteem, and positive thinking. As Maslow's hierarchy of needs, happiness of middle-aged women is related to basic needs (health status, financial distress, and social support), psychological needs (self-esteem and positive thinking) and self-fulfillment needs (happiness). CONCLUSION: Our study shows that it is required intervention for meeting basic factor such as health status, financial distress and social support in order to increase happiness of middle-aged women.

Inhalation Effects of Aroma Essential Oil on Quality of Sleep for Shift Nurses after Night Work

PURPOSE: This study was an experimental study to compare the inhalation effects of aroma essential oil on the quality of sleep (QOS) for shift nurses after working nights. METHODS: The participants were 60 healthy adults who didn't have any disease. As an experimental treatment, the participants in the experimental group were asked to inhale essential oil for 3 minutes at a distance of approximately 10 cm fromt heir nose and then they were asked to sleep with the aroma stone beside their head (within a 30 cm distance). QOS were measured four times on Pretest, Day 1, Day 2, and Day 3 after they slept. To measure QOS, Perceived QOS (Numeric Rating Scale), the Verran & Synder-Halpern (VSH) Sleep Scale were used, and number of awakenings (NoA) was measured by Actigraph. RESULTS: There were no significant differences in the homogeneity tests for general characteristics and dependent variables prior to the experiments, except for VSH of subjective sleep quality. Also, there was no significant interaction between group and time. The VSH of the experimental group was higher than the control group (F=6.39, p=.002). The NoA between the experimental group and the control group was significantly different after experimental treatment 3rd day (F=13.35, p=.001). CONCLUSION: The findings show that the inhalation of aroma essential oil had effects to increase the quality of sleep. Therefore, the inhalation of aroma essential oil could be applied to general nursing interventions to improve the quality of sleep.

Effects of Aromatherapy on Menopausal Symptoms, Perceived Stress and Depression in Middle-aged Women: A Systematic Review

PURPOSE: This study was a systematic review to evaluate the effects of aromatherapy on menopausal symptoms, perceived stress and depression in middle aged-women. METHODS: Eight databases were searched from their inception September 8, 2015. Two reviewers independently performed the selection of the studies, data abstraction and validations. The risk of bias was assessed using Cochrane criteria. For analysis of the data, a meta-analysis of the studies was performed. RESULTS: From the electronic databases, 73 articles were selected, and 19 removed due to duplication. After two reviewers read the abstracts of 54 studies, 34 studies were selected. Complete papers for 34 original articles were read and, 12 studies which met selection criteria were reviewed and the effects of aromatherapy on menopausal symptoms, stress and depression analyzed using meta-analysis with RevMan. In the 2 studies which included Randomized Controlled Trials testing of aromatherapy on menopausal symptoms and comparison of control and placebo groups were done. Aromatherapy massage was favorably effective in reducing the menopausal symptoms compared to the control group (n=118, MD=-6.33; 95% CI -11.51 to -1.15), and compared to the placebo group (n=117, MD=-4.14; 95% CI -7.63 to -0.64). Also aromatherapy was effective in reducing stress (n=72, SMD=-0.64; 95% CI -1.12 to -0.17) and depression (n=158, MD=-5.63; 95% CI -10.04 to -1.22). CONCLUSION: There is limited evidence suggesting that aromatherapy for middle-aged women may be effective in controlling menopausal symptoms, perceived stress and depression.

Effect of Emotional Labor and Stress on Premenstrual Syndrome among Hospital Nurses

PURPOSE: This study is an explorative survey to examine emotional labor, stress, and premenstrual syndrome among hospital nurses and to examine relationships among them. METHODS: Data were collected from 228 nurses working at hospitals using structured questionnaires from September to October, 2014. Data were analyzed using SPSS 21.0 by frequency, descriptive statistics, t-test, one-way ANOVA, and Pearson's correlation coefficient. RESULTS: Score of emotional labor was different by work time per week (F=4.03, p=.019), and menstrual amount (F=5.18, p=.006). Level of stress was different by marital status (t=2.29, p=.023), pattern of work (t=-3.63, p<.001), work time per week (F=3.39, p=.035), regularity of menstrual cycle (t=-4.20, p<.001), and exercise frequency (F=4.28, p=.015). Scores of premenstrual syndrome were different by regularity of menstrual cycle (t=-3.18, p=.002), and menstrual amount (F=5.88, p=.003). Emotional labor was related with perceived stress (r=.40, p<.001) and premenstrual syndrome (r=.23, p<.001). Also, perceived stress was related with premenstrual syndrome (r=.33, p<.001). CONCLUSION: Nurses' emotional labor, stress, and premenstrual syndrome were higher than the average. Emotional labor was correlated with stress and premenstrual syndrome, premenstrual syndrome with stress. This study shows that it is necessary to understand these relationships and to search for nursing intervention to ease emotional labor, stress, and premenstrual syndrome.

Sleep Quality, Fatigue, and Postpartum Depression of Mother at Six Months after Delivery

PURPOSE: This study was correlation study to identify the factors influencing sleep quality, fatigue, and postnatal depression in mothers who have given birth during the past 6 months. METHODS: The study was conducted using a survey with questionnaires to 329 mothers who visited E University Medical Center, or three local clinics located in D city, between August and October 2013. Collected data were analyzed using the SPSS/WIN 20.0 program. RESULTS: Out of 329 subjects, 18.2% showed that they had mild postnatal depression whereas 24.3% had severe postnatal depression. Accordingly, 42.5% reported having postnatal depression. Postnatal depression had a significant correlation with sleep hours after childbirth (r=-.16, p=.003), spousal support (r=-.28, p<.001), sleep quality (r=-.35, p<.001), physical fatigue (r=.66, p<.001), psychological fatigue (r=.69, p<.001), and neurosensory fatigue (r=.56, p<.001). Factors influencing postnatal depression include psychological fatigue, sleep quality, number of child births, and neurosensory fatigue, and these accounted for 53% of postnatal depression. CONCLUSION: Results indicate that factors influencing postnatal depression involve psychological fatigue, sleep quality, number of child births, and neurosensory fatigue. Therefore for nursing intervention for postpartum mothers, it is necessary to assess the level of depression, fatigue, and sleep quality, and to provide interventions to relieve depression.

Effects of Oketani Breast Massage on Breast Pain, the Breast Milk pH of Mothers, and the Sucking Speed of Neonates

PURPOSE: This study was done to test the effects of Oketani breast massage on breast pain and breast milk pH of mothers, and sucking speed of neonates. METHODS: A nonequivalent control group and a pretest-posttest design was used. Postpartum mothers complaining of breast pain were recruited at a postpartum care center. The application of Oketani breast massage by an Oketani massage therapist was the experimental treatment. The control group received the conventional massage technique from a nurse at the postpartum care centre. The collected data were analysed using a chi2-test and a t-test with the SPSS WIN 12.0 program. RESULTS: The participants were homogeneous in age, gestation period, and birth weight. Breast pain (t=8.384, p<.001) was significantly relieved, and breast milk pH (t=4.793, p<.001) was significantly increased in the experimental group compared to the control group. The sucking speed of the neonates in the experimental group was significantly increased compared to the control group (t=9.920, p<.001). CONCLUSION: These findings indicate that Oketani breast massage is effective in relieving breast pain and increasing breast milk pH as well as the sucking speed of neonates.

Effects of A-solution on Halitosis and Oral Status in Preoperative NPO Patients

PURPOSE: The aim of this study was to explore the effects of A-solution on halitosis and oral status in preoperative NPO patients. METHODS: A nonequivalent control group, non-synchronized pretest-posttest design was used in this study. The participants in this study were 66 patients who were admitted for gynecologic surgery. The experimental treatment was to give oral gargling with A-solution, blended essential oils and diluted with distilled water. To identify the experimental treatment effects, halitosis, salivary pH, and oral status were measured by a portable halitosis detector, visual analogue scale, Bromo Thymol Blue (BTB), Bromo Cresol Purple (BCP) test paper and oral assessment guide. Data were analyzed using chi2-test, t-test with PASW 18.0 version. RESULTS: Participants were homogeneous before experimental treatment. Objective halitosis in the experimental group, measured by a portable halitosis detector (t= -8.34, p<.001) was significantly lower than the control group. Subjective halitosis was significantly lower in the experimental group (t= -9.29, p<.001). Salivary pH was significantly different between two groups (t=8.81, p<.001). Oral status was significantly better in the experimental group (t= -13.31, p<.001). CONCLUSION: These findings indicate that oral gargling using A-solution is effective in reducing patient halitosis, and improving oral status.

Predictors of Compliance in Hypertensive Patients / 기본간호학회지

PURPOSE: The purposes of this study were to identify knowledge, health belief and compliance in patients with hypertension and to identify the most important predictors for compliance of hypertensive patient. METHOD: The participants in this study were 117 patients who were receiving treatment for hypertension at E. university hospital or one of three local clinics in D-city. Data were collected using a knowledge measurement instrument, health belief scale, and an instrument on compliance. Collected data were analyzed using chi2 test, ANOVA, multiple linear regression with PASW statistics 18.0 program. RESULTS: There were statistically significantly positive correlations between knowledge of hypertension and health belief, health belief and compliance. But there was no correlation between knowledge of hypertension and compliance. In the multiple regression analysis, perceived barriers, perceived severity, perceived benefits were significant predictors to explain compliance and accounted for 54.1% of the variance in compliance. CONCLUSION: The results of the study indicate that health belief and compliance are significantly strongly correlated. Thus it is suggested that nursing interventions to improve compliance should include nursing care plans to increase health belief, perceived severity, perceived benefit and to decrease perceived barrier.

Effects of the Spouse's Aromatherapy Massage on Labor Pain, Anxiety and Childbirth Satisfaction for Laboring Women / 여성건강간호학회지

PURPOSE: The purpose of this study was to determine the effects of the spouse's aromatherapy massage on labor pain, anxiety during labor and childbirth satisfaction for laboring women. METHODS: The subjects of this study were laboring women who didn't have any complication during pregnancy and who have admitted for childbirth with their spouse to E. hospital in D city. This study was carried out from June to November in 2007. The subjects were allocated into three groups: spouse's aromatherapy massage group, spouse's carrier oil massage group and control group. Aromatherapy massage and carrier oil massage was applied for ten minutes every hour after the cervix dilated 5cm. The subjects in the control group were with their spouse during labor. RESULTS: The labor pain by VAS was significantly different among the three groups (Kruskal-Wallis chi2=7.09 p=.029) in the deceleration phase. The anxiety during labor by VAS were significantly different among the three groups (Kruskal-Wallis chi2=6.77 p=.034) in the deceleration phase. There was no significant difference in childbirth satisfaction among the three groups. CONCLUSION: The spouse's aromatherapy massage using Lavender, Clary sage, Frankincense and Neroli could be effective in decreasing labor pain and decreasing anxiety level during labor.

Student Experience and Satisfaction with Clinical Nursing Practice in Women's Health Nursing / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify students' experiences of performance and their satisfaction with clinical nursing practice in Women's health nursing. METHODS: Data was collected using questionnaire consisting of 104; 89,; and 82 nursing activities with 12; 10; and 7 domains for delivery floor, obstetric, and gynecologic wards retrospectively. Five hundred ninety nursing students from 10 four year and one three year colleges, were recruited and selected for data collection. RESULTS: Site specific core nursing activities among top 15 items of performed experience were: interpreting fetal monitoring; massage for pain reduction; breathing technique; perineal pad change; non stress test; manual check for uterine contraction; and position change for the delivery floor. Experiences of clinical nursing practice for the obstetric ward and the gynecologic ward were identified and ranked as well. Observation of delivery, measurement & test during labor and observation of anesthesia and operation were the highest ranked activity domains of satisfaction for delivery floor, obstetric and gynecologic wards retrospectively. CONCLUSION: Discussions are needed to standardize curriculum for clinical practice in women's health nursing initiated at the level of Korean Society of Womens' Health Nursing by reflecting this result. Strategic approaches are emphasized in order to enhance a collaboration between clinical fields and colleges.

Mother's Prenatal Care and Delivery Services Satisfaction according to Mode of Delivery / 여성건강간호학회지

PURPOSE: This study aimed to provide fundamental information about childbirth and antenatal care for pregnancy women and to find differences in mother's antenatal care and delivery service satisfaction between vaginal delivery and cesarean section. METHODS: This study was conducted in 4 residential areas and a study sample of 184 postpartum mothers who agreed to collect data. Data was collected from September 1 to October 20 2007 and a structured questionnaire were recruited by the survey. The data was analyzed by t-test and chi-squire test using SPSS/WIN 12.0. RESULTS: There was a significant difference in delivery place between vaginal delivery and cesarean delivery. Only 10.7% of vaginal delivery group delivered in general hospitals, however 24.5% of the cesarean section group delivered in general hospitals. Early antenatal care also showed statistical difference in mode of delivery. 43.5% of vaginal delivery mothers visited hospitals for the detection of pregnancy but 28.3% of cesarean section mothers did that. Vaginal delivery mothers more satisfied with her own delivery method and suggested a vaginal delivery to others. CONCLUSION: These results suggest that cesarean section mother's sensitivity of early antenatal care was less than vaginal delivery mother. Satisfaction related to delivery care services were higher in the vaginal delivery group.

The Effects of a Multi Agent Obesity Control Program in Obese School Children / 간호학회지

PURPOSE: The purpose of this study was to identify the effects of a multi agent obesity control program in obese school children. This program was composed of strategies to modify diet and exercise habits and to change cognitive behavior variables(stress, coping, and self-efficacy). METHOD: The subjects were 40 obese school children who participated in our project voluntarily via homepage, TV, newspaper, public paper and school official documents. The program was implemented daily for 4 sessions per day for ten days from August 16 to 26, 2004. The daily program consisted of exercise therapy, dance therapy, cognitive behavior therapy and aroma therapy. The data was analyzed by paired t-test using the SPSSWIN program. RESULT: There was a significant decrease in children's waist-hip ratio (p=.04) and in children's stress (p=.00) after the program. There was a significant increase in children's self-confidence after the program(p=.02) and a significant decrease in children's diet habit after the program(p=.02). CONCLUSION: This study provides evidence that a multiagent obese control program is effective in changing waist-hip ratio, stress, self-confidence, and diet habits in obese school children.

A Study on Sexual Behavior, and Correlation between Knowledge of Contraception and Attitude of Contraception among University Students / 간호학회지

PURPOSE: The purpose of this study was to describe sexual behavior and understand the correlation between knowledge and attitude of contraception and provide preliminary data to develop a sex education program. METHOD: The subjects of this study were 400 university students. Data was collected from November 14 to 20,2005 by using structured questionnaires. RESULT: The percent of subjects that experienced sexual intercourse was 32%. The respondents' score of knowledge of contraception was a mean score of 15.33 on a scale of 20 and there were significant differences in major departments, existence or nonexistence of sexual intercourse and sexual knowledge. The respondents' score of attitude of contraception was a mean score of 40.98 on a scale of 60 and there were significant differences in sex. There was no significant correlation between knowledge and attitude of contraception. CONCLUSION: A sex education program that uses practical knowledge and attitude of contraception to prevent conception should be developed rather than the present sex education that only attaches schoolbook knowledge.

The Effects of Inhalation of Essential Oils on the Body Weight, Food Efficiency Rate and Serum Leptin of Growing SD Rats / 간호학회지

PURPOSES: This experimental study was designed to verify the effect of inhalation of essential oils on body weight, feed intake, food efficiency rate and serum leptin. METHODS: The subjects of this study were 90 growing SD rats (46 males and 44 females). They were allocated into one of four groups, the Fennel group, Patchouli group, Bergamot group and control group. The experimental treatment was the inhalation of aromatherapy essential oils which was applied two times a day for 10 minutes each during 8 weeks. To evaluate the effects, body weight, feed intake, food efficiency rate and serum leptin were measured before and after the treatment. The collected data was analyzed by repeated measures of Kolmogorov-smirnov test and Normal Q-Q plot for nomality, Kruskal Wallis test and X2-test for experimental effects with the SPSS program. RESULTS: The food efficiency rate was significantly lower in the Patchouli group and Fennel group than in the Bergamot group and control group (P=.000). No significant group effects were found for SD rat's body weight, feeding amount and serum leptin. CONCLUSION: In conclusion, these findings indicate that the inhalation of essential oils could be effective in lowering the food efficiency rate rather than the feed intake.

A Study on Fluid Intake among Nursing Home Residents / 간호학회지

PURPOSE: The purposes of this study were to examine the amount of daily fluid intake among nursing home residents and to explore the caregiver's perceived barriers to elderly's fluid intake. METHOD: Data was collected from 111 nursing home residents and 64 caregiver's in 4 nursing homes. A random, non-consecutive three days of 24 hour fluid intake was measured and recorded. The caregiver's perceived barriers to elderly's fluid intake was assessed using a structured questionnaire. RESULTS: The average amount of daily fluid intake was 1,035(SD=359)ml with the range of 210ml to 2,050ml. About 52% (n=58) of the subjects had a less than adequate fluid intake. The amount of daily fluid intake was significantly associated with age, mental status, physical functioning, and the number of oral medications ordered. The most frequently mentioned caregiver's perceived barrier was elderly's concern about incontinence with increased fluid intake. CONCLUSION: Inadequate fluid intake among nursing home residents is prevalent. To enhance adequate hydration of nursing home residents, an institution wide nursing intervention is necessary.