Dietary Sodium Intake and Health-Related Quality of Life in Patients with Stable Heart Failure

BACKGROUND: Dietary sodium restriction is an essential component of self-care behavior for improved health-related quality of life (HRQoL) in patients with heart failure (HF). However, there is little direct evidence about the impact of dietary sodium restriction on HRQoL. The purpose of this study was to determine the impact of dietary sodium intake on HRQoL in HF patients with no cardiac events over 1-year of follow-up. METHODS: A total of 106 patients with HF completed a 3-day food diary to estimate daily sodium intake. Patients were divided into 4 groups (4 g). The Minnesota Living with Heart Failure Questionnaire was used to assess HRQoL at baseline and one year later. Hierarchical linear and logistic regressions were used to determine the relationship between dietary sodium intake and HRQoL. RESULTS: Thirty-seven (35%) patients had a daily sodium intake >3 g. Greater than 4 g of daily sodium intake was independently associated with a worse HRQoL at baseline and one year later (F=3.15, P=0.028; F=4.33, P=0.006) and an almost 5.2 times higher risk of a worsening HRQoL at one year follow-up (P=0.040) after controlling for age, gender, etiology, body mass index, New York Heart Association class, ejection fraction, total comorbidity score, and use of beta blockers. CONCLUSIONS: This finding provides additional evidence that greater than 4 g of daily sodium intake is associated with worsening HRQoL in stable HF patients who are free from cardiac events.

Dietary Sodium Intake and Health-Related Quality of Life in Patients with Stable Heart Failure

BACKGROUND: Dietary sodium restriction is an essential component of self-care behavior for improved health-related quality of life (HRQoL) in patients with heart failure (HF). However, there is little direct evidence about the impact of dietary sodium restriction on HRQoL. The purpose of this study was to determine the impact of dietary sodium intake on HRQoL in HF patients with no cardiac events over 1-year of follow-up. METHODS: A total of 106 patients with HF completed a 3-day food diary to estimate daily sodium intake. Patients were divided into 4 groups (4 g). The Minnesota Living with Heart Failure Questionnaire was used to assess HRQoL at baseline and one year later. Hierarchical linear and logistic regressions were used to determine the relationship between dietary sodium intake and HRQoL. RESULTS: Thirty-seven (35%) patients had a daily sodium intake >3 g. Greater than 4 g of daily sodium intake was independently associated with a worse HRQoL at baseline and one year later (F=3.15, P=0.028; F=4.33, P=0.006) and an almost 5.2 times higher risk of a worsening HRQoL at one year follow-up (P=0.040) after controlling for age, gender, etiology, body mass index, New York Heart Association class, ejection fraction, total comorbidity score, and use of beta blockers. CONCLUSIONS: This finding provides additional evidence that greater than 4 g of daily sodium intake is associated with worsening HRQoL in stable HF patients who are free from cardiac events.

Dietary Sodium Intake and Health-Related Quality of Life in Patients with Stable Heart Failure

BACKGROUND: Dietary sodium restriction is an essential component of self-care behavior for improved health-related quality of life (HRQoL) in patients with heart failure (HF). However, there is little direct evidence about the impact of dietary sodium restriction on HRQoL. The purpose of this study was to determine the impact of dietary sodium intake on HRQoL in HF patients with no cardiac events over 1-year of follow-up. METHODS: A total of 106 patients with HF completed a 3-day food diary to estimate daily sodium intake. Patients were divided into 4 groups (4 g). The Minnesota Living with Heart Failure Questionnaire was used to assess HRQoL at baseline and one year later. Hierarchical linear and logistic regressions were used to determine the relationship between dietary sodium intake and HRQoL. RESULTS: Thirty-seven (35%) patients had a daily sodium intake >3 g. Greater than 4 g of daily sodium intake was independently associated with a worse HRQoL at baseline and one year later (F=3.15, P=0.028; F=4.33, P=0.006) and an almost 5.2 times higher risk of a worsening HRQoL at one year follow-up (P=0.040) after controlling for age, gender, etiology, body mass index, New York Heart Association class, ejection fraction, total comorbidity score, and use of beta blockers. CONCLUSIONS: This finding provides additional evidence that greater than 4 g of daily sodium intake is associated with worsening HRQoL in stable HF patients who are free from cardiac events.

Impact of Health Literacy on Disease-related Knowledge and Adherence to Self-care in Patients with Hypertension / 기본간호학회지

PURPOSE: The purposes of this study were to identify the level of health literacy and to determine its impact on disease-related knowledge and adherence to self-care in adults with hypertension. METHODS: This was a cross-sectional, descriptive study in which patients with hypertension were recruited from outpatient hypertension clinics in Seoul, Korea from December, 2009 to February, 2010. A total 186 patients completed series of questionnaires to assess health literacy, disease-related knowledge, and adherence to self-care. Hierarchical linear regression was used to determine whether health literacy was associated with disease-related knowledge and adherence to self-care. RESULTS: Seventy-one (38.2%) and seventy-two (38.7%) patients had inadequate and marginal health literacy, respectively. In hierarchical linear regression, health literacy independently predicted disease-related knowledge (beta= .43, p < .001) and adherence to self-care (beta= .37, p < .001) after controlling for age, education level, having a job or not, and body mass index. CONCLUSION: These findings show that health care providers need to pay attention to patients with hypertension who have inadequate health literacy. Further, it is recommended to develop and implement new strategies for assessing health literacy in clinical practices. Interventions to improve health literacy could promote disease-related knowledge and adherence to self-care in patients with hypertension.

Impact of Body Mass Index and Perceived Health Status on Depression in Elderly Women Living Alone in the Community / 정신간호학회지

PURPOSE: This study was done to identify the prevalence of depression and determine the relationship of body mass index and perceived health status to depression for elderly women who live alone in the community. METHODS: A total of 175 adults aged over 60 participated in this cross-sectional descriptive study. Perceived heath status was measured using a self-report one-item questionnaire. Body mass index was calculated as weight in kilograms divided by the square of height in meters. Depression was assessed using the Korean short version of the geriatric depression scale. Hierarchical linear regression was used to identify associations between variables. RESULTS: Approximately 61.7% of elderly women who lived alone were depressed. The mean score for depression was 7.4 (SD 3.39). Hierarchical linear regression showed body mass index (beta=.25, p<.001) and perceived health status (beta=-.26, p<.001) were independently associated with depression adjusting for general characteristics. These two predictors accounted for 12% of the variance in depression. CONCLUSION: These results suggest that obesity and perceived health status are risk factors for depression in elderly women living alone. Therefore, these factors should be considered when developing intervention program for elderly women with depression.

Development of an Eye Care Protocol for ICU Patients / 기본간호학회지

PURPOSE: The purpose of this study was to develop an eye care protocol for intensive care unit (ICU) patients. METHOD: A systematic review was conducted to develop an eye care protocol for ICU patients. Searches were performed using computerized databases (CINAHL, MEDLINE, EBM Review) and citation search from 1996 to January 2007. For the keywords, "eye care", and "randomized controlled trial" were used to identify experimental studies regarding eye care for ICU patients. After reviewing the collected studies, a preliminary eye care protocol algorithm was created. Then, content validity was examined with ophthalmologists and ICU nurses. RESULTS: Six studies were included to serve as a basis for framing of the preliminary algorithm. The final eye care protocol was completed after verifying the preliminary algorithm's content validity. The final eye care protocol was organized in the following manner: 3 items in the assessment stage, 7 items in the no-risk stage, 4 items in the low-risk stage, and 5 items in the high-risk stage. CONCLUSION: The results indicate that, for ICU patients, nurses can broaden their knowledge regarding ocular diseases, as well as improve their practice-based eye care nursing performance.

The Analysis of Type D Personality Research as a Psychosocial Risk Factor in Cardiovascular Disease for Elders with a Chronic Disease / 간호학회지

PURPOSE: The purpose of this paper was to examine the relationship between type D personality and cardiovascular disease, and to suggest future research directions. METHOD: A literature search was conducted from the following nine databases: 1) MEDLINE, 2) CINAHL, 3) Pubmed Unrestricted, 4) PsycINFO, 5) KISS, 6) RICHIS, 7) RISS4U, and 8) Nanet. The combinations of the words, "type D personality", "personality", "heart", "cardiovascular", and "coronary" were used for keyword searches to find relevant articles. Twenty eight studies were identified. RESULT: Type D personality has been associated with increased morbidity and mortality in patients with established cardiovascular disease. Type D patients are also at increased risk for impaired quality of life, and seem to benefit less from medical and invasive treatment. CONCLUSION: There is substantial evidence for a relationship between type D personality and clinical outcomes related to cardiovascular disease. Randomized clinical trials are needed to further evaluate the value of controlling type D personality to improve survival and reduce morbidity in patients with cardiovascular disease. Accumulating evidence from this analysis indicates the urgent need to adopt a personality approach in order to optimize the identification of patients at risk for stress related cardiac events.

Knowledge, Perception & Practice of Eye Care Nursing among Nurses in Intensive Care Units / 기본간호학회지

PURPOSE: The purpose of this study was to identify levels of knowledge, perception, and practice of eye care as part of nursing care in the ICU. METHOD: A descriptive, cross-sectional study design was used. The participants in this study were 269 registered nurses working in the ICUs of five university hospitals in Seoul, Korea. Between November 2005 and December 2005, data were collected using a semi-structured questionnaire developed by the researchers, and analyzed using the SPSS Program. RESULTS: In general, levels of knowledge of nursing care for the eyes were moderate among ICU nurses, but levels of perception of nursing care for the eyes were very high. Of the respondents, 61.7% reported that they would consult a doctor whenever they found an eye problem. Only 42.4% nurses answered that they provide eye care as part of the daily routine and 43.9% nurses responded that they cleanse the eye lids with wet saline gauze. In regression analysis, the practice of eye care as part of nursing was significantly influenced by perception of nursing care for the eyes, and knowledge of interventions for nursing care for the eyes. CONCLUSION: These results suggest that education on care of the eyes for ICU nurses and the development of a standardized eye care protocol should be done to improve quality of nursing care in the ICU.

Development and Evaluation of an 'Activity and Rest' Integrated Course / 성인간호학회지

PURPOSE: This study was conducted to develop an integrated undergraduate course including a PBL based on a blended learning strategy, and evaluate learners' responses. METHODS: The learning contents of cardiovascular, respiratory, and musculoskeletal medical systems, and nursing diagnoses of 'activity and rest' domain (NANADA's classification II, 2005) were analyzed. Six clinical scenarios with the clients in different life cycles were developed for PBL. Classical lecture and group presentation with on-line self learning were implemented in addition to PBL. The developed course was implemented on 84 junior nursing students in a university for 7 weeks with 5 hours per day, two days per week. Students were asked to complete structured questionnaires including problem solving, critical thinking, and nursing diagnosis differentiation abilities. RESULTS: Learner's evaluation was positive in problem solving skills and in the differentiation ability of nursing diagnoses relevant to an 'activity and rest' functional health pattern. CONCLUSION: Development and implementation of integrated courses based on a blended learning method need to be continued to enhance students' thinking and self-directed learning abilities. Supporting strategies for individual learners should be added for successful blended learning such as individual on-line feedback and consideration of individual learning outcomes.

The Life Style and Quality of Life according to the Pattern of Type D Personality in Patients with Hypertension / 성인간호학회지

PURPOSE: The purposes of this study were to describe the pattern of type D personality, to compare the life style and quality of life between type D personality and non-type D personality patients, and to investigate the factors influencing quality of life in patients with hypertension. METHODS: A cross sectional, descriptive study was used. The participants in this study were 193 outpatients who were diagnosed with hypertension at two university hospitals in urban area, Korea. The data was collected from December, 2006 to January, 2007. Type D personality was measured by the DS-14 scale. RESULTS: The prevalence of type D personality was 83.9%. Patients of type D personality were significantly different in educational status, monthly income, fat intake and exercise, and had a lower overall quality of life than patients of non-type D personality. Under controlled general characteristics and life style factors, multiple linear regression analysis was performed. The most significant factor influencing quality of life in hypertensive patients was type D personality, and this factor explained their quality of life with a variance of 14.8%. CONCLUSIONS: Various programs for psychological intervention are required to control for the distressed personality of patients with hypertension. Further studies should be conducted prospectively on a larger patient population.

Relationship between Psychosocial Factors and Symptom Experience in Patients with Cardiovascular Disease: Over a Six-month Follow-up Period / 기본간호학회지

PURPOSE: The purpose of this study was to identify the relationship between psychosocial factors and symptom experience of patients with cardiovascular disease over a 6-month follow-up period. METHOD: Baseline data for each of the 138 patients were collected. Eighteen patients were dropped for a final total of 120 patients in the present study. To monitor patients' symptom experience after discharge, each patient was interviewed by telephone, and interviewed directly with a questionnaire at each clinic visit. RESULTS: Mean scores for hostility, anger, anxiety, and depression were 51.63, 22.87, 48.95, and 41.21, respectively. Mean scores for the level of symptom experience at discharge, 3 months and 6 months after discharge were 32.83, 24.79, and 26.70, respectively. There were significant differences in the level of hostility by gender, BMI, job, and monthly income. Also the differences in the level of anxiety and depression were statistically significant according to gender and existence of spouse. In the regression analysis, depression was identified as the significant factor associated with symptom experience at discharge, 3 months, and 6 months after discharge. CONCLUSION: This study presented baseline data to elucidate whether psychosocial factors were associated with the progression of cardiovascular diseases. Accordingly, it suggests that nurses need to take into consideration psychosocial factor as well as physiological factor in symptom management for patients with cardiovascular disease.

Factors Influencing Functional Status in Patients with Heart Failure / 간호학회지

PURPOSE: The purpose of this study was to identify the factors that influence the functional status of patients with heart failure. METHOD: A descriptive, correlational study design was used. The participants in this study were 260 patients with heart failure who were admitted at Y University and U University in Seoul, Korea. Between September 2005 and December 2005 data was collected by an interview using a questionnaire and from medical records. The Functional status was measured with KASI. Physical factors (dyspnea, ankle edema, chest pain, fatigue, and sleep dysfunction), psychological factors (anxiety and depression), and situational factors (self-management compliance and family support) were examined. RESULT: In general, the functional status, anxiety, depression, self-management compliance, and family support was relatively not good. The level of fatigue was highest and the level of ankle edema was lowest for physical symptom experiences. In regression analysis, functional status was significantly influenced by dyspnea(23%), age(13%), monthly income(7%), fatigue(3%), ankle edema(2%), depression(1%), and length of stay in the hospital(1%). These factors explained 50% of the variables in the functional status. CONCLUSION: These results suggest that psycho-physiological symptoms management should be a focus to improve the functional status in patients with heart failure.

Effect of a Telephone Monitoring on Self-management & Symptom Experiences in Patients With Heart Failure / 성인간호학회지

PURPOSE: The main purpose of this study was to examine the effectiveness of a standardized telephone monitoring intervention in addressing the symptom experience and improving self-management ability in patients with heart failure. METHODS: A non-equivalent control group pre-post test design was used. There were 17 patients in the experimental group, and 16 in the control group. According to the protocol, patients in the experimental group received 15 to 30 minute-telephone monitoring four times, once a week for 4 weeks. Data were analyzed by chi2-test, Mann-Whitney U test. RESULTS: 1) The experimental group showed a significant increase in compliance with self-management compared to the control group. 2) There was a significant decrease in degree for 3 symptoms(DOE, PND, & continuing fatigue) in the experimental group, after telephone monitoring. However, the experimental group did not show significant decrease in the degree of the total symptom experiences. CONCLUSIONS: The results of this study provide evidence that standardized telephone monitoring is effective in relieving symptom experience and improving self- management in patients with heart failure over the course of telephone monitoring.

Cytokine Profile in the Aspirated Cystic Fluids in Autosomal Dominant Polycystic Kidney Disease (ADPKD) Patients / 대한신장학회잡지

BACKGROUND: The pathogenesis of ADPKD is still unknown but the proliferation of cystic epithelia and the fluid secretion to cystic lumen are thought to be important. Cytokines play a pivotal role in growth, differentiation, and apoptosis in general, but there were few reports about the cytokine profile in ADPKD cysts. METHODS: In this study, we measured cytokine content in aerobic culture-negative cystic fluids from 23 patients with symptomatic normal to end-stage (n=3) ADPKD in order to elucidate the possibility that cytokines are related to the development and progression of disease. Enzyme-linked immunosorbent assays (ELISAs) were used to detect IL-1beta, IL-2, IL-4, IL-6, IL-10, and IFN-gamma with commercial kits. RESULTS: Male to female ratio was 6 : 17 and the median age at examination was 52 years (range 36 to 78). IL-1beta was present in 18 of 23[78%] (11 to 173 pg/mL), IL-2 in 18 of 23[78%] (5 to 159 pg/ mL), IL-4 in 9 0f 23[39%] (8 to 156 pg/mL) and IL-6 in 10 of 23[43%] (16 to 1498 pg/mL). IL-10, and IFN-gamma were not detected. IL-1beta concentrations correlated directly with those of IL-2 (r=0.7671). IL- 6 levels in patients with azotemia (n=7) [288.4+/-26.2 (mean+/-S.D.)] were significantly higher than those of normal renal function group (98.3+/-413.9)(p<0.01). Such difference was not found in other cytokines. Cytokine concentrations did not correlate with sodium concentrations, nor with cystic fluid osmolality, indicating that differences in concentrations among fluids could not be explained by differences in water content. And, there was no significant correlation between the intracystic concentrations of these cytokines and the corresponding cyst diameters. CONCLUSION: These data identify proinflammatory cytokines as possible mediators to the morbidity of ADPKD. Especially, IL-6 levels of cystic fluid were elevated in the azotemic ADPKD patients.