Development and Effects of a Person-Centered Fall Prevention Program for Older Adults with Dementia in Long-Term Care Hospitals: For Older Adults with Dementia and Caregivers in LongTerm Care Hospitals

Purpose@#This study examined the effects of a person-centered fall prevention program for older adults with dementia in long-term care hospitals. @*Methods@#A nonequivalent control group pretest-posttest design was used. The study sample included 42 older adults with dementia (experimental group: 21, control group: 21) and 42 caregivers (experimental group: 21, control group: 21). The program comprised 48 sessions held over 12 weeks and included exercise intervention with resistance and balance, dance walking (45~60 min, three times/week), cognitive and emotional intervention (35~50 min, once per week), and person-centered fall prevention education (10 min, once per week). The program for caregivers consisted of six educational sessions (i.e., fall prevention competency enhancement and person-centered care strategy education, 80 min, once per week) for six weeks. Data were collected before participation and 12 weeks after program completion from February 18 to May 12, 2019. Data analysis was conducted using the chi-square test, t-test, and Mann―Whitney U test with SPSS/WIN 21.0. @*Results@#The experimental group of older adults with dementia showed significant improvement in physical and cognitive functions, and a decrease in depression, and behavioral and psychological symptoms, when compared with the control group. caregivers in the experimental group exhibited significant improvement in fall-related knowledge and person-centered care of older adults with dementia compared to the control group. @*Conclusion@#The study findings indicate that this program was effective as a nursing intervention for fall prevention among older adults with dementia in long-term care hospitals.

Factors Affecting Intention of Signing an Advanced Directives in Cancer Patients / 기본간호학회지

Purpose@#The purpose of this study was to identify factors affecting intention to sign an Advanced Directives (AD) in cancer patients. @*Methods@#A descriptive correlational study design was used. Participants were 173 adult cancer patients in outpatient and inpatient departments at the cancer center of G University Hospital located in J city. Data were collected from February 25 to August 30, 2019. Data were analyzed using x2 test, independent t-test, and multivariate logistic regression with SPSS/WIN 24.0. @*Results@#Factors influencing an intention to sign an AD in cancer patients were job status (OR 2.81, 95% CI=1.20~6.56), whether or not any acquaintances had signed an AD (OR 51.48, 95% CI=3.76~704.71), proper time to sign an AD (when diagnosed with end-stage: OR 0.28, 95% CI=0.10~0.80; when near death: OR 0.09, 95% CI=0.02~0.46; reference: when healthy), discussion with family members about signing an AD (OR 15.87, 95% CI=2.28~110.54) and attitude towards AD (OR 6.50, 95% CI=1.23~34.38). @*Conclusion@#In order to increase the intention to sign an AD in cancer patients, the development and implementation of nursing interventions to promote a positive attitude towards AD is highly recommended. Further, encouraging discussion with family members about signing an AD is recommended, and helping cancer patients to recognize that signing an AD is appropriate at a time when it is possible to make a treatment decision rather than when the patients has been diagnosed with end stage cancer.

Utilization of Evidence-Based Clinical Nursing Practice Guidelines in Tertiary Hospitals and General Hospitals / 임상간호연구

Purpose@#The purpose of this study was to investigate the actual utilization of clinical practice guidelines developed by Hospital Nurses Association. @*Methods@#The subjects were 70 nurses who were in charge of guideline distributions in 70 advanced general hospital and general hospitals with 500 beds or more nationwide.Data were collected between June and August, 2020 by mail (return rate: 88.6%). Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/WIN 24.0. @*Results@#Among the clinical practice guidelines developed by Hospital Nurses Association, 72.9~90.1% were placed with book and electronic file in nursing department and 24.3~35.8% were placed with book and electronic file in each nursing unit at hospital. The average number of utilized clinical practice guidelines were 3.96±3.88, and average score of guideline utilization was score 2.85±0.79 which means ‘use sometimes’. @*Conclusion@#To improve the distribution and utilization of the clinical practice guidelines, it is necessary to enhance the recognition of values of evidence based nursing practice targeting head of nursing department and to stimulate the distribution and utilization of the clinical practice guidelines using diverse education programs for staff nurses.

Development and effects of a nursing information literacy competency education program for undergraduate nursing students / 한국간호교육학회지

Purpose@#This study was conducted to develop and test the effects of a nursing information literacy competency education program for undergraduate nursing students. @*Methods@#A non-equivalent control group pretest-posttest design was used. The subjects consisted of 42 sophomore undergraduate nursing students who had completed a fundamental nursing course (experimental group: n=21, control group n=21). The nursing information literacy competency education program consisted of 8 steps in 8 sessions, taught over 4 weeks, which was 20 hours in total. Data were collected between January 23 and March 14, 2019 and were analyzed using Chi-square test, Fisher's exact test, t-test, paired t-test, and repeated measure ANOVA with SPSS/WIN 23.0. @*Results@#Significant differences were shown between the experimental and control groups regarding nursing information literacy competency (F=91.74, p<.001), problem-solving ability (F=52.43, p<.001), self-directed learning ability (F=36.61, p<.001), and evidence-based practice competency (F=59.66, p<.001). @*Conclusion@#The nursing information literacy competency education program was effective in improving the nursing information literacy competency, problem-solving ability, self-directed learning ability, and evidence-based practice competency of nursing students. Hence, we recommend the nursing information literacy education program will be included as an independent course in the nursing curriculum for undergraduate nursing students to promote a needed proficiency in nursing information literacy competency.

Development and effects of a nursing information literacy competency education program for undergraduate nursing students / 한국간호교육학회지

Purpose@#This study was conducted to develop and test the effects of a nursing information literacy competency education program for undergraduate nursing students. @*Methods@#A non-equivalent control group pretest-posttest design was used. The subjects consisted of 42 sophomore undergraduate nursing students who had completed a fundamental nursing course (experimental group: n=21, control group n=21). The nursing information literacy competency education program consisted of 8 steps in 8 sessions, taught over 4 weeks, which was 20 hours in total. Data were collected between January 23 and March 14, 2019 and were analyzed using Chi-square test, Fisher's exact test, t-test, paired t-test, and repeated measure ANOVA with SPSS/WIN 23.0. @*Results@#Significant differences were shown between the experimental and control groups regarding nursing information literacy competency (F=91.74, p<.001), problem-solving ability (F=52.43, p<.001), self-directed learning ability (F=36.61, p<.001), and evidence-based practice competency (F=59.66, p<.001). @*Conclusion@#The nursing information literacy competency education program was effective in improving the nursing information literacy competency, problem-solving ability, self-directed learning ability, and evidence-based practice competency of nursing students. Hence, we recommend the nursing information literacy education program will be included as an independent course in the nursing curriculum for undergraduate nursing students to promote a needed proficiency in nursing information literacy competency.

Development and Effects of Combined Exercise and an Exercise Habit Formation Program for Undergraduate Nursing Students / 기본간호학회지

Purpose@#This study was conducted to develop and test the effects of a combined exercise and exercise habit formation program for undergraduate nursing students. @*Methods@#A non-equivalent control group pre-post test design was used. The participants were 44 students (experimental group: 23, control group: 21) who had not done regular exercise for over 3 months before this study. The program was developed based on theory of planned behavior and the habit formation model. The program consisted of 24 sessions for 8 weeks and included combined exercise (aerobic exercise 30 minutes, resistance exercise 20 minutes, and flexibility exercise 10 minutes), exercise intention promotion strategy and exercise habit formation strategy (30 minutes, weekly). Data collection was done before, and immediately after the program: September 4 to October 29. Data were analyzed using t-test, paired t-test, x2 test, Mann-Whitney U test, and Wilcoxon signed rank-sum test with SPSS/ WIN 21.0 program. @*Results@#Exercise intention, exercise habit strength, exercise behavior, and physical fitness (cardiopulmonary endurance, muscle strength, and muscle endurance) were significantly better and stress and fatigue were significantly lower in the experimental group compared to the control group. @*Conclusion@#The study findings indicate that the combined exercise and exercise habit formation program for undergraduate nursing students was effective and can be recommended as an intervention for improving healthy lifestyle of undergraduate nursing students.

The Effects of Venous Thromboembolism Prevention Education for Elderly Patients with Total Knee Arthroplasty / 기본간호학회지

PURPOSE@#This study was conducted to develop and test the effects of venous thromboembolism prevention education for elderly patients with total knee arthroplasty.@*METHODS@#A non-equivalent control group posttest only non-synchronized design was used. The participants were 43 older adults (experimental group: 21, control group: 20) who had experienced total knee arthroplasty surgery at *university hospital located in *city. Venous thromboembolism prevention education consisted of a 20 minute intervention on the evening before the operation and a 5 minute intervention on the operation day including education and strategies for enhancing health belief. Data were collected from October 20, 2017 to March 10, 2018. Data were analyzed using independent t-test and Mann-Whitney U test with SPSS/WIN 24.0.@*RESULTS@#The experimental group showed significantly higher levels of knowledge, self-reported preventive behaviors, and number of ankle movements compared to the control group.@*CONCLUSION@#The study findings indicate that venous thromboembolism prevention education can be recommended as an effective nursing intervention for preventing venous thromboembolism of elderly patients with total knee arthroplasty.

Development and Effects of Combined Exercise Program for Older Adults with Sarcopenia Based on Transtheoretical Model

PURPOSE: The purpose of this study was to develop and examine the effects of combined exercise program for older adults with sarcopenia based on transtheoretical model (TTM). METHODS: A non-equivalent control group with a pretest-posttest design was used. The subjects consisted of 43 older adults with sarcopenia in precontemplation stage, contemplation stage and preparation stage of TTM (experimental group: 22, control group: 21). The developed program consisted of 36 sessions for 12 weeks including combined exercise (60 minutes) and TTM based strategies for enhancing exercise behavior (10 minutes) per session. Data were collected before, immediately after the program between July 31 to October 27, 2017. The data were analyzed using independent t-test, Mann-Whitney U test with SPSS/WIN 18.0. RESULTS: Compared with their counterparts in the control groups, older adults with sarcopenia in the experimental group showed a significantly greater improvement in process of exercise behavior change, pros and cons of decisional balance for exercise behavior, exercise self-efficacy, parameters of muscle, and the level of physical performance. CONCLUSION: The study findings indicate that this combined exercise program for older adults with sarcopenia based on TTM model was effective and can be recommended as a nursing intervention for older adults with sarcopenia.

Structural Equation Model for Sleep Quality of Female Shift Work Nurses

PURPOSE: This study aimed to develop and test a structural model for sleep quality in female shift work nurses. The hypothetical model was constructed on the basis of Spielman's 3P model of insomnia and previous research related to the sleep quality of shift nurses. METHODS: This cross-sectional study used structural equation modeling and recruited 285 female shift work nurses from four general and university hospitals with over 300 beds located in C and J cities in Gyeongsangnamdo. Data were collected from September 27 to October 20, 2016, and then analyzed using descriptive statistics, Pearson's correlation, and structural equation modeling. The study used SPSS/Win 18.0 and AMOS 18.0 in processing the data. RESULTS: The final model showed good fit to the empirical data: χ2/df=2.19, SRMR=.07, RMSEA=.07, AGFI=.85, TLI=.91, GFI=.93, GFI=.89, NFI=.87. The factors that influenced sleep quality were sleep hygiene (β=.32), perceived shift work status (β=−.16), stress response (β=.16), shift work experience (β=.15), perceived health status (β=−.14), and circadian rhythm (β=−.13) explaining 36.0% of the variance. CONCLUSION: The model of sleep quality of the shift work nurses constructed in this study is recommended as a model to understand and predict the sleep quality of shift work nurses. The results suggest that strategies for improving the sleep quality of shift work nurses should focus on sleep hygiene, perceived health status, stress response, circadian rhythm, perceived shift work status, and shift work experience.

Development and Effects of a Coping Skill Training Program for Caregivers in Feeding Difficulty of Older Adults with Dementia in Long-Term Care Facilities

PURPOSE: We developed and tested the effects of a coping skill training program for caregivers in feeding difficulty among older adults with dementia in long-term care facilities. METHODS: A non-equivalent control group pretest-posttest design was used. The subjects comprised 34 caregivers (experimental group: 17, control group: 17) and 40 older adults with dementia (experimental group: 20, control group: 20). The developed program was delivered in 4-hour sessions over 6 weeks (including 2 weeks of lectures and lab practice on feeding difficulty coping skills, and 4 weeks of field practice). Data were collected before, immediately after, and 4 weeks after the program (January 3 to April 6, 2016). The data were analyzed using t-test and repeated measures ANOVA using SPSS/WIN 20.0. RESULTS: Compared to their counterparts in the control group, caregivers in the experimental group showed a significantly greater improvement in feeding knowledge and feeding behavior, while older adults with dementia showed greater improvements in feeding difficulty and Body Mass Index. CONCLUSION: The study findings indicate that this coping skill training program for caregivers in feeding difficulty is an effective intervention for older adults with dementia in long-term care facilities.

Updates of Nursing Practice Guideline for Intravenous Infusion / 임상간호연구

PURPOSE: This study was conducted to update the existing nursing practice guideline for intravenous infusion guidelines according to the evidence-based practice guideline in South Korea. METHODS: Guideline update process was performed using 22 steps according to the manuals developed by NICE and SIGN. RESULTS: Updated nursing practice guidelines for the intravenous infusion were consisted of 23 domains and 322 recommendations. The number of recommendations in each domain were 4 for general instruction, 12 for vascular access device selection, 20 for site selection, 9 for insertion, 54 for stabilization, 21 for maintaining patency, 4 for blood sampling, 33 for exchange and removal, 28 for add-on device selection, 28, 72 for infusion related complications, 56 for infusion therapies, 7 for education, and 2 for documentation and report. There were 15.9% of A, 30.2% of B, 53.9% of C in terms of grade recommendations. A total of 178 (51.6%) recommendations were newly developed and 24 previous recommendations have been deleted. CONCLUSION: Updated nursing practice guideline for intravenous infusion was expected to be an evidence-based practice guideline for intravenous infusion in South Korea. This guideline is suggested to be disseminated to clinical nursing settings nationwide to improve the efficiency of intravenous infusion practice.

Comparison of Walking, Muscle Strength, Balance, and Fear of Falling Between Repeated Fall Group, One-time Fall Group, and Nonfall Group of the Elderly Receiving Home Care Service

PURPOSE: The purpose of this study was to provide information to develop a program to prevent repeated falls by analyzing the difference in gait, muscle strength, balance, and fear of falling according to their fall experience. METHODS: The study subjects were 110 elderly individuals aged over 60 years who agreed to their participation in this research. The study participants were categorized into a repeated fall group (n = 40), a one-time fall group (n = 15), and a nonfall group (n = 46) of the elderly. Measurements of gait, muscle strength, balance, and fear of falling were taken in each group. RESULTS: With regard to gait, there were significant differences among three groups in gait cycle (F = 3.50, p = .034), speed (F = 13.06, p < .001), and cadence (F = 5.59, p = .005). Regarding muscle strength in the upper and lower limbs, statistically significant differences were shown among three groups in muscle strength of upper (F = 16.98, p < .001) and lower (F = 10.55, p < .001) limbs. With regard to balance, the nonfall group had significantly greater results than the one-time fall group and repeated fall group in dynamic balance (F = 10.80, p < .001) and static balance (F = 8.20, p = .001). In the case of the fear of falling, the repeated fall group had significantly higher score than other two groups (F = 20.62, p < .001). CONCLUSION: This study suggests that intervention program should be tailored to fall risk factors to enhance gait and balance and lower body muscle strength and reduce the fear of falling to prevent repeated incidences of falls in this population.

Comparative Study on Self-care Behavior Related Factors for Good, Inadequate and Poor Glycemic Control Groups: Based on Variables from Theory of Planned Behavior, Habit, and Family Support / 기본간호학회지

PURPOSE: This study was conducted to compare self-care behaviors and self-care behavior related factors for groups of patients with good, inadequate and poor glycemic control. The study was based on variables of the Theory of Planned Behavior by Ajzen, habit and family support. (1991). METHODS: Participants were 134 patients with type 2 diabetes (good glycemic control group: 57, inadequate glycemic control group: 40, poor glycemic control group: 37). Self-care behaviors, intention to self-care behavior and self-care behavior related variables (attitude, subjective norms, perceived behavior control, habits and family support) were measured. Data were collected from August 12 to September 25, 2014 and were analyzed using χ²-test, Fisher's exact test, ANCOVA, and logistic regression with SPSS/WIN 21.0. RESULTS: Among the three glycemic groups, there were significant differences in self-care behavior, subjective norms, perceived behavior control, family support, and habits. Multinomial logistic regression showed that poor blood glucose probability was associated with duration of diabetes mellitus, method of DM therapy, perceived behavior control and habits. CONCLUSION: The study findings reveal the important role of self-care behavior, subjective norms, perceived behavior control, family support, and habits in blood glucose control in adults with type 2 diabetes.

Development and Effects of a Motivational Interviewing Self-management Program for Elderly Patients with Diabetes Mellitus

PURPOSE: This study was conducted to develop and test the effects of a motivational interviewing self-management program for use with elderly patients with diabetes mellitus. METHODS: A non-equivalent control group pretest-posttest design was used. The participants were 42 elderly diabetic patients (experimental group: 21, control group: 21). The motivational interviewing self-management program for elders with diabetes mellitus developed in this study consisted of a 12-week program in total (8 weeks for group motivational interviewing and education and 4 weeks for individual motivational interviewing on the phone). Data were collected between February 13 and May 3, 2013 and were analyzed using t-test, paired t-test, and repeated measure ANOVA with SPSS/WIN 18.0. RESULTS: For the experimental group, significant improvement was found for self-efficacy, self-care behavior, glycemic control and quality of life (daily life satisfaction, influence of disease) as compared to the control group. CONCLUSION: The study findings indicate that the motivational interviewing self-management program is effective and can be recommended as a nursing intervention for elderly patients with diabetes mellitus.

Development and Effects of Emotional Intelligence Program for Undergraduate Nursing Students: Mixed Methods Research

PURPOSE: This study was conducted to develop and test the effects of an emotional intelligence program for undergraduate nursing students. METHODS: The study design was a mixed method research. Participants were 36 nursing students (intervention group: 17, control group: 19). The emotional intelligence program was provided for 4 weeks (8 sessions, 20 hours). Data were collected between August 6 and October 4, 2013. Quantitative data were analyzed using Chi-square, Fisher's exact test, t-test, repeated measure ANOVA, and paired t-test with SPSS/WIN 18.0. Qualitative data were analyzed using content analysis. RESULTS: Quantitative results showed that emotional intelligence, communication skills, resilience, stress coping strategy, and clinical competence were significantly better in the experimental group compared to the control group. According to the qualitative results, the nursing students experienced improvement in emotional intelligence, interpersonal relationships, and empowerment, as well as a reduction in clinical practice stress after participation in the emotional intelligence program. CONCLUSION: Study findings indicate that the emotional intelligence program for undergraduate nursing students is effective and can be recommended as an intervention for improving the clinical competence of undergraduate students in a nursing curriculum.

Comparative Study on Self-Care Behavior, Diabetes-related Stress, and Stress Coping among Good, Inadequate, and Poor Glycemic Control Groups / 기본간호학회지

PURPOSE: The purpose of this study was to compare self-care behavior, diabetes-related stress and stress coping style among 3 blood glucose control groups (good, inadequate, and poor blood glucose control groups). METHODS: Participants were 102 type 2 diabetic patients (good group: 41, inadequate group: 31, poor group: 30). Data were collected from Feb 19 to Mar 24, 2010 and were analyzed using Chi-square, Fisher's exact test and ANCOVA with SPSS/WIN 12.0. RESULTS: Using ANCOVA with frequency of admission, and illness duration as covariates, significant differences were found among the 3 groups in self-care behavior (total score) and the exercise subscale. Using ANCOVA significant differences were found among 3 groups in diabetes-related stress (total score), emotional burden subscale and regimen distress subscale. Using ANCOVA no difference in stress coping was found among the 3 groups, but there was a significant difference in the problem-oriented coping subscale. CONCLUSION: Self-care behavior, diabetes-related stress, and stress coping style are factors influencing blood glucose control. The results of this study suggest that for improving blood glucose control, self care education program focused on diet and exercise in addition to stress management program for promoting problem oriented coping capability are recommended.

Analysis of Trends and Contents of Nursing Doctoral Dissertations in Korea

PURPOSE: This study aimed to identify contents and trends of Korean nursing doctoral dissertations in terms of research methodology and theoretical characteristics. METHODS: The design of the study was descriptive study and a total of 1,089 quantitative studies completed between 1982 and 2010 were reviewed using the analytical framework developed by the researchers. RESULTS: The majority of studies utilized the experimental design (51.5%) and the others were survey design (38.8%) and methodological design (5.0%). Study subjects were shown as patients (45%), care givers (11.2%), ordinary persons (40.6%) and others (3.2%). There were growing trends in experimental design and patients as subjects. The prevailing data collection settings were hospitals (45.8%) and community (27.8%). The theoretical frameworks that studies were based on were the existing theories (37%) and a newly developed theoretical framework by a researcher (25.2%). a framework derived from other studies by the researcher (25.2%). Majority of studies (78.5%) employed a single theory as a theoretical framework. However, 31.8% of studies had no theoretical framework based on. CONCLUSION: Findings of this study provided the opportunities to shed new light on the current status of Korean doctoral dissertation and to deliberate on the future direction of nursing studies in Korea.

Effects of an Elder Health Promotion Program using the Strategy of Elder Health Leader Training in Senior Citizen Halls

PURPOSE: This study was conducted to develop and test the effects of an elder health promotion program and apply strategies for elder health leader training sessions with elders at senior citizen halls. METHODS: A nonequivalent control group pretest-posttest design was used. Participants were 49 elders at a senior citizen hall (intervention: 27, control: 22). The elder health promotion program consisted of health education and exercise. A professional leader led the program for 4 weeks, and then an elder health leader and research assistant led for 8 weeks (total 12 weeks). Scales for elder health promoting behaviors, perceived health status, life satisfaction and senior citizen hall capability were used and physical fitness levels were measured. Data were collected between April 21 and July 28, 2010 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANOVA with SPSS/WIN 12.0. RESULTS: Health promoting behaviors, physical fitness, perceived health status, and senior citizen hall capacity were significantly better in the experimental group after the intervention compared to the control group. CONCLUSION: Study findings indicate that elder health promotion programs applying strategies of elder health leader training are effective and can be recommended as nursing interventions for health promotion of these elders.

Effects of Community Health Promotion Project for Garlic Cultivating Farmers Based on Self-efficacy Theory and Community Capacity Building Framework

PURPOSE: This study was conducted to test the effects of a community health promotion project for farmers cultivating garlic. Bandura's self-efficacy theory (1986) and Chaskin's community capacity framework (2001) were used as the theoretical framework. METHODS: A nonequivalent control group pretest-posttest design was used. Study participants were 72 garlic farmers (intervention: 36, control: 36). The community health promotion project consisted of health promotion program and community capacity building strategies and was provided for 12 weeks (8 during farming off-season and 4 during farming season). Data were collected between February 23 and May 31, 2009 and were analyzed using chi-square test, Fisher's exact test, t-test, and repeated measure ANOVA using SPSS/WIN 12.0. RESULTS: For the experimental group, significant improvement was found for self-efficacy, farming related health behavior, physical fitness (muscle strength, muscle endurance, upper body flexibility, lower body flexibility, cardiovascular endurance, balance, agility), farmer's syndrome, and health related quality of life as compared to the control group. CONCLUSION: The findings of the study indicate that the community health promotion project for garlic farmers is effective and can be recommended as a nursing intervention for health promotion of garlic cultivating farmers.

Educational Needs Assessment on Research Ethics among Nursing Researchers

PURPOSE: This study aimed to investigate the educational needs of research ethics among nursing researchers. METHODS: Convenience sample of 161 nursing professors and 262 master or doctoral nursing students participated in the study. Data was collected with self-reported questionnaire from June to August 2009, and analyzed with descriptive statistics using SPSS WIN (version 14.0). RESULTS: Among 161 nursing professors, about 31.7% has educated nursing ethics in the postgraduate course. The most common course was nursing research or methodology (62.7%), and median education time was 2 hr. Areas that showed difficulty in understanding was the conflict of interest and plagiarism for professors and falsification and fabrication for graduate students. Average knowledge on the research ethics was 75.4 points for professors and 61.6 points for students based on the 100 points. CONCLUSION: Educational needs of research ethics among nursing professors and students in the postgraduate course was high. We recommend both basic and advanced research ethics educational programs for the nursing researchers. The basic course should be at least 6 hr and include various cases and something to discuss.