Incidence and Predictors of Cataract among People with Type 2 Diabetes Mellitus: Using Secondary Data Analysis from the Ansan Cohort of the Korean Genome and Epidemiology Study

Purpose@#This study investigated the incidence and risk factors of cataract in people with diabetes mellitus (DM) using data from Ansan cohort of the Korean Genome and Epidemiology Study (KoGES). @*Methods@#Data from a total of 329 patients with type 2 DM without cataract who participated in Ansan cohort of the KoGES from baseline survey (2001–2002) to fifth follow-up visit (2011–2012) were examined.The characteristics of the subjects were analyzed with frequency and percentage, and mean and standard deviation. Cataract incidence was measured as incidence proportion (%). For risk factors of cataract, hazard ratio (HR) and 95% confidence interval (CI) were obtained using the Cox proportional hazard model. @*Results@#The cataract incidence over a 10-year follow-up period was 19.1% (15.1 in males and 25.8 in females), and mean age at the incidence of cataract was 63.48 years (61.58 years in males and 65.31 years in females). Age (HR=1.09, 95% CI=1.05–1.13) and HbA1c (HR=1.21, 95% CI=1.07–1.37) or the duration of DM (HR=1.05, 95% CI=1.00–1.09) were found to be independently associated with cataract development. @*Conclusion@#Cataract development in people with DM is common, and its likelihood increases with age, HbA1c, and the duration of DM. Considering negative effect of cataract on their quality of life and economic burden, nurses should identify people with DM at a higher risk of cataract development, and plan individual eye examination programs to detect cataract development as early as possible.

The Relationships of End-of-life Care Stress with Compassionate Competence and Attitudes toward End-of-life Care among Pediatric Nurses / 한국호스피스완화의료학회지

Purpose@#This study aimed to provide basic data for developing interventions to relieve the end-of-life care stress experienced by pediatric nurses by examining the relationships of end-of-life care stress with compassionate competence and attitudes toward end-of-life care. @*Methods@#Data were collected via a survey that was conducted from September 10to September 30, 2018 and administered to 113 nurses who had worked for more than 6months in a pediatric unit at a tertiary hospital in Seoul, South Korea. The data were analyzed for frequency, percentage, mean, and standard deviation, and the independent t-test, one-way analysis of variance, and Pearson correlation analysis were conducted using SPSS version 25.0. @*Results@#End-of-life care stress among pediatric nurses had a weak positive correlation (r=0.216, P＜0.05) with compassionate competence and had no significant cor-relation with attitudes toward end-of-life care. Among the sub-factors of end-of-life care stress, psychological difficulties had a weak positive correlation with sensitivity (r=0.309, P ＜0.01) and communication (r=0.230, P＜0.05), which are aspects of compassionate com-petence. Lack of knowledge about end-of-life care had a weak positive correlation withcommunication (r=0.209, P＜0.05) as an aspect of compassionate competence. @*Conclusion@#To improve the quality of end–of–life care provided by pediatric nurses, it is necessary to improve their compassionate competence and reduce their end-of-life care stress by developing education and support programs tailored to the characteristics of children and specific communication methods.

Effect of Preoperative Warming on Prevention of Hypothermia during Surgery in Patients with Total Hip Replacement Arthroplasty under Spinal Anesthesia / 임상간호연구

Purpose@#The purpose of this study was to evaluate the effect of preoperative warming to prevent hypothermia in surgery for patients undergoing total hip replacement arthroplasty under spinal anesthesia. @*Methods@#A randomized experimental study was conducted. Data were collected at an S University hospital in Gyeonggido from December 3, 2019 to March 31, 2020. A random allocation program was used to randomize participants into intervention and control groups. A total of 90 participants were assigned to the study: 30 people were randomized to a pre-warming group using Bair Hugger forced-air warming blankets(Model 505) 30 minutes before surgery, 30 to a pre-warming group 15 minutes before surgery, or 30 to a control group. The findings from 88 participants were analyzed. For data analysis, x2 test and ANOVA were used utilizing the SPSS 21.0 program. @*Results@#The pre-warming group 30 minutes before surgery had significantly higher body temperature than the control group, from 30 minutes after inducing anesthesia to the end of anesthesia. Body temperature over anesthesia time showed significant differences among the three groups, but there were no statistically significant differences in interactions between time and groups. @*Conclusion@#Warming patients' body for 30 minutes before surgery was effective in maintaining normal body temperature while preventing intraoperative hypothermia.

Effect of Preoperative Warming on Prevention of Hypothermia during Surgery in Patients with Total Hip Replacement Arthroplasty under Spinal Anesthesia / 임상간호연구

Purpose@#The purpose of this study was to evaluate the effect of preoperative warming to prevent hypothermia in surgery for patients undergoing total hip replacement arthroplasty under spinal anesthesia. @*Methods@#A randomized experimental study was conducted. Data were collected at an S University hospital in Gyeonggido from December 3, 2019 to March 31, 2020. A random allocation program was used to randomize participants into intervention and control groups. A total of 90 participants were assigned to the study: 30 people were randomized to a pre-warming group using Bair Hugger forced-air warming blankets(Model 505) 30 minutes before surgery, 30 to a pre-warming group 15 minutes before surgery, or 30 to a control group. The findings from 88 participants were analyzed. For data analysis, x2 test and ANOVA were used utilizing the SPSS 21.0 program. @*Results@#The pre-warming group 30 minutes before surgery had significantly higher body temperature than the control group, from 30 minutes after inducing anesthesia to the end of anesthesia. Body temperature over anesthesia time showed significant differences among the three groups, but there were no statistically significant differences in interactions between time and groups. @*Conclusion@#Warming patients' body for 30 minutes before surgery was effective in maintaining normal body temperature while preventing intraoperative hypothermia.

Study on the Shelf Life of Sterilized Products according to Packaging Materials / 임상간호연구

PURPOSE@#The purpose of this study was to determine the most appropriate shelf life for sterilized products according to their packaging material.@*METHODS@#Samples were prepared to target six nursing units in one general hospital in Seoul. After steam and E.O gas sterilization, sterilized product, samples were supplied to wards. Data collection was conducted for 3 months, after the expiration date of 3 months had passed for samples packaged with crepe paper and nonwoven wraps. For samples packaged with paper-plastic pouches, data collection conducted for 3 months when the expiration date of 9 months had passed. The sterilized products were collected and tested for microbial contamination. Identification of the storage environment was done as samples were collected.@*RESULTS@#This study confirmed that the storage environment met international standards such as CDC, except for temperature. For steam sterilized crepe paper packaging samples and steam and E.O gas sterilized for nonwoven packaging samples no contamination in all products was found for 3 months past the expiration date. However, in the E.O gas sterilized paper-plastic pouch packaging sterile samples, Gram-positive bacilli were detected in one sample from a surgical intensive care unit at 45 weeks and another sample from an operating room at 47 weeks. Furthermore, the results did not show any microorganisms for up to 52 weeks in all products.@*CONCLUSION@#According to the results of this study, sterilized product packaging made with crepe paper and nonwoven wraps is better able an extended shelf life from 3 months to 6 months, reducing unnecessary costs.

Influence of Professionalism and Organizational Communication on Patient Safety Culture of Nurses in Hemodialysis Units / 임상간호연구

PURPOSE: The study was conducted to investigate correlation between professionalism, organizational communication the and patient safety culture of nurses in hemodialysis units and verify factors that affect patient safety culture. METHODS: Data were collected from 109 nurses working in hemodialysis units located in Seoul and Gyeonggi-do. collected data were analyzed using descriptive statistics including t-test, one-way ANOVA, Pearson correlation coefficient and stepwise multiple regression with the SPSS 21.0 program. RESULTS: The Professionalism of participants was significantly correlated with patient safety culture while the Organizational communication was also correlated with patient safety culture. Factors influencing participants' patient safety culture included professionalism, organizational communication, employment history in current hospital, and the number of patients per nurse. These factors explained 57.8% of patient safety culture. CONCLUSION: The research findings suggest that in order to increase the awareness of patient safety culture of nurses in hemodialysis units, strategic efforts are needed to enhance professionalism and organizational communication satisfaction of nurses in hemodialysis units.

Nursing Needs and Satisfaction of Family of Pediatric Cancer Patients during Chemotherapy

PURPOSE: The aim of this study was to explore the nursing needs and satisfaction of pediatric cancer patient families during chemotherapy. METHODS: Data collection was conducted from April to July 2016 using the questionnaire of nursing needs and satisfaction developed by the researchers in 123 families of children who were diagnosed with pediatric cancer and undergoing chemotherapy. The collected data were analyzed by descriptive statistics, t-test, and ANCOVA using the SPSS 22.0 program. RESULTS: Nursing needs and satisfaction were 4.27 ± 0.78 and 4.16 ± 0.57, respectively. Significant differences between nursing need and satisfaction were observed in the educational/informational domain (t=3.94, p=<.001) and community resources nursing domain (t=2.16, p=.032). Also, in terms of general characteristics, the nursing needs were significantly different depending on the elapsed time after diagnosis (t=1.98, p=.049), and the nursing satisfaction was significantly different depending on the type of treatment (F=4.02, p=.009). CONCLUSION: Based on the results of this study, when caring for children who are receiving chemotherapy and their family, it is necessary to develop nursing interventions that meet the individualized nursing needs of those directly and indirectly affected.

Development and Evaluation of a Motivational Interviewing Program for Exercise Improvement in Persons with Physical Disabilities

PURPOSE: The aims of this study were to develop a motivational interviewing program for exercise improvement in persons with physical disabilities and to examine the effect of this motivational interviewing intervention. METHODS: The study employed a nonequivalent control group pretest and posttest design. A total of 62 persons with physical disabilities (30 in the experimental group, 32 in the control group) were recruited from 2 community rehabilitation centers. The experimental group received 8 sessions of a group motivational interviewing program, scheduled once a week, with each session lasting 60 minutes. Test measures were completed before the intervention, immediately after the end of the intervention, 2 weeks later, and 6 weeks after the end of the intervention. Measures included self-efficacy for exercise, decisional balance for exercise, stage of change for exercise, regularity of exercise, exercise maintenance, and independent living ability. Data were analyzed using the χ²-test, Fisher's exact test, Independent samples t-test, and repeated measures ANOVA, conducted using IBM SPSS Statistics version 18. RESULTS: The experimental group showed a significant increase in self-efficacy for exercise (F=50.98, p<.001), benefit (pros) of exercise (F=24.16, p<.001), and independent living ability (F=50.94, p<.001), and a significant decrease in loss (cons) of exercise (F=26.50, p<.001). There were significant differences between the two groups in stages of change for exercise (p<.001), regularity of exercise (p<.001), and exercise maintenance (χ²=26.61, p<.001). CONCLUSION: The motivational interviewing program has the potential to improve exercise levels in persons with physical disabilities.

Validity Test of K-SKAGOAO for Korean Nursing Groups and the Relationship of Nursing Group Power and Job Satisfaction, Organizational Commitment, Organizational Performance / 임상간호연구

PURPOSE: The purpose of this study was to test validity and reliability of the Korean-Sieloff King Assessment of Group Outcome Attainment within organization in Korea (K-SKAGOAO), and also to explore the relationship of Korean nursing group power and job satisfaction, organizational commitment, organizational performance. METHODS: Participants were 481 nurse managers, nurse unit managers or staff nurses with over 7 years experience. Data were collected by post mail and analyzed using descriptive statistics, ANOVA, Kruskal-Wallis test, Tukey test, and Spearman's correlation. RESULTS: Content Validity Index was over .82 and Cronbach's α coefficient for the K-SKAGOAO was .97. The mean score for Korean nursing group power was 136.77 among the total participants, 139.89 among nurse managers, 136.74 among nurse unit managers and 132.47 among staff nurses. These results showed high nursing group power in Korea nursing organization in hospitals. There was also a significant difference according to nurse position (p=.003). Korean nursing group power was positively related to job satisfaction, organizational commitment, and organizational performance. CONCLUSION: Findings show that the K-SKAGOAO has validity and reliability. Nursing groups can use the K-SKAGOAO to evaluate the nursing group power of each nursing organization and to develop strategies to improve nursing power and nursing outcomes.

Factors Influencing Quality of Caregiving by Caregivers for Elders with Dementia

PURPOSE: The aim of the study is to determine factors influencing quality of caregiving by caregivers for the elderly with dementia. METHODS: Data were collected from 87 caregivers for elders with dementia who had visited in Busan Metropolitan Center for Dementia and D-University hospital outpatient center from July 10 to September 30, 2015. A self-reported questionnaire was used to assess the severity of the elders' dementia and knowledge of dementia, burdens and quality of caregiving by the caregivers. The SPSS 21.0 version program was used for data analysis. Data were analyzed using descriptive statistics, Pearson's correlation, t-test, ANOVA and multiple regression. RESULTS: Significant predictors of quality of caregiving by caregivers included caregivers' burdens (explanation power 25%), knowledge of dementia (explanation power 4%) and levels of education (explanation power 3%). These factors explained 32.3% of the variances in quality of caregiving. CONCLUSION: Burdens on caregivers were a major factor that decreased quality of caregiving, and knowledge of dementia was a factor that increased it. These findings show that educational programs and intervention for reducing burdens and improving knowledge of dementia are necessary to improve quality of caregiving by caregivers.

The Effect of Abuse Experience and Coping Styles on Suicidal Ideation in the Elderly

PURPOSE: The aim of this study is to determine the impact of abuse experience and coping styles on suicidal ideation in Korean elders. METHODS: Data were collected from the 2011 Korean National Survey on the Elderly. The participants were 10,537 elders aged 65 or older who had replied to the question on suicidal ideation. Socio-demographic and health related factors, abuse experience, and coping style were included as the influence factors of suicidal ideation. Data were analyzed using x2-test and logistic stepwise regression with the SPSS/WIN 21.0 program. RESULTS: The prevalence of abuse experience among the elders was 12.7% and that of suicidal ideation was 11.2%. Elders with abuse experience (OR=2.79, 95% CI=2.39~3.26) were more likely to have suicidal ideation but those with an active coping style (OR=0.69, 95% CI=0.57~0.84) were less likely to have suicidal ideation even with other influence factors controlled. CONCLUSION: Abuse experience of the elderly was a major risk factor that increased suicidal ideation, and active coping style was a protective factor that reduced suicidal ideation. These findings show that careful attention to elderly abuse and education for active coping style are necessary to reduce suicidal ideation among the elderly.

Ursodeoxycholic Acid Ameliorates Pain Severity and Cartilage Degeneration in Monosodium Iodoacetate-Induced Osteoarthritis in Rats

Osteoarthritis (OA) is a degenerative joint disease characterized by a progressive loss of cartilage. And, increased oxidative stress plays a relevant role in the pathogenesis of OA. Ursodeoxycholic acid (UDCA) is a used drug for liver diseases known for its free radical-scavenging property. The objectives of this study were to investigate the in vivo effects of UDCA on pain severity and cartilage degeneration using an experimental OA model and to explore its mode of actions. OA was induced in rats by intra-articular injection of monosodium iodoacetate (MIA) to the knee. Oral administration UDCA was initiated on the day of MIA injection. Limb nociception was assessed by measuring the paw withdrawal latency and threshold. Samples were analyzed macroscopically and histologically. Immunohistochemistry was used to investigate the expression of interleukin-1beta (IL-1beta), IL-6, nitrotyrosine and inducible nitric oxide synthase (iNOS) in knee joints. UDCA showed an antinociceptive property and attenuated cartilage degeneration. OA rats given oral UDCA significantly exhibited a decreased number of osteoclasts in subchondral bone legion compared with the vehicle-treated OA group. UDCA reduced the expression of IL-1beta, IL-6, nitrotyrosine and iNOS in articular cartilage. UDCA treatment significantly attenuated the mRNA expression of matrix metalloproteinase-3 (MMP-3), -13, and ADAMTS5 in IL-1beta-stimulated human OA chondrocytes. These results show the inhibitory effects of UDCA on pain production and cartilage degeneration in experimentally induced OA. The chondroprotective properties of UDCA were achieved by suppressing oxidative damage and inhibiting catabolic factors that are implicated in the pathogenesis of cartilage damage in OA.

Health Literacy, Health Risk Perception and Health Behavior of Elders

PURPOSE: The aim of this study is to clarify the level of health literacy, health risk perception and health behavior of Korean elders and to determine the impact of their health literacy and health risk perception on their health behavior. METHODS: A descriptive correlation study was conducted with 188 elders aged 65 or older in senior welfare centers in Busan. Questionnaires were used to measure levels of health literacy, health risk perception, and health behavior. Descriptive statistics, t-test, ANOVA, Kruskal Wallis test, Pearson's correlation, and hierarchical regression were performed. RESULTS: 43.6% of the subjects had low levels of health literacy. There was a negative relation between health literacy and health risk perception, and between health risk perception and health behavior. There was a positive relation between health literacy and health behavior. Health concern, health literacy affected health behavior. Health literacy independently accounted for 24% of health behavior. Health risk perception didn't affect health behavior. CONCLUSION: Many of the Korean elders had low levels of health literacy and health literacy was independently associated with health behavior. These findings show that interventions for improving health literacy are necessary to enhance health behavior of the elderly.

Effectiveness of Nutrition-Exercise Education Program on Weight Control of Adult Women / 대한지역사회영양학회지

This study was conducted to investigate the effectiveness of a nutrition and exercise education program on weight control of adult women. The subjects of this study were 28 adult women aged 20-59 years residing in the Daegu area. The nutrition-exercise educational period was 12 weeks. The collected data consisted of items on general characteristics, anthropometric data, blood biochemical values, physical strength data, dietary behavior and nutrition knowledge scores of the subjects. During the 12 weeks of weight control, body mass index (BMI), % of body fat, body fat mass and waist-hip ratio significantly decreased. The level of plasma triglyceride decreased, but not significantly. The level of total cholesterol did not change compared to baseline before the program. After the weight control program, back muscle strength, sit-ups, push-ups, and sit-and-reach tests of the subjects significantly improved. The nutrition knowledge scores of the subjects significantly increased. Therefore, these results suggest that the nutrition-exercise education program may contribute effectively to weight reduction with improvement of physical strength in adult women.