Exercise Experience of Elderly Medicaid Beneficiaries with Osteoarthritis Based on Self-Determination Theory

Background@#Osteoarthritis is the most common chronic disease among elders, and it crucially requires self-management. This study aimed to qualitatively examine exercise experiences of elderly Medicaid beneficiaries with osteoarthritis receiving exercise intervention based on self-determination theory (SDT). @*Methods@#Eight elders who received a community-based exercise intervention were interviewed three times. Using the interview transcriptions and field notes, researchers conducted an interpretative phenomenological analysis based on SDT to explore the motivational process of exercise compliance. @*Results@#Three meaningful profiles (non-compliant, intermitter, and compliant) were identified along with satisfaction with needs (autonomy, competence, and relatedness) that motivate exercise compliance based on SDT. Compliance of exercise is primarily initiated by external regulation and followed by the internalization process of recognizing and accepting the value of the behavior. @*Conclusions@#The concepts of SDT could be used to explore factors associated with motivation and gradual behavior change among elderly Medicaid beneficiaries with osteoarthritis. Autonomy, competence, relatedness, external regulation, and identified regulation control may be applied to establish a strategy that promotes behavior change by satisfying the psychological needs and internalizing the behavior of these elders.

Exercise Experience of Elderly Medicaid Beneficiaries with Osteoarthritis Based on Self-Determination Theory

Background@#Osteoarthritis is the most common chronic disease among elders, and it crucially requires self-management. This study aimed to qualitatively examine exercise experiences of elderly Medicaid beneficiaries with osteoarthritis receiving exercise intervention based on self-determination theory (SDT). @*Methods@#Eight elders who received a community-based exercise intervention were interviewed three times. Using the interview transcriptions and field notes, researchers conducted an interpretative phenomenological analysis based on SDT to explore the motivational process of exercise compliance. @*Results@#Three meaningful profiles (non-compliant, intermitter, and compliant) were identified along with satisfaction with needs (autonomy, competence, and relatedness) that motivate exercise compliance based on SDT. Compliance of exercise is primarily initiated by external regulation and followed by the internalization process of recognizing and accepting the value of the behavior. @*Conclusions@#The concepts of SDT could be used to explore factors associated with motivation and gradual behavior change among elderly Medicaid beneficiaries with osteoarthritis. Autonomy, competence, relatedness, external regulation, and identified regulation control may be applied to establish a strategy that promotes behavior change by satisfying the psychological needs and internalizing the behavior of these elders.

Development of a mobile-based self-management health alarm program for obese children in South Korea and a test of its feasibility for metabolic outcomes: A study based on the information-motivation-behavioral skills model

Purpose@#This study aimed to develop a mobile-based self-management health alarm (MSHA) program for modifying obese children's lifestyle based on the information-motivation-behavioral skills (IMB) model and to test its feasibility. @*Methods@#A methodological study for the development of the MSHA program and pilot study with a one-group pretest-posttest design for feasibility testing was conducted. The MSHA program was designed to provide obesity-related information (I), monitor daily diet and exercise, provide motivational text messages (M), and enhance healthy diet and exercise skills (B) via a mobile-based web platform. In the feasibility test, six obese children participated in the 4-week program, and the number of days per week that they achieved their goals and differences in metabolic components were assessed. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. @*Results@#Participants successfully achieved their diet and exercise goals≥5 days per week. Body mass index (z=-1.99, p=.046), waist circumference (z=-2.20, p=.028), and triglyceride levels (z=-2.21, p=.027) significantly decreased. @*Conclusion@#The MSHA program showed positive effects on health behaviors and metabolic syndrome risk. The program may be effective in improving metabolic syndrome in obese children by promoting self-health management behaviors.

Factors Affecting Interpersonal Competence of Nursing Students: Focused on Self-Assertiveness and Empathy / 기본간호학회지

Purpose@#Interpersonal competence, a key competence for patient-centered care by nurses, should be understood. Therefore, factors influencing the interpersonal competence of nursing students should be identified to explore and enhance their interpersonal relationships during the undergraduate educational curriculum for nursing educators. In this study factors influencing interpersonal competence, especially on self-assertiveness and empathy in nursing students were identified and analysed. @*Methods@#A cross-sectional study design was used for the study in two Korean nursing colleges with similar baccalaureate nursing curricula. A total of 251 nursing students from freshman to senior year completed a questionnaire to measure related factors that were assumed to influence nursing students’ interpersonal competence. Data were collected from October 11~31, 2016. Study variables included self-assertiveness, empathy, interpersonal competence, and socio-demographic status. Multiple regression analysis was used for data analysis. @*Results@#Nursing students’ interpersonal competence was explained by personality (β=.22), self-assertiveness (β=.16) and empathy (β=.38). The explanatory power of these predictors was 26.8% (p<.001). @*Conclusions@#Nursing students’ interpersonal competence during the undergraduate nursing years can be enhanced by educational strategies that improve their interpersonal relationship as patient-centered care providers. Simultaneously, the attitude of the nurse educator is also important for nursing students who are to be treated as valuable learners and to improve students' empathy and self-assertiveness ability.

Gender and age differences in the prevalence and associated factors of metabolic syndrome among children and adolescents in South Korea

Purpose@#This study examined the prevalence of metabolic syndrome (MetS) in South Korean children and adolescents by gender and age and analyzed gender-specific factors associated with MetS. @*Methods@#This study used data on children aged 10~18 from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2010 to 2015. Analyses included descriptive statistics, the independent t-test, the x2 test, and univariate logistic regression analysis (p<.050). @*Results@#The prevalence of MetS was 4.8% in boys and 3.4% in girls. The prevalence was higher in girls up to the age of 12, but higher in boys who were 13 or older. Abdominal obesity was frequent in girls, whereas low high-density lipoprotein cholesterol (HDL-C) and elevated blood pressure were more common in boys. Higher body mass index, waist-to-height ratio, waist circumference, blood pressure, triglycerides, HDL-C, perceived "fat" body shape, and weight loss efforts were associated with MetS in both genders. Increasing age, having one meal per day, and weight maintenance were associated factors unique to boys. Fasting plasma glucose, familial medical history of low HDL-C, and perceived "thin" body shape were associated factors in girls. @*Conclusion@#Gender and age differences should be considered in the risk assessment and prevention of MetS.

Influence of Psychosocial Factors on Energy Drink Consumption in Korean Nursing Students: Never-consumers versus Ever-consumers

PURPOSE: This study aimed to investigate the status of caffeine-containing energy drink consumption among Korean nursing students and to identify associated psychological factors. METHODS: In total, 187 Korean nursing students participated in this cross-sectional study. A self-administered questionnaire was used to identify participants' general characteristics and psychosocial factors (self-esteem, academic stress, depression, and college adjustment) associated with energy drink consumption. Data were analyzed with SPSS using descriptive statistics, the χ² test, the t-test, and logistic regression. RESULTS: More than two-thirds (73.3%) of the participants had consumed energy drinks. Among the investigated psychological factors, depression appeared to most strongly influence energy drink consumption behaviors in this population. CONCLUSION: The consumption of caffeine-containing energy drinks was found to be common among nursing students preparing to become health care professionals; depressed nursing students were more likely to have consumed energy drinks than non-depressed students. Nursing educators should emphasize the early detection of unhealthy beverage consumption habits and provide appropriate education to enhance healthy behaviors in future health care professionals.

Effectiveness of Self-directed Learning on Competency in Physical Assessment, Academic Self-confidence and Learning Satisfaction of Nursing Students / 기본간호학회지

PURPOSE: Competency in physical assessment is an important component of nursing practice. However, some physical assessment skills are not being utilized within the current teacher-centered, content-heavy curriculum. This study was conducted to identify the effects of student-centered, self-directed learning in the physical assessment class. METHODS: An experimental study with a post-test only control group design was used to compare an intervention group that was provided self-directed learning classes and a control group that was provided traditional lecture and practice classes. Competency in physical assessment, academic self-confidence, and learning satisfaction were evaluated. Collected data were analyzed using χ²-test (Fisher's exact test) and independent t-test. RESULTS: Competency in physical assessment was significantly higher in the experimental group. However, academic self-confidence and learning satisfaction were not significantly different between the groups. CONCLUSION: The findings in this study indicate that self-directed learning can improve nursing students competency in physical assessment and that self-directed learning is a good education method to improve nursing students' competency in physical assessment during clinical practice and perform quality patient care by making active use of physical assessment skills.

Epigenetic modulation as a therapeutic approach for pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is a rare but progressive and currently incurable disease, which is characterized by vascular remodeling in association with muscularization of the arterioles, medial thickening and plexiform lesion formation. Despite our advanced understanding of the pathogenesis of PAH and the recent therapeutic advances, PAH still remains a fatal disease. In addition, the susceptibility to PAH has not yet been adequately explained. Much evidence points to the involvement of epigenetic changes in the pathogenesis of a number of human diseases including cancer, peripheral hypertension and asthma. The knowledge gained from the epigenetic study of various human diseases can also be applied to PAH. Thus, the pursuit of novel therapeutic targets via understanding the epigenetic alterations involved in the pathogenesis of PAH, such as DNA methylation, histone modification and microRNA, might be an attractive therapeutic avenue for the development of a novel and more effective treatment. This review provides a general overview of the current advances in epigenetics associated with PAH, and discusses the potential for improved treatment through understanding the role of epigenetics in the development of PAH.

Mediating Effects of Perceived Barriers on the Relationship between Depression and Diabetes Management Self-efficacy in Type 2 Diabetes Patients

BACKGROUND: Diabetes mellitus is a life threatening disease that one out of ten Korean adults aged over 30 has it. Depression of diabetes patients affects the perception on their health negatively and self-management inefficiently, and then leads to a failure in blood sugar control. Therefore, it is necessary to investigate the relationships among depression, perceived barriers and self-efficacy on diabetes management in depth. METHODS: This descriptive study was undertaken to identify the mediating effects of perceived barriers on the relationship between depression and self-efficacy on diabetes management among type 2 diabetes patients. 173 patients with type 2 diabetes were recruited from an out-patient clinic of Y university hospital. Data were collected from June 26 to July 18, 2014 using a structured self-report questionnaire, and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, multiple regressions, and Sobel test. RESULTS: Among173 participants, 12.1% were classified as depressed group. Self-efficacy on diabetes management was found to be significantly associated with education level and the presence of complications. Depression and perceived barriers were positively related to each other, but both were negatively related to self-efficacy on diabetes management. In addition, perceived barriers were found to mediate the relationship between depression and diabetes management self-efficacy. CONCLUSIONS: Strategic nursing interventions based on considerations of the relationship between perceived barriers and self-efficacy on diabetes management need to be provided for type 2 diabetes patients with depression.

Health Behaviors among Korean Adolescents: A Content Analysis

BACKGROUND: Adolescence is the starting period for health behaviors that will affect their lives throughout adulthood. Unhealthy behaviors in Korean adolescents have increased compared to previous generations. To promote health behaviors in this group, a comprehensive measurement of Korean adolescents' health behaviors is necessary. Most previous studies have used revised instruments, which were developed in other cultures, but not tools developed to measure health behaviors based on the perspectives of Korean adolescents. Identifying the perception of health behavior among Korean adolescents is important for the future of health promotion. Therefore, this study was conducted to investigate Korean adolescents' perceptions of their health behaviors. METHODS: A qualitative study was conducted to attain a condensed and broad description of the health behaviors that adolescents perceived as health-promoting behaviors or risk behaviors. From October to December 2008, 61 Korean middle and high school students were interviewed on their perceptions of health behaviors. Data were analyzed using inductive qualitative content analysis. RESULTS: Korean adolescents reported health behaviors related to stress, mental health, sleep habits, dietary habits, weight control, physical activity, hygiene habits, safety, computer use, substance use, health screening and others. CONCLUSIONS: The results provide socio-cultural characteristics about the perception of health behaviors among Korean adolescents and should contribute to guiding assessment of health behaviors in Korean adolescents and provide a reference for developing valuable health-promoting interventions based on these characteristics.

Factors Affecting Aggression in South Korean Middle School Students

PURPOSE: The study was undertaken to assess levels of aggression, and to determine factors affecting aggression among South Korean middle school students. METHODS: A descriptive study was conducted using self-report questionnaires. The participants were 340 girls and boys from two middle schools and 302 questionnaires were used for the final data analysis. Aggression, academic stress, depression, self esteem, decision-making competency, and happiness were measured. Data were analyzed using descriptive statistics including t tests, one-way analysis of variance, Pearson's correlation coefficients and multiple regressions. RESULTS: Aggression had significant correlations with academic stress (r = .21, p < .001), depression (r = .43, p < .001), self esteem (r = -.25, p < .001), decision-making competency (r = -.25, p < .001), and happiness (r = -.21, p < .001). Mean score for aggression was 2.49 out of 5. Significant explanatory variables for aggression were grade (t = 4.39, p < .001), academic stress (t = 2.78, p = .006), and depression (t = 5.03, p < .001). The explanatory power of these factors was 26.9%, and this was statistically significant (F = 16.06, p < .001). CONCLUSION: Findings indicate that depression, academic stress, and grade (second grade) influence aggression. To decrease aggressive behavior, it is necessary to provide systematic and political programs in schools and local communities that can ameliorate negative emotional factors like depression and academic stress. Additionally, development of positive factors such as self esteem, decision-making skills, and happiness in middle school students is important to reduce aggression.

Posture Management Program Based on Theory of Planned Behavior for Adolescents with Mild Idiopathic Scoliosis

PURPOSE: The purpose of this study was to evaluate the effects of a devised posture management program based on the Theory of Planned Behavior in adolescents with mild idiopathic scoliosis. METHODS: A quasi-experimental study was conducted. It involved a nonequivalent comparison group design with pretest and posttest. Forty-four female adolescents with mild idiopathic scoliosis participated; data from 35 participants (20 for the test group, 15 for the control group) were used for the final analyses. The devised posture management program ran for 6 weeks. Posture management behavioral determinants (attitude, subjective norms, perceived behavioral control, and behavioral intention) as cognitive outcomes and muscular strength and flexibility as physical outcomes were measured three times: at baseline, week 6 and week 8. Cobb's angle as another physical outcome was measured twice: at baseline and week 8. Descriptive analysis, repeated measures analysis of variance and t test were used for data analyses. RESULTS: Attitude, perceived control, and behavioral intention were consistently enhanced by the posture management program. The intervention increased flexibility and muscular strength and decreased Cobb's angle, which reduced spinal curvature. Frequency of posture management exercise showed a gradual increase in the test group. CONCLUSION: The results indicate that the posture management program is effective in maintaining posture management behavior in adolescents with mild idiopathic scoliosis for both cognitive and physical outcomes. The posture management program should be helpful in expanding the role of school nurses in improving the health status of adolescents with mild idiopathic scoliosis.

Factors Affecting the Perception of Importance and Practice of Patient Safety Management among Hospital Employees in Korea

PURPOSE: The study was undertaken to identify factors affecting perception of the importance and practice of patient safety management (PSM) among hospital employees in Korea. METHODS: This study was conducted using a descriptive design and a self-report questionnaire. Two hundred and eighty employees were recruited from three hospitals using a convenience sampling method. Measures were perception of the importance, practice, and characteristics of PSM. Data were analyzed using descriptive statistics including t test, one-way analysis of variance, Pearson's correlation analysis, and multiple regression. RESULTS: Factors affecting perception of the importance of PSM were whether hospital employees were in contact with patients while on duty, weekly working hours, education on PSM, and perceived adequacy of PSM system construction. Factors affecting the practice of PSM were perceived adequacy of work load, perceived adequacy of PSM system construction and perception of its importance. CONCLUSION: The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies.

Effects of Decision Making Competency, Nursing Professionalism, and Job Satisfaction on Turnover Impulse among Nurses / 간호행정학회지

PURPOSE: The study was undertaken to investigate effects of decision making competency, nursing professionalism and job satisfaction on turnover impulse, and identify factors contributing to turnover impulse among nurses. METHODS: The study was a descriptive study with 231 nurses from 4 general tertiary hospitals participating. Data were collected during March, 2013 using a structured self-report questionnaire. Decision making competency, nursing professionalism, and job satisfaction were measured with validated instruments, and turnover impulse was measured with one question using a 5-point Likert scale. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression. RESULTS: The significant predictors of turnover impulse among nurses were professionalism (beta=-0.18, p=.015) and job satisfaction (beta=-0.18, p=.009). These variables explained 12% of the variance in turnover impulse among nurses. CONCLUSION: The results indicate that nursing managers need to put efforts in improving nurses' job satisfaction and to develop plans to increase nursing professionalism in order to reduce nurses' turnover impulse.