Characteristics of Mixed Urinary Incontinence and Stress Urinary Incontinence: Relationship between Lower Urinary Tract Symptoms and Urodynamic Parameters

PURPOSE: The purpose of this study was to analyze the relationship between lower urinary tract symptoms and urodynamic parameters to investigate the characteristics of mixed urinary incontinence (MUI) and stress urinary incontinence (SUI). METHODS: The subjects were 318 women with MUI and 128 women with SUI. Data were collected retrospectively from electronic medical records including Bristol Female Lower Urinary Tract Symptoms-Scored Form (BFLUTS-SF), Incontinence Quality of Life Instrument (I-QOL), voiding diaries, and urodynamic parameters. RESULTS: Compared with the SUI group, the MUI group was older and showed lower I-QOL and more severe urinary tract symptoms. The MUI group had more urinary frequency, more nocturia, and a higher urgency score than the SUI group. In the correlation analysis, the greatest difference between the two groups was that urgency was associated with Qmax, maximal cystometric capacity, and detrusor condition over activity only in the MUI group (r=−.175, p=.004; r=−.281, p<.001; r=.232, p<.001, respectively). CONCLUSION: As a result of this study, we propose that a customized management program that emphasizes the control of pelvic floor for the MUI group, and one that effectively strengthens the weak pelvic floor for the SUI group.

Chief Complaints of Elderly Individuals on Presentation to Emergency Department: A Retrospective Analysis of South Korean National Data 2014

PURPOSE: We aimed to assess the chief complaints (CCs) of elderly individuals on presentation to the emergency department (ED) according to gender, age, and disease-related and injury-related visits. METHODS: The 2014 registry database of the National Emergency Department Information System in South Korea, which included data on 908,761 ED visits by individuals aged 65 years and over, was reviewed. RESULTS: We found that 80.7% ED visits were related to disease, whereas the remaining visits were related to injury. The most common CCs presented by elderly male and female individuals with disease-related visits were dyspnea and dizziness, respectively. The 10 most common CCs accounted for 45.5% and 49.2% of the total disease-related visits for male and female individuals, respectively. The most common CC in male and female individuals with injury-related visits was headache and hip pain, respectively. The CC rank showed minimal variance among the different age groups, but a difference was observed between male and female individuals. The most common mechanism of injury in elderly male and female individuals was slipping, wherein females showed a higher occurrence rate than their male counterparts. CONCLUSIONS: These findings can be used to establish an ED training curriculum for nursing students and ED nurses, particularly for ED triage in the elderly.

Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness

PURPOSE: The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. METHODS: A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. RESULTS: Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. CONCLUSION: The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.

Successful Aging of Korean Older Adults based on Rowe and Kahn's Model: A Comparative Study According to the Use of Community Senior Facilities

PURPOSE: This study was conducted to examine the prevalence of successful aging and factors influencing successful aging. METHODS: This was a secondary analysis study. Data were analyzed from 10,462 elderly people who participated in the 2011 National Elderly Survey. According to the use of community senior facilities, participants were divided into 4 groups: those who used senior centers (group A, n=580), village senior clubs (group B, n=3,240), both of the 2 facilities (group C, n=339), and neither of the 2 facilities (group D, n=6,303). Cross-tabulation and logistic regression were performed. RESULTS: The prevalence of successful aging was highest in group C (20.94%) and lowest in group D (10.41%). The physical & mental function and active engagement domains were highest in group C, while they were lowest in group D. The disease & risk factors domain were highest in group A, while lowest in group B. An educational level of middleschool or higher and income level in the third or higher quintile were significant factors for predicting successful aging in all groups. CONCLUSION: These results provide a basis for designing prevention and management programs as interventions to increase the prevalence of successful aging in Korean older adults.

Effects of Self-management Program applying Dongsasub Training on Self-efficacy, Self-esteem, Self-management Behavior and Blood Pressure in Older Adults with Hypertension

PURPOSE: The purpose of this study was to develop a self-management program applying Dongsasub training based on self-efficacy theory, and to verify the program effectiveness on self-esteem as well as self-efficacy, self-management behaviors, and blood pressure. METHODS: The study design was a non-equivalent, pre-post controlled quasi-experiment study. Thirty-eight patients aged 65 and older from a senior welfare center in Seoul participated in this study (20 patients in the experimental group and 18 patients in the control group). The self-management program applying Dongsasub training consisted of eight sessions. After development was complete the program was used with the experimental group. Outcome variables included self-efficacy, self-esteem, self-management behaviors measured by questionnaires, and blood pressure measured by electronic manometer. RESULTS: Self-efficacy (t=2.42, p =.021), self-esteem (t=2.57, p =.014) and self-management behaviors (t=2.21, p =.034) were significantly higher and systolic blood pressure (t=-2.14, p =.040) was significantly lower in the experimental group compared to the control group. However, diastolic blood pressure (t=-.85, p =.400) was not significantly different between the two groups. CONCLUSION: The results indicate that the self-management program applying Dongsasub training can be used as a nursing intervention in community settings for improving self-management behaviors for older adults with hypertension.

Diabetes Self-management Education in the Community / 임상당뇨병

Currently, diabetes self-management education (DSME) is usually provided in hospitals, often in the form of a lecture. Evidence has indicated better strategies for DSME, such as behavioral outcome-focused, patient empowering, theory-based, and community-based long-term education. This manuscript presents guiding principles of DSME developed by a joint taskforce team of AADE (American Association of Diabetes Educators) and ADA (American Diabetes Association) members to address the need for community-based DSME and strategies to develop such programs. In conclusion, well-developed community DSME should have these characteristics; 1) consensus of needs and strategies for DSME among community, recipients, and provider, 2) standardized form based on current evidence, 3) education provided by a qualified DSME educator, and 4) include a system for continuous evaluation and revision of the program.

Intervention Strategies Based on Information-Motivation-Behavioral Skills Model for Health Behavior Change: A Systematic Review

PURPOSE: This study systematically reviewed research on behavioral interventions based on the information-motivation-behavioral skills (IMB) model to investigate specific intervention strategies that focus on information, motivation, and behavioral skills and to evaluate their effectiveness for people with chronic diseases. METHODS: A systematic review was conducted in accordance with the guidelines of both the National Evidence-based Healthcare Collaborating Agency and Im and Chang. A literature search was conducted using electronic databases. Randomized controlled trials that tested behavioral interventions based on the IMB model for promoting health behaviors among people with chronic diseases were included. Four investigators independently reviewed the studies and assessed the quality of each study. A narrative synthesis was used. RESULTS: A total of 12 studies were included in the review.Nine studies investigated patients with HIV/AIDS. The most frequently used intervention strategies were instructional pamphlets for the information construct, motivational interviewing techniques for the motivation construct, and instruction or role playing for the behavioral skills construct. Ten studies reported significant behavior changes at the first post-intervention assessment. CONCLUSION: This review indicates the potential strength of the IMB model as a theoretical framework to develop behavioral interventions. The specific integration strategies delineated for each construct of the model can be utilized to design model-based interventions.

Knowledge and Management of Tracheal Tube Cuffs Among ICU Nurses in Korea / 성인간호학회지

PURPOSE: The aim of this research was to determine knowledge and management of tracheal tube cuffs among nurses of ICU. METHODS: This descriptive survey recruited 150 nurses working at 8 different adult ICUs within 2 tertiary hospitals in Seoul. A survey questionnaire was developed to measure cuff management. The internal reliability of the tool was examined by Cronbach's alpha Descriptive statistics and multiple regressions were used to analyze data. RESULTS: Among the 150 nurses, 94.0% replied that they would measure the pressure themselves. With regard to nurses' knowledge about tracheal tube cuffs, only 6% answered that they knew 'the appropriate cuff pressure'. The existence of a measuring device (p < .001), a guideline (p < .001), the level of knowledge on its related complications(p = .003), and clinical experience (p < .001) together accounted for 35.0% of the total variation in cuff management. They pointed out that the lack of time and the lack of education were major barriers to appropriate management; whereas education update was the most imperative factor for good management. CONCLUSION: ICU nurses have inappropriate knowledge and practice in cuff management. Therefore continuing education is necessary for better practice of tracheal tube cuff management.

The Validity and Reliability of a Korean Version of the Summary of Diabetes Self-Care Activities Questionnaire for Older Patients with Type 2 Diabetes / 성인간호학회지

PURPOSE: This research was carried out to evaluate the validity and reliability of the Korean version of the Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) for Korean older adults with type 2 diabetes. METHODS: Translation and back-translation were performed to develop the Korean version of the SDSCA. Then the Korean version SDSCA was applied to a sample of 112 older adults who had participated in diabetes self management education in Seoul. The internal consistency and the test-retest reliability were examined to test the reliability. Factor analysis was used to examine the construct validity. RESULTS: The internal consistency measured with Cronbach's alpha was .77 and the total test-retest reliability was .68 with items ranging from .21 to 1.00. As the result of the factor analysis, six factors -foot care, diet, exercise, blood sugar test, medication, and smoking- were revealed as the original instrument subcategories. These six factors explained 81.17% of total variance. CONCLUSION: The reliability and validity of the Korean version SDSCA Questionnaire was supported for use in older patients with type 2 diabetes in Korea.

Foot Ulcer Risk, Foot Care Knowledge, and Foot Care Practice in Patients with Type 2 Diabetics / 성인간호학회지

PURPOSE: The purpose of this study was to investigate foot ulcer risk factors, foot care knowledge, and foot care practice in patients with type 2 diabetes. METHOD: One hundred fifty type 2 diabetic patients were in and out-patients in a large urban hospital. The data were collected using a self-report questionnaire, chart review and foot examination. The questionnaires were developed by the researchers through the experts consultation and literature review. High risk for foot ulcer was evaluated by peripheral neuropathy(PN), peripheral vascular disease(PVD), and prior foot ulcer. Foot risk scores(FRS) means numbers of present risk factors. RESULTS: 31.3% of subjects show 1 FRS, and 13.3% showed 2 FRS. Mean foot care frequency was 3.5 times per week. There were significant differences in foot care knowledge according to DM education (t=2.96, p=.004) and foot care education (t=3.65, p=.001). There were significant differences in the foot care practice activities according to duration of DM (t=3.48, p=.010) and educational levels. CONCLUSION: There were high proportion of foot ulcer risk among the patients. It is necessary to screen high risk foot ulcer patients and provide practical education for foot care practice of diabetic patients.

Comparison of Nursing Activities Reflected in Nursing Notes and In-depth Interviews of Nurses in an Acute Hospital / 간호학회지

PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.

Model Development of Change of Family Functioning with Chronic Illness / 간호학회지

The main objectives of this study were to investigate the concept of family function from the perspective of the contemporary Korean family, and to construct model of change of family function whit chronic illness. The hybrid model approach was applied in which three phases(theoretical phase, empirical phase, and analytic phase) of concept development were explored for family functioning. The study was conducted from 1997 to 1998. In empirical phase, two groups of purposive samples were drawn : normal family group composed of six families without ill family member, and ill family group composed of seven families of which wives have rheumatoid arthritis. Only families with child(or children)in primary or secondary schools were included in the study. The results were as follows: In theoretical phase, six dimensions of family concept were emerged : affective, structural, control, cognitive, financial, and reproductive dimension. In order to analyze the Korean normal family function in middle class with middle-age women, financial and reproductive dimension were not included. In empirical phase, five dimensions(affective, structural, control, cognitive, and external relationship) were fond from the normal family data. External relationship dimension is very important factor as a resource of the support, especially when their parents or siblings had no help or support to them. In the affective dimension, Korean family emphasized harmony and balance rather than affective expression harmony and balance rather than affective expression between couples and between parents and children. They also showed common goals of the families to solve their problems to control the family members. The priority of the goals was getting into the higher education of their children or helping their unhealthy parents or family members. Six dimension(affective, structural, control, cognitive, external relationship, and financial) of family functions were emerged from the ill family data. From the analysis of ill family data, types of restructuring house chore after wives illness were developed : (a) negociated, (b) accomodated, and (c) isolated, enduring types. Although the dimensions of family functioning identified in this study are similar to the conceptualizations that exist in the western literature, there where distinct differences in the nature of major themes and subconcepts under these family function dimensions.

A Study on the Occurence of Intravenous-Related Phlebitis(Data from Patients Cared by the IV Nurses) / 성인간호학회지

The Purpose of this study was to obtain the basic data to identify effective nursing methods for intravenous therapy patients by means of investigating the incidence of phlebitis and identifying the risk factors for intravenous-related phlebitis which cared by the IV team nurses. The data collected from August, 30, 1995 to October, 2, 1995. The subjects of this study were 495 IV catheters of 270 patients hospitalized to the 3 internal medicine and the 3 surgical wards of large general hospital who received the continuous IV therapy. In order to investigate the incidence of phlebitis, investigator developed the criteria for judging phlebitis and assessment records concerning the phlebitis. Catheter sites was inspected on a daily basis by IV team nurses, and development of phlebitis was graded and documented. The data were analyzed using the PC-SAS program : Percentages and Chi-Square test were used. The results were summarized as follows ; 1. Over-all rate of incidence of intravenous-related phlebitis was 8.7%(Grade III 8.5%, Grade IV 0.2%). 2. There was significant difference in the incidence of phlebitis by sex. It was 12.00% in female as compared to 6.44% in male. 3. There was no significant difference in the incidence of phlebitis by age. 4. There was significant difference in the incidence of phlebitis according to duration of catheter placement. The incidence of phlebitis was the highest within 24 hour after insertion. 5. There was significant difference in the incidence of phlebitis according to the location of the insertion site. Lower extremities were 22.22% as compared to 8.18% in upper extremities. But, there was no difference in the incidence of phlebitis according to the location of the insertion site among upper extremities catheters. 6. There was significant difference in the incidence of phlebitis by the size of cannula 22G was 11.08% as compared to 4.14% in 18G. 7. There was no significant difference in the incidence of phlebitis between surgical and medical wards. It was 10.96% in surgical wards as compared to 6.88% in medical wards. In conclusion, the following risk factors can be attributed to the incidence of phlebitis : sex, the duration of catheter placement, the location of the insertion site and the size of cannula inserted. Consequently, in order to prevent and detect the intravenous-related phlebitis early, a consistent, organized assessment and evaluation of the above factors during the intravenous therapy.