Diabetes Self-Management Experience of Patients with Diabetes: Focused on the Visually Impaired

Purpose@#This study aimed to understand and describe the diabetes self-management experience of visually impaired people with diabetes. @*Methods@#Ten participants were recruited through a website used by the visually impaired from February to March 2020. Data were collected through two focus group interviews conducted in June 2020; each group consisted of five participants. All interviews were recorded with the consent of the participants and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. @*Results@#Seven categories were as follows; a two-faced, lifelong companion, an unprepared encounter, struggle to live, love-hate relationship with family, strategies to adapt, lessening attention to self-management, the desire to learn properly. @*Conclusion@#It can be concluded that the visually impaired have fewer opportunities for receiving diabetes self-management education than general diabetic patients. Consequently, plans to improve the education available to such patients are required. Additionally, psychological counseling and diabetes education for patients’ families are necessary, and improving the perception of medical workers regarding the visually impaired will be prove useful.

Special Considerations in Diabetes Self-Management Education for Older Adults with Diabetes: A Study Focusing on Community Senior Welfare Centers / 임상당뇨병

Optimal diabetes self-management can lead to positive outcomes such as blood glucose control, prevention of diabetes-related complications, and improvement in quality of life. Various strategies have been developed for delivering diabetes self-management education to older adults with diabetes. This paper describes factors that should be considered when planning diabetes self-management education in community senior welfare centers. Diabetes educators should be aware of cognitive changes, such as changes in executive function and cognitive impairment, and health literacy. In addition, physical changes such as vision and hearing impairment and psychosocial changes such as depression should be considered when implementing diabetes self-management education for older adults with diabetes.

Estimation of Expected Nursing Hours Based on Patients’ Nursing Care Needs and a Comparison with Actual Nursing Hours in Comprehensive Nursing Care Wards / 간호행정학회지

Purpose@#To compare actual versus expected nursing hours based on patients’ nursing care needs. @*Methods@#The nursing care needs of 898 inpatients in 20 wards at 11 hospitals were measured using the 14 items developed by the National Health Insurance Service (NHIS). Nursing activities from 474 nursing personnel were observed every 10 minutes for 24 hours. Actual hours indicated direct care hours per patient day provided by registered nurses according to 3 types: (1) standard hours based on staffing standards approved by the NHIS, (2) scheduled hours excluding overtime hours, and (3) observed hours including overtime. Expected hours were estimated from the linear mixed effect model including hospital type, nursing care need items and their interaction terms. @*Results@#Standard hours ranged from 0.92 to 2.15; scheduled hours from 0.88 to 1.95; observed hours from 1.00 to 2.40; expected hours from 0.88 to 2.33. Eight hospitals had standard hours not meeting the expected hours and 2 hospitals did observed hours not meeting the expected hours due to nurses’ overtime. In 3 hospitals, all types of actual hours exceeded the expected hours. @*Conclusion@#Staffing needs to be determined based on patients’ care needs and to be improved to minimize nurses’ overtime work.

Special Considerations in Diabetes Self-Management Education for Older Adults with Diabetes: A Study Focusing on Community Senior Welfare Centers / 임상당뇨병

Optimal diabetes self-management can lead to positive outcomes such as blood glucose control, prevention of diabetes-related complications, and improvement in quality of life. Various strategies have been developed for delivering diabetes self-management education to older adults with diabetes. This paper describes factors that should be considered when planning diabetes self-management education in community senior welfare centers. Diabetes educators should be aware of cognitive changes, such as changes in executive function and cognitive impairment, and health literacy. In addition, physical changes such as vision and hearing impairment and psychosocial changes such as depression should be considered when implementing diabetes self-management education for older adults with diabetes.

The Relevance between Biological Nursing Subjects and Registered Nurse Licensure Examination Workbook in Republic of Korea and the United States of America

PURPOSE: This is a descriptive study to investigate the relevance between biological nursing science subjects (structure and function of the human body (SFHB), mechanism and effects of drugs (MED), clinical microbiology) and examination workbook items for Registered Nurse Licensure Examination (RNLE) in Republic of Korea (ROK) and the United States of America (USA). METHODS: RNLE 8 workbooks which were published by the Korean Nurses Association were utilized for analysis of Korean RNLE. Saunders comprehensive review for the NCLEX-RN® examination was used for analysis of US RNLE. The relevance between items in the standard syllabuses of biological nursing science subjects (SFHB, MED, clinical microbiology) and the RNLE items of these workbooks in ROK and the USA was analyzed. RESULTS: The relevance rates of ROK and the USA were 3.6% vs 0.4% in SFHB, 8.9% vs 23.0% in MED, and 4.5% vs 5.8% in clinical microbiology. CONCLUSION: In SFHB, the relevance of the RNLE in ROK was higher than that of the USA. However in MED the relevance of the RNLE in USA was higher than that of the ROK. Since medications are one of major tasks of nurses, it is necessary to increase the number of related items in the RNLE in ROK.

Effects of the Flipped Classroom Approach on the Psychiatric Nursing Practicum Course / 정신간호학회지

PURPOSE: In this study effects of a flipped learning-based psychiatric nursing practicum were evaluated for appropriateness with undergraduate nursing students who are digital natives and tech-savvy millennial students. METHODS: For this retrospective comparative study data from 146 undergraduate students (flipped learning group n=70, traditional learning group n=76) were evaluated for academic performance and life core competencies. RESULTS: There was no significant difference between the flipped and traditional learning groups in prior homogeneity tests. The academic performance of the flipped learning group was higher than the control group in all aspects, except for practical quiz scores. The flipped leaning group had significantly higher self-assessment scores for academic performance (t=2.77, p=.006) and therapeutic communication simulation scores (t=3.18, p=.002). In addition, they showed a significant increase in core life competencies after participating in the flipped-learning practicum (t=-8.56, p<.001). They showed significant increases in all subdomains except Identity-value [Socialization (t=-5.13, p<.001), Responsibility-practice (t=-3.52, p=.001), Problem-solving (t=-2.67, p=.010), Knowledge-construction (t=-2.48, p=.016), and Information-management (t=-5.54, p<.001)]. Nursing students in the flipped learning-based clinical practicum showed significant improvement in performance and life core competencies. CONCLUSION: These results suggest that as a student-centered pedagogy, flipped learning is an effective strategy for improving academic performance and core competencies.

The Relevance between Pathophysiological Subject and Examination Workbook Items for National Nurse Licensure Examination in South Korea and the United States

PURPOSE: This study is a descriptive study to investigate the relevance between pathophysiological subject and examination workbook items for national nurse licensure examination in South Korea and the United States. METHODS: Eight registered nurse licensure examination workbooks published by the Korean nurses association were used for the analysis. Saunders comprehensive review for the national council licensure examination (NCLEX-RN) was used for analysis of those in the United States. The relevance between the subjects in the standard syllabuses of pathophysiology and the registered nurse licensure exam items of these workbooks in South Korea and the United States respectively was analyzed. RESULTS: The Relevance rates in South Korea and the United States were : fundamentals of nursing 6.34% vs 32.12%, adult nursing 25.5% vs 25.92% child health nursing 7.81% vs 21.7%, woman health nursing 5.1% vs 17.07% psychiatric mental health nursing 2.7% vs 7.32%, and community health nursing 0.9% vs 0%. CONCLUSION: the relevance in pathophysiology between the registered nurse licensure exam in South Korea and the United States was high in adult nursing and fundamentals of nursing (especially in the United States). In developing integrated registered nurse licensure exam questions, we should consider pathophysiology as an important subject.

Factors Influencing Physical Activity among Community-dwelling Older Adults with Type 2 Diabetes: A Path Analysis

PURPOSE: The purpose of the study was to identify factors influencing physical activity among community-dwelling older adults with type 2 diabetes. The study design was based on the Theory of Triadic Influence. METHODS: A total of 242 older adults with type 2 diabetes participated in this study. Six variables related to physical activity in older adults, including self-efficacy, social normative belief, attitudes, intention, experience, and level of physical activity, were measured using reliable instruments. Data were analyzed using descriptive statistics, Pearson's correlation analyses, and a path analysis. RESULTS: The mean physical activity score was 104.2, range from zero to 381.21. The path analysis showed that self-efficacy had the greatest total effect on physical activity. Also, experience had direct and total effects on physical activity as well as mediated the paths of social normative beliefs to attitudes and intention to physical activity. These factors accounted for 10% of the total variance, and the fit indices of the model satisfied the criteria of fitness. CONCLUSION: The findings of the study reveal the important role of self-efficacy and past experience in physical activity in older adults with type 2 diabetes.

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.

Does Chemotherapy Really Affect the Quality of Life of Women with Breast Cancer? / 한국유방암학회지

PURPOSE: The aims of this cross-sectional study were to explore and evaluate the impact of adjuvant chemotherapy on quality of life in breast cancer patients according to the survival time from surgery. METHODS: Completed questionnaires were collected from 534 women with breast cancer. Clinical and sociodemographic characteristics were reviewed and Functional Assessment of Cancer Therapy-Breast cancer instrument, global quality of life, Beck Depression Inventory, and unmet sexuality needs were administered. Descriptive statistics, t-tests, chi-square tests and multiple analysis of covariance were performed while controlling for confounding variables. RESULTS: Statistically significant differences were found between chemotherapy and no chemotherapy group on depression (p=0.026), unmet sexuality needs (p=0.010), breast cancer specific concerns (p=0.010), physical well-being (p=0.001), and emotional well-being (p=0.028). Chemotherapy effects also varied according to survival time since surgery such as for group 1 (3 years since surgery) on depression (p=0.019) and physical well-being (p=0.028) respectively; however, there were no significant differences between chemotherapy and no chemotherapy group for group 2 (1-3 years since surgery). CONCLUSION: As expected, breast cancer patients who underwent adjuvant chemotherapy experienced significantly worse quality of life than those who did not receive chemotherapy. Furthermore, the adverse chemotherapy effects on the quality of life appear to vary according to the time since surgery. These results suggest that health care professionals may need to address long-term as well as short-term chemotherapy side-effects and intervene accordingly to enhance quality of life of breast cancer patients.

Development of Meditation Treatment Program / 신경정신의학

OBJECTIVES: Despite evidence of its therapeutic benefits and popular use for health purposes, meditation is out of the medicine in Korea. For the promotion of clinical use and research, it is needed to develop the standardized and structured meditation treatment program. METHODS: The authors selected a traditional Korean meditation as the model for a new meditation treatment program and surveyed the practitioners of this form of meditation to collect information about its effects and safety. The original meditation was modified for the physically or mentally compromised to practice it. The modified meditation was then used with psychiatric patients and breast cancer patients. RESULTS: The practitioners of a traditional Korean meditation were satisfied with the positive effects of meditation on physical and mental health. Original meditation was modified as a shorter and simpler form. In an empirical trial of the modified meditation technique, psychiatric inpatients showed low motivation and little benefit, but the breast cancer patients reported improvements in physical and mental status. There were no obvious adverse effects in either of the two clinical groups. CONCLUSION: A meditation treatment program based on a traditional Korean meditation was developed and found to be safe in psychiatric and breast cancer patients. The program proved effective in improving the quality of life for breast cancer patients. Further research into the clinical efficacy and the mechanisms of this meditation treatment program is needed.