The Validity and Reliability of Nursing Assessment Communication-Competence Scale for Clinical Nurses / 기본간호학회지

Purpose@#The aim of this study was to evaluate the validity and reliability of the short-version for clinical nurses on a communication competence scale developed to measure the communication competence of clinical nurses. @*Methods@#Data were collected from 396 clinical nurses who work at general hospitals in Korea. The original version of the Communication Ability Scale was shorted and content, construct, item-convergent/discriminant, convergent validity and also internal consistency and test-retest reliability were evaluated. Data were analyzed using exploratory and confirmatory factor analyses, Pearsons's correlation coefficient and Cronbach’s ⍺. @*Results@#As a result of item analysis and exploratory factor analysis, 5 subscales and a total of 20 items were derived. The confirmatory factor analysis showed adequate model fit indices (Normed x2=1.88, RMR=.04, RMSEA=.07, GFI=.87, CFI=.90, TLI=.87, IFI=.89). The items convergence and discrimination validity were verified using the Average Variance Extracted (.50~.56), composite reliability (.76~.86) and Φ±2SE (.42~.99). Convergent validity was demonstrated using Korean Version of Self-Efficacy Questionnaire (r=.59, p<.001). Internal consistency reliability and test-retest reliability were found to be acceptable, as indicated by a Cronbach’s ⍺ of .65~.79 and an intra-class correlation coefficient of .82~.90. The validity and reliability of the scale were verified. @*Conclusion@#The NACCS is a valid and reliable instrument for measuring communication competence for clinical nurses in Korea.

Development of the Self-Care Non-adherence Risk Assessment Scale for Patients with Chronic Illness

Purpose@#The purpose of this study was to develop the Self-Care Non-adherence Risk Assessment Scale (SCNRAS) for patients with chronic illness in South Korea. @*Methods@#This study was conducted from April to July, 2020 and utilized a convenience sampling method to recruit 336 patients with chronic illness from three hospitals located in South Korea. The content, factorial structure, item-convergent/discriminant validity, convergent validity, internal consistency reliability, and test-retest reliability of the scale were evaluated. The data were analyzed using exploratory and confirmatory factor analyses, Pearson’s correlation coefficient, Cronbach’s ⍺, and intra-class correlation coefficient. @*Results@#The exploratory and confirmatory factor analyses yielded six-factors. Convergent validity was demonstrated using measures of defining issues. Internal consistency reliability and test-retest reliability were found to be acceptable, as indicated by a Cronbach’s ⍺ of .65~.81 and an intra-class correlation coefficient of .93~.98. The Self-Care Non-adherence Risk Assessment Scale for patients with chronic illness is a new instrument that comprehensively measures the knowledge, skill, physical function status, access to health care, social support, motivation, and confidence. It comprises 18 items scored on a 5-point Likert scale. The validity and reliability of the scale were verified. Conclusion: The scale developed through this study is expected to screen those who need nursing intervention early by predicting the self-care non-adherence risk group.

Reliability and Validity of the Korean version of Short-Form Health Literacy Scale for Adults

Purpose@#The aim of this study was to evaluate the validity and reliability of the Korean version of Short-form Health Literacy Scale (HLS-SF-K12) for Adults. @*Methods@#The English HLS-SF12 was translated into Korean with forward and backward translation. Survey data were collected from 204 adults who visited two hospitals in Korea. Content validity, construct validity, and known-groups validity were evaluated. Cronbach's ⍺ for internal consistency and test-retest were used to assess reliability. SPSS 21.0 and AMOS 21.0 software were used for data analysis. @*Results@#The HLS-SF-K12 was composed of 12 items, and three subscales (health care, disease prevention, and health promotion). The instrument explained reliable internal consistency with Cronbach’s ⍺ for the total scale of .89, and .74~.81 for subscales. The model of three subscales for the HLS-SF-K12 was validated by confirmatory factor analysis (Normed x 2 =2.14 (p<.001), GFI=.92, RMR=.04, RMSEA=.08, CFI=.94, TLI=.92, IFI=.94). The hypothesis testing which analyzed the differences in health literacy by age and education level was satisfied. @*Conclusion@#The HLS-SF-K12 is a valid and reliable instrument for measuring health information comprehension for adults in Korea.

Reliability and Validity of the Korean version of Short-Form Health Literacy Scale for Adults

Purpose@#The aim of this study was to evaluate the validity and reliability of the Korean version of Short-form Health Literacy Scale (HLS-SF-K12) for Adults. @*Methods@#The English HLS-SF12 was translated into Korean with forward and backward translation. Survey data were collected from 204 adults who visited two hospitals in Korea. Content validity, construct validity, and known-groups validity were evaluated. Cronbach's ⍺ for internal consistency and test-retest were used to assess reliability. SPSS 21.0 and AMOS 21.0 software were used for data analysis. @*Results@#The HLS-SF-K12 was composed of 12 items, and three subscales (health care, disease prevention, and health promotion). The instrument explained reliable internal consistency with Cronbach’s ⍺ for the total scale of .89, and .74~.81 for subscales. The model of three subscales for the HLS-SF-K12 was validated by confirmatory factor analysis (Normed x 2 =2.14 (p<.001), GFI=.92, RMR=.04, RMSEA=.08, CFI=.94, TLI=.92, IFI=.94). The hypothesis testing which analyzed the differences in health literacy by age and education level was satisfied. @*Conclusion@#The HLS-SF-K12 is a valid and reliable instrument for measuring health information comprehension for adults in Korea.

Development and Evaluation of a Community based Multifaceted Cognitive Training Program for the Elderly with Mild Cognitive Impairment

PURPOSE: The purpose of this study is to develop and evaluate the effects of a multifaceted cognitive training program on cognitive function, depression, and instrumental activities of daily living (IADL) in community dwelling elders with mild cognitive impairment. METHODS: A non-equivalent control group pretest-posttest design was used. The subjects were recruited from a community health center in D metropolitan city and were assigned to the experimental or control group. Weekly 50-minute session intervention was delivered to the experimental group over 12 weeks. 8 weeks and 12weeks after intervention, the changes in cognitive function, depression, and IADL in the groups were measured and compared. Data were analyzed with Mann-Whitney U test, Wilcoxon Signed Rank test, and post-hoc test with Bonferroni correction using SPSS/WIN 23.0. RESULTS: When compared with their counterparts (n=15), the elders in the experimental group (n=12) showed significant improvement in cognitive function and depression at week 12. The mean scores of IADL at week 12 were not significantly different between the groups. CONCLUSION: The results indicate that this multifaceted cognitive training program is effective in improving cognitive function, depression, and avoiding deterioration of IADL among elders with mild cognitive impairment.

Incidence of Colon Cancer Related to Cigarette Smoking and Alcohol Consumption in Adults with Metabolic Syndrome: Prospective Cohort Study / 간호학회지

PURPOSE: The purpose of this study was to identify the impact of cigarette smoking and alcohol consumption on the incidence of colon cancer in adults with metabolic syndrome.METHODS: This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study (KoGES). The data of a sample of 2,327 adults with metabolic syndrome tracked every two years from 2001 to 2014 were used in this study. Statistical data analyses of the frequency, number of cases per 100,000 person-years, log-rank test, Kaplan-Meier curve, and Cox's proportional hazards regression were performed using IBM SPSS statistics version 24.RESULTS: During the observation period, the number of colon cancer cases was 46, and the total person-years were 252,444. The incidence of colon cancer was higher in current, over 10 pack-year smokers when compared to non-smokers (hazard ratio=3.38, 95% confidence interval=1.09~8.42).CONCLUSION: Excessive and long-term smoking should be avoided to prevent colon cancer, especially in adults with metabolic syndrome, since it might exacerbate the risk factors of colon cancer. Particularly, health professionals need to provide individualized smoking cessation interventions to those at high risk of colon cancer.

Incidence of Colon Cancer Related to Cigarette Smoking and Alcohol Consumption in Adults with Metabolic Syndrome: Prospective Cohort Study

Purpose@#The purpose of this study was to identify the impact of cigarette smoking and alcohol consumption on the incidence of colon cancer in adults with metabolic syndrome. @*Methods@#This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study (KoGES). The data of a sample of 2,327 adults with metabolic syndrome tracked every two years from 2001 to 2014 were used in this study. Statistical data analyses of the frequency, number of cases per 100,000 person-years, log-rank test, Kaplan-Meier curve, and Cox’s proportional hazards regression were performed using IBM SPSS statistics version 24. @*Results@#During the observation period, the number of colon cancer cases was 46, and the total person-years were 252,444. The incidence of colon cancer was higher in current, over 10 pack-year smokers when compared to non-smokers (hazard ratio=3.38, 95% confidence interval=1.09~8.42). @*Conclusion@#Excessive and longterm smoking should be avoided to prevent colon cancer, especially in adults with metabolic syndrome, since it might exacerbate the risk factors of colon cancer. Particularly, health professionals need to provide individualized smoking cessation interventions to those at high risk of colon cancer.

Testing a Middle-Range Theory of Self-Care of Chronic Illness: A Validation for Korean Adult Patients with Severe Hypertension

PURPOSE: The aims of this study are to provide a theoretical framework for improving the self-care of adults with severe hypertension and to examine the practical suitability of a middle-range theory of self-care for chronic illness by validating the structural model. METHODS: Data were collected at a university hospital in D metropolitan city from July 1 to August 14, 2015. A total of 224 Korean adult patients with severe hypertension were recruited. Data were analyzed using SPSS 22.0 and AMOS 22.0. RESULTS: The results show that the fit index of the hypothetical model meets the recommended level; 7 out of 8 hypothetical model paths were statistically significant. Motivation, self-efficacy, support from others, and accessibility to care showed statistical significance and explained 67.3% of the self-care process. The self-care process explained 45.3%, 63.6%, and 26.5% of quality of life, health, and illness stability, respectively. CONCLUSION: This model can be used as a theoretical framework for improving self-care among adult Korean patients with severe hypertension. Moreover, the practical suitability and validity of the middle-range theory of self-care for chronic illness is secured.

Development and Psychometric Testing of the Clinical Nursing Competency Scale for Clinical Preceptor Use (CNCS-CP)

PURPOSE: The purpose of this study was to develop and establish the psychometric properties of a clinical nursing competency evaluation tool to be utilized by clinical preceptors. METHODS: The initial items were identified through in-depth literature review and field interviews based on a hybrid model. Content validation of the items was evaluated through three rounds of content validity testing. Participants were 34 clinical preceptors and 443 nursing students participating in clinical practice. Data were analyzed using exploratory and confirmatory factor analysis, convergence and discriminant validity, internal consistency and inter-rater reliability. RESULTS: The final scale consisted of 23 items and four factors, fundamental nursing skills performance, critical thinking skills based on the nursing process, basic nursing knowledge, and professional attitude; these factor explained 69.7% of the total variance. The analysis with multi-trait/multi-item matrix correlation coefficients yielded 100.0% and 95.7 % convergence and discriminant validity, respectively. Cronbach's alpha for the total items was .95. The four subscale model tested by confirmatory factor analysis was satisfactory. Inter-rater reliability ranged from .912 to .967. CONCLUSION: This scale was found to be a reliable and valid instrument that clinical preceptors can apply for evaluating the clinical nursing competency of nursing students in clinical settings.

Risk Factors for Unawareness of Obstructive Airflow Limitation among Adults with Chronic Obstructive Pulmonary Disease

PURPOSE: The purpose of the present study is to examine risk factors for unawareness of obstructive airflow limitation among adults with chronic obstructive pulmonary disease. METHODS: Secondary data analysis was performed with the data from the 6th Korea National Health and Nutrition Examination Survey (KNHANES; 2013–2014). The data were analyzed with the IBM SPSS 22.0 version using frequency, percentage, odds ratio, and logistic regression. RESULTS: Ninety-eight percent of subject with a pulmonary function test score of FEV1/FVC < 0.7 (N=833) did not recognize that their lung function was impaired. The heavy drink, absence of tuberculosis or asthma diagnosis, and no symptom of expelling phlegm were identified as major risk factors for unawareness of airflow limitation. CONCLUSION: In order to increase awareness of airflow limitation and to prevent the worsening of the condition, the pulmonary function screening test should be provided to community residents including those who do not show symptoms of respiratory illness.

Age-differentiated Risk Factors of Suicidal Ideation among Young and Middle-aged Korean Adults

OBJECTIVES: This study aimed to determine the prevalence of suicidal ideation among young and middle-aged adults, and explore the risk factors that affect suicidal ideation. METHODS: A descriptive study design was used for secondary data analysis. A total sample of 5,214 was drawn from two waves (2012–2013) of the 7th Korea Health Panel (KHP) survey. The KHP data were collected by a well-trained interviewer using the face-to-face method during home visits as well as self-report method. Descriptive statistics of frequency, percentage, chi-square test, and logistic regression analysis were performed using SPSS 22.0. RESULTS: The prevalence of suicidal ideation in young and middle-aged adults was 4.4% and 5.6%, respectively. For young adults, suicidal ideation risk was higher among those with low income or heavy drinking habits. In middle-aged adults, low income, poor perceived health status, negative perception of peer-compared health status, and negative social perspective were the major risk factors. CONCLUSION: There is considerable risk of suicidal ideation in adulthood. Opportunities for increased income, avoidance of heavy drinking, and the construction of positive subjective health status and social perspective should be considered in suicide prevention interventions for Korean young and middle-aged adults.

Comparison of Confidence in Practice and Satisfaction by Feedback Types Following Objective Structured Clinical Examination(OSCE) among Nursing Students: Focus on Intermittent Gavage Tube Feeding / 기본간호학회지

PURPOSE: The purposes of this study were to compare confidence in practice of intermittent gavage tube feeding and participants' satisfaction by three types of feedback; professor verbal feedback, professor feedback with smartphone video, and peer feedback with smartphone video. In addition, frequently failed items in the intermittent gavage tube feeding procedure were analyzed. METHODS: Data were collected from a convenience sample of 78 nursing college students in November 2014. Students were randomly assigned to the control group, experimental group I (smartphone video with professor feedback) or group II (smartphone video with peer feedback). Data were analyzed using descriptive statistics including chi-square test, ANOVA, and Scheffe test with SPSS 21.0. RESULTS: Confidence in practice of intermittent gavage tube feeding and satisfaction with feedback were highest in experimental group I that had professor feedback with smartphone video. For the procedure, the most frequently failed item was giving an explanation to patients about the purpose and the procedure of tube feeding. CONCLUSION: The results indicate that professor verbal feedback with smartphone video is the most benefit to the nursing students in acquiring core nursing practice skills.

Validation of a Korean Translated Version of the Critical Care Pain Observation Tool (CPOT) for ICU Patients

PURPOSE: The purpose of this methodological study was to examine the reliability and validity of a translated Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. METHODS: A cross-sectional study design was used. Data were collected from a convenience sample of 202 critically ill patients admitted to a university hospital. Upon establishment of content and translation equivalence between the English and Korean version of CPOT, psychometric properties were evaluated. RESULTS: The interrater reliability was found to be acceptable with the weighted kappa coefficients of .81-.88. Significant high correlations between the CPOT and the Checklist of Nonverbal Pain Indicators were found indicating good concurrent validity (r=.72-.83, p<.001). Data showed the area under the ROC curve of 0.86 with a cut-off point of 1, which resulted in 76.9% sensitivity and 88.6% specificity. The mean score of CPOT during suctioning was significantly different from that of before (t=-14.16, p<.001) or 20 minutes after suctioning (t=16.31, p<.001). CONCLUSION: Results of this study suggest that the CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal patients.

Translation and Validation of the Korean Version of MUDI and MUSIQ with Urinary Incontinent Older Men

PURPOSE: The purpose of this study was to evaluate the psychometric properties of the Korean version of the Male Urinary Distress Inventory (MUDI) and Male Urinary Symptom Impact Questionnaire (MUSIQ). PATIENTS AND METHODS: A convenient sample of community-dwelling older men with urinary incontinence participated. A cross-sectional survey design was used for this study. A panel of experts completed the initial translation into Korean and back-translated the MUDI and MUSIQ. Upon establishment of the content and translation equivalence between English and Korean versions of the MUDI and MUSIQ, psychometric properties were evaluated for reliability, concurrent, and construct validity with a sample of 143 older men. RESULTS: The internal consistencies of both instruments were found to be acceptable, and Cronbach's coefficients were 0.88 for the MUDI-K and 0.92 for the MUSIQ-K. A significant moderate correlation between MUDI-K and MUSIQ-K was found in this study, indicating modest concurrent validity between these 2 instruments (r = 0.56, p < 0.001). For construct validity, the mean scores of the MUDI-K were significantly different for age, marital status, prostate surgery, erectile dysfunction, and depression (p < 0.05). The means scores of MUSIQ-K were significantly different for depression (p < 0.05) only. For both the MUDI-K and MUSIQ-K, 7 factors were extracted, accounting for 68.1% and 72.1% of the variance. CONCLUSION: Results of this study suggest that the MUDI-K and MUSIQ-K can be used as a reliable and valid measure of health-related quality of life in community- dwelling Korean older men with urinary incontinence.

A Study on Fluid Intake among Nursing Home Residents / 간호학회지

PURPOSE: The purposes of this study were to examine the amount of daily fluid intake among nursing home residents and to explore the caregiver's perceived barriers to elderly's fluid intake. METHOD: Data was collected from 111 nursing home residents and 64 caregiver's in 4 nursing homes. A random, non-consecutive three days of 24 hour fluid intake was measured and recorded. The caregiver's perceived barriers to elderly's fluid intake was assessed using a structured questionnaire. RESULTS: The average amount of daily fluid intake was 1,035(SD=359)ml with the range of 210ml to 2,050ml. About 52% (n=58) of the subjects had a less than adequate fluid intake. The amount of daily fluid intake was significantly associated with age, mental status, physical functioning, and the number of oral medications ordered. The most frequently mentioned caregiver's perceived barrier was elderly's concern about incontinence with increased fluid intake. CONCLUSION: Inadequate fluid intake among nursing home residents is prevalent. To enhance adequate hydration of nursing home residents, an institution wide nursing intervention is necessary.

Development and Analysis of the Effects of Caregiver Training Program on Aggressive Behavior in Elders with Cognitive Impairment / 간호학회지

PURPOSE: The purposes of this study were to 1) describe the type and frequency of aggressive behavior of cognitively impaired nursing home resident, 2) develop a caregiver training program on prevention and management of aggressive behavior, 3) examine the effects of caregiver training program on the incidence of aggressive behavior of cognitively impaired nursing home resident, and 4) examine the effects of caregiver training program on nursing staff's aggressive behavior management skills. METHODS: One-group, time series, quasi-experimental design with a pre-test and two post-tests was used. Data were collected from cognitively impaired home residents (N=32) and nursing staff (N=36) in a proprietary nursing home using Ryden Aggression Scale I, II, and Aggressive Behavior Management Scale. Data were entered and analyzed by descriptive statistics and repeated measures ANOVA. RESULTS: Incidence of aggressive behavior was high with a mean score of 3.09 (SD=3.11) at baseline. Caregiver training program was developed based on Progressively Lowered Stress Threshold (PLST) model and gerontological and psychiatric literature. The mean scores of aggressive behavior at baseline, Post I, and II did not differ significantly although the difference approached to the significant level (F=2.925, p=.066). Nursing staff's aggressive behavior management skills increased at Post I, and at Post II when compared to baseline, and the difference was significant (F=12.736, p=<.001). CONCLUSION: Caregiver training program showed potential impact on reduction of aggressive behavior in elders with cognitive impairment and was effective in increasing nursing staff's aggressive behavior management skills.

A Study on Aggressive Behavior Among Nursing Home Residents with Cognitive Impairment / 간호학회지

PURPOSE: With a sample of cognitively impaired nursing home residents and nursing staff, the following were examined 1) the proportion and nature of aggressive behavior, 2) the frequency and types of aggressive behavior, 3) the difference between the residents who demonstrate aggressive behavior and those who do not demonstrate aggressive behavior (age, mental status, functional status, and pain, length of nursing home stay), and 4) nursing staff responses to aggressive behavior by residents. METHODS: A cross-sectional descriptive study design was used. Data were collected from cognitively impaired nursing home residents (N=205) and nursing staff (N=60) at two nursing homes using Ryden Aggression Scale I and II, Mini-Mental State Exam, Modified Barthel Index, Verbal Descriptor Scale, and aggressive behavior management questionnaire. Data were analyzed using descriptive statistics including t-test. RESULTS: About 62.9% residents were found to be aggressive and 38.5% were both physically and verbally aggressive. Pushing, making threatening gestures, hitting, slapping, cursing/obscene/vulgar languages, making verbal threats were occurred frequently. Aggressive residents were significantly older, had more cognitive impairment, had more pain, and stayed longer in the nursing home when compared with non-aggressive residents. Considerable proportion of nursing staff responded to aggressive behaviors inadequately. CONCLUSION: Aggressive behavior among cognitively impaired nursing home residents is prevalent thus needs to be prevented and reduced. Along with environmental modification, educational programs for nursing staff and family caregivers need to be developed and implemented so that they can have extensive knowledge and skills to manage aggressive behaviors.