Factors associated with the quality of life of living kidney donors in Korea: A cross-sectional study.

This study investigated the relationship between self-determination, physical health status, and Health related Quality of Life (=HRQoL) among living kidney donors. A descriptive survey was conducted between 2019 and 2020 and included 111 kidney donors. Data were collected using a self-report questionnaire on general and donation-related characteristics, self-determination, and HRQoL. The data also included medical records reflecting the physical health status at the time of the survey. Data were analyzed using a multiple regression model. Factors associated with HRQoL were perceived health recovery after donation (ß = 0.42, P < .001), up to 1 year since donation (ß = 0.33, P = .008), more than 1 up to 5 years since donation (ß = 0.52, P < .001), more than 5 up to 10 years since donation (ß = 0.53, P < .001), and competence of self-determination (ß = 0.23, P = .033). The explanatory power of these variables was 43.3%. HRQoL of living kidney donors can be affected by subjective and psychological factors. Therefore, health care providers should help living kidney donors have high self-determination during pre and post donation and concentrate on the subjective and psychological factors as well as objective health status.

[Lived Experience of Kidney Transplant Recipients with Kidney Graft Failure].

PURPOSE: The study aimed to understand the semantic structure and nature of the disease experience of kidney transplant recipients with kidney graft failure by applying phenomenological research methods. METHODS: Data were collected between February and September 2021 through individual in-depth interviews with 12 kidney transplant recipients with kidney graft failure. Colaizzi's phenomenological analysis was used to analyze the meaning of the participants' illness experiences. RESULTS: 5 theme clusters and 15 themes were derived. The five theme clusters are as follows: (1) First transplant giving me a second life; (2) Body and mind becoming sick again; (3) Waiting for a re-transplant with hope and worry; (4) Life supported by gratefulness; (5) Having control over my own life. CONCLUSION: This study shows that kidney transplant recipients with kidney graft failure experience physical and psychological difficulties during the long disease period and require help from many people, including family members, friends, colleagues, and health care providers, to overcome their difficulties.

Relationship between depression, anxiety, stress, and health-related quality of life in adults with and without chronic diseases: A cross-sectional study.

Health-related quality of life (HRQoL) in patients with chronic diseases is an important tool to measure patient-reported health outcomes and evaluate the usefulness of treatment, management, and rehabilitation programs. Patients with chronic diseases are more likely than those without to experience psychological problems such as depression, anxiety, and stress, all of which can affect HRQoL. This study evaluated the impact of psychological problems such as depression, anxiety, and stress on HRQoL in people with and without chronic diseases in South Korea. The study's descriptive survey included 501 participants (191 with and 310 without chronic diseases). Data were collected using structured questionnaires between April and May 2021. The general characteristics, DASS-21, and HRQOL of this study were analyzed using descriptive statistics. Differences in DASS-21 and HRQoL based on general characteristics were analyzed using t tests and ANOVA. The study analyzed the factors influencing the participants' HRQoL using stepwise multiple regression analysis with SPSS Win 27.0. HRQoL was generally lower for patients with chronic diseases than for patients without. In patients with chronic diseases, the major variables affecting HRQoL were depression (ß = -0.244, t = -3.582, P < .001), exercise (ß = 0.201, t = 2.927, P = .004), and economic status (ß = -0.150, t = -2.184, P = .030), of which depression was the most influential. These variables explained 12.5% of the variance in the regression model for total HRQoL. These results emphasize the need to explore intervention measures that can reduce depression in patients with chronic diseases and anxiety in patients without chronic diseases to improve their HRQoL. In addition, national efforts are needed to provide economic support, as economic status is an influential factor in HRQoL regardless of the presence of chronic disease. The study's limitations include the fact that neither did it consider disease severity among chronically ill patients nor did it examine all the variables affecting HRQoL.

The relationship between shoulder pain and shoulder disability in women: The mediating role of sleep quality and psychological disorders.

The number of patients complaining of shoulder pain is gradually increasing, and women with shoulder pain in particular tend to present with psychological disorders and poor sleep quality. Therefore, the purpose of this study was to investigate whether psychological disorder and poor sleep quality mediated the relationship between shoulder pain and shoulder disability in women. This is a descriptive survey study of 222 women from 3 community centers in Seoul and Gyeonggi-do regions in South Korea. Data about shoulder pain, shoulder disability, sleep quality, depression, anxiety, and stress were collected using structured questionnaires between May 10 and June 7, 2021, and were analyzed by serial mediation analysis. The direct effect of shoulder pain on shoulder disability was statistically significant. Serial mediation model showed that sleep quality and psychological disorders (depression, anxiety, and stress) were sequential mediators between shoulder pain and shoulder disability among women. The relationship between shoulder pain and shoulder disability among women was partially mediated by sleep quality and psychological disorders (depression, anxiety, and stress). The results emphasize the importance of sleep quality and psychological factors in shoulder disability and suggest the use of strategies to improve sleep quality and alleviate psychological factors when developing an intervention program to mitigate shoulder disability in women with shoulder pain.

Influence of Self-Determination and Social Support on Post-Traumatic Growth among Living Kidney Donors: A Cross-Sectional Study.

Background and Objectives: Although many studies have reported that kidney donation is not physically harmful to living kidney donors, there are few studies on the psychological changes that they experience, especially post-traumatic growth. This study aimed to investigate the influence of self-determination and social support on post-traumatic growth among living kidney donors. Materials and Methods: This study used a descriptive, cross-sectional design. Data were collected from 114 living kidney donors who visited the outpatient solid organ transplant center at Seoul National University Hospital. The data were analyzed using the t-test, one-way analysis of variance, and stepwise multiple regression. Results: The results showed that the mean for post-traumatic growth of living kidney donors was 4.24 (0.81), a level higher than the midpoint. The factors affecting total post-traumatic growth were the relatedness of self-determination, the social support of their significant other, and donor type. In particular, the relatedness of self-determination was a significant factor affecting changed perceptions of self, relating to others, and spiritual change, subscales of post-traumatic growth. Additionally, the social support of donors' significant others was a significant factor affecting relating to others and new possibilities, subscales of post-traumatic growth. Conclusions: Healthcare providers should endeavor to help living kidney donors experience post-traumatic growth, which can be facilitated by improving their self-determination and social support.

The Lived Experiences of COVID-19 Patients in South Korea: A Qualitative Study.

The purpose of this qualitative study is to provide an in-depth understanding and description of the disease experiences of COVID-19 patients. The participants were 16 patients discharged from hospitals after receiving treatment for COVID-19 in isolation. Data collection was conducted through individual in-depth interviews until data saturation, and the interviews were recorded and transcribed verbatim. Data were analyzed using Colaizzi's phenomenological method. The participants were quarantined after their COVID-19 diagnosis was confirmed, and they experienced desperate and uncertain times during treatment. The participants expressed shock and dissatisfaction due to an excessive invasion of privacy during the quarantine process and in the quarantine system. As confirmed COVID-19 cases, the participants experienced social stigma and feelings of guilt, negative attitudes from others and society, and negative influences from social networking services and the media. The participants also experienced mental and physical difficulties due to COVID-19 symptoms. However, they rediscovered meaningful relationships through the support of their family and friends in the midst of adversity. It is necessary to provide an integrated psychosocial rehabilitation program to reduce social stigma and improve the resilience of COVID-19 patients.

Factors associated with health-related quality of life in kidney transplant recipients in Korea.

Health-related quality of life (HRQOL) of kidney transplant recipients is an outcome evaluation after kidney transplants. Therefore, we investigated the associations among perceived health status, social support, self-determination, post-traumatic growth, and kidney transplant recipients' HRQOL. This study involved a descriptive, self-report survey of 163 kidney transplant recipients visiting an outpatient solid organ transplant center in South Korea. Participants' general and transplant characteristics, perceived health status, post-traumatic growth, social support, self-determination, and HRQOL were collected. Data were statistically analyzed using the software SPSS version 25.0. HRQOL showed statistically significant positive correlation with perceived health status (r = .56, p < .001), post-traumatic growth (r = .18, p = .022), social support (r = .25, p = .002), and self-determination (r = .36, p < .001). The factors affecting HRQOL were perceived health status (ß = 0.47, p < 0.001), post-transplant occupation (ß = 0.17, p = 0.009), and income source (ß = -0.13, p = 0.046). The explanatory power of these variables was 34.8% (F = 28.81, p < 0.001). In the subdomains of HRQOL, the factors influencing HRQOL of mental component summary were perceived health status (ß = 0.45, p < 0.001), self-determination (ß = 0.27, p < 0.001), and education level (ß = 0.18, p = 0.006). The explanatory power of these variables was 34.8% (F = 28.81, p < 0.001). To promote the HRQOL of kidney transplant recipients, an institutional system to assist kidney transplant recipients in returning to work needs to be developed. Additionally, creating an environment that allows kidney transplant recipients to act with self-determination, and developing intervention programs that can enhance self-determination will contribute to enhancing the HRQOL of kidney transplant recipients.

The Relationship between Self-Directed Learning and Problem-Solving Ability: The Mediating Role of Academic Self-Efficacy and Self-Regulated Learning among Nursing Students.

Problem-solving ability is necessary for the clinical reasoning and decision-making of nurses to solve patients' health problems. This study aims to investigate the association between self-directed learning and problem-solving ability using the multiple mediation model to identify strategies to enhance problem-solving ability in nursing students. This is a descriptive survey study of 193 nursing students from two universities in South Korea. Data about self-directed learning, self-regulated learning, academic self-efficacy, and problem-solving ability were collected using structured questionnaires between 5 March and 17 June 2018, and were analyzed using serial multiple mediation analysis. The direct effect of self-directed learning on problem-solving ability was statistically significant. The serial multiple mediation technique predicting problem-solving ability from self-directed learning, academic self-efficacy, and self-regulated learning was significant, explaining 40% of the variance in problem-solving ability. The relationship between self-directed learning and problem-solving ability was partially mediated by academic self-efficacy and self-regulated learning. This study suggests the suitability of considering academic self-efficacy and self-regulated learning together when conducting self-directed learning to improve nursing students' problem-solving ability.

Factors Affecting Health-Promoting Behaviors among Nursing Students.

Health-promoting behaviors help prevent chronic illness. Health-promoting behaviors of nursing students can affect not only their own health, but also the health of their future patients, for whom they can act as role models. Nursing students should participate in health-promoting behaviors; however, nursing students often have unhealthy behaviors. This study aimed to investigate the factors affecting health-promoting behaviors in nursing students. A descriptive, self-report survey of 304 nursing students from three universities in South Korea was conducted. Subjects' general characteristics, health perceptions, health concerns, and health-promoting behaviors were collected. Of the total participants, 90.1% were female and the mean age was 20.4 years. The mean score for health-promoting behaviors was 2.47, higher than the midpoint. The mean for the subscale of physical activity among health-promoting behaviors was the lowest. The main factors affecting health-promoting behaviors were gender, health perceptions, health concern, and time per week spent searching online for health-related information. The main factors affecting physical activity were gender, health concern, and time per week spent searching online for health-related information. Based on the study findings, it is recommended that a program to empower nursing students to perform health-promoting behaviors be incorporated into the nursing education curriculum with regard to unique needs based on gender. Specifically, it would be effective to develop programs that are easily accessible via the Internet.

[The Lived Experience of Patients with Heart Transplantation: A Phenomenological Study].

PURPOSE: The purpose of this study was to describe the lived experience of patients with heart transplantation in Korea. METHODS: Individual indepth interviews and a focus group interview were used to collect the data from nine patients who had heart transplantations in 2015. All interviews were audio-taped and verbatim transcripts were made for the analysis. Data were analyzed using Colaizzi's phenomenological method. RESULTS: Among the nine participants, eight were men. Mean age was 57.30 years. Six theme clusters emerged from the analysis. 'Joy of rebirth obtained by good luck' describes the pleasure and expectation of new life after narrow survival. 'Suffering from adverse drug effects' illustrates various psychosocial difficulties, such as low self-esteem, helplessness, alienation, and burnout, arising from the side effects of medications. 'Body and mind of being bewildered' illustrates disintegrated health and haunting fear of death. 'Alienation disconnected with society' describes isolated feeling of existence due to misunderstandings from society. 'Suffering overcome with gratitude and responsibility' includes overcoming experience through various social supports and suitable jobs. Finally, 'acceptance of suffering accompanied with new heart' illustrate changed perspective of life itself. CONCLUSION: The findings in this study provide deep understanding and insights of the lived experience of heart related illness for these patients and should help in the development of tailored-interventions for patients with heart transplantation.

[Study on the changes in limb circumferences and muscle areas of critically ill patients using ventilators].

PURPOSE: The purpose of this study was to identify muscle atrophy in critically ill patients on ventilators. A comparison was made between limb circumferences and muscle areas on the day of admission to an intensive care unit (ICU) and on the 8th day after admission. METHODS: The data were collected from 30 critically ill patients using ventilators at S hospital ICU in Seoul during the period from October 2005 to April 2006. Limb circumferences and skinfold thickness were measured on the day of admission and on the 8th day after admission to the ICU. Limb circumferences and skinfold thickness were measured on the right mid-arm, right mid-thigh, and right mid-calf using a measuring tape and a skinfold calipers. Limb muscle areas were calculated by an equation after measuring limb circumferences and skinfold thickness. The data were analyzed by paired t-test and independent t-test. RESULTS: 1) Mid-arm circumference, mid-thigh circumference and mid-calf circumference on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 2) Mid-arm muscle area, mid-thigh muscle area and mid-calf muscle area on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 3) Steroid and vecuronium medication didn't affect changes in limb circumferences (mid-arm, mid-thigh, mid-calf) and muscle areas (mid-arm, mid-thigh, mid-calf) on the 8th day after admission to the ICU compared to the day of admission. CONCLUSION: Limb muscle atrophy may occur on the 8th day after admission to the ICU in critically ill patients using ventilator.