[A Structural Equation Model of Health-Related Quality of Life among Older Women Following Bilateral Total Knee Replacement].

PURPOSE: This study aimed to develop and test a structural equation model of health-related quality of life among older women following bilateral total knee replacement based on a literature review and Wilson and Cleary's model of health-related quality of life. METHODS: One hundred ninety three women who were diagnosed with osteoarthritis, were older than 65 years, and were between 13 weeks and 12 months of having a bilateral total knee replacement were recruited from an outpatient clinic. Data were collected from July 2017 to April 2018 using a structured questionnaire and medical records. Data were analyzed using SPSS/WIN 22.0, AMOS 22.0, and Smart PLS 3.2.4. RESULTS: The fitness of the hypothetical model was good, with coefficients of determination (R²) ranging between .28 and .75 and predictive relevance (Q²) between .26 and .73. The standardized root mean square residual of the model fit indices for the hypothetical model was .04; which explained 64.2% of physical and 62.5% of mental health-related quality of life. Self-efficacy, symptom status, functional status, and general health perceptions had a significant direct effect on physical health-related quality of life, while social support, symptom status, and general health perceptions had a significant direct effect on participants' mental-health-related quality of life. CONCLUSION: To improve the physical and mental quality of life of older women who receive bilateral knee replacement, nursing-based intervention strategies that reduce symptoms, improve functional status, and increase health perceptions, self-efficacy, and social support are needed. The most important factor is the symptom status.

The Effects of a Culturally Tailored, Patient-Centered Psychosocial Intervention in South Korean Cancer Survivors.

This study aimed to develop a culturally tailored, patient-centered psychosocial intervention program and to investigate the effects of the program on health-related quality of life, sleep disturbance, and depression in cancer survivors. This was a one-group pretest and posttest design. A total of 19 cancer survivors participated in the program. The program was designed to have an 8-week duration with one class per week. Every class was composed of a 90-min education session and a 90-min exercise. Among the health-related quality of life subscales, the scores of global health status/quality of life, physical functioning, and emotional functioning at posttest were statistically increased than those at pretest. Fatigue scores significantly decreased, whereas no changes were observed in sleep disturbance or depression scores. The findings of this study suggested that a culturally tailored, patient-centered psychosocial intervention could be applied in clinical settings to improve health-related quality of life in cancer survivors.

Association of Emotional Labor, Self-efficacy, and Type A Personality with Burnout in Korean Dental Hygienists.

The purpose of this study was to examine the relationship between emotional labor and burnout, and whether the levels of self-efficacy and type A personality characteristics increase the risk of burnout in a sample of Korean female dental hygienists. Participants were 807 female dental hygienists with experience in performing customer service for one year or more in dental clinics, dental hospitals, or general hospitals in Korea. Data were collected using a structured self-administered questionnaire. A hierarchical multiple linear regression analysis was used to examine the effects of emotional labor on burnout, and to elucidate the additive effects of self-efficacy and type A personality on burnout. The results showed that "overload and conflict in customer service," "emotional disharmony and hurt," and "lack of a supportive and protective system in the organization" were positively associated with burnout. With reference to the relationship between personality traits and burnout, we found that personal traits such as self-efficacy and type A personality were significantly related to burnout, which confirmed the additive effects of self-efficacy and type A personality on burnout. These results indicate that engaging in excessive and prolonged emotional work in customer service roles is more likely to increase burnout. Additionally, an insufficient organizational supportive and protective system toward the negative consequences of emotional labor was found to accelerate burnout. The present findings also revealed that personality traits such as self-efficacy and type A personality are also important in understanding the relationship between emotional labor and burnout.

Influence of load and carrying method on gait, specifically pelvic movement.

[Purpose] The purpose of this study was to examine how carrying methods and load affects pelvic movement while walking. [Subjects and Methods] Sixteen healthy subjects (age 20.68 ± 1.95 years, height 167.56 ± 8.46 cm, weight 60.25 ± 9.37 kg) volunteered. The items carried included a hand bag, shoulder bag, cross bag, and a back pack. The load weights were 0%, 5%, 10% and 15% of body weight. G-Walk was used to record and analyze pelvic movement while the participants walked with different loads. [Results] In the case of hand bags and shoulder bags, pelvic tilt increased along with weight. In particular, when compared with the 0%, 5% and 10% load conditions, the 15% load of a hand bag induced a significant increase. Pelvic rotation showed a tendency to decrease as the weight increased. [Conclusion] Lateral pelvic tilt is thought to increase when the weight exceeds 15% of body weight, thereby resulting in decreased efficiency of gait. The pelvic rotation is thought to decrease as the weight increases, causing restricted upper limb movements.

The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome.

[Purpose] The purpose of this study was to determine the effectiveness of strength and stretching exercises on upper crossed syndrome. [Subjects and Methods] After measuring cervical alignment using the Global Posture System, 30 students with forward head posture were selected and divided into two groups. The experimental group (n=15) participated in strength and stretching exercises, three times per week for 4 weeks. The control group (n=15) did not participate in the exercises. The exercise program comprised middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises. The temperature of the posterior neck was then measured using digital infrared thermographic imaging. [Results] There was a significant difference between the pretest and posttest results in the experimental group, and a significant difference in posterior neck temperature between the two groups. [Conclusion] This study showed that middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises are more effective for upper crossed syndrome.

Association between Metabolic Syndrome and Microalbuminuria in Korean Adults.

BACKGROUND: We conducted a population-based cross-sectional study of Korean adults to evaluate the association between metabolic syndrome and microalbuminuria as a marker for early-stage chronic kidney disease. METHODS: A total of 8,497 adults (3,625 men and 4,872 women) who participated in the Korea National Health and Nutrition Examination Survey between 2011 and 2012 were included. Metabolic syndrome was defined according to recommendation from a joint interim statement of international organizations published in 2009. Microalbuminuria was defined as a urinary albumin-to-creatinine ratio of 30 to 300 mg/g. The association between metabolic syndrome and microalbuminuria was evaluated using logistic regression analysis with adjustment for covariates while considering sampling weights and the complex survey design. RESULTS: The prevalence of microalbuminuriain subjects with metabolic syndrome was 11% for men and 14.4% for women, whereas the prevalence in subjects without metabolic syndrome was 3.1% for men and 6.7% for women. Metabolic syndrome was significantly associated with an increased risk of microalbuminuriain both women (odds ratio, 2.79; 95% confidence interval, 2.01 to 3.88) and men (odds ratio, 3.00; 95% confidence interval, 2.11 to 4.27). All components of the metabolic syndrome were associated with a significantly increased risk of microalbuminuria with the strongest association for high blood pressure. The risk of microalbuminuria increased in a dose-dependent manner (P-value for trend < 0.001) with the number of metabolic syndrome components observed for both sexes. CONCLUSION: These findings suggest that metabolic syndrome is a risk factor for chronic kidney disease from an early stage.

How different modes of child delivery influence abdominal muscle activities in the active straight leg raise.

[Purpose] The purpose of this study was to examine the activities of the abdominal muscles of women who had experienced vaginal delivery in comparison with those who had experienced Cesarean childbirth. [Subjects and Methods] A total of 14 subjects (7 vaginal delivery, 7 Cesarean section) performed an active straight leg raise to 20 cm above the ground, and we measured the activities of the internal oblique abdominal muscle, the external oblique abdominal muscle, and the rectus abdominal muscle on both sides using electromyography. The effort required to raise the leg was scored on a Likert scale. Then, the subjects conducted maximum isometric contraction for hip joint flexion with the leg raised at 20 cm, and maximum torque and abdominal muscle activities were measured using electromyography. [Results] During the active straight leg raise, abdominal muscle activities were higher in the Cesarean section subjects. The Likert scale did not show a significant difference. The activities of the abdominal muscles and the maximum torque of the hip joint flexion at maximum isometric contraction were higher in the vaginal delivery subjects. [Conclusion] The abdominal muscles of Cesarean section subjects showed greater recruitment for maintaining pelvic stability during the active straight leg raising, but were relatively weaker when powerful force was required. Therefore, we consider that more abdominal muscle training is necessary for maintaining pelvic stability of Cesarean section subjects.

How different knee flexion angles influence the hip extensor in the prone position.

[Purpose] The present study examined the effects of knee flexion angle on hip extensor muscle activity. [Subjects and Methods] Twenty healthy subjects maintained knee flexion angles of 0°, 30°, 60°, 90° and 110° in the prone position and performed maximal voluntary contraction in hip extension. Maximum torque in hip extension at the different angles was measured, and surface electromyogram activities of the gluteus maximus (GM), biceps femoris (BF) and semitendinosus (ST) were recorded and normalized by the maximum voluntary isometric contraction (MVIC). [Results] The maximum torque of the hip extensor showed significant decreases between 0°and 60°, 90° and 110° of knee flexion. The muscle activity of BF was significantly high at 0°, and GM showed a significantly higher activity than both BF and ST at 60°, 90°and 110° of knee flexion. [Conclusion] The maximum torque in hip extension and muscle activities of BF and ST were significantly high at 0° but they decreased at knee flexion angles of more than 60°. Therefore, we consider that more than 60° of knee joint flexion is required to increase GM activity, and to reduce the muscle activities of BF and ST.