[Development and Effect of a Fall Prevention Program Based on the King's Goal Attainment Theory for Fall High-Risk Elderly Patients in Long-Term Care Hospital].

PURPOSE: The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects. METHODS: This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an χ²-test, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software. RESULTS: For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368). CONCLUSION: These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

Design and preliminary results of a metropolitan lifestyle intervention program for people with metabolic syndrome in South Korea.

INTRODUCTION: The Seoul Metabolic Syndrome Management (SMESY) project, a metropolitan lifestyle intervention program aimed at decreasing the risk of metabolic syndrome to the residents of the city, has recently been implemented in 2011. METHODS: Our target population consisted of residents of Seoul who were 30-64 years old. Subjects visiting a Public Health Center were screened for five risk factors for metabolic syndrome and then divided into three groups according to the number of the risk factors: active counseling, for having more than three risk factors; motivational guide, for having one or two; and information support for having none. Members of the active counseling group, the main target of the project, were provided with monthly in-person counseling on health-related lifestyle choices, as well as a follow-up examination every 3 months during the 12-month program. RESULTS: In the active counseling group, subjects showed statistically significant improvements in all five risk factors and the average number of retained risk factors decreased from 3.5 to 2.7. However, the percentage of active counseling group members who attended at least 3 out of the 4 sessions provided was only 11.3%. As for the motivational guide group and the information support group, clinically significant improvements were not observed and the percentage of members who attended all sessions were 10.4% and 11.8%, respectively. CONCLUSIONS: Increased public participation for the ongoing project is expected to lead to great positive changes in the health of people with metabolic syndrome.

Effect of domain-specific life satisfaction on depressive symptoms in late adulthood and old age: results of a cross-sectional descriptive survey.

PURPOSE: The aim of this study was to determine the effect of domain-specific life satisfaction on the risk of depressive symptoms in late adulthood and old age. METHODS: A cross-sectional descriptive survey was conducted using stratified data from the Korean Longitudinal Study of Aging (KLoSA). The respondents completed the Korean version CES-D and domain-specific life satisfaction. RESULTS: In both groups, satisfaction with health and economic status were significant predictors of depressive symptoms. In the old age group, depressive symptoms were also predicted by satisfaction with the relationships with one's spouse and with one's children. CONCLUSION: Life satisfaction was a crucial predictive factor for depressive symptoms in late adulthood and old age.

[Effects of a palliative care program based on home care nursing].

PURPOSE: This study was done to develop and test a palliative care program based on home care nursing. METHODS: A quasi-experimental design was employed. Changes in the variables were evaluated to test effects of the developed program. Participants were patients with terminal cancer and their families receiving home care nursing from six hospitals (experimental group: 24 and control group: 22). Data collection was conducted from February to October, 2006. chi-square test, Fisher's exact test, t-test, Mann-Whitney U test and repeated measures ANOVA were used to analyse the data. RESULTS: Hypothesis 1, the experimental group receiving this program will experience less pain (severe, average, weak pain) than the control group, was supported. Hypothesis 2, the experimental group will have less symptom experience than the control group, was supported. Hypothesis 3, the experimental group will have higher QOL than the control group, was supported and the last hypothesis 4, family burden in the experimental group will be less than the control group, was supported. CONCLUSION: The home care nursing based palliative program developed in this study was found to be an effective program to reduce patient pain and symptom experience, to improve patient QOL and to decrease family burden.

An estimation of the cost per visit of nursing home care services.

Procedures used for analyzing the cost of providing home care nursing services through hospital-based home care agencies (HCAs) was the focus of this study. A cross-sectional descriptive study design was used to analyze the workload and caseload of 36 home care nurses from ten HCAs. In addition, information obtained from a national health insurance database, including 54,639 home care claim cases from a total of 185 HCAs during a 6-month period, were analyzed. The findings provide a foundation for improving the alternative home care billing and reimbursement system by using the actual amount of time invested in providing home care when calculating the cost of providing home care nursing services. Further, this study provides a procedure for calculating nursing service costs by analyzing actual data. The results have great potential for use in nursing service cost analysis methodology, which is an essential step in developing a policy for providing home care.

[Development and evaluation of a school-based anger management program (SAMP) for adolescents].

PURPOSE: This study was done to develop a school-based anger management program (SAMP) of 4 sessions and examine its effects on the anger, anger expression, psychosomatic responses, psychosocial responses, and immunologic responses in adolescents. METHODS: A quasi-experimental study using a nonequivalent control group, pre-post design with repeated measures was used. Chi-square test, t-test, paired t-test, and Fisher's exact test were used to analyze the data. RESULTS: There were no differences between the experimental and control groups in outcome variables except for lymphocytes. However, following additional analyses, statistically significant differences by time point were observed for pain sensitivity, T cell, Helper T (Th) cell, Suppressor (Ts) cell and Natural Killer (NK) cell post-treatment, entrapment and psychosomatic symptoms at the 4-week follow-up, and resilience at the 10-week follow-up for the experimental group. CONCLUSION: Although some modifications in contents and administration will be required to increase the effectiveness of the program for anger management, SAMP can be used to promote anger management ability in adolescents.

[Estimating the cost of visiting nursing service by visiting nursing model for urban public health center in Korea].

PURPOSE: This study focused on analysing costs per visiting nursing care based on nursing activities in a public health center. METHOD: The Easley-Storfjell Instrument(1997) was used for a prospective descriptive analysis of self-records for workload data from 10 visiting nurses during 4 weeks on all nursing activities. In addition, analysis of the 478 visiting nursing records and cost data from 5 home visiting departments in public health centers during one year of 2003 was done. RESULT: The workload of visiting nurses by the type of model was identified as follows: Type I showed that caseloads made up 32.9 % of all nurse activities, and type II showed that the caseloads made up 45.8 %. Second, The cost per visit in type I was 33,088 won and 31,323 won in type II. Third, the estimated budgets were 1,902,436 won to 12,057,696 won for the type I model. and 4,151,316 won to 17,432,712 won for the type II model for one year. CONCLUSION: This study's results will contribute to baseline data used to establish on infrastructure for visiting nursing program and visiting nursing agencies based on the budget of visiting nursing services.

[A workload analysis of a visiting nursing service based on a health center in Seoul].

PURPOSE: This study focused on analysing the workload of visiting nurses based on a health center. METHOD: A Prospective descriptive analysis of self-records for workload data from 115 visiting nurses during 4 weeks was done. In addition, a cross-sectional analysis of linked data to grasp the priority of visiting nursing services from 155 visiting nurses at the 25 health centers in Seoul. RESULT: Time allocation that was performed on all nursing workload of visiting nurses was identified as follows: First, the inside workload of the health center took up 60% of all visiting nurse activities. Second, providing direct nursing care(caseload) took up 25%. Third, outside nursing activities excluding the caseload provided in the health center took up 15% of all working time. Fourth, the core works to have a high priority among visiting nursing activities were family health assessment, planning and evaluation of a visiting nursing program, personal health assessment, and so forth. CONCLUSION: The workload of a visiting nurse suggests that the caseload of visiting nurses in a health center needs to be increased. Also, our results will contribute to baseline data used to establish a proper visiting nurses infrastructure based on the demand of visiting nursing services.