Evaluation of a Community-based Child (Infants and Toddlers) Health Promotion Pilot Project in a Migrant Village in Kyrgyzstan

PURPOSE: Children in migrant villages in Kyrgyzstan have a high incidence of anemia and need effective health promotion programs. The purpose of this study was to evaluate a pilot study of a health promotion project for infants and toddlers based on community participation.METHODS: This was a retrospective study conducted to evaluate the effectiveness of the project. The project was carried out by nurses at a public health center, community health workers, and local residents in a migrant village. After the operational system of the project was established, health assessments, child-care education, provision of vouchers for iron supplements, and activities to improve residents' awareness were conducted during 6 months among 100 children, of whom 85 were finally analyzed.RESULTS: In international health projects, close cooperation of the project team with community residents and health workers is important. Access to the community-based program was feasible in the socially and economically poor migrant village, and improvements were shown in children's anemia and awareness of health care.CONCLUSION: By focusing on the effective aspects of this preliminary project, plans to utilize community health workers and promotion strategies can be added to the main project to improve health promotion among children in this area.

Comparison of Fatigue Severity and Quality of Life between Unexplained Fatigue Patients and Explained Fatigue Patients / 가정의학회지

BACKGROUND: Recently, despite the high prevalence of fatigue in patients, there is a lack of research on the quality of life (QoL) in unexplained fatigue patients, indicating that they are not properly diagnosed and treated. The aim of this study was to compare fatigue severity and QoL between patients with explained and unexplained fatigue. METHODS: The study consisted of 200 Korean adults who complained of fatigue without underlying disease. Fatigue Severity Scale, Short Form Health Survey-36 version 2 (SF-36v2), and Beck Depression Inventory-II (BDI-II) self-questionnaires were administered. Participants were dichotomized to two groups, namely, patients with unexplained or explained fatigue, sorted according to laboratory examination results. The chi-square test, t-test, and Wilcoxon rank-sum test were used, and analysis of covariance was calculated after adjusting for age, sex, body mass index, smoking status, and physical component summary (PCS) of SF-36v2 or BDI-II. RESULTS: PCS of SF-36v2 between the two groups showed significant difference. Compared to patients with explained fatigue, those with unexplained fatigue showed lower physical component scores of QoL. CONCLUSION: QoL of patients with unexplained fatigue could largely diminish than those with explained fatigue. The primary clinician should be aware of poor QoL in patients with unexplained fatigue to identify who is in need of more attention and intervention.

Association of Depression and Survival in Patients with Cancer over 10 Years

PURPOSE: This study was conducted to identify the effects of depression on the survival of patients with cancer over a 10 year period. METHODS: A retrospective review was conducted to examine survival of 218 patients with stomach, colorectal and breast cancer, who had been treated for cancer from 2002 to 2011. Depression was assessed by using the Symptom Check List-90 Revision in 2002, and hope, fighting spirit and other potential confounders were also measured to control for their effects on the association between depression and the survival time. Data on survival were collected from the Statistics Korea and also from medical record in 2011. Kaplan-Meier survival analysis and Cox proportional hazard regression model were used to examine if depression affected survival. RESULTS: The total number of death was 106, and the non-survivors scored higher on depression than survivors. Depression was found to be one of the influencing factors on survival from cancer. CONCLUSION: Depression was significantly associated with the increased risk of death in cancer patients. Further research is needed to identify in details which type of emotional interventions can extend the survival time of cancer patients in depression.

Health Behaviors and Risk Factors Associated with Chronic Kidney Disease in Korean Patients with Diabetes: The Fourth Korean National Health and Nutritional Examination Survey

PURPOSE: The purpose of this study was to identify health behavior and risk factors for chronic kidney disease (CKD) in Korean patients with diabetes. METHODS: This study was a secondary analysis of the Fourth Korean National Health and Nutritional Examination Survey (2007-2009). Of the 24,871 participants, 1,239 aged over 19 years with diagnosis of diabetes were included. Stratified and cluster variables in the analysis-plan file for a weighted, complex sample were analyzed. CKD was confirmed by the estimated glomerular filtration rate level of 15.0-59.9 mL/min/1.732 m2. Odds ratios between the variables and CKD were calculated using logistic regression analysis with adjustment for gender, age, educational background, income, and duration of diagnosis. RESULTS: The results showed that 14.7% of participants with diabetes were accompanied with CKD. The risk of developing CKD in those who made efforts to take proper nutrition but failed was 1.76 times higher than those taking nutrition properly. In those who used to smoke compared to their nonsmoking counterparts, the risk was 2.06 times higher; in those who did not do vigorous exercise compared to those who did, the risk was 2.12 times higher; in those with hypertension than those without, the risk was 2.4 times higher; and in those with anemia compared to those without, the risk was 2.32 times higher. Only 19% of the participants received health education for diabetes, which did not affect the incidence of CKD. CONCLUSION: Since renal functions are affected by lifestyle factors, it is critical for healthcare professionals to provide diabetic patients with health education focused on changing their behavior so that it is conducive to health. It is also necessary to consider that diabetes education should be made more available and provided more effectively to these patients.

Effects of Body Weight Control Behaviors on Bone Mineral Density in Korean Young Adult Women

PURPOSE: This study identified the effects of body weight control behaviors on bone mineral density (BMD) in Korean women aged 20 to 39 years. METHODS: A secondary analysis of the 5th Korean National Health and Nutrition Examination Survey was conducted. Asian-Pacific criteria of BMI (Body Mass Index) and BMD were calculated for 1,026 women selected. The effects of body weight control behaviors were assessed using binary multiple logistic regression analysis while controlling for BMI. RESULTS: Osteopenia and osteoporosis rates were 32.8% and 2.0%, respectively. About 69% of women performed weight control behaviors, and a combination of diet/exercise (22.7%) and drug added methods (10.9%) for weight control. Women who performed both diet control and exercise had a lower possibility to have abnormal BMD than those who did not try weight control (OR=0.67, CI=0.45~0.98, p=.039). Further weight control behaviors did not influence abnormal BMD. CONCLUSION: Body weight control should include proper diet and exercise in accordance with each woman's BMI level.

Changes in Upper Extemity Sensation and the Quality of Life for Patients Following Mastectomy / 종양간호학회지

PURPOSE: The purpose of this study was to examine the sensation changes in upper extremity and the quality of life for post-operative mastectomy patients. METHODS: This study used a descriptive study design. The participants were 132 women who had mastectomies after being diagnosed with breast cancer and were participating in breast cancer self-help groups. The sensation changes in the arm of the surgery site was measured by the arm symptoms which were subjective uncomfortable feelings of the affected arm, and the quality of life was measured by Medical Outcomes Study Short Form-36. Collected data were analyzed by ANOVA, t-test, chi2-test and multiple regression with SPSS WIN 12.0 program. RESULTS: Patients with stage IV breast cancer had severe changes in sensation of the arm. Participants with lymphedema had statistically significant changes in sensation compared to participants without lymphedema, but the quality of life was not different between the two groups. Pain by the SF 36 was statistically different between the two groups, with- and without-lymphedema. The factors in upper extremity's sensation changes which influence on quality of life were pain and heaviness. CONCLUSION: Nursing intervention for relieving pain and heaviness of the affected arm needs to be developed in order to improve QOL of the breast cancer survivors.

Comparison of Health Promotion Lifestyles and Self-esteem of Korean and Chinese Nursing Students / 정신간호학회지

PURPOSE: The purpose of this study was to compare health promotion lifestyles and self-esteem of nursing students in Korea and China. METHODS: With a descriptive comparative design, a total of 305 Korean and 317 Chinese nursing students were recruited. The health promotion lifestyles was measured by Walker's Health-promoting Lifestyle Profile II instrument and self esteem was measured by Rosenberg's self esteem instrument. Data were analyzed by descriptive statistics and multiple regression. RESULTS: Korean students showed significantly higher levels of health responsibility, nutritional habit, interpersonal relations, and spiritual growth compared with Chinese students, but physical activity was higher in Chinese students. The factors influencing health promotion lifestyle were self-esteem, nation, and satisfaction of school life. The levels of health promotion lifestyles positively correlated with self-esteem in Korean and Chinese nursing students. CONCLUSION: Nurse educators should consider to develop health-promoting activities and programs reflecting curricular and cross-cultural perspectives.

Comparison of Health Promotion Lifestyles and Self-esteem of Korean and Chinese Nursing Students / 정신간호학회지

PURPOSE: The purpose of this study was to compare health promotion lifestyles and self-esteem of nursing students in Korea and China. METHODS: With a descriptive comparative design, a total of 305 Korean and 317 Chinese nursing students were recruited. The health promotion lifestyles was measured by Walker's Health-promoting Lifestyle Profile II instrument and self esteem was measured by Rosenberg's self esteem instrument. Data were analyzed by descriptive statistics and multiple regression. RESULTS: Korean students showed significantly higher levels of health responsibility, nutritional habit, interpersonal relations, and spiritual growth compared with Chinese students, but physical activity was higher in Chinese students. The factors influencing health promotion lifestyle were self-esteem, nation, and satisfaction of school life. The levels of health promotion lifestyles positively correlated with self-esteem in Korean and Chinese nursing students. CONCLUSION: Nurse educators should consider to develop health-promoting activities and programs reflecting curricular and cross-cultural perspectives.

Comparison of Gender Stereotype between Female Nursing Students and Humanities Students

PURPOSE: The purpose of this study was to identify difference in gender stereotype between female nursing students and humanities students. METHODS: A descriptive comparative study was done. The subjects were 300 nursing students and 114 humanities students who were selected by convenient sampling. Data were collected from September 2008 to October 2008 using a constructive questionnaire with 30 questions, which was prepared for this study by modifying the instrument about gender stereotype developed by Kim. The data were analyzed through ANCOVA, factor analysis and Chronbach's alpha using the SPSS program. RESULTS: 1) Of the six subcategories of gender stereotype, five were higher in the nursing students than in the humanities students, but occupational gender stereotype was not. 2) Age affected total, familiar, social, external, and intellectual gender stereotype. 3) Self-satisfaction and major satisfaction affected social gender stereotype. 4) In the analysis of difference in gender stereotype with controlling age, self-satisfaction and major satisfaction, the nursing students showed statistically significant higher scores in intellectual stereotype than the humanities students. CONCLUSION: Because female nursing students tended to show high gender stereotype, nursing educators need to develop programs for helping nursing students escape from gender stereotypes and increase their self-satisfaction.

A Meta Analysis on the Effects of Exercise on Bone Mineral Density among Middle-aged and Older Women

PURPOSE: This study was to examine the effectiveness of exercise for bone mineral density (BMD). METHODS: Four investigators reviewed English articles from Pub Med and CINAHL, selecting randomized controlled trials on exercise programs for middle-aged and older women. Out of 25 studies identified, 14 that satisfied with the inclusion criteria were included in the meta-analysis. The quality of the studies was assessed using recognized methods and the effect size was calculated as a Hedges' g using Comprehensive Meta-analysis Version 2.0. Primary outcomes were changes in BMD at femoral neck, trochanter, and lumbar spine. Subgroup analysis included changes in BMD according to exercise style. RESULTS: Weight bearing exercise was effective (Q = 20.1, p > .05, ES = 0.32), and resistance exercise was effective in case of comparing to pre and post intervention (Q = 4.15, p = .98, ES = 0.14). At the femoral neck, 9 study groups were homogeneous and the experimental groups demonstrated a positive effect on BMD (Q = 19.5, p > .05, ES = 0.33). In contrast, marked heterogeneity (Q = 33.3, p < 0.01) was apparent in 7 study groups evaluating trochanter. CONCLUSION: These findings suggest that weight bearing is effective for BMD of the femoral neck, and is relevant to the non-pharmacological treatment of bone loss for middle-aged and older women.

Influence of Depression on Cancer Metastasis / 종양간호학회지

PURPOSE: This study was a retrospective analysis with survey study which analyze influence of depression of patients with cancer on metastasis. METHODS: The subjects of this research were 223 patients who underwent chemotherapy or are in follow-up management with stomach, colon, or breast cancer. The questionnaires were collected in 2002 and medical documents were reviewed 400 days after the first data collection. Subjects were divided according to the depression level into over-average group and under average group. RESULTS: In survival analysis, metastasis occurred in 49 of 211 in 223 subjects for whom follow-up review was done after 400 days. The depression and anxiety level were higher in the group with metastasis than the other with no metastasis. As a result, it showed that the lower depression they have, the lesser the metastasis occurred. CONCLUSION: This research showed that patients who have higher level of depression, experienced higher risk for cancer metastasis. Nurses who take care of cancer patients are responsible for giving patients with positivity with intention to subside their depression.

Change in the Sensation of the Arms, the Range of Motion in the Shoulders and Depression in Breast Cancer Patients

PURPOSE: The purpose of this study was to examine the association among change in the sensation of the arms, the range of motion in the shoulders and depression in breast cancer patients. METHOD: This is a descriptive study on correlation. The participants were 132 patients who had been diagnosed with breast cancer and had mastectomy at a university hospital, and had participated in a breast cancer self-help group. The degree of depression was assessed by SCL-90-R scores. Collected data were analyzed with SPSS 12.0 for Windows. RESULTS: The participants complained of 'heaviness' as the most frequent and serious symptom of change in the sensation of the arms. 'Completely zip up the dress with a back-fastening zipper' was the most difficult motion of the shoulders. Participants who were in a worse stage of disease were in a worse condition in shoulder functions, and on a higher degree of depression. The degree of change in sensation and shoulder functions showed a positive correlation with each other, and both of them showed a negative correlation with the degree of depression. CONCLUSION: Sensation and motion change in the arms and the shoulders were common phenomena that affected depression in patients who had mastectomy. Nurses should consider not only depression but also discomfort of the arms and the shoulders for patients with mastectomy.

The Use of Propensity Score Matching for Evaluation of the Effects of Nursing Interventions / 간호학회지

BACKGROUND: Nursing intervention studies often suffer from a selection bias introduced by failure of random assignment. Evaluation with selection bias could under or over-estimate any intervention's effects. PS matching (PSM) can reduce a selection bias through matching similar Propensity Scores (PS). PS is defined as the conditional probability of being treated given the individual's covariates and it can be reused to balance the covariates of two groups. PURPOSE: This study was done to assess the significance of PSM as an alternative evaluation method of nursing interventions. METHOD: An intervention study for patients with some baseline individual characteristic differences between two groups was used for this demonstration. The result of a t-test with PSM was compared with a t-test without matching. RESULTS: The level of HbA1c at 12 months after baseline was different between the two groups in terms of matching or not. CONCLUSION: This study demonstrated the effects of a quasi-random assignment. Evaluation using PSM can reduce a selection bias impact that affects the result of the nursing intervention. Analyzing nursing research more objectively to reduce selection bias using PSM is needed.

The Use of Propensity Score Matching for Evaluation of the Effects of Nursing Interventions / 간호학회지

BACKGROUND: Nursing intervention studies often suffer from a selection bias introduced by failure of random assignment. Evaluation with selection bias could under or over-estimate any intervention's effects. PS matching (PSM) can reduce a selection bias through matching similar Propensity Scores (PS). PS is defined as the conditional probability of being treated given the individual's covariates and it can be reused to balance the covariates of two groups. PURPOSE: This study was done to assess the significance of PSM as an alternative evaluation method of nursing interventions. METHOD: An intervention study for patients with some baseline individual characteristic differences between two groups was used for this demonstration. The result of a t-test with PSM was compared with a t-test without matching. RESULTS: The level of HbA1c at 12 months after baseline was different between the two groups in terms of matching or not. CONCLUSION: This study demonstrated the effects of a quasi-random assignment. Evaluation using PSM can reduce a selection bias impact that affects the result of the nursing intervention. Analyzing nursing research more objectively to reduce selection bias using PSM is needed.

The Effects of Visiting Nursing Intervention on Self Care Behavior and Blood Pressure in Persons with High Risk of Cerebrovascular Diseases

PURPOSE: This study was to evaluate the effects of visiting nursing intervention on self care behavior and blood pressure with high risk of cerebrovascular diseases. METHOD: A one-group pretest-posttest was designed. Data collection was done in 150 participants from March, 2003 to November, 2003 at a public health center. Self care behavior was assessed by the scores of smoking, alcohol, diet, exercise, stress and medication compliance. The scores of knowledge related cerebrovascular diseases, blood pressure, blood glucose were estimated. The Participants were intervened in with basic assessment, emotional support, education. This program took a period ranging from 3 months to 7 months depending on the cerebrovascular risk level. The mean number of visiting times was 1.67 per month. RESULT: 1. Knowledge level was improved(t=-2.542, p=.012). 2. Systolic and diastolic pressure were lower(t=5.439, p<.001; t=4.966, p<.001). 3. Self care level was higher (t=-12.981, p=.001) after the intervention. CONCLUSION: The visiting nursing intervention was found to have an effect on the scores of knowledge, self care behavior and blood pressure with high risk of cerebrovascular diseases. The results provided evidences for the importance of visiting nursing intervention in the high risk factor of cerebrovascular disease for self care.

The Effects of a Comprehensive Life Style Modification Program on Glycemic Control and Stress Response in Type 2 Diabetes / 간호학회지

PURPOSE: This study was to evaluate the effects of a comprehensive life style modification program on glycemic control and stress response in type 2 diabetes. METHOD: The participants(n=34) with type 2 diabetes were divided into either a usual care(control) or treatment(experimental) group. The experimental group(n=21) received a program that was based on a comprehensive life style modification protocol at a weekly meeting for 16 weeks. They also participated in individually prescribed exercise and diet along with stress management and self monitoring. The participants were followed for 6 months, during which postprandial glucose, HbA1C, and stress response inventory were measured. RESULT: The experimental group showed a significant lower postprandial glucose and stress response compared to those of the control group. However, there was no significant change in the HbA1C value in either group. CONCLUSIONS: These results suggest that a type 2 diabetes comprehensive lifestyle modification program may lead to clinical improvement in glycemic control and reduce the stress response.

Evaluation of Visiting Nursing Care Using Geographical Information System(GIS) Technology / 간호학회지

PURPOSE: Previous evaluation studies of the visiting nursing program explained an average change of the participants' health status, without considering socio-ecological characteristics and their impacts. However, these factors must affect individual health problems and lifestyles. For effective and appropriate community based programs, the Geographical Information System(GIS) can be utilized. GIS is a computer-based tool for mapping and analyzing things that happen on earth, and integrates statistical analysis with unique visualization. The purpose of this study was to evaluate visiting nursing care and to advocate the usefulness of planning and evaluating visiting nursing programs using Exploratory Spatial Data Analysis(ESDA) with GIS technology. METHODS: One hundred eighty-four elderly participants with cerebrovascular risk factors who lived in 13 areas of one community received visiting nursing care. The data analyzed characteristics of pre-post change and autocorrelation by ESDA using GIS technology. RESULTS: Visiting nursing care showed an improvement in the participants' lifestyle habits, and family management ability and stress level, while the improvements were different depending on the regions. The change of family management ability and stress level correlated with neighborhoods (Morgan's I= 0.1841, 0.1675). CONCLUSIONS: Community health providers need to consider the individual participant's health status as well as socio-ecological factors. Analysis using GIS technology will contribute to the effective monitoring, evaluation and design of a visiting nursing program.

Effects of Spirituality Promoting Intervention on Spirituality, Social Support and Fighting Spirit among the Cancer Patients / 성인간호학회지

PURPOSE: This study examined the effects of spirituality promoting intervention for the stomach and colon cancer patients. METHOD: A quasi-experimental design was used. Data collection was carried out from April 2004 to June, 2004 at a cancer center in Korea. The intervention included pray, meditation, group education and discussion for coping with cancer. The experimental group were received a 1-hour intervention per week for 6 weeks, while the control group received usual care. Data collection was done at pre and post intervention. The degree of spirituality was measured by the Korean version of WHOQOL-SRPB pilot test(WHO Quality of Life-Spirituality, Religiousness and Personal Beliefs pilot test) Module, and social support was measured using scores on a PRQ 85(Personal Resources Questionnaire). Fighting spirit was measured by the scores of MAC(Mental Adjustment to Cancer) scale. RESULTS: The experimental group showed significant increase in the scores of social support and fighting spirit compared to those in the control group after the intervention. There were no significant changes in terms of the spirituality score compared to the baseline score in the experimental group and the control group. CONCLUSION: This intervention appeared to be effective in increasing social support and fighting spirit, which considered to be very helpful in cancer adjustment.

The Effects of Rehabilitation Excercise Program on Physical Function and Mental Health Status in Patients with Hemiparesis Following Chronic Stroke

No abstract available.

A Meta-Analysis of the Effects of Exercise Programs on Glucose and Lipid Metabolism and Cardiac Function in Patients with TypeII Diabetes Mellitus / 간호학회지

PURPOSE: This study was a systematic review and meta-analysis of the effects of exercise programs in patients with type II diabetes mellitus. METHOD: Two investigators systematically searched and reviewed English articles from PUBMED from 1988 to 2004, selecting randomized controlled trials on structured exercise programs for DM patients. Out of 87 studies identified, a meta analysis was done for eleven studies which satisfied inclusion criteria and focused on glycemic indices, lipid indices, and cardiac function indices. RESULTS: The means and standard deviations were compared for experimental groups that received exercise-only or exercise and diet programs and control groups that received no intervention or only diet education. The groups were considered homogeneous as the p value of the Q score in each variable group was over 0.05. The experimental groups demonstrated a moderate positive effect on HbA1c and VO2max (d=0.55 & 0.5), and a small positive effect on fasting blood glucose and cholesterol (d=0.38 & 0.27) compared to the control groups. HDL and LDL cholesterol levels, however, showed a very low positive effect (d=0.11 & 0.12) in the experimental groups. Aerobic exercise was more beneficial than resistance exercise on HbA1c (d=0.59 vs 0.28) in the groups. CONCLUSIONS: Regular exercise has a positive effect on HbA1c, fasting blood glucose, total cholesterol, HDL cholesterol, LDL cholesterol, and VO2max in Type 2 diabetic patients.