Healthy lifestyle interventions for childhood and adolescent cancer survivors: a systematic review and meta-analysis

Purpose@#This study investigated the effects of healthy lifestyle interventions (HLSIs) on health-related quality of life (HR-QoL) in childhood and adolescent cancer survivors (CACS). @*Methods@#Major databases were searched for English-language original articles published between January 1, 2000 and May 2, 2021. Randomized controlled trials (RCTs) and non-RCTs were included. Quality was assessed using the revised Cochrane risk-of-bias tool, and a meta-analysis was conducted using RevMan 5.3 software. @*Results@#Nineteen studies were included. Significant effects on HR-QoL were found for interventions using a multi-modal approach (exercise and education) (d=-0.46; 95% confidence interval [CI]=-0.84 to -0.07, p=.02), lasting not less than 6 months (d=-0.72; 95% CI=-1.15 to -0.29, p=.0010), and using a group approach (d=-0.46; 95% CI=-0.85 to -0.06, p=.02). Self-efficacy showed significant effects when HLSIs provided health education only (d=-0.55; 95% CI=-0.92 to -0.18; p=.003), lasted for less than 6 months (d=-0.40; 95% CI=-0.69 to -0.11, p=.006), and were conducted individually (d=-0.55; 95% CI=-0.92 to -0.18, p=.003). The physical outcomes (physical activity, fatigue, exercise capacity-VO2, exercise capacity-upper body, body mass index) revealed no statistical significance. @*Conclusion@#Areas of HLSIs for CACS requiring further study were identified, and needs and directions of research for holistic health management were suggested.

Factors Affecting Job Satisfaction of Oncology Advanced Practice Nurses

PURPOSE: This study was conducted to provide basic data for quality improvement among oncology advanced practice nurses (oncology APNs) through increasing job satisfaction by determining their job satisfaction level and analyzing the influencing factors. METHODS: The subjects were 114 certified oncology APNs working at general hospitals in metropolitan areas. Data were collected using a structured questionnaire from August 4 to October 29, 2018. The instruments were the Role Conflict Scale, Self-Efficacy Scale, Professional Self-Concept Scale, and the Level of Job Satisfaction. The data were analyzed using descriptive statistics, t-tests, chi-square tests, ANOVA, Pearson’s correlation coefficients and multiple regression in SPSS version 23.0, IBM. RESULTS: Factors that significantly affected job satisfaction were number of years since being certified as an oncology APN (β=-.20, p=.031), oncology advanced practice (β=.38, p<.001), and professional self-concept (β=.44, p<.001). The explanatory power was 39.4%. CONCLUSION: These results showed that factors significantly affecting job satisfaction were number of years since being certified as an oncology APN, advanced practice in oncology, and professional self-concept. Job satisfaction was found to be higher when the number of years since being certified as an oncology APN was shorter and professional self-concept was higher.

A Content Analysis of Disaster Nursing Education in Korean and Japanese Universities

PURPOSE: The purpose of this study is to analyze the contents of disaster nursing education at universities in Korea and Japan, with focus on textbooks. METHODS: Disaster nursing contents from 11 Korean community health nursing textbooks and 3 Japanese disaster nursing textbooks were analysed. RESULTS: Three themes and 8 categories of disaster nursing content in the selected textbooks were analyzed. The themes classified include ‘understanding of disaster’, ‘disaster management’ and ‘disaster management system’. The theme of ‘understanding of disaster’ consists of such categories as ‘disaster concept/outline’, ‘classification of disaster’, ‘disaster management step’ and ‘disaster impact’. The theme of ‘disaster management activities’ consists of categories such as ‘disaster management activities’ and ‘disaster nursing’. The theme of ‘national disaster management system’ consists of categories like ‘national disaster management system’ and ‘international disaster relief’. From the comparison of disaster nursing education in the two countries, we found that themes were similar but there were differences between the two countries in content configuration. Korea and Japan have adopted the framework of International Council of Nurses for disaster nursing education. Korea stressed legal and ethical capabilities, while Japan included psychological support for disaster management service providers. CONCLUSION: Disaster education is an important factor in a nurse's ability for a disaster management. Development of a comprehensive disaster education program is necessary to enhance disaster care capacities.

An Integrative Review of Meaning-Centered Intervention Studies for Patients with Advanced or Terminal Cancer

PURPOSE: The purpose of this study was to review studies of Meaning-Centered Intervention (MCI) in advanced or terminal cancer patients using Whittemore and Knafl's integrative review method. METHODS: We conducted a literature search using nine English or Korean electronic databases by using the keywords ‘meaning therapy OR meaning-centered intervention OR psychotherapy’. All studies were original articles about MCI in peer-reviewed journals from inception to August 2017. A risk of bias assessment tool for non-randomized studies was used for quality assessment. RESULTS: Seventeen studies matched the criteria. Thirteen studies assessed through RoBANS had a low risk of bias in most areas. The most frequently used tools were 8 group intervention sessions around 90 or 120 minutes in length. The outcome variables used in this study were quality of life, anxiety, depression, meaning of life, and spiritual well-being. The purpose of MCI was to improve the spiritual well-being and quality of life for patients by finding meaning in life even when faced with cancer. CONCLUSION: In this study, spiritual care was identified as an important factor from the MCI applied evidence-based data. The MCI could be effective way to improve spiritual well-being for the patients with advanced or terminal cancer and their families.

Comparison between Korean and Japanese Nursing Students in Their Disaster Preparedness

PURPOSE: The purpose of this study is to identify differences in disaster awareness, disaster preparedness, and nursing knowledge and practices between Korean and Japanese nursing students. METHODS: The study subjects were 4th grade nursing students who completed their nursing education in Korea or in Japan. 359 students from Korea and 135 students from Japan participated in this study. Data were analyzed using IBM SPSS 21.0. The χ2 test and the t-test were used to analyze the homogeneity of subjects' general characteristics and disaster-related characteristics. The comparison between the Korean and Japanese nursing students in disaster awareness, disaster preparedness, and nursing knowledge and practices were conducted using ANCOVA. RESULTS: The Korean nursing students' disaster awareness, disaster preparedness, and nursing knowledge and practice were different from their Japanese counterparts'. The Korean nursing students recognized that the system of disaster management in Korea was insufficient and the negligence of management was one of the causes of the disaster. They wanted to participate in activities for disaster preparedness education and management. CONCLUSION: A disaster nursing curriculum dealing with disaster awareness, disaster preparedness, and nursing knowledge and practices, should be developed, implemented, and evaluated particularly for Korean nursing students.

Effects of Psychosocial Interventions for School-aged Children's Internet Addiction, Self-control and Self-esteem: Meta-Analysis / 대한의료정보학회지

OBJECTIVES: This study was conducted to perform an effect size analysis of psychosocial interventions for internet addiction and to identify the intervention moderators applied to school-aged children. METHODS: For the meta-analysis, studies were included that were published in English or Korean until January 2015, without limitation in terms of the year. They were retrieved from 11 electronic databases and by manual searches according to predefined inclusion criteria. RESULTS: A total of 37 studies were selected, which included 11 treatment conditions and covered a total of 1,490 participants. The effect size estimates showed that psychosocial interventions had a large effect for reducing internet addiction (standardized mean difference [SMD], -1.19; 95% confidence interval [CI], -1.52 to -0.87) and improving self-control (SMD, 0.29; 95% CI, 0.11 to 0.47) and self-esteem (mean difference, 3.58; 95% CI, 2.03 to 5.12). The moderator analyses reveals that group treatments, a selective approach, a long duration, a community setting, or higher school grade had a larger effect. CONCLUSIONS: The findings of this review suggest that psychosocial intervention may be used to prevent Internet addiction in school-aged children, although further research should be conducted using a randomized controlled trial design or diverse age groups to provide evidence-based recommendations.

A Systematic Review of Literature on Community Health Center Exercise Programs

PURPOSE: The purpose of this study was to investigate the research methods, types and effects of community health center exercise programs for the elderly. METHODS: We established the PICOTS-SD (Participants, Interventions, Comparisons, Outcomes, Timing of outcome measurement, Setting, Study Design), reviewed 583 studies from electronic database of DBpia, KoreaMed, KISS, RISS, NDSL and Pubmed, and finally selected 20 studies based on the inclusion and exclusion criteria. Methodological quality was assessed with the Risk-of-Bias Assessment tool for non-randomized studies. RESULTS: With regard to research methods, the majority of studies on community health center exercise programs for the elderly were performed after 2010 and using non-equivalent control group pretest-posttest research design. As for the types and effects of exercise programs, the exercise period ranged from 6 to 28 weeks, and the most common exercise frequency was three times a week for 60 minutes. In addition, mixed-type and group exercise programs were performed most commonly. CONCLUSION: The results of this study provide a basis for the development of exercise programs to improve elders' health.

Relations of Job Satisfaction with Emotional Labor, Job Stress, and Personal Resources in Home Healthcare Nurses

PURPOSE: The aim of this study is to identify effects of emotional labor, job stress and personal resources on job satisfaction in home healthcare nurses. METHODS: The subjects were 149 home healthcare nurses working for home healthcare centers at 61 hospitals. Data were collected using a structured questionnaire from November 22, 2010 to February 28, 2011 and analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation, Hierarchical multiple linear regression analysis. RESULTS: The mean score of emotional labor level was 4.23+/-0.95, that of job stress level 3.39+/-0.57, that of personal resources 3.38+/-0.36, and that of job satisfaction 3.31+/-0.40. There were positive correlations among emotional labor, job stress, personal resources and job satisfaction. After age, educational level, job position, and work period in home health care, and traffic accident were controlled, the variables, emotional labor (beta=-.198, p = .034) and personal resources (beta=.236, p = .005) turned out to account for 13.3% of the job satisfaction. But job stress was not a statistically significant predictor. CONCLUSION: Home healthcare nurses were needed to minimize emotional labor and revitalize personal resources in order to maintain a comparatively high level of job satisfaction. Furthermore, it is necessary to carry out systematic education and an organizational management scheme into practice.

Clinical Outcomes and Quality of Life of Home Health Care Patients

PURPOSE: This study aimed to evaluate the quality of life (QOL) in home health care patients according to change in health status outcomes between the start of care and discharge or 60 days, whichever came first. METHODS: This is a prospective descriptive study. The convenience sample consisted of 100 home health care patients, who started receiving home health care services from a home health care agency in the United States. The World Health Organization Quality of Life Scale-Brief (WHOQOL-BREF) was used for measuring QOL; activities of daily living (ADLs) and instrumental ADLs were collected from the Outcome and Assessment Information Set data via Centers for Medicare and Medicaid Services-required home health agencies. Descriptive statistics, paired t tests, and multiple linear regressions were used for data analysis. RESULTS: ADLs and instrumental ADLs of participants significantly improved between start of care and discharge or 60 days. Overall QOL, general health, and three of four QOL domains (physical, psychological, and environmental, but not social domain) were significantly improved at discharge or 60 days. CONCLUSION: Home health care nurses should maintain and improve the functional ability of patients, as this could improve the QOL of these patients.

Meta-analysis of Psychosocial Interventions to Reduce Pain in Patients with Cancer

PURPOSE: The purpose of this study was to investigate the effects of psychosocial interventions on pain in cancer patients. METHODS: Eight studies published between 1980 and 2012 in Korean and ten studies published between 2002 and 2012 in English met the inclusion criteria with a total of 1539 participants. Methodological quality assessed by Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. The data were analyzed by the RevMan 5.2 program of Cochrane library. RESULTS: Overall, study quality was moderate to high. Effect sizes were heterogeneous and subgroup analysis was done. Cognitive behavioral therapy (CBT) were effective for pain (ES= -0.35; 95% CI= -0.56, -0.13). Pain education studies measured with NRS and VAS were effective for pain (ES= -0.77; 95% CI= -1.01, -0.52). Publication bias was not detected. CONCLUSION: This study support the use of psychosocial interventions administered to cancer patients for their pain management. However, more well-designed studies are needed.

A Study of Intensive Care Unit Nurses' Understanding of the Meaning of Death, Death Anxiety, Death Concern and Respect for Life / 한국호스피스완화의료학회지

PURPOSE: We investigated how intensive care unit (ICU) nurses understand the meaning of death, death anxiety, death concern and respect for life. METHODS: From November 2009 through February 2010, a survey was conducted on 230 nurses working at the ICU of 10 general hospitals located in Seoul and Gyeonggi province. Participants were asked to answer a questionnaire consisted of 67 questions under four categories of the meaning of death, death anxiety, death concern and respect for life. RESULTS: Participants scored 4.27 points on their understanding of the meaning of death, 4.43 on death anxiety, 4.12 on death concern and 4.18 on respect for life. Participants' meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' positive meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' negative meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' death anxiety was positively correlated with death concern and negatively with respect for life. Participants' death concern was negatively correlated with respect for life. CONCLUSION: Compared with nurses who served at ICU for a long time, nurses with less ICU experience scored lower on the meaning of death and respect for life, while they presented high anxiety and concern about death. A training course may help nurses develop their view on the meaning of death, which in turn would enhance their performance in caring dying patients.

The Effects of Lifestyle Factors on Metabolic Syndrome among Korean Adults

PURPOSE: The purpose of this study was to estimate the effects of lifestyle factors on metabolic syndrome (MS) among Korean adults (age> or =20). METHODS: A total of 7,798 subjects (weighted subjects=37,215,961) were recruited from the 2009 Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-3). Data were analyzed by t-test, chi2-test, and logistic regression in consideration of strata, cluster and weight as national data using the SAS 9.1 program. RESULTS: The prevalence of MS by definition of AHA/NHLBI and waist circumference cutoff points for Koreans was 22.4%. The mean clinical MS score for MS patients was 3.4, but the mean score for the non-MS group was 1.2 out of 5.0. Among the lifestyle factors, smoking (OR=1.024), stress (0.546< or =OR< or =0.587) and drinking (OR=1.005) had significant influence on the MS risk and MS scores, but exercise did not. CONCLUSION: The results of this study indicate that further research is necessary on the effect of lifestyle factors on MS risk and nurses should focus on effective programs about smoking, stress and drinking for the prevention and reduction of MS risk.

Comparison of Emotional Labor and Job Stress of Hospital Nursing Staff / 산업간호학회지

PURPOSE: This study was to investigate the relationship between the level of emotional labor and occupational job stress of hospital nursing staff. METHODS: The survey was conducted from Mar. to Oct. 2009 to collect data from clinical nurses (N=496). RESULTS: The study showed that nurses without religion and those working in big-sized hospitals had higher scores in emotional labor, and those of 26~30 years old felt the highest stress in the occupational role. The same applied to the married, more work experienced, atheist and those working in big-sized hospitals. Unmarried, under educated nurses with less work experience working in the big-sized hospitals showed higher scores in personal strain. The scores of the personal resources depended on religion, work experience, marital status and position of their jobs. Emotional labor was positively correlated with an occupational role and personal strain, respectively, but the emotional labor, occupational role and personal strain were negatively correlated with personal resources respectively. CONCLUSION: Intervention program is required to reduce overload of nurse's role and to relieve physical and psychological strains of the under-30-age-group. Also, social support and rational/cognitive coping must be reinforced.

Needlestick/Sharps Injuries in Nursing Students in Korea: A Descriptive Survey / 병원감염관리

BACKGROUND: The purpose of this study was to examine the frequency and characteristics of needlestick/sharps injuries (NSIs) in nursing students in Korea. METHODS: The study was based on a survey of questionnaires completed by 341 nursing students who had sustained at least one NSI during clinical practice in hospitals. RESULTS: The NSI incidence rate was 36.4%. Approximately half of the students reported two to four NSIs. Most (90.2%) of the NSIs occurred on the fingertips and were caused by a hollow-bore needle (46.8%) or lancet (45.8%). Some students were exposed to used needles contaminated with unknown pathogens (37.3%), HBs Ag (2.3%), Venereal Disease Research Laboratory (VDRL) (0.8%), or HIV (0.6%). Students cited the reason for injury as carelessness, inexperience, hastiness, or recapping. Almost two-thirds of students who reported having experienced an NSI knew about post-exposure treatment. However, only one-third of the students with NSIs completed an official report. CONCLUSION: Korean nursing students lack knowledge about injury prevention, report procedures, and treatment after NSI. A revised educational approach with emphasis on occupational risk, skill development, and injury reporting is necessary to prevent NSI and to ensure that students obtain post-exposure prophylaxis.

Development of Health Education Program Components for Early Childhood and the Investigation of Teachers' Awareness and Performance Rate of Health Education

PURPOSE: This study was conducted to develop health education program components for early childhood and to investigate teachers' awareness of the importance of health education and their performance rate of health education. METHODS: Early childhood health education program components were developed using two rounds of the Delphi method. The Delphi group consisted of 21 experts in childhood education. After health education program components were developed, they were used in surveying child care teachers' awareness of importance and performance rate and 151 teachers sampled from 30 child care centers participated in the survey. RESULTS: The early childhood health education program components consisted of 5 areas, 16 subjects and 33 specific contents. Early childhood teachers' awareness of importance was over 4.5 points in all the areas and in 11 out of the 16 subjects. The most frequently educated subjects were 'the importance of hand washing' and the least frequently educated subject was 'obesity prevention'. The teachers' awareness of importance and their performance rate of specific contents were high in 'maintaining order' and 'using children's rides safely,' and low in 'obesity prevention' and 'infectious disease prevention.' CONCLUSION: The components of this health program were developed in consideration of field feasibility and the relationship of health program education in elementary, middle and high school.

The Effect of Non-Smoking Campaign for Subway Workers on Their Health Behavior / 산업간호학회지

PURPOSE: This study was done to investigate the effect of non-smoking campaign for subway workers on their health behavior such as smoking, drinking, and exercise. METHOD: The study was done on the subjects of 112 male employees for 3 years from 2003 to 2005 working at the Seoul Metropolitan Rapid Transit Corporation. However, the subjects decreased to 105 in 2004 and 111 in 2005 due to work transfer. The data were obtained through administering questionnaires. The non-smoking campaign was done with health education using various strategies and methods by an administrator-in-charge assisted by the community health center. RESULTS: Smoking rate and cigarette consumption decreased but there was no statistical significance. Smokers' frequency of drinking and exercise were higher than that of non-smokers, but there was no statistical significance. CONCLUSION: The result indicated the program was not effective to change the subjects' health behavior; therefore, tailored program considering the subjects is recommended.

The Effect of Non-Smoking Campaign for Subway Workers on Their Health Behavior / 산업간호학회지

PURPOSE: This study was done to investigate the effect of non-smoking campaign for subway workers on their health behavior such as smoking, drinking, and exercise. METHOD: The study was done on the subjects of 112 male employees for 3 years from 2003 to 2005 working at the Seoul Metropolitan Rapid Transit Corporation. However, the subjects decreased to 105 in 2004 and 111 in 2005 due to work transfer. The data were obtained through administering questionnaires. The non-smoking campaign was done with health education using various strategies and methods by an administrator-in-charge assisted by the community health center. RESULTS: Smoking rate and cigarette consumption decreased but there was no statistical significance. Smokers' frequency of drinking and exercise were higher than that of non-smokers, but there was no statistical significance. CONCLUSION: The result indicated the program was not effective to change the subjects' health behavior; therefore, tailored program considering the subjects is recommended.

Comparison of Sleep Pattern, Factors of Sleep Disturbance and Sleep Enhancement Behaviors between Sleep Disturbance and Non-Sleep Disturbance Aged Patients / 기본간호학회지

PURPOSE: This study was done to compare sleep patterns, factors of sleep disturbance and sleep enhancement behaviors between sleep disturbance and non-sleep disturbance elderly patients. METHOD: The participants were 117 patients over 65 years old who were hospitalized at 5 general hospitals in Seoul. There were 83 patients in the good sleeper group and 34 in the poor sleeper group. The survey questionnaires included questions on general characteristics, sleep patterns, sleep disturbing factors, and sleep enhancement behaviors of the patients. RESULTS: For sleep patterns and environmental factors of sleep disturbance, the poor sleepers was significantly higher than that of the good sleepers. Significant differences between good sleepers and poor sleepers were also found on the following variables: Environmental factors of sleep disturbance -'Sound of other patient's or care-giver's', 'Discomfort of bed, linen, pillow and patient's gown', 'Light in the room', 'Emergency situations', 'Temperature of patients rooms too hot or too cold'. The significant physical factor of sleep disturbance was 'Hard to breath even without moving' and for sleep enhancement behaviors: 'Use of ear plugs or eye covers'. CONCLUSION: Consequently it is necessary to develop positive and differentiated programs for sleep enhancement for the inactive and poor sleeper among the elderly patients.

Task Analysis of Korean Geriatric Care Managers / 간호학회지

PURPOSE: This study was designed to create a job description for Korean geriatric care managers and examine performance frequency, importance, and difficulty of task elements. METHOD: The sample consisted of 38 geriatric care managers and professors who performed duties related to geriatric care management at community based-facilities in Korea. A survey method was used, and the questionnaire included frequency, importance, and difficulty of task elements in job descriptions using the DACUM method. Using SPSS WIN 10.0, descriptive statistics such as frequency distribution, means, and standard deviation were conducted to examine the subject's general characteristics, frequency, importance, and difficulties of task performance. RESULT: The job descri ption of geriatric care managers revealed 10 duties, 34 tasks, and 105 task elements. On all ten duties, the average performance frequency, importance, and difficulty was 2.55, 2.21 and 2.43 respectively. CONCLUSION: The job description of geriatric care managers includes duty, task, and task elements and the definition of a completed job. Thus we recommend a data based trial to confirm and validate the information gathered.

Knowledge, Compliance and Levels of Risk Factor Recognition for Needlestick Injuries in Student Nurses / 기본간호학회지

PURPOSE: The purpose of this study was to investigate the levels in student nurse of knowledge, compliance and risk factor recognition for needlestick injuries. METHOD: Nine hundred and thirty eight(938) student nurse from 3 universities and 3 junior colleges participated in this study. Completed questionnaires were collected between October and November 2004. They were analyzed by using the descriptive statistics and chi2-test, t-test with the SAS program. RESULTS: There were no significant differences in the general characteristics of participants between the two groups - Needlestick Injury(NSI) group and non-Needlestick Injury(non-NSI) group. The scores for knowledge levels of treatment after needlestick injuries and the risk factor recognition level were significantly higher in the NSI group. The scores for performance level as to handling and using needles after needlestick injuries were significantly higher in the non-NSI group. CONCLUSION: It is necessary to develop a preventive program to decrease the needlestick injury rate among student nurse.