Association between metabolically obese but normal weight and cardiovascular diseases in Korean menopausal women.

OBJECTIVE: The aim of this study was to present useful data for developing effective health management strategies for cardiovascular disease (CVD) prevention in postmenopausal women by investigating health-related behaviors and the prevalence of CVD for different types of obesity classified according to metabolic health status and body mass index criteria. METHODS: Using the 2016 Korean National Health and Nutrition Examination Survey VII-1 data, 1,190 menopausal women aged 50 years or older were analyzed in this cross-sectional study. The participants were divided into four groups as follows: metabolically healthy and normal weight (MHNW), metabolically obese but normal weight (MONW), metabolically healthy but obese, and metabolically obese and obese. Complex-samples general linear analysis, t tests, and logistic regression analysis were used to compare the differences in health-related behaviors and the risk of CVD among the four groups. RESULTS: The risk for stroke was 3.61 times higher (95% CI, 1.18-11.03) in the MONW group than in the MHNW group. CONCLUSIONS: We found a strong association between the MONW group of obesity and the risk for CVD, particularly stroke, in postmenopausal women. These findings would serve as valuable evidence for developing and implementing interventions to prevent stroke in postmenopausal women in the MONW group.

A structural equation modeling approach to understanding physical function of terminal cancer patients.

PURPOSE: Understanding the activities of daily living (ADL) of cancer patients at the end-of-life stage may help healthcare providers develop interventions for preserving physical function and enhance patient's dignity in an everyday care context. This study aims to develop and test a causal effect model of physical function in terminal cancer patients. METHODS: A total of 238 participants were recruited from two hospitals in South Korea. The data were collected using a structured questionnaire including demographics, visual analogue scale for pain, Functional Assessment of Chronic Illness Therapy-Fatigue, and Katz index of independence in ADL. The collected data were analyzed using SPSS WIN 25.0 and AMOS 23.0 programs for structural equation modeling procedures. RESULTS: Most participants were aged 65 years or older (65.5%), male (53.8%), and inpatients (74.4%). The most common primary cancer site was gastrointestinal tract (44.1%). Physical function of the participants was positively influenced by regular exercise and negatively influenced by hospitalization, fatigue, and pain, explaining 35.1% of the variance. In this study, regular exercise improved participants' ADL level directly and indirectly either by reducing fatigue or decreasing fatigue through controlling pain. Pain did not affect ADL directly but decreased ADL level indirectly through fatigue as a mediator. CONCLUSION: ADL was positively influenced by regular exercise and was negatively influenced by hospitalization, fatigue, and pain. Based on these results, in order to minimizing the problems of physical function in terminal cancer patients, interventions that reduce pain and fatigue and provide regular exercise are required.

Association between eating alone and cardiovascular diseases in elderly women: a cross-sectional study of KNHANES 2016 data.

OBJECTIVE: To investigate differences in health behaviors, nutritional status, and the likelihood of having cardiovascular diseases and its risk factors according to the presence of an eating companion in older women. METHODS: Using 2016 Korean National Health and Nutrition Examination Survey VII-1 data, 590 menopausal women aged ≥65 years were analyzed in this cross-sectional study. Participants who ate more than two meals a day alone were assigned to an eating-alone (EA) group and those who ate more than two meals a day with others were assigned to an eating-with-others (EO) group. Complex-samples general linear analysis, t tests, and logistic regression were used for the analysis of the data. RESULTS: Awareness of nutrition labels (P = 0.012), using of nutrition labels (P = 0.014), and impact of nutrition labels (P = 0.016) were lower in the EA group than in the EO group. The intake of energy, carbohydrates, dietary fiber, sodium, and potassium was lower in the EA group than in the EO group (P < 0.05). The likelihood of having angina was 2.58 times higher in the EA group than in the EO group (95% CI, 1.20-5.55). CONCLUSIONS: Older women who ate alone had poorer nutritional knowledge and intake. In addition, eating alone in older women was strongly associated with the prevalence of angina. Thus, it is necessary to consider nutrition education and cardiovascular disease screening for older women who mainly eat alone.

Mediating Effects of Empathy on Competence of Korean Nursing Students.

BACKGROUND: Empathic communication is important for nurses to establish therapeutic relationships with patients and to improve the quality of care. Thus, empathy is essential for nursing students who will be future nurses. The aim of this study was to examine the mediating role of empathy in the influence of communication competence on interpersonal competence of nursing students. METHODS: This study was conducted at the Catholic University of Korea. Participants were 218 nursing students who completed a survey questionnaire on general characteristics, Interpersonal Reactivity Index, Primary Communication Inventory, and Interpersonal Competence Questionnaire from Feb. 20 to Feb. 21, 2014. Data were analyzed using simple and multiple regression analyses. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. RESULTS: A three-step regression analysis was performed to verify the mediating role of empathy in the relationship between communication competence and interpersonal competence. Results confirmed that communication competence significantly influenced interpersonal competence, showing that empathy had a partial mediating role (Z=2.40, P=.016). CONCLUSION: Communication competence improved interpersonal competence through mediation by empathy in nursing students. Result of this study suggested that nursing schools should implement communication education that can strengthen empathy in order to boost nursing students' interpersonal competence.

Effects of a conflict resolution training program on nursing students: A quasi-experimental study based on the situated learning theory.

BACKGROUND: Conflict among nurses within the healthcare system negatively impacts them and patient outcomes. Therefore, it is essential to prepare nursing students for conflict resolution in clinical practice. OBJECTIVES: This study aimed to develop a conflict resolution training program based on the situated learning theory (SLT) for nursing students and to verify the impact of the program on abilities of communication, problem-solving, and conflict resolution. DESIGN: This quasi-experimental study was conducted using a non-randomized control group pretest and posttest design. SETTINGS: A college of nursing with the main campus in South Korea. PARTICIPANTS: The subjects were 48 senior nursing students in the last semester of their nursing program. METHODS: The program was developed based on the SLT. It was delivered to the experimental group (90 min per session, a total of eight sessions) while the control group received no intervention. Data were analyzed with χ2-test, Fisher's exact test, unpaired t-test, Mann-Whitney U test, repeated-measures ANOVA, and Bonferroni correction using SPSS/WIN 25.0 program. RESULTS: There were significant interactions between group and time in problem-solving ability (p = 0.048) and subjective conflict resolution ability (p = 0.005). Problem-solving ability and subjective conflict resolution ability in the experimental group significantly improved compared to the control group based on post-hoc test. After the program, objective conflict resolution ability was significantly higher in the experimental group than the control group (p < 0.001). For communication ability, there was a significant interaction between group and time (p = 0.046). However, it showed no significant difference between the two groups in a post-hoc test. CONCLUSIONS: The conflict resolution training program based on the SLT was found to be effective in improving the abilities of problem-solving and conflict resolution of nursing students.

Comparison of health-related habits and metabolic syndrome risk factors according to obesity type in Korean postmenopausal women.

OBJECTIVE: This study aimed to investigate the differences in health-related habits, metabolic syndrome risk factors, and related diseases prevalence according to obesity type in postmenopausal women. METHODS: This cross-sectional study used a data set of 1,443 postmenopausal women who were 40 years or older (range = 45-80, mean = 64.10) from the 2016 Korean National Health and Nutrition Examination Survey VII-1. The participants were classified into normal group (body mass index [BMI] <25 kg/m, waist circumference (WC) <85 cm), BMI obesity group (BMI ≥25 kg/m, WC <85 cm), abdominal obesity group (BMI <25 kg/m, WC ≥85 cm), and BMI and abdominal obesity group (BMI ≥25 kg/m, WC ≥85 cm). To compare health-related habits and metabolic syndrome risk factors according to obesity type, a chi-square test and t test were performed. The relationship between obesity and metabolic syndrome was assessed using a logistic regression analysis of adjusted demographic and women's health covariates. RESULTS: The abdominal obesity group had a significantly longer sedentary time per day (524.31 min), a higher activity restriction rate (25.0%), and a lower nutrition labeling recognition rate (3.6%) than the other groups (P < 0.001). The occurrence of metabolic syndrome was the highest in the BMI and abdominal obesity group (66.1%), followed by the abdominal obesity group (59.3%). Compared with the normal group, the prevalence of metabolic syndrome was significantly higher in the BMI obesity group (adjusted odds ratio [OR] = 2.23, 95% CI = 1.15-4.31), abdominal obesity group (adjusted OR = 7.33, 95% CI = 4.38-12.25), and the BMI and abdominal obesity group (adjusted OR = 12.44, 95% CI = 8.78-17.62). CONCLUSIONS: In postmenopausal women, the abdominal obesity group was associated with a high prevalence of metabolic syndrome and related diseases. Therefore, to reduce abdominal obesity in postmenopausal women, it is necessary to correct long sedentary time, high activity restriction rate, and low nutritional labeling recognition rate identified as health-related habits of the abdominal obesity group.

[Experiences of Ego Integrity Recovery in Elderly Cancer Patients: Grounded Theory Approach].

PURPOSE: This study was conducted to derive a substantive theory on lived experiences of elderly cancer patients. METHODS: The data were collected from February to March 2018 through in-depth personal interviews with 14 elderly cancer patients. The collected data were analyzed based on Corbin and Strauss's grounded theory. RESULTS: The core category was "the journey to find balance in daily lives as a cancer patient by recovering disturbed ego integrity." The core phenomenon was "shattered by suffering from cancer," and the causal conditions were "physical change" and "limitations in daily life." The contextual conditions were "decreased self-esteem," "feelings of guilt toward the family," and the sense of "economic burden." The participants' action and interaction strategies were "maintaining or avoiding social relations," "seeking meaning of the illness," "falling into despair," and "strengthening the willingness to battle the cancer." The intervening conditions were "support from health care providers and family," "dissatisfaction with health care providers," "spiritual help from religion," and "the improvement or worsening of health conditions." The consequences were "having a new insight for life," "living positively along with cancer illness," and "the loss of willingness to live." A summary of the series of processes includes the "crisis stage," "reorganizing stage," and the "ego integration stage." CONCLUSION: This study explored the holistic process of ego integrity impairment and the recovery experience of elderly cancer patients. This study is expected to be used as a basis for the development of nursing interventions that can support patients when coping with all stages of their cancer illness trajectory.

Relationships between Exercise Behavior and Anger Control of Hospital Nurses.

PURPOSE: This study examined the relationships between nurses' exercise behavior and their anger control using a cross-sectional descriptive design. METHODS: The participants were 290 nurses in South Korea, who completed a survey questionnaire on general characteristics, the stage of exercise behavior change, and anger emotion, evaluated using state anger and anger expression method. RESULTS: Those who engaged in regular exercise behavior exhibited lower levels of state anger and higher levels of anger control than those who did not. In the prediction model, a significant association of exercise behavior with anger control was found. The levels of anger control decreased as the age, education level, and work experiences of nurses decreased. Anger control scores were significantly higher than anger suppression scores and anger expression-out scores in the hospital nurses. CONCLUSION: Engaging in regular exercise may help nurses manage anger emotions better.

Smartphone Addiction and Interpersonal Competence of Nursing Students.

BACKGROUND: Interpersonal competence is an important capacity for nurses. Recently, the advent of smartphones has instigated considerable changes in daily life. Because smartphone has multiple functions, people tend to use them for numerous activities, often leading to addictive behavior. METHODS: This cross-sectional study performed a detailed analysis of smartphone addiction subscales and social support related to interpersonal competence of nursing students. Overall, 324 college students were recruited at Catholic University in Seoul, Korea from Feb 2013 to Mar 2013. Participants completed a self-reported questionnaire, which included scales that measured smartphone addiction, social support, interpersonal competence, and general characteristics. Path analysis was used to evaluate structural relations between subscales of smartphone addictions, social support, and interpersonal competence. RESULTS: The effect of cyberspace-oriented relationships and social support on interpersonal competence were 1.360 (P=.004) and 0.555 (P<.001), respectively. CONCLUSION: Cyberspace-oriented relationship, which is a smartphone addiction subscale, and social support were positively correlated with interpersonal competence of nursing students, while other smartphone addiction subscales were not related to nursing student interpersonal competence. Therefore, effective smartphone teaching methods be developed to enhance nursing student motivation.

[Influence of Nurse Managers' Authentic Leadership on Nurses' Organizational Commitment and Job Satisfaction: Focused on the Mediating Effects of Empowerment].

PURPOSE: The aim of this study was to examine the mediating effect of empowerment in the relationship of nurse managers' authentic leadership, with nurses' organizational commitment and job satisfaction. METHODS: The participants in this study were 273 registered nurses working in five University hospitals located in Seoul and Gyeonggi Province. The measurements included the Authentic Leadership Questionnaire, Condition of Work Effectiveness Questionnaire-II, Organizational Commitment Questionnaire and Korea-Minnesota Satisfaction Questionnaire. Data were analyzed using t-test, ANOVA, Scheffé test, Pearson correlation coefficients, simple and multiple regression techniques with the SPSS 18.0 program. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. RESULTS: There were significant correlations among authentic leadership, empowerment, organizational commitment and job satisfaction. Empowerment showed perfect mediating effects in the relationship between authentic leadership and organizational commitment. It had partial mediating effects in the relationship between authentic leadership and job satisfaction. CONCLUSION: In this study, nurse managers' authentic leadership had significant influences on nurses organizational commitment and job satisfaction via empowerment. Therefore, to enhance nurses' organizational commitment and job satisfaction, it is necessary to build effective strategies to enhance nurse manager's authentic leadership and to develop empowering education programs for nurses.