Improving Medication Adherence in Isolated Patients With Cognitive Impairment Using Automated Telephone Reminders.

Background and Purpose: Medication adherence is essential for effective medical treatment. However, it is challenging for cognitively impaired patients. We investigated whether an automated telephone reminder service improves medication adherence and reduces the decline of cognitive function in isolated patients with cognitive impairment. Methods: This was a single-center, randomized clinical trial. We enrolled mild cognitive impairment (MCI) or Alzheimer's disease (AD) patients who lived alone or with a cognitively impaired spouse. We provided an automated telephone reminder service for taking medication to the intervention group for 6 months. The control group was provided with general guidelines for taking the medication every month. The participants underwent neuropsychological assessment at the beginning and end of the study. Statistical significance was tested using nonparametric Wilcoxon rank sum and Wilcoxon matched-pairs signed-rank tests. Results: Thirty participants were allocated randomly to groups, and data for 29 participants were analyzed. The mean age was 79.6 (standard deviation, 6.0) years and 79.3% of the participants were female. There was no significant difference in medication adherence between the 2 groups. However, a subgroup analysis among participants with more than 70% response rates showed better medication adherence compared to the control group (intervention: 94.6%; control: 90.2%, p=0.0478). There was no significant difference in the change in cognitive function between the 2 groups. Conclusions: If a patient's compliance is good, telephone reminders might be effective in improving medication adherence. It is necessary to develop reminder tools that can improve compliance for cognitively impaired patients.

Factors influencing the health-related quality of life in Korean menopausal women: a cross-sectional study based on the theory of unpleasant symptoms.

Purpose: Based on the theory of unpleasant symptoms (TOUS), this study aimed to examine the direct effect of antecedent factors on health-related quality of life (HRQoL) and its indirect effect via symptoms in Korean women during the late menopausal transition (MT) and early postmenopause. Methods: This cross-sectional survey employed a descriptive correlational research design. The respondents were 152 middle-aged women 40 to 60 years with an intermenstrual interval of 60 days or more (late MT) or less than 5 years from the last menstrual period (early postmenopause). The respondents were recruited through convenience sampling in Busan, Korea, from December 1, 2020, to January 31, 2021. Based on the TOUS, self-report data were collected on perceived health status, psychological distress, social support, menopausal symptoms, and HRQoL. The collected data were analyzed using descriptive statics, independent t-test, one-way analysis of variance, Pearson's correlation coefficient, and the Hayes' PROCESS macro. Results: TOUS was supported on this sample (n=152) of Korean women during the late MT and early postmenopause. Perceived health status, psychological distress, and social support had significant direct relationships with HRQoL. Menopausal symptoms had significant indirect relationships between antecedent factors (perceived health status, psychological distress, and social support) and partially mediated HRQoL. Conclusion: The findings of this study indicate that menopausal symptoms play an important role as an intervening factor of HRQoL in women during the late MT and early postmenopause. Therefore, women need an integrated program that manages antecedent factors and menopausal symptoms to improve HRQoL in these menopausal stages.

[Influence of pregnant couples' attitudes towards sex during pregnancy on sexual function]. / ìž„ì‹ ì¤‘ 성에 대한 태도가 ìž„ì‹ ë¶€ë¶€ì˜ 성기능에 미치는 영향.

Purpose: This study was conducted to identify the influences of the attitudes of pregnant women and their husbands towards sex during pregnancy on sexual function. Additional purpose was to compare the frequency of sexual dysfunction according to gender and gestational trimester and to describe the changes in sexual behavior according to the gestational trimester. Methods: In this study, 231 pregnant couples completed self-report questionnaires during their visits to women's hospitals or community health centers. The questionnaires assessed general characteristics, maternal/paternal sexual attitudes towards sex during pregnancy (Maternal Sex during Pregnancy Scale, MSP/Paternal Sex during Pregnancy Scale, PSP), and sexual function (using the Female Sexual Function Index and International Index of Erectile Function, respectively). Multiple regression analysis was done to test the research model using SPSS version 23.0. Results: In this study, 74.9% of pregnant women and 38.5% of their husbands reported sexual dysfunction. Sexual dysfunction was prevalent in pregnant women in the first trimester and prevalent in husbands in the third trimester. MSP (ß=.44, p<.001) in pregnant women and PSP (ß=.39, p<.001) and being in the first trimester (ß=.17, p=.012) in husbands influenced sexual function during pregnancy. In the first trimester, the scores for attitudes towards sex during pregnancy were the lowest in pregnant women, while they were the highest in their husbands. Conclusion: Positive attitudes about sex during pregnancy are important for sexual function in pregnant couples. Because the difference in attitudes towards sex during pregnancy between pregnant women and their husbands was greatest in the first trimester, sexual health interventions need to be provided in early pregnancy.

[Work performance and calling as factors influencing job satisfaction among nurse midwives working in the delivery room]. / 분만실에 근무하는 조산사의 직무수행과 ì†Œëª ì˜ì‹ì´ 직무만족도에 미치는 영향.

Purpose: The purpose of this study was to investigate work performance and calling as determinants of job satisfaction among nurse midwives. Methods: The participants of this study were registered nurse midwives who had worked in the delivery room for more than 6 months. Data were collected by face-to-face interviews, postal mail, and mobile devices. Subjects completed self-report questionnaires from July to August 2017. The dataset was analyzed using descriptive statistics, the independent t-test, analysis of variance, the Pearson correlation coefficient, and multiple regression. Results: The mean score for job satisfaction was 3.42±0.45. Among the sub-factors, income had the lowest score (2.67±0.72) and management of delivery had the highest score (3.81±0.66). Job satisfaction was significantly different according to marital status (t=2.25, p=.028), residential area (t=2.43, p=.016), and cause of job satisfaction (F=4.54, p=.012). Job satisfaction showed a significant positive correlation with work performance (r=.29, p<.001) and calling (r=.57, p<.001). The correlation between work performance and calling was also positive and statistically significant (r=.32, p<.001). Purpose and meaning (ß=.48, p<.001) and marital status (ß=-.15, p=.025) significantly influenced job satisfaction. The model developed in this study explained 45% of variation in job satisfaction. Conclusion: Nurse midwives' job satisfaction may be enhanced by entrusting them with professional roles and tasks. Above all, it is necessary to develop and provide programs that help nurse midwives connect their jobs with the meaning and purpose of their lives.

Unplanned readmission of patients with heart transplantation in 1 year: A retrospective study.

AIM: To investigate readmission rate and its association with patient characteristics to identify key risk factors associated with unplanned readmission in 1 year after heart transplantation. BACKGROUND: Unplanned readmission after heart transplantation due to complications affects patients' quality of life and long-term survival rate. DESIGN: A retrospective cohort study. METHODS: Individual, disease-related and therapeutic characteristics were included from electronic medical records. Participants were 484 adult patients who underwent heart transplantation between 1992 - 2016 at a tertiary hospital in Korea. RESULTS: A total of 204 patients underwent unplanned readmission. The most frequent causes were infection or rejection. Multivariate analysis revealed hypertension and pre-operative estimated glomerular filtration rate to be risk factors for unplanned readmission. CONCLUSION: Early screening educational programs and interventions based on recommended risk factors are needed to reduce the unplanned readmission rate of heart transplantation patients. IMPACT: Nurses who care for heart-transplanted patients should initially assess risk factors during the postoperative and recovery periods to reduce risk of readmission following surgery. These findings may contribute to early assessment criteria and development of discharge nursing education materials.

Factors Affecting the Sexual Function of Pregnant Women.

PURPOSE: To determine whether maternal attitude toward sex during pregnancy and health-related quality of life could influence sexual function of pregnant women. METHODS: In this study, 138 second and third trimester pregnant women completed self-report questionnaires during their visits to women's hospitals or community health centers to assess their general characteristics, attitude toward sex during pregnancy (PIES-M), health-related quality of life (EQ-5D), and sexual function (FSFI-6K). Multiple regression analysis was performed to test the research model with SPSS version 23. RESULTS: Pregnant women who had discontinued their sexual life after recognizing their pregnancy accounted for 27.5% of women questioned. The average sexual function score of pregnant women was higher in the second trimester than the third trimester. Attitude toward sex during pregnancy (ß=-.38, p< .001), maintaining sexual life (ß=.20, p=.028), health-related quality of life (ß=.18, p=.030), and adverse symptoms during sex (ß=.18, p=.042) were determinants of sexual function during pregnancy. CONCLUSION: Nurses in antenatal care units need to help pregnant women maintain a positive attitude toward sexual activity during pregnancy and manage their health-related quality of life to maintain their sexual life during pregnancy.

Research Trend of Women's Health in Korean Nursing Journals (2010~2015).

PURPOSE: To explore trends of women's health in nursing research by analyzing articles on women aged 13 years or older that were published in Korean Journal for Women Health Nursing from 2010 to 2015. METHODS: Seven focus areas were identified and modified to reflect integrative conceptual models of women's health: maternity care, menstrual concerns, health problems in women, gender influences on health risks, social influences on women's health, women and health care policy, and sexual health and violence against women. A total of 383 studies were analyzed according to these seven focus areas. RESULTS: Health problems in women, maternity care, and societal influences on women's health were the most widely studied topics in Korean women's health. There was increased attention to societal influences on women's health and gender influences on health risk. However, these areas are still limited in nursing research. Only 1% of these studies were in area of women's health policy. CONCLUSION: More studies in area of sexual health and violence against women are needed. Studies in area of women and health care policy are also needed to improve women's health in Korea.

The effect of lumbar-pelvic alignment and abdominal muscle thickness on primary dysmenorrhea.

[Purpose] The purpose of this study was to identify effects of malalignment of the lumbar pelvis, as a passive element, and the thicknesses of abdominal muscles, as active elements, on primary dysmenorrhea. [Subjects and Methods] The subjects were divided into a primary dysmenorrhea group and normal group according to Visual Analogue Scale, and ultimately there were 28 subjects in the dysmenorrhea group and 22 subjects in the normal group. Alignment of the lumbar pelvis was measured by using a Formetric 4D analysis system, and the thicknesses of abdominal muscles were measured by using ultrasound imaging. [Result] Scoliosis was 6.7 ± 4.3° in the primary dysmenorrhea group and 3.8 ± 2.0° in the normal group, and the lordotic angles of the two groups were 0.6 ± 0.5° and 0.1 ± 0.3°, respectively. The thickness of the internal oblique was 3.8 ± 1.3 mm in the primary dysmenorrhea group and 6.0 ± 1.9 mm in the thicknesses of the transverse abdominis in the two groups were 2.6 ± 6.8 mm and 3.5 ± 6.1 mm, respectively. Furthermore, the thickness of the normal group, and the external oblique was 4.0 ± 0.8 mm in the primary dysmenorrhea group and 5.4 ± 1.4 mm in the normal group. [Conclusion] This study showed significant differences between the primary dysmenorrhea group and the normal group in lumbar-pelvic alignment and thicknesses of abdominal muscles.

The relationship between pelvic alignment and dysmenorrhea.

[Purpose] The purpose of this study was to investigate the relationship between pelvic alignment and dysmenorrhea in general women. [Subjects and Methods] One hundred two females participated in this study. They were divided into a dysmenorrhea group and a normal group based on the results of a Visual Analogue Scale (VAS) assessment of pain and the Menstrual Distress Questionnaire (MDQ). The survey data was collecting from 5th July to 20th September, 2014. Formetric 4D was used to measure the pelvic alignment, including the values of Trunk Imbalance, Pelvic Tilt, Surface Rotation, Lateral Deviation, Kyphosis Angle, Lordosis Angle. [Results] There was a difference in the spine alignments of each group. The value of pelvic torsion was 2.4 ± 1.8 degree in those with dysmenorrhea, while it was 1.7 ± 1.1 degree in those without. [Conclusion] In conclusion, the results suggest that there is a relationship between menstrual pain and pelvic torsion.

Effects of Sanhujori and Menopausal Adaptation on Health-related QOL in Middle-aged Women.

PURPOSE: This study investigated the effects of menopausal adaptation and Sanhujori (Korean traditional postnatal care) on the Health-related quality of life in middle-aged women. METHODS: Women aged from 45 to 60 completed questionnaires consisting of SF-36 ver. 2 and menopausal adaptation scale between July to Aug, 2013. Two hundred and eighteen participants' data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple regression. RESULTS: Physical health (69.5+/-15.1) was better than mental health (68.8+/-17.1), and bodily pain and social functioning were the same results as 2009 general U.S. population, with the sub-variables of quality of life being lower. Menopausal adaptation was at moderate level, and correlation of its sub-variables with quality of life were significant: fatigue (r=.60, p<.001), accomplishing feeling (r=.55, p<.001), confidence (r=.54, p<.001), dryness (r=.51, p<.001), flush (r=.38, p<.001), dominance (r=-.36, p<.001), stability (r=.26, p<.001). Fatigue, confidence, stability, period of sanhujori, and dryness revealed as influencing quality of life, while the total variation explained by these components was at 52%. CONCLUSION: To improve quality of life of middle aged women, health care providers need to provide nursing intervention to relieve fatigue and dryness; and address psychosocial concerns with developing nursing strategies to improve stability and confidence. For post-partum women, enough periods of sanhujori needs to be recommended.

A Comparative Study on Birth Outcomes between Korean Women and Immigrant Women.

PURPOSE: The purpose of this study was to compare birth outcomes between Korean women and immigrant women. METHODS: Medical records were reviewed retrospectively from 201 immigrant women and 201 Korean women who delivered babies at K women's hospital in U city from January 2006 to December 2009. Maternal outcomes related factors included nationality, age, obstetric history, delivery type, indications of cesarean section, and complications of pregnancy and delivery. Principal neonatal outcomes were birth weight, Apgar scores, and complications of newborns. RESULTS: Immigrant women were younger and had fewer pregnancies, abortions, and surviving children than Korean women. The rate of primary cesarean section and its indication in immigrant women were not significantly different from Korean women. However, immigrant women's newborn were more likely to have low birth weight and meconium staining. CONCLUSION: The results of this study indicate less equity of immigrant women in women's health care, although immigrant women's babies had lower Apgar score and more meconium staining. Nurses should help immigrant women cope with labor process effectively to prevent adverse health outcomes for their newborns.

Grandmother's Life Satisfaction and Influencing Factors by Grandparenting.

PURPOSE: The study was to compare the factors of life satisfaction between grandmothers parenting and not parenting their grandchildren. METHODS: A descriptive design with a convenience sampling was used for this study. From communities in S and U city, 85 parenting grandmothers (PG) and 103 non-parenting grandmothers (NPG) were recruited. The PG were those grandmothers who cared for preschooler grandchildren for their daughter or daughter-in-law who was employed. RESULTS: The demographics of the two groups were similar, however the value of grandparenting was significantly higher in the PG than the NPG (t=4.56, p<.001). In the PG, strong and significant correlations were found among the value of grandparenting, health status, quality of relations with adult children, and life satisfaction. However, demographics were more related to health status and life satisfaction in the NPG. The value of grandparenting, health status, and quality of grandmother-adult children relations were found to be significant factors of life satisfaction (F=20.75, p<.001) explaining 42% of the variances. In the NPG, only health status was a significant factor (F=50.66, p<.001) explaining 33% of the variances. CONCLUSION: This study shows that grandmothers' perceptions of grandparenting and family relationships need to be incorporated into the lifestyle in order to support parenting grandmothers' life satisfaction while grandmothers' health is the common concern of elderly women's life satisfaction.

[The life of elderly women living alone].

PURPOSE: This study aimed to uncover the fundamental nature of living alone in female elderly. METHODS: The phenomenological research approach developed by van Manen was adopted. RESULTS: The theme was 'taking a firm stand alone on the edges of life'. The composition elements of living alone experienced by elderly women were as follows: 1) Corporeality: participants perceived their bodies by their health status. Unhealthy participants were suffering with diseases and dependant on other persons, while healthy participants were free from family responsibility and kept on moving. 2) Spatiality: participants felt both freedom and loneliness while they stayed home. 3) Relationality: participants felt pity and yearning for their bereaved husband and sometimes talked to his picture. According to their children's filial piety, participants were pleased or displeased. However, they incessantly devoted themselves to their children. 4) Temporality: participants considered the rest of their life as extra-time which was proceeding to death, and tried to keep themselves busy before they died. CONCLUSION: A nurse should understand the multifarious aspects of elderly women's life, and then intervene to consolidate their strengths for self-supporting the final years of life.

Deleted in cancer 1 (DICE1) is an essential protein controlling the topology of the inner mitochondrial membrane in C. elegans.

DICE1 (deleted in cancer 1), first identified in human lung carcinoma cell lines, is a candidate tumor suppressor, but the details of its activity remain largely unknown. We have found that RNA interference of its C. elegans homolog (DIC-1) produced inviable embryos with increased apoptosis, cavities in cells and abnormal morphogenesis. In the dic-1(RNAi) germ line, ced-3-dependent apoptosis increased, and cell cavities appeared at the late-pachytene/oogenic stage, leading to defective oogenesis. Immunofluorescence microscopy of DIC-1 revealed its ubiquitous expression in the form of cytoplasmic foci, and cryoelectron microscopy narrowed down the location of the foci to the inner membrane of mitochondria. After dic-1 RNAi, mitochondria had an irregular morphology and contained numerous internal vesicles. Homozygous embryos from a heterozygous dic-1 mother arrested at the L3 larval stage, in agreement with the essential role of DIC-1 in mitochondria. In summary, C. elegans DIC-1 plays a crucial role in the formation of normal morphology of the mitochondrial cristae/inner membrane. Our results suggest that human DICE1 may have several functions in multiple intracellular locations.