• Korean Journal of Adult Nursing
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• v.23 no.4
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• pp.374-385
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• 2011

Purpose: The purpose of this study was to identify the factors that influence medication adherence and self-care among low-income older adults with hypertension. Methods: A sample of 297 low-income older adults with hypertension was recruited from June 30 to July 30, 2010. Data collection was done using a face-to-face interview with structured questions. The data were analyzed using descriptive statistics, Pearson's correlation coefficient, and path analysis. Results: Subjective health status, duration of hypertension, number of drugs excluding antihypertensives, body mass index, knowledge about hypertension, sense of coherence, benefit, barrier, and self-efficacy were identified as significant predictors. Subjective health status and duration of hypertension, knowledge, depression, and self-care showed direct effects on medication adherence. Depression had the strongest direct influence on medication adherence. Body mass index, benefit, self-efficacy, and depression showed a direct effect on self-care. Sense of coherence was a strong predictor of depression which significantly influenced on medication adherence and self-care. Conclusion: For enhancing medication adherence and self-care, it is suggested that a psycho-education program reducing depression and increasing knowledge about hypertension should be provided into low-income older adults with hypertension.

• Journal of Korean Critical Care Nursing
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• v.2 no.1
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• pp.48-57
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• 2009

Purpose: The purpose of this study is to establish reliability and validity and to identify the conversion index. Method: The WMSCN for ICU was revised from Workload Management System for Nurses(WMSN) of Walter Reed Army Hospital. Reliability of the WMSCN was evaluated interrater reliability between head nurses and staff nurses at 124 patients in April 2008. Validity through the correlation between direct nursing care hours and WMSCN score was conducted at 20 ICUs of 10 hospitals. Finally the conversion index was identified by total nursing hours and it divided by WMSCN score. Results: The scores by nurses were highly correlated with head nurses’(p=.967), and also scores of the WMSCN were highly correlated with the direct nursing care hours(p<.001). The distribution of patient classification ranks into class V(61.3%), class IV(24.2%) and class VI(11.3%). The scores of the WMSCN were no differences between MICU and SICU. Finally, the conversion index was 8.2 minutes. Conclusion: WMSCN is available to classify the nursing workload for critical care patients. The repeated evaluation of validity and reliability are requisite to use WMSCN effectively. And the conversion index should be adjusted to estimate the appropriate staffing in Korea.

• The Korean Nurse
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• v.32 no.5
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• pp.66-77
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• 1994

The purpose of this study was to develop a new nursing unit which can meet changing health care needs, enhance patients' satisfaction and nurses' job satisfaction, and finally guarantee quality nursing care with present manpower. For this, one medical unit was selected as a unit for quality care. And one medical unit which is similar in staffing and patients' characteristics was selected as a control unit. To assess present problems and identify the remedies to the problems a hospital-wide survey and a workshop were performed. According to the survey results, educational programs and improvement of the facilities and equipment supply system, managereal support for interdepartmental cooperation and intensification of bed-side nursing care were adopted as main principles for operating model unit, This model unit was operated for 3 months from Sep. 1, 1992 to Nov. 30, 1992. To evaluate the effectiveness of the model unit, derect/indirect nursing care hours, patients' satisfaction to nursing care, nurses' job satisfaction, and quality care index were measured. Direct/indirect nursing care hours were compared with that of the control unit, and patients' and nurses' satisfaction and quality care index were measured before and after operating model unit and compared with each other. The results of the study were as follows; 1. In the model unit mean direct nursing care hours per cach shift was 146.88 minutes and indirect nursing care hours was 354.72 minutes. The ratio of the direct nursing care hour to indirect nursing hour was 29.6 ; 70.4 and that of the control unit was 26.9 : 73.1. Direct nursing care hour in model unit was longer than that of the control unit. But, the difference was not significant. In subcategories of direct nursing care, the time spent in mobility and exercise, conservation of body temperature, hygiene, and communication and health education were longer than that of the con" trol unit. 2. Indirect nursing care hour in model unit was shorter than that of the control unit. But, the difference was not significant. In subcategories of indirect nursing care, the time spent in drug management and ward arrangement was shorter than that of the control unit. 3. Patients' satisfaction to nursing care was increased significantly after operating the model unit (T=-3.48, P=-0.002) and satisfaction to subcategories of physical comfort measure, psychological cate, and unit management components were significantly higher than before. 4. In the model unit, nurses' total job satisfaction was increased significantly after operating the model unit(Z=2.1004, P=.0357) and satisfaction to subcategory of satisfaction to administration was significantly higher than before (Z=-2.0732, P=.0382). 5. After operating the model unit, quality care index was increased from 89 to 93. With this results, it can be summarized that all the measures tried for quality care, such as educational programs, managereal support for interdepartmental cooperation, and improvement of the equipment and facility provision resulted in partial increase in direct nursing care hours, nurses satisfaction to their job and patients' satisfaction to nursing care. In can be postulated that managereal support and motivation without proper staff supplementation is not enough for increasing direct nursing care hours. And for the enhancement of the level in clinical nursing, and staff supplement must be considered sincerely and the measures for reducing indirect nursing care hours, such as computerization of nursing care activities, improvement of facilities and equipment and facilities supply system, must be instituted in addition.

• Journal of muscle and joint health
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• v.3 no.1
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• pp.4-22
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• 1996

Purposes of this study were to identify a hospital-based home care model and to improve the physical, emotional and economical effectiveness of arthritic patients through medical and nursing team approach. The design in nonequivalent control group pretest-posttest design with matched samples in terms of age, sex and disease severity. Fifty two patients in each group were assigned in Seoul, Kyunggi, Kangwon and Kwangju. Before and after 6-month period of home care, level of pain, duration of morning stiffness, Richie Index, ADL, self efficacy, depression, cost expenditure were measured. Nine patients were excluded from the control group in the period of study because of denial of participation. Contents of home care provided to the experimental group include mainly distribution of prescribed drugs, 'assessment of patients' condition and side-reactions of drug. All of the information related to the home care patient were reported to the physician. On the bases of these data, the physician prescribe the specific drugs to each patient. Each patient visited the physician every 2 or 3 month for laboratory test. Patients assigned to the control group visited the outpatient clinic once a month as usual. Null hypotheses were selected because physicians concerned about the ineffective change of patients' conditions due to indirect communication with patients through nurses. Level of pain, Richie index, ADL, self-efficacy, depression, duration of morning stiffness and direct medical cost were the home care provided to them. If a family member accompany in a home care group can save 10,676 Won/month in Seoul, 34,000 Won/month in other districts. Other in-direct cost for transportation and meal can also be saved. In conclusion, those patients with low level of ADL, high level of pain and Richie index, living in the remote area definitely need the home care.

• Journal of Korean society of Dental Hygiene
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• v.18 no.5
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• pp.853-862
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• 2018

Objectives: This study involved a non-equivalent control group, pre-test/post-test measurement experiment to evaluate the efficacy of distributing plaque disclosing agents to healthy adults living in South Korea and promoting its self-application. Methods: O'Leary index, PHP index, oral health behavior intention, and oral care satisfaction were used as research tools. A notice was posted on the bulletin board from September 12 to October 15, 2016, to recruit adults aged 20-50 years. Data were analyzed using SPSS Version 22.0, and frequency analysis, Pearson's chi-squared, one-way analysis of variance (ANOVA), Kruskal-Wallis, and repeated measures ANOVA were performed. Results: The O'Leary index was significantly reduced in the group (p<0.01), and time (p<0.01) after education and width of the decrease had the highest score in the group that received education on plaque disclosing only. They were followed by the group that received education on plaque disclosing and the rolling method, the group that received education on the rolling method alone, and the control group. The PHP index significantly decreased in the group(p<0.01) and time (p<0.01), and the group time (p=0.039) after education, and width of the decrease had the highest score in the group that received education on plaque disclosing and rolling method. They were followed by the group that received education on plaque disclosing alone, the group that received education on the rolling method alone, and the control group. Conclusions: Based on the aforementioned findings, the direct use of plaque disclosing had a marked effect on self-oral care. These results suggest that the self-application of plaque disclosing could be an effective self-care method for improving the oral environment.

• Journal of Korean Academy of Nursing
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• v.45 no.6
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• pp.919-927
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• 2015

Purpose: Effective transitional care is needed to improve the quality of life in older adult patients with chronic illness and avoid discontinuity of care and adverse events. The aim of this article is to provide an overview of the key features, broader implications, and the utility of Meleis' transition theory intended for the transitional care of older adults with chronic illnesses. We present the role of nurse in the context of transitional care and propose future directions to increase the quality of nursing care. Methods: The online databases Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Science Direct were searched for relevant literature published since 1970 along with textbooks regarding nursing theory. Results: An evaluation of the usefulness of transition theory based on transitional care in older adult patients with chronic illnesses is provided. Healthy transition should be the expected standard of nursing care for older adults across all healthcare settings. Conclusion: Nurses need to contribute to the development of transitional care for vulnerable populations; however, transition theory needs to be enhanced through additional theoretical work and repeated evaluations of the applicability in areas of transitional care.

• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.476-490
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• 1992

This study was designed to develop and test a structural model for maternal adaptation and family stress in families with mentally handicapped children. A hypothetical model was constructed on the basis of the family stress theory developed by McCubbin etc. The model included 6 theoretical concepts and 11 paths. For the purpose of the model testing, empirical data were collected from May to August, 1992. The subjects of the study constituted 190 mothers of children in five special schools and one private institute in Seoul and Choong Nam. An SPSS PC＋ and PC－LISREL 7.13 computer programs were used for descriptive and covariance structure analysis. The results of the study were as follows. (1) The hypothetical model showed itself a good fit to the empirical data ［Chi - square＝18.35(df＝7, P＝0.005), Goodness of Fit Index＝0.991, Adjusted Goodness of Fit Index＝0.959, Root Mean Square Residual＝0.042), Non Normed Fit Index＝0.90, Normed Fit Index＝0.96］. (2) The results of Hypothesis testing indicated : 1) Social support(${\gamma}$$_{11}$＝.238, T＝2.352), Family functioning(${\gamma}$$_{12}$＝.729, T＝5.957) and Family life event stress(${\gamma}$$_{13}$＝.125) had direct effects on situational definition. 2) Life event stress(${\gamma}$$_{23}$＝.319, T＝3.872) had direct effects on the effect of the handicapped child on the family. Family functioning(${\gamma}$$_{22}$＝-.245) and situational definition($\beta$$_{21}$＝-.335, T＝3.227) had direct effects on the effect of the handicapped child on the family. 3) Situational definition($\beta$$_{31}$＝-.273, T＝3.493), family life event stress (${\gamma}$$_{33}$＝.124, T＝2.169) and the effect of the handicapped child on the family($\beta$$_{32}$＝.264, T＝-3.227) showed the direct effect on the maternal adaptation. The model was supported by the empirical data. Thus it was suggested that the model could be applied to family nursing care with the families with the mentally handicapped. The construction and testing of the comprehensive model seem to be the first trial in Korea.a.a.a.

• Journal of information and communication convergence engineering
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• v.7 no.3
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• pp.275-280
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• 2009

While database(DB) and information retrieval(IR) have been developed independently, there have been emerging requirements that both data management and efficient text retrieval should be supported simultaneously in an information system such as health care, customer support, XML data management, and digital libraries. The great divide between DB and IR has caused different manners in index maintenance for newly arriving documents. While DB has extended its SQL layer to cope with text fields due to lack of intact mechanism to build IR-like index, IR usually treats a block of new documents as a logical unit of index maintenance since it has no concept of integrity constraint. However, In the DB-IR integrations, a transaction on adding or updating a document should include maintenance of the posting lists accompanied by the document. Although DB-IR integration has been budded in the research filed, the issue will remain difficult and rewarding areas for a while. One of the primary reasons is lack of efficient online transactional index maintenance. In this paper, performance of a few strategies for per-document basis transactional index maintenance - direct index update, pulsing auxiliary index and posting segmentation index - will be evaluated. The result shows that the pulsing auxiliary strategy and posting segmentation indexing scheme, can be a challenging candidates for text field indexing in DB-IR integration.

• Tuberculosis and Respiratory Diseases
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• v.84 no.2
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• pp.96-104
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• 2021

Background: Many chronic obstructive pulmonary disease (COPD) patients receiving monotherapy continue to experience symptoms, exacerbations and poor quality of life. This study aimed to assess the efficacy and safety of direct switch from once-daily tiotropium (TIO) 18 ㎍ to indacaterol/glycopyrronium (IND/GLY) 110/50 ㎍ once daily in COPD patients in Korea. Methods: This was a randomized, open-label, parallel group, 12-week trial in mild-to-moderate COPD patients who received TIO 18 ㎍ once daily for ≥12 weeks prior to study initiation. Patients aged ≥40 years, with predicted post-bronchodilator forced expiratory volume in 1 second (FEV₁) ≥50%, post-bronchodilator FEV₁/forced vital capacity <0.7 and smoking history of ≥10 pack-years were included. Eligible patients were randomized in a 1:1 ratio to either IND/GLY or TIO. The primary objective was to demonstrate superiority of IND/GLY over TIO in pre-dose trough FEV₁ at week 12. Secondary endpoints included transition dyspnea index (TDI) focal score, COPD assessment test (CAT) total score, and rescue medication use following the 12-week treatment, and safety assessment. Results: Of the 442 patients screened, 379 were randomized and 347 completed the study. IND/GLY demonstrated superiority in pre-dose trough FEV₁ versus TIO at week 12 (least squares mean treatment difference [Δ], 50 mL; p=0.013). Also, numerical improvements were observed with IND/GLY in the TDI focal score (Δ, 0.31), CAT total score (Δ, -0.81), and rescue medication use (Δ, -0.09 puffs/day). Both treatments were well tolerated by patients. Conclusion: A direct switch from TIO to IND/GLY provided improvements in lung function and other patient-reported outcomes with an acceptable safety profile in patients with mild-to-moderate airflow limitation.

• Journal of Korean Academy of Nursing
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• v.33 no.1
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• pp.122-129
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• 2003

Purpose: The purpose of this study is to examine the difference of direct nursing activity and patient outcomes as mortality rate, complication rate, readmission rate and length of stay related to graded fee of nursing management for inpatient. Method: The subjects of this study were 44 general hospitals with more than 500 beds. Data totaled to 86,044 claims provided to inpatients in Jan. 2001 requested by an electronic data interchange from a Health Insurance Review Agency. The data was analyzed by SPSS win(ver.10.0) and statistical methods used were frequency, one-way ANOVA, $X^2$-Test and regression. Result: Synthetic judgment through performance index and 95% confidence interval, direct nursing activity showed to provided adequate quality of nursing care on 2nd, 3rd, 4th and 6th nursing degree. Also, patient outcomes showed difference by graded fee of nursing management for inpatient. Mortality rate of 2nd was the lowest with P.I. 67.9, 3rd, 5th, 6th, 4th in order. In case of complication rate, 2nd, 3rd and 4th were lower than other nursing degree. Readmission rate of 4th and 5th was the lowest. Length of stay of 2nd was the shortest with P.I. 88.3, 3rd, 4th, 5th, 4th, 6th in order. Conclusion: The findings from this study showed that, the higher nurse-to-patient ratio, the greater amount of direct nursing care activity for the patient. Also, the more direct nursing activities influenced a lower mortality rate, complication rate and readmission rate, shorter length of stay.