• Title/Summary/Keyword: Intervention Strategies

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The Influences of Self-Leadership, Role Conflict, Nursing Work Environment on Nursing Service Quality in Comprehensive Nursing Care Service Wards (간호·간병통합서비스병동 간호사의 셀프리더십, 역할갈등, 간호근무환경이 간호서비스 질에 미치는 영향)

  • Kim, Mi Sun;Shin, Sung Hee;Seo, Eunju
    • Journal of East-West Nursing Research
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    • v.27 no.1
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    • pp.22-31
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    • 2021
  • Purpose: This study aims to examine the relationships between the self-leadership, role conflict, nursing work environment, and quality of nursing service in comprehensive nursing care service wards and identify the factors that affect the quality of nursing service. Methods: The data were collected from 158 nurses working in comprehensive nursing care service wards from three general hospitals with 200 beds or more in Seoul, Korea. The data were analyzed by descriptive statistics, t-test, ANOVA, scheffe test, Pearson's correlation coefficient, and multiple linear regression analysis of enter method using SPSS/WIN ver 22.0 program. Results: The factors of quality of nursing services were self-leadership (β=.44, p<.001), nursing work environment (β=.17, p=.014), and the work experience in comprehensive nursing care service wards (β=-.15, p=.035) explaining 32% of the total variance. Conclusions: The results indicated that self-leadership, work experience in the comprehensive nursing care service wards, and nursing work environment affect the quality of nursing services of nurses in the comprehensive nursing care service wards. It is necessary to make efforts for seeking various intervention strategies and improving nursing work environment.

Effects of pain neuroscience education on kinesiophobia in patients with chronic pain: a systematic review and meta-analysis

  • Kim, Hyunjoong;Lee, Seungwon
    • Physical Therapy Rehabilitation Science
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    • v.9 no.4
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    • pp.309-317
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    • 2020
  • Objective: One of the treatment strategies for controlling chronic pain and preventing disability is patient education. Pain neuroscience education (PNE) has been proven to be effective in explaining the biological and physiological processes associated with pain experiences to patients. The purpose of this review is to investigate the effectiveness of PNE for kinesiophobia such as avoidance response in patients with chronic pain. Design: A systematic review and meta-analysis. Methods: MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of controlled trials databases were searched through November 2020 and included a randomized controlled trials evaluating kinesiophobia in musculoskeletal patients with chronic pain. In 8 randomized controlled trial studies, 'Cochrane's risk of bias (RoB) tool was used for qualitative analysis, and results of post-intervention were analyzed through RevMan 5.4 for quantitative analysis. Results: For this review, 8 randomized controlled trials of 369 patients with chronic pain were selected for PNE. A systematic review and meta-analysis also included 8 randomized controlled trials. The effect on kinesiophobia was more effective than the control group (-0.86; 95% confidence interval [CI], -1.22 to -0.51; heterogeneity [χ2=21.18, df=7, I2=67%]; overall effect [Z=4.80]). In addition, the effect on pain was more effective than the control group (-0.53; 95% CI, -1.05 to -0.01; heterogeneity [χ2=47.42, df=7, I2=85%]; overall effect [Z=2.01]). Conclusions: The results of this review suggest that PNE and combined PNE have a positive effect on the improvement of pain and kinesiophobia in patients with chronic pain.

Structural Equation Modeling for Quality of Life of Mothers of Children with Developmental Disabilities: Focusing on the Self-Help Model (발달장애아 어머니 삶의 질 구조모형: Self-Help Model을 중심으로)

  • Yang, Mi Ran;Yu, Mi
    • Journal of Korean Academy of Nursing
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    • v.52 no.3
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    • pp.308-323
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    • 2022
  • Purpose: This study aimed to construct and test a predictive model for the quality of life (QOL) in mothers of children with developmental disabilities (DB). The hypothesized model included severity of illness, distress, uncertainty, self-help, and parenting efficacy as influencing factors, QOL as a consequence based on the Braden's Self-Help Model. Methods: The data were collected through a direct and online surveys from 206 mothers in 8 locations, including welfare or daycare centers, developmental treatment centers, and The Parents' Coalition for the Disabled located in two provinces of Korea. Data were analysed using SPSS/WIN 23.0 and AMOS 21.0 program. Results: The fit indices of the predictive model satisfied recommended levels; 𝛘2 = 165.79 (p < .001), normed 𝛘2 (𝛘2/df) = 2.44, RMR = .04, RMSEA = .08, GFI = .90, AGFI = .85, NFI = .91, TLI = .93, CFI = .95. Among the variables, distress (β = - .46, p < .001), parenting efficacy (β = .22, p < .001), and self-help (β = .17, p = .018) had direct effects on QOL. Severity of illness (β = - .61, p = .010) and uncertainty (β = - .08, p = .014) showed indirect effects. The explanatory power of variables was 61.0%. Conclusion: The study results confirm the utility of Braden's Self-Help Model. They provide a theoretical basis for improving QOL in mothers of children with DB. Nursing intervention strategies that can relieve mothers' distress and uncertainty related to disease and enhance parenting efficacy and self-help behavior should be considered.

Factors Influencing the Mental Health of Female Middle School Students Living in Rural Area After COVID-19 Quarantine Lifts (COVID-19 격리 해제 이후 농촌 여중생의 정신건강 영향요인)

  • Han, Sukhee;Gang, Moonhee
    • Journal of Industrial Convergence
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    • v.20 no.10
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    • pp.71-77
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    • 2022
  • The purpose of this study was to identify factors affecting the mental health of female middle school students living in rural areas. The study period was from March 14 to 25, 2022, and was conducted with 239 female middle school students attending three middle schools located in G district. The collected data were analyzed using descriptive statistics, t-test, Pearson's correlation, and multiple regression. As a result of the study, significant influencing factors on the subject's mental health were living with both parents (β=.12, t=2.50, p =.013), past subjective mental health status (β=.15, t=2.83, p=.005), subjective physical health status (β=-.21, t=-3.94, p<.001), loneliness (β=.22, t=4.23, p<.001), and severity of insomnia (β=.36, t=6.55, p<.001), and these variables showed 46% explanatory power for mental health. Through this study, further research is needed to specify the causal relationship between living with both parents, past mental health status, physical health status, loneliness, and severity of insomnia and intervention strategies for the mental health of female middle school students considering these variables.

Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review

  • Jain, Preyal D.;Nayak, Akshatha;Karnad, Shreekanth D.;Doctor, Kaiorisa N.
    • Clinical and Experimental Pediatrics
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    • v.65 no.3
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    • pp.142-149
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    • 2022
  • Background: Individuals with Down syndrome present with several impairments such as hypotonia, ligament laxity, decreased muscle strength, insufficient muscular cocontraction, inadequate postural control, and disturbed proprioception. These factors are responsible for the developmental challenges faced by children with Down syndrome. These individuals also present with balance dysfunctions. Purpose: This systematic review aims to describe the motor dysfunction and balance impairments in children and adolescents with Down syndrome. Methods: We searched the Scopus, ScienceDirect, MEDLINE, Wiley, and EBSCO databases for observational studies evaluating the motor abilities and balance performance in individuals with Down syndrome. The review was registered on PROSPERO. Results: A total of 1,096 articles were retrieved; after careful screening and scrutinizing against the inclusion and exclusion criteria, 10 articles were included in the review. Overall, the children and adolescents with Down syndrome showed delays and dysfunction in performing various activities such as sitting, pulling to stand, standing, and walking. They also presented with compensatory mechanisms to maintain their equilibrium in static and dynamic activities. Conclusion: The motor development of children with Down syndrome is significantly delayed due to structural differences in the brain. These individuals have inefficient compensatory strategies like increasing step width, increasing frequency of mediolateral center of pressure displacement, decreasing anteroposterior displacement, increasing trunk stiffness, and increasing posterior trunk displacement to maintain equilibrium. Down syndrome presents with interindividual variations; therefore, a thorough evaluation is required before a structured intervention is developed to improve motor and balance dysfunction.

Factors influencing the health-related quality of life of postmenopausal women with diabetes and osteoporosis: a secondary analysis of the Seventh Korea National Health and Nutrition Examination Survey (2016-2018) (골다공증이 있는 폐경 후 당뇨 여성의 건강관련 삶의 질 영향요인: 제7기 국민건강영양조사 자료(2016-2018년) 활용)

  • Kim, Hyuk Joon;Kim, Hye Young
    • Women's Health Nursing
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    • v.28 no.2
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    • pp.112-122
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    • 2022
  • Purpose: The prevalence of osteoporosis in postmenopausal women is increasing, and diabetes patients have decreased bone density. Their health-related quality of life (HRQoL) is diminished by the resultant physical dysfunction and depression. The purpose of this study was to identify factors influencing HRQoL in postmenopausal women with diabetes and osteoporosis. Methods: This was a secondary data analysis of the Seventh Korea Health and Nutrition Examination Survey (2016-2018), which utilized a complex, multistage probability sample design. The participants in the study were 237 women with diabetes and osteoporosis. To evaluate the factors that influenced HRQoL, a complex-samples general linear model was constructed, and the Bonferroni correction was performed. Results: In this sample of women aged 45 to 80 years (mean±standard deviation, 71.12±7.21 years), the average HRQoL score was 0.83±0.18 out of 1.0. Factors influencing HRQoL were age (70s: t=-3.74, p<.001; 80s: t=-3.42, p=.001), walking for exercise more than 5 days a week (t=-2.83, p=.005), cerebrovascular disease (t=-8.33, p<.001), osteoarthritis (t=-2.04, p=.014), hypertension (t=2.03, p=.044), higher perceived stress (t=-2.17, p=.032), poor glycemic control (t=3.40, p=.001), waist circumference (t=-2.76, p=.007), sitting time per day (t=-2.10, p=.038), and a longer postmenopausal period (t=3.09, p=.002). Conclusion: In order to improve the HRQoL of postmenopausal women with osteoporosis and diabetes, it is necessary to implement intervention strategies that enable the effective management of chronic diseases, while preventing the complications of diabetes and minimizing stress through physical activity.

Development and Psychometric Evaluation of the Ischemic Stroke Distress Scale (ISDS) (허혈성 뇌졸중 환자의 디스트레스 측정도구 개발 및 평가)

  • Kang, Jaejin;Yoo, Yang-Sook
    • Journal of Korean Academy of Nursing
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    • v.53 no.1
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    • pp.12-27
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    • 2023
  • Purpose: This study aimed to develop a scale to measure distress in patients with ischemic stroke and verify its validity and reliability. Methods: Preliminary items were developed from literature review and in-depth interviews. The final preliminary scale was confirmed through a content validity test of eight experts and a preliminary survey of 10 stroke patients. The participants for psychometric testing were 305 stroke patients in the outpatient clinic. Validity and reliability analyses included item analysis, exploratory and confirmatory factor analysis, convergent validity, known-group validity, and internal consistency of the scale. Results: The final scale consisted of 17 items and 3 factors. The three distinct factors were 'self-deprecation, worry about future health, and withdrawal from society' and this structure was validated using a confirmatory factor analysis. Convergent validity was supported by comparison with the Center for Epidemiologic Studies Depression Scale (r = .54, p < .001) and Brief Illness Perception Questionnaire (r = .67, p < .001). Known-groups validity was verified by dividing groups according to 'duration since diagnosis' (t = 2.65, p = .009), 'presence of sequela' (t = 10.16, p < .001), and 'awareness of distress' (t = 12.09, p < .001). The internal consistency of the scale using Cronbach's α for the total items was .93. Conclusion: The Ischemic Stroke Distress Scale is a valid and reliable tool that reflects stroke distress effectively. It is expected to be used as a basic tool to develop various intervention strategies to reduce distress in ischemic stroke patients.

Factors Affecting Readmission After Discharge in Stroke Patients: A Retrospective Study (뇌졸중 환자의 퇴원 후 재입원에 영향을 미치는 요인: 후향적 연구)

  • Kang, Ae Jeong;Lee, Song Hee;Kim, Rock Beum;Jeon, Mi Yang
    • Journal of Korean Biological Nursing Science
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    • v.24 no.4
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    • pp.262-271
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    • 2022
  • Purpose: The purpose of this study was to identify the factors affecting readmission in stroke patients. Methods: A retrospective study design was used. Participants were 3,675 adult cerebral stroke patients in the inpatient wards of the Department of Neurology and Neurosurgery of G University Hospital located in C city. Data were collected from January 1, 2016 to December 31, 2021 and data were analyzed using χ2 test, independent t-test, and multivariate logistic regression with SPSS/WIN 24.0. Results: After discharge for stroke, the readmission rate was 23.7%, and the mortality rate was 0.3%. The variables with significant differences between the readmission group and non-readmission group were age, type of stroke, surgery, ICU treatment, mRS score, blood pressure, diabetes, and heart disease. Factors influencing an readmission in stroke patients were Age 65-74 (OR 1.30, 95% CI=1.03-1.64), ≥ 75 (OR 1.28, 95% CI=1.02-1.62), mRS score 2points (OR 2.50, 95% CI=1.99-3.13), HTN status (OR 1.26, 95% CI=1.07-1.50), CVD status (OR 1.38, 95% CI=1.01-1.90), TC (OR 1.60, 95% CI=1.05-2.44). Conclusion: To lower the readmission rate of stroke patients, it is essential to control lifestyle, including whether or not to take treatment drugs, after diagnosing risk factors such as high blood pressure, diabetes, and heart disease, hyperlipidemia. Nursing interventions that can provide information on risk factor management and coping strategies are urgently needed as symptoms change. In addition, research is needed to develop and implement an intervention strategy that can improve the function of stroke patients as much as possible at home or in society so that they can lead an independent life without the help of others, and verify their effectiveness.

Personalized Diabetes Risk Assessment Through Multifaceted Analysis (PD- RAMA): A Novel Machine Learning Approach to Early Detection and Management of Type 2 Diabetes

  • Gharbi Alshammari
    • International Journal of Computer Science & Network Security
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    • v.23 no.8
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    • pp.17-25
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    • 2023
  • The alarming global prevalence of Type 2 Diabetes Mellitus (T2DM) has catalyzed an urgent need for robust, early diagnostic methodologies. This study unveils a pioneering approach to predicting T2DM, employing the Extreme Gradient Boosting (XGBoost) algorithm, renowned for its predictive accuracy and computational efficiency. The investigation harnesses a meticulously curated dataset of 4303 samples, extracted from a comprehensive Chinese research study, scrupulously aligned with the World Health Organization's indicators and standards. The dataset encapsulates a multifaceted spectrum of clinical, demographic, and lifestyle attributes. Through an intricate process of hyperparameter optimization, the XGBoost model exhibited an unparalleled best score, elucidating a distinctive combination of parameters such as a learning rate of 0.1, max depth of 3, 150 estimators, and specific colsample strategies. The model's validation accuracy of 0.957, coupled with a sensitivity of 0.9898 and specificity of 0.8897, underlines its robustness in classifying T2DM. A detailed analysis of the confusion matrix further substantiated the model's diagnostic prowess, with an F1-score of 0.9308, illustrating its balanced performance in true positive and negative classifications. The precision and recall metrics provided nuanced insights into the model's ability to minimize false predictions, thereby enhancing its clinical applicability. The research findings not only underline the remarkable efficacy of XGBoost in T2DM prediction but also contribute to the burgeoning field of machine learning applications in personalized healthcare. By elucidating a novel paradigm that accentuates the synergistic integration of multifaceted clinical parameters, this study fosters a promising avenue for precise early detection, risk stratification, and patient-centric intervention in diabetes care. The research serves as a beacon, inspiring further exploration and innovation in leveraging advanced analytical techniques for transformative impacts on predictive diagnostics and chronic disease management.

Hazardous Alcohol Consumption and the Risk of Hearing Impairment in Adults Based on the Korean National Health and Nutrition Survey: A Retrospective Study

  • Park, Jin-A;Suh, Michelle J.
    • Journal of Audiology & Otology
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    • v.23 no.2
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    • pp.63-68
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    • 2019
  • Background and Objectives: To investigate the relationship between hearing impairment and alcohol drinking patterns in South Korean adults. Subjects and Methods: Data collection was performed by Korean National Health and Nutrition Survey from January 1 to December 31, 2012. Data analyses were performed from February 20 to March 3, 2018. Data from 3,860 adults 20 years of age or older without a history of malignancy or chronic otitis media in the Korean National Health and Nutrition Survey 2012 database who participated in the health questionnaires, and who had available results from otologic examinations that included pure tone audiogram, were included. Pure-tone average hearing thresholds were calculated at 500, 1,000, 2,000, and 4,000 Hz. Hearing loss was defined as a pure-tone average >40 dB in one or both ears. The Alcohol Use Disorder Identification Test was used to evaluate drinking statuses of subjects. Data were analyzed using the complex-sample χ2-test of independence and a complex-sample logistic regression analysis. Results: Of the 29,954,319 individuals in the weighted cross-sectional study population, 15,106,040 (50.4%) were men and 14,848,098 (49.6%) were women. A total of 8.1% of men and 7% of women had hearing impairment. The degrees of drinking with appropriate, risky, and hazardous drinking habits were 58.2, 32.1, and 9.7% among men; and 76.4, 12.5, and 11.1% among women, respectively. Among men, the odds ratio of hearing loss increased by 2.506 times when comparing hazardous and appropriate drinking (confidence interval, 1.083 to 5.800, p=0.002). Moderate alcohol consumption (≤2 drinks per day) was not protective for hearing in either group. Conclusions: As hazardous drinking tends to coexist with hearing impairment in men, appropriate prevention and intervention strategies should be emphasized. A longitudinal study to investigate harmful drinking and the mechanism of hearing loss should be performed.