Purpose: The aim of this study was to evaluate the level of self-care adherence in the elderly with diabetes mellitus (DM) who have lived alone, and to investigate the association between health literacy, diabetic knowledge and self-care adherence. Methods: Descriptive research using the cross-sectional approach was conducted. Data was collected by using a convenience sampling of 201 participants who aged sixty-five years old or more and have lived alone. Statistical analysis was conducted by using an independent t-test, one-way ANOVA, $Scheff{\acute{e}}$ test, Pearson correlation coefficient and stepwise multiple regression analysis. Results: Mean scores of health literacy, diabetic knowledge and adherence of self-care were $4.41{\pm}3.54$ points out of a possible $12, 6.22{\pm}2.55$ points out of a possible $15, 58.56{\pm}17.28$ points out of a possible 112, respectively. Adherence of self-care showed a statistical association with health literacy (r=.26, p<.001) and diabetic knowledge (r=.30, p<.001). Statistically significant factors in the regression model were monthly income, diabetic knowledge and exercise. Conclusion: The level of self-care adherence in the elderly with diabetes living alone was relatively low. Diabetic knowledge was an important factor to improve the level of self-care adherence for the elderly with diabetes living alone.
Purpose: The purpose of this study was to develop and validate health care providers' counseling manual in mobile application for lifelong health care among patients with chronic hepatitis B. Methods: The mobile application was developed using a prototyping approach and system developing life cycle method, evaluated by users for their satisfaction with the counseling manual and experts for the quality of the manual. To evaluate application of the counseling manual, knowledge and counselor self-efficacy of the subjects were measured and compared before and after application of the counseling manual. Results: There were statistically significant increases in knowledge and counselor self-efficacy in the user group. A mobile application with high accessibility and applicability including information and counseling factors can promote counseling competence of the nurse as health care provider caring chronic hepatitis B patients. Conclusion: The results of this study indicate that the counseling manual in mobile application is effective in increasing knowledge and counselor self-efficacy among nurses to promote lifelong health care among patients with chronic hepatitis B. Therefore, it can be usefully utilized in the field of nursing for patients with chronic hepatitis B as a nursing intervention.
The purpose of this study was to figure out a direction for midwifes' expanded roles for integrative woman's health care focused on health promotion & maintenance and primary prevention of women's health disorders including family health in the new millenium as a primary women's health practitioner. Data sources used for analysis were the book published from International Confederation of Midwives including role, code, situation and others from the international aspects : the empirical data from direct contact by participation in the ICM held in Manila, Philipine, May 22-26, 1999 : and documentation of Korean Midwives Association. Historical and current changing perspectives toward woman's health & nurse-midwifery and the reality women's health & nurse-midwifery and the reality of expand role that should be acquired toward the new millenium are discussed. In conclusion, Nurse-midwives are the very primary women's health care providers who can provide not only the exact needs of women who have health related problems, which are developed in the unique socio-cultural context women are belonged to, but also reproductive affairs including labor and delivery as it was midwive's traditional role, not just as practitioner, educator, counselor but conscious raiser for women's right. Futhermore, for this, thorough preparation through various kind of active and contemplated approach such as remodeling roles and education and continuing education system, training for high skilled & technical action, making laws and policy, and others is absolutely required.
Purpose: This study was to investigate the relationships between among health literacy, knowledge and self-care behavior in elderly patients with heart failure(HF). Methods: 166 patients (age ${\geq}65$ years) with HF were recruited in a cardiovascular center of an university affiliated hospital. The structured questionnaire included Health literacy, Dutch Heart Failure Knowledge Scale, European Heart Failure Self-care Behavior, Self-Care of Heart Failure Index. Data were analyzed by descriptive statistics, Chi-test, Pearson correlation analysis, t-test and ANCOVA using SPSS/WIN version 21.0. Results: Participants with the high level of health literacy were more likely to be younger (p=.001), men (p=.001), with more education (p<.001), and have a job (p=.004), and with a higher economic status (p=.005). The positive correlations between the level of health literacy, knowledge, and self-care behavior were confirmed (p<.001). Participants with the high level of health literacy showed higher level of knowledge, more self-care behavior for health maintenance, and confidence. Conclusion: This study shows that the level of health literacy may influence knowledge and self-care behavior in elderly patients with HF. In order to improve self-care behaviors in elderly patients, a strategic nursing approach based on the level of patients' health literacy needs to be considered.
Purpose: The purpose of this study was to investigate the effects of simulation in nursing education based on caring for elderly cognition disorder patients. The education consisted of a caring program for patients that included a process of assessment of a patient's mental status, diagnosis of the patient's health condition, and intervention to address the problems by using therapeutic communication. Methods: A nonequivalent control group pretest-posttest design was used. A total of 69 subjects (undergraduate students) participated in the education and they were assigned to two groups: the experimental group (n=32) and the control group (n=37). Data-gathering structured questionnaires that included communication competence, academic self-efficacy, and attitudes about the elderly. The data were collected from October 2013 to December 2013, and statistical analyses were conducted with-test and t-test using the SPSS 21.0 program. Results: With respect to education, there was significant improvement in communication competence in the experiment group (t=2.41, p=.022) compared with in the control group (t=.69, p=.494). However, there was no statistically significant difference in academic self-efficacy and attitude about the elderly. Conclusion: Simulation-based education should continue to be developed further for better elderly-patient care. Integrated education in particular using a high-fidelity simulator will contribute to improvements in nursing competence in this area.
Purpose: This study was conducted to examine the effectiveness of a self-management program on patients with thyroid cancer, particularly during the time of waiting for surgery after cancer diagnosis. Psychological distress, biological responses of immune cell counts, and quality of life were the variables of this study. Methods: One group pre-post test design was used with the nature of a pilot study. Ten newly diagnosed thyroid cancer patients were recruited through physicians' referrals. After drop out of 4 participants, final data were collected from six participants. Small group technique, a one and half hour-session per week for one month (total 4 sessions, 6 hours) was used. Relaxation techniques, meditation training, and strategies to reduce distress were provided by researchers. Standardized questionnaires and an established bio-assay were used for collection of data. Results: Participants showed significant lowering of psychological distress (p<.05) and improvement in global quality of life (p<.05). Biological responses of immune cell counts did not show statistical significance. Conclusion: The self-management program may reduce psychological distress and improve quality of life of patients with thyroid cancer between the time of diagnosis and surgery. The self-management program would be a valuable approach for patients with an unexpected cancer diagnosis to prepare for their disease experience in a community setting.
Purpose: The purpose of this study was to identify the predictors of clinical competence in new graduate nurses. Methods: The subjects of this study were 238 nurses at 13 general hospitals who have had less than 12 months of nursing experience. The data were collected by structured questionnaire from August 5 to August 31 of 2009 and analyzed by the SPSS Win 12.0 program. Results: The total mean score for clinical competence was $181.05{\pm}15.17$, critical thinking disposition was $94.65{\pm}8.12$, and practice environment was $41.00{\pm}5.55$. There were significant differences of clinical competence according to the GPA (t=-3.58, p<.001), the number of beds in the hospital (t=-3.22, p=.001), instruction by preceptor (t=-2.32, p=.021), and previous experience of clinical practice in the hospital (t=-2.21, p=.028). Additionally, critical thinking disposition and practice environment were positively correlated to clinical competence (r=.50, p<.001; r=.20, p=.002). In multivariate approach, predictors included in this study explained 43% of variance in clinical competence. Significant predictors of clinical competence were critical thinking disposition ($\beta=.50$, p<.001), practice environment ($\beta=.14$, p=.012), and working duration ($\beta=.13$, p=.018). Conclusions: Based on these findings, it is needed that providing supportive practice environment and developing curriculum for enhancing the critical thinking disposition to improve the clinical competence in new graduate nurses.
Purpose: This study was done to verify the reliability and validity of the Korean version of DMCI in Korean adolescents. Methods: A methodological study design was used with Cronbach's ${\alpha}$ for reliability, and an exploratory factor analysis and contrasted groups approach for construct validity. DMCI was translated into Korean and tested with a sample of 406 adolescents in Korea. The data were analyzed using Cronbach's ${\alpha}$, item correlation with total, principal component factor analysis, and t-test. Results: The translated content of the DMCI was validated by nursing faculty members and translation equivalency was obtained. The Cronbach's ${\alpha}$ of the DMCI simplified with 18 items was .78. The factor analysis revealed three factors explaining 41.5% of total variance and the corresponding factors were self-observation (21.6%), self-judgement (11.4%), and self-confidence (8.6%). The mean score for the DMCI in the aggression group was significantly lower than the non-aggression group. Conclusion: Results of this study suggest that the Korean version of DMCI can used as a reliable and valid measure to assess decision making competency in Korean adolescents.
Purpose: This study aimed to identify the effect of integrated nursing using cognicise and neurofeedback on cognition and α waves among elderly individuals. Methods: This quasi-experimental single group pretest-posttest study included 29 Korean adults aged 65 years or older who participated at a senior welfare center in Y city from February to May 2019. Each integrated nursing session consisted of cognicise (10 minutes) and neurofeedback (20 minutes). Subjects participated twice a week for 10 weeks. Structured questionnaires to assess participants' general characteristics and the Korean version of the Mini-Mental Status Examination for Dementia Screening (K-MMSE-DS) were applied. Alpha waves were measured using BrainMaster. Results: Following the integrated nursing program, alpha waves improved in F3 (t=2.41, p=.023), C3 (t=3.00, p=.006), C4 (t=2.60, p=.015), P3 (t=2.43, p=.022), O1 (t=2.30, p=.029), T3 (t=3.05, p=.005), T4 (t=2.28, p=.030), T5 (t=2.91, p=.007), Fz (t=2.30, p=.029), Cz (t=2.73, p=.011), and Pz (t=2.23, p=.034). Most subjects experienced improvement in concentration after participating in the intervention. Conclusion: This study provides evidence for the use of a neuroscientific approach including brain wave measurement to improve cognitive health among community-living elderly people.
Purpose: This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method. Methods: By searching through nine Korean and English databases, we compared 37 qualitative studies on caring experiences of family members of patients with dementia. The selected studies were synthesized through meta-synthesis, proposed by Sandelowski and Barroso (2007). Results: The meta-synthesis elicited four themes: tough life due to care for patients, changes in relationships, adaptation to caregiver's roles, and new perspectives of life through personal growth. Caregivers were shocked when a sudden diagnosis of dementia was made prior to any preparation on their part. They were tied to their patients all the time and their mind and body got exhausted. Their relationship with patients began to change and they looked at them differently. They experienced conflicts with the other non-caring family members and were alienated from them. They were also socially isolated. However, by building their own care strategies and utilizing social resources, they gradually adapted to their caregiver roles. Finally, they experienced personal growth and acquired a new perspective toward life by accepting their roles and finding meaning in their lives. Shifting the caregiver's centricity from themselves to the patient was the process of becoming human beings who actively constructed their realities while giving meaning to their painful lives and interacting with the environment. Conclusion: The results of the study can be useful for nurses in understanding the experiences of caregivers of the patients with dementia and in providing them with practical interventions.
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