Purpose: This study was done to identify Community Health Practitioner's (CHP's) perception of barriers to research utilization Method: Participants were 153 CHPs working in Chungbuk Province. Modified Barriers Scale was utilized in the research, and 4 sub-scales were nurse factor, organization factor, research factor and communication factor. Data was analyzed by using SPSS/WIN12.0. Results: Research factor showed the highest barrier score among four sub-scales, and nurse factor was the lowest. CHPs with membership in any nursing academic society showed lower scores on the four sub-scales. Those who had taken a course related to research were less likely to see the research factor or communication as barriers. Barriers to research utilization were not associated with work experience years or to demographics. Conclusion: It is highly recommended that CHPs be trained in research methods and evidence-based practice and that research articles be written more clearly.
Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.
Purpose: To examine the relationships between self-care, social support, and biological markers in liver transplant recipients. Methods: The participants included 118 liver transplant recipients who visited outpatient clinic at Y University Hospital in Seoul from April to May, 2013. Questionnaires consisted of self-care and social support scales. The biological markers were collected by reviewing electronic medical records. Data were analyzed with descriptive statistics, t-test, ANOVA with Scheff$\acute{e}$ post-hoc test, and Pearson's correlation. Results: The self-care score was significantly higher in a patient group within 6 months post-transplant when compared to a patient group post-transplant 3 to 5 years (F=3.10, p=.018). The self-care showed positive correlation with social support with statistical significance (r=.36, p<.001). Conclusion: As the self-care in liver transplant recipients had a positive correlation with social support from family and healthcare providers, the development of comprehensive long-term nursing intervention systems including counseling, education, and support in consideration of progress of time period after transplantation is necessary to enhance self-care behaviors among this population.
Purpose: This study was conducted to examine the effects of a self-control promotion program on self-efficacy, self-care and physiological indicators of patients with diabetes who live in local communities. Method: This research was designed using a nonequivalent control group pre, posttest study. Data were collected from December, 2008 through March, 2009. The participants of the study consisted of 93 patients with diabetes who live in a local community. A self-control promotion program was provided for the experimental group for 12 weeks. Data were collected through self-report questionnaires and direct measurements, and analyzed using descriptive statistics, $X^2$-test, and repeated measures ANOVA. Results: There were significant differences in self-efficacy and self-care between the experimental and control groups. However, there were no significant differences in physiological indicators such as fasting blood sugar, HbA1C, BMI, and BP between the two groups. Conclusion: The results indicate that the self-control promotion program was effective in promoting self-efficacy and self-care, which are crucial factors in controlling diabetes mellitus. However, a longitudinal study needs to be done to confirm the effects of self-control promotion programs on long-term glucose control.
Purpose: This study was a descriptive study to investigate correlations between self-care behaviors and quality of hypertension management by hypertensive patients being cared by community health practitioners. Method: Participants were 583 people who were prescribed antihypertensive medications at a health clinic located in South Chungcheong Province. The survey was done from June 1 to July 30, 2018. A self-report questionnaire was administered, and data analysis was performed using descriptive statistics and Pearson correlation coefficients with the SPSS 24.0 program. Results: The rate of awareness, treatment, and control of hypertension were 97.9%, 99.1% and 92.8%, respectively. The number of hypertensive self-care behaviors was 1.82 (${\pm}0.36$) out of 3 points. The quality of hypertension management was 3.22 (${\pm}0.46$) out of 4 points. There was a moderate correlation between hypertensive self-care behaviors and quality of hypertension management (r=.340, p<.001). Conclusions: Results of this study confirm that the quality of hypertension management by community health practitioners is related to self-care behaviors of hypertensive patients. Therefore, it is necessary to improve the quality of hypertension management by health care specialists for self-management of hypertension patients. In addition, a systematic program to improve the quality of hypertension management by community health practitioner is needed.
The purpose of this study was to determine the effects of self-help management program which strengthens self-efficacy for post stroke elders who attend day care center in Chongju. One group pretest-posttest design was used, and the subjects were 7 post stroke elders with hemiparesis. The self-help management program consisted of 5 sessions and each session included group education on stroke, ROM exercise, recreation and self-care strategies. Those strategies for encouraging and reinforcing self-efficacy provided verbal persuasion, performance accomplishment and vicarious experience. All subjects were questioned before and after the program about ADLs, IADLs, self-efficacy, self-care behavior and depression. The analysis of data revealed that the program was effective to increase the IADLs, self-efficacy and self-care behavior. However, there was no significant difference between pre and post ADLs and depression. The results indicated that this program may be adopted to improve the physical and psychological function of post stroke elderly patients in community settings.
Purpose: The purpose of this study is to identify main factors affecting patients' uncertainty following lumbar spinal surgery. Methods: A survey was conducted of a sample 155 post -operative patients in April to June 2010. Uncertainty and knowledge about self-care after spinal surgery and the back pain evaluation were measured. Data were analyzed with t-test, ANOVA, Pearson correlation, and multiple regressions. Results: The mean score of uncertainty level was $27.66{\pm}6.32$. Levels of uncertainty were different by age, gender, educational level, pain duration, and number of types of pain. Uncertainty was positively correlated with knowledge of post-op self-care, back pain, and mental health. The results of multiple regression indicated that knowledge of post-op self-care and mental health were significant predictors with 35.1% of the variance in uncertainty. Conclusion: A program including post-operative self-care education and mental health promotion is required to reduce uncertainty of patients with lumbar spinal surgery.
The effect s of social support on post-stroke depression were investigated. Social support was classified into three categories : primary caregiver's, significant other's, and professional support. And primary caregiver's and significant other's support were divided into their relation, living state (which means they living together or not), frequency which they met at, and perceived satisfaction about the support, respectively. Professional support was divided into number of professionals who take care of, frequency they met at, and perceived satisfaction. The subjects were 254 stroke patients who had been discharged and were taken follow-up care at the out patient department. The depression was measured using CES-D. Out of the primary caregiver's support, only relation and perceived satisfaction were identified to affect the post-stroke depression. The patients who primarily their spouse takes care of were less depressed than those who their adult children take care of. None of the significant other's support affects the post-stroke depression. Only perceived satisfaction of the professional support was found to affect the post-stroke depression. So it was found that the quality, not the amount, of care was important to post-stroke depression. These results also support the claim that the facilities and teaching programs for primary caregivers are necessary.
Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed.
Purpose : Post-intensive care syndrome (PICS) is characterized by a constellation of mental health, physical, and cognitive impairments, and is recognized as a long-term sequela among survivors of intensive care units (ICUs). The objective of this study was to explore the impact of intensive care experience (ICE) on the development of PICS in individuals surviving critical care. Methods : This secondary analysis utilized data derived from a prospective, multicenter cohort study of ICU survivors. The cohort comprised 143 survivors who were enrolled between July and August 2019. The original study's participants completed the Korean version of the ICE questionnaire (K-ICEQ) within one week following discharge from the ICU. Of these, 82 individuals completed the PICS questionnaire (PICSQ) three months subsequent to discharge from hospital. The influence of ICE on the manifestation of PICS was examined through Partial Least Squares-Structural Equation Modeling (PLS-SEM). Result : The R2 values of the final model ranged from 0.35 to 0.51, while the Q2 values were all greater than 0, indicating adequacy for prediction of PICS. Notable pathways in the relationship between the four ICE dimensions and the three PICS domains included significant associations from 'ICE-awareness of surroundings' to 'PICS-cognitive', from 'ICE-recall of experience' to 'PICS-cognitive', and from 'ICE-frightening experiences' to 'PICS-mental health'. Analysis found no significant moderating effects of age or disease severity on these relationships. Additionally, gender differences were identified in the significant pathways within the model. Conclusion : Adverse ICU experiences may detrimentally impact the cognitive and mental health domains of PICS following discharge. In order to improve long-term outcomes of individuals who survive critical care, it is imperative to develop nursing interventions aimed at enhancing the ICU experience for patients.
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