• Title/Summary/Keyword: Tailored Intervention

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Effects of a Postnatal Care Program on Self-efficacy, Self-management, and Glycemic Control in Women with Gestational Diabetes Mellitus (임신성 당뇨병 산모를 위한 산후관리 프로그램이 자기효능감, 자가 관리 및 혈당 조절에 미치는 영향)

  • Jeon, Yeong Kyung;Kim, Hyo Jin;Yang, Mi Yeon;Jung, Da Yeong;Yoon, Kum Young;Noh, Gie Ok
    • Women's Health Nursing
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    • v.24 no.4
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    • pp.367-378
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    • 2018
  • Purpose: To examine effects of a postnatal care program on self-efficacy, self-management, and glycemic control in women with gestational diabetes mellitus (GDM). Methods: A non-equivalent control group non-synchronized quasi-experimental design was used. Sixty-two women with GDM were enrolled and assigned to either an experimental group (n=30) or a control group (n=32). The experimental group received an intervention which was postnatal care program for women with GDM. The postnatal care program for GDM included an individual education with leaflet and mobile web-based video with three times of telephone counseling. Effects of the intervention were measured with self-efficacy, self-management questionnaire, and a 75 g oral glucose tolerance test (75g OGTT). Statistical significance was examined using independent t-test and $x^2-test$. Results: Although there was no significant difference in 75g OGTT ($x^2=.11$, p=.748) or self-management (t=-1.28, p=.206), there was a statistically significant increase in self-efficacy (t=-2.02, p=.048) in the experimental group compared to that in the control group. Conclusion: A postnatal care program is needed for women with GDM to improve their self-efficacy. Further studies are warranted to improve self-management and glycemic control through tailored education for GDM postpartum women.

Targeting motor and cognitive networks with multichannel transcranial direct current stimulation along with peripheral stimulation in a subacute stroke survivor: single case study

  • Midha, Divya;Arumugam, Narkeesh
    • Physical Therapy Rehabilitation Science
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    • v.9 no.4
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    • pp.318-323
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    • 2020
  • Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

Endoscopic Intervention for Anastomotic Leakage After Gastrectomy

  • Ji Yoon Kim;Hyunsoo Chung
    • Journal of Gastric Cancer
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    • v.24 no.1
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    • pp.108-121
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    • 2024
  • Anastomotic leaks and fistulas are significant complications of gastric surgery that potentially lead to increased postoperative morbidity and mortality. Surgical intervention is reserved for cases with severe symptoms or hemodynamic instability; however, surgery carries a higher risk of complications. With advancements in endoscopic treatment options, endoscopic approaches have emerged as the primary choice for managing these complications. Endoscopic clipping is a traditional method comprising 2 main categories: through-the-scope clips and over-the-scope clips. Through-the-scope clips are user friendly and adaptable to various clinical scenarios, whereas over-the-scope clips can close larger defects. Another promising approach is endoscopic stent insertion, which has shown a high success rate for leak closure, although vigilant monitoring is required to monitor stent migration. Infection control is essential in post-surgical leakage cases, and endoscopic internal drainage provides a relatively safe and noninvasive means to manage fluids, contributing to infection control and wound healing promotion. Endoscopic suturing offers full-thickness wound closure, but requires additional training and endoscopic versatility. As a promising tool, endoscopic vacuum therapy potentially surpasses stent therapy by draining inflammatory materials and closing defects. Furthermore, the use of tissue sealants, such as fibrin glue and cyanoacrylate, has been reported to be effective in selected situations. The choice of endoscopic device should be tailored to individual cases and specific patient conditions, with careful consideration of the nature of the defect. Further extensive studies involving larger patient populations are required to provide more robust evidence on the efficacy of endoscopic approach in managing post-gastric anastomotic leaks.

Korean Adolescents' Experience of Yoga Class: "Healthy Habits Beyond Exercise"

  • Lee, Ji Hye;Chae, Sun Mi
    • Perspectives in Nursing Science
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    • v.11 no.2
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    • pp.132-143
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    • 2014
  • Purpose: This study was designed to explore adolescents' experience with yoga class in South Korea. Methods: Qualitative data were collected by focus group interviews from February to March 2014. Eleven adolescents who experienced yoga class were recruited from two different schools. The interview questions investigated adolescents' experience with yoga regarding expectations before yoga class, positive changes after yoga, and advice for future yoga classes. Results: Three primary themes from the qualitative content analysis include 1) motivation to join a yoga class, 2) perceived benefits after class and 3) suggestions for school-based yoga. We found that high school students had intrinsic and extrinsic motivations to join yoga classes, and the perceived benefits included physical, psychological, cognitive and social aspects. The students also indicated the need for support by person, yoga with fun and information, yoga tailored by individual goal, simple and easy class. Conclusion: These results suggest that yoga could be an appropriate intervention for holistic health care, and school-based yoga should be applied by focusing on the various situational needs of adolescents'. Furthermore, when yoga leads to healthy habits compared to just simple exercise, a balanced development of adolescents can be achieved.

Classification of Adolescent Suicide Based on Student Suicide Reports

  • Kwon, Hoin;Hong, Hyun Ju;Kweon, Yong-Sil
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.4
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    • pp.169-176
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    • 2020
  • Exploring the risk factors of adolescent suicide is important for effective suicide prevention. This study explored the clustering of adolescent suicides based on six risk factors: mental disorder, broken family, depression, anxiety, previous suicide attempts, and deviant behaviors. Using 173 student suicide reports obtained from the Ministry of Education, we evaluated the associations between suicide and variables related to mental disorders; dysfunctional family life; depression and anxiety; previous suicide attempts; deviant behaviors such as drinking and smoking; and school life characteristics, including attendance and discipline, problems within the past year, and incidents prior to suicide. In addition, reports of warning signs just before suicide were included in the analysis. The two-stage cluster analysis classified the students into three clusters: the silent type (cluster 1; 48.55%), in which no risk factors were observed; environmental-risk type (cluster 2: 24.28%), which featured a high frequency of broken households, deviant behaviors such as smoking/drinking and running away from home; and depressive type (cluster 3: 27.17%), which featured a high frequency of mental health problems such as depression, anxiety, and suicide attempts. Identifying the sub-types of adolescent suicide may help to inform tailored suicide prevention and intervention strategies in school.

Validity and Reliability of an Instrument for Predictive Nursing Intention for SARS Patient Care (SARS 환자간호 의도예측 도구의 타당도 및 신뢰도 검증 연구)

  • Yoo, Hye Ra;Kwon, Bo Eun;Jang, Yon Soo;Youn, Heun Keung
    • Journal of Korean Academy of Nursing
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    • v.35 no.6
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    • pp.1063-1071
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    • 2005
  • Purpose: This study was done to develop and test validity and reliability of on instrument for predicting nursing intention for SARS patient care. Method: The psychometric properties of a SARS patient care attrition prediction tool, based on the Theory of Planned Behavior, were examined in this study. The Three-phase design involved a) salient beliefs generated from clinical nurses (n=43) b) content validation by expert panel evaluations(n=5) c) face validation by plot testing (n=10) d) and instrument validation in a cross sectional survey (n=299). Psychometric analysis of survey data provided empirical evidence of the construct validity and reliability of the instrument. Result: Principal component analysis verified the hypothesized 6-factor solution, explaining $68.2\%$ of variance, and Alpha coefficients of .7538 to .9389 indicated a high internal consistency of the instrument. Conclusion: The instrument can be used by nurse administrators and researcher to assess clinical nurses' salient beliefs about caring for SARS patients, guide tailored intervention strategies to effective caring, and evaluate the effectiveness of interventions.

Prospective Study on the Relating Factors to the Stages of Change in Smoking Cessation and Barriers in Coronary Artery Disease Patients* (관상동맥질환자의 금연변화단계와 관련된 요인 및 장애요인에 대한 전향적 연구)

  • Kim, Hwa-Soon
    • Journal of Korean Academy of Nursing
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    • v.35 no.1
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    • pp.27-36
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    • 2005
  • Purpose: The main purpose of this study was to investigate that the stages of change in smoking cessation behavior among coronary artery disease patients for six months progressed following the stages of change suggested by the transtheoretical model. Method: Subjects for this descriptive survey were 59 coronary disease patients who were smoking or who had stopped smoking for less than six months. Result: In the baseline, the distribution of the subjects’ stages of change was as follows: pre-contemplation stage 25.4%, contemplation stage 25.4%, preparation stage 22%, and action stage 27.1%. After six months, more subjects in the contemplation(33.3%) and preparation stages(30.8%) progressed to the action stage than those of the pre-contemplation stage(0%). Eighty-one percent of the subjects in the action stage at baseline progressed to the maintenance stage. The relationship between the numbers of smoking cessation attempts for six months and stages of change at baseline was significant(p=.001). However, the relationships between self-efficacy and nicotine dependence at baseline and progression in stages of change after six months were not significant. Conclusion: Progression in the stages of change for six months among subjects corresponded to the stages of change suggested by the transtheoretical model. Hence, future development and evaluation of intervention programs should be tailored individually considering each patient's stage of change.

Factors Influencing the Stages of Change in Medication Adherence in Patients with Hypertension (고혈압 환자의 복약순응행위 변화단계에 영향을 미치는 요인)

  • Byeon, Young Soon;Kim, Soon Ock;Cho, Jeong-Hyun
    • Research in Community and Public Health Nursing
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    • v.23 no.2
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    • pp.189-200
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    • 2012
  • Purpose: The purpose of this study is to identify factors associated with the stages of change in medication adherence in patients with hypertension. Methods: Participants were 323 patients with hypertension. Sociodemographic/medication-related characteristics, stages of change, processes of change, self efficacy and decisional balance were self-administered. Results: Stages of change were significantly different according to gender, age, job and living arrangement. A multinominal logistic regression analysis has revealed that gender, age, living arrangement, self-liberation, and self-efficacy were significantly associated with the precontemplation stage. Age and self-liberation were significantly associated with the contemplation stage. Gender, age, living arrangement, and self-liberation were significantly associated with the preparation stage. Gender and helping relationship were significantly associated with the action stage. This model explained 52.0% of the stages of change in medication adherence. Conclusion: The tailored intervention strategies based on the stages of change may be needed for improving medication adherence in patients with hypertension.

A study on the Effectiveness of Case Management in Elderly Medicaid Beneficiaries by Geographic Location (노인 의료급여 수급권자의 지역별 사례관리 효과에 관한 연구 - 대도시, 중소도시, 농촌 지역을 중심으로 -)

  • Cho, Jeong-Hyun;Kim, Soon-Ock;Song, Myeong-Kyeong;Yim, Eun-Shil
    • Journal of Korean Public Health Nursing
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    • v.26 no.2
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    • pp.289-302
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    • 2012
  • Purpose: The purpose of this study was to compare the effectiveness of case management in elderly medicaid beneficiaries according to geographic location. Methods: Data were collected from 23,633 elderly medicaid beneficiaries assigned from over users of medicaid. We used the need assessment tool developed by the government, which consists of 19 items with four subscales. Results: Among elderly medicaid beneficiaries, statistically significant differences in effectiveness of case management were observed for quality of life, self-care competency, medical care utility, and support system. Differences in case management effectiveness were higher in urban areas than in metropolitan or rural areas. Conclusion: The differentiated and tailored intervention model based on characteristics of participants, resource distribution, and geographic location may be needed for effective case management for elderly medicaid beneficiaries.

Effects of Taekwondo and Walking Exercises on the Double-Leg Balance Control of Elderly Females

  • Youm, Chang-Hong;Lee, Joong-Sook;Seo, Kook-Eun
    • Korean Journal of Applied Biomechanics
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    • v.21 no.2
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    • pp.123-129
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    • 2011
  • The purpose of this study was to compare and analyze the effect of twelve-week Taekwondo and walking exercises on the double-leg balance control by dividing elderly females into Taekwondo, walking exercise and control groups. In total, 30 elderly females were randomly divided into Taekwondo, walking exercise, and control groups, with 10 subjects in each group. Subjects participating in this study were 10(age $69.4{\pm}5.8$ years), 10(age $71.4{\pm}7.6$ years) and 10(age $70.6{\pm}4.8$ years) in the three groups, respectively. Although the AP measures were not significantly different among the groups and times, the ML RMS distance and ML velocity, among the ML measures showed a significant difference among the groups and times. Average velocity and 95% confidence ellipse area were also significantly different among the groups and times. Twelve-week Taekwondo and walking exercises were found to be effective in improving static balance control. Future studies on the development of a Taekwondo intervention program tailored for the elderly with many subjects conducted by using a long-term training program are expected.