• Research in Community and Public Health Nursing
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• v.30 no.4
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• pp.494-507
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• 2019

Purpose: The purpose of this study is to provide a clear definition of the health literacy for patients with cardiovascular disease by analyzing the dimensions and properties using Hybrid concept analysis. Methods: The concept of health literacy of patients with cardiovascular disease was analyzed according to the cyclic process of theoretical phase-field work phase-final analysis phase presented in the Hybrid model. We reviewed 26 literatures and conducted in-depth interviews with 13 patients with cardiovascular disease. Results: The concept of health literacy in cardiovascular patients is derived from two dimensions and five attributes. Literacy skills, health information search ability and health information utilization skills were derived as attributes in the individual functional dimension, while active communication with the medical team and utilization of health information support resources were derived at the interrelational dimension. It is defined as the individualized and integrated ability of an individual to explore and utilize the various health information needed to make appropriate health decisions during the chronic course after diagnosis of cardiovascular disease, to communicate proactively with medical staffs and to utilize support resources. Conclusion: This study will contribute to the development and related research of health literacy measurement tools that can be used in cardiovascular nursing practice based on the attributes and indicators of health literacy for patients with cardiovascular disease.

• Research in Community and Public Health Nursing
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• v.26 no.2
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• pp.150-159
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• 2015

Purpose: This study was performed in order to identify the relationships among self-care behavior, health conservation, and cardiovascular risk factors and to examine the influence of self-care behavior and health conservation on cardiovascular risk factors among Korean elders with diabetes mellitus. Methods: The participants were 105 elders with diabetes mellitus using senior welfare centers and elderly leisure houses in Daegu. Data were collected through interviews during the period from April to May in 2014. Self-care behavior was measured with Kim's (1997) Self-care Behavior Scale, health conservation with Sung's (2005) Health Conservation Scale, and cardiovascular risk factors with the Arizona Heart Institute Cardiovascular Risk Factor Questionnaire. Collected data were analyzed through one-way ANOVA, independent t-test, Pearson's correlation, and stepwise multiple regression using the SPSS/WIN 19.0 program. Results: A negative correlation was found between self-care behavior and cardiovascular risk factors, and between health conservation and cardiovascular risk factors. Self-care behavior explained 6% and health conservation did 49% of variance in elderly diabetes mellitus patients' cardiovascular risk. Conclusion: The results indicate that, in order to reduce cardiovascular risk factors among Korean elders with diabetes mellitus, we need nursing interventions for increasing health conservation and self-care behavior.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.14-19
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• 2016

Background: This study uses the relevance index to understand the condition of regional medical service use for cardiovascular surgery and to identify the medical service use imbalance between regions. Methods: This study calculated the relevance index of 16 metropolitan cities and provinces using resident registration address data from the Ministry of Government Administration and Home Affairs and the 2010-2014 health insurance, medical care assistance, and medical benefits claims data from the Health Insurance Review and Assessment Service. We identified developments over the 5-year time period and analyzed the level of regional imbalance regarding cardiovascular surgery through the relative comparison of relevance indexes between cardiovascular and other types of surgery. Results: The relevance index was high in large cities such as Seoul, Daegu, and Gwangju, but low in regions that were geographically far from the capital area, such as the Gangwon and Jeju areas. Relevance indexes also fell as the years passed. Cardiovascular surgery has a relatively low relevance index compared to key types of surgery of other fields, such as neurosurgery and colorectal surgery. Conclusion: This study identified medical service use imbalance between regions for cardiovascular surgery. Results of this study demonstrate the need for political intervention to enhance the accessibility of necessary special treatment, such as cardiovascular surgery.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.37-43
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• 2016

Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.

• Journal of Chest Surgery
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• v.53 no.2
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• pp.79-81
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• 2020

Treatment options for children with end-stage heart failure are limited. We report the first case of a successful pediatric heart transplantation bridged with a durable left ventricular assist device in Korea. A 10-month-old female infant with dilated cardiomyopathy and left ventricular non-compaction was listed for heart transplantation. During the waiting period, the patient's status deteriorated. Therefore, we decided to provide support with a durable left ventricular assist device as a bridge to transplantation. The patient was successfully bridged to heart transplantation with effective support and without any major adverse events.

• Journal of Korean Public Health Nursing
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• v.22 no.1
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• pp.27-38
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• 2008

Purpose: To determine the degree of cardiovascular disease risk according to socioeconomic factors among midlife women in the community and thereby provide baseline data for the development of health promotion programs. Method: A total of 200 women participated in health screenings and a health survey. The survey was performed in November and December, 2006. The survey instruments included socioeconomic factors, health behavior (smoking and exercise), and family history. Biophysical measurement included BMI and blood pressure. Blood samples were drawn for glucose and total cholesterol tests. Results: The mean age was 52.5 years, 34.0% had received education less than 6 years, 70.0% earned a monthly income of less than \1,500,000, and 61.5% were homemakers. Cardiovascular disease risk was significantly different by age (BMI, systolic BP, and exercise), education (systolic BP), monthly income (T. cholesterol), marital status (smoking), and occupation (exercise). Most women had 2 or 3 cardiovascular disease risks. Older age, lower education, and lower income were significantly associated with increased cardiovascular disease risk. Conclusion: Efforts should be made to decrease the number and severity of cardiovascular disease risk factors for midlife women in the community by developing health promotion programs targeting to modify their cardiovascular disease risk factors.

• Korean Journal of Adult Nursing
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• v.14 no.2
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• pp.233-243
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• 2002

Purpose: This study is aimed at testing the effect of health promotion program on health promoting behavior and cardiovascular risk factors of middle-aged women. Method: The research design was the nonequivalent control group pre-post test. Twelve middle-aged women were the experimental group and ten were the control group. The 8-week health promotion program was given to the experimental group. There were health promotion theories, flexibility and muscle strength exercise, cardiopulmonary endurance exercise, nutrition, stress management, cancer prevention and early detection, management of menopause and wrap-up in health promotion program for middle-aged women. The measurement tool was Health Promoting Behavior developed by researcher using serum cholesterol, obesity rate, systolic blood pressure, and diastolic blood pressure as cardiovascular risk factors. Result: The experimental group showed a higher score of health promoting behavior than the control group. There were no differences on cardiovascular risk factors(cholesterol, obesity rate, diastolic blood pressure) between the experimental and control groups except systolic blood pressure. Conclusion: Conclusively, this health promotion program for middle-aged women was effective in increasing health promotion behaviors, but wasn't effective in decreasing cardiovascular risk factors except the systolic blood pressure. It seems it's necessary to re-study this using more samples and a longer duration of the program, and smaller mortality rate.

• Journal of Chest Surgery
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• v.55 no.5
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• pp.378-387
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• 2022

Background: Atrial fibrillation (Afib) is a marker of increased cardiovascular morbidity and mortality. Owing to the increased prevalence of Afib in patients undergoing cardiac surgery, assessing the effect of Afib on postsurgical outcomes is important. We aimed to analyze the effect of preoperative Afib on clinical outcomes in patients undergoing cardiac surgery using a large surgical database. Methods: This retrospective cohort study was based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th revision. Results: We included 1,037 patients (0.1%) who had undergone cardiac surgery from a randomized 1,000,000-patient cohort, and 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of these 1,022 patients, 412 (39.7%), 303 (29.2%), and 92 (9.0%) underwent coronary artery bypass, heart valve surgery, and Cox-maze surgery, respectively. Preoperative Afib was associated with higher patient mortality (p=0.028), regardless of the surgical procedure. Patients with preoperative Afib (n=190, 18.6%) experienced a higher cumulative risk of overall mortality (hazard ratio [HR], 1.435; 95% confidence interval [CI], 1.263-2.107; p=0.034). Subgroup analysis revealed a reduced risk of overall mortality with Cox-maze surgery in Afib patients (HR, 0.500; 95% CI, 0.266-0.938; p=0.031). Postoperative cerebral ischemia or hemorrhage events were not related to Afib. Conclusion: Preoperative Afib was independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-maze surgery may improve the survival rate.

• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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• pp.319-328
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• 2013

Objectives: This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea. Methods: In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics. Results: There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality. Conclusions: Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.

• Research in Community and Public Health Nursing
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• v.17 no.2
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• pp.153-165
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• 2006

Purpose: The purpose of this study was to develop and test a structural model on cardiovascular disease risk factors among male manufacturing workers. Methods: Data were collected through questionnaires and health exams from 201 workers in a local electronic company during September 2004. Data analysis was done with SAS 9.1 for descriptive statistics and PC-LISREL 8.54 for covariance structural analysis Results: The overall fit of the hypothetical model to the data was moderate, it was modified by deleting five paths. The modified model had a better fit to the data($x^2=504.23$(p<001, df: 180), $x^2/df=2.80$, GFI=.95, RMR=.07, NFI=.90, PGFI=.64). Health behaviors and psychosocial distress were found to have significant direct effects on the cardiovascular disease risk factors. Self-concept had direct effect on psychosocial distress or health behaviors. Self-concept, work environment, and work condition had direct effect on social support. Work environment had indirect effect on psychosocial distress. Social support had indirect effect on health behaviors. But work environment and work condition were found to have little direct effect on health behaviors, psychosocial distress or cardiovascular disease risk factors. Conclusion: A cardiovascular health promotion program should therefore include psycho-social factors as well as health behavioral determinants in worksites.