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The Mediating Effect of Regimen Distress in the Relationship between Medication Adherence and Glycemic Control in Men with Type 2 Diabetes Mellitus (제2형 당뇨병 성인 남성 환자의 약물치료 이행과 혈당 조절 수준 간에 치료 스트레스의 매개효과)

  • Seo, Yeong-Mi;Choi, Won-Hee
    • Journal of East-West Nursing Research
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    • v.22 no.2
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    • pp.170-177
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    • 2016
  • Purpose: The purpose of this study was to examine the mediating effect of regimen distress in the relationship between medication adherence and glycemic control in men with type 2 diabetes. Methods: A total of 116 patients with type 2 diabetes was recruited for the cross-sectional survey design. Data were analyzed using descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression using Baron and Kenny steps for mediation. Results: The mean score for medication adherence was 6.32, and the mean glycemic control level (HbA1c) was 7.47%. The mean score was 2.37 for regimen distress. There were significant correlations among medication adherence, regimen distress, and HbA1c. Regimen distress had a partial mediating effect (${\beta}$=.22, p=.005) in the relationship between medication adherence and HbA1c (Sobel test: Z=2.47, p=.013). Conclusion: Regimen distress was found to be associated with glycemic control in men with type 2 diabetes. Based on the findings of this study, nursing intervention programs focusing on decreasing regimen distress are highly recommended to improve level of glycemic control in patients with type 2 diabetes.

Development of an E-learning Education Program for Preventing Nursing Errors and Adverse Events of Operating Room Nurses (수술실의 간호오류 및 과오 예방을 위한 E-learning 실무교육 프로그램의 개발 및 평가)

  • Kim, Jung-Soon;Kim, Myung-Soo;Hwang, Sun-Kyung
    • Korean Journal of Adult Nursing
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    • v.17 no.5
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    • pp.697-708
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    • 2005
  • Purpose: This study was to develop, implement, and evaluate an e-learning education program for improving practical knowledge and preventing nursing errors and adverse events of nurses working in the operating room (OR). Method: The e-learning program was developed and evaluated according to the following processes: 1) preparation phase 2) implementation phase 3) evaluation phase. In evaluation phase, the effectiveness was analyzed based on the Kirkpatrick's model. Results: The e-learning program consisted of OR basic nursing skills and techniques and nursing activities' manual based on the categories of nursing errors: surgical operation preparation, nursing skills and techniques, environment management, patient safety and comfort, and patient monitoring. The program was provided through on-line, http://cafe.daum.net/pnuhorn, for 4 weeks. The mean score(percent) of participants' satisfaction was $21.24{\pm}1.71$(68.2%). Their total knowledge level was significantly improved(Z=-3.00, p=.003) and specifically in the category of environment management(Z=-3.77, p<.001) and patient monitoring(Z=-2.46, p=.014). The occurrence of nursing errors or adverse events was a little decreased, but not statistically significant(Z=-3.10, p=.756). Conclusion: E-learning for nurses is one way of effective and efficient teaching-learning strategies. For better e-learning, it is important to develop the vital content of the education and objective measures for detecting nursing errors and adverse events.

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Factors Influencing Subjective Happiness in Korean Nursing Students (간호대학생의 주관적 행복감에의 영향요인)

  • Kim, Eun Man;Yang, Young Hee;Lee, Haeyoung;Yu, Mi
    • The Journal of Korean Academic Society of Nursing Education
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    • v.22 no.3
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    • pp.294-303
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    • 2016
  • Purpose: The purpose of this study was to determine subjective happiness related factors in Korean nursing students. Methods: A purposive sample of 200 nursing students was recruited for the cross-sectional survey design. The instruments were perceived stress scale, major satisfaction scale, resilience scale, and subjective happiness scale. Data were analyzed using descriptive statistics, hierarchical linear regression, and the Sobel test for testing mediating effects. Results: The mean score of stress, major satisfaction, resilience and subjective happiness was 2.21, 3.95, 3.60 and 5.03, respectively. Perceived health status, stress_positive perception, stress_negative perception, resilience_self confidence, resilience_positivity, resilience_social support had significant effects on subjective happiness. Explained variance for the subjective happiness was 53.4%. Resilience had a partial mediating effect in the relationship between stress and subjective happiness (Sobel test: Z=-5.67, p<.001). Also, resilience had a mediating effect in the relationship between major satisfaction and subjective happiness (Sobel test: Z=5.65, p<.001). Conclusion: Based on the findings of this study, nursing intervention programs focusing on improving resilience are recommended to improve subjective happiness in nursing students.

Comparative of Bone Mineral Density according to the Body Mass Index and Eating Habits of Female U niversity Students (여대생의 체질량지수와 식습관에 따른 골밀도 비교)

  • Lee, In-Ja
    • Journal of radiological science and technology
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    • v.40 no.4
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    • pp.581-587
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    • 2017
  • This study was based on the data of total mineral content of about 99% at the age of 16-26 years, we aimed at female university students who are important for bone formation in their early 20s. The purpose of this study was to investigate factors of eating habits affecting their bone density and to provide data to prevent osteoporosis which might occur in the future. It was conducted on 100 female university students in their 20s, the bone mineral density according to BMI was measured by DEAX, and the analysis of 10 eating habits items and the results of BMD measurement on their own results in Excel 2010. As a result, the height was $161.08{\pm}4.70cm$, the weight was $52.43{\pm}6.43kg$, and the BMI was $20.22{\pm}2.48$, which correlated with BMD (p<0.05). According to the BMI classification, 20 had low weight and 80 had normal weight, and BMD was $0.20{\pm}0.41$ at normal weight. In the same sex, the mean T-score of the young adult group was $-0.04{\pm}0.99$ compared with the BMD of the young adult group, and the mean Z-score of the same age group was $0.02{\pm}0.93$ (p<0.001). Eating habits affecting bone mineral density were significantly affected by 3 meals per day, 1-3 cups of coffee per day and p<0.05 for Low salt formula intake. 6-9 dairy product intake was also p<0.05 but not significant. Therefore, it is considered that when 20s female students become middle-aged woman, they should have proper eating habits so that osteogenesis can be improved at young age in order to prevent bone disease.

Final height of Korean patients with early treated congenital hypothyroidism

  • Lee, Jiyun;Lee, Jeongho;Lee, Dong Hwan
    • Clinical and Experimental Pediatrics
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    • v.61 no.7
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    • pp.221-225
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    • 2018
  • Purpose: Congenital hypothyroidism (CH) is the most common endocrine disorder in children. Thyroid hormone deprivation results not only in mental retardation but also growth retardation. This study investigates the final height (FH) in Korean patients with CH detected by newborn screening and examines factors that may affect the FH. Methods: The medical records of Korean CH patients (n=45) were reviewed. The FH was examined and target height (TH) was calculated based on mid-parental height. The FH z score (FHZ) and TH z score (THZ) were computed using the 2007 Korean National Growth Chart. The FHZ and THZ were compared with a Student t test. The impact of the etiology of CH (athyreosis, dyshormonogenesis, ectopic thyoid, hypoplastic thyroid), initial serum thyroid stimulating hormone (TSH) level, initial free thyroxine (T4) level, and time of therapy initiation based on FH was assessed. Results: The mean FHZ was $0.10{\pm}1.01$ for male patients and $-0.11{\pm}1.09$ for female patients. There were no significant differences between FHZ and THZ for both female (P=0.356) and male patients (P=0.237). No significant relationship was found between FH and the etiology of CH, initial TSH level, initial free T4 level, and the time of therapy initiation. Conclusion: Early intervention and satisfactory management do not appear to impede growth in Korean patients with CH. Thus, early detection and proper management of patients with CH detected by newborn screening program are necessary.

Intra-Rater and Inter-Rater Reliability of Brain Surface Intensity Model (BSIM)-Based Cortical Thickness Analysis Using 3T MRI

  • Jeon, Ji Young;Moon, Won-Jin;Moon, Yeon-Sil;Han, Seol-Heui
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.3
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    • pp.168-177
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    • 2015
  • Purpose: Brain surface intensity model (BSIM)-based cortical thickness analysis does not require complicated 3D segmentation of brain gray/white matters. Instead, this technique uses the local intensity profile to compute cortical thickness. The aim of the present study was to evaluate intra-rater and inter-rater reliability of BSIM-based cortical thickness analysis using images from elderly participants. Materials and Methods: Fifteen healthy elderly participants (ages, 55-84 years) were included in this study. High-resolution 3D T1-spoiled gradient recalled-echo (SPGR) images were obtained using 3T MRI. BSIM-based processing steps included an inhomogeneity correction, intensity normalization, skull stripping, atlas registration, extraction of intensity profiles, and calculation of cortical thickness. Processing steps were automatic, with the exception of semiautomatic skull stripping. Individual cortical thicknesses were compared to a database indicating mean cortical thickness of healthy adults, in order to produce Z-score thinning maps. Intra-class correlation coefficients (ICCs) were calculated in order to evaluate inter-rater and intra-rater reliabilities. Results: ICCs for intra-rater reliability were excellent, ranging from 0.751-0.940 in brain regions except the right occipital, left anterior cingulate, and left and right cerebellum (ICCs = 0.65-0.741). Although ICCs for inter-rater reliability were fair to excellent in most regions, poor inter-rater correlations were observed for the cingulate and occipital regions. Processing time, including manual skull stripping, was $17.07{\pm}3.43min$. Z-score maps for all participants indicated that cortical thicknesses were not significantly different from those in the comparison databases of healthy adults. Conclusion: BSIM-based cortical thickness measurements provide acceptable intra-rater and inter-rater reliability. We therefore suggest BSIM-based cortical thickness analysis as an adjunct clinical tool to detect cortical atrophy.

Growth hormone treatment for children with mucopolysaccharidosis I or II

  • Minji Im;Chiwoo Kim;Juyoung Sung;Insung Kim;Ji-Hoon Hwang;Min-Sun Kim;Sung Yoon Cho
    • Journal of Genetic Medicine
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    • v.20 no.2
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    • pp.60-69
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    • 2023
  • Purpose: Despite enzyme replacement therapy (ERT) and/or allogeneic hematopoietic stem cell transplantation, individuals with mucopolysaccharidosis (MPS) I or II often experience significant growth deficiencies. This study aimed to assess the safety and efficacy of recombinant human growth hormone (hGH) treatment in children diagnosed with MPS I or II. Materials and Methods: A total of nine pediatric patients-four with MPS I and five with MPS II-underwent treatment with ERT and hGH at Samsung Medical Center. Results: The mean hGH dose administered was 0.26±0.03 mg/kg/week. In the MPS I group, three patients showed an increase in height Z-score from -4.09±0.83 to -3.68±0.43 after 1 year of hGH treatment, and to -3.10±0.72 by the end of the hGH regimen. In the MPS II group, while the height Z-score of four patients decreased according to standard growth charts, it improved from 1.61±1.79 to 2.71±1.68 based on the disease-specific growth chart through hGH treatment. Two patients discontinued hGH treatment due to lack of efficacy after 22 and 6 months each of treatment, respectively. No new-onset neurological symptoms or necessity for prosthetic or orthopedic surgery were reported during hGH treatment. Conclusion: This study provides insights into the impact of hGH on MPS patients, demonstrating its potential to reverse growth deceleration in some cases. Further research is needed to explore the long-term effects of hGH on changes in body composition, muscle strength, and bone health in this population.

Disturbance in ADL from Chemotherapy-induced Peripheral Neuropathy and Quality of Life in Cancer Patients: The Mediating Effect of Psychological Distress (암 환자의 말초신경병증 관련 일상활동장애와 삶의 질: 심리적 디스트레스의 매개효과)

  • Kim, Kyung Yeon;Lee, Seung Hee;Kim, Jeong Hye;Oh, Pok Ja
    • Journal of Korean Academy of Nursing
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    • v.45 no.5
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    • pp.661-670
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    • 2015
  • Purpose: The purpose of this study was to examine the mediation of psychological distress in the relationship between disturbance in ADL from chemotherapy induced peripheral neuropathy and quality of life in order to provide a basis for planning nursing interventions to improve the quality of life in cancer patients. Methods: A purposive sample of 130 patients treated with chemotherapy were recruited in the cross-sectional survey design. Data were collected using self-report questionnaires. The instruments were the Chemotherapy Induced Peripheral Neuropathy Assessment Tool (CIPNAT), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Results: The mean score for disturbance in ADL from chemotherapy induced peripheral neuropathy was 3.30. Overall quality of life was 2.48. The mean score was 1.04 for psychological distress. The prevalence was 35.4% for anxiety and 47.7% for depression. There were significant correlations among the three variables, disturbance in ADL from chemotherapy induced peripheral neuropathy, psychosocial distress, and quality of life. Psychosocial distress had a complete mediating effect (${\beta}$= -.74, p <.001) in the relationship between disturbance in ADL from chemotherapy induced peripheral neuropathy and quality of life (Sobel test: Z= -6.11, p <.001). Conclusion: Based on the findings of this study, nursing intervention programs focusing on disturbance of ADL management, and decrease of psychological distress are highly recommended to improve quality of life in cancer patients.

Chemotherapy-related Cognitive Impairment and Quality of Life in People with Colon Cancer: The Mediating Effect of Psychological Distress (대장암 환자의 항암화학요법 관련 인지손상과 삶의 질: 심리적 디스트레스(우울·불안)의 매개효과)

  • Oh, Pok Ja;Kim, Jeong Hye
    • Journal of Korean Academy of Nursing
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    • v.46 no.1
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    • pp.19-28
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    • 2016
  • Purpose: The purpose of this study was to test the mediating effect of psychological distress in the relationship between chemotherapy related cognitive impairment (CRCI) and quality of life (QOL) in people with cancer. Methods: A purposive sample of 130 patients undergoing chemotherapy was recruited for the cross-sectional survey design. Data were collected from November 2014 to June 2015. The instruments were K-MMSE (Korean Mini-Mental State Examination), Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny steps for mediation. Results: The mean score for objective cognitive function was 27.95 and 69.32 for perceived cognitive decline. Overall quality of life was 91.74. The mean score was 17.52 for psychological distress. The prevalence was 56.2% for anxiety and 63.1% for depression, and 20.0% for CRCI. There were significant correlations among the variables, objective cognitive function and self-reported cognitive decline, psychological distress, and quality of life. Psychological distress was directly affected by CRCI. ($R^2=29%$). QOL was directly affected by CRCI. Psychological distress and CRCI effected QOL ($R^2=43%$). Psychological distress had a partial mediating effect (${\beta}=-.56$, p <.001) in the relationship between self-reported cognitive decline and quality of life (Sobel test: Z= -5.08, p <.001). Conclusion: Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline, and decreasing psychological distress are highly recommended to improve quality of life in cancer patients.

Impact of Uncertainty on the Anxiety of Hospitalized Pregnant Women Diagnosed with Preterm Labor: Focusing on Mediating Effect of Uncertainty Appraisal and Coping Style (입원한 조기진통 임부의 불확실성이 불안에 미치는 영향: 불확실성 평가와 대처양상의 매개효과를 중심으로)

  • Kim, Eun Mi;Hong, Sehoon
    • Journal of Korean Academy of Nursing
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    • v.48 no.4
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    • pp.485-496
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    • 2018
  • Purpose: This study aimed to test the mediating effect of uncertainty appraisal and coping style in the relation between uncertainty and anxiety in hospitalized pregnant women diagnosed with preterm labor. Methods: The participants were 105 pregnant women diagnosed with preterm labor in hospitals in Korea. Data were collected from July to October 2017. The measurements included the Uncertainty in Illness Scale, Uncertainty Appraisal Scale, Coping Style Scale, and State Anxiety Inventory. Data were analyzed using descriptive statistics, an independent t-test, correlation, and multiple regression following the Baron and Kenny method and Sobel test for mediation. Results: The mean score for anxiety was 2.29 out of 4.00 points and for uncertainty it was 2.46 out of 5.00 points. There were significant correlations among uncertainty, uncertainty danger appraisal, uncertainty opportunity appraisal, problem-focused coping, emotion-focused coping, and anxiety. Uncertainty danger appraisal (${\beta}=.64$, p<.001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=4.54, p<.001). Uncertainty opportunity appraisal (${\beta}=-.45$, p<.001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=3.28, p<.001). Emotion-focused coping (${\beta}=-.23$, p=.021) had a partial mediating effect in the relation between uncertainty and anxiety (Z=2.02, p=.044). Conclusion: Nursing intervention programs focusing on managing uncertainty appraisal and improving emotion-focused coping are highly recommended to decrease anxiety in hospitalized pregnant women diagnosed with preterm labor.