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Purpose The objective of this study was to assess effects of a medication adherence promotion program for breast cancer patients receiving adjuvant hormonal therapy. Methods This study used a randomized control group repeated measures design. A total of 79 participants were recruited from an outpatient clinic in the Chonbuk National University Hospital, Jeonju city. The program's effects on medication adherence, perceived stress, depression, and fatigue were assessed at three points: before, at the 9th week, and again at the 16th week of the program application. The data were collected from July 3 to November 9, 2017. Results Statistically significant differences in changes in medication adherence, perceived stress, and depression over the assessment points between experimental and control groups were revealed. Scores on medication adherence in the experimental group improved at the 9th week mark and lowered a little at the 16th week, but remained higher than before the program application, however. Scores on perceived stress and depression in the experimental group improved at the 9th week and stayed almost at the same level at the 16th week. Conclusion It is clear that consistent nursing interventions are needed to promote and maintain medication adherence and associated symptoms, particularly for breast cancer patients who require long-term hormonal therapy.
Purpose This study aimed to explore the level of well-dying in the elderly and identify the effects of social support, family support, and repulsion related nursing home on that. Methods The sample for this cross-sectional study consisted of 110 community-dwelling elderly and 103 nursing home residents. Data were collected using a structured questionnaire from August to October 2019. SPSS/WIN 25.0 program was used to conduct statistical analyses, including descriptive statistics, an independent t-test, a one-way analysis of variance, and stepwise multiple linear regression. Results The mean score for well-dying was 2.63±0.28 (range 1~4). Well-dying had a statistically significant relationship with religion (t=5.56, p<.001), household income (F=14.04, p<.001) and perceived health status (F=44.59, p<.001). Furthermore, social support (r=.71, p<.001), family support (r=.42, p<.001), and repulsion related nursing home (r=-.56, p<.001) significantly correlated with well-dying. Stepwise multiple linear regression demonstrated that social support, repulsion related nursing home, and having a religion explained 62.0% of the variance in well-dying. Conclusion Social support was found to have the largest influence on well-dying, followed by repulsion related nursing home and religion. The results highlight the need to develop a detailed nursing intervention that considers these factors to promote well-dying in the elderly.
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Purpose The purpose of this study was to identify the risk factors for suicidal ideation according to gender of old-old adults in South Korea. Methods Data were collected from the 2017 Living Profiles of Older People Survey, and participants were 4214 older adults (aged 75 years and above). Data were analyzed using SPSS Statistics 21.0 for Windows. Differences in suicidal ideation by gender were identified using the x2 test or independent t-test, with multi-variate logistic regression analyses conducted to determine the factors associated with suicidal ideation by gender. Results Among old-old adult participant, the prevalence of suicidal ideation in men and women were 5.4% and 6.7%, respectively. The significant predictive factors for suicidal ideation in men were the following: living alone, frequency of contact with children and friends etc., experience of discrimination, conflict with children, self-blame, anxiety, perceived health, number of chronic diseases, and diagnosed depression. The significant predictive factors for suicidal ideation in women were the following: frequency of contact with children, experience of discrimination, experience of abuse, conflict with children, anxiety, number of chronic diseases, perceived economic status, and diagnosed depression. Conclusion The study revealed differences in factors associated with suicidal ideation according to gender among old-old adults. These findings suggested that different approaches and strategies for suicidal prevention programs should therefore be considered according to gender in this population age group.
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Purpose This study aimed to examine the effects of auricular acupressure on shoulder pain and shoulder joint Range of Motion (ROM) in older adults. Methods This is an experimental, single-blind, randomized study with a placebo-controlled approach. The participants were older adults with shoulder pain. Each group was assigned 27 participants. The experimental group received auricular acupressure on shoulder pain-related points and the placebo-control group received auricular acupressure on shoulder pain-unrelated points. The intervention was implemented for eight weeks. To validate the effects of the treatment, a Visual Analogue Scale (VAS), the Shoulder Pain and Disability Index (SPADI), Pressure Pain Thresholds (PPTs), and ROM were conducted. VAS was measured before and after every intervention. SPADI, PPTs, and ROM were measured at the beginning and end of every intervention. Results The VAS scores in the experimental group with auricular acupressure significantly decreased with time (p<.001) and SPADI scores also significantly decreased (p<.001) compared with the scores of the placebo-control group. The experimental group's PPTs for their upper trapezius, levator scapulae, and rhomboideus major increased significantly, compared to that of the placebo-control group. The experimental group's ROM of flexion, abduction, and external rotation increased significantly compared to the placebo-control group. but there were no significant differences in internal rotation. Conclusion Auricular acupressure, applied for eight weeks, was found to effectively reduce shoulder joint pain and shoulder ROM. Consequently, auricular acupressure can be used as a nursing intervention method to reduce joint pain and improve shoulder ROM in elders.
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Purpose As the rate of older people visiting Emergency Departments (EDs) increases, nurses are responsible for identifying patients at risk of poor outcomes and providing preventive interventions. The aim of this study was to identify the factors associated with the mortality of older adults hospitalized through EDs. Methods The study design was a retrospective correlational design using the electronic medical records from a tertiary hospital in Korea. Data were collected from January 3 to March 6, 2016 through the hospital information center based on elderly patients admitted from January 1, 2011 to August 31, 2015. The study variables included general and admission characterstics, disease characteristics, and mortality of older patients visiting EDs. Results Of the 9,896 patients, the mortality rate was 7.4%; highest in patients aged over 86 years, men, or those hospitalized from nursing homes. Older adults arriving by private ambulance were 2.36 times more likely to die than walk-ins, and 1.38 times more likely for those using the 119 government emergency ambulance. Older patients hospitalized for more than four weeks were 2.17 times more likely to die than those hospitalized for less than a week. Conclusion Based on the study findings ward nurses will be able to early detect older patients at risk of poor outcomes and make better clinical decisions to improve the quality of nursing care. Nurses can propose health policies such as stricter management of the private ambulance service and considering the most efficient length of hospital stay for older adults hospitalized through EDs.
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Purpose This study aimed to identify factors influencing performance of pain assessment and pain intervention for dementia patients among long-term care hospital nurses. Methods In this descriptive study, participants were 106 nurses working in seven long-term care hospitals. Data were collected from August 13 to August 30, 2019. Nurses’ performance of pain assessment and pain intervention, attitude toward dementia, empathy, and knowledge about dementia-related pain were measured through self-reported questionnaires. Results The factors influencing performance of pain assessment were a total clinical career of 5 to 9 years (β=.29, p=.013) and a total clinical career of more than 15 years (β=.31, p=.013), which together explained 15.9% of the variance in the model. The factor influencing performance of pain intervention was attitude toward dementia (β=.31, p=.018), and explained 8.7% of the variance in the model. Empathy and knowledge about dementia-related pain were not found to be significant factors in either of the models. Conclusion The study findings suggest that a specialized education program for nurses with short clinical careers should be developed. Additionally, when designing the education program, it is recommended that varied content that can induce psychological and emotional attitude changes be included, as well as knowledge-oriented content. Finally, the more effective the pain assessment for dementia patients, the more appropriate the pain intervention and its performance will be. Thus, it is necessary to provide systematic training to enhance the pain assessment skills through a case study-based approach.
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Purpose This study examined physical activity and health-related factors affecting Health-Related Quality of Life (HRQoL) in older adults with lower educational levels. Methods Data were obtained from the Seventh Korea National Health and Nutrition Examination Survey (Ⅶ-1, 2016; Ⅶ-2, 2017). The sample consisted of 2,985 individuals aged 65 years or older, and the focus was on 1,788 older adults with low educational levels. The data were analyzed using an independent t-test, x2 test, and hierarchical multiple linear regression using the SPSS/WIN 24.0 program. Results The results of the hierarchical multiple regression analysis showed that subjective perceived health, cognitive stress, number of chronic diseases, and daily activity explained 25% of the variance in HRQoL after controlling for age and gender. In final model, physical activity types explained an additional 1% of the variance in HRQoL; walking was a significant predictor. Especially, among the various physical activity types, walking proved important for HRQoL. While aerobic exercise and strength exercise were associated with health status, in the hierarchical multiple regression analysis, they did not have an impact on HRQoL. Conclusion A walking-centric health care program to improve physical activity should be considered for HRQoL improvement in older adults with lower educational levels. Further research should consider how aerobic exercise and strength exercise could contribute to HRQoL improvement in this population.
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Purpose The purpose of this study was to verify the mediating effect of self-care performance between Self-Care Efficacy (SCE) and Health-Related Quality of Life (HRQoL) among patients on primary treatment for pulmonary tuberculosis. Methods A structured self-report survey was conducted with 143 patients on primary treatment for pulmonary tuberculosis. The collected data were analyzed using descriptive statistics, analysis of variance, Pearson correlation coefficient, hierarchical multiple linear regression, and Sobel test. Results There were significant correlations between participants’ SCE and self-care performance (r=.62, p<.001), SCE and HRQoL (r=.44, p<.001), and self-care performance and HRQoL (r=.54, p<.001). Self-care performance completely mediated the relationship between SCE and HRQoL (z=3.72, p<.001). Conclusion It is necessary to develop interventions for reinforcing SCE, focusing on low self-care groups, to ultimately improve the HRQoL of patients on primary treatment for pulmonary tuberculosis.
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Purpose This study aimed to identify the mediating effect of postoperative pain in the relationship between preoperative anxiety and Postoperative Nausea/Vomiting (PONV) in patients undergoing laparoscopic abdominal surgery. Methods The participants were 85 patients who were receiving laparoscopic abdominal surgery and undergoing general anesthesia at a university hospital. Data were collected from September 30 to December 13, 2019 using self-report questionnaires and clinical electronic medical records. The collected data were analyzed with descriptive statistics, independent t-tests, one-way analysis of variance, Pearson's correlation coefficient, and a three-step mediated regression analysis using SPSS/WIN 23.0. Results Significant positive correlations were observed between preoperative anxiety and postoperative pain (average score 24 hours after discharge from the recovery room) (r=.38, p<.001), preoperative anxiety and PONV (r=.45, p<.001), and postoperative pain (average score 24 hours after discharge from the recovery room) and PONV (r=.51, p<.001). Postoperative pain had a partial mediating effect (Z=2.28, p=.023) in the relationship between preoperative anxiety and PONV. Conclusion To reduce PONV experienced by patients who have undergone laparoscopic abdominal surgery, developing interventions and techniques to manage preoperative anxiety and alleviate postoperative pain is important.
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Purpose The purpose of this study was to explore and describe the process of illness adaptation of patients with Atrial Fibrillation (AF). Methods Data were collected from December 2017 to July 2018 through individual in-depth interviews with thirteen patients with AF. Verbatim transcripts were analyzed using the grounded theory methodology developed by Corbin and Strauss. Results The core category about the illness adaptation process of patients with AF was identified as “living a life managing the silent insurrection of the heart.” The process of illness adaptation of patients with AF consisted of four phases: “withdrawal”, “transition”, “practice”, and “adeptness”. Conclusion An in-depth understanding of the illness adaptation process of patients with AF will guide nurses in proactively developing and implementing effective nursing interventions to better support patients with AF in Korea.