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Volume 35(4); November 2023

Invited Article

The Significance of Sarcopenia in Patients with Heart Failure: What Do We Know and Need to Know?
Youn-Jung Son, Sook Hyun Park
Korean J Adult Nurs 2023;35(4):303-310.   Published online November 30, 2023
DOI: https://doi.org/10.7475/kjan.2023.35.4.303
Purpose
Sarcopenia is significantly associated with frailty, readmission, and mortality in patients with heart failure. This review aims to provide an overview of the literature on sarcopenia in individuals with heart failure.
Methods
A comprehensive literature review was conducted regarding the current state of knowledge on assessment tools for the diagnosis, prognosis, and optimal management of sarcopenia in patients with heart failure.
Results
Sarcopenia can be defined as the loss of muscle mass with low muscle strength and/or poor physical performance. Sarcopenia has been officially listed as a disease in the eighth revision of the Korean Classification of Diseases in 2021. The causes of sarcopenia in patients with heart failure are multifactorial, including chronic inflammation, hormonal imbalances, nutritional deficiencies, low muscle blood flow, and endothelial dysfunction. The management of sarcopenia is primarily focused on exercise and/or nutritional management because there is no specific pharmacological therapy to treat sarcopenia.
Conclusion
Healthcare professionals should be aware of the significance of early detection and timely management of sarcopenia to avoid physical disability, long-term institutional care, and mortality in individuals with heart failure. Clinical trials are required to evaluate the effectiveness of interventions including exercise and nutrition, alone or in combination, on sarcopenia in patients with heart failure. In addition, more research is required to identify multidimensional risk factors and diagnostic biomarkers for sarcopenia.
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Review Article

Present and Future of Research on Continuous Glucose Monitoring: A Narrative Review
Junhee Ahn, Jeong Hee Kang, Jihyon Pahn, Youngran Yang
Korean J Adult Nurs 2023;35(4):311-326.   Published online November 30, 2023
DOI: https://doi.org/10.7475/kjan.2023.35.4.311
Purpose
Continuous Glucose Monitoring (CGM) plays a crucial role in helping patients with diabetes manage their blood sugar levels. This review aimed to understand the context and scope of CGM-related studies in Korea and identified areas for future research, particularly in nursing science.
Methods
The search strategy involved examining eight electronic databases for published studies on CGM, with the search period ending in March 2022. Four independent reviewers conducted screening, selection, and narrative review of the studies.
Results
Descriptive and substantive analyses were performed for 68 studies on CGM, which covered diverse areas, including: (1) evaluating the CGM performance through comparisons with self-monitoring of blood glucose and correlations with existing indices; (2) validating the efficacy of CGM in improving patient outcomes and assessing various interventions; and (3) expanding the use of CGM, such as clinical guidelines and reviews, developing predictive models, and other clinical studies.
Conclusion
Research on CGM has expanded to include early performance evaluation, efficacy verification, and utilization in various clinical settings. However, there is a lack of nursing-focused studies of CGM. It is recommended to incorporate CGM in nursing research aimed at enhancing self-management for patients with diabetes. Future projects should focus on developing and applying patient-customized CGM user manuals, comparing the effectiveness of CGM among patients with different types of diabetes, exploring qualitative experiences of CGM use, and addressing related issues.

Citations

Citations to this article as recorded by  
  • Exploring the Initial Encounter with Continuous Glucose Monitoring among Individuals with Type 2 Diabetes: A Two-Week Trip
    Miseon Shin, Youngran Yang, Jeong Hee Kang, Heung Yong Jin
    Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 3521.     CrossRef
  • 73 View
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  • 1 Crossref
  • 1 Scopus
Original Articles
Quality of Life in Middle-aged Men with Prostatic hyperplasia: A Structural Equation Model
Hee Nam Moon, Seung Hee Yang
Korean J Adult Nurs 2023;35(4):327-339.   Published online November 30, 2023
DOI: https://doi.org/10.7475/kjan.2023.35.4.327
Purpose
This study employed structural equation modeling to verify the suitability and causality of a hypothetical model constructed based on Wilson and Cleary's health-related quality of life model. The aim was to explain and identify the factors that influence quality of life in middle-aged men with prostatic hyperplasia.
Methods
The study included 217 middle-aged men diagnosed with prostatic hyperplasia between February and March 2022 at the urology department of a general hospital in UJB city. The measurement tools used included biological characteristics, International Prostate Symptom Scores, functional health, general health perceptions, social support, and quality of life. The data collected were analyzed using the SPSS 25.0 and AMOS 25.0 programs.
Results
The final model revealed that the variables with the highest explanatory power for quality of life in middle-aged men with prostatic hyperplasia were general health perceptions, followed by the International Prostate Symptom Score, functional health, and prostate size. The explanatory power of the variables for quality of life in middle-aged men with prostatic hyperplasia was 89.7%.
Conclusion
The model used in this study was found to be suitable for assessing quality of life in middle-aged men with prostatic hyperplasia. Based on the study's findings, it is deemed necessary to foster competencies for managing the disease through the development of educational programs, nursing interventions, and countermeasures. These should be based on general health perceptions, symptoms, and functional health, with an accurate knowledge of the characteristics of prostatic hyperplasia, as per Wilson and Cleary (1995)'s health-related quality of life theory.
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Self-Management Behaviors for Chronic Low Back Pain in Patients with Spinal Disease: A Structural Equation Modeling Analysis
Jeom Suk Jung, Gwang Suk Kim
Korean J Adult Nurs 2023;35(4):340-355.   Published online November 30, 2023
DOI: https://doi.org/10.7475/kjan.2023.35.4.340
Purpose
The purpose of this study was to construct and test a hypothetical model of self-management behavior in patients with chronic low back pain based on the results of previous studies and a literature review.
Methods
Data from 218 outpatients with spinal disease who visited a university hospital from January 21 to August 3, 2021 with chronic back pain that had lasted for more than 3 months were collected and analyzed.
Results
The goodness-of-fit of the final model satisfied recommendations (RMR=.01, RMSEA=.07, GFI=.97, NFI=.95, TLI=.92, CFI=.97). Negative illness perception directly and negatively influenced self-management behavior (β=-.15, p=.021), and also indirectly affected self-management behavior through self-efficacy (β=-.07, p=.007). Positive illness perception directly exerted a positive impact on self-management behavior. Active participation, internal health control, and self-efficacy all directly influenced self-management behavior.
Conclusion
In order to improve self-management behavior in patients with chronic low back pain and spinal diseases, it is crucial to first determine whether the patient's perception of their illness is positive or negative. Patients should be encouraged to adopt a positive attitude towards their condition and to persist with self-management.
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Purpose
The triage process in the emergency department is a complex decision-making task influenced by individual competence and a multitude of factors. Unlike patient-related factors, nurse-related factors can be improved through education. This study sought to determine the impact of grit, self-leadership, and communication skills of emergency department nurses on their triage competency.
Methods
We surveyed a convenience sample of 152 emergency department nurses to evaluate their grit, self-leadership, communication skills, and triage competency. The differences in these skills and competencies were analyzed according to the participants' general characteristics using the independent t-test and one-way analysis of variance. Hierarchical regression analysis was performed to identify the factors influencing nurses' triage competency.
Results
Triage experience, self-leadership, and communication skills influenced triage competency. Although triage competency can be positively impacted by knowledge gained from experience, expert assessment was identified as the least developed category of triage competency.
Conclusion
To improve nurses' triage competency, it is necessary to implement educational programs that utilize various methods to address self-leadership and communication skills. Moreover, reflective methods can be employed to help develop self-leadership, thereby improving triage competency. These findings can contribute to improving the work culture and the development of educational programs. Specifically, these programs should treat nurses' mistakes during work as learning opportunities rather than failures, thereby significantly advancing their competency.

Citations

Citations to this article as recorded by  
  • The Association Between Self‐Esteem, Assertiveness, and Professional Competence Among Palestinian Newly Graduated Emergency and Critical Care Nurses
    Malakeh Z. Malak, Ahamd Ayed, Anas Shehadeh, Moath Abu Ejheisheh, Ahmad Batran
    International Nursing Review.2025;[Epub]     CrossRef
  • Experiences of Emergency Nurses Providing End‐of‐Life Care During the COVID‐19 Pandemic
    Alysha Cowley, Julia Morphet, Kimberley Crawford
    Journal of Advanced Nursing.2025;[Epub]     CrossRef
  • 65 View
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  • 2 Crossref
  • 3 Scopus
Purpose
The purpose of this study was to investigate the impacts of digital literacy, attitudes towards internet health information, and e-health literacy on health promotion behavior among adults.
Methods
A cross-sectional survey design was used. Data were collected from 260 adults aged 19 and older from two provinces. Data were collected from September 1 to 22, 2020. The data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression analysis.
Results
Hierarchic multiple regression analysis was conducted to evaluate the impact of the analyzed variables on participants' health promotion progress older age, better self-perceived health status, frequency of exercise (≥3/week), frequency of exercise (1~2/week), higher digital literacy scores, and no smoking history were associated with a higher degree of health promotion behavior, with an explanatory power of 37.0%.
Conclusion
Based on these results, in order to improve health promotion behavior in adults, it is necessary to pay more attention to younger people, those who do not exercise regularly, and smokers. In particular, as digital literacy was found to be a factor influencing health promotion behavior in adults, it is necessary to consider strategies that are tailored towards improving digital literacy in adults from all age groups and to conduct systematic education on digital devices.

Citations

Citations to this article as recorded by  
  • The Effect of Digital Health Literacy, Self-Efficacy on Self-Care Behaviors among Community-Dwelling Elderly: Focusing on Gyeongsangbuk-do
    Hyojin Son, Youngran Han
    Research in Community and Public Health Nursing.2025; 36: 59.     CrossRef
  • The Parallels, Pearls, and Perils of Health and Genomic Literacy
    Rebecca Kronk, Kim Subasic
    Nursing Clinics of North America.2025; 60(2): 229.     CrossRef
  • 80 View
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  • 2 Crossref
  • 2 Scopus
Purpose
This study investigated the knowledge, performance, and barrier awareness of Intensive Care Unit (ICU) medical staff concerning the prevention and management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in critically ill adult patients, and aimed to identify the factors influencing the performance of evidence-based PADIS management.
Methods
This cross-sectional and correlational study included 189 medical staff (17 physicians, 172 nurses) working in ICUs in two hospitals and recruited between July 13 and 31, 2022. Multiple linear regression analysis was performed to identify the factors associated with the PADIS-related performance of medical staff.
Results
The evidence-based performance level for PADIS prevention and management had a mean score of 3.55±0.37 out of 5 points, and the mean knowledge score was 28.23±3.00 out of 33 points. The mean awareness score for barriers to implementing PADIS prevention and management guidelines was 2.91±0.39 out of 5 points. Multiple regression analysis indicated that knowledge of delirium (β=.19, p=.014) and awareness of barriers within the individual domains of medical staff (β=-.20, p=.034) significantly influenced PADIS-related performance.
Conclusion
To implement evidence-based practices for the prevention and management of PADIS, steps should be taken to improve the knowledge and awareness of medical staff regarding PADIS. This could be improved through organizational support, such as systematic education and staffing. Specifically, an education program centered on delirium could significantly improve PADIS-related knowledge and performance.

Citations

Citations to this article as recorded by  
  • Review of advanced emergency evacuation procedures in hospital buildings: comprehensive analysis and insights
    Hao Wu, Ruimin Nie, Xu Zeng, Chuanjie Cheng, Jing Pan, Daguang Han, Haidar Hosamo
    Frontiers in Built Environment.2024;[Epub]     CrossRef
  • 63 View
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  • 1 Crossref
  • 1 Scopus
Purpose
The purpose of this study was to investigate the awareness and educational demand regarding Vancomycin-Resistant Enterococci (VRE) infection control among nurses in wards with cohort isolation rooms.
Methods
A mixed-methods design was applied. Quantitative data were collected via structured questionnaires and data from 61 nurses and analyzed using SPSS for Windows version 23.0. An Importance-Performance Analysis (IPA) was conducted. Qualitative data were collected through focus groups with 12 nurses who worked in wards with VRE cohort isolation rooms, and content analysis was conducted.
Results
All items had lower performance scores than their importance scores, with significant differences. In the qualitative/descriptive analysis, the barriers to implementing VRE infection control were a lack of awareness of infection control, increased work burden, and lack of resources.
Conclusion
The findings indicate that it is necessary to develop systematic education tailored to nurses in wards with cohort isolation rooms. Furthermore, adequate resource support, distinct from the general infection control practices in other wards, is necessary. This includes considering additional infection control tasks and procedures when staffing the ward, as well as supplying equipment in accordance with cohort isolation requirements.
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Effects of Clinical Nurses' Responses to Violence on Burnout: The Moderating Role of Positive Psychological Capital
Haejun Choi, Sujin Shin, Seungji Kim, Sungran Kim
Korean J Adult Nurs 2023;35(4):406-417.   Published online November 30, 2023
DOI: https://doi.org/10.7475/kjan.2023.35.4.406
Purpose
The purpose of this study was to investigate the moderating role of positive psychological capital on the effects of clinical nurses' responses to violence on burnout and to provide basic date for an intervention program that reduces nurse burnout.
Methods
The participants in this study were 172 nurses recruited through convenience sampling at one general hospital in Seoul. Data were collected from June 5 to 10, 2023 using structured questionnaires. The collected data were analyzed using SPSS/WIN 26.0.
Results
Burnout was positively correlated with violence responses and negatively correlated with positive psychological capital among clinical nurses. Verbal violence experience (β=.14, p=.014), job satisfaction (β=.31, p<.001), social violence response (β=.15, p=.035) and positive psychological capital (β=-.39, p<.001) were identified as factors significantly influencing clinical nurses' burnout. The interaction term between social violence response and positive psychological capital significantly influenced burnout (β=.18, p=.044).
Conclusion
Social violence response affected burnout among clinical nurses, and positive psychological capital was identified as a moderating factor in burnout. Therefore, hospital and nursing organizational efforts such as fostering an appropriate organizational atmosphere, providing social support that encourages trust and creativity among organizational members, and implementing various educational and mentoring programs are required to reduce nurses' social violence response and enhance positive psychological capital.
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Risk Predictors of Post-Embolization Syndrome after Transarterial Chemoembolization by Sex: A Retrospective Study
Han Byeol Lim, Myoung Soo Kim
Korean J Adult Nurs 2023;35(4):418-427.   Published online November 30, 2023
DOI: https://doi.org/10.7475/kjan.2023.35.4.418
Purpose
After Transarterial Chemoembolization (TACE), patients may experience Post-Embolization Syndrome (PES), which is characterized by abdominal pain, fever, and nausea/vomiting. Various risk factors, including demographic, clinical, laboratory, and radiological data, have been reported. This study aimed to identify sex-specific risk predictors of PES following TACE.
Methods
This retrospective study included 1,495 patients who underwent TACE and were discharged from January 1, 2014 to December 31, 2021. The demographic, clinical, laboratory, and radiological characteristics of the patients undergoing TACE were analyzed. Descriptive statistics, the χ2 test, the independent t-test (or Mann-Whitney U test), Spearman correlation analysis, and logistic regression were used.
Results
The incidence of PES was higher in female (43.9%) than in male (37.3%). Multivariate logistic regression analysis Alanine aminotransaminase (ALT) levels as the only independent predictor of PES in female patients (Exp [B]=1.01, 95% Confidence Interval [CI]=1.00~1.01). The risk factors of PES in male patients were a tumor >5 cm in diameter (Exp [B]=2.51, 95% CI=1.46~4.32), the amount of lipiodol (Exp [B]=1.27, 95% CI=1.01~1.60), C-Reactive Protein (CRP) levels (Exp [B]=1.11, 95% CI=1.02~1.21), ALT level (Exp [B]=1.00, 95% CI=1.00-1.01), lymphocyte levels (Exp [B]=0.98, 95% CI=0.96~0.99), and right posterior section (S6-S7) (Exp [B]=0.71, 95% CI=0.55-0.92).
Conclusion
Oncology nurses should be aware of sex-specific differences in PES risk and monitor clinical, laboratory, and radiological data to evaluate PES in female and male after TACE. The results of this study will serve as basic data for establishing a clinical decision-supporting system.
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