Purpose This study aimed to investigate the impact of physical performance and fear of falling on fall risk in patients with End-Stage Renal Disease (ESRD) undergoing hemodialysis.
Methods: This study included 132 patients who regularly received hemodialysis treatment at outpatient clinics in B City from January to April 2022. Data were collected on demographic and clinical characteristics, physical performance (the Short Physical Performance Battery [SPPB]), fear of falling (the Korean Falls Efficacy Scale-International [KFES-I]), and fall risk (the Morse Fall Scale [MFS]). The collected data were analyzed using hierarchical multiple regression in the SPSS/WIN 25.0 program.
Results: Thirty-eight patients (28.8%) had experienced accidental falls in the past year, with an average of 1.68 falls per patient. The average SPPB score was 7.89±3.55 (range, 0 to 12), the KFES-I score was 23.18±9.36 (range, 16 to 64), and the MFS score was 45.68±19.52 (range, 0 to 125). Fall risk showed a significant negative correlation with physical function (r=-.72, p<.001) and a significant positive correlation with fear of falling (r=.65, p<.001). Factors affecting the patients' fall risk included the level of serum intact parathyroid hormone (β=.15, p=.004), fear of falling (β=.24, p=.010), number of falls (β=.34, p<.001), and physical performance (β=-.41, p<.001). The regression model was statistically significant (F=22.71, p<.001), with an explanatory power of 64.9%.
Conclusion: To prevent accidental falls in ESRD patients undergoing hemodialysis treatment, it is necessary to develop and apply interventions that can enhance physical performance and reduce the fear of falling.
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Purpose This study aimed to explore the differences between patient and nurse perceptions of nursing needs and performance in integrated nursing care service wards within small to medium-sized hospitals.
Methods: The participants of the study were 116 patients and 116 nurses in the integrated nursing care service wards of small and medium-sized hospitals in U and Y cities. Data collection was conducted between July 18 and August 12, 2022.
The collected data were analyzed using descriptive statistics, the paired t-test, the independent t-test, and the importance-performance analysis.
Results: Only the difference between nurse-perceived nursing needs and nursing performance (gap 2) was statistically significant (t=4.18, p<.001). Patients' physical needs were higher than what nurses perceived, and patients' financial were higher than nursing performance as perceived by both nurses and patients. In addition, nurses' performance was lower than the perceived nursing needs in all domains.
According to the importance-performance analysis, the "concentrate here" areas included infection control, respect for patients' rights, and education of patients and families about diseases and treatment plans. Additionally, financial issues in nursing were identified as a "low priority" area requiring long-term intervention.
Conclusion: It is crucial to prioritize nursing care that addresses patients' needs for infection control, respect for rights, and education.
Nurses should also meet the physical and economic support needs of patients. Furthermore, it is recommended to adjust the nurse staffing ratio and foster systematic collaboration among hospitals, taking into account the circumstances of small to medium-sized hospitals.
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Purpose This study aimed to confirm the relationship between supportive care needs and resilience of female genital cancer patients, and to investigate the mediating effect of resilience in the relationship between supportive care needs and quality of life. Methods This study was conducted with 105 outpatients and inpatients who were receiving treatment for female genital cancer at K University Hospital in B City. Data were collected from July 22, 2021 to August 17, 2021 and analyzed by using the SPSS/WIN 23.0 program. The correlation between the patients’ supportive care needs, resilience, and quality of life was analyzed by Pearson's correlation coefficients, and SPSS Process Macro was used for the significance of parameter indirect effects. Results The quality of life of female genital cancer patients showed a significant negative correlation with supportive care needs (r=-.68, p<.001), and a significant positive correlation with resilience (r=.53, p<.001). Moreover, resilience partially mediated the relationship between supportive care needs and quality of life (95% CI -0.009~-0.032). Conclusion Based on the results of this study, improving the resilience of female genital cancer patients may act as an additional coping strategy to reduce supportive care needs and establish an enhanced quality of life.
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Korean J Adult Nurs 2021;33(4):406-414. Published online August 31, 2021
Purpose The purpose of this study was to assess the research performance during Coronavirus Disease 2019 (COVID-19) pandemic among nursing researchers.
Methods: A cross-sectional online survey was conducted for Korean Society of Adult Nursing where 103 subjects participated from April 15 to May 14, 2021. The survey tool developed by researchers had 32 items including difficulties in performing research activities, perception of the impact of COVID-19 on research validity, and three open-ended questions.
Results: In the research planning phase, 88 subjects (90.7%) reported difficulties in the recruitment plan and 83 subjects (89.3%) reported difficulties selecting a research design. In the recruitment and data collection phase, 85 subjects (88.6%) had difficulties accessing data collection site and 78 subjects (85.7%) had difficulties in face-to-face data collection. In the provision of intervention phase (for experimental study), 26 subjects (66.7%) reported that they should have changed the method of delivery of intervention. In research administration and manpower management, 62 subjects (75.6%) reported difficulties in face-to-face meeting. In research outcome management, 65 subjects (85.5%) reported that they should have changed the way of research-related events. Lastly, 80 subjects (81.6%) perceived that difficulties caused by COVID-19 impacted research validity.
Conclusion: Majority of participants perceived that the difficulties in research activities may decrease research validity. To ensure research quality during COVID-19 pandemic, we should recognize potential threats to research validity and actively pursue adaptable innovations of research designs and data collection methods.
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 methodological study was conducted to evaluate the interrater agreement in pressure ulcer risk assessment using the Braden scale, and in pressure ulcer classification, by nurses in a medium-sized hospital. METHODS Data were collected from a medium-sized hospital, located in Seoul, from December 18, 2017 to February 28, 2018. The author (Rater 1) and 20 randomly sampled nurses (Rater 2) independently assessed 100 patients. The Braden scale for risk assessment and the six-stage pressure ulcer classification system were used. The interrater agreement was evaluated using the Intraclass Correlation Coefficient (ICC), the proportion of agreement (Po), and the Bland-Altman plots. RESULTS For the total score on the Braden scale, the ICC was .85 and the Po was .29. Among the scale items, ‘moisture’ had the lowest agreement (ICC=.55, Po=.46). The interrater agreement had Po values of .84 and .69 for the presence and the classification of pressure ulcers, respectively. CONCLUSION For nurses in medium-sized hospitals, interrater agreement for the Braden scale and for the classification of pressure ulcers should be enhanced. In order to do this, overall institutional support is needed, including training in the accurate use of tools for pressure ulcer care.
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PURPOSE The purpose of this study was to identify the characteristics of nutritional status and its risk factors in patients with Chronic Obstructive Pulmonary Disease (COPD). METHODS Participants included 136 patients with COPD in Donga University hospital and Haeundae paik hospital in Busan city. The data, collected by a trained research assistant from January 10 to July 18, 2017, were analyzed using Fisher's exact test, the Mann-Whitney U test, and logistic regression analysis with SPSS/WIN 21.0. RESULTS Among the 136 patients with COPD, 31 (22.8%) had abnormal nutritional status. According to the results of the logistic regression analysis, gender (Odds Ratio [OR]=5.27, 95% Confidence Interval [CI]=1.18~23.49, p=.029), percent predicted forced expiratory volume in one second [FEV1%] (OR=1.04, 95% CI=0.92~0.99, p=.012), symptom experience (OR=16.19, 95% CI=3.08~85.00, p=.001), carbohydrate intake (OR=1.01, 95% CI=1.00~1.02, p=.037), protein intake (OR=1.06, 95% CI=0.90~0.99, p=.012), and fat intake (OR=1.04, 95% CI=1.01-1.08, p=.015) were associated with nutritional status in patients with COPD. CONCLUSION In order to improve the nutrutional status of COPD patients, nursing education is needed with intensive screen on female patients and patients with low lung function, managing symptoms and increasing protein intake.
PURPOSE The purpose of this study was to identify the relationship between the supportive care needs and quality of life of back-to-work breast cancer survivors, and determine the factors that affect their quality of life. METHODS Data were collected from 146 patients who had undergone surgery and treatment for breast cancer at Konyang University Hospital in Daejeon city and were receiving outpatient care from December 21, 2017 to November 30, 2018. The collected data were analyzed using the SPSS/WIN 21.0 program with descriptive statistics, an independent t-test, a one-way ANOVA, the Duncan test, Pearson's correlation coefficient, and hierarchical multiple regression. RESULTS Back-to-work breast cancer survivors show higher physical and mental health indices, which reflect quality of life, when they have fewer physical supportive care needs. Additionally, their physical and mental health indices based on the characteristics of the illness differed according to the cancer stage. CONCLUSION It is necessary to develop and test the effectiveness of health education programs that meet the supportive care needs and improve the quality of life of breast cancer survivors returning to work.
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PURPOSE This study aimed to compare the needs of family caregivers and program providers in family support program by exploring perspectives about the program in the long-term care system. METHODS This was a secondary analysis study using the content analysis method. The data of 11 family caregivers and 7 program providers that were collected from focus group interviews in two primary studies were used. Each data was collected in April and May 2015. The units of analysis were dyads of family caregivers and program providers. RESULTS The data were deductively analyzed within three main categories: program purpose, program content, and program method. Within the main categories, ten subcategories represented the essential elements for developing a family support program. There were differences between family caregivers and program providers in terms of the contents and intentions of the family support program. Family caregivers wanted to receive help from the family support program in a passive manner, while program providers expected the family support program to improve families' ability to solve their own problems. CONCLUSION Based on the results of this study, it is important to establish the strategies of customized and flexible program considering the needs of the caregivers to make family support program more effective. Further, it is necessary to fill the gap between the needs of the two groups and focus on family-centered approaches to conduct family support program more effectively.
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PURPOSE The purposes of this secondary analysis study was to examine prevalence, risk factors and unmet healthcare needs among adults with hypertension. METHODS A sample of 3,386 adults over the age of 40 with hypertension were drawn from the Korea Health Panel Study (2013). Using SPSS 22.0 version, descriptive statistics including frequency, percentage, chi-square and logistic regression were performed. RESULTS Results showed that 18.9% of the sample reported unmet healthcare needs with the most frequently cited one was financial burdens (43.2%). The reported experiences of unmet healthcare needs differed by gender, marital status, vision or hearing impairment, memory problem, impaired mobility, subjective health status, total family income, depressive episode and the difficulty in making decisions. The sample participants were more likely to report unmet healthcare if they had vision impairment, low income and perception that their health status as moderate to poor. Those without vision impairment were less likely to report unmet healthcare needs. CONCLUSION The identified risk factors of unmet healthcare needs should be addressed which would enhance access both to health care and to resolution of unmet healthcare needs. Since visual ability seems to impact perception of unmet healthcare needs, it may be useful to find ways to address this factor.
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PURPOSE This study identified the reasons why tuberculosis (TB) patients withhold treatment in a bid to develop a assessment scale to select patients who needs nursing intervention in the early stage and decrease the risk of discontinuation of treatment. Sample: There were two samples. A sample of 191 patients with TB and having primary treatment and a second sample of N who were under re-treatment. METHODS The study design included qualitative and quantitative methods. Qualitative data were collected from in-depth interviews of TB patients under re-treatment. The quantitative data were collected from 191 patients with TB under primary treatment. RESULTS Exploratory factor analysis revealed 11 factors explaining 69.6% of total variance. These factors were categorized into four subgroups. A depression scale was used to establish concurrent validity. The depression scale had a positive relationship (r=54) with the discontinuing of primary treatment. The internal consistency reliability for the four subgroups was over .84. The confidence coefficient was Cronbach's alpha.95. The final scale was a self-reported four Likert scale including 50 items. CONCLUSION Reliability and validity was established for the scale and the scale can be used to examine the risk of treatment discontinuation for TB. The scale is an important resource for nursing interventions in identifying and treating high risk clients.
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PURPOSE This study was to develop a Health Dieting Competency (HDC) scale to assess self-rated health dieting competence of college students. METHODS The scale was developed as follows: items generated, and tests of validity and reliability. Items were developed through a literature review, review of instruments, and interviews. A panel of four experts reviewed the scale for content validity. Factor analysis, Pearson correlation, descriptive statistics and Cronbach's alpha were used to analyze the data (N=183). RESULTS In the preliminary stage, thirty-three items were generated. Final items were fourteen that were selected through exploratory factor analysis. The HDC scale was consisted with five factors and fourteen items that were Goal-Directed (5-items), Health Support (2-items), Health Self-Efficacy (3-items), Health Perception (2-items), and Escaping from Health (2-items). The internal consistency of HDC as measured by Cronbach's alpha was .78. CONCLUSION Content validity, construct validity, and reliability of the HDC were established. The HDC scale is a reliable and valid instrument for early adulthood youth who are willing to assess health dieting competency.
PURPOSE Purposes of this study were to develop a reliable and valid checklist to assess and manage post-stroke dysphagia and to identify its utilization. METHODS The first step was to develop checklist through systematic literatures reviews, to test the content validity from 11 clinical experts, and to test the construct validity and the internal consistency from 97 patients with post-stroke dysphagia. The second step was to identify clinical use of the checklist from the same 97 patients. RESULTS A total of 18 items compromised the assessment checklist and 64 items for intervention checklist. Internal consistencies of assessment checklist and intervention checklist were .84 and .98, respectively. In both checklists, level of utilization of general appearance was the highest, while that of early signs of aspiration was the lowest. The utilization levels of two checklists were significantly higher among patients who were less than 60 years old, and had liquid diet, facial paralysis, and previous history of aspiration pneumonia. CONCLUSION We found that the checklists were reliable and valid. Further study is needed to develop specific strategies to improve nurses' use of assessment and intervention checklists for post-stroke dysphagia.
PURPOSE The purpose of this study was to identify the fall risk factors and to evaluate the effectiveness of the Morse Fall Scale(MFS) as an assessment tool among hospitalized inpatients. METHODS The medical records of a total of 294 patients who admitted to hospital from January 1 to December 31, 2010 were reviewed. One hundred forth seven patients who had experienced fall were matched with 147 patients who have never experienced fall. The fall information was obtained from electronic medical records and fall reports. RESULTS There were significant differences in visual disturbances, pain, emotional disturbances, sleep disorder, urination problems and elimination disorder at admission between fallers and non-fallers. Patients who had higher MFS scores at admission were more likely to fall as compared to the patients with lower MFS scores. When falls did occur, these occurred within five days following admission, in the patient room, among patients with alert mental status, and among patients who were ambulant with some assistance. CONCLUSION The findings of this study support the need of using risk assessment tool for predicting risk for falls. This finding can be used as a useful resource to develop nursing intervention strategies for fall prevention at the hospital.
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Fall Risk Factors and Characteristics of an Acute Hospital Setting across Clinical Departments In-Sil Jang, Sun-Gyo Lee Journal of Korean Academy of Fundamentals of Nursing.2014; 21(3): 264. CrossRef
PURPOSE This study was to examine the reliability and validity of Patient-Generated Subjective Global Assessment (PG-SGA) as a nutritional measurement for stroke patients. METHODS This was a methodological study performed from May 6 to June 10, 2009 at a tertiary university hospital in Seoul. For reliability of PG-SGA, inter-rater reliability was used for statistics. For concurrent validity, BMI and biomarkers were compared between PG-SGA 0 ~ 8 and > or = 9. In addition, sensitivity, specificity, and predictive value of PG-SGA compared with SGA were calculated using a contingency table. For predictive validity, hospital day, complications, and readmission within 1-month after discharge were compared between PG-SGA 0 ~ 8 and > or = 9. RESULTS Correlation of PG-SGA score between two observers was 0.83, and kappa value for the agreement of severe malnutrition was 0.78(all p(s) < .001). The scored PG-SGA showed high sensitivity and specificity (100% and 96.7%, respectively). Severe undernourished patients (PG-SGA > or = 9) had significantly low TLC, protein, albumin, and prealbumin (all p(s) < .01) compared with non-undernourished patients (PG-SGA 0 ~ 8). Also, in severe undernourished patients, complications and readmission (all p(s) = 0.01) were more often represented, and hospital days (p = .013) were significantly delayed. CONCLUSION PG-SGA is a reliable and valid measurement to assess nutritional status for stroke patients.
PURPOSE The purpose of the study were to examine the nutritional status of severe brain injury adult patients in critical period, and to compare the nutritional states before and after tube feeding. METHODS Data from 19 patients admitted to the SICU in a university hospital due to severe brain injury were analyzed. Nutritional states were measured by anthropometric and blood biochemical indicators. RESULTS MAC and MAMC were significantly decreased only at 7 days after admission compared with those on the day of admission. TSF was significantly decreased from 7 days to 14 days after admission. Fat rate was significantly decreased from 3 days to 14 days after admission. Hb was significantly decreased only at 3 days after admission. Albumin was significantly decreased from 3 days to 14 days after admission. However, lymphocyte was significantly increased at 14 days after admission. TSF and Albumin became significantly worse even after initiating tube feeding. CONCLUSIONS Nutritional status of severe brain injury patients in SICU became worse after admission whichever indicators were adopted to evaluate nutritional status, anthropometric or blood biochemical indicators, and became worse even after initiating tube feeding.
PURPOSE The purpose of this study was to describe perception and performance of health assessment among clinical nurses. METHODS The sample of this study consisted of 177 staff nurses working at university affiliated hospitals and a self-report questionnaire was used to collect data. Data were analyzed with SPSS WIN 12.0 program. RESULTS The overall mean scores of perception and performance of health assessment were 3.67 and 1.71 respectively. There were no significant differences according to educational level, working department, and type of health assessment courses taken for perception of health assessment. The variable significantly affecting health assessment performance was the working department. There was a statistically significant correlation between perception and performance of health assessment. CONCLUSION These findings suggest the need to develop a nursing education strategy to increase the performance of health assessment.
PURPOSE The purpose of this study was To exam the skin and pressure sore and To evaluate the predictive validity for the new pressure sores risk assessment scale. METHOD: There was finally 211 neurosurgery subject admitted in Chung-Ang Univ. Hospital from Nov, 11, 2002 to Feb, 11, 2003. Data was collected three times per week from 48-72hr after admission until incidence of pressure sores or discharge or die. Inclusion criteria were; (1) no pressure sores at admittance, (2) at least 3 times assessment, (3) adults older than 16yrs, (4) patients consent to participate in study. RESULT: 1. 34 case of 211 developed pressure sores(11.6%). 2. The coccyx area was the most common occurrence site of pressure sores. 3. At the cutoff point 23 of sensitivity 100%, specificity 76.3% was higher in 2003 than specificity 63.8% at the cutoff point 26 of sencitivity 100% in 1991. 4. "Moisture" of subscale for pressure sores risk factor was the strongest predictor. CONCLUSION: This study shows that the New Pressure Sores Risk Assessment Scale still predict the risk of developing pressure sores in neurosurgical subject.
This study tried to suggest the basic materials that can be efficiently applied in clinical cases by understanding problems through a content analysis of an adult nursing assessment tool and opinion agreement about nurse's practical usage presently used in the hospital. The study was carried out in 36 attached hospitals in nationwide universities from May to December, 1999, the two hundred and twenty five reports were for analysis. The contents of the collected nursing assessment tool were analyzed. It was found that the tool had been used with various names and content and there were instances of partial omission of a number of items, such as documentation and time records. Other results revealed that they mostly had a systematic classification of items, formation of details a form of a check list, and the effect of saving time. In spite of the adult nursing assessment tool, it was suggested that its style be subdivided according to the specialized of a department and that standardized style be amended and supplemented. The respondents also answered that there had to be education about continuous and sufficient health assessment skills on the physical examination record. The most frequently suggested items to be added were: past history, marital status, patient and caregiver's address and telephone number. It was found that a patient's education career, economic status, religion, hygienic practice, sexual life and hobby were the most frequently omitted items on record. The reason given wes because the items were associated with his/her privacy. These results highlight the importance of analyzing the content with an complete data collection, supplying basic content for a more accurate nursing record, computerization, sharing information and standardization of the form.