Purpose This study was conducted to develop a conceptual framework for understanding non-adherence to self-management among patients with Chronic Obstructive Pulmonary Disease (COPD). This was accomplished through a literature review, in-depth interviews with patients, and a survey of healthcare professionals featuring semi-structured open-ended questions. Methods First, a systematic literature review was conducted across five databases. Next, 25 patients with COPD participated in detailed interviews that included seven semi-structured questions. Subsequently, 15 healthcare professionals completed a survey about factor categories and specific factors associated with non-adherence to COPD self-management. Categories and factors identified at least once across these three methods were documented. Finally, two researchers conducted preliminary mapping of the relationships between factor categories and individual factors, which was assessed for face validity by a third researcher. All processes were conducted from March 28, 2022, and January 30, 2023. Results The research revealed eight factor categories and 53 individual factors associated with non-adherence to COPD self-management. The categories encompassed personal, socioeconomic, disease-related, functional, treatment- related, health system-related, and environmental characteristics. The literature review, patient interviews, and survey of healthcare professionals yielded 35, 19, and 44 factors, respectively. Twelve factors were identified using all three sources. All processes were conducted from March 28, 2022, and January 30, 2023. Conclusion In this study, quantitative and qualitative methods were employed to develop a conceptual framework for non-adherence to COPD self-management. The findings indicate that effective self-management of this condition requires not only patient effort but also adaptations to complex treatment regimens, societal perceptions, and workplace environments.
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Purpose This study aimed to evaluate the validity and reliability of the revised Korean version of the Chronic Hepatitis B Self-Management Scale-K16 (CHBSMS-K16).
Methods Using the convenience sampling method, the data of chronic hepatitis B patients (N=200) were collected from August to October 2021. The participants were recruited from two hospitals in D metropolitan city and 3 internet cafes for hepatitis patients. The data were analyzed using SPSS 26.0 and AMOS programs. The content, structure, item-convergent/discriminant, and convergent validities and internal consistency were evaluated.
Results Based on the statistical analysis, 9 items from the original version were excluded-resulting in 4 subscales with a total of 16 items. The confirmatory factor analysis demonstrated adequate model fit indices. The items convergence and discrimination validity were verified using extracted mean variance (.46~.65) and composition reliability (.81~.88). The convergent validity was satisfactory, as demonstrated by its correlation with the New General Self Efficacy scale (r=.63, p<.001). The Cronbach’s α for the overall scale was .88, and that of the four subscales ranged from .63 to .74.
Conclusion The CHBSMS-K16 is a valid and reliable instrument. Therefore, this tool can be used to measure the level of self-management of Korean patients with chronic hepatitis B. Additionally, this scale can be used in clinical settings as well as in educational and research settings.
Purpose The treatment of chronic kidney disease aims to delay dialysis and prevent progression to end-stage health complications. This study aimed to validate the Korean version of the Chronic Kidney Disease Self-Care (CKDSC-K) scale, which is used to measure self-care behaviors in patients with chronic kidney disease.
Methods Data from 285 participants were collected between August and November 2020. Validity was assessed in terms of content, construct, and concurrence through the content validity index and exploratory and confirmatory factor analyses. The reliability of the CKDSC-K was examined using internal consistency.
Results The final instrument consisted of 15 items across five factors (medication adherence, diet control, exercise, smoking behaviors, and blood pressure monitoring). The content validity index of the CKDSC-K was ≥.80. Confirmatory factor analysis indicated that factor loadings for the five factors ranged from .41 to .99, which explains the total variance of 75.3%. The internal reliability of the instrument was .81.
Conclusion The CKDSC-K scale has demonstrated acceptable reliability and validity and can be utilized to assess self-care behaviours in patients with chronic kidney disease. Additional research is recommended to expand the psychometric evaluation of the CKDSC-K.
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Purpose This narrative review aims to provide an introduction and overview of dyadic research within the context of chronic illness. In addition, some methodological considerations and future directions for conducting dyadic research are presented. Methods The focus of this review is on adult participants in dyads and with chronic illness based on the previous studies and literatures on dyadic science. Results Theory of Dyadic Illness Management and Dyadic Regulation-Connectivity Model (DR-CM) may be appropriate for performing dyadic research. At present, there is a lack of qualitative and quantitative knowledge on the dyadic approach for research on chronic diseases. Dyadic health interventions for building collaborative relationships within a dyad may be beneficial to improve dyadic health outcomes. This article addressed some of the challenges regarding recruitment, data collection, and analysis when it comes to planning dyadic research pertaining to chronic illnesses. Conclusion Healthcare professionals should prioritize needs and preferences at the dyadic level when designing effective chronic disease management. Particularly, it is critical to regularly monitor the dyadic relationships or type of dyadic care during illness trajectories. More research should be undertaken on patient-family caregiver dyads in chronic care, considering the various types of chronic diseases and cultural diversities.
Purpose The study sought to investigate the relationships between beliefs about medications, self-efficacy of medication use, social support and medication adherence, and the general factors associated with medication adherence among the elderly living with chronic disease.
Methods: This study took the form of a descriptive survey involving 222 elderly outpatients - aged 65 years or older - who visited S medical center, located in S city. Data were collected through self-report questionnaires from July to August 2019. Data analysis was conducted using descriptive statistics, an independent t-test, a one-way ANOVA, Pearson's correlation coefficient, and a hierarchical multiple regression via the SPSS/WIN 25.0 program.
Results: The mean score for medication adherence was 61.80±10.19 (range 16~80). Participants' medication adherence positively correlated with beliefs about medications (r=.17, p=.012), self-efficacy for medication use (r=.31, p<.001) and social support (r=.20, p=.003). Frequency of alcohol consumption (β=-.20, p=.001), burden level of medical costs (β=-.18, p=.012), experience of side-effects (β=-.21, p=.001), medication-taking education (β=.17, p=.008), beliefs about medication (β=.13, p=.038), and self-efficacy for medication use (β=.19, p=.004) explained for 24.9% of medication adherence (F=6.23, p<.001).
Conclusion: It is necessary to consider the beliefs about medication and self-efficacy for medication use when developing educational programs aimed at improving medication adherence among the elderly living with chronic diseases.
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Purpose This study was performed to explore the contexts and meanings of health life among patients with chronic kidney failure undergoing hemodialysis.
Methods: The ethnography steps presented by Spradley were utilized. The participants were 12 patients from two hemodialysis centers. Data were collected by iterative fieldwork through in-depth interviews and participant observations and analyzed using text analysis and taxonomic methods. Field notes were used along with interviews and dialogue between authors to enhance interpretation.
Results: Five themes on the health life of participants emerged: experiencing the loss of normality of the body and the collapse of daily life, establishing the role of dialysis patients, reorganizing the network, building an integrated coping pattern, and new normalization of the pattern of life. Patients' experiences differed in health life's patterns and meanings according to various individual situations and sociocultural contexts.
Conclusion: Establishing new patterns of life of hemodialysis patients was a normalization process to ensure the adequacy of physical indicators and stability amid physical, emotional, and social challenges. To achieve quality health life, patients should be provided with tailored nursing interventions that consider their individual, social, and cultural situations.
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Purpose This study examined sociodemographic and health factors affecting Health-Related Quality of Life (HRQoL) among older adults with osteoarthritis based on the duration of osteoarthritis. Methods Data were obtained from the Seventh Korean National Health and Nutrition Examination Survey (Ⅶ-1, 2016; Ⅶ-2, 2017). The sample consisted of total 747 older adults with osteoarthritis. The complex sample analysis was performed using an independent t-test, ANOVA, x2 test, and multiple linear regression using the SPSS/WIN 24.0 program. Results The HRQoL of older adults who had experienced osteoarthritis for 10 years or more was lower than the group who had experienced osteoarthritis for less than 10 years. The most influential factors affecting HRQoL across both groups were subjective health, limit of daily activity, and sickbed experience. Current alcohol consumption and body weight control were factors affecting HRQoL in the group who had experienced osteoarthritis for less than 10 years, while gender, current smoking, and walking were factors affecting HRQoL in the group who had experienced osteoarthritis for 10 years or more. Conclusion Community nurses should consider the target population and customize interventions based on the duration of osteoarthritis in order to improve HRQoL in older adults with osteoarthritis.
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Purpose This study evaluated the impact of Chronic Kidney Disease (CKD) on depression, perceived health, and Health-Related Quality of Life (HRQOL) in community-dwelling adults. Methods Data from 9,778 adults who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) in 2014 and 2016 were analyzed. The estimated glomerular filtration rate was calculated using the CKD Epidemiology Collaboration (CKD EPI) equation. Depression was defined as a score of at least 10 points on Patient Health Questionnaire-9 (PHQ-9).
The HRQOL was measured using the EuroQol-5D (EQ-5D). The effects of CKD on depression were analyzed using multivariate logistic regression, and the effects on perceived health and HRQOL were analyzed using multivariate ordered logistic regression. Results The prevalence of CKD was 3.7%. Among the adults with CKD, 13.1% had depression, 42.9% perceived their health to be bad, and their HRQOL was significantly lower than that of their non-CKD counterparts. The odds ratio for depression in patients with CKD was 1.66 (95% Confidence Interval [CI]=1.10~2.52, p=.017) and that of perceived bad or fair health was 1.80 (95% CI=1.35~2.40, p<.001). The likelihood of lower HRQOL in CKD patients was 1.44 times higher than in the non-CKD patients (95% CI=1.09~1.90, p=.010). Conclusion The prevalence of psychological problems in CKD patients was higher than in non-CKD patients. The results suggest the importance of comprehensive intervention for patients with CKD. Policies are needed to help assess and manage patients with CKD who are experiencing emotional problems.
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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 This study compares the characteristics of patients with Chronic Obstructive Pulmonary Disease (COPD) according to hospitalization frequency due to Acute Exacerbation (AE) using a retrospective medical records review. METHODS From August to October 2017, COPD patients who had visited the chonnam national university hospital were classified into three groups: (1) not hospitalization (n=115), (2) hospitalized once owing to AE (n=79) and (3) hospitalized twice or more owing to AE (n=47), and their medical records were reviewed. Data were analyzed using χ2, Kruskal Wallis, and Mann-Whitney tests, and logistic regression. RESULTS Home oxygen therapy, metered dose inhaler use, long-acting beta2-agonist, and Inhaled Corticosteroids (ICS) were used most in patients who were hospitalized twice or more. Symptoms of dyspnea and fever, prescription of phosphodiesterase-4 and oral corticosteroid were the least frequent in the patients who were not hospitalized, and they had the best pulmonary function test results. Home oxygen therapy (Odds Ratio [OR]=9.59, 95% Confidence Interval [CI]=2.53~36.46), and prescribed ICS (OR=2.77, 95% CI=1.14~6.77) and phosphodiesterase-4 (OR=5.35, 95% CI=1.69~16.93) were significantly associated with COPD readmission. For patients who were hospitalized once, SpO2 (p=.016), the frequency of positive pressure ventilation therapy (p=.023) and monitoring of oxygen saturation in nursing activities (p=.022) were higher than that of patients who were hospitalized twice or more. There was no significant difference in discharge education between the two hospitalized groups. CONCLUSION Regardless of the severity of illness, presence of respiratory symptoms, drug prescribed, or admission frequency, there were no differences in nursing activities and discharge education.
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PURPOSE The aim of this study was to investigate factors affecting medication adherence in hemodialysis patients. METHODS A convenience sample of 140 patients receiving hemodialysis was selected. Data were collected from December. 1. 2016 to January. 15. 2017 using a self-reported questionnaires including the eight-item Morisky's Medication Adherence Scale Korean version (K-MMAS-8). The collected data were analyzed with a descriptive test, independent t-test, one-way ANOVA, Pearson's correlation coefficient and stepwise multiple regression with SPSS/WIN 23.0. RESULTS The patients showed a low level of medication adherence (M±SD=5.75±1.65). There were significant differences in medication adherence according to subjective health status (F=6.88, p=.001) and discomfort in taking medication (t=−4.59, p<.001). Expectation of medication (r=.42, p<.001) and disgust of medication (r=−.36, p<.001) were the significant factors related to medication adherence. It was explained by expectation of medication (β=.30, p<001), disgust of medication (β=−.21, p=.007), discomfort in taking medication (β=.20, p=.010) and subjective health status (β=−.18, p=.016). CONCLUSION It is necessary not only to regularly monitor patients' medication behavior but also develop and implement an individualized nursing intervention that reflects expectation and disgust of medication.
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PURPOSE The purpose of this study was to identify factors affecting hyperphosphatemia in hemodialysis patients. METHODS The participants of the study were 129 patients who had been diagnosed with end-stage renal disease and received hemodialysis. Data were collected from June 15 to August 15, 2017, and analyzed with frequency, percentage, average, standard deviation, independent t-test, χ2 test, and logistic regression using SPSS/WIN 24.0 version. RESULTS Out of the 129 hemodialysis patients, 71 (55%) had hyperphosphatemia. There were significant differences between healthy group and hyperphosphatemia group in terms of age (p=.048), BMI (Body Mass Index) (p=.004), causative disease of chronic renal failure (p=.026), frequency of hemodialysis per week (p=.024), nutritional status (p < .001), weight gain on maintenance hemodialysis (p=.001), TIBC(Total Iron Binding Capacity) (p=.035), Ca (Calcium) × P (Phosphorus) (p < .001), BUN(Blood Urea Nitrogen) (p < .001), creatine (p=.012), and diet factors of self-care (p=.035). Results of the analysis of factors affecting hyperphosphatemia in hemodialysis patients indicated an increased risk of hyperphosphatemia with diabetes (Odds Ratio [OR]=21.45, 95% Confidence Interval [CI]=1.38~333.47), hypertension (OR=14.41, 95% CI=1.15~180.12), nutritional status (OR=9.37, 95% CI=1.36~64.18), weight gain on maintenance hemodialysis (OR=4.86, 95% CI=1.18~20.05), and BUN (OR=1.07, 95% CI=1.01~1.14). CONCLUSION Based on the results of this study, it is imperative to manage diabetes and hypertension of hemodialysis patients to prevent hyperphosphatemia. Additionally, it is necessary to not only regularly monitor patients' nutritional conditions and results of blood tests, but also develop and provide an individualized nursing intervention that reflects individual nutritional conditions and biochemical results.
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PURPOSE The aim of this study was to evaluate the effect of exercise on chronic musculoskeletal pain in older adults. METHODS In order to conduct a meta-analysis, a total 7,186 studies were retrieved from seven databases (Pubmed, CINAHL, Cochrane Library, RISS, KISS, NDSL, KoreaMed) without restriction on publication year and the articles published until June 2018 were selected for this study. Sixteen studies were selected for the meta-analysis based on their satisfaction of the inclusion criteria and low risk of bias. Baseline demographic data, exercise features, and outcome data were extracted from all included trials. The data was analyzed using the RevMan 5.2 and CMA 3.0. program. RESULTS The results of the meta-analysis (n=16) revealed that the exercise intervention was found to be significantly superior to control group on pain (Standardized Mean Difference [Hedges'g]=−0.43, 95% Confidence Interval [CI]=−0.59~−0.27). Also, meta-ANOVA was performed using study period, length and frequency of session and type of exercise, but no statistically significant moderators were found. CONCLUSION In this study, the exercise demonstrated significant reduction in pain intensity in older adults and there was no difference in pain reduction according to type or duration of exercise. Therefore, exercise that older adults prefers and is feasible in where they are, should be adopted as a nursing intervention for older adults' chronic musculoskeletal pain management.
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PURPOSE The aim of this study was to investigate the factors contributing to health-related quality of life (HRQOL) among patients with chronic hepatitis B (CHB). METHODS A cross-sectional, descriptive design was used. The sample included 114 patients in a gastroenterology outpatient department at one hospital located in G city. Data were collected using a structured questionnaire from June to December 2009. The collected data were analyzed using SPSS/WIN 15.0. RESULTS Health-related quality of life was most strongly related to age, sex, income, occupation, and the care provider. Old age, female gender, lower income, not having an occupation and having a non-medical person were associated with lower HRQOL (R2=.03~.22, p=.041~<.001). CONCLUSION CHB infection had a negative impact on HRQOL among the older, female gender, low socioeconomic status and not having medically knowledgeable care givers. Interventions beyond nursing care may be needed to improve the quality of health for patients with Chronic Hepatitis B.
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Quality of Life of Chronic Hepatitis C Patients and Its Associated Factors Hoo Jeung Cho, Euna Park Osong Public Health and Research Perspectives.2017; 8(2): 124. CrossRef
Related Factors of Quality of Life in Middle-male with Chronic Liver Disease Eun-Su Do, Sun-Mi Lee, Young-Sook Seo Journal of Digital Convergence.2015; 13(2): 267. CrossRef
PURPOSE The purpose of this study was to explore the chronic patients' references for care near the end of life. METHODS This is a descriptive survey research, with subjects of 161 outpatients with hypertension, diabetes mellitus or chronic renal failure. RESULTS The majority of the subjects do not want meaningless life sustaining treatment and they report thinking positively about family or health care professional to participate in their end of life decision making process. Subjects reported preferring adequate pain management and spiritual support at the end of life. In regard to advance directives (ADs), those subjects with chronic disease report thinking positively about the necessity of ADs and its institutionalization. However, the subjects report not having the detailed information on the proper time and method of writing their ADs. CONCLUSION Based on these results, educational programs on end of life decision making for chronic patients need to be developed. Also, the nurse should try to reflect the opinion of chronic patients as much as possible when make an end-of-life decision.
PURPOSE The purpose of this study was to examine relationships among blood glucose, HbA1c, and self management comparing these with general and illness characteristics of subjects with Type II Diabetes living in the community. METHODS Using a comprehensive survey developed for the study, data were collected from 82 type II diabetes patients who were registered at five community health departments. The variables of self management, blood glucose and HbA1c were assessed by nurses. Data were analyzed with descriptive statistics including t-test, ANOVA and Pearson's correlation coefficient to compare self management and level of HbA1c by subject's general and illness characteristics and to examine the relationships among variables. RESULTS About 73.2% of the subjects' HbA1c were 7.0% or higher and 54.9% of subjects' blood glucose were 200 mg/dL or higher. The level of self management was moderate. Most frequently perceived reasons for failure of blood glucose control were dietary failure (32.9%). There was significant relationship between self management and HbA1c(r=-.223, p=.040). The mean score of self management were higher among female (t=-2.37, p=.021), who are not on diabetes medication (t=6.70, p=.011). CONCLUSION Comprehensive intervention is needed to improve dietary self management, especially for male and those who is on diabetes medication.
PURPOSE This study was conducted to develop and test an explanatory model on functional capacity in patients with chronic obstructive pulmonary disease using path analysis. METHODS: Data were collected from 149 chronic obstructive pulmonary disease patients using 6-minute walk test, measurement of oxygen saturation, pulmonary function test, and self-reported questionnaires from June to October, 2005. The collected data were analyzed using SPSS/WIN 12.0 program and AMOS/WIN 4.0 program. RESULTS: The overall fitness indices of modified model were good( chi-square = 14.324, p = .281 GFI = .981, RMSEA = .006, AGFI = .944, NFI = .927, NNFI = .999, CFI = .999, PNFI = .613, chi-square /df = 1.194). Functional capacity was influenced directly by age(beta = -.304, p = .000), dyspnea(beta = -.278, p = .000), self-efficacy(beta = .240, p = .000), social support(beta = .175, p = .004), pulmonary function(beta = .169, p = .008), and oxygen saturation(beta = .099, p = .048). These variables explained 39.3% in functional capacity. CONCLUSION: The findings of this study suggest that comprehensive nursing interventions should focus on decreasing dyspnea and increasing self-efficacy, social support, and oxygen saturation. In this perspective, pulmonary rehabilitation would be an effective strategy for improving functional capacity in patients with chronic obstructive pulmonary disease.
PURPOSE This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. METHODS The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of FEV1/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, FEV1% predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. RESULTS The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). CONCLUSION It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.
PURPOSE This study was to identify the relationship between family support, self-efficacy and self-care performance in patients with chronic illness. METHODS: The subjects were 100 in-and out-patients who were diagnosed with chronic illness at university hospital in Cheonan. The data analyzed using descriptive statistics, Pearson correlation coefficient and stepwise multiple regression with SPSS WIN 12.0. RESULTS: The level of family support, self-efficacy and self-care performance were high. The family support in patients with chronic illness indicated a significant positive correlation to self-care performance but no significant correlation to self-efficacy. The self-efficacy in patients with chronic illness indicated a significant positive correlation to self-care performance. Family support and self-efficacy account for 24.4% of variance of the self-care performance. The most significant predictor which influenced self-care performance in patients with chronic illness was family support. CONCLUSION: The results of this study showed that family support and self-efficacy are very important variables in explaining the self-care performance. Therefore, these variables should be considered in nursing intervention development and education.
PURPOSE The research aims to understand the lived experience of the caregivers of chronic renal failure(CRF) patients and its essential meaning. The results of the study can be used as basic materials for developing comprehensive intervention methods of care givers of CRF patients. METHOD: The research used van Manen's hermeneutic and phenomenological research methods in order to describe the lived experience and to understand its meaning. It concentrates on the understanding the essence of experience and consists of existential survey, hermeneutic and phenomenological reflection and hermeneutic writings. Participants in this research were five women care givers of CRF patients who had hemolysis at C university hospital in a metropolitan city, the period of data collection was from July 27 to Sep. 4, 2004 and major data of results in the following 5 essential themes. 'sole responsibility for the patient enduring everything', 'creating their own field', 'heavy and painful life without hope of their private life', 'wishing not to be inherited and consoling each other'. CONCLUSION: The above findings point out that the experience of care givers of CRF patient affected and changed all parts of an individual life and his or her family life. Therefore, it suggests that total family nursing care must be considered in order to provide the holistic caring for CRF patients and their care givers.
PURPOSE The purpose of this study was to evaluate and compare the predictive ability of three mortality scoring systems; Acute Physiology and Chronic Health Evaluation(APACHE) III, Simplified Acute Physiology Score(SAPS) II, and Mortality Probability Model(MPM) II in discriminating in-hospital mortality for intensive care unit(ICU) patients with spontaneous intracerebral hemorrhage. METHODS: Eighty-nine patients admitted to the ICU at a university hospital in Daejeon Korea were recruited for this study. Medical records of the subject were reviewed by a researcher from January 1, 2003 to March 31, 2004, retrospectively. Data were analyzed using SAS 8.1. General characteristic of the subjects were analyzed for frequency and percentage. RESULTS: The results of this study were summarized as follows. The values of the Hosmer-Lemeshow's goodness-of-fit test for the APACHE III, the SAPS II and the MPM II were chi-square H=4.3849 p=0.7345, chi-square H= 15.4491 p=0.0307, and chi-square H=0.3356 p=0.8455, respectively. Thus, The calibration of the MPM II found to be the best scoring system, followed by APACHE III. For ROC curve analysis, the areas under the curves of APACHE III, SAPS II, and MPM II were 0.934, 0.918 and 0.813, respectively. Thus, the discrimination of three scoring systems were satisfactory. For two-by-two decision matrices with a decision criterion of 0.5, the correct classification of three scoring systems were good. CONCLUSION: Both the APACHE III and the MPM II had an excellent power of mortality prediction and discrimination for spontaneous intracerebral hemorrhage patients in ICU.
PURPOSE This study was conducted to explore the degree of depression, perceived health status, chronic disease and quality of life(QOL) among rural elderly and to determine the factors related to their QOL. METHOD: The design of this study was a correlational study. The subjects were 423 elderly consisted of 157(37.1%) men and 266(62.9%) women dwelling in a rural area of N City. Data were collected from May to December, 2003 using a structured questionnaire. A stepwise multiple regression analysis was performed to identify the factors related to the QOL. RESULT: It was found that the mean score of QOL was in total with 2.15 out of 5.00 and women elderly's score was significantly lower than men(t=2.20, p=.028). Perceived health status showed statistically significant positive relationship with QOL(r=.608, p<.05), while depression(r=-.751, p<.01) and chronic illness(r=-.336, p<.01) showed statistically significant negative relationship. Depression was found to have the highest correlation with QOL among the subjects. Depression score explained QOL at the most, accounting for 36.8% of the variability, followed by perceived health(8.2%) and the number of chronic illness(.7%). Other factors related to the QOL were economic status and absence of spouse. CONCLUSION: In order to increase the QOL of rural elderly, it is necessary to decrease the depression, to increase their perceived health status and to decrease the number of chronic illness. We suggest the implementation of a program not only to promote physical health status and self-care ability but to take care of mental health for the rural elderly.
PURPOSE This study was performed to identify the illness intrusiveness, quality of life, and their relationships in patients with chronic liver disease. METHOD Data was collected using scales of illness intrusiveness developed by Devins et al and Korean health related quality of life (KoQoLS) developed by Shim et al to measure the illness intrusiveness and quality of life from 141 chronic liver disease patients. RESULT The total mean score of illness intrusiveness was 38.85+/-18.45. The domain of illness intrusiveness which showed the highest mean score was health (4.60+/-2.02), and the lowest mean score domain was relationship with spouse (2.04+/-1.69). The subcategory of KoQoLS which showed the highest mean score was bodily pain (6.96+/-2.98), and the lowest mean score subcategory was vitality (2.75+/-1.20). There were negative relationships between illness intrusiveness and KoQoLS in all subcategories. Abovel all, Illness intrusiveness had the strongest negative relationship with role limitation (r=-0.641) among the KoQoLS subcategories. CONCLUSION Because the illness intrusiveness had negative influence on the quality of life in patients with chronic liver disease, further research will need to specify detailed illness intrusiveness and to explore influencing factors on quality of life in them.
PURPOSE The purpose of this study was to assess social support, mood, and commitment to a plan for exercise of Korean adults with chronic diseases. Further, the relationships between social support, mood, and commitment to a plan for exercise were assessed. METHOD The participants in this study were 230 Korean adults over 18 years of age with chronic diseases who were recruited in hospitals or health centers. The instruments used in this study were Exercise Social Support Scale, POMS (Profile of Mood States), and Commitment to a Plan for Exercise Scale. RESULT The results of descriptive analysis showed that Korean adults with chronic diseases were perceived with relatively low commitment to a plan for exercise while they were perceived with moderate social support and mood states. Pearson's correlation coefficient showed significant relationship between these three variables. Stepwise regression indicated that 37% of the variance in commitment to a plan for exercise was explained by social support and vigor factor of the POMS. CONCLUSION Health professionals can use this information for planning a targeted strategy to increase regular exercise among Korean adults with chronic diseases in order to improve their quality of life and control disease-related symptoms.
PURPOSE The aim of this study was to investigate the difference of in the level of pain, depression, and quality of life by coping strategy in the chronic arthritis patients. METHOD These data were collected by means of a self-reported questionnaire from 90 chronic arthritis patients undergoing treatment at a university hospital in Daegu city from June 10, 2000 to July 15, 2000. The instruments of study were coping strategy scale by Jeon(1985), pain scale by Lee and Song(1987), depression scale by Radloff(1977) and quality of life scale by Cho(1987). Data analysis was done by SPSS Win 10.0 program and Pearson correlation, t-test, Cronbach's-alpha were used. RESULT The results of this study were as follows: 1. The item mean score of pain for chronic arthritis patient was 6.54. The item mean score of depression for chronic arthritis patient was 2.18. The item mean score of quality of life for chronic arthritis patient was 5.69. 2. The chronic arthritis patients with problem-focused coping experienced pain higher than those with emotion-focused coping(t=o.400, p=o.o45). The chronic arthritis patients with emotion-focused coping experienced depression higher than those with problem-focused coping(t=-2.564, p=0.012). The chronic arthritis patients with problem-focused coping experienced quality of life higher than emotion-focused coping(t=-1.682, p=0.046). CONCLUSION In conclusion this study showed that any coping strategy can control the arthritis patient's problem. Therfore, The development of a coping strategy to reduce pain and depression and improve the quality of life in the chronic arthritis patient will be needed.
In Korea, most of the patients with chronic liver diseases have been using some kind of alternative therapies at home. however, the question is why do people turn to alternative therapy and how the patients are able to use the alternative therapies widely, though the effects have not been proven scientifically. Therefore, it is necessary to explore the process of the patients' experiences using the alternative therapies. The 16 participants were from internal- medical departments in hospital and the permission was received to participate in this study from the subjects. The data were collected with interviews and participants observations, analyzed by the grounded theory methodology of Strauss and Corbin(1990). With the analysis of the data, 15 categories were generated such as psychological pressures, barriers of role performances, distrusts of western medicine, blind obediences to the treatments, attitudes towards alternative therapies, supportive systems, obstacles to taking alternative therapies, financial burdens, collecting informations, pursuing alternative modalities, efforting diversities, analyzing by themselves, managing the body, accepting the disease, and ambivalence. The paradigm model was developed to identify the relationships of categories. The central phenomenon of the experiences of seeking alternative therapies was named jagi momdasrim. The central concept of jagi momdasrim is a mind-set to desire to wellness and to take more responsibility for one's own healing by pursuing alternate healing modalities rather than the western medical system. The process of jagi momdasrim evolved several stages such as seeking, finding, struggling, overcoming, fulfilling, and governing the diseases. Four patterns of taking alternative therapies were found as follows: the bulsin-chujong-hyung, the suyoung-hyung, the yangdari-gulchiki-hyung, the chamjae-hyung. In conclusion, the phenomenon of alternative therapies as consumer-driven force to heal the chronic liver diseases of the patients could be explained as an adaptive behavior through the process of jagi momdasrim. However, since most of the participants practicing some kind of alternative therapies had no evidences of its effects and never tried to consult with their medical doctors about alternative therapies, we should approach more actively. Therefore, it is recommended for nurses to listen and watch the patients behaviors of using alternative therapies and find out how to educate the patients about the proper and safe way to take the alternative therapies.
The purpose of the study was to investigate two areas as a basis for providing an educational program for pulmonary rehabilitation. A) the learning needs about chronic obstructive pulmonary disease in patients with chronic obstructive pulmonary disease and B) the perception of nurses of the same learning needs. The subjects consisted of 57 patients, with chronic obstructive pulmonary disease, at the general hospital in Seoul and 71 nurses, who were working in the medical ward. Data was obtained from a "learning need" questionnaire between October 29 and November 19, '99. Data was analyzed using SAS program for t-test, ANOVA, Scheff test. The result were as follows: 1. The learning needs of the nurses(mean 4.36 +/- .38) were higher than those of the patients (mean 3.56 +/- .83). (t=6.78, P=.001) 2. The highest ranked patient education needs were as follows ; a)"how to control dyspnea", b)"cause for activating dyspnea", and c)"how to minimize the necessity of oxygen in daily living": and nurses' learning needs were ; a)"how to cope with the risk situation", b)"management after discharge", and c)"how to control dyspnea". 3. In the patient group, those who had a college degree or higher education and paid their own hospital expenses were higher in the learning needs. According to the above results, we should consider an educational program which is realistic and effective for patients by evaluating the items the patients really want to learn about and how much they know about the evaluated items.
This study was conducted to identify the relationships among quality of life, ADL, depression and self-efficacy in people with chronic arthritis. Firth two patients with chronic arthritis participated in this study. The data were collected from 5th Jan. To 15th Oct., 1997. SPSS program was utilized for data with mean, standard deviation, pearson's correlation coefficient. The results of this study were as follows ; 1. The mean score of quality of life was 5.47, representing moderate degree of quality of life. The mean scores were 2.54 for ADL, 2.06 for depression and 61.69 for self-efficacy. 2. Significant correlations between quality of life and ADL, self-efficacy, and depression were found. quality of life was positively related to ADL and self-efficacy, while negative correlation was shown between quality of life and depression. 3. When correlated with demographic characteristics, quality of life was significantly negatively related to duration of illness. The study results suggested that nursing intervention such as, self-help education improving self-efficacy would be useful for patients who are depressed and have limited ADL.
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