Purpose The aim of this study was to identify the coping profiles of patients with coronary artery disease and to examine their associations with cardiac health behavior. Methods In this cross-sectional study, data from 203 patients undergoing percutaneous coronary intervention for coronary artery disease were analyzed. Data collection occurred between September 2020 and June 2021, utilizing self-report questionnaires and electronic medical records at a cardiology outpatient clinic. Descriptive statistics, latent profile analysis, and logistic regression were employed for data analysis. Results The Type I coping profile was characterized by the greater use of most coping strategies, particularly problem-focused approaches, relative to the other profiles. The Type II coping profile exhibited below-average use of all coping strategies, except for substance use. The Type III coping profile displayed higher tendencies toward venting, self-blame, denial, behavioral disengagement, and substance use compared to the other profiles. Patients with the Type I coping profile displayed greater engagement in cardiac health behavior than those with Type II and Type III, as indicated by odds ratios of 2.57 (95% confidence interval=1.31~5.07) and 7.19 (95% confidence interval=2.10~24.56), respectively. Conclusion Participation in cardiac health behavior varies according to the coping profiles of patients with coronary artery disease. Healthcare providers should recognize and support appropriate coping strategies in these patients to promote healthy behaviors. A longitudinal study investigating how changes in coping profiles relate to cardiac health behavior could assist patients with coronary artery disease in maintaining such behaviors.
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 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.
Purpose This study identified and compared the pain and associated symptoms of stable coronary artery diseases and acute coronary syndrome. Methods The study participants comprised 180 patients with stable coronary artery diseases and acute coronary syndrome. The data were collected from August 25, 2020, to October 30, 2020. Results We found that 77.2% of participants had pain and associated symptoms, and 85.6% had one or more associated symptoms. In the associated symptoms, patients with acute coronary syndrome expressed squeezing, and patients with stable coronary artery diseases expressed expanding. Patients with stable coronary artery diseases reported increased pain during exercise. Moreover, although there was no statistically significant difference, drinking, eating, and cold weather often exacerbated pain in patients with acute coronary syndrome.
The average pain intensity of patients with stable coronary artery diseases was moderate (4.09±2.79). The average pain intensity of acute coronary syndrome patients was severe (5.68±3.34). Patients with acute coronary syndrome mainly reported cold sweat and loss of consciousness. Palpitations and dizziness were prevalent complaints in patients with stable coronary artery diseases. Conclusion Based on this study's results, a nursing assessment can be performed when managing patients with coronary artery disease. In addition, a nursing assessment protocol could be developed based on the analysis results regarding pain and associated symptoms in patients with stable coronary artery diseases and acute coronary syndrome.
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Purpose This study aimed to identify factors related to nurses’ preparedness to care for patients with highly infectious diseases in long-term care hospitals based on the Theory of Planned Behavior (TPB).
Methods: The participants were 226 nurses from 10 long-term care hospitals located in a metropolitan city in Korea. Core components of the TPB, organizational culture for infection control, nursing practice environment, and preparedness to care for patients with highly infectious diseases were measured using a structured online self-report questionnaire. Data were collected from October 25 to December 26, 2021 and were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and multiple regression.
Results: The mean score of preparedness to care for patients with highly infectious diseases was 4.99±1.90 out of 10. The perceived behavioral control (β=.37, p<.001), control beliefs (β=.24, p<.001), attitude toward behavior (β=.18, p=.001), behavioral belief (β=.12, p=.035), and nursing practice environment (β=.12, p=.023) significantly predicted the nursing staff’s preparedness to care for these patients (Adj. R 2 =.62).
Conclusion: Theory-based interventions are needed to enhance the confidence of nurses in caring for the patients with highly infectious diseases and to improve their attitude and beliefs regarding positive outcomes in caring for these patients. High quality teamwork and support of resources are necessary to increase the preparedness to care for patients with highly infectious diseases in the nursing practice environment in long-term care hospitals.
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Purpose This study aims to confirm the influence of type D personality and health literacy on resilience of patients hospitalized for Cardiovascular Diseases (CVDs), and provide basic information for improving resilience as a post-discharge strategy to promote self-care among patients with chronic diseases.
Methods A questionnaire-based survey was carried out in this cross-sectional study. The subjects were 142 patients who were being treated at a tertiary general hospital for CVDs such as coronary artery disease, arrhythmia, and heart failure. Data were collected from July to October 2022 using a structured questionnaire, and then analyzed using the SPSS program version 26.0.
Results 75.3% of the study subjects (n=107) had type D personalities, and the average health literacy and resilience scores were 48.96±9.13 points and 68.27±13.02 points, respectively, indicating relatively low grades. Following a hierarchical regression analysis, low monthly income (β=-.62, p<.001), current smokers (β=-.23, p=.010), patients with type D personality (β=-.24, p=.001), and patients with low health literacy (β=.27, p<.001) were identified as significant predictors of resilience (Adjusted R2=.57, F=14.32, p<.001).
Conclusion In order to increase the resilience of patients hospitalized for CVD, it is necessary to identify and take into account smokers with low socioeconomic status, poor health literacy, and type D personality. We advise doing a follow-up study to ascertain if the resilience of patients hospitalized for CVD influences post-discharge self-care and clinical outcomes.
Purpose This study investigated the level of Activities of Daily Living (ADL) of elderly patients with pulmonary disease preparing for discharge and the factors affecting it.
Methods The participants of this cross-sectional, descriptive study were 104 patients aged over 65 diagnosed with pulmonary disease at an acute care hospital. Data were collected from November 28, 2018 to March 15, 2019 using a structured questionnaire and the participants’ electronic medical record. The questionnaire asked about demographic and disease-related characteristics and respiratory symptoms experience, and included the Korean versions of the ENRICHD Social Support Instrument, Hospital Anxiety and Depression Scale, and Katz’s ADL.
Results In the enter-method multiple linear regression analysis, the model explained 38.1% of the ADL (F=4.26, p<.001). The higher the participants’ level of depression, the lower their level of ADL (β=0.43, p<.001), while those without a history of any neurological or psychiatric disease had higher levels of ADL than their counterparts with it (β=-0.22, p=.024).
Conclusion The findings suggest that an intervention that considers depression and history of neurological or psychiatric disease should be implemented to promote ADL among elderly patients with pulmonary disease preparing for discharge. In addition, the results of this study can be used as fundamental information to assess the discharge readiness of elderly patients with pulmonary disease and improve their health-related quality of life by promoting ADL.
Purpose This study aimed to develop and examine the effects of a mobile application-based self-management program for Chemotherapy-Induced Peripheral Neuropathy (CIPN) in colorectal cancer patients. Methods This study used a nonequivalent control group and a pretest-posttest design. Eighty-three patients with colorectal cancer undergoing neurotoxic chemotherapy were included in the study (experimental group, n=41; control group, n=42).
The self-management program for CIPN consisted of an eight-week program (for individual training and telephonic coaching). CIPN 20, a CIPN assessment tool, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 scale were used to assess CIPN, disturbance of activities of daily living, and quality of life, respectively. The study was conducted from December 7, 2018, to August 20, 2019. For data analysis, descriptive statistics, a test of homogeneity in the pretest, independent t-tests, and repeated-measures analysis of variance were used. Results In the experimental group, significant improvements were found in CIPN (F=5.88, p=.018) and disturbance of activities of daily living (F=8.26, p=.005) compared to those in the control group. There was no significant difference in the interaction between the groups and time in terms of quality of life. Conclusion Our results indicate that the mobile application-based self-management program used in this study is effective and could be used as a nursing intervention for cancer patients with CIPN.
Purpose The purpose of this study was to identify the incidence and risk factors associated with the unplanned removal of nasogastric (NG) tubes in neurocritical patients. Methods Data were collected retrospectively from the medical records of 479 patients admitted to the tertiary hospital's neuro-intensive care units (NCU). Subjects were divided into two groups depending on whether there was unplanned NG tube removal. Multivariate logistic regression analysis was used to identify risk factors. Results Unplanned removal of NG tubes occurred in 35.9% of patients. The incidence of unplanned NG tube removal was 47.2 per 1,000 patient days. Intubated time of the NG tube was 3.96 days in patients with unplanned removal. Risk factors associated with unplanned removal were men (Odds Ratio [OR]=2.19), epilepsy (OR=9.99), traumatic brain injury (OR=5.50), stroke (OR=4.42), improvement of Glasgow Coma Scale (GCS) (OR=1.08), delirium (OR=1.88), physical restraint (OR=2.44), and drainage or decompression purpose (OR=1.67). Conclusion Unplanned removal of NG tubes occurred very frequently in neurocritical patients. Care should be taken for patients with neurological diseases who show improvement in their level of consciousness but are still confused due to brain lesions or delirium to reduce it. The application of physical restraints cannot guarantee the prevention of unplanned NG tube removal. Therefore, nurses need to assess the condition of patients and NG tubes frequently.In particular, more attention should be paid to using NG tubes for decompression or drainage purposes. It is also proposed to actively review the NG tube removal plan through periodic evaluation.
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Purpose This study was conducted to verify the effects of foot bathing on peripheral neuropathy, sleep disorder, and fatigue in gynecologic patients with cancer undergoing chemotherapy. Methods: There were 30 participants in this study who had been diagnosed with gynecologic cancer and were undergoing chemotherapy. Among them, 15 were in the experimental group of the K university hospital and 15 in the control group of the other K university hospital in D city. The experimental group received foot bathing once a day for 30 minutes over 10 days, an hour before bedtime, while the control group did not receive any foot bathing. Results: The results of the study showed that the experimental group that received foot bathing had significant changes in objective peripheral neuropathy (p=.021), sleep disorder (p=.002), and fatigue (p=.030), as compared to the control group. However, no significant difference was found between the experimental and the control groups regarding subjective peripheral neuropathy (p=.256). Conclusion: Hence, our study confirmed that foot bathing can be an effective nursing intervention to reduce peripheral neuropathy, sleep disorder, and fatigue in gynecologic patients with cancer undergoing chemotherapy.
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Purpose This review aimed to evaluate the effectiveness of exercise on Chemotherapy-induced Peripheral Neuropathy (CIPN). Methods The medical databases PubMed, EMBASE, and CINAHL, and several Korean databases were searched until December 2020. Additionally, a manual search was conducted. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. The Review Manager 5.3 version of the Cochrane Library was used to estimate effect size through meta-analysis. Results Nine studies were included. The most common types of exercise reported were yoga, combined aerobics and strength exercise, and combined strength and balance exercise; each was backed by two studies. Four randomized controlled trials were meta-analyzed, and five studies were synthesized qualitatively. A significant effect on CIPN was found using meta-analysis (standardized mean difference=-0.28, 95% confidence interval=-0.47~-0.09, p=.004). As a result of qualitative synthesis, groups that did exercises were reported to have significantly lessened CIPN symptoms than control groups in three studies. In one study, the exercise group showed significant reduction in CIPN symptoms. And in another, the exercise group was more relieved of CIPN symptoms than the control group, although the difference was not significant. Conclusion The results indicate that exercise should be part of the regimen for patients who are receiving or have completed neurotoxic chemotherapy, for relieving CIPN symptoms. However, these results should be interpreted cautiously, especially due to the limited number of studies and the small number of participants. Therefore, further well-designed studies with sufficient numbers of participants are required.
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Purpose This meta-analysis was conducted to analyze the effect of Diabetes Mellitus (DM) on the risk of Parkinson Disease (PD). Methods Original prospective observational studies were searched through PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest, Web of Science, Science Direct, Koreanstudies Information Service System (KISS), and DBpia published up to March 2020. The Relative Risks (RRs) were calculated using the random-effects model. Results An integrated analysis of ten large population-based cohort studies, involving 10,730,117 participants, showed that patients with DM had a 30% higher risk of PD than those without DM (pooled RR=1.30, 95% Confidence Interval [CI]=1.14~1.48). Subgroup analyses based on the characteristics of the studies were conducted, and the association between DM and PD was significant in studies conducted in Asia (RR=1.30, 95% CI=1.01~1.69) and Europe (RR=1.45, 95% CI=1.09~1.94), and for patients with DM durations less than ten years (RR=1.31, 95% CI=1.27~1.37) and stroke (RR=1.16, 95% CI=1.03~1.31). Each study included in the analysis had methodologically good quality and showed no evidence of publication bias. Conclusion DM resulted in a significantly increased risk of PD; therefore, prevention and early detection of PD in patients with DM should be encouraged.
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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 conducted to confirm the effect of providing video-program-related information on coronary disease to patients undergoing Percutaneous Coronary Intervention (PCI) on anxiety, vital signs, pain, and knowledge level related to coronary disease.
Methods: A quasi-experimental design of nonequivalent control group pretest-posttest was used. The subjects of this study were 60 coronary heart disease patients hospitalized in the heart treatment center for Video educational Program (VP)-PCI (30 in the experimental group, 30 in the control group) in a general hospital in Gyeonggido Province. Data were collected from May 10 to November 30, 2019. Subjects of the experimental group were provided common nursing care and viewed a video education program before the PCI. The control group was provided common nursing care before the PCI. The data were analyzed via the χ2 test, independent t-test, and repeated measured ANOVA through the SPSS 23.0 program.
Results: There were significant differences in the pain of the puncture site (F=6.83, p=.011) and knowledge related to coronary disease (F=89.94, p<.001) between the experimental group and the control group.
Conclusion: Based on the findings, this study suggested that the nursing education program related to knowledge of coronary disease provided by tablet PC to PCI patients was effective to decrease the perception of pain and enhance levels of knowledge related to coronary disease. Therefore, the result is useful in nursing practice and should be utilized as a tool of nursing intervention to improve the knowledge of coronary disease patients.
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Purpose This study aimed to identify socioeconomic clusters of older adults and compare cardiovascular health among the identified clusters.
Methods: A secondary analysis was performed using the data from 3,303 older adults (over 65 years of age; 56.5% women) who participated in the Korean National Health and Nutrition Examination Survey (2016~2017). A two-step cluster analysis was used to identify older adults’ socioeconomic clusters based on 11 factors associated with Socioeconomic Status (SES). Differences in the cardiovascular health outcomes among the identified clusters were analyzed using the x2 test and one-way ANOVA. Results: A three-cluster solution was selected (p<.001) composed of low (n=715), middle (n=1,425), and high-SES clusters (n=1,163). The three clusters differed significantly in the prevalence of diabetes (p<.010), hypertension (p<.001), and metabolic syndrome (p<.001), with greater prevalence in the lower SES clusters. Similarly, systolic blood pressure (p<.001), body mass index (p<.010), and total cholesterol (p<.010) differed significantly among the clusters in the same pattern.
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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 Patients with pulmonary disease are more vulnerable to Particulate Matter (PM). It is important to promote health behaviors to minimize negative effects. This study aims to investigate risk perception, knowledge, and PM-related health behaviors in patients with pulmonary disease and identify the factors affecting PM-related health behaviors. Methods Participants were 201 patients with pulmonary disease who visited the outpatient clinic in a hospital. Data were collected using self-administered questionnaires and medical records from December 2019 to February 2020. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple regression analysis. Results The average score of PM-related health behaviors was 22.79±4.43. In multiple regression analysis, factors affecting PM-related health behaviors were participants with higher risk perception of PM (,p<.001) and with longer pulmonary disease (p=.006). Moreover, participants who smoked previously but not currently (p<.001) and had never smoked (p=.001) had higher level of health behaviors than those who smoke. Conclusion Patients with pulmonary disease reported to have high level of overall PM-related health behaviors, but their performance on health behaviors that required knowledge was reported to be insufficient. Therefore, a patient-tailored educational program is needed to improve PM-related health behaviors by emphasizing risk perception related to PM. Special attention should be given to smokers and patients who experience a short disease period to improve PM-related health behaviors.
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Purpose This study investigated factors affecting Quality of Life (QoL) of patients with Meniere disease. Methods A descriptive study design was used. Data were collected from March to April 2020 through an online survey of 130 participants diagnosed with probable or definite Meniere disease from a community of online-based patients.
The data were analyzed using the independent t-test, Pearson’s correlation coefficient, and multiple linear regression analysis. Results Perceived health, anxiety, depression, family support, and health care provider support significantly correlated with QoL. As a result of the multiple regression analysis, family support, perceived health, anxiety, and ear fullness were identified as factors influencing QoL, and these factors accounted for 65.0% of the variance in QoL. Of these variables, family support was the factor affecting the participants’ QoL the most (β=.45). Conclusion These results indicate a need for continuous efforts and strategies to increase family support to enhance the QoL of this population. In addition, to increase perceived health (which was the second most influencing factor on the QoL of this population), improved health care provider support (which showed a positive correlation with perceived health) is also warranted. Therefore, nursing interventions aiming to increase social support should be developed and implemented.
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 Maintaining a healthy lifestyle and quality of life after receiving acute treatment is important in patients with coronary artery disease (CAD). This study aims to compare the lifestyle and the quality of life of CAD patients with those of healthy people through a propensity-matched comparison. Methods This study is a secondary analysis of the data from the Korea National Health and Nutrition Examination Survey conducted with 23,657 subjects from 2015 to 2017. A propensity-matched comparison was conducted for 472 CAD patients and 941 healthy individuals using 1:2 matching of nine sociodemographic characteristics. R program version 3.6.2 was used for statistical analysis and an independent t-test was employed to examine the differences between the relevant variables of the two matched groups. Results The rate of aerobic physical activity, the levels of quality of life, and the subjective health condition of the CAD patients were significantly lower as compared to the healthy group (p<.001). The degree of perceived stress was higher in patients with CAD than those in the healthy group (p<.001). However, no statistical difference was found in smoking and drinking behavior and body mass index. Conclusion This study found that the CAD group's level of physical activity is lower and their emotional health conditions are worse than those of healthy people. Therefore, relevant support, including follow-up intervention programs, is required for CAD patients to prevent secondary adverse cardiac events and to maintain a healthier life.
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Purpose Identify the cluster-type risk factors when disease occurs in patients with coronary artery disease (CAD) and examine the impact of the cluster-type on adverse clinical prognosis in CAD patients. Methods Secondary data analysis was utilized with data collected from electronic medical records of patients who underwent percutaneous coronary intervention in a university hospital from 2011 to 2015 and who were on an outpatient follow-up visit as of January 2020. The K-means cluster analysis was performed on seven cardiovascular risk factors. Major adverse cardiac events (MACEs), including hospitalization due to restenosis or cardiac-related death, was required in clinical prognosis. The Cox proportional-hazard regression and Kaplan-Meier survival analyses were used. Results Cluster analysis identified three clusters of ‘obesity and family history’ (n=150), ‘smoking and drinking’ (n=178), and ‘chronic disease’ (n=190). The MACEs occurred in 10.4% of study subjects. When the ‘obesity and family history’ cluster (62.94±12.09 years) was used as a reference, the relative risk of MACEs was 2.57 times higher in the ‘smoking and drinking’ cluster (62.63±13.31 years) and 2.41 times higher in the ‘chronic disease’ cluster (70.90±10.30 years). Conclusion Cluster-type risk factors are necessary when considering secondary prevention strategies for MACEs in patients with CAD. Patients with smoking, drinking, and chronic diseases are especially required to improve their lifestyles and to regularly monitor their management of underlying diseases during follow-up periods.
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PURPOSE This study aimed to examine the mediating role of physical activity in the relationship between depressive symptoms and health-related quality of life in patients with coronary artery disease. METHODS A descriptive cross-sectional study design was conducted using the data from the 2016 Korea Community Health Survey. The participants comprised 6,072 patients with coronary artery disease aged 19 years or older. Depressive symptoms, physical activity, and health-related quality of life were assessed. The collected data were analyzed by a complex sample test using SPSS/WIN 24.0 program. Bootstrapping methodology was utilized to examine the mediating role of physical activity in the relationship between depressive symptoms and health-related quality of life with SPSS PROCESS macro Model 4. RESULTS The results of the hierarchical linear regression analysis showed that depressive symptoms (t=−22.37, p<.001) and physical activity (t=12.12, p<.001) were significant predictor of health-related quality of life. A mediation analysis further revealed that physical activity mediates the relationship between depressive symptoms and health-related quality of life. CONCLUSION This study suggests that the negative impact of depressive symptoms on health-related quality of life can be improved through physical activity. Healthcare providers should consider these finding during early assessment of depressive symptoms in patients with coronary artery disease. Moreover, developing intervention strategies to enhance the level of physical activity could improve health-related quality of life of patients.
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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 was conducted to identify cardiovascular risk factor cluster types in early middle-aged male workers in their 30s and 40s, and to identify differences in awareness of mobile health and preventive health behaviors by cluster type. METHODS This study adopted a cross-sectional descriptive design. Male workers aged 30~49 years with cardiovascular risk factors (n=166) at three medical device manufacturers in June, 2019 were recruited. Self-reported questionnaires were administered. K-means cluster analysis was performed using four measurement tools: e-health literacy, behavior of seeking health information on the internet, intent to use mobile health, and preventive health behavior. RESULTS Three cluster groups were identified based on 7 risk factors: "unhealthy behavior (51.8%)", "chronic disease (28.9%)", and "dyslipid · family history (19.3%)". In the "unhealthy behavior" group where more than 70% of the participants were smoking and drinking heavily, the awareness of mobile health utilization such as behavior of seeking information on the internet and intent to use mobile health, especially usefulness, was significantly lower than that in the other two groups. The preventive health behavior was also the lowest among the three groups. CONCLUSION We suggest that when planning for mobile-use cardiovascular prevention education for early middle-aged male workers, it is necessary to consider a cluster of risk factors. Strategies for raising positive awareness of the use of mobile health should be included prior to cardiovascular health education for workers with unhealthy lifestyles such as smoking and excessive drinking alcohol.
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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 purpose of this study was to investigate the impact of Type D personality among patients with Coronary Artery Disease (CAD). METHODS Seven databases were searched to conduct a systematic review and meta-analysis. Two reviewers independently searched, selected, extracted, and assessed the studies. The quality of studies was evaluated using the JBI Critical Appraisal Checklist. To estimate the effect size, meta-analysis of the studies was performed using the Comprehensive Meta-Analysis 3.0 program. RESULTS Of 1,128 publications identified, 31 studies that met the inclusion criteria were used to estimate the effect size of Type D personality. Effect size (Standardized Mean Difference [SMD]) was used in the analyses. Patients with CAD who had Type D personality had higher levels of depression (SMD=0.92; 95% Confidecne Interval (CI)=0.74~1.10) and anxiety (SMD=1.19; 95% CI=0.81~1.57), but lower levels of physical and mental health-related quality of life (SMD=−0.56; 95% CI=−0.75~−0.38; SMD=−0.91; 95% CI=−1.10~−0.73). Publication bias was not detected. CONCLUSION Type D personality was associated with increased depression and anxiety and impaired health-related quality of life in patients with CAD. Personality and psychosocial risk screening in patients with CAD should be conducted in the clinical setting.
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PURPOSE The purpose of this study was to construct and test a predictive model for physical activity adherence for secondary prevention among patients with coronary artery disease. METHODS Two hundred and eighty-two patients with coronary artery disease were recruited at cardiology outpatient clinics in four general hospitals and the data collection was conducted from September 1 to October 19, 2015. RESULTS The model fit indices for the final hypothetical model satisfied the recommended levels: χ2/dF=0.77, adjusted goodness of fit index=.98, comparative fit index=1.00, normal fit index=1.00, incremental fit index=1.00, standardized root mean residual=.01, root mean square error of approximation=.03. Autonomy support (β=.50), competence (β=.27), and autonomous motivation (β=.31) had significant direct effects on physical activity adherence for secondary prevention among patients with coronary artery disease. This variable explained 35.1% of the variance in physical activity adherence. CONCLUSION This study showed that autonomy support from healthcare providers plays a key role in promoting physical activity adherence for secondary prevention among patients with coronary artery disease. The findings suggest that developing intervention programs to increase feelings of competence and autonomous motivation through autonomy support from healthcare providers are needed to promote physical activity adherence for secondary prevention among patients with coronary artery disease.
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PURPOSE Geriatric depression is often closely connected with physical symptoms among older adults. This study aimed to determine the factors related to depressive symptoms among older adults with multiple chronic diseases. METHODS We assessed 6,672 older adults using data extracted from the 2014 National Survey on the Elderly in Korea. The short form of the Geriatric Depression Scale and the Korean versions of the Mini-Mental State Examination for dementia screening and the DETERMINE Your Nutrition Health Checklist were used. Statistical analyses included independent t-test, χ2 test, and logistic regression analysis. RESULTS We found that 36.7% of the older adults exhibited depressive symptoms, and the average score on the short form of the Geriatric Depression Scale was 5.90±4.53. The factors significantly related to depressive symptoms were unemployment (Odds Ratio [OR]=1.85, 95% Confidence Interval [CI]=1.59~2.15), “high risk†nutritional management status (OR=1.19, 95% CI=1.16~1.22), slight visual dysfunction (OR=1.21, 95% CI=1.05~1.38), high visual dysfunction (OR=1.41, 95% CI=1.04~1.91), slight hearing dysfunction (OR=1.22, 95% CI=1.05~1.43), slight chewing dysfunction (OR=1.37, 95% CI=1.19~1.59), high chewing dysfunction (OR=1.59, 95% CI=1.30~1.95), low cellphone utilization (OR=1.60, 95% CI=1.04~2.46), older age (OR=0.99, 95% CI=0.98~1.00), and higher educational level (OR=0.96, 95% CI=0.95~0.98). CONCLUSION Preventive interventions for depressive symptoms should include nutritional education programs, functional assistive devices, and the use of information technology.
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