PURPOSE
The purpose of this study was to examine the mediation of Self-Esteem in the relationship between Social Support and attitude toward the Withdrawal of Life-Sustaining Treatment (WLST) for community dwelling elderly in order to provide a basis for planning nursing interventions to improve the attitude of elderly.
METHODS
The participants were 252 elderly residing in Seoul. The data were collected through a questionnaire survey distributed in March, 2016. The survey included scales on Social Support, attitude towards WLST and measures of Self-esteem. Collected data were analyzed using SPSS/WIN 21.0 program.
RESULTS
The mean score for the attitude towards WLST was 73.83. Self-Esteem was 29.44. Overall Social Support was 42.51. There were significant correlations among the three variables. Self-esteem was directly affected by the attitude (R²=24%). Attitude towards WLST was directly affected by Family Support. Family Support and Self-esteem affected by the attitude on WLST (R²=19%). Self-esteem had a partial mediating effect (β=.23, p < .001) in the relationship between Family Support and reported attitude from the WLST (Sobel test: Z=4.93, p < .001).
CONCLUSION
Based on the findings of this study, programs can be created focusing on Social Support and Self-Esteem improvement. The programs may positively change the elderly's attitude towards WLST.

Citations

• Influence of Advance Directives' Self-efficacy of Community-dwelling Older Adults on the Completion of Advance Directives: Mediating the Effect of Intention for Advance Directives: A Cross-Sectional Study
  Hyun Sook Kim, Gye Jeong Yeom
  Journal of Korean Gerontological Nursing.2022; 24(2): 133.     CrossRef
• Mediating Effects of Role Perception of Life-sustaining Treatment in the Relationship between Knowledge of Lifesustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment among Nursing College Students
  Youngmi Park, Keumhee Nam, Joohee Bae
  The Korean Journal of Hospice and Palliative Care.2021; 24(1): 36.     CrossRef
• Preferences for life-sustaining treatment in Korean adults: a cross-sectional study
  HyunChul Youn, Suk-young Lee, Han-yong Jung, Shin-Gyeom Kim, Seung‑Hyun Kim, Hyun-Ghang Jeong
  BMJ Open.2021; 11(1): e039470.     CrossRef
• Family's Perception of Proxy Decision Making to Authorize Do Not Resuscitate Order of Elderly Patients in Long Term Care Facility: A Q-Methodological Study
  Hyeon Jin Cho, Jiyeon Kang
  Journal of Korean Academy of Nursing.2021; 51(1): 15.     CrossRef
• Relationships among Perceptions of Dying Well, Attitudes toward Advance Directives, and Preferences for Advance Directives among Elderly Living Alone
  Eun-Jin Ryu, So-Eun Choi
  The Korean Journal of Hospice and Palliative Care.2020; 23(4): 241.     CrossRef
• Effects of Advance Care Planning on End-of-Life Decision Making: A Systematic Review and Meta-Analysis
  Minju Kim, Jieun Lee
  The Korean Journal of Hospice and Palliative Care.2020; 23(2): 71.     CrossRef
• Influence of Older Person's Ego Integrity and Knowledge of Advance Directives on their Attitude toward Withdrawal from Life-sustaining Treatment
  Eun Yi Yeom, Kum Sook Seo
  Journal of Korean Gerontological Nursing.2019; 21(3): 173.     CrossRef
• The Relationship among Attitudes toward the Withdrawal of Life-sustaining Treatment, Death Anxiety, and Death Acceptance among Hospitalized Elderly Cancer Patients
  YeonMi Seo, Sujin Shin
  Asian Oncology Nursing.2019; 19(3): 142.     CrossRef

PURPOSE
The purpose of this study was to investigate the combined influence of smoking and alcohol drinking on suicidal ideation and attempts among Korean adults.
METHODS
This cross sectional study used secondary data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011. A total of 13,064 adults were included in the study. Logistic regression was used to analyze the combined influence of smoking and alcohol drinking on suicidal ideation and attempts.
RESULTS
Persons who smoke and use alcohol were more likely to report suicidal ideation and attempts than those who did not smoke and reported normal drinking. The group who reported both smoking and harmful drinking/alcohol had significantly higher incidence of suicidal ideation and attempts than the comparison group of non-smoking/normal drinking (Suicidal ideation: Adjusted Odds Ratio [AOR]: 2.13, 95% Confidence Interval [CI]: 1.60~2.83; suicidal attempts: AOR: 3.81, 95% CI: 1.60~9.05).
CONCLUSION
Based on the results of this study, smoking and alcohol drinking were individually important health behaviors for prevention of suicidal ideation and attempts. Especially, suicidal prevention programs might be needed for adults who smoke and drink at the same time to decrease suicidal ideation and attempt.

Citations

• Analysis of suicide statistics and trends between 2011 and 2021 among Korean women
  Hyunjung Jang, Seokmin Lee, Sanghee Park, Bobae Kang, Hyunkyung Choi
  Korean Journal of Women Health Nursing.2023; 29(4): 348.     CrossRef
• Effects of Alcohol Consumption and Smoking Dual Use Experience on Culturally Diverse Adolescents’ Suicidal Behaviors: Using Date from the 15~17th Korean Youth Risk Behavior Web-based Survey
  Hyun Jung Lee, Euna Si
  Journal of Korean Academy of psychiatric and Mental Health Nursing.2022; 31(4): 415.     CrossRef
• Perceived discrimination and suicidal ideation of Korean adults with disability: Examining the mediating role of depressive symptoms
  Seojin Won, Hyemee Kim
  Korean Journal of Health Education and Promotion.2019; 36(2): 65.     CrossRef
• Do the associated factors with high-risk drinking differ by smoking?
  Hyo Young Lee, Hyuk Im, Hye Sook Kim, Min Jung Kim
  Korean Journal of Health Education and Promotion.2019; 36(3): 15.     CrossRef

PURPOSE
This study was conducted to identify factors that influence on self-determination for withdrawal of life-sustaining treatment in the community dwelling elderly.
METHODS
This study used a descriptive correlational design. A convenience sample of 201 elderly were recruited from a welfare center located in Seoul, Korea. Data collection was done from September 1 to September 18, 2015. Four survey questionnaires were used: Multidimensional Scale of Perceived Social Support (MSPSS), Life Satisfaction Index-Z (LSI-Z), Attitude on Do Not Resuscitate (DNR), and Self-determination for Withdrawing Life-sustaining Treatment. Data analysis was done by t-test, ANOVA, Pearson's correlation, and hierrarchical multiple regression.
RESULTS
Hierarchial multiple regression showed that the factors predicting the level of self-determination for withdrawing life-sustaining treatment were educational level, DNR experience in family, life satisfaction, and DNR attitude. These factors explained 44% of the self-determination for withdrawing life-sustaining treatment in community dwelling elderly.
CONCLUSION
The results of this study suggest developing educational programs aiming at changing elderly's DNR attitude positive ways so that they can enhance self-determination for withdrawing life-sustaining treatment. Further study is needed with more elderly population in extended areas.

Citations

• Influence of Advance Directives' Self-efficacy of Community-dwelling Older Adults on the Completion of Advance Directives: Mediating the Effect of Intention for Advance Directives: A Cross-Sectional Study
  Hyun Sook Kim, Gye Jeong Yeom
  Journal of Korean Gerontological Nursing.2022; 24(2): 133.     CrossRef
• Factors influencing intention to use life-sustaining treatment of community-dwelling older adults using the 2020 national survey of older Koreans: Secondary analysis research
  Yun Hee Hwang, Hye Jung Jun, Hye-Ryeon Park
  Journal of Korean Gerontological Nursing.2022; 24(4): 424.     CrossRef
• Influence of Older Person's Ego Integrity and Knowledge of Advance Directives on their Attitude toward Withdrawal from Life-sustaining Treatment
  Eun Yi Yeom, Kum Sook Seo
  Journal of Korean Gerontological Nursing.2019; 21(3): 173.     CrossRef

BACKGROUND
Few nurses are trained in palliative care for long-term care in Korea. The End-of-Life Nursing Education Consortium (ELNEC)-Geriatric training program improves nurses' ability to promote palliative care for the elderly. PURPOSE: The aim of this study was to evaluate nurses' satisfaction and knowledge following the attendance at the ELNEC-Geriatric curriculum on nurses' knowledge of palliative care.
METHODS
Nine ELNEC-Geriatric modules were presented to 203 interdisciplinary professionals on July 1 and 3, 2010, in Seoul, South Korea. The Palliative care quiz for nursing (PCQN) was used to evaluate nurses' knowledge. Of all the participants, 128 nurses were completed the questionnaire. Of these nurses, 45.2% were staff nurses and 73.4% were hospital nurses.
RESULTS
Approximately eight nine percent of the nurses reported previous experience in caring for dying patients and attending various hospice palliative care training programs. Overall program satisfaction of the participants was 4.03 on a 5-point scale, and their mean of the total PCQN score was 12.75 out of 20 after participating in ELNEC-Geriatric course, which was a significant improvement (p=.022) from the pretest.
CONCLUSION
The results of this study demonstrate that ELNEC-Geriatric curriculum was successfully implemented and significantly contributed to increasing the nurses' knowledge for palliative care in long-term care in Korea.

PURPOSE
This study was to explore the predictors of subjective well-being of Korean older adults. METHOD: Data were collected through the structured interview using questionnaire with 199 older adults over 60 years. To identify the most effective predictor of the SWB, a stepwise regression analysis was conducted on each subscale of SWB measure. RESULTS: The results showed that receiving support from family was the effective factor of life satisfaction. Receiving support from family, health, optimism, economy, positive reappraisal, and giving support to family were the effective factors of emotional well-being. CONCLUSION: This study found that family support was the most important predictor on SWB among Korean older adults.

PURPOSE
The purpose of this study was to examine the effects of family function, self-esteem, and loneliness on subjective health status in middle-aged women. METHODS: A five-item family APGAR was used to measure family function. Self-esteem was measured by the Rosenberg's Self-esteem scale, and the level of loneliness was measured using RULS. One-item was used to investigate subjective health status. RESULT: In this study, the level of family function was moderate. The mean score of self-esteem was 29.06, and subjects revealed moderate loneliness. Subjects rated their health status as 'fair'. There were differences in subjective health status according to education and economic status. Through multiple regression, it was found that self-esteem was a variable predicting subjective health status in middle-aged women. CONCLUSION: Facilitating self-esteem of the middle-aged women can be one of the important nursing interventions in maintaining subjective health status as good.

The purpose of this study was to identify the barrier factors of health behaviors of urban and rural elderly and to compare the health behaviors and level of barriers between two groups, and finally to get the basic informations about the adequate nursing strategies to promote the health state of urban and rural elderly. The subjects of this study were 177 over the age of 65, 81 elderly lived in Seoul and 96 elderly lived in rural areas. The instruments for this study were the health behavior scale(14 items) and the barrier scale (118 items) developed by Gu et al(2003). For the data analysis, SPSS PC program was utilized for descriptive statistics, chi2- test, t-test, Pearson correlation. The results of this study were ; 1. The mean score of health behaviors (range 1-4) was 2.69 in urban elderly and 2.33 in rural elderly ; there was significant difference(t=5.03, P=.00). 2. There were significant differences in levels of barriers(range 1-3) between the two groups, such as calcium intake(t=-3.16, P=.00), regular exercise(t=-3.80, P=.00), exercise time(t=-5.54, P=.00), use of stress reduction method(t=-3.45, P=.00), regular check up(t=-3.89, P=.00), vaccination(t= -3.83, P=.00). Higher levels of barriers were found in rural elderly than in urban elderly.3. Lack of habituation, lack of will power and lack of knowledge in calcium intake; lack of time, lack of habituatuion, lack of family support, lack of will power and lack of environment in exercise; lack of perceived benefit, lack of time, lack of will power and lack of knowledge in use of stress reduction method; lack of time, lack of interest, lack of habituation and lack of will power in disease prevention were significantly higher in rural elderly than in urban elderly.In the conclusion, nursing interventions should be planned based on the social environment of elderly. To promote the health state of elderly, interventions to decrease the barrier levels and to reduce the barrier factors to health behaviors should be implemented.

PURPOSE
The purpose of this study was to identify the effect of hand moxibustion for reduction of pain during menstruation. METHOD: Fifteen women were selected as subjects and data collection was conducted from September to December 2003. The Visual Analogue Scale (VAS) and Digital Infrared Thermotraphic Image (DITI) were used to measure the degree of pain and body heat. RESULT: The results showed that there was a significant reduction of pain during menstruation when hand moxibustion was performed. Also, there were significant differences in the change of body heat. These were left hands (Z=-2.805, p=.005), right hands (Z=-2.805, p=.005) and lower abdomen (Z=-2.803, p=.005). CONCLUSION: It was found that hand moxibustion decreased pain during menstruation and increased body heat. Therefore, hand moxibustion may be a good method for intervention to decrease pain during menstruation.

PURPOSE
The purpose of this research was to describe how nurses in intensive care units (ICU) work.
METHOD
A total of 18 ICU nurses participated in the research. The data was collected through individual in-depth interviews and analyzed by grounded theory method using NUDIST 4.0 software program.
RESULTS
Three different patterns regarding nursing performance among ICU nurses were identified. These are 1) nursing performance of nurses who perform excellently, 2) nursing performance of nurses who do not perform well because of their lack of experience, and 3) nursing performance of nurses who do not perform well in spite of their good years of experience. These three different nursing performances were described in terms of seven different categories; 1) assessing and monitoring nursing problems, 2) clinical decision making, 3) interpersonal relationships, 4) holistic care, 5) technical skills, 6) problem solving, 7) working independently and creatively. This study also identified two intervening factors that influenced the advancement of their expertise.
CONCLUSION
The results of this study might help nurse managers in developing continuing educational programs for inexperienced nurses or those nurses not performing well to become experts by a deeper understanding of the nature of nursing performance and the factors that influence nursing performance in ICU settings.