Purpose To explore the nature of psychological resistance to the initiation of antihypertensive medication. Methods Participants were 13 adults with hypertension who were refusing or had refused to take antihypertensive drugs from July 2016 to October 2016. The data were collected through face-to-face in-depth interviews, and analyzed according to Braun and Clarke’s 6 steps of thematic analysis. Results Analysis of the psychological resistance experience to drug therapy in hypertensive patients resulted in 5 themes and 10 sub-themes from a total of 42 free codes. Participants were “holding out as much as possible without medication” without taking antihypertensive drugs due to “psychological opposition to starting treatment” and “situational barriers related to medication”. However, they were “coming to grips with reality” that they were not taking medication but would take it someday, and they gained “momentum for change” to start taking it. Conclusion The 5 themes derived from the data analysis of the experiences of 13 participants are interrelated and suggest the direction of intervention to lower psychological resistance. In particular, we propose the development of an intervention to assist patients in self-decision regarding taking antihypertensive medication. Additional research into the role of medical staff in lowering the psychological resistance of young hypertensive patients is needed.
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PURPOSE The purpose of this study was to conduct a systematically review of factors related to the reported intention of hospital nurses in Korea to leave their positions. METHODS Appropriate studies in the recent ten years were selected from databases. A total of 263 studies were selected for the systematic review on the basis of the PRISMA flow. The correlational effect size of 35 studies was analyzed through meta-analysis using CMA 3.0. RESULTS Through systematic review, 52 related factors were classified by ecological system: 18 individual, 12 microsystem, 11 mesosystem, 8 exosystem, and 3 macrosystem. The overall effect size of turnover intention was 3.26. The total correlational effect size of related factors was 0.28: 0.14 for individual, 0.50 for microsystem, 0.25 for mesosystem and 0.40 for exosystem. Among single factors with larger effect size, emotional labor, role conflict, and work-home conflict were classified into contributors whereas organizational commitment, job satisfaction, and internal marketing were classified as inhibitors. CONCLUSION Previous studies focused on the individual and the microsystem in the quantitative respect. In addition, the effect size was relatively greater for the microsystem and the exosystem. It is therefore necessary to conduct further research on the systems with larger effects.
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PURPOSE The purpose of this study was to develop sleeve-type restraints and to compare the sleeve-type and conventional wrist restraints. METHODS Forty four pairs of intensive care unit (ICU) patients and their families participated in the experiment. The nurses applied sleeve-type restraints to the patients in the experimental group, and wrist restraints to the control group. The trained research assistant measured ROMs, skin temperature, edema, and skin lesions of both upper extremities (UEs) before, 24, 48, and 72 hours after the restraints applied. The emotional response of family was measured 72 hours after the restraints applied. Thirty one ICU nurses evaluated the efficiency of both types of restraints. RESULTS Compared to the control group, changes of ROMs, edema, and skin abrasions on both U/Es of the experimental group indicated a significant difference in physical side effects. The emotional response scores of the experimental group were significantly lower than those of the control group. The mean efficiency scores for the sleeve-type restraints were significantly higher than those for the wrist restraints. CONCLUSION The results indicate that the sleeve-type restraints are better than wrist restraints with respect to physical side effects, emotional responses of family members, and application efficiency.
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PURPOSE The purpose of this study was to investigate the emotional response of family members of physically restrained patients in the intensive care units (ICUs). METHODS The study subjects were 200 family members of ICU patients who had been on physical restraints in two university hospitals. Data were collected using the "Instrument of family's emotional response toward physically restrained patients". RESULTS The mean score of familial emotional response was 2.69 out of a possible 5. The subcategory of acceptance was the highest with 3.56 points followed by depression (3.02), helplessness (2.94), anxiety (2.87), shock (2.74), avoidance (2.64), and grudge (2.08). Multiple stepwise regression analysis indicated that the age of family members, side effects of restraints, and information provision were the variables influencing on negative emotional response of family. CONCLUSION Family members showed slightly negative emotional response toward the physical restraints. This finding could be influenced by their limited knowledge of the need for the restraints. Educational programs or fact sheets to be given to family members may be helpful.
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The Conditions for Ethical Application of Restraints Parker Crutchfield, Tyler S. Gibb, Michael J. Redinger, Daniel Ferman, John Livingstone Chest.2019; 155(3): 617. CrossRef
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Evidence-Based Practice Guideline: Changing the Practice of Physical Restraint Use in Acute Care Helen W. Lach, Kathy M. Leach, Howard K. Butcher Journal of Gerontological Nursing.2016; 42(2): 17. CrossRef
Families' Perception and Attitude toward Applied Physical Restraints in General Neurological Wards So-Yeon Ha, Yi-Kyung Ha, Myung-Hee Kim Journal of the Korea Academia-Industrial cooperation Society.2015; 16(5): 3293. 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.
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