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"Models"

Review Article

Purpose
This study involved a meta-synthesis of qualitative research concerning the experiences of women with infertility and infertility treatments. Based on an analysis of emotional changes and adaptation processes, it aimed to propose an interaction model encompassing expectation, loss, and resilience and clarify the conceptual meaning of each component.
Methods
Thomas and Harden’s five-step qualitative meta-synthesis methodology was employed. A total of 22 studies published between 2014 and 2024 were comprehensively analyzed and synthesized. The findings were integrated into a model representing the experiences of women undergoing infertility and infertility treatments.
Results
The meta-synthesis identified six key themes: changes in identity and inner growth; strengthening resilience through the roles of spouses, family, and peers; strategies for recovery and growth; support systems amidst economic and social burdens; life in the tension of waiting and hope; and the reconfiguration of couple and family relationships. Based on these themes, a dynamic interaction model, named the Model of Psychological Changes and Resilience (PCR Model), was developed to illustrate the interrelationships among expectation, loss, and resilience. The conceptual implications of these relationships were also explicated.
Conclusion
The cyclical interplay between expectation and loss among women experiencing infertility is intensified by social ideologies and cultural contexts, while resilience is strengthened through overcoming distress and finding meaning in life. Further quantitative research is necessary to validate these relationships in clinical settings by obtaining empirical data that apply this model.
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Original Article

Development of a Conceptual Framework for Non-Adherence to Self-Management in Patients with Chronic Obstructive Pulmonary Disease: An Exploratory Study
Ja Yun Choi, Eui Jeong Ryu, So Young Yun, Sehyun Cho
Korean J Adult Nurs 2024;36(2):126-135.   Published online May 31, 2024
DOI: https://doi.org/10.7475/kjan.2024.36.2.126
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.

Citations

Citations to this article as recorded by  
  • Development of a deep learning model to predict smoking status in patients with chronic obstructive pulmonary disease: A secondary analysis of cross-sectional national survey
    Sudarshan Pant, Hyung Jeong Yang, Sehyun Cho, EuiJeong Ryu, Ja Yun Choi
    DIGITAL HEALTH.2025;[Epub]     CrossRef
  • Factors Associated with Non-Adherence to Self-Management Among Patients with Chronic Obstructive Pulmonary Disease: A Survey Using the Delphi Technique and Analytic Hierarchy Process
    Ja Yun Choi, Eui Jeong Ryu
    International Journal of Chronic Obstructive Pulmonary Disease.2024; Volume 19: 1247.     CrossRef
  • 252 View
  • 3 Download
  • 2 Crossref
  • 2 Scopus

Review Article

The Application of Theories in Research on Advance Care Planning (2010~2022): A Scoping Review
Jeongwon Shin, Sujin Lim, Hwain Kim, Kyunghee Lee, Heejung Jeon
Korean J Adult Nurs 2024;36(1):1-14.   Published online February 29, 2024
DOI: https://doi.org/10.7475/kjan.2024.36.1.1
Purpose
This scoping review aimed to identify the current state of the application of theories in research related to advance care planning and to analyze the types and characteristics of the theories applied. Methods: Using the scoping review methodology presented by Arksey & O'Malley, the articles published from 2010 to 2022 were searched by combining the terms "advance care planning," "theory," and "model" in five electronic databases; PubMed, CINAHL, EMBASE, KMBASE, and KISS. Results: Thirty-two studies were identified. Theory-based research has been actively conducted since 2019, with a total of 25 theories applied. Psychological theories were the most prevalent, accounting for 75.0% of the applications, followed by sociological theories (12.5%), public health theories (6.3%), and one nursing theory (3.1%). Theories were utilized to create a framework for data analysis, establish a philosophical underpinning, develop intervention frameworks, and derive new tools. Conclusion: Various theories have been applied to research on advance care planning, yet the application of nursing theory has been limited. To optimize end-of-life care and advance care planning from a nursing perspective, further research incorporating nursing theory is essential.
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  • 0 Scopus
Original Articles
Risk Predictors of Post-Embolization Syndrome after Transarterial Chemoembolization by Sex: A Retrospective Study
Han Byeol Lim, Myoung Soo Kim
Korean J Adult Nurs 2023;35(4):418-427.   Published online November 30, 2023
DOI: https://doi.org/10.7475/kjan.2023.35.4.418
Purpose
After Transarterial Chemoembolization (TACE), patients may experience Post-Embolization Syndrome (PES), which is characterized by abdominal pain, fever, and nausea/vomiting. Various risk factors, including demographic, clinical, laboratory, and radiological data, have been reported. This study aimed to identify sex-specific risk predictors of PES following TACE.
Methods
This retrospective study included 1,495 patients who underwent TACE and were discharged from January 1, 2014 to December 31, 2021. The demographic, clinical, laboratory, and radiological characteristics of the patients undergoing TACE were analyzed. Descriptive statistics, the χ2 test, the independent t-test (or Mann-Whitney U test), Spearman correlation analysis, and logistic regression were used.
Results
The incidence of PES was higher in female (43.9%) than in male (37.3%). Multivariate logistic regression analysis Alanine aminotransaminase (ALT) levels as the only independent predictor of PES in female patients (Exp [B]=1.01, 95% Confidence Interval [CI]=1.00~1.01). The risk factors of PES in male patients were a tumor >5 cm in diameter (Exp [B]=2.51, 95% CI=1.46~4.32), the amount of lipiodol (Exp [B]=1.27, 95% CI=1.01~1.60), C-Reactive Protein (CRP) levels (Exp [B]=1.11, 95% CI=1.02~1.21), ALT level (Exp [B]=1.00, 95% CI=1.00-1.01), lymphocyte levels (Exp [B]=0.98, 95% CI=0.96~0.99), and right posterior section (S6-S7) (Exp [B]=0.71, 95% CI=0.55-0.92).
Conclusion
Oncology nurses should be aware of sex-specific differences in PES risk and monitor clinical, laboratory, and radiological data to evaluate PES in female and male after TACE. The results of this study will serve as basic data for establishing a clinical decision-supporting system.
  • 172 View
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  • 0 Scopus
A Structural Equation Modeling of Sexual Adjustment in Radical Prostatectomy Patients
Min Kweon Ahn, Hyun Kyung Kim
Korean J Adult Nurs 2021;33(5):532-543.   Published online October 31, 2021
DOI: https://doi.org/10.7475/kjan.2021.33.5.532
Purpose
This study aimed to identify variables influencing the sexual adjustment of patients who underwent radical prostatectomy in order to establish a structural model and intervention strategy for improving patients’ sexual adjustment.
Methods
Participants were 179 patients who received follow-up care after undergoing radical prostatectomy at two university hospitals in South Korea. Data were collected from July to November, 2017 using structured questionnaires. The exogenous variables were urinary symptoms and age, and the endogenous variables were sexual function, self-esteem, depression, couple intimacy, and sexual adjustment. The collected data were analyzed using SPSS 21.0 and AMOS 21.0.
Results
The goodness-of-fit measures of the final hypothetical model were satisfactory, as follows: χ2 /df=2.68, GFI=.91, CFI=.90, RMSEA=.09, SRMR=.07. Sexual function, self-esteem, and couple intimacy had direct and total effects on sexual adjustment in patients who underwent radical prostatectomy, and age had only an indirect effect. These variables explained 66.5% of sexual adjustment among patients. Urinary symptoms and depression did not show any significant effects, however.
Conclusion
To improve sexual adjustment in patients who underwent radical prostatectomy, it is imperative to establish active and effective nursing interventions to strengthen their sexual function, self-esteem, and couple intimacy, considering their age.
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  • 0 Scopus
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.

Citations

Citations to this article as recorded by  
  • Self‐care behaviours and their determinants in people affected by coronary heart disease
    Roberta Di Matteo, Tatiana Bolgeo, Alberto Dal Molin, Barbara Bassola, Maura Lusignani, Antonio Maconi, Laura Rasero, Ercole Vellone, Paolo Iovino
    Journal of Clinical Nursing.2025; 34(5): 1713.     CrossRef
  • Prognostic factors of adherence to home-based exercise therapy in patients with chronic diseases: A systematic review and meta-analysis
    Ellen Ricke, Arie Dijkstra, Eric W. Bakker
    Frontiers in Sports and Active Living.2023;[Epub]     CrossRef
  • Association between Social Support and Physical Activity in Patients with Coronary Artery Disease: Multiple Mediating Roles of Self-Efficacy and Autonomous Motivation
    Nam-Sin Han, Mi-Hwa Won
    Healthcare.2022; 10(3): 425.     CrossRef
  • Concept Analysis of the Empowerment of Patients With Coronary Artery Disease Using a Hybrid Model
    Jiyoung Kim, Nayeon Shin
    Advances in Nursing Science.2022; 45(1): E31.     CrossRef
  • Lifestyle and Quality of Life in Patients with Coronary Artery Disease: A Propensity-Matched Comparison with a Healthy Control Group
    Seong Hui Choi, Seon Young Hwang
    Korean Journal of Adult Nursing.2020; 32(2): 199.     CrossRef
  • 177 View
  • 3 Download
  • 5 Crossref
  • 5 Scopus
Structural Equation Modeling on Health-related Quality of Life among Patients with Thyroid Cancer
Seon Young Lee, Hyun Kyung Kim
Korean J Adult Nurs 2018;30(2):171-182.   Published online April 30, 2018
DOI: https://doi.org/10.7475/kjan.2018.30.2.171
PURPOSE
The aim of the study was to create a structural model based on Wilson and Cleary's Conceptual Model of Patient Outcomes. Secondly, the intention was to identify variables influencing the health-related quality of life (HRQoL) as reported by patients with thyroid cancer.
METHODS
A total of 201 patients with thyroid cancer were recruited from an outpatient clinic. Data were collected from June to November, 2015, using a structured questionnaire. The questionnaire included the Quality of Life-Thyroid Scale, Thyroid Stimulating Hormone (TSH), Medical Outcome Study Social Support Survey, MD Anderson Symptom Inventory-Thyroid, the Brief Illness Perception Questionnaire, and general characteristics of patients. The data were analyzed using the SPSS/WIN 21.0, AMOS 21.0, and SmartPLS 3.2.3 programs.
RESULTS
The fitness of the hypothetical model with the Wilson and Cleary model was satisfactory, showing that the coefficients of determination (R2) were between .101 and .692 and the predictive relevance (Q2) were between .124 and .320. The model explained 69.2% of the HRQoL. Symptom experience, functional status, disease perception, and social support directly and indirectly affected HRQoL. Age and TSH had an indirect influence on the HRQoL with the mediation effect of reported symptom experience.
CONCLUSION
To improve the quality of life for patients with thyroid cancer, comprehensive nursing interventions need to be developed and applied. Decreasing the reported symptoms, changing the perception of the disease, improving functional status, and increasing social support may contribute to a higher quality of life among patients with thyroid cancer.

Citations

Citations to this article as recorded by  
  • Can the Correlation of Periodontopathies with Gastrointestinal Diseases Be Used as Indicators in Severe Colorectal Diseases?
    Lavinia Rat, Andrada Moldovan, Daniela Trifan, Loredana Matiș, Gelu Murvai, Lavinia Maris, Timea Ghitea, Marius Maghiar
    Biomedicines.2023; 11(2): 402.     CrossRef
  • A Structural Model of Quality of Life in Patients after Colorectal Cancer Surgery
    Jeong Won Yeom, Yeon Ok Suh
    International Journal of Environmental Research and Public Health.2022; 19(5): 2564.     CrossRef
  • Analysis of the Effect of Nursing Intervention for Thyroid Diseases Based on Family Nursing Methods
    Xin Chen, Osamah Ibrahim Khalaf
    Computational and Mathematical Methods in Medicine.2022; 2022: 1.     CrossRef
  • Influence of Sleep Quality, Coffee Consumption, and Perceived Stress on the Incidence of Thyroid Cancer in Healthy Korean Adults
    Myoyoun Kim, Seon Young Hwang
    Korean Journal of Adult Nursing.2021; 33(2): 125.     CrossRef
  • Mediating Effect of Stress on the Relationship between Illness Perception and Sleep in Patients at Risk of Metabolic Syndrome
    Hyun-E Yeom, Jee-Won Shin
    Korean Journal of Adult Nursing.2019; 31(4): 449.     CrossRef
  • 209 View
  • 5 Download
  • 5 Crossref
  • 4 Scopus
Factors Influencing Hemodialysis Unit Nurses' Compliance with Standard Precautions using Hierarchical Linear Modeling
Miyeun Kim, Juhhyun Shin
Korean J Adult Nurs 2018;30(2):161-170.   Published online April 30, 2018
DOI: https://doi.org/10.7475/kjan.2018.30.2.161
PURPOSE
The purpose of this study was to identify the factors associated with compliance with standard precautions among hemodialysis unit nurses.
METHODS
A cross-sectional study design was used. One hundred ninety six nurses were recruited from 18 hemodialysis units in South Korea. Data were analyzed using SPSS/WIN 23.0 to provide descriptive statistics to describe the characteristics of the sample and variables. A hierarchical linear model was used to analyze effects of individual and hospital characteristics on nurses' compliance with standard precautions.
RESULTS
The majority of the sample was female (98%) and reported receiving in-service education on infection control (80%). The participants' average year of work experience in hemodialysis units was 7 years and the average nurse-patient ratio was 7:1. At the individual level, the perception of patients' severity, the length of work experience in hemodialysis unit, and the safety climate on infection prevention practices were significantly associated with nurse's compliance with standard precautions. At the hospital level, clinics showed a lower compliance with standard precautions than general hospital or university hospital.
CONCLUSION
In order to enhance compliance with standard precautions among hemodialysis unit nurses, it is imperative to warrant safety climate on infection prevention practice at clinics and develop infection control educational program for nurses with less work experience in hemodialysis units.

Citations

Citations to this article as recorded by  
  • Factors Influencing Emergency Department Nurses’ Compliance with Standard Precautions Using Multilevel Analysis
    Su Jung Kim, Eun Ju Lee
    International Journal of Environmental Research and Public Health.2021; 18(11): 6149.     CrossRef
  • Factors influencing the adherence of nurses to standard precautions in South Korea hospital settings
    Eunja Oh, Jeong Sil Choi
    American Journal of Infection Control.2019; 47(11): 1346.     CrossRef
  • 133 View
  • 4 Download
  • 2 Crossref
  • 2 Scopus
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