Purpose Middle-aged women often experience weight gain, particularly as visceral fat, due to hormonal changes associated with menopause. Visceral fat, which accumulates in the abdomen, poses significant risks to cardiometabolic health. This cross-sectional study aimed to compare the cardiometabolic risks associated with Visceral Fat Obesity (VFO) and Subcutaneous Fat Obesity (SFO) in middle-aged Korean women and to identify factors that influence VFO. Methods Women aged 40 to 64 with overweight or obesity were recruited from March to April 2019. The study involved anthropometric measurements, fasting blood tests, and low-volume abdominal computed tomography. Additionally, participants provided self-reported sociodemographic, health-related, and lifestyle information, including Physical Activity (PA) and dietary intake. Results Of all participants, 70.8% were post-menopausal, and 55.1% had VFO. Those with VFO exhibited significantly higher mean values for waist circumference, total cholesterol, low-density lipoprotein cholesterol, triglycerides, fasting glucose, high sensitivity C-reactive protein, and the Framingham risk score compared to those with SFO. The factors influencing VFO were age (odds ratio (OR)=1.14; 95% confidence interval (CI), 1.032~1.247), body mass index (OR=1.47; 95% CI, 1.151 ~1.875), days of vigorous PA per week (OR=0.42; 95% CI, 0.244~0.735), and intake of animal calcium (OR=0.99; 95% CI, 0.988~0.997). Conclusion The findings indicate that middle-aged women with VFO face increased cardiometabolic risks. Since menopause is inevitable in women, targeting modifiable behaviors to reduce weight, particularly visceral fat, is crucial for lowering cardiometabolic risk.
Purpose Cancer diagnosis is associated with psychological distress, which often leads to a significant reduction in adaptation and quality of life. This study aimed to identify the prevalence and related factors of psychological distress in newly diagnosed breast cancer patients. Methods The study included 138 women scheduled for surgery or neoadjuvant chemotherapy following a recent breast cancer diagnosis at a university hospital in Korea.
Psychological distress was assessed using the National Comprehensive Cancer Network Distress Thermometer and problem lists. Data collection occurred from November 1, 2021, to November 30, 2022. Descriptive statistics and logistic regression analysis were utilized for data analysis. Results The average age of the participants was 51.72 years. Among the 138 participants, 67.4% (n=93) reported moderate to severe levels of psychological distress. Multivariate logistic regression analysis identified financial burden (Odds Ratio [OR]=4.32), fears (OR=5.35), and nervousness (OR=5.50) as predictors of moderate to severe psychological distress. Conclusion Approximately two-thirds of newly diagnosed breast cancer patients experienced significant psychological distress.
Nervousness, fears, and financial burden were significant factors influencing this distress. Therefore, management of psychological distress should be implemented for patients experiencing financial burdens or emotional problems, such as nervousness and fear, from the time of diagnosis.
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.
Purpose This descriptive study aimed to present the incidence of delirium and identify risk factors for delirium in Trauma Intensive Care Unit (TICU) patients.
Methods: The participants were 184 patients who were hospitalized in the TICU at a Regional Trauma Center in Gyeonggi-do. Data were collected between April and November 2019. For delirium measurement, the author used the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Diverse dependent variables were collected through electronic medical records. Data were analyzed using descriptive statistics, independent t-test, x2 -test, and binomial logistic regression.
Results: Incidence of delirium in TICU patients was 34.8%. Logistic regression analysis showed that the risk factors for delirium in TICU patients were hemoglobin (Odds Ratio [OR]=0.62, 95% Confidence Interval [CI]=0.43~0.88), injury severity score (OR=1.10, 95% CI=1.01~1.20), length of TICU stay (OR=1.15, 95% CI=1.03~1.29), administered sedatives (OR=6.04, 95% CI=2.47~14.76), and use of restraints (OR=5.75, 95% CI=2.29~14.42).
Conclusion: Based on the results of this study, healthcare providers, especially TICU nurses, should try to detect the signs and symptoms of delirium as early as possible, taking into account the specified risk factors of the patient. Preventive and practical intervention programs considering the risk factors must also be developed to prevent and alleviate delirium in TICU patients in the future.
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PURPOSE Delirium is a common symptom among heart surgery patients, and its prevalence is reported to range from 16.0~73.0%. As patients with delirium exhibit multiple negative prognoses, it is important to identify and prevent the risk factors for delirium. However, little research has been conducted to identify the prevalence of delirium and its risk factors among patients who have undergone heart surgery in Korea. Therefore, the aim of this study is to explore the prevalence of delirium and its risk factors in heart surgery patients in the Intensive Care Unit (ICU). METHODS This is a retrospective descriptive correlational study. From 623 patients who entered the ICU after heart surgery in a tertiary referral hospital from September 2016 to August 2017, 421 were selected for this study. Data were collected using electronic medical record. Delirium was evaluated using the Korean Nursing Delirium Screening Scale (Nu-DESC). RESULTS A total of 63 participants (15.0%) were diagnosed with delirium. Multivariate logistic regression analysis of the variables identified that complex surgery (Odds Ratio [OR]=7.24, 95% Confidence Interval [CI]= 2.80~18.74, p<.001), aortic aneurysm surgery (OR=3.30, 95% CI=1.40~7.77, p=.006), creatinine (OR=2.32, 95% CI=1.17~4.60, p=.016), and ICU length of stay (OR=1.72, 95% CI=1.48~1.99, p<.001) were associated with delirium after heart surgery. CONCLUSION The prevalence of delirium after heart surgery in Korean ICU patients is similar to that reported by the American Heart Association study. Type of surgery, lab data, ICU length of stay should be considered in the prevention and management of delirium in heart surgery patients in Korea.
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PURPOSE The study aims to evaluate the effects of Tai Chi applied cardiac rehabilitation program(TCCRP) on cardiovascular risks, recurrence risk in ten years, and cardiac specific quality of life in individuals with coronary artery disease. METHODS The sample was comprised of individuals diagnosed with coronary artery disease within six months of the study who were referred by their primary physicians to participate in the TCCRP. The design was a pretest/posttest with non-equivalent groups with 30 in TCCRP program and 33 wait-listed comparison group. RESULTS The average age of all participants was sixty seven years. At the completion of the TCCRP, the Tai Chi group showed significant reduction in their ten year recurrent risk for coronary artery disease measured by Framingham's algorithm. The quality of life for the experimental group was reported as significantly higher than the comparison group, especially the area of general symptom. CONCLUSION The outpatient cardiac rehabilitation with Tai Chi was applied effectively and safely without any complication to individuals with coronary artery disease. Tai Chi can be useful as an alternative exercise for cardiac rehabilitation program which may provide more access to individuals for cardiovascular risk management in the community settings.
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PURPOSE The purpose of this study was to identify the prevalence and risk factors of sleep disturbance among community dwelling adults in Korea. METHODS Data were collected from nine hundred fifty nine adults dwelling in a metropolitan city in Korea. Subjects were older than 45 years, did not take medication for sleep problems on a regular basis, and did not work at night. The Pittsburgh Sleep Quality Index was used to collect data about sleep disturbance. Sociodemographic, life style, and health related factors were included as risk factors. Chi square test and logistic stepwise regression were used to identify the risk factors. RESULTS The prevalence of sleep disturbance was 13.1%. The significant risk factors were being female, age, number of toilet use at night, perceived health, and pain. Risk factors were somewhat different by gender. Emotional and job status were the risk factors only for men and menopausal status were for women. CONCLUSION Prevalence of sleep disturbance in community dwelling adults in Korea was not greater than those dwelling in other countries. Females, older adults, the number of toilet use at night, perceived health, and pain were the most important risk factors for sleep disturbances. Gender was a factor in reported sleep disturbances. It might be useful to investigate the factors that contribute to the number of toilet use at night as this might have some underlying factors that could be corrected.
PURPOSE Cardiovascular risk factor modification is important for patients with coronary artery disease to prevent poor progression of the disease. Without an understanding and an awareness of risk factors, patients with coronary artery disease are not able to reduce their risk by the lifestyle modification. The aims of this study were to assess patient's awareness of risk factors and to identify predictors of awareness of risk factors. METHODS A descriptive correlational study using a cross-sectional survey method was performed. The sites of the study were three hospitals in Seoul, Korea. The sample consisted of 214 subjects. The awareness of risk factors and other subjects' characteristics were measured by a questionnaire developed for this study. RESULTS A range of subjects (gender: 72.0%; hyperlipidemia: 51.9%; hypertension: 40.7%; obese: 37.4%; age: 35.5%; smoking: 22.4%; diabetes: 19.2%; family history: 18.2%) were not able to accurately identify the risk factors. Among predictors, gender (beta=-.17) and diabetics (beta=-.25) had statistically significant influences on awareness of risk factors. CONCLUSION Our findings highlight the lack of awareness of risk factors for coronary artery disease. The findings have important implications for nursing practice in terms of guiding educational strategies for the modification of risk factors for coronary heart disease.
PURPOSE This descriptive study was conducted to identify the level of knowledge of stroke symptoms and risk factors among older adults. METHODS A total of 200 older adults over 65 years of age were conveniently recruited from out patient departments of two hospitals and a health care center from October to November 2008. The level of knowledge was assessed using both open-ended questions and a structured questionnaire based on semi-structured interviews. Data were analyzed by t-tests and ANOVA using the SPSS program. RESULTS 52.5% of the sample had hypertension and 30% had diabetes. The mean knowledge scores for symptoms and risk factors were 8.4 +/- 3.1(out of 15) and 9.5 +/- 3.9 (out of 16), respectively. The older adults who had lower education, lower family income, and who lived in rural areas were more likely to have less knowledge of stroke symptom and risk factors(p < .05). There was no significant knowledge difference between the older adults who had at least one risk factor and those who had no risk factor for stroke. CONCLUSIONS Educational intervention should be focused on informing older adults who are at risk for stroke about the early symptoms and management of risk factors, especially those who have low education and low social status.
PURPOSE The purpose of this study was to investigate foot ulcer risk factors, foot care knowledge, and foot care practice in patients with type 2 diabetes. METHOD One hundred fifty type 2 diabetic patients were in and out-patients in a large urban hospital. The data were collected using a self-report questionnaire, chart review and foot examination. The questionnaires were developed by the researchers through the experts consultation and literature review. High risk for foot ulcer was evaluated by peripheral neuropathy(PN), peripheral vascular disease(PVD), and prior foot ulcer. Foot risk scores(FRS) means numbers of present risk factors. RESULTS 31.3% of subjects show 1 FRS, and 13.3% showed 2 FRS. Mean foot care frequency was 3.5 times per week. There were significant differences in foot care knowledge according to DM education (t=2.96, p=.004) and foot care education (t=3.65, p=.001). There were significant differences in the foot care practice activities according to duration of DM (t=3.48, p=.010) and educational levels. CONCLUSION There were high proportion of foot ulcer risk among the patients. It is necessary to screen high risk foot ulcer patients and provide practical education for foot care practice of diabetic patients.
PURPOSE This study is aimed at testing the effect of health promotion program on health promoting behavior and cardiovascular risk factors of middle-aged women. METHOD The research design was the nonequivalent control group pre-post test. Twelve middle-aged women were the experimental group and ten were the control group. The 8-week health promotion program was given to the experimental group. There were health promotion theories, flexibility and muscle strength exercise, cardiopulmonary endurance exercise, nutrition, stress management, cancer prevention and early detection, management of menopause and wrap-up in health promotion program for middle-aged women. The measurement tool was Health Promoting Behavior developed by researcher using serum cholesterol, obesity rate, systolic blood pressure, and diastolic blood pressure as cardiovascular risk factors. RESULT The experimental group showed a higher score of health promoting behavior than the control group. There were no differences on cardiovascular risk factors(cholesterol, obesity rate, diastolic blood pressure) between the experimental and control groups except systolic blood pressure. CONCLUSION Conclusively, this health promotion program for middle-aged women was effective in increasing health promotion behaviors, but wasn't effective in decreasing cardiovascular risk factors except the systolic blood pressure. It seems it's necessary to re-study this using more samples and a longer duration of the program, and smaller mortality rate.
PURPOSE This study purposed to examine the disease-related knowledge level and compliance with good health behavior in patients with myocardial infarction according to the atherosclerotic risk factors. METHOD The subjects consisted of 72 patients with myocardial infarction and the data were collected by interviewing the subjects with questionnaires and reviewing their medical records from September, 15, 1999 to July 31, 2000. Data were analyzed using the SAS program. RESULTS 1) With regard to atherosclerotic risk factors: of the subjects, 91.7% lacked regular exercise, followed by smoking (61.1%). 2) The average knowledge score of the patients was 19.7 and the average compliance score was 53.9. 3) There were no significant differences in the total knowledge scores according to the patients' atherosclerotic risk factors. 4) Non-diabetics were significantly higher in knowledge scores on domain of risk factors than the diabetics. 5) The overweight patients were significantly higher in knowledge score on domain of nature of disease than the normal-weight patients. 6) The total compliance scores of the non-smokers were significantly higher than those of the smokers. 7) The total compliance scores of the patients who do regular exercise were significantly higher than those of the patients who forgo regular exercise. 8) The non-smokers were significantly higher in compliance scores on domain of diet than the smokers. 9) The diabetic patients were significantly higher in compliance scores on domain of smoking cessation than the non-diabetics. 10) Patients who do regular exercise were significantly higher in compliance scores on other domains than the patients who forgo regular exercise. CONCLUSION According to the above findings, it can be concluded that intensive nursing care and education should be provided to patients who have atherosclerotic risk factors such as smoking, hypertension, diabetes mellitus, lack of exercise, over weight, or hypercholesterolemia to increase disease related knowledge level and to improve compliance with good health behavior.
The purpose of this study was to examine the relationship among variables which are categorized by two groups : the first group consists of obesity, serum lipids, and blood pressure which were measured by physical index or physiological index, and the second group consists of demographic variables and variables related to lifestyle that is known to influence the first group. The canonical correlation analysis was conducted with the data collected from 400 male clients who visited one university hospital located in Inchon in a period, from May 1996 to December 1996, for physical examination. According to the results, blood pressure and HDL of the first group were shown to have strong relationship with age, alcohol, smoking, exercise of the second group. And total cholesterol, triglyceride, systolic, BMI of the first group were shown to have strong relationship with income status, education, exercise of the second group. And all of the serum lipids (total cholesterol, triglyceride, HDL), BMI, and diastolic were shown to have relationship with education, smoking, alcohol. It should be noted that fat rate, which was one of the indices for obesity, was not significant in any of the canonical variates. From the comparative study results on which combination of indices of obesity, serum lipids and blood pressure was related to either alcohol or smoking more, it can be seem that smoking was more highly related to two blood pressure indices such as systolic and diastolic, and that alcohol was highly related to serum lipid indices such as HDL, total cholesterol, triglyceride. Also investigation on what differences exist between the combination of variables showing high relationship to systolic and the combination of variables showing high relationship to diastolic was conducted. Systolic turned out to have relationship with total cholesterol, triglyceride, obesity (fat rate), income status, education, exercise. And diastolic was related to HDL-c, total cholesterol, tryglyceride, obesity (BMI), education, smoking, alcohol. From this results, it could be seen that the combination of variables which have high relationship to systolic and diastolic have different patterns. Lastly, the investigation on what relationships exist between serum lipids and demographic variables/lifestyle variables was conducted. It turned out that HDL-c had high relationship with age, education, income status, alcohol, and that all of serum lipids (total cholesterol, triglyceride, HDL) were shown to have high relationship with income status, education, age, exercise. From these results, it could be seen that the demographic variables were more influential both on HDL and on all of serum lipids than lifestyle variables were.
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