Purpose This study examined the relationships of health literacy, physical activity, and grip strength with self-care compliance in older male patients with chronic heart failure. Methods A cross-sectional descriptive was conducted, and 106 older male outpatients with chronic HF were recruited from a veterans’ hospital in Seoul. Data were collected from February 7, 2022 to April 10, 2022 using a self-reported questionnaire and were analyzed using SPSS/WIN 23.0. Results The average age of the participants was 76.3±4.5 years, and the average time elapsed since the heart failure diagnosis was 3.22±2.01 years. The mean self-care compliance score was 42.21±6.03 out of 60 points.
In the univariate analysis, grip strength was not significantly correlated with self-care compliance. The hierarchical regression analysis indicated that health literacy (β=.33, p<.001), physical activity (β=.32, p=.001), and alcohol drinking (β=-.28, p=.001) had statistically significant effects on self-care compliance, collectively explaining 34% of the variance (adjusted R2 =.34, F=12.00, p<.001). Conclusion The study highlights the necessity of periodically assessing and considering health literacy and the level of physical activity when developing educational strategies to promote self-care compliance among older male patients with heart failure in outpatient nursing practice.
Purpose This study investigated the prevalence and risk factors of undernutrition among older adults living in nonsubsidized Residential Care Homes (RCHs).
Methods: Face-to-face interviews and assessments were conducted in a convenience sample of 298 older adults (aged 65 years or older) residing in nonsubsidized RCHs in Hong Kong in January 2015. Subjects who ate by mouth (with or without assistance) and who had no communication barriers were included. We employed a descriptive cross-sectional study design according to the STROBE reporting guidelines. Data were collected on participants' demographics, history of chronic illness, physical function (assessed by the 10-item Simplified Barthel Index with the self-care ability and mobility subscales), cognitive function (assessed by the 10-item Abbreviated Mental Test), and nutritional status (assessed by the 18-item Mini Nutritional Assessment). After identifying the variables associated with undernutrition, hierarchical multivariate logistic regression was used to identify salient predictors.
Results: In total, 40.9% of participants had undernutrition, which was associated with a longer length of stay in RCHs and poorer physical and cognitive functions compared to adequate nutrition or being at risk of undernutrition. Hierarchical multivariate logistic regression showed that residents with better cognitive function (adjusted Odds Ratio [OR]=0.88) and self-care ability (adjusted OR=0.75) were at a lower risk of undernutrition.
Conclusion: Undernutrition is prevalent among residents in RCHs in Hong Kong and poses a significant risk of cognitive impairment and poor self-care skills. To lessen the likelihood and the consequences of undernutrition, RCHs must give special consideration to residents with these risk factors.
Purpose This study investigated the effects of spiritual well-being on the self-care practices of people undergoing hemodialysis with hope as a mediator.
Methods Using convenience sampling, 126 people undergoing hemodialysis were recruited from April 17th to July 15th, 2022 for a cross-sectional survey. Data were collected using the Spiritual Well-Being Scale, Hope Scale, and Self-Care practices Scale and analyzed using descriptive statistics and Pearson’s correlation coefficient. In addition, multiple regression analysis was performed to analyze the mediating effect using Baron and Kenny’s three-step method.
Results The mean scores for spiritual well-being, hope, and self-care practices were 75.67, 51.37, and 128.82 respectively. There were significant correlations between the three variables. In step 1, spiritual well-being had a statistically significant positive effect on hope (β=.59, p<.001) (R2=37.8%). In step 2, spiritual well-being had a significant positive effect on self-care practices (β=.31, p<.001) (R2=14.6%). In step 3, the direct effect of spiritual well-being on self-care practices was not significant when the mediating variable hope was introduced; hope was observed to have a complete mediating effect (β=.36, p<.001) on the relationship between spiritual well-being and self-care practices (Sobel test: Z=3.18, p<.001).
Conclusion Based on these results, hope enhancement can help in self-care practices, and hope can also be promoted through spiritual well-being resources. Thus, it is necessary to develop a holistic nursing program that includes spiritual care to promote spiritual well-being and hope for improving self-care practices in people undergoing hemodialysis.
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Purpose The purpose of this study was to investigate the effect of a self-care education program using a QR-Code on self-efficacy, self-care performance, and education satisfaction among pneumothorax patients after discharge from a hospital. Methods The participants comprised 60 inpatients diagnosed with spontaneous pneumothorax and operated on at a tertiary general hospital in G city. The experimental group (n=30) attended a self-nursing education program using handouts and a QR-Code, and the control group (n=30) was provided discharge education through existing handouts. χ2 test, fisher’s exact test, independent t-test, and repeated measures ANOVA were performed to analyze the collected data using the SPSS 26.0 version program. Results After three weeks of intervention, the experimental group showed a significant increase in self-efficacy (t=-4.50, p<.001) and self-care performance (t=-5.54, p<.001). The experimental group also showed significant increases in self-efficacy (F=37.72, p<.001) and self-care performance over time (F=52.00, p<.001). and reported significantly higher education satisfaction compared to the control group (t=-6.84, p<.001). Conclusion QR-Code-based self-care education increases self-efficacy, self-care performance, and education satisfaction among pneumothorax patients. Thus, this program can be used as an effective nursing intervention to maintain and improve the health of pneumothorax patients.
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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 This study investigates the mediating effects of self-care competence on the relationship between uncertainty and quality of life in stroke patients.
Methods: This study adopts a descriptive research approach using 158 patients diagnosed with ischemic or hemorrhagic stroke through brain Magnetic Resonance Imaging (MRI) or Computed Tomography (CT). The data collection period was from May 20, 2020 to September 29, 2020. The data were analyzed using descriptive statistics, Pearson’s correlation coefficient analysis, and a three-step regression analysis using Baron and Kenny’s method for mediation.
Results: The mean scores for uncertainty, self-care competence, and quality of life were 3.07±0.49, 3.66±1.07, and 3.54±0.93, respectively. Self-care competence was found to completely mediate the relationship between uncertainty and quality of life (z=-5.31, p<.001), and its explanatory power was 77.2%.
Conclusion: To improve the quality of life among stoke patients in uncertain situations, it is necessary to improve their self-care competence and develop step-by-step and differentiated self-care competence enhancement programs through multidisciplinary collaboration.
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PURPOSE The purpose of this study was to investigate the health literacy and self-care activities of elderly diabetes patients and identify the effects of mediation of resilience in the relationship between them. METHODS A structured self-report questionnaire measuring health literacy, resilience and self-care activities was completed by 145 elderly people aged 65 years or older, who were diagnosed with type 2 diabetes mellitus at the Pusan National University hospital in Busan city, and who visited the outpatient clinic for endocrinology. Data collection was conducted from February 10, 2017 to March 31, 2017, and the collected data were analyzed using SPSS/WIN 23.0 program. RESULTS The subjects' health literacy and resilience (r=.19, p=.023), health literacy and self-care activities (r=.26, p=.001), resilience and self-care activities (r=.39, p < .001) were significantly correlated. Resilience completely mediated in the relationship between health literacy and self-care activities (z=2.37, p=.017). CONCLUSION Resilience plays a mediating role in the association among health literacy and self-care activities. It is necessary to develop a variety of intervention programs that can improve resilience in increasing self-care activities.
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PURPOSE The purpose of this study was to explore self-management support experiences among breast cancer survivors. METHODS Individual in-depth interviews were performed for survivors who had treated breast cancer after completion of chemotherapy and radiation therapy. Data were collected from April 2014 to July 2014 and analyzed using phenomenological method by Colaizzi. RESULTS Five essential themes were found as follows: 1) Need for continuous help and support to maintain self-management, 2) Need for professional resources to carry out regular exercise, 3) Overcoming psychological difficulties through others rather than health care professionals, 4) Disappointment with time with and circumstances of health care consultation, 5) Dependence on means of media for health related information. CONCLUSION The results might contribute to an understanding of self-management support experienced by breast cancer survivors in Korea. It is suggested that evidence-based program for self-management support should be developed and applied to nursing intervention for breast cancer survivors.
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PURPOSE The purpose of this study was to investigate health literacy, diabetic knowledge, and diabetic self-care among foreign diabetic patients at a hospital in South Korea. METHODS Participants was 134 foreign patients diagnosed with diabetes and who understand English. Data were analyzed by SPSS version 20.0. RESULTS Health literacy significantly differed with HbA1c levels, whereas diabetic knowledge significantly differed with education levels, and time since diagnosed. Diabetic self-care significantly differed with time since the diagnosis. Health literacy significantly differed with diabetic knowledge and diabetic self-care. There was a correlation between health literacy and diabetic knowledge and between diabetic knowledge and diabetic self-care but not between health literacy and diabetic self-care. CONCLUSION There are significant results on health literacy, diabetic knowledge and diabetic self-care. Subject with adequate health literacy had high scores on diabetic knowledge and self-care.
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PURPOSE The objective of this study was to identify the predictors of self-care behaviors among elderly patients with hypertension using quantile regression method. METHODS A total of 253 elderly patients diagnosed with hypertension was recruited via 3 different medical clinics for the study. The quantile regression and a liner regression was conducted using Stata 12.0 program by analyzing predictors of self-care behaviors. RESULTS In the ordinary least square, self-efficacy, period of disease, and education level explained 42% of the variance in self-care activities. In the quantile regression, affecting predictors of self-care behaviors were self-efficacy for all quantiles, the period of disease for from 60% quantile to 90% quantile, education level for 20%, 30%, and 50% quantiles, economic status for 10%, 50%, and 60% quantiles, age for 10%, 70% quantiles, fatigue for 10% quantile, knowledge about hypertension for 10% and 20% quantiles, and depression for 30% and 40% quantiles. CONCLUSION The affecting predictors of self-care behaviors among elderly with hypertension were different from the level of self-care behaviors. These results indicated the significance in assessing predictors according to the level of self-care behaviors when clinical nurses examine the patients' health behaviors and plan any intervention strategies. Specially, education level and knowledge about hypertension were the significant predictors of self-care activities for low quantiles. Clinical nurses may promote self-care activities of the given population though health education programs.
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PURPOSE To evaluate heart failure knowledge and adherence to self-care behaviors, and to identify factors affecting adherence to self-care behaviors among Korean patients with heart failure. METHODS Correlational research using the European Heart Failure Self-care Behavior Scale, the Duke Activity Status Index, the Dutch Heart Failure Knowledge Scale, the New York Heart Association Functional Classification, and the Medical Outcomes Study Social Support Survey was conducted. A total of 280 outpatients with heart failure responded to the five questionnaires. RESULTS The mean scores for self-care adherence and heart failure knowledge were 31.98 +/- 6.81 and 8.78 +/- 2.53, respectively, indicating lower adherence and knowledge than those previously reported. Subjects with lower functional status, more social supports, and greater knowledge of heart failure are more likely to adhere to prescribed regimens. CONCLUSION Nurses should focus on patient education and support to improve their adherence to self-care behaviors.
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PURPOSE To examine the relationships between self-care, social support, and biological markers in liver transplant recipients. METHODS The participants included 118 liver transplant recipients who visited outpatient clinic at Y University Hospital in Seoul from April to May, 2013. Questionnaires consisted of self-care and social support scales. The biological markers were collected by reviewing electronic medical records. Data were analyzed with descriptive statistics, t-test, ANOVA with Scheffe post-hoc test, and Pearson's correlation. RESULTS The self-care score was significantly higher in a patient group within 6 months post-transplant when compared to a patient group post-transplant 3 to 5 years (F=3.10, p=.018). The self-care showed positive correlation with social support with statistical significance (r=.36, p<.001). CONCLUSION As the self-care in liver transplant recipients had a positive correlation with social support from family and healthcare providers, the development of comprehensive long-term nursing intervention systems including counseling, education, and support in consideration of progress of time period after transplantation is necessary to enhance self-care behaviors among this population.
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PURPOSE The purpose of this study was to investigate the effects of a structured preoperative instruction upon anxiety and postoperative self-care compliance. METHODS A randomized control group pre-post design was used. Sixty subjects undergoing cataract surgery were randomly assigned to one of two groups. The instruction consisted of cataract surgery procedure, sensory information, deep breathing, use of eye drop, and post op self-care regimen and was provided to the experimental group with control group receiving an usual treatment. State anxiety NRS, pulse, BP, and self-care compliance scale developed by Cho&Rho were used. Data were collected at two time periods: on the day of surgery in the clinic and prior to anesthesia in the operating room. The postoperative self-care compliance scores were measured at their second visits to the hospital after surgery. Data were analyzed using Kolmogorov Smirnov test, t-test, and Mann-Whitney U test. RESULTS There were significant differences between the two groups in the postoperative state anxiety (t=-3.57, p=.001) and the postoperative self-care compliance score (t=3.92, p<.001). There were no significant difference between the two groups in the postoperative blood pressure and pulse rate. CONCLUSION The results of this study suggest that the structured preoperative instruction could be a nursing intervention for cataract surgery patients.
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PURPOSE This research was carried out to evaluate the validity and reliability of the Korean version of the Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) for Korean older adults with type 2 diabetes. METHODS Translation and back-translation were performed to develop the Korean version of the SDSCA. Then the Korean version SDSCA was applied to a sample of 112 older adults who had participated in diabetes self management education in Seoul. The internal consistency and the test-retest reliability were examined to test the reliability. Factor analysis was used to examine the construct validity. RESULTS The internal consistency measured with Cronbach's alpha was .77 and the total test-retest reliability was .68 with items ranging from .21 to 1.00. As the result of the factor analysis, six factors -foot care, diet, exercise, blood sugar test, medication, and smoking- were revealed as the original instrument subcategories. These six factors explained 81.17% of total variance. CONCLUSION The reliability and validity of the Korean version SDSCA Questionnaire was supported for use in older patients with type 2 diabetes in Korea.
PURPOSE The purpose of this study was to examine the relationship among cognitive function, depression, social support, and self-care in elderly with hypertension. METHODS The subjects were 132 elderly with hypertension living in Seoul, Korea. Data were collected through face-to-face interviews using the Korean version of Mini-Mental State Examination(MMSE-K), Short form geriatric depression scale, social support questionnaire 6, and hypertension self-care scale. RESULTS Thirty-four percent of the subjects had questionable dementia and forty-two percent of the subjects were depressed. Means for social support were 2.40 for network size and 4.07 for satisfaction. The mean score of hypertension self-care was 60.34, indicating that the subjects took care of themselves moderately well. Cognitive function was negatively related to depression. Social support network and satisfaction were negatively related to depression. Self-care was negatively related to social support network. CONCLUSION Programs are needed for elderly with hypertension to improve their cognitive function, depression, and social support. Also further studies are needed to confirm the factors related to self-care in the elderly with hypertension.
PURPOSE This study was to investigate the sex differences in risk of cardiovascular disease(CVD), depression and self-care activities in type 2 diabetes with metabolic syndrome. METHODS The descriptive correlational design was conducted using a convenient sample. One hundred and twenty-nine diabetic patients with metabolic syndrome were recruited in a university hospital. The data were analyzed using descriptive statistics, the Pearson correlation coefficient, Students' t-test, one way ANOVA, and stepwise multiple regression with SPSS/WIN 12.0. RESULTS The risk of CVD in diabetic patients with metabolic syndrome indicated a significantly negative correlation to self-care activities and age, and positive correlation to waist_C, SBP, DBP and TG. The metabolic syndrome is associated with an approximate 1.7-fold increase in the relative risk in CVD in diabetic women. The main significant predictors influencing CVD risk of diabetes with metabolic syndrome were age, waist_C, SBP and TG, which explained about 29.7%. CONCLUSION These results indicate that patients with diabetes with metabolic syndrome with a high degree of waist_C, SBP and TG are likely to be high in risk of CVD.
PURPOSE The purpose of this study was to identify predictors of cardiovascular risk factors of type 2 diabetic patients. METHODS Diabetic patients (N=160) were interviewed from November, 2003 to June, 2004. The 24 hour dietary recall, the International Physical Activity Questionnaire, the Diabetes Management Self-Efficacy Scale for patient with Type 2 diabetes, the Revised Summary of Diabetes Self-Care Activities Measure Scale and Parma Cardiovascular Risk Index were used to measure the predictors. Data were analyzed by descriptive analyses, Pearson correlation coefficients, and stepwise multiple regression using the SPSS WIN 10.0. RESULTS Mean dietary intakes of the participants were protein(P) of 64.5g, carbohydrate(C) of 280.74g, fat(F) of 30g, and calcium of 511.45mg. The ratio of CPF was 75:17:8. About 45% of the participants didn't exercise on a regular basis. The levels of self-efficacy, self-care, and cardiovascular risk factors of the participants were moderate. Self-efficacy was the most important predictor of cardiovascular risk factors along with self-care, exercising for more than 6 months, carbohydrate intakes and levels of physical activities. CONCLUSION The findings of the study suggest that intervention programs increasing self-efficacy on diabetic management would be more beneficial than the fractional approach focusing only on diet or physical activities.
PURPOSE The purpose of this study was to provide nursing intervention with basic data extracted through investigating self-care and nursing of lymphedema in patient who have had a mastectomy. METHOD The subjects for this study consisted of 214 mastectomy patients in 2 hospitals. The data were collected from December 1, 2004 to February 28, 2005. The instruments used for this study were both the Self-care Practice Scale by Cho, Myoung-Ok et al.(2003) which we modified and the Nursing Evaluation Scale developed by the researchers. RESULTS The mean score of self-care on lymphedema was 59.96+/-12.46. The mean score of nursing was 25.64+/-9.25. Factors influencing the self-care were the postoperative period (F= 17.505, p<.001), the location of the tumor (F= 3.826, p=.023), menstruation (t=7.333, p=.007), and complications (F=5.427, p<.001). CONCLUSION Self-care and nursing care on the lymphedema management were shown to be lower than expected. Especially, the score of self-care was the lowest in the more than 3 year postoperative period. Therefore, the longer the postoperative period is, the more active management on lymphedema needs to be. Also, education should be given to both nurses and patients on the importance of self-care on lymphedema with mastectomies.
PURPOSE This study was attempted to estimate the effects of diabetic education fortified with individual practice on plasma glucose, self-care, and self reported physical symptoms in type 2 diabetes patients METHOD: The subjects consisted of 46 patients with type 2 diabetes patients, who took the hospitalization diabetes education program from July 2003 until February 2004 at Seoul C university hospital. The experimental group was assessed at pre- and post intervention. The diabetes education was provided for one week. The education consisted of diabetes education videos for the diabetic introduction, group education for medication therapy, dietetic treatment and diabetes complication education. Also individual education for nurses examination of glycemia and insulin injection practice. RESULTS The HbA1c values significantly decreased from 9.6% on the time of hospitalization to 7.4% 3 months after discharge. In respect to the number of days of self-care, medication, diet, exercise, cleansing feet, and carrying sweets to prepare for hypoglycemia all significantly increased 3 months after discharge compared to the values at the time of hospitalization. Self reported physical symptoms were also significantly increased 3 months after discharge compared to the time of hospitalization. CONCLUSION The diabetic education fortified with individual practice can be practically used as a plan for managing glycemia, self-care, and self reported physical symptom of diabetes patients.
PURPOSE This study was performed to identify relationships among stress, hardiness, and the level of self-care in kidney transplant patients and use the results of this study as baseline data for developing self-care promotion programs. METHOD Subjects were 41 patients who undergone a kidney transplantation surgery at least one month before and were receiving regular follow-up care via OPD. Four researchers interviewed each subjects by filling out questionnaires. RESULTS The mean score of the level of stress was 2.32(SD=0.54) on a 4 point scale and the mean score of hardiness was 4.68(SD=0.62) on a 6 point scale. The mean score of self-care among the subjects was 3.83(SD=0.55). There was statistically a significant positive relationship between self-care and hardiness(r=0.42). Especially, relationships between self-care and commitment (r=.51) and control(r=.36) as the sub- dimensions of hardiness were significant. The item suggested as most stressful was economic burden and the item suggested as least stressful was sexual activity. CONCLUSION Although transplant patients have various stressors, the positive self-care activities of the patients could be increased if the commitment and control were enhanced by proper intervention programs.
PURPOSE This study was conducted to examine the effects of the secondary stroke prevention education program to inhibit the recurrence of the acute ischemic stroke patients, and to maintain and promote knowledge about stroke, self-efficacy and self-care. METHOD: This study was designed to take a quasi-experimental pre- and post-test with the nonequivalent control group. The experimental group consists of 20 patients and control group consists of 20 patients. The experimental group was applied the secondary stroke prevention education program. In order to verify the effects of the secondary stroke prevention education program, knowledge about stroke, self-efficacy and self-care scale were measured before the intervention and 4 weeks, 12 weeks after discharge. The tools for measuring knowledge about stroke, self-efficacy and self-care are developed by the researcher. The data was analyzed by SPSS win 10.0 program using chi2-test, Fisher's Exact Test, t-test, Kolmogorov- Smirnov Z, and Repeated Measures ANOVA. RESULT: There was a statistically significant difference in knowledge about stroke (F=4.021, p=.026), self-efficacy(F=6.096, p=.018), and self-care(F=8.026, p=.007) between the experimental and the control group after intervention. CONCLUSION: It is considered that the program can be used as an effective nursing intervention in clinical practice.
PURPOSE The main purpose of this study was to examine the effectiveness of a standardized telephone monitoring intervention in addressing the symptom experience and improving self-management ability in patients with heart failure. METHODS: A non-equivalent control group pre-post test design was used. There were 17 patients in the experimental group, and 16 in the control group. According to the protocol, patients in the experimental group received 15 to 30 minute-telephone monitoring four times, once a week for 4 weeks. Data were analyzed by chi2-test, Mann-Whitney U test. RESULTS: 1) The experimental group showed a significant increase in compliance with self-management compared to the control group. 2) There was a significant decrease in degree for 3 symptoms(DOE, PND, & continuing fatigue) in the experimental group, after telephone monitoring. However, the experimental group did not show significant decrease in the degree of the total symptom experiences. CONCLUSIONS: The results of this study provide evidence that standardized telephone monitoring is effective in relieving symptom experience and improving self- management in patients with heart failure over the course of telephone monitoring.
PURPOSE The purpose of this descriptive study was to gain basic data to develop a self-care protocol for the lymphedema patients. METHOD The subjects of this study consisted of 115 patients with lymphedema from 8 hospitals and two community health and welfare centers in Busan and Seoul. The data was collected with questionnaire by self reporting of patients between March 2001 and December 2001. Data was analyzed by mean and percentage. RESULT For self-care activities in daily life, compliance of 'use skin care preparations', 'use heat and cold', 'protect from local compression on affected limbs', 'protect from insect biting', 'use aids to protect affected limbs', 'take diuretics and take protein diet' did not reach to 50%. For self-care activities related to complex physical therapy, 28.7% of subjects complied with compression garment, 14.8% with manual lymph drainage, and 13.0% with exercise. 20.0% of subjects tried to treat with acupuncture and 13.9% with heat therapy. CONCLUSION From this study, it is suggested that patients need to get a self-care education with correct information about self care activities and health care professionals need to develop more convenience self-care techniques of massage and exercise.
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