Purpose This study aimed to determine the rates of intensive care unit readmission and to identify the factors influencing readmission among intensive care unit patients aged≥65 years with internal medicine conditions.
Methods We retrospectively reviewed electronic medical records from a tertiary care hospital in Seoul, analyzing the characteristics of patients who were and were not readmitted between December 2020 and September 2022.
Results A total of 351 patients were included. The unplanned intensive care unit readmission rate was 4.8% within 7 days and 9.1% beyond 7 days after discharge. Comorbid diabetes, higher total bilirubin levels at intensive care unit admission, lower PaO2/FiO2 ratios at discharge, and elevated Blood Urea Nitrogen (BUN) levels at discharge were associated with an increased risk of readmission within 7 days. In contrast, hypertension, prolonged intensive care unit stays, and lower hemoglobin levels at discharge were associated with readmissions occurring after 7 days.
Conclusion Intensive care unit readmission among older patients is influenced by several clinical and hematological factors. Nurses should consider a patient's history of diabetes and hypertension, length of intensive care unit stay, and laboratory values-specifically total bilirubin at admission, and PaO2/FiO2 ratio, hemoglobin, and BUN levels at discharge-when making discharge decisions. These findings can inform the development of discharge guidelines.
Soo Hyun Kim, Seongmi Moon, Seieun Oh, Youn-Jung Son, Youngrye Park, Soo Jung Chang, Kisook Kim, Jooyoung Cheon, Eun Hee Jang, Jeonghyun Cho, Sung-Hee Yoo, Hee Sun Kim, Sung Reul Kim, Yu Hyeon Choe
Korean J Adult Nurs 2021;33(4):406-414. Published online August 31, 2021
Purpose The purpose of this study was to assess the research performance during Coronavirus Disease 2019 (COVID-19) pandemic among nursing researchers.
Methods: A cross-sectional online survey was conducted for Korean Society of Adult Nursing where 103 subjects participated from April 15 to May 14, 2021. The survey tool developed by researchers had 32 items including difficulties in performing research activities, perception of the impact of COVID-19 on research validity, and three open-ended questions.
Results: In the research planning phase, 88 subjects (90.7%) reported difficulties in the recruitment plan and 83 subjects (89.3%) reported difficulties selecting a research design. In the recruitment and data collection phase, 85 subjects (88.6%) had difficulties accessing data collection site and 78 subjects (85.7%) had difficulties in face-to-face data collection. In the provision of intervention phase (for experimental study), 26 subjects (66.7%) reported that they should have changed the method of delivery of intervention. In research administration and manpower management, 62 subjects (75.6%) reported difficulties in face-to-face meeting. In research outcome management, 65 subjects (85.5%) reported that they should have changed the way of research-related events. Lastly, 80 subjects (81.6%) perceived that difficulties caused by COVID-19 impacted research validity.
Conclusion: Majority of participants perceived that the difficulties in research activities may decrease research validity. To ensure research quality during COVID-19 pandemic, we should recognize potential threats to research validity and actively pursue adaptable innovations of research designs and data collection methods.
PURPOSE The aims of this study were to describe the incidence rate of delirium and to identify factors influencing delirium in neurological intensive care unit patients. METHODS The participants were 193 critically ill patients with neurological disorder from Chonbuk national university hospital in Jeonju. Data were collected between April 1 and November 25, 2017 using four structured questionnaires: Confusion Assessment Method for the Intensive Care Unit, Glasgow Coma Scale, Acute Physiology and Chronic Health Evaluation II, and Karnofsky Performance Scale. Data were analyzed using descriptive statistics, independent t-test, χ2 test, Mann-Whitney U test, and logistic regression using the SPSS/WIN 24.0 program. RESULTS The incidence rate of delirium was 11.9%. Delirium was related with age, length of stay in intensive care unit, Glasgow Coma Scale score, Acute Physiology and Chronic Health Evaluation II score, Karnofsky Performance Scale score, use of physical restraint, antihypertensive drugs, and anticonvulsants. Logistic regression analysis showed that age, length of stay in intensive care unit, use of physical restraint, and anticonvulsants were factors influencing delirium in neurological intensive care unit patients. CONCLUSION Delirium was related to demographic, clinical, medication-related, and environmental factors in patients in neurological intensive care units. Therefore, nurses should consider the patient's age, length of stay intensive care unit, use of physical restraint, and anticonvulsants in assessing delirium in neurological intensive care unit patients. Delirium prevention programs considering these factors may be effective for such patients.
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PURPOSE The aim of this study was to investigate the influencing effects of type D personality on symptom experiences and quality of life in percutaneous coronary intervention patients. METHODS A descriptive, cross-sectional study design was used. A total of 158 patients with percutaneous coronary intervention participated in this study, between July 1 and November 1, 2015. Data were analyzed by means, standard deviations, t-test, χ2 test, ANCOVA, and stepwise multiple regression analysis using SPSS 22.0 program. RESULTS About 53.8% of participants were classified as type D personality. The type D personality group reported statistically significantly higher symptom experience, lower cardiac function, and lower cardiovascular-specific quality of life compared to non-type D personality group. On stepwise multiple regression, the most significant factor of quality of life was symptom experiences (adjusted R²=.25, p<.001), followed by type D personality (adjusted R²=.31, p<.001). CONCLUSION Personality trait assessment is recommended for patients with percutaneous coronary intervention to assess symptom experiences and quality of life. In addition, development of nursing intervention might be beneficial to manage symptom experience and quality of life in percutaneous coronary intervention patients with type D personality.
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PURPOSE Fatigue is a common problem in Parkinson's disease (PD), affecting 30~65% of patients with that diagnosis. Only recently has fatigue been recognized as an important clinical feature of PD. The aim of this study was to investigate the level of fatigue and related factors in patients with PD. METHODS Between March 1, and September, 30, 2010, a sample of 181 PD patients agreed to be interviewed. RESULTS The female patients' PFS (Parkinson Fatigue Scale) score was higher than those of the male patients. Household income and having a Job were significantly correlated with the PFS scores. Among the disease characteristics, motor fluctuations, dyskinesia and modified Hoehn and Yahr stage were significantly correlated with the PFS scores. On stepwise regression analysis, the most important factors related to the PFS scores were depression and sleep disturbance. CONCLUSION Fatigue in patients with PD was associated with many factors and strongly associated with depression and sleep disturbance. Fatigue is a multidimensional construct; therefore, multidimensional strategies for relieving specific aspects of fatigue are needed.
PURPOSE This study explored cardiovascular health (CVH), depressive symptoms, and well-being among community-based Korean women according to hwa-byung (HB) symptoms. METHODS This cross-sectional study measured HB symptoms, depressive symptoms, quality of life (QoL), and spiritual well-being (SWB) in addition to biophysical indicators of CVH. RESULTS Fourteen women of the HB group are more likely to live alone with lower income than 36 women in the comparison group. Compared to the comparison group, the HB group has larger mean waist circumference and higher prevalence of abdominal obesity along with more knee arthritis and back pain. Although women in the HB group appeared worse in other CVH than their counterparts, this was not statistically significant. It is noteworthy, that the HB group showed a higher probability of having a hard cardiovascular event (CVE) within 10 years than the comparison group. Women in the HB group reported more depressive symptoms, poor QoL, and low SWB as well as smoking and sleep difficulties. CONCLUSION Despite the small sample size, significant relationships of HB symptoms to abdominal obesity, the probability of a hard CVE within 10 years, and psychosocial health were found. Strategies for effective community-based cardiovascular programs for Korean women may include HB screening and/or management.
PURPOSE The purpose of this study was to explore the life experiences of patients with a severe Chronic Obstructive Pulmonary Disease (COPD). METHODS The data were collected through in-depth interviews of six patients suffering from severe COPD. The interviewed data were audio-recorded and transcribed verbatim and checked for accuracy. The Giorgi method of phenomenology was used for analyzing data. RESULTS Eight themes forming the, units of meaning, were: Repeated and Unpredictable Suffering of Dyspnea, Confidence Loss/Exhaustion Life due to non-efficient breathing, Gradually Deprived Liberty, Absolute Being to Sustaining my life, Source of Burden but Significant Person I am in the Family, Endless Tug-of-War-Capability/Endeavor to Breath, Longing for my Life, and Dead-end of breathing. CONCLUSION The study results provide an in-depth understanding of life experiences of patients suffering from severe COPD. The findings will be useful to nurses caring for this population.
PURPOSE The aim of this study was to investigate the level of resilience and related factors in patients with Parkinson's disease (PD) in Korea. METHODS Data were obtained from 148 patients using the Resilience Scale (RS), Beck's Depression Inventory (BDI), and Spielberger's Anxiety Inventory (AI). RESULTS The mean scores of the RS, BDI, and AI were 127.7+/-21.6, 12.9+/-9.3, and 41.9+/-11.1, respectively. The RS score was strongly correlated with the BDI score (r=-.531, p<.001) and the AI (r=-.572, p<.001). The resilience was significantly revealed by household income (F=4.002, p=.009) and presence of a hobby (t=-3.300, p=.001). In addition, resilience was significantly correlated with age of disease onset (r=.164, p=.046), years of living with PD (r=-.262, p=.001), and the length of treatment with levodopa (r=-.283, p<.001). From the stepwise multiple regression analysis, the most important factors related to the RS score were the AI score, household income, and length of treatment with levodopa. CONCLUSION Understanding these factors is essential for developing effective interventions to improve resilience in patients with PD.
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