PURPOSE: Health literacy has been attracting increasing attention because low health literacy is considered an important predictor of adverse health outcomes in many chronic conditions, including diabetes. However, it is unclear how health literacy is associated with health outcomes. The purpose of this study was to formulate a hypothetical structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life (HRQOL) in patients with type 2 diabetes. METHODS: cross-sectional survey design was employed, and 459 patients with type 2 diabetes were recruited from outpatient clinics in two university hospitals. The patients completed a pack of questionnaires. The hypothetical model was tested using structural equation modeling analysis. RESULTS: The values of multiple fit indices indicated that the proposed model provided a good fit to the data. Health literacy exerted not only a direct effect on self-care activities, but also an indirect effect on self-care activities via self-efficacy. However, health literacy exerted only an indirect effect on HRQOL. This structural model was invariant across hemoglobin-A1c-controlled and hemoglobin-A1c-uncontrolled groups. Based on R2 values, the final model accounted for 20.0% of the variance in selfefficacy, 61.0% of the variance in self-care activities, and 16.0% of the variance in HRQOL. CONCLUSIONS: This study suggests that self-care activities are crucial to the link between health literacy and HRQOL. Both health literacy and self-efficacy need to be considered in clinical practice for enhancing self-care activities in patients with type 2 diabetes. This approach may ultimately improve HRQOL in these patients.
Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*nursing/*psychology ; Female ; *Health Knowledge, Attitudes, Practice ; *Health Literacy ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Quality of Life/*psychology ; Republic of Korea ; Self Care/*psychology ; *Self Efficacy ; Surveys and Questionnaires ; Young Adult

PURPOSE: This study was conducted to determine the health behaviors of Turkish female baccalaureate nursing students and to examine the impact of sociodemographic and health-related factors and their mothers' health behaviors on the health behaviors of nursing students. METHODS: This cross-sectional study included 337 nursing students and 337 mothers. Data were collected using self-administered questionnaires that included a personal information form, the Perception of Health Scale and the Health-Promoting Lifestyle Profile-II (HPLP-II). Descriptive statistics, one-way analysis of variance, Student's t test, Pearson's correlation coefficients and linear regression analysis were used for data analysis. RESULTS: The total HPLP-II mean score of the students was 131.98 ± 17.15 (item M = 2.61, SD = 0.33). Among the subscales of the HPLP-II, the spiritual growth had the highest mean subscale score, followed by the interpersonal relations subscale, while the physical activity had the lowest mean subscale score. Significant predictors of health behaviors of the students were school year (unstandardized β = .09, p < .012), total score for the Perception of Health Scale (unstandardized β = .02, p < .001), and the mothers' total HPLP-II score (unstandardized β = .33, p < .001), after controlling for specific variables. CONCLUSIONS: This study demonstrated that the students who were attending the first-year program, those with higher levels of perceptions of health and those whose mothers had better health behaviors were more likely to have better health behaviors. The results of this study emphasize the importance of making culturally appropriate interventions by taking into account the factors contributing to the health behaviors of nursing students.
Adult ; Attitude to Health ; Cross-Sectional Studies ; Exercise/*psychology ; Female ; *Health Behavior ; Health Knowledge, Attitudes, Practice ; *Health Promotion ; Humans ; *Life Style ; Middle Aged ; Mothers/*psychology ; *Parent-Child Relations ; Socioeconomic Factors ; Students, Nursing/*psychology ; Surveys and Questionnaires ; Turkey ; Young Adult

PURPOSE: The purpose of this study was to investigate the association between vocational identity and ego identity status among Korean nursing students. METHODS: The participants were 311 nursing students in South Korea who were attending either a 4-year bachelor's program or a 3-year diploma program. Data were collected using self-report questionnaires that addressed vocational identity, ego identity status, and demographic information. The data were analyzed using descriptive statistics, one-way analysis of variance, t test, and Chi-square test. RESULTS: In terms of ego identity status, 31.5% of nursing students were classified as being in diffusion status, followed by 28.3% in low profile moratorium status, 14.8% in moratorium status, 14.1% in foreclosure status, and 11.3% in achievement status. Vocational identity differed according to ego identity status; vocational identity among students who were in achievement status was higher than for those in all other statuses. Vocational identity also differed according to grade level and monthly family income. Ego identity status was related to the type of program enrolled in, grade level, and monthly family income. CONCLUSIONS: These findings show that nursing students in identity achievement status have secure and clear vocational identities. Further longitudinal and qualitative studies are needed to find out if identity formation among nursing students changes with age.
Adolescent ; Adult ; *Career Choice ; Cross-Sectional Studies ; *Ego ; Female ; Humans ; Male ; Middle Aged ; Republic of Korea ; *Self Concept ; Self Report ; Socioeconomic Factors ; Students, Nursing/*psychology ; Young Adult

PURPOSE: The aim of the research was to evaluate the psychometric properties of the Pediatric Daytime Sleepiness Scale-Turkish Version (PDSS-T). METHODS: The researchers chose a study sample of 522 grade 5e11 students. Data were collected using a demographic data collection form and the PDSS-T. RESULTS: Cronbach a for the scale was .79 and Kaiser-Meyer-Olkin coefficient was .78. Item-total correlations for the scale varied between .53 and .73 (p < .001). The indices of model fit were determined to be the root mean square error of approximation at .07, the goodness of fit index at .97, and the comparative fit index at .97. CONCLUSIONS: The study's results showed that PDSS-T is a valid and reliable instrument for detecting Turkish-speaking children's and adolescents' daytime sleepiness. PDSS-T is convenient for professionals to prevent and manage daytime sleepiness.
Adolescent ; Child ; Cross-Sectional Studies ; Disorders of Excessive Somnolence/*diagnosis ; Female ; Humans ; Male ; Psychometrics/*instrumentation ; Reproducibility of Results ; Severity of Illness Index ; Surveys and Questionnaires ; Translations ; Turkey

PURPOSE: The purpose of this study was to survey the current state of measles vaccination in university nursing students during a measles outbreak and to identify factors influencing nursing students' vaccination rate. METHODS: In 2014, this study used a self-administered questionnaire to survey 380 university nursing students. Factors influencing measles vaccination were identified through logistic regression analysis using variables between the vaccinated and nonvaccinated groups. RESULTS: Measles vaccination rate was 52.1%. The vaccination rate was significantly higher in juniors, seniors, and those who had heard about measles. In relation to health beliefs, the measles vaccination rate was higher when perceived benefits were high and perceived barriers were low. CONCLUSIONS: A systematic measles vaccination program targeting nursing students upon their entry to university is needed. In order to increase the measles vaccination rate, application of effective promotion campaigns and education programs is necessary.
Adult ; Disease Outbreaks/*prevention & control ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; Immunization Programs/*statistics & numerical data ; Male ; Measles/*prevention & control ; Republic of Korea ; Students, Nursing/*psychology ; Surveys and Questionnaires ; Universities ; Vaccination/*psychology ; Young Adult

PURPOSE: This study aimed to identify the differences in functional fitness between older adults who were at risk of falling and those who were not. METHODS: A total of 104 older adults aged 65-74 years were recruited from a local community senior center. They were independent older adults without a history of falls in the preceding 12 months. Falling risk status was assessed using the Fall Risk Test. Five dimensions of functional fitness with seven testing parameters (i.e., 30-second chair stand test, 30-second arm curl test, 2-minute step test, chair sit and reach test, back scratch test, 8-foot up and go test, and body mass index) were evaluated by the Senior Fitness Test. RESULTS: Only 78 participants completed all the tests, of which 48 participants were identified with risk of falling, and 30 participants were free from risk of falling. Results from multivariate analysis of variance found significant differences on the combined outcome variables, especially in the 8-foot up and go test, 2-minute step test, and 30-second arm curl test. Results from discriminant analysis found a significant discriminant function among all the seven testing parameters, where the 8-foot up and go test, and the 2-minute step test contributed most. CONCLUSIONS: Older adults who are at the early stage of risk of falling tend to have lower functional fitness capacities, especially in agility and dynamic balance, aerobic endurance as well as in a combined relationship among all the testing parameters.
*Accidental Falls ; Aged ; Aged, 80 and over ; Aging/*physiology ; Female ; Hong Kong ; Humans ; Male ; *Physical Fitness ; Risk Factors

PURPOSE: High-risk types of human papillomavirus (HPV) are a critical etiologic factor behind cervical cancer. Adolescents are a vulnerable group for HPV infection. However, the literature on adolescent women for HPV infection and cervical cancer is limited. This study was to investigate HPV-related knowledge and perceived risk of HPV infection and cervical cancer among Taiwanese adolescent women in order to assess intervention strategies for prevention of cervical cancer and maintenance of reproductive health. METHODS: A descriptive cross-sectional study design was implemented. There were 610 adolescent women from three colleges in Southern Taiwan who participated in this study. Data were collected using an anonymous self-administered questionnaire survey. RESULTS: The results showed that the percentage of appropriate answers to HPV-related knowledge questions was only 36.8%, and smoking as the leading cause of cervical cancer received the lowest mean score for appropriate answers among the HPV-related knowledge items. The perceived risk of HPV infection and cervical cancer were moderate, with relatively lower susceptibility to infection with HPV than to cervical cancer (P < .001). Only 11.5% of the participants reported that they had received information about HPV vaccination from healthcare professionals. CONCLUSIONS: Participants lacked a comprehensive understanding of cervical cancer prevention and were not aware of their susceptibility to HPV infection. Adolescent women rarely obtained HPV-related information from healthcare professionals. Appropriate education strategies should be developed and conducted by healthcare professionals to reduce the risk of cervical cancer threat from adolescence.
Adolescent ; Adolescent Behavior/*psychology ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Papillomavirus Infections/*epidemiology/*psychology ; Risk Factors ; Sexually Transmitted Diseases, Viral/*psychology ; Students/*psychology ; Surveys and Questionnaires ; Taiwan ; Uterine Cervical Neoplasms/*epidemiology/*psychology

PURPOSE: Health care delivery systems in rural areas face numerous challenges in meeting the community's needs. There is a lack of adequate attention for this problem. This study aims to explore the challenges of the health care process in rural Iran according to health care providers' experiences. METHODS: This was a qualitative study that used the content analysis method. We selected a total of 21 health care providers based on purposive sampling. Data collection consisted of semi-structured individual interviews that were analyzed by qualitative content analysis. RESULTS: Data analysis led to the formation of one main category, the challenges of process of health care in rural society. Within this main category, we created the following subcategories: change in characteristics of the rural society, increase in complexity of the health care process, decrease in workforce efficiency, and decrease in propensity of people's care. CONCLUSION: The findings of this study indicate that the process of health care in Iranian rural society is changing rapidly with community health workers encountering new challenges. There is diminished efficiency in responding to the changing care process in Iran's rural society. Considering this change in process of care, therefore, the health care system should respond to these new challenges by establishing new health care models.
Community Health Workers ; Data Collection ; Delivery of Health Care ; Health Personnel ; Humans ; Iran ; Nursing Care ; Rural Health ; Rural Population ; Statistics as Topic

PURPOSE: This was a cross-sectional study designed to evaluate the subjective understanding of technical terms and contents of the informed consent forms given to patients about to undergo conscious sedative upper gastrointestinal endoscopy. METHODS: A group of conveniently selected 180 patients, who were undergoing sedative endoscopy were recruited in the endoscopy procedure room in a tertiary hospital from June to July 2011. Data were collected with a structured questionnaire. RESULTS: The average number of terms exposed was 8.12 out of 10 items, the average number of terms understood well by the patients was 5.53 out of 10 items, and the average number of right answers was 3.30 out of 5 items, and the percent of correct answers ranged from 26.1% to 90.0%. The exposure to terms differed by gender, education, and previous exposure to sedative endoscopy procedures. The number of "understanding of the terms well" responses differed according to age and previous exposure to sedative endoscopy procedures, and the correct answer rate was differed by education. CONCLUSION: The understanding of the terms and knowledge about the procedures were disappointing. Therefore, sufficient explanations should be provided to the patients. While the informed consent was taken by doctors, the level of understanding should be monitored by nurses. In particular, subjects who did not have any previous experience with endoscopy procedures showed relatively lower level of understanding. We recommend that medical terms should be replaced with more common and nontechnical words in consent forms.
Comprehension ; Consent Forms ; Cross-Sectional Studies ; Endoscopy ; Endoscopy, Gastrointestinal ; Humans ; Informed Consent ; Tertiary Care Centers

PURPOSE: The study was undertaken to identify factors affecting perception of the importance and practice of patient safety management (PSM) among hospital employees in Korea. METHODS: This study was conducted using a descriptive design and a self-report questionnaire. Two hundred and eighty employees were recruited from three hospitals using a convenience sampling method. Measures were perception of the importance, practice, and characteristics of PSM. Data were analyzed using descriptive statistics including t test, one-way analysis of variance, Pearson's correlation analysis, and multiple regression. RESULTS: Factors affecting perception of the importance of PSM were whether hospital employees were in contact with patients while on duty, weekly working hours, education on PSM, and perceived adequacy of PSM system construction. Factors affecting the practice of PSM were perceived adequacy of work load, perceived adequacy of PSM system construction and perception of its importance. CONCLUSION: The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies.
Humans ; Korea ; Patient Safety ; Safety Management ; Surveys and Questionnaires