PURPOSE: This study investigated the relationship between family composition and the prevalence of metabolic syndrome by gender in Korean adults aged 45 years and older. METHODS: The sample consisted of 11,291 participants in the Korea National Health and Nutrition Examination Survey from 2010 to 2012. We used complex sample analyses, including strata, cluster, and sample weighting, to allow generalization to the Korean population. Complex samples crosstabs and chisquare tests were conducted to compare the percentage of sociodemographic characteristics to the prevalence of metabolic syndrome and its components by gender and family composition. Next, a complex sample logistic regression was performed to examine the association between family composition and the prevalence of metabolic syndrome by gender. RESULTS: The percentage of adults living alone was 5.6% for men and 13.9% for women. Slightly more women (14.0%) than men (10.1%) reported living with three generations. The percentage of metabolic syndrome in Korean adults aged 45 years and older was 53.2% for men and 35.7% for women. For women, we found that living with one or three generations was significantly associated with a higher risk of metabolic syndrome, blood pressure, and triglyceride abnormality after adjusting for age, education, household income, smoking, physical activity, and body mass index, when compared to living alone. No significant relationships were found for men. CONCLUSIONS: A national strategy, tailored on gender and family composition, needs to be developed in order to prevent the increase of metabolic syndrome in Korean women over middle age.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group/*statistics & numerical data ; Child ; Child, Preschool ; *Family Characteristics ; Female ; Humans ; Infant, Newborn ; Male ; Metabolic Syndrome X/*epidemiology/*psychology ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Sex Factors ; Socioeconomic Factors ; Young Adult

PURPOSE: The lack of reliable and valid evaluation tools targeting Korean nursing students' critical thinking (CT) abilities has been reported as one of the barriers to instructing and evaluating students in undergraduate programs. Yoon's Critical Thinking Disposition (YCTD) instrument was developed for Korean nursing students, but few studies have assessed its validity. This study aimed to validate the YCTD. Specifically, the YCTD was assessed to identify its cross-sectional and longitudinal measurement invariance. METHODS: This was a validation study in which a cross-sectional and longitudinal (prenursing and postnursing practicum) survey was used to validate the YCTD using 345 nursing students at three universities in Seoul, Korea. The participants' CT abilities were assessed using the YCTD before and after completing an established pediatric nursing practicum. The validity of the YCTD was estimated and then group invariance test using multigroup confirmatory factor analysis was performed to confirm the measurement compatibility of multigroups. RESULTS: A test of the seven-factor model showed that the YCTD demonstrated good construct validity. Multigroup confirmatory factor analysis findings for the measurement invariance suggested that this model structure demonstrated strong invariance between groups (i.e., configural, factor loading, and intercept combined) but weak invariance within a group (i.e., configural and factor loading combined). CONCLUSIONS: In general, traditional methods for assessing instrument validity have been less than thorough. In this study, multigroup confirmatory factor analysis using cross-sectional and longitudinal measurement data allowed validation of the YCTD. This study concluded that the YCTD can be used for evaluating Korean nursing students' CT abilities.
Adult ; Cross-Sectional Studies ; Female ; Humans ; Longitudinal Studies ; Male ; Pediatric Nursing/*education ; Psychometrics ; Reproducibility of Results ; Seoul ; Students, Nursing/*psychology ; *Thinking ; Young Adult

PURPOSE: The purpose of this study was to determine the intensive care unit (ICU) experiences of cardiovascular surgery (CS) patients and to define the associations between their ICU experiences and related factors. METHODS: The study used a descriptive design. In total, 106 CS patients were interviewed at least 24 hours after discharge from an ICU in an educational research hospital in Ankara, Turkey between January and July 2012. Data were collected using the Intensive Care Experience Scale (ICES), a sociodemographic and clinical characteristics data form and two open-ended questions inquiring about smells and light. Statistical analyses were conducted using SPSS 15.0. RESULTS: The patients were moderately aware of their ICU environments, partly recalled their ICU experiences, highly recollected frightening experiences, and expressed good satisfaction with care. Age, education, marital status, and pain were associated with ICU experiences. Patients who sensed smell had higher scores of frightening experiences than those who did not. Patients who were annoyed with excessive light reported less satisfaction with care than those who were not. CONCLUSIONS: The results suggest that measuring the patients' characteristics and environmental factors may be beneficial for healthcare teams to improve the recovery of CS patients in the ICU.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Cardiovascular Surgical Procedures/*psychology ; Critical Care/*psychology ; Female ; Humans ; Light ; Male ; Middle Aged ; Patient Satisfaction/*statistics & numerical data ; Patients/*psychology ; Smell ; Socioeconomic Factors ; Surveys and Questionnaires ; Turkey

PURPOSE: The aim of this study was to evaluate the effectiveness of a community-based intervention for prehypertensive adults, to enhance stroke risk awareness and to adopt a preventive lifestyle for primary stroke prevention. METHODS: This was a single-blinded, repeated measures quasi-experimental study with 47 participants (23 in the experimental group and 24 in the control group) recruited through convenience sampling from two urban areas. The stroke risk self-management intervention consisted of three weekly, 2-hour, face-to-face sessions and two booster telephone sessions, utilizing strategies to enhance motivation for behavioral changes based on the Self-Determination Theory. All participants completed a pretest, a 1- month and a 3-month post test of stroke risk awareness and preventive lifestyle including blood pressure self-monitoring, healthy diet, and regular physical activity. Data were analyzed using descriptive statistics, chi-square test, two sample t test, repeated measures analysis of variance, and Friedman test with PASW Statistics 18.0. RESULTS: After the intervention, significant improvements were found in the experimental group for stroke risk awareness, blood pressure self-monitoring and regular physical activity, and were sustained over time. CONCLUSIONS: Our preliminary results indicate that the stroke risk self-management intervention is feasible and associated with improvement in self-management of stroke risk factors for primary stroke prevention among a prehypertensive population.
Adult ; Behavior Therapy/*education ; Blood Pressure Determination/*methods ; Female ; Humans ; Male ; Middle Aged ; Motivation ; *Patient Education as Topic ; Prehypertension/*nursing ; Primary Prevention/*methods ; Republic of Korea ; Risk Factors ; Self Care/*methods ; Stroke/*prevention & control ; Urban Population/statistics & numerical data

PURPOSE: This study aimed to determine whether a blended Infant MassageeParenting Enhancement Program (IMPEP) improved maternal psychosocial health outcomes (parenting stress, depressive symptoms, self-esteem, maternal attachment) and maternal-infant interaction among substanceaddicted mothers (SAMs) actively engaged in outpatient rehabilitation. METHODS: Designed as a randomized, three-group controlled trial testing two levels of psychoeducational intervention (IMPEP vs. PEP) and a control group (standard care parenting resources), the studywas conducted in two substance abuse centers in southeast Florida on a convenience sample of 138 recovering SAM-infant pairs. IMPEP or PEP classes were held weekly onWeeks 2e5, with data collected at baseline (Week 1),Week 6, andWeek 12 via structured interviews, observation (Observation Checklist onMaternal-Infant Interaction), and self-administered questionnaires (Abidin Parenting Stress Index, Beck Depression Inventory, Rosenberg Self-Esteem Scale, Muller's Maternal Attachment Inventory), analyzed descriptively and inferentially using Kruskall-Wallis analysis of variance and post hoc Wilcoxon rank sum and Mann-Whitney U tests. RESULTS: Both IMPEP and PEP groups had significantly increased Parenting Stress Index scores (decreased parenting stress) and decreased Beck Depression Inventory scores (decreased depressive symptoms) compared to controls at Week 12, whereas there were no clinically meaningful differences among study groups in Rosenberg Self-Esteem Scale, Muller's Maternal Attachment Inventory, or Observation Checklist on Maternal-Infant Interaction scores. Only the IMPEP group showed significant improvements in both psychological and physical (waist-hip ratio) measures of parenting stress over time. CONCLUSIONS: The findings suggest that infant massage blended into a structured parenting program has value-added effects in decreasing parenting stress and maternal depressive symptoms, but not on SAM's self-esteem, attachment, or maternal-infant interaction.
Adult ; Depressive Disorder/*prevention & control ; Female ; Florida ; Humans ; Infant ; Infant, Newborn ; Male ; Massage ; Maternal Behavior/*psychology ; Mother-Child Relations/*psychology ; Mothers/*education/*psychology ; Parenting/*psychology ; Program Evaluation ; Self Concept ; Stress, Psychological ; Substance-Related Disorders/*psychology/rehabilitation ; Young Adult

PURPOSE: The purpose of this study was to develop and preliminarily evaluate the reliability and validity of the Symptom-Management Self-Efficacy ScaleeBreast Cancer (SMSES-BC) related to chemotherapy. METHODS: The study included three stages. This paper presents the results of stage 2 and stage 3. In total, 34 items in the SMSES-BC were found during stage 1 from qualitative findings, a literature review, and expert suggestions; the 34 items were used for the psychometric properties test. Test-retest reliability and Cronbach alpha were assessed in the first sample, which included 45 participants for the pilot test (stage 2). The second sample, which included 152 patients, was used to assess the construct validity and concurrent validity (stage 3). RESULTS: The pilot test results revealed a test-retest reliability of .73 (p < .001) and Cronbach alpha coefficient of .96 for the total scale. Three factors (managing chemotherapy-related symptoms, acquiring problem solving, and managing emotional and interpersonal disturbances) were identified from exploratory factor analysis. Correlation coefficient r was .40 (p < .001), which supported the association between SMSES-BC and the General Self-Efficacy Scale for concurrent validity. CONCLUSIONS: The study results demonstrate acceptable reliability and validity for the SMSES-BC that was developed for measuring symptom-management self-efficacy related to chemotherapy for patients with breast cancer. This study suggests further research to validate the construct of the SMSES-BC.
Adult ; Aged ; Antineoplastic Agents/*therapeutic use ; Breast Neoplasms/*drug therapy/*psychology ; Drug Therapy/*psychology ; Factor Analysis, Statistical ; Female ; Humans ; Middle Aged ; Patients/*psychology ; Pilot Projects ; Psychometrics ; Reproducibility of Results ; Self Care/*psychology ; Self Efficacy ; Surveys and Questionnaires ; Taiwan

PURPOSE: The aim of this study was to determine the perceptions of patients with atrial fibrillation regarding the disease, to reveal their feelings, thoughts and wishes, and to investigate their perspectives and coping behaviors towards their condition. METHODS: Phenomenological methodology was used. The study population consisted of a total of 225 patients treated by the cardiology department of a university hospital, while the study sample consisted of 32 patients who met the inclusion criteria. A semistructured interview addressed perceptions of patients with atrial fibrillation regarding the disease. Data were collected by asking the participants the three questions on the In-depth Individual Interview Form. Data were analyzed using the continuous comparative method of Colaizzi. RESULTS: In the study sample, 50.0% of participants were female, 69.0% were married, and the mean age was 66.90 years (+/- 7.90 years). As a result of the content analysis, four main themes and 15 subthemes were identified: patient's mental status regarding the disease, patient's social status regarding the disease, patient's physical condition regarding the disease, and disease management and coping with the disease. The study found that individuals with atrial fibrillation faced major limitations in their daily living activities and social lives due to the disease symptoms and warfarin use. CONCLUSIONS: Patients need to be provided with relevant individual training and counselling so that they lead more satisfactory lives. In addition, appropriate health appointment and monitoring systems should be developed for patients to reduce the problems associated with frequent follow-up appointments.
Activities of Daily Living/*psychology ; *Adaptation, Psychological ; Aged ; Atrial Fibrillation/*psychology ; Attitude to Health ; Female ; Humans ; Male ; Middle Aged ; Patients/*psychology ; Quality of Life/*psychology ; Surveys and Questionnaires ; Turkey

PURPOSE: The purpose of the study was to determine factors associated with underweight and obesity in elementary school children in Korea. METHODS: Study participants included 4,895 children attending 59 elementary schools across Korea. Children were grouped into underweight [< 5% body mass index (BMI)-for-age], normal weight (5%-85% BMI-for-age), and overweight/obese (> or = 85% BMI-for age). The questionnaire included demographic characteristics, health status, and diet and exercise behavior of children, and environmental characteristics of schools. RESULTS: Twelve percent of the children were overweight or obese. The results showed that demographic (age and gender), health status (atopic dermatitis and poor subjective health), and the characteristics of diet and exercise (unbalanced diet and diet experiences) were associated with underweight (p < .05), while demographic (age and gender), health status (poor subjective health), behavioral characteristics (fast food consumption and diet experiences), and school environmental characteristics (rural area) were associated with overweight/obesity (p < .05). CONCLUSIONS: Programs and interventions to reduce underweight and overweight/obesity in Korean elementary schools must consider behavioral and environmental characteristics of children.
Age Factors ; Body Mass Index ; Body Weight ; Child ; Child Behavior/*psychology ; *Diet ; *Exercise ; *Feeding Behavior/psychology ; Female ; Health Status ; Humans ; Male ; Obesity/epidemiology/*psychology ; Republic of Korea ; Sex Factors ; Socioeconomic Factors ; Surveys and Questionnaires ; Thinness/epidemiology/*psychology

PURPOSE: This study was conducted to identify direct and indirect factors influencing self-care compliance in patients with first acute coronary syndrome through examining the relationship among multidimensional factors. METHODS: Outpatients who made hospital visits to receive a follow-up care at more than 6 months after percutaneous coronary intervention were recruited at a national university hospital in Korea. Data of 430 participants were collected through self-administered questionnaires and analyzed using AMOS version 7.0. The fitness of the hypothetical model and the degree of significance of direct and indirect paths were analyzed. RESULTS: Three paths were found to have a significant effect on self-care compliance in the modified model. Social support indirectly influenced self-care compliance through enhancing self-efficacy, reducing anxiety and increasing perceived benefit. In addition, social support and body function indirectly influenced self-care compliance through reducing depression which affected self-efficacy. Self-efficacy was the most influential factor and played an important role as a mediating variable. CONCLUSION: Results of this study suggest that nurses' counselling and education as a form of social support should be encouraged to enhance self-efficacy and self-care compliance among outpatients during follow-up care after percutaneous coronary intervention.
Acute Coronary Syndrome* ; Anxiety ; Compliance* ; Depression ; Education ; Follow-Up Studies ; Humans ; Korea ; Models, Structural ; Negotiating ; Outpatients ; Patient Compliance ; Percutaneous Coronary Intervention* ; Self Care* ; Surveys and Questionnaires

PURPOSE: Problem-based learning (PBL) is now extensively utilized within contemporary nursing education. This study was done to explore the nursing students' experiences with facilitators in PBL classes as they transitioned from the first package to the fourth package during the entire sophomore year. METHODS: Twelve nursing students who had taken the course were interviewed after PBL classes. Data were analyzed using dimensional and comparative analysis based on Strauss and Corbin's grounded theory. RESULTS: Findings were organized into phases of participants' experiences with facilitators during PBL classes. They faced interpersonal relationship challenges with facilitators as they moved through the three phases of the continuum: feeling uneasy, overcoming the uneasiness, and valuing the help of the facilitator. In the beginning, uneasiness resulted from proximity to the facilitator. However, seven strategies were derived to respond to the uneasiness during the continuum: (a) searching for information about the facilitator, (b) making efforts to build a positive impression with the facilitator, (c) wanting facilitation, (d) weighing own experiences with facilitator against others' experiences, (e) following facilitator's guidance, (f) reflecting on facilitation experience, and (g) retaining facilitator's remarks. CONCLUSION: Participants overcame the uneasiness and accepted the facilitator as an advisor. These results are significant in providing optimal facilitation for students in PBL classes because they are based on the PBL participants' perspectives of facilitation. Further studies related to facilitators' experiences in the PBL are recommended.
Education, Nursing ; Humans ; Nursing* ; Problem-Based Learning* ; Students, Nursing