As evidence-based practice has become an important issue in healthcare settings, the educational needs for knowledge and skills for the generation and utilization of healthcare evidence are increasing. Systematic review (SR), a way of evidence generation, is a synthesis of primary scientific evidence, which summarizes the best evidence on a specific clinical question using a transparent, a priori protocol driven approach. SR methodology requires a critical appraisal of primary studies, data extraction in a reliable and repeatable way, and examination for validity of the results. SRs are considered hierarchically as the highest form of evidence as they are a systematic search, identification, and summarization of the available evidence to answer a focused clinical question with particular attention to the methodological quality of studies or the credibility of opinion and text. The purpose of this paper is to introduce an overview of the fundamental knowledge, principals and processes in SR. The focus of this paper is on SR especially for the synthesis of quantitative data from primary research studies that examines the effectiveness of healthcare interventions. To activate evidence-based nursing care in various healthcare settings, the best and available scientific evidence are essential components. This paper will include some examples to promote understandings.
Data Interpretation, Statistical ; Evidence-Based Nursing ; Humans ; Information Storage and Retrieval/methods ; Meta-Analysis as Topic ; Research Design ; *Review Literature as Topic

PURPOSE: This study investigated prediction of North Korean refugees' adaptation to the South Korean society and verified the goodness of fit between a hypothetical model and actual data in order to suggest the best model. METHODS: This survey was conducted with 445 North Korean refugees living in a metropolitan area. Data were collected from September 1st to November 20th, 2012, and analyzed using SPSS Windows 18.0 and AMOS 17.0. RESULTS: Traumatic experiences of North Korean refugees increased self-efficacy and psychological trauma. Acculturation stress decreased self-efficacy and increased passive coping. Self-efficacy affected active and passive coping, decreased psychological trauma, and increased resilience. Resilience is successful adaptation and refers to North Korean refugees' abilities to adapt effectively to stress. In particular, self-efficacy as the main parameter affecting resilience was confirmed. CONCLUSIONS: The results suggest that resilience can be improved through self-efficacy. It was the most significant factor decreasing psychological trauma and increasing resilience. Therefore, we need to develop programs for self-efficacy. The results also provide basic data for policy making for North Korean refugees.
Acculturation ; Adaptation, Psychological/*physiology ; Adult ; Aged ; Democratic People's Republic of Korea/ethnology ; Female ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Personal Satisfaction ; Psychological Trauma/*ethnology ; Refugees/*psychology ; Republic of Korea/epidemiology ; Resilience, Psychological ; Self Efficacy ; Young Adult

PURPOSE: The project was to test a structural equation model in which self-efficacy, self-care health behaviors, and modifiable risk factors predict the quality of life (QOL) of individuals with coronary artery disease. METHODS: The data set from the intervention study with 130 patients with coronary artery disease before the intervention was included in the secondary analysis for this study. The following parameters were measured: self-efficacy, self-care health behaviors with the subscales of health responsibility, exercise, consumption of a healthy diet, stress management, and smoking cessation; modifiable risk score; and QOL (assessed using the 36-item Short-Form Health Survey instrument). RESULTS: The mean age of the participants was 66.1 years. The following evaluation parameters indicated that the proposed model provided a good fit to the data: comparative fit index at .87, goodness of fit index at .91, adjusted goodness of fit index at .84, standardized root mean square residual at .06, root mean square error of estimation at .09, and confidence interval at 0.06-0.13. Self-efficacy, self-care health behaviors, and modifiable risk factors had significant effects on QOL and explained 64.0% of the variance, with modifiable risk factors mediating between self-care health behaviors and QOL. CONCLUSIONS: The findings indicate that self-efficacy, self-care health behaviors, and modifiable risk factors play an important role in QOL in adults with coronary artery disease. Patients could be more confident in performing self-care health behaviors, leading to a better QOL, by more effectively managing their cardiovascular risk factors. Nursing strategies to improve QOL in this population should include motivating them to perform self-care health behaviors.
Adult ; Aged ; Cardiovascular Diseases/etiology ; Coronary Artery Disease/psychology/*therapy ; Cross-Sectional Studies ; Female ; *Health Behavior ; Humans ; Male ; Middle Aged ; Models, Theoretical ; *Quality of Life ; Risk Factors ; Self Care/*methods/psychology ; Self Efficacy

PURPOSE: Myocardial infarction can occur due to known risk factors and lifestyle choices. The difficulties that patients experience after discharge can lead to readmission and nonadherence to lifestyle change. The purpose of this study was to analyze the difficulties experienced by patients after hospitalization due to myocardial infarction and to identify the predictors of readmission and unchanged lifestyles. METHODS: The study used a mixed-methods design across 106 patients who had experienced a first episode of acute myocardial infarction. The data were collected from two patient interviews and the patients' medical records. A logistic regression was used to predict unchanged lifestyle and readmission. RESULTS: In the first interview, 74.5% of the patients reported receiving information prior to discharge. Six months after discharge, 80.2% mentioned that they had changed their lifestyles, but only 59.4% reported that their health had improved, and 75.5% continued to have concerns regarding their health. Patients described difficulties with regard to psychological problems, family dynamics, professional issues, problems with managing cardiovascular symptoms, and complications associated with hospital interventions. A follow-up assessment revealed that 12.3% of patients had been readmitted for cardiovascular disease. CONCLUSIONS: The analysis revealed significant predictors of readmission amongst patients with hypertension and three-vessel disease. Specifically, the number of people in the household, per capita income, and a lack of information/education provided at discharge as well as problems related to mental health after discharge predicted unchanged lifestyle. An educational program might be advantageous to clarify doubts and involve patients in their own disease management.
Activities of Daily Living ; Adult ; Attitude to Health/ethnology ; Female ; Follow-Up Studies ; Health Education/methods ; Healthy Lifestyle ; Humans ; Male ; Middle Aged ; Myocardial Infarction/ethnology/psychology/*therapy ; Patient Readmission/statistics & numerical data ; Portugal/ethnology ; Risk Factors ; Self Care

PURPOSE: Most undergraduate students are in the phase of gaining mental and physical autonomy from their parents as they expand their worlds. The ways that sexual ethics are established during this time may have an important influence on healthy lifestyles and the maintenance of social order. This study aims to determine a typology of undergraduate students' sexual ethics and the characteristics that compose the types. METHODS: Q methodology, which analyzes the subjectivity of each type of attitude, was used. The 44 selected Q statements from 43 participants were classified into the shape of a normal distribution using a 9-point scale. The collected data were analyzed using the PC-QUANL program. RESULTS: The results revealed three discrete groups of students with respect to sexual ethics: traditional absolute purity type, open-minded compromise type, and rational responsibility type. CONCLUSIONS: The results of this study indicate that different approaches to educational programs on sexual ethics are recommended for undergraduate students based on the three types studied.
Attitude to Health ; Consensus ; Female ; Healthy Lifestyle ; Humans ; Male ; Republic of Korea ; Sex Education/statistics & numerical data ; Sexuality/*ethics ; Social Responsibility ; Students/*psychology ; Young Adult

PURPOSE: The purpose of this study was to assess the differences in the prevalence of metabolic syndrome in women in their 30s and 40s by breastfeeding experience, using the the fifth Korea National Health and Nutrition Examination Survey (2010) data. METHODS: In this cross-sectional study, a total of 1,053 healthy women in their 30s and 40s, who had given birth was analyzed. To compare women with and without breastfeeding experience, chi-square test and t test were used. The relationship between metabolic syndrome and breastfeeding was assessed using logistic regression analysis adjusted demographic and lifestyle covariates. RESULTS: The breastfeeding experience ofwomen in their 30swas associated with a decreased risk of elevated triglyceride after controlling for income, education, exercise andthe last childbirthage [odds ratio (OR)=0.44, 95% confidence interval (CI) (0.21, 0.95)]. In addition, women who breastfed more children had high odds of metabolic syndrome [OR = 4.03, 95%CI (2.03, 8.00)], and components of metabolic syndrome [abdominal obesity: OR = 2.02, 95%CI (1.17, 3.51), elevated triglyceride: OR = 1.98, 95%CI (1.14, 3.45), elevated blood pressure: OR = 2.65, 95%CI (1.28, 5.49)] than those who never breastfed children. CONCLUSIONS: This study found that postpartum breastfeeding may play a significant role in reducing the risk of metabolic syndrome and also that childbearing is associated with a higher incidence of metabolic syndrome among women in their 30s. For women in their 40s, the risk of metabolic syndrome did not significantly differ depending on the breastfeeding experience. This study indicated that breastfeeding can be a way to reduce metabolic health burdens in women in their 30s.
Adult ; Alcohol Drinking/epidemiology ; Breast Feeding/*statistics & numerical data ; Cross-Sectional Studies ; Exercise/physiology ; Female ; Gravidity ; Humans ; Life Style ; Metabolic Syndrome X/*epidemiology ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Risk Reduction Behavior ; Social Class

PURPOSE: In Korea, most elderly with dementia receive care from family members, yet little research is available on the experience of dementia-related anxiety in middle-aged female caregivers for a family member with dementia. The purpose of this study was to describe the lived experience of dementia-related anxiety in middle-aged female caregivers for family members with dementia. METHODS: A descriptive phenomenological study was conducted. A purposive sampling strategy was used to recruit participants. Twelve middle-aged women (40-59 years, mean age = 51.90 years) who were family caregivers were interviewed from February 2014 to August 2014. Data were collected through semistructured interviews and analyzed using Giorgi's method. RESULTS: The essential structure of the phenomenon was a fear of losing self-identity. The main essence was represented by six components: keenly feeling the effects of aging because of memory deficit, continuous comparison of the family member's behavior with that of the participant's, Finding it painful to see a family member with dementia as he/she does not know how this will end, not knowing the conclusion of the disease process, reducing the risk of dementia, and trying to change one's lifestyle from what it used to be in the past. CONCLUSIONS: The study provides the essential structure of the experience on dementia-related anxiety that caregivers of a family member with dementia have. The findings could help healthcare providers and researchers have better understanding of dementia-related anxiety and give more attention to the caregivers to relieve their anxiety
Adult ; Anxiety/*etiology ; Caregivers/*psychology ; Dementia/*psychology ; Family/*psychology ; Family Relations ; Fear ; Female ; Humans ; Middle Aged ; Self Concept

PURPOSE: This study aimed to examine the most prominent health-related behaviors impacting the academic performance of Korean adolescents. METHODS: The 2012 Korea Youth Risk Behavior Web-Based Survey data were analyzed using an ordinal regression analysis after adjusting for general and other health behaviors. RESULTS: Before adjustment, all health behaviors were significantly associated with academic performance. After adjustment for other health behaviors and confounding factors, only smoking [odds ratio (OR) = 2.07, 95% confidence interval (CI) (1.98, 2.16), p < .001], alcohol consumption [OR = 1.22, 95% CI (1.18, 1.27), p < .001], and physical activity [OR = 1.09, 95% CI (1.06, 1.13), p < .001] were associated with lower academic performance, and engaging in a regular diet [OR = 0.65, 95% CI (0.65, 0.62), p < .001] was associated with higher academic performance. CONCLUSIONS: Regular diet, reducing smoking and alcohol drinking, and physical activity should be the target when designing health interventions for improving academic performance in Korean adolescents.
*Achievement ; Adolescent ; Alcohol Drinking/psychology ; Diet/psychology ; Educational Status ; Exercise/psychology ; Female ; *Health Behavior ; Health Status ; Humans ; Male ; Republic of Korea ; Smoking/psychology ; Social Class

PURPOSE: The purpose was to evaluate the effects of a transtheoretical model (TTM) based exercise counseling offered with music skipping rope exercise on components of the TTM (stages of change, decisional balance, and self-efficacy), body mass index, glucose, and lipid profile of overweight/obese children in Korea. METHODS: This study used a nonequivalent pretest and posttest experimental study design. A total of 75 overweight/obese children participated in the study. Eight sessions of exercise counseling combined with music skipping rope exercise for 12 weeks were offered for children in the experimental group, while one session of exercise counseling with music skipping rope exercise for 12 weeks was offered for children in the control group. Outcomes were measured at baseline, and 6 months after the intervention. RESULTS: After the intervention, self-efficacy significantly improved among children in the experimental group (p = .049), while these children maintained their baseline BMI at 6-month follow-up (p > .05). Among children in the control group, BMI significantly increased (p < .05). Fasting blood sugar significantly increased for both groups after the intervention (p < .05). However, a greater increase was observed for the control group. CONCLUSIONS: Our study partially supports the hypothesis that a TTM-based exercise intervention is effective in maintaining BMI and improving self-efficacy of overweight/obese children. The TTM-based counseling combined with exercise classes has potential to control weight among overweight/obese children, while involvement of parents and children in the development of the theory-based intervention may generate further benefits regarding health and well-being of overweight/obese children.
Adolescent ; Attitude to Health ; Body Mass Index ; Child ; Combined Modality Therapy ; Counseling/*methods ; Exercise Therapy/*methods ; Female ; Humans ; Male ; Music Therapy/*methods ; Pediatric Obesity/*prevention & control ; Play and Playthings ; Self Efficacy ; Treatment Outcome

PURPOSE: This study aimed to develop the Scale for Quality of Life in Pediatric Oncology Patients Aged 13-18: Adolescent Form and Parent Form. METHODS: We used the child and parent information form, Visual Quality of Life Scale, and our own scale, the Scale for Quality of Life in Pediatric Oncology Patients Aged 13-18: Adolescent Form and Parent Form.We finalized the 35-item scale to determine the items, received opinions from 14 specialists on the scale, and pilot-tested the scale in 25 children and their parents. We used Pearson correlation analysis, Cronbach α coefficient, factor analysis and receiver operating characteristics analysis to analyze the data. RESULTS: The total Cronbach α of the parent form was .97, the total factor load was .60-.97 and the total variance was 80.4%. The cutoff point of the parent formwas 85.50. The total Cronbach α of the adolescent form was .98, the total factor load was .62-.96, and the total variance explained was 83.4%. The cutoff point of the adolescent form was 75.50. As a result of the parent form factor analysis, we determined the Kaiser-Meyer-Olkin coefficient as .83, the Barlett test χ2 as 12,615.92; the factor coefficients of all items of the parent form ranged from .63 to .98. The factor coefficients of all items of the adolescent form ranged from .34 to .99. As a result of the adolescent form factor analysis, we determined the KMO as .79, and the Barlett test χ2 as 13,970.62. CONCLUSIONS: Conclusively, we found that the adolescent form and the parent formwere valid and reliable in assessing the children's quality of life.
Adolescent ; Female ; Humans ; Male ; Neoplasms/*psychology ; Parents ; *Quality of Life ; ROC Curve ; Reproducibility of Results ; Surveys and Questionnaires/*standards