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.
Compliance ; Evaluation Studies as Topic ; Heart Failure* ; Heart* ; Humans ; Self Care* ; Telephone*

PURPOSE: The purpose of this paper was to examine the relationship between type D personality and cardiovascular disease, and to suggest future research directions. METHOD: A literature search was conducted from the following nine databases: 1) MEDLINE, 2) CINAHL, 3) Pubmed Unrestricted, 4) PsycINFO, 5) KISS, 6) RICHIS, 7) RISS4U, and 8) Nanet. The combinations of the words, "type D personality", "personality", "heart", "cardiovascular", and "coronary" were used for keyword searches to find relevant articles. Twenty eight studies were identified. RESULT: Type D personality has been associated with increased morbidity and mortality in patients with established cardiovascular disease. Type D patients are also at increased risk for impaired quality of life, and seem to benefit less from medical and invasive treatment. CONCLUSION: There is substantial evidence for a relationship between type D personality and clinical outcomes related to cardiovascular disease. Randomized clinical trials are needed to further evaluate the value of controlling type D personality to improve survival and reduce morbidity in patients with cardiovascular disease. Accumulating evidence from this analysis indicates the urgent need to adopt a personality approach in order to optimize the identification of patients at risk for stress related cardiac events.
Aged ; Cardiovascular Diseases/*psychology ; Chronic Disease ; Humans ; Middle Aged ; *Personality ; Risk Factors ; *Stress, Psychological

PURPOSE: This study was done to identify the prevalence of depression and determine the relationship of body mass index and perceived health status to depression for elderly women who live alone in the community. METHODS: A total of 175 adults aged over 60 participated in this cross-sectional descriptive study. Perceived heath status was measured using a self-report one-item questionnaire. Body mass index was calculated as weight in kilograms divided by the square of height in meters. Depression was assessed using the Korean short version of the geriatric depression scale. Hierarchical linear regression was used to identify associations between variables. RESULTS: Approximately 61.7% of elderly women who lived alone were depressed. The mean score for depression was 7.4 (SD 3.39). Hierarchical linear regression showed body mass index (beta=.25, p<.001) and perceived health status (beta=-.26, p<.001) were independently associated with depression adjusting for general characteristics. These two predictors accounted for 12% of the variance in depression. CONCLUSION: These results suggest that obesity and perceived health status are risk factors for depression in elderly women living alone. Therefore, these factors should be considered when developing intervention program for elderly women with depression.
Adult ; Aged* ; Body Mass Index* ; Depression* ; Female ; Humans ; Linear Models ; Obesity ; Prevalence ; Surveys and Questionnaires ; Residence Characteristics ; Risk Factors

PURPOSE: The purposes of this study were to describe the pattern of type D personality, to compare the life style and quality of life between type D personality and non-type D personality patients, and to investigate the factors influencing quality of life in patients with hypertension. METHODS: A cross sectional, descriptive study was used. The participants in this study were 193 outpatients who were diagnosed with hypertension at two university hospitals in urban area, Korea. The data was collected from December, 2006 to January, 2007. Type D personality was measured by the DS-14 scale. RESULTS: The prevalence of type D personality was 83.9%. Patients of type D personality were significantly different in educational status, monthly income, fat intake and exercise, and had a lower overall quality of life than patients of non-type D personality. Under controlled general characteristics and life style factors, multiple linear regression analysis was performed. The most significant factor influencing quality of life in hypertensive patients was type D personality, and this factor explained their quality of life with a variance of 14.8%. CONCLUSIONS: Various programs for psychological intervention are required to control for the distressed personality of patients with hypertension. Further studies should be conducted prospectively on a larger patient population.
Educational Status ; Hospitals, University ; Humans ; Hypertension* ; Korea ; Life Style* ; Linear Models ; Outpatients ; Prevalence ; Quality of Life* ; Type D Personality*

BACKGROUND: Dietary sodium restriction is an essential component of self-care behavior for improved health-related quality of life (HRQoL) in patients with heart failure (HF). However, there is little direct evidence about the impact of dietary sodium restriction on HRQoL. The purpose of this study was to determine the impact of dietary sodium intake on HRQoL in HF patients with no cardiac events over 1-year of follow-up. METHODS: A total of 106 patients with HF completed a 3-day food diary to estimate daily sodium intake. Patients were divided into 4 groups (<2 g, 2-3 g, 3-4 g, and >4 g). The Minnesota Living with Heart Failure Questionnaire was used to assess HRQoL at baseline and one year later. Hierarchical linear and logistic regressions were used to determine the relationship between dietary sodium intake and HRQoL. RESULTS: Thirty-seven (35%) patients had a daily sodium intake >3 g. Greater than 4 g of daily sodium intake was independently associated with a worse HRQoL at baseline and one year later (F=3.15, P=0.028; F=4.33, P=0.006) and an almost 5.2 times higher risk of a worsening HRQoL at one year follow-up (P=0.040) after controlling for age, gender, etiology, body mass index, New York Heart Association class, ejection fraction, total comorbidity score, and use of beta blockers. CONCLUSIONS: This finding provides additional evidence that greater than 4 g of daily sodium intake is associated with worsening HRQoL in stable HF patients who are free from cardiac events.
Body Mass Index ; Comorbidity ; Diet Records ; Diet, Sodium-Restricted ; Follow-Up Studies ; Heart ; Heart Failure ; Humans ; Logistic Models ; Minnesota ; New York ; Quality of Life ; Self Care ; Sodium ; Sodium, Dietary ; Surveys and Questionnaires

BACKGROUND: Dietary sodium restriction is an essential component of self-care behavior for improved health-related quality of life (HRQoL) in patients with heart failure (HF). However, there is little direct evidence about the impact of dietary sodium restriction on HRQoL. The purpose of this study was to determine the impact of dietary sodium intake on HRQoL in HF patients with no cardiac events over 1-year of follow-up. METHODS: A total of 106 patients with HF completed a 3-day food diary to estimate daily sodium intake. Patients were divided into 4 groups (<2 g, 2-3 g, 3-4 g, and >4 g). The Minnesota Living with Heart Failure Questionnaire was used to assess HRQoL at baseline and one year later. Hierarchical linear and logistic regressions were used to determine the relationship between dietary sodium intake and HRQoL. RESULTS: Thirty-seven (35%) patients had a daily sodium intake >3 g. Greater than 4 g of daily sodium intake was independently associated with a worse HRQoL at baseline and one year later (F=3.15, P=0.028; F=4.33, P=0.006) and an almost 5.2 times higher risk of a worsening HRQoL at one year follow-up (P=0.040) after controlling for age, gender, etiology, body mass index, New York Heart Association class, ejection fraction, total comorbidity score, and use of beta blockers. CONCLUSIONS: This finding provides additional evidence that greater than 4 g of daily sodium intake is associated with worsening HRQoL in stable HF patients who are free from cardiac events.
Body Mass Index ; Comorbidity ; Diet Records ; Diet, Sodium-Restricted ; Follow-Up Studies ; Heart ; Heart Failure ; Humans ; Logistic Models ; Minnesota ; New York ; Quality of Life ; Self Care ; Sodium ; Sodium, Dietary ; Surveys and Questionnaires

PURPOSE: The purposes of this study were to identify the level of health literacy and to determine its impact on disease-related knowledge and adherence to self-care in adults with hypertension. METHODS: This was a cross-sectional, descriptive study in which patients with hypertension were recruited from outpatient hypertension clinics in Seoul, Korea from December, 2009 to February, 2010. A total 186 patients completed series of questionnaires to assess health literacy, disease-related knowledge, and adherence to self-care. Hierarchical linear regression was used to determine whether health literacy was associated with disease-related knowledge and adherence to self-care. RESULTS: Seventy-one (38.2%) and seventy-two (38.7%) patients had inadequate and marginal health literacy, respectively. In hierarchical linear regression, health literacy independently predicted disease-related knowledge (beta= .43, p < .001) and adherence to self-care (beta= .37, p < .001) after controlling for age, education level, having a job or not, and body mass index. CONCLUSION: These findings show that health care providers need to pay attention to patients with hypertension who have inadequate health literacy. Further, it is recommended to develop and implement new strategies for assessing health literacy in clinical practices. Interventions to improve health literacy could promote disease-related knowledge and adherence to self-care in patients with hypertension.
Adult ; Health Literacy ; Health Personnel ; Health Status ; Humans ; Hypertension ; Korea ; Linear Models ; Outpatients ; Surveys and Questionnaires ; Self Care

BACKGROUND: Dietary sodium restriction is an essential component of self-care behavior for improved health-related quality of life (HRQoL) in patients with heart failure (HF). However, there is little direct evidence about the impact of dietary sodium restriction on HRQoL. The purpose of this study was to determine the impact of dietary sodium intake on HRQoL in HF patients with no cardiac events over 1-year of follow-up. METHODS: A total of 106 patients with HF completed a 3-day food diary to estimate daily sodium intake. Patients were divided into 4 groups (<2 g, 2-3 g, 3-4 g, and >4 g). The Minnesota Living with Heart Failure Questionnaire was used to assess HRQoL at baseline and one year later. Hierarchical linear and logistic regressions were used to determine the relationship between dietary sodium intake and HRQoL. RESULTS: Thirty-seven (35%) patients had a daily sodium intake >3 g. Greater than 4 g of daily sodium intake was independently associated with a worse HRQoL at baseline and one year later (F=3.15, P=0.028; F=4.33, P=0.006) and an almost 5.2 times higher risk of a worsening HRQoL at one year follow-up (P=0.040) after controlling for age, gender, etiology, body mass index, New York Heart Association class, ejection fraction, total comorbidity score, and use of beta blockers. CONCLUSIONS: This finding provides additional evidence that greater than 4 g of daily sodium intake is associated with worsening HRQoL in stable HF patients who are free from cardiac events.
Body Mass Index ; Comorbidity ; Diet Records ; Diet, Sodium-Restricted ; Follow-Up Studies ; Heart ; Heart Failure ; Humans ; Logistic Models ; Minnesota ; New York ; Quality of Life ; Self Care ; Sodium ; Sodium, Dietary ; Surveys and Questionnaires

PURPOSE: This study was conducted to develop an integrated undergraduate course including a PBL based on a blended learning strategy, and evaluate learners' responses. METHODS: The learning contents of cardiovascular, respiratory, and musculoskeletal medical systems, and nursing diagnoses of 'activity and rest' domain (NANADA's classification II, 2005) were analyzed. Six clinical scenarios with the clients in different life cycles were developed for PBL. Classical lecture and group presentation with on-line self learning were implemented in addition to PBL. The developed course was implemented on 84 junior nursing students in a university for 7 weeks with 5 hours per day, two days per week. Students were asked to complete structured questionnaires including problem solving, critical thinking, and nursing diagnosis differentiation abilities. RESULTS: Learner's evaluation was positive in problem solving skills and in the differentiation ability of nursing diagnoses relevant to an 'activity and rest' functional health pattern. CONCLUSION: Development and implementation of integrated courses based on a blended learning method need to be continued to enhance students' thinking and self-directed learning abilities. Supporting strategies for individual learners should be added for successful blended learning such as individual on-line feedback and consideration of individual learning outcomes.
Classification ; Humans ; Learning ; Life Cycle Stages ; Nursing Diagnosis ; Problem Solving ; Problem-Based Learning ; Students, Nursing ; Thinking ; Surveys and Questionnaires

Purpose: This study aimed to determine the impact of an intervention using voice recording of family members on pain, anxiety, and agitation in patients undergoing weaning from mechanical ventilation. Methods: A randomized control pre-post experimental design was implemented to 53 participants, with 27 and 26 participants in the experimental and control groups, respectively. A 70-second voice recording of a family member, repeated three times at 10-minute intervals was used as an intervention for the experimental group. Meanwhile, participants in the control group used headset for 30 minutes. Structured instruments were utilized to measure pain, anxiety, agitation, and the weaning process. Wilcoxon Signed Ranks test and the Mann-Whitney U test, or χ2 test, were used for data analysis. Results: The experimental group exhibited significant decrease in pain (Z = - 3.53, p < .001), anxiety (t = 5.45, p < .001), and agitation (Z = - 2.99, p = .003) scores compared with those of the control group. However, there was no significant difference between groups in the weaning process’ simplification (χ2 = 0.63, p = .727). Conclusion Intervention using family members’ voice recording effectively reduces pain, anxiety, and agitation in patients undergoing weaning from mechanical ventilation. This can be actively utilized to provide a more comfortable process for patients.