OBJECTIVES: The purpose of this study was to identify the differences in nutrient intake according to using diuretics, symptom severity and degree of physical functioning in heart failure patients. METHODS: A secondary data analysis was conducted by using baseline data of an intervention study for heart failure patients. In this study, 131 heart failure patients were included. Data were collected using medical records, NYHA (New York Heart Association functional classification) class, and 6-minute-walking test and 24-hour diet recall. Data were analyzed using descriptive statistics and Chi-square test by SPSS 21.0. Nutrient intake was assessed using CAN-pro 2.0. RESULTS: Majority of the participants consumed total calorie less than Estimated Energy Requirement (EER) and consumed carbohydrates more than 65% of their total calorie intakes. 24.4% of the participants consumed fat more than 30% of their total calorie intakes and 23.7% consumed saturated fat more than 7% of their total calorie intakes. 100.0% of the participants consumed protein less than 7% of their total calorie intakes and 73.3% of the participants consumed more than recommended intakes of sodium. More than 90.0% of the participants consumed less than adequate intakes of potassium (90.1%) and Vitamin D (91.6%), respectively. 100% and 62.6% of the participants consumed less than Estimated Average Requirement (EAR) of magnesium and Vitamin B1, respectively. Nutrient intakes in heart failure patients were different for potassium intake according to the usage of diuretics. The participants with symptom severity tended to intake protein less properly and the participants walking more than 300.0 m tended to intake sodium improperly high. CONCLUSIONS: The findings of this study indicated the need for screening nutrient intakes of heart failure patients. It is necessary to increase the intake of total calories and most nutrients and to restrict sodium intakes among heart failure patients.
Carbohydrates ; Diet ; Diuretics* ; Heart Failure* ; Heart* ; Humans ; Clinical Trial ; Magnesium ; Mass Screening ; Medical Records ; Potassium ; Sodium ; Statistics as Topic ; Thiamine ; Vitamin D ; Walking

PURPOSE: The purpose of this study was to explore the predictors of cardiovascular risk factors among type 2 diabetic patients. METHOD: Data were collected from November, 2003 to June, 2004 using a physiological index and questionnaires. Patients(N=159) aged 40 and above were conveniently recruited from health care centers in B city. Data were analyzed with descriptive statistics, Pearson correlation and stepwise multiple regression using SPSS WIN 10.0 program. RESULTS: The cardiovascular risk factors were negatively related with female gender, household monthly income, educational experience about diabetes, physical activity, self-care, self-efficacy and problem oriented coping, while positively related with the duration of diabetes, diabetic family history and depression. Self-care, diabetic family history, female gender, monthly household income, self-efficacy, affective-oriented coping and physical activity predicted 41.5% of the variance in cardiovascular risk factors of diabetic patients. CONCLUSION: According to the findings of this study, we concluded that cardiovascular risk factors of type 2 diabetic patients are related to the modifiable and non-modifiable variables. Self-care, self-efficacy, affective- oriented coping, and physical activity were identified as modifiable variables. Intervention programs to increase those variables are warranted to reduce cardiovascular risk factors among type 2 diabetic patients.
Delivery of Health Care ; Depression ; Diabetes Complications ; Family Characteristics ; Female ; Humans ; Motor Activity ; Risk Factors* ; Self Care ; Self Efficacy ; Surveys and Questionnaires

Purpose: The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects. Methods: The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus. Results: The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences. Conclusion The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients’ self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.

PURPOSE: This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS). METHODS: A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA. RESULTS: At the completion of SAPS significant differences were found between groups in motivation for exercise (t=−3.24, p=.005), physical activity (t=−4.15, p<.001), total calorie intake (t=3.42, p=.002), calories from fat (t=−3.01, p=.005), intake of vegetables (t=−2.83, p=.008), and BMI (t=5.21, p<.001). Significant differences in BMI (t=4.13, p<.001) remained up to 3 months after SAPS completion. No significant differences was shown between groups in self-efficacy for exercise, either immediately after or 3 months after SAPS. CONCLUSION The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.

PURPOSE: To compare the effects of the Interaction Model of Client Health Behavior (IMCHB)-based oral health program (OHP) and walking exercise program (WEP) on oral health behaviors, periodontal disease, physical activity, and psychological indicators (depression, stress, and quality of life) in pregnant women. METHODS: A nonequivalent control group pretest-posttest design was adopted to compare the effects of a 12-week OHP and WEP on pregnant women (n=65). Pregnant women were randomly assigned to the oral health group (OHG; n=23), walking exercise group (WEG; n=21), or control group (CG; n=21). Data were analyzed by the χ2-test, Fisher's exact test, Scheffe test, and repeated measures ANOVA, using the Statistical Package for the Social Sciences for Windows (version 21.0). RESULTS: The OHG and WEG showed significant improvements in oral health behaviors, periodontal disease, and psychological indicators as compared to the CG. The WEG showed significant improvement in physical activity as compared to the OHG and CG. CONCLUSION: These findings indicate that the IMCHB-based OHP and WEP were effective in improving periodontal disease, physical activity, and psychological indicators. However, further studies are needed to identify the positive effects of the OHP and WEP on birth outcomes.
Female ; Health Behavior ; Humans ; Motor Activity ; Oral Health* ; Parturition ; Periodontal Diseases ; Pregnant Women* ; Social Sciences ; Walking*

PURPOSE: This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS). METHODS: A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA. RESULTS: At the completion of SAPS significant differences were found between groups in motivation for exercise (t=−3.24, p=.005), physical activity (t=−4.15, p<.001), total calorie intake (t=3.42, p=.002), calories from fat (t=−3.01, p=.005), intake of vegetables (t=−2.83, p=.008), and BMI (t=5.21, p<.001). Significant differences in BMI (t=4.13, p<.001) remained up to 3 months after SAPS completion. No significant differences was shown between groups in self-efficacy for exercise, either immediately after or 3 months after SAPS. CONCLUSION: The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.
Body Mass Index ; Breast Neoplasms ; Breast ; Diet ; Education ; Health Behavior ; Humans ; Motivation ; Motor Activity ; Overweight ; Peer Group ; Smartphone ; Survivors ; Vegetables

Purpose: Preventing diabetic complications involves regular outpatient follow-up and maintaining low variability in hemoglobin A1c (HbA1c) levels. This study investigated the factors associated with diabetic complications, with a specific focus on the impact of regular outpatient follow-up and HbA1c variability, among patients with type 2 diabetes. Methods: The study design was secondary data analysis of electronic medical records from a university hospital in Korea. It included patients aged 40–79 with type 2 diabetes who were prescribed diabetes medication within three months of their first HbA1c test by an endocrinologist and were followed up for at least five years. Follow-up regularity, adjusted standard deviation of HbA1c levels, and diabetic complication indices were collected. Data were analyzed using the Chi-square test, independent t-test, repeated measures analysis of variance, and multiple regression analysis. Results: The study included 1566 patients. Lower follow-up regularity was observed in patients of older age, with comorbidities, diabetic complications, insulin treatment, a history of hospitalization, lower baseline estimated glomerular filtration rate (eGFR) and total cholesterol (TC), and higher HbA1c variability. Higher HbA1c variability was observed in younger patients without comorbidity but with insulin treatment, a history of hospitalization, higher baseline blood glucose (BG), HbA1c, TC, and triglyceride levels. HbA1c variability had the strongest influence on BG and HbA1c levels at the five-year follow-up. Baseline eGFR and TC were the most influential factors for their respective levels at the five-year follow-up. Follow-up regularity significantly affected BG, HbA1c, eGFR, and TC at five-year follow-up. Conclusions It has been shown that several variables besides regular follow-up and HbA1c variability have an influence. However, these are the two that can be corrected through nursing intervention and are important, so intervention on these is important.

Purpose: Evidence on non-pharmacological interventions for adolescents with type 1 diabetes is unclear. This review aimed to evaluate the effectiveness of non-pharmacological intervention in adolescents with type 1 diabetes. Methods: We conducted a search on databases from November 11 to 19, 2022, for randomized controlled trials for the effects of non-pharmacological intervention in adolescents with type 1 diabetes. To identify recent research trends, we included studies published from 2017 to November 2022. The risk of bias was assessed using the Cochrane risk-of-bias tool 2.0. To estimate the effect size, a meta-analysis was performed using RevMan 5.4 program and R Studio. Results: A total of 45 studies were included in the systematic review. Among those, 30 studies were included in the meta-analysis. Non-pharmacological interventions were significantly effective in improving Glycated hemoglobin (HbA1c) (standardized mean difference [SMD] = −0.26, 95% confidence interval [CI]: −0.42, −0.09), quality of life (SMD = 0.44, 95% CI: 0.13 to 0.76), and anxiety (SMD = −0.91, 95% CI: −1.26, −0.56). Subgroup analysis showed that duration of intervention was not a covariate related to HbA1c levels. Conclusions Non-pharmacological interventions have shown effectiveness in improving the HbA1c, quality of life, and anxiety in adolescents with type 1 diabetes. Future studies with more rigorous methodology are needed to confirm and strengthen the validity of these findings. Additionally, attention to changes in the lipid profile and self-care motivation among adolescents with type 1 diabetes is warranted.

Purpose: In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). Methods: A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2). Results: Eighteen randomized studies, involving 2,898 participants, were included.Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality. Conclusion Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).

PURPOSE: The purpose of the study was to identify the effects of problem solving nursing counseling and intensified walking exercise on diabetic self-care, coping strategies, and glycemic control among older adults with DM type II. METHOD: Ninety nine DM patients who were older than 50 were recruited from DM clinics or public health centers and conveniently assigned into three groups: the Polar(n=41), counseling(n=30) and control groups (n=28). Participants in both Polar and counseling groups attended weekly problem solving nursing counseling for 12 weeks. Polar heart rate monitors were used in the Polar group to intensify walking exercise. Data was collected from November 2003 to August 2004 and analyzed by ANOVA or ANCOVA using the SPSS WIN program. RESULT: After a 12 week intervention, participants in both the Polar and counseling groups reported increased diabetic self care behaviors and decreased blood glucose levels, which is significantly different from those in the control group. There were no distinctively different program effects between the Polar and counseling groups. CONCLUSION: Based on the findings, we concluded that problem solving counseling alone could have positive effects on diabetic self care and glycemic controls for older adults with DM. Future research is needed to identify long-term effects of the program.
Walking ; *Self Care ; *Problem Solving ; Middle Aged ; Male ; Humans ; Female ; *Exercise ; Diabetes Mellitus, Type 2/blood/*nursing/psychology ; *Counseling ; Blood Glucose/*analysis ; Aged ; *Adaptation, Psychological