BACKGROUND: Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. METHODS: We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2000 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. RESULTS: Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714-0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699-0.771). CONCLUSIONS We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.
Aged ; Cohort Studies ; Female ; Geriatric Assessment/statistics & numerical data* ; Humans ; Independent Living/statistics & numerical data* ; Japan ; Male ; Middle Aged ; Nursing Homes/statistics & numerical data* ; Risk Assessment ; Risk Factors

PURPOSE: The purpose of this study was to assess the psychosocial status of candidates for deceased donor kidney transplantation (DDKT) in South Korea and identify factors associated with high-risk psychosocial status.METHODS: The descriptive cross-sectional design included application of a standardized transplantation-specific assessment tool, the Psychosocial Assessment Candidacy Transplantation (PACT) instrument, and review of candidates' medical records. A total of 157 patients awaiting DDKT were recruited from a Korean organ transplantation center. The collected data were analyzed using descriptive statistics and binary logistic regression. Candidates were divided into high- and low-psychosocial risk groups using 3 as the cutoff point of PACT.RESULTS: The mean score for the PACT final rating was 2.10, and the lowest average subscale score was 2.30 for understanding the processes of transplantation and follow up. Poor physical candidacy, especially due to comorbidities, and older age were associated with high psychosocial risk.CONCLUSION: The results of this study showed that the psychosocial status of Korean DDKT candidates was problematic. Development of systematic management programs for effective clinical strategies in the care of candidates is crucial to maintain their desirable psychosocial status in case of an emergency DDKT operation and improve post-transplantation outcomes. Continuous education is absolutely necessary to enhance understanding of the transplantation process for high-risk psychosocial candidates. Additionally, nurses and transplantation professionals should screen candidates with high-risk psychosocial status early in the process using transplantation-specific assessment tools and provide intensive interventions, particularly for poor physical candidacy patients and older candidates.
Comorbidity ; Education ; Emergencies ; Follow-Up Studies ; Humans ; Kidney Transplantation ; Kidney ; Korea ; Logistic Models ; Medical Records ; Nursing Assessment ; Organ Transplantation ; Psychology ; Tissue Donors ; Transplants ; Waiting Lists

PURPOSE: The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls.METHODS: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls.RESULTS: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ≥81, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs.CONCLUSION: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.
Accidental Falls ; Comorbidity ; Gait Disorders, Neurologic ; Hospitalization ; Humans ; Incidence ; Inpatients ; Joints ; Nursing ; Organization and Administration ; Patient Care ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Self-Help Devices ; Survival Analysis ; Survival Rate ; Tertiary Care Centers

PURPOSE: Childhood leukemia is a serious trauma affecting both adolescents and their parents, who experience painful process. However, adolescents with leukemia and their parents also experience positive changes, which is referred to as posttraumatic growth. We examined posttraumatic growth, core beliefs, impact of event, and event-related rumination in adolescents within 5 years of a diagnosis of childhood leukemia and their parents. METHODS: The participants were 68 adolescents with childhood leukemia (aged 13~18 years) and their parents, who were recruited from C university hospital in Korea from May to September 2016. The Posttraumatic Growth Inventory, Core Belief Inventory, Impact of Event Scale-Revised, and Event-related Rumination Inventory were completed by the adolescents and their parents. The mean scores and correlations between variables were investigated for both set of participants. RESULTS: Parents showed significantly higher levels of posttraumatic growth, disruption of core beliefs, impact of event, and invasive rumination than adolescents. Disruption of core beliefs and deliberate rumination were positively correlated with posttraumatic growth in both groups. CONCLUSION: Nursing intervention programs that involve modifying core beliefs and inducing a positive thought can help adolescents with leukemia and their parents grow after traumatic events.
Adolescent* ; Diagnosis ; Humans ; Korea ; Leukemia* ; Nursing ; Parents* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Stress Disorders, Post-Traumatic

PURPOSE: The objective of this study was to investigate the patients' needs on integrated supportive service programs for the abortion women. METHODS: The 49 participants in this study were abortion experienced women in 2 infertility hospitals. Data were collected using a structure self-report questionnaire including medical treatment and nursing after abortion, symptom recognition and sexual problems after abortion, management in daily care after abortion and supportive system after abortion. RESULTS: Participants had an average score 3.54 for the need of medical treatment and nursing after abortion, 3.50 for the need of symptom recognition and sexual problems after abortion, 3.27 for the need of management in daily care after abortion and 3.28 for the need of supportive system after abortion. CONCLUSION: In order to effectively conduct integrated supportive service programs for the abortion women, it is necessary to understand appropriate nursing care for women after abortion.
Comprehensive Health Care ; Female ; Health Services Needs and Demand ; Humans ; Infertility ; Needs Assessment ; Nursing Care ; Nursing ; Pregnancy Complications

PURPOSE: This study aimed to identify the difficulties with end-of-life care (EOLC) experienced by intensive care unit (ICU) nurses and to investigate their educational needs for EOLC. METHODS: This study aimed to identify the difficulties with end-of-life care (EOLC) experienced by intensive care unit (ICU) nurses and to investigate their educational needs for EOLC. RESULTS: The mean score on the difficulty of EOLC was 3.41 out of 5. The education needs derived from the qualitative analysis was categorized into four themes: 1) guidelines on professional EOLC, 2) spiritual care, 3) a program to take care of feelings of patients, families and nurses, and 4) activities to think about death. CONCLUSION: This study confirmed that ICU nurses were experiencing an extreme difficulty in providing EOLC. In addition, a qualitative analysis confirmed that they needed an EOL nursing program. To mitigate the difficulties experienced by nurses involved in EOLC, there is an urgent need to develop an education program for EOLC tailored to nurses' needs.
Critical Care ; Education ; Humans ; Intensive Care Units ; Methods ; Needs Assessment ; Nursing ; Terminal Care

PURPOSE: The purpose of this article was to identify and define concepts of post-traumatic growth of family caregivers of cancer patients. METHODS: This study was conducted according to the method of Walker and Avant (2005)'s, focusing on research articles and books published from 2000 to 2017. RESULTS: There were five attributes of the concept: personal growth, reinforcing relationships with others, understanding of others, finding meaning of care, and gratitude for life. Furthermore, antecedents were as follows: cancer diagnosis of a family member, cancer severity, role acceptance of caregiver, caregiving related burden, self-esteem, and hope. The consequences, therefore, were promoting patient' s posttraumatic growth and psychological well-being, increased the quality of life, health related habits change, balance of life, satisfaction of life, and continuation of care. CONCLUSION: Knowing the factors of posttraumatic growth in nursing can be used to devise an intervention to enhance the posttraumatic growth of family caregivers of cancer patient, which can then be applied to a variety of nursing areas.
Caregivers ; Diagnosis ; Hope ; Humans ; Methods ; Nursing ; Quality of Life ; Walkers

PURPOSE: The purpose of this study was to explore educational needs of communication, focusing on how nursing students evaluate their current communication skills and what students think is most crucial in communication competency. METHODS: This cross-sectional descriptive study collected data from 276 nursing students at multiple universities from September to November 2016. Main analyses included descriptive statistics, independent t-tests, and one-way ANOVA with SPSS/WIN and R 3.2.3, as well as importance-performance analysis by Martilla and James. RESULTS: There was a difference in the perceived importance of communication depending on field experience. Students who reported excellent communication skills compared to their peers had higher perceived communication importance than those who reported similar or inferior skills. The perceived need for dominant communication of goal setting skills was the highest. After confirming the list of priorities for Borich's needs assessment, the education need for goal setting skills was the highest with 1.79. CONCLUSION: Our study findings emphasize that the highest need for education of nursing students was the dominant communication of goal setting skills. This is needed to develop an education program that can strengthen goal setting communication for nursing students with a special focus on dominant communication.
Education ; Humans ; Needs Assessment ; Nursing ; Students, Nursing

PURPOSE: To identify needs for pregnancy and postpartum adaptation of Chinese immigrant women and Vietnamese immigrant women in South Korea. METHODS: A descriptive research design was employed. Data were collected from 244 Chinese immigrant women and Vietnamese immigrant women from 3 provinces, 20 health care centers, and multi-cultural family support centers. Data were analyzed with descriptive statistics, t-test and ANOVA. RESULTS: An average score for needs perceived by Chinese immigrant women was significantly higher than that perceived by Vietnamese immigrant women. There were significantly differences in physical and emotional adaptation after childbirth, nutrition during pregnancy, cross cultural understanding and personal respect, and adaptation daily activity during pregnancy between the 2 groups. The highest score of needs in Chinese immigrant women was for nutrition during pregnancy and that in Vietnamese immigrant women was for baby rearing and family support. CONCLUSION: Based on needs of pregnancy and postpartum adaption, nursing intervention program in consideration of cultural characteristics of Chinese immigrant women and Vietnam immigrant women need to be developed for their pregnancy and postpartum health care.
Adaptation, Physiological ; Asian Continental Ancestry Group ; Cultural Characteristics ; Delivery of Health Care ; Emigrants and Immigrants ; Emotional Adjustment ; Female ; Humans ; Korea ; Needs Assessment ; Nursing ; Parturition ; Postpartum Period ; Pregnancy ; Prenatal Nutritional Physiological Phenomena ; Research Design ; Vietnam

PURPOSE: This study aimed to develop a model for estimating the quality of life mediated by adaptation to changes experienced after stomach cancer diagnosis and surgery in patients with gastrectomy and to verify the model based on the Cancer Survivor Adaptation Model by Naus et al. (2009) and literature reviews. METHODS: Data was collected from 297 gastric cancer patients who underwent a gastrectomy at an outpatient clinic of two university hospitals in Daegu city from May to August, 2016. The exogenous variableswere perceived gastrointestinal symptoms, self-efficacy, anxiety, social support, and spiritual well-being. The endogenous variableswere adaptation and quality of life, and adaptationwas themediating variable. For data analysis, structural equation modeling was performed using IBM SPSS 21.0 and AMOS 18.0. RESULTS: The fitness parameters of the final model showed a reasonable fit to the data. Based on R², the exogenous variables explained 73.9% of the quality of life of stomach cancer patients who underwent surgery, through the mediation of adaptation; adaptation alone explained 73.5% of quality of life. Adaptation of stomach cancer patients with gastrectomy was a factor that strongly influenced their quality of life. CONCLUSION: It is important for gastric cancer patients with gastrectomy to adapt well to changes after surgery in order to improve the quality of life. Nursing interventions to aid successful adaptation would ultimately exert positive influences and improve the patients' quality of life.
Ambulatory Care Facilities ; Anxiety ; Daegu ; Diagnosis ; Gastrectomy ; Hospitals, University ; Humans ; Negotiating ; Nursing ; Quality of Life ; Statistics as Topic ; Stomach Neoplasms ; Survivors