BACKGROUND: Although there have been a great number of research studies based on the model of uncertainty in illness, few studies have considered the appraisal portion of model. PURPOSE: The purpose of this study was to test the mediating effect of appraisal in the model of uncertainty in illness. Additionally, this study aimed to examine the relationships among uncertainty, symptom severity, appraisal, and anxiety in patients newly diagnosed with atrial fibrillation. METHODS: This study employed a descriptive correlational and cross-sectional survey design using a face-to-face interview method. Patients diagnosed with atrial fibrillation within the previous 6 months prior to data collection were interviewed by Mishel Uncertainty in Illness Scale-Community Form, appraisal scale, Symptom Checklist-Severity V.3, and State Anxiety Inventory. RESULTS: A total of 81 patients with atrial fibrillation were recruited from two large urban medical centers in Cleveland, Ohio, U.S.A.. Symptom severity was the significant variable in explaining uncertainty (beta=0.34). Individuals with greater symptom severity perceived more uncertainty. Uncertainty was appraised as a danger rather than opportunity, and those with greater uncertainty appraised a greater danger (p<.01). While the appraisal of opportunity had the negative relationship with anxiety (r=-0.25), the appraisal of danger was positively associated with anxiety (r=0.78). The measure of goodness of fit (Q) of the model was .7863, and the significant test (X2) for the Q was statistically significant (df =3, p<.001). Accordingly, the overall mediating model of uncertainty in illness was proven not to be fit to the empirical data of patients with atrial fibrillation. Consequently, the mediating effect of appraisal was not supported by the empirical data of this study. CONCLUSION: The findings of this study were discussed in terms of their relevance compared with those of previous studies or theoretical framework and the plausible explanations on study findings. Lastly, in order to expand the present body of knowledge on uncertainty in illness model, recommendations for the future nursing studies were included.

No abstract available.
Nursing Theory* ; Nursing* ; Uncertainty*

PURPOSE: The purposes of this study were to explore the concept of uncertainty and to examine the relationships among uncertainty, appraisal of uncertainty, depression, anxiety, and perceived health status in patients with atrial fibrillation. METHOD: The study utilized a descriptive correlational survey design using a face to face interview method. A convenience sample of 49 subjects were recruited from K university hospital over 8 months. The data were analyzed by t-test, ANOVA, Pearson correlation and partial correlation analysis. RESULTS: 1) Subjects perceived with moderately high uncertainty(M=65.98); moderate physical health(M=39.80), mental health(M=47.38), and general health(M=2.94); moderate anxiety(M= 44.78); and slightly low depression(M=15.33). 2) There were significant differences in uncertainty by gender and education. 3) Uncertainty and danger appraisal were significantly correlated(r=.32, p=.03) while the uncertainty was not associated with opportunity appraisal. 4) Uncertainty was significantly correlated with mental health(r=-.31, p=.04), anxiety(r=.38, p=.01), and depression(r=37, p=.01). CONCLUSION: This study was the first trial to explore uncertainty and to examine the relationships among its associated factors in Korean patients with atrial fibrillation. Thus, based on the findings of this study, directions for nursing practice and further nursing research for patients with atrial fibrillation were suggested.
Anxiety* ; Atrial Fibrillation* ; Depression* ; Education ; Humans ; Nursing ; Nursing Research ; Uncertainty*

PURPOSE: The purposes of this study were to explore the concept of uncertainty and to examine the relationships among uncertainty, appraisal of uncertainty, depression, anxiety, and perceived health status in patients with atrial fibrillation. METHOD: The study utilized a descriptive correlational survey design using a face to face interview method. A convenience sample of 49 subjects were recruited from K university hospital over 8 months. The data were analyzed by t-test, ANOVA, Pearson correlation and partial correlation analysis. RESULTS: 1) Subjects perceived with moderately high uncertainty(M=65.98); moderate physical health(M=39.80), mental health(M=47.38), and general health(M=2.94); moderate anxiety(M= 44.78); and slightly low depression(M=15.33). 2) There were significant differences in uncertainty by gender and education. 3) Uncertainty and danger appraisal were significantly correlated(r=.32, p=.03) while the uncertainty was not associated with opportunity appraisal. 4) Uncertainty was significantly correlated with mental health(r=-.31, p=.04), anxiety(r=.38, p=.01), and depression(r=37, p=.01). CONCLUSION: This study was the first trial to explore uncertainty and to examine the relationships among its associated factors in Korean patients with atrial fibrillation. Thus, based on the findings of this study, directions for nursing practice and further nursing research for patients with atrial fibrillation were suggested.
Anxiety* ; Atrial Fibrillation* ; Depression* ; Education ; Humans ; Nursing ; Nursing Research ; Uncertainty*

Purpose: This study developed an instrument to evaluate the health empowerment of North Korean women refugees and examined its validity and reliability. Methods: Through literature review and focused group interviews, 66 preliminary items with three constructs, including perceived control, perceived competence, and goal internalization were selected based on Menon’s psychological health empowerment model. A questionnaire survey was conducted with 239 North Korean women refugees in the community from August 31 to September 4, 2020. Content, construct, convergent, and discriminative validity were evaluated. Cronbach’s α was used to evaluate the reli-ability of scale. Results: The final instrument consisted of 31 items with three factors that were identified through confirmatory factor analysis. The convergent validity showed that the correlation coefficient was .52 (p < .001), which confirmed the validity of the developed measurement tool. Cronbach’s α for all the items was .94, and Cronbach's α for the factors was .76~.91. Conclusion This health empowerment scale has been developed to include aspects of health empowerment, provide a conceptual framework, and offer objective indicators to evaluate the effectiveness of a health education program.

PURPOSE: Cardiovascular risk factor modification is important for patients with coronary artery disease to prevent poor progression of the disease. Without an understanding and an awareness of risk factors, patients with coronary artery disease are not able to reduce their risk by the lifestyle modification. The aims of this study were to assess patient's awareness of risk factors and to identify predictors of awareness of risk factors. METHODS: A descriptive correlational study using a cross-sectional survey method was performed. The sites of the study were three hospitals in Seoul, Korea. The sample consisted of 214 subjects. The awareness of risk factors and other subjects' characteristics were measured by a questionnaire developed for this study. RESULTS: A range of subjects (gender: 72.0%; hyperlipidemia: 51.9%; hypertension: 40.7%; obese: 37.4%; age: 35.5%; smoking: 22.4%; diabetes: 19.2%; family history: 18.2%) were not able to accurately identify the risk factors. Among predictors, gender (beta=-.17) and diabetics (beta=-.25) had statistically significant influences on awareness of risk factors. CONCLUSION: Our findings highlight the lack of awareness of risk factors for coronary artery disease. The findings have important implications for nursing practice in terms of guiding educational strategies for the modification of risk factors for coronary heart disease.
Coronary Artery Disease ; Coronary Disease ; Coronary Vessels ; Cross-Sectional Studies ; Humans ; Korea ; Life Style ; Risk Factors ; Surveys and Questionnaires

PURPOSE: This study aimed to identify the associated factors of the perceived health status of the elderly in Korea and to provide basic data for developing nursing interventions for the elderly's health management. METHODS: This study used a descriptive correlational research design. The subjects of this study were 335 elderly people over 60 yr living in an urban city. Data were collected through personal interviews using questionnaires from September 2006 to March 2007. Empirical indicators of perceived health status were measured by SF-36, nutritional screening initiative (NSI), activities of daily living (ADL) Index, and instrumental activities of daily living (IADL) scale. The collected data were analyzed by descriptive statistics, Pearson's correlation, and hierarchical regression. RESULTS: The mean age of the subjects was 72.8 and 57.0% of subjects were female. 41.5% of variance in physical health was explained by nutrition, ADL, IADL, and the number of years attending school. Among them the most important factor was ADL. 13.2% of variance in mental health was explained by the number of family, nutrition, and IADL. Among them the most important factor was nutrition. CONCLUSION: It is necessary to develop supportive interventions for improving the perceived health status of elderly people by considering the most important factors shown in this study.
*Activities of Daily Living ; Aged ; Aged, 80 and over ; Female ; Frail Elderly/*psychology ; *Health Status ; Homes for the Aged ; Humans ; Interviews as Topic ; Korea ; Male ; Middle Aged ; *Nutritional Status ; Questionnaires ; Urban Population

PURPOSE OF THE STUDY: Atrial fibrillation is the most common sustained cardiac rhythm disturbance encountered in clinical practice. In contrast to its high prevalence and the associated high number of hospital admissions, there is a paucity of published studies that have evaluated the perspective of patients with atrial fibrillation or patients' perceptions or responses to diagnosis, treatment, or prognosis of atrial fibrillation in health care literature and clinical studies. This study aimed to explore uncertainty in diagnosis, treatment, and prognosis of atrial fibrillation. METHODS: This study employed a descriptive cross-sectional survey design using a face-to-face interview method to explore uncertainty. Patients with atrial fibrillation confirmed by 12-lead ECG were interviewed. Uncertainty was measured by the Mishel Uncertainty in Illness Scale-Community Form (MUIS-C), and the data collected were analyzed by the Statistical Package for Social Science software program. RESULTS: A total of 81 subjects were included in this study and their mean score of uncertainty was 62.60 with the standard deviation of 10.81. Uncertainty in patients with atrial fibrillation was higher than that reported in other disease populations such as bowel resection surgery, breast cancer, myocardial infarction, and so forth. However, it was lower than the level of uncertainty in patients with cardiac arrest and HIV disease. CONCLUSION: From the findings of the present study, it was demonstrated that uncertainty existed in patients with atrial fibrillation, and this was considered to be part of patients' responses to atrial fibrillation. In terms of nursing practice and nursing research, uncertainty was explored and described as one of the most relevant phenomena in patients newly diagnosed with atrial fibrillation.
Atrial Fibrillation* ; Breast Neoplasms ; Cross-Sectional Studies ; Delivery of Health Care ; Diagnosis ; Electrocardiography ; Heart Arrest ; HIV ; Humans ; Myocardial Infarction ; Nursing ; Nursing Research ; Prevalence ; Prognosis ; Social Sciences ; Uncertainty*

PURPOSE: The purpose of this study was to determine correlates of depression and perceived health status in patients with atrial fibrillation. METHODS: The study utilized a descriptive correlational survey design. A convenience sample of 115 subjects were recruited from 3 tertiary medical centers. The data were analyzed by descriptive statistics, hierarchical multiple regression. RESULTS: 1) Study subjects perceived the low frequency of symptoms, relatively high social support, low depression, moderately low physical health, and mental health. 2) The 38% of variance in depression was significantly explained by symptom(beta= .49), social support(beta= -.21), and education(beta= -.17). 3) The 40% of variance in physical health was significantly explained by symptom(beta= -.55), social support(beta= .16), and education(beta= .20). 4) the 12% of variance in mental health was significantly explained by symptom(beta= -.26), and social support(beta= .24). CONCLUSION: Most health care providers assume atrial fibrillation patients have very few symptoms. However, symptom related to atrial fibrillation was found to be the most important factors in explaining depression and perceived health status. Additionally, higher social support had great influences on the lower depression and higher perceived health status. Based on the findings of this study, directions for nursing practice and further nursing research for patients with atrial fibrillation are suggested.
Atrial Fibrillation ; Depression ; Health Personnel ; Humans ; Mental Health ; Nursing Research

PURPOSE: The purposes of this study were to identify the relationships among perceived parental bonding, illness perception, and anxiety and to determine the influences of perceived parental bonding and illness perception on anxiety in adult patients with congenital heart diseases. METHODS: In this study a descriptive correlational design with survey method was utilized. The participants were 143 adult patients with congenital heart disease being cared for in the cardiology out-patient clinic of A medical center. Data were collected using the Parental Bonding Instrument, Illness Perception Questionnaire Revised Scale, and Cardiac Anxiety Questionnaire Scale. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation analysis, and hierarchial regression analyses. RESULTS: There showed significant positive relationships of anxiety with maternal overprotection, consequences, and personal control respectively. Among predictors, maternal overprotection (β=.45), consequence (β=.26), and personal control (β=-.03) had statistically significant influence on anxiety. CONCLUSION: Nursing interventions to decrease maternal overprotection and negative consequence, and to enhance personal control are essential to decrease the anxiety of adult patients with congenital heart diseases.
Adult* ; Anxiety* ; Cardiology ; Family Relations ; Heart Defects, Congenital ; Heart Diseases* ; Heart* ; Humans ; Nursing ; Outpatients ; Parents* ; Surveys and Questionnaires