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A Web-based Health Promotion Program for Patients with Metabolic Syndrome.

Ji Soon KANG ; Hyun Sook KANG ; Younhee JEONG

Asian Nursing Research.2014;8(1):82-89.

PURPOSE: The population of metabolic syndrome is increasing in Korea. The prevalence is related to lifestyle, such as lack of physical activity and irregular diet. Most patients with metabolic syndrome know that lifestyle intervention is important to managing the condition. However, they do not always follow the intervention for various reasons, including lack of knowledge on how to change their lifestyle and lack of accessibility to that knowledge. The purpose of this study was to test the web-based health promotion program we developed. METHODS: Fifty-six adult workers from eight areas of business were recruited. They all had a confirmed metabolic syndrome diagnosis after being registered at a university hospital for annual health checkups. Twenty-nine workers were assigned to the experimental group, and the others were assigned to the control group. The web-based program was applied to the experimental group as an intervention for 8 weeks.Waist circumference, fasting blood glucose, triglyceride, high-density lipoprotein cholesterol, and blood pressure were measured before and after the program. Data were analyzed using chi-square test, Fisher's exact test, and t test. RESULTS: There were statistically significant differences between the two groups in waist circumference and high-density lipoprotein cholesterol (t = -4.43, p < .001; t = 2.22, p = .031, respectively). Of the 29 participants, 13 (44.83%) in the intervention group had less than two indices for metabolic syndrome. CONCLUSIONS: This study suggests that a web-based program is useful for patients with metabolic syndrome to improve physiologic parameters related to metabolic syndrome. The web-based program may be easily applicable to community as well as clinical setting.
Adult ; Blood Glucose/metabolism ; Case-Control Studies ; Female ; *Health Behavior ; Health Promotion/*methods/standards ; Humans ; *Internet ; *Life Style ; Lipoproteins, HDL/blood ; Male ; Metabolic Syndrome X/*rehabilitation ; Middle Aged ; Triglycerides/blood ; Waist Circumference ; Young Adult

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Validation of the Korean version of the 39-Item Parkinson's Disease Questionnaire (PDQ-39).

Hye Ja PARK ; Kyeong Yae SOHNG ; Sehyun KIM

Asian Nursing Research.2014;8(1):67-74.

PURPOSE: To evaluate the reliability and validity of the Korean version of the 39-item Parkinson's disease questionnaire (PDQ-39). METHODS: Cross-cultural adaptation was performed according to the international guidelines: forward and backward translation, focus group meeting, and a field test. With Korean consensus translation produced, validation was assessed by evaluating reliability and validity. Ninety-three outpatients with Parkinson's disease (PD) and 89 healthy aged controls were recruited. Internal consistency reliability was assessed by Cronbach's alpha. Validity was assessed by Spearman correlation analysis, t test, factor analysis, and analysis of variance with Duncan's multiple range tests. RESULTS: In the PD group, mean age was 65.13 +/- 9.84 years, and mean duration of PD was 42.41 +/- 37.01 months. Ceiling and floor effects ranged 1.1%-2.2% and 1.1%-15.1%, respectively. Cronbach's alpha of eight dimensions ranged from .70 to .97. All dimensions were correlated with each other, except for the stigma dimension. PD patients had significantly lower quality of life than healthy aged controls did, except for the bodily discomfort dimension. Eight dimensions of Korean PDQ-39 loaded on one factor. PD patients with a Modified Hoehn and Yarh Staging score of 4 had the worst quality of life. The relationships among the eight dimensions of Koran PDQ-39 and the Modified Hoehn and Yarh Staging is fair to good, except for the stigma and social support dimension. CONCLUSION: The Korean PDQ-39 was proved to be reliable and valid. Our results suggest that Korean PDQ-39 could be used in clinical research to assess and evaluate the disease process and its impacts on health-related quality of life in Korean PD patients.
Aged ; Case-Control Studies ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Parkinson Disease/*psychology ; Psychometrics/*standards ; Quality of Life ; Questionnaires/*standards ; Reproducibility of Results ; Republic of Korea ; Translations

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Development of a Standardized Job Description for Healthcare Managers of Metabolic Syndrome Management Programs in Korean Community Health Centers.

Youngjin LEE ; Jina CHOO ; Jeonghyun CHO ; So Nam KIM ; Hye Eun LEE ; Seok Jun YOON ; Gyeongae SEOMUN

Asian Nursing Research.2014;8(1):57-66.

PURPOSE: This study aimed to develop a job description for healthcare managers of metabolic syndrome management programs using task analysis. METHODS: Exploratory research was performed by using the Developing a Curriculum method, the Intervention Wheel model, and focus group discussions. Subsequently, we conducted a survey of 215 healthcare workers from 25 community health centers to verify that the job description we created was accurate. RESULTS: We defined the role of healthcare managers. Next, we elucidated the tasks of healthcare managers and performed needs analysis to examine the frequency, importance, and difficulty of each of their duties. Finally, we verified that our job description was accurate. Based on the 8 duties, 30 tasks, and 44 task elements assigned to healthcare managers, we found that the healthcare managers functioned both as team coordinators responsible for providing multidisciplinary health services and nurse specialists providing health promotion services. In terms of importance and difficulty of tasks performed by the healthcare managers, which were measured using a determinant coefficient, the highest-ranked task was planning social marketing (15.4), while the lowest-ranked task was managing human resources (9.9). CONCLUSION: A job description for healthcare managers may provide basic data essential for the development of a job training program for healthcare managers working in community health promotion programs.
*Administrative Personnel ; Adult ; Attitude of Health Personnel ; Community Health Centers/*manpower ; Focus Groups ; Humans ; Job Description/*standards ; Metabolic Syndrome X/*therapy ; Middle Aged ; Republic of Korea ; Task Performance and Analysis ; Young Adult

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Effect of a Mind-Body Therapeutic Program for Infertile Women Repeating In Vitro Fertilization Treatment on Uncertainty, Anxiety, and Implantation Rate.

Miok KIM ; Sue KIM ; Soon Bok CHANG ; Ji Soo YOO ; Hee Kyung KIM ; Jung Hyun CHO

Asian Nursing Research.2014;8(1):49-56.

PURPOSE: The study aimed to develop a mind-body therapeutic program and evaluate its effects on mitigating uncertainty, anxiety, and implantation rate of second-trial in vitro fertilization (IVF) women. METHODS: This study employed a nonequivalent control group nonsynchronized design. The conceptual framework and program content were developed from a preliminary survey of eight infertile women and the extensive review of the literature. Program focuses on three uncertainty-induced anxieties in infertile women: cognitive, emotional, and biological responses. To evaluate the effect of the intervention, the infertile women with unknown cause preparing for a second IVF treatment were sampled at convenience (26 experimental and 24 control). RESULTS: The experimental group in the study showed greater decrease in uncertainty and anxiety in premeasurements and postmeasurements than the control group did. However, no statistically significant differences in the implantation rate between groups were observed. CONCLUSION: This study is meaningful as the first intervention program for alleviating uncertainty and anxiety provided during the IVF treatment process. The positive effects of the mind-body therapeutic program in alleviating both uncertainty and anxiety have direct meaning for clinical applications.
Adult ; *Anxiety/psychology/therapy ; Case-Control Studies ; Embryo Implantation ; Female ; Fertilization in Vitro/*psychology ; Humans ; Infertility, Female/*psychology ; Mind-Body Therapies/*methods ; Treatment Outcome ; *Uncertainty ; Women/*psychology

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Path Analysis of Empowerment and Work Effectiveness among Staff Nurses.

Yong Sook EO ; Young Hae KIM ; Nae Young LEE

Asian Nursing Research.2014;8(1):42-48.

PURPOSE: The purpose of this study was to test a predictive model that could predict and explain work effectiveness among staff nurses at local hospitals. METHODS: Between April 1 and May 15, 2009, 340 nurses were recruited from two hospitals (one in Ulsan and one in Yangsan). Data were collected via self-administered questionnaires and analyzed using structural equation modeling. RESULTS: A modified model was retained, as the final path model showed a very good fit with the data. Job characteristics and compensation justice were found to have direct and positive effects on empowerment. Job characteristics, transformational leadership, and empowerment were found to directly and positively affect work effectiveness. In addition, job characteristics were found to have a greater effect on empowerment and work effectiveness than other factors do. CONCLUSION: This structural equation model was used to test the relationships between these factors and work effectiveness. Empowerment mediated the relationship between job characteristics, transformational leadership, and work effectiveness. Findings from this study can be used to design the strategies for increasing work effectiveness in Korean nurses.
Adult ; Cross-Sectional Studies ; Humans ; *Leadership ; *Models, Theoretical ; Nurses/*psychology ; Nursing Staff, Hospital/*psychology ; *Power (Psychology) ; Questionnaires ; Republic of Korea ; Young Adult

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Relationship between Quality of Life and Nurse-led Bedside Symptom Evaluations in Patients with Chemotherapy-induced Peripheral Neuropathy.

Yang Sook YOO ; Ok Hee CHO

Asian Nursing Research.2014;8(1):36-41.

PURPOSE: This cross-sectional study aimed at determining the relationship between patient-reported quality of life (QOL) and nurse-led bedside evaluations of chemotherapy-induced peripheral neuropathy symptoms. METHODS: One hundred ninety-five patients treated at the oncology clinic at our institution were assessed using Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity and nurse-led bedside examinations. The relationship between self-reported QOL and bedside examinations was evaluated using Spearman rank correlations. RESULTS: Scores of upper and lower extremity muscle strength based on the bedside examinations showed a weak negative correlation with the emotional well-being subscale of Functional Assessment of Cancer Therapy-General. Further, weak negative relationships were present between QOL and the following nurse-reported parameters: vibration perception in the hand, upper extremity muscle strength, touch and vibration perception in the feet, and tendon reflexes. CONCLUSION: Collectively, our results indicate that nurse-led bedside evaluation is a noninvasive and useful method for detecting neurotoxicity and evaluating the patient's QOL both during and after treatment.
Aged ; Antineoplastic Agents/adverse effects ; *Attitude of Health Personnel ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Neoplasms/drug therapy ; Neurotoxicity Syndromes/*diagnosis/etiology ; Nurses/*psychology ; Peripheral Nervous System Diseases/chemically induced/*diagnosis ; Platinum Compounds/adverse effects ; *Quality of Life ; Questionnaires ; Symptom Assessment/methods/*standards ; Taxoids/adverse effects

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Taiwanese Parents' Experience of Making a "Do Not Resuscitate" Decision for Their Child in Pediatric Intensive Care Unit.

Shu Mei LIU ; Hung Ru LIN ; Frank L LU ; Tzu Ying LEE

Asian Nursing Research.2014;8(1):29-35.

PURPOSE: The purpose of this project was to explore the parental experience of making a "do not resuscitate" (DNR) decision for their child who is or was cared for in a pediatric intensive care unit in Taiwan. METHODS: A descriptive qualitative study was conducted following parental signing of a standard hospital DNR form on behalf of their critically ill child. Sixteen Taiwanese parents of 11 children aged 1 month to 18 years were interviewed. Interviews were recorded, transcribed, analyzed and sorted into themes by the sole interviewer plus other researchers. RESULTS: Three major themes were identified: (a) "convincing points to sign", (b) "feelings immediately after signing", and (c) "postsigning relief or regret". Feelings following signing the DNR form were mixed and included "frustration", "guilt", and "conflicting hope". Parents adjusted their attitudes to thoughts such as "I have done my best," and "the child's life is beyond my control." Some parents whose child had died before the time of the interview expressed among other things "regret not having enough time to be with and talk to my child". CONCLUSION: Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child's end of life process.
Adolescent ; Adult ; Child ; Child, Preschool ; *Decision Making ; Female ; Humans ; Infant ; Intensive Care Units, Pediatric ; Male ; Middle Aged ; Palliative Care/*psychology ; Parents/*psychology ; *Professional-Family Relations ; Qualitative Research ; Resuscitation Orders/*psychology ; Taiwan ; Young Adult

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Efficacy of Distraction Methods on Procedural Pain and Anxiety by Applying Distraction Cards and Kaleidoscope in Children.

Nejla CANBULAT ; Sevil INAL ; Hacer SONMEZER

Asian Nursing Research.2014;8(1):23-28.

PURPOSE: This study aims to investigate two different distraction methods, distraction cards and kaleidoscope, on pain and anxiety relief of children during phlebotomy. METHODS: This study is a prospective, randomized and controlled trial. The sample consisted of 7-11 year-old children who required blood tests. Children were randomized into three groups: the distraction cards group, the kaleidoscope group, and the control group. Data were obtained by interviewing the children with their parents and the observer before and after the procedure. The pain levels of the children were assessed by the parent and observer reports as well as self report using the Wong Baker FACES Pain Rating Scale. The anxiety levels of children were assessed by parent and observer reports using Children Fear Scale. RESULTS: One hundred and eighty-eight children (mean age, 8.8 +/- 1.5 years) were included. The pain levels of children showed significant differences among the groups (p = .005). Both the distraction card group (2.41 +/- 2.49) and the kaleidoscope group (3.10 +/- 2.16) had lower pain levels than the control group did (4.44 +/- 3.64). The distraction card group had the lowest pain levels (2.41 +/- 2.49) among all groups. The procedural anxiety levels of children were significantly different among the groups (p = <.001). Both the distraction card group (1.10 +/- 1.20) and the kaleidoscope group (1.61 +/- 1.12) had lower anxiety levels than the control group did (2.41 +/- 1.30). The distraction card group had the lowest anxiety levels (p = <.001). CONCLUSION: The distraction cards were the most effective method for pain and anxiety relief of children during phlebotomy. Also the distraction method with kaleidoscope was an effective method for pain and anxiety relief during phlebotomy in children.
Anxiety/etiology/*prevention & control/psychology ; *Attention ; Child ; Female ; Humans ; Male ; Pain/etiology/*prevention & control/psychology ; Pain Management/instrumentation/*methods ; Parents/psychology ; Phlebotomy/*adverse effects/psychology ; Prospective Studies ; Questionnaires ; Treatment Outcome

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Problems of Clinical Nurse Performance Appraisal System: A Qualitative Study.

Nasrin NIKPEYMA ; Zhila ABED_SAEEDI ; Eznollah AZARGASHB ; Hamid ALAVI_MAJD

Asian Nursing Research.2014;8(1):15-22.

PURPOSE: The purpose of this study is to explore problems of clinical nurse performance appraisal system. METHODS: This study employed a descriptive qualitative approach. The participants were purposively selected from clinical nurses working across all of the hospital units in a large metropolitan teaching hospital in Tehran, Iran in 2012. Data were collected using five focus group interviews, which were audio taped. The number of participants in each group ranged from 7 to 10. The semi-structured interviews were guided by a set of nondirective questions, and continued until the data reached saturation. Data were analyzed using framework analysis. RESULTS: Four major themes regarding the problems of clinical nurse performance appraisal system emerged from the analysis of textual data. These themes were contextual problems, problems related to performance appraisal structure, problems related to performance appraisal process and those related to performance appraisal results. CONCLUSION: The findings of this study reveal that the nurse performance appraisal system confronts with various problems. Some of these problems are related to organizational context while the others concerned structure, process and results of the performance appraisal system. In order to achieve high quality of patient care as the final goal of performance appraisal, changing and revision of this system is necessary.
Adult ; *Clinical Competence ; Employee Performance Appraisal/*standards ; Female ; Focus Groups ; Humans ; Iran ; Male ; Middle Aged ; Nurse Clinicians/*standards ; *Nursing Methodology Research ; Nursing Staff, Hospital/*standards ; Qualitative Research

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Health Behaviors and Risk Factors Associated with Chronic Kidney Disease in Korean Patients with Diabetes: The Fourth Korean National Health and Nutritional Examination Survey.

Suk Jeong LEE ; Chae Weon CHUNG

Asian Nursing Research.2014;8(1):8-14.

PURPOSE: The purpose of this study was to identify health behavior and risk factors for chronic kidney disease (CKD) in Korean patients with diabetes. METHODS: This study was a secondary analysis of the Fourth Korean National Health and Nutritional Examination Survey (2007-2009). Of the 24,871 participants, 1,239 aged over 19 years with diagnosis of diabetes were included. Stratified and cluster variables in the analysis-plan file for a weighted, complex sample were analyzed. CKD was confirmed by the estimated glomerular filtration rate level of 15.0-59.9 mL/min/1.732 m2. Odds ratios between the variables and CKD were calculated using logistic regression analysis with adjustment for gender, age, educational background, income, and duration of diagnosis. RESULTS: The results showed that 14.7% of participants with diabetes were accompanied with CKD. The risk of developing CKD in those who made efforts to take proper nutrition but failed was 1.76 times higher than those taking nutrition properly. In those who used to smoke compared to their nonsmoking counterparts, the risk was 2.06 times higher; in those who did not do vigorous exercise compared to those who did, the risk was 2.12 times higher; in those with hypertension than those without, the risk was 2.4 times higher; and in those with anemia compared to those without, the risk was 2.32 times higher. Only 19% of the participants received health education for diabetes, which did not affect the incidence of CKD. CONCLUSION: Since renal functions are affected by lifestyle factors, it is critical for healthcare professionals to provide diabetic patients with health education focused on changing their behavior so that it is conducive to health. It is also necessary to consider that diabetes education should be made more available and provided more effectively to these patients.
Adult ; Aged ; Anemia/complications/epidemiology ; Diabetes Complications/*epidemiology ; Diabetes Mellitus/*epidemiology ; Diet/statistics & numerical data ; Exercise ; Female ; *Health Behavior ; Health Surveys ; Humans ; Hypertension/complications/epidemiology ; Male ; Middle Aged ; Nutrition Surveys ; Patient Education as Topic/statistics & numerical data ; Renal Insufficiency, Chronic/complications/*epidemiology ; Republic of Korea/epidemiology ; Risk Factors ; Smoking/epidemiology ; Young Adult

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