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Appraisals, Burnout and Outcomes in Informal Caregiving.

Asian Nursing Research.2010;4(1):32-44.

OBJECTIVES: This study draws from the resource depletion and conservation theories to develop a process model of informal caregiving. The model includes the burnout as a key mediator of the relationship between benefit/threat appraisals and critical outcomes including perceived physical health, depression and life satisfaction. METHODS: A self-report questionnaire was utilized to collect relevant data from 137 informal caregivers of older adults. The proposed model and hypotheses were evaluated with the Structural Equation Modeling method using the software EQS. RESULTS: The relatively high reported levels of emotional exhaustion and reduced personal accomplishment established the relevance of the burnout construct for informal caregivers. In addition, the test of the proposed model provides support for the hypothesis that burnout is an important mediator in the appraisal process model of informal caregiving. However, while burnout effectively mediates the influence of threat appraisals, its role in mediating the effect of benefit appraisals is mixed. CONCLUSION: The proposed model and results highlight the significance and potential for utilizing a process approach for understanding the link between appraisals and outcomes for informal caregivers. More importantly, the proposed model suggests that attention must be paid toward burnout tendencies to reveal fruitful intervention directions for researchers and practitioners to enhance the positive outcomes of informal caregivers, and maintain their psychological and physical well-being.
Adult ; Aluminum Hydroxide ; Carbonates ; Caregivers ; Depression ; Fruit ; Humans ; Negotiating ; Surveys and Questionnaires

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Identification of Hypertension Management-related Errors in a Personal Digital Assistant-based Clinical Log for Nurses in Advanced Practice Nurse Training.

Nam Ju LEE ; Eunhee CHO ; Suzanne BAKKEN

Asian Nursing Research.2010;4(1):19-31.

PURPOSE: The purposes of this study were to develop a taxonomy for detection of errors related to hypertension management and to apply the taxonomy to retrospectively analyze the documentation of nurses in Advanced Practice Nurse (APN) training. Method: We developed the Hypertension Diagnosis and Management Error Taxonomy and applied it in a sample of adult patient encounters (N = 15,862) that were documented in a personal digital assistantbased clinical log by registered nurses in APN training. We used Standard Query Language queries to retrieve hypertension-related data from the central database. The data were summarized using descriptive statistics. Result: Blood pressure was documented in 77.5% (n = 12,297) of encounters; 21% had high blood pressure values. Missed diagnosis, incomplete diagnosis and misdiagnosis rates were 63.7%, 6.8% and 7.5% respectively. In terms of treatment, the omission rates were 17.9% for essential medications and 69.9% for essential patient teaching. Contraindicated anti-hypertensive medications were documented in 12% of encounters with co-occurring diagnoses of hypertension and asthma. CONCLUSION: The Hypertension Diagnosis and Management Error Taxonomy was useful for identifying errors based on documentation in a clinical log. The results provide an initial understanding of the nature of errors associated with hypertension diagnosis and management of nurses in APN training. The information gained from this study can contribute to educational interventions that promote APN competencies in identification and management of hypertension as well as overall patient safety and informatics competencies.
Adult ; Advanced Practice Nursing ; Asthma ; Blood Pressure ; Computers, Handheld ; Diagnostic Errors ; Education, Nursing ; Humans ; Hypertension ; Informatics ; Medical Errors ; Patient Safety ; Retrospective Studies

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Predictors of Hearing Protection Behavior Among Power Plant Workers.

Youngmi KIM ; Ihnsook JEONG ; Oi Saeng HONG

Asian Nursing Research.2010;4(1):10-18.

PURPOSE: This study aimed to identify factors affecting the use of the hearing protection devices (HPDs) among workers exposed to noise using the Pender Health Promotion Model. METHODS: The 222 subjects came from thermal power plants with similar noise levels, which are between 80 dB and 90 dB in South Korea. Data were collected with self-administered questionnaires designed to measure concepts from the Health Promotion Model. RESULTS: Mean percent times of using the HPDs at their most recent job site were 50.9%, and 20.3% had never the HPDs. The predictors of HPD use were social modeling (OR = 1.380), perceived benefits (OR = 1.150), and working at noisy worksites (OR = 4.925) when the outcome was based on the "non-use" versus "used at least once". However, the predictors of HPD use were social modeling (OR = 1.795) and perceived benefits (OR = 1.139) based on the "less than half-of-the-time-use" versus "more than half-of-the-time-use". CONCLUSION: Social modeling and perceived benefits of using the HPDs are important for workers to keep minimal or certain level of using the HPDs.
Ear Protective Devices ; Health Promotion ; Hearing ; Noise ; Porphyrins ; Power Plants ; Republic of Korea ; Workplace ; Surveys and Questionnaires

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Development and Validation of a Scale for the End of Life Caregiving Appraisal.

JuHee LEE ; Ji Soo YOO ; Tae Hee KIM ; Jeong In JEONG ; Soo Jung CHANG ; Dukyoo JUNG

Asian Nursing Research.2010;4(1):1-9.

PURPOSE: End-of-life caregiving experiences can be complex. Family members experience physical and mental suffering as they anticipate their impending loss. Healthcare providers should be able to provide good quality of end-of-life (EOL) care and support for primary EOL caregivers. Studies have highlighted the role of healthcare providers providing information in the EOL situation to caregivers of chronic disease patients. This has resulted in the development of the End-of-life Caregiving Experience Appraisal Scale (EOLCAS) presented in this paper. The purposes of this study were to develop a scale that can evaluate the experiences of EOL caregivers, and to test the reliability and validity of this scale. METHODS: The scale domains were derived from systematic review of 35 relevant studies. We then examined its content validity with nurse scholars and clinicians using content validity index. To examine construct validity, a total of 175 caregivers from tertiary hospital setting in Korea participated in this study from December 2007 to May 2008. For the construct validity, factor analysis was utilized. RESULTS: The scale was composed of 32 items with four subscales: two negative appraisals (physical suffering and burden), one positive appraisal (maturation), and one neutral appraisal (social support pursuit). In this sample, the Cronbach's alpha for the entire scale was .84 indicating adequate reliability. However, Cronbach's alpha of subscales was varied. CONCLUSION: Nurses and other healthcare professionals could use the EOLCAS to assess the experiences of EOL caregivers to understand their experience in the EOL and enhance their quality of life although psychometrics of EOLCAS shows limited findings.
Advance Care Planning ; Caregivers ; Chronic Disease ; Delivery of Health Care ; Health Personnel ; Humans ; Korea ; Psychometrics ; Quality of Life ; Reproducibility of Results ; Stress, Psychological ; Tertiary Care Centers

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Changes in and Factors Affecting Second-hand Smoke Exposure in Nonsmoking Korean Americans in California: A Panel Study.

Hyeongsu KIM ; C Richard HOFSTETTER ; Suzanne HUGHES ; Veronica L IRVIN ; Sunny KANG ; Melbourne F HOVELL

Asian Nursing Research.2014;8(4):313-318. doi:10.1016/j.anr.2014.07.004

PURPOSE: We evaluated changes in and factors affecting second-hand smoke (SHS) exposure in a panel study of nonsmokers. METHODS: This study was based on data from a larger study of tobacco use among a representative sample of adults of Korean descent residing in California. Participants included 846 males and 1,399 females who were nonsmokers at baseline (2005-2006) and at follow-up (2007-2009). Participants were selected by probability sampling and were interviewed by telephone. RESULTS: At baseline, 50.0% were exposed to any SHS, and at follow-up 2 years later, 60.4% were exposed to any SHS (p < .001). SHS exposure at baseline was associated with acculturation, employment, spousal smoking, and having a friend who smoked (p < .001). Employment, spousal smoking, and other family members smoking were associated with SHS at follow-up (p < .001). The odds ratio of SHS in the employed group declined from 2.01 at baseline to 1.53 at follow-up, that of the group having a smoking spouse increased from 1.88 to 2.36, and that of the group having other family members smoking increased from 1.20 to 1.69. CONCLUSIONS: We showed that SHS exposure increased among Korean American nonsmokers in California, and the most important variables explaining the change in SHS exposure involved smoking among others with whom the subject is associated. These findings could be used as objective evidence for developing public health policies to reduce SHS exposure.
Adolescent ; Adult ; Aged ; Asian Americans/*statistics & numerical data ; California/epidemiology ; Environmental Exposure/*statistics & numerical data ; Family ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Republic of Korea/ethnology ; Residence Characteristics ; Risk Factors ; Social Environment ; Tobacco Smoke Pollution/*statistics & numerical data ; Workplace ; Young Adult

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Development and Psychometric Evaluation of the Korean Version of the Cultural Competence Scale for Clinical Nurses.

Duck Hee CHAE ; Chung Yul LEE

Asian Nursing Research.2014;8(4):305-312. doi:10.1016/j.anr.2014.06.004

PURPOSE: To develop and psychometrically test the Korean version of the Cultural Competence Scale for Nurses (K-CCSN). METHODS: A multi-phase questionnaire development method was used to develop the scale from November 2012 to April 2013. The item pool was generated based on literature review, existing scales and in-depth interviews. The content validity was evaluated twice by an expert panel. The scale validation was conducted with a convenience sample of 456 general hospital nurses recruited from five general hospitals and a nursing college in the Seoul Metropolitan Area of South Korea. The construct-related and criterion-related validity and internal consistency reliability of the scale were tested. RESULTS: The 33-item K-CCSN comprised four subscalesdcultural awareness, cultural knowledge, cultural sensitivity and cultural skillsdexplaining 53.96% of the total variance. The criterion-related validity was supported by a known-group comparison. The reliability analysis showed an acceptable-to-high Cronbach's alpha in total and for subscales ranging from .879 to .932. CONCLUSION: This preliminary evaluation of psychometric scale properties demonstrated acceptable validity and reliability. The K-CCSN is able to provide scientific and empirical data regarding the cultural competence of clinical nurses. However, further studies are needed to test the applicability of the scale in different settings and contexts.
Adult ; *Cultural Competency ; Culturally Competent Care/*standards ; Humans ; *Nursing Staff, Hospital ; Psychometrics/*standards ; Questionnaires ; Reproducibility of Results ; Republic of Korea ; *Students, Nursing

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Factors Affecting Unused Remaining Volume of Intravenous Patient-controlled Analgesia in Patients Following Laparoscopic Gynecologic Surgery.

Kyoung Ok KIM ; Ju Won ROH ; Eun Jung SHIN ; Junyong IN ; Tae Hun SONG

Asian Nursing Research.2014;8(4):300-304. doi:10.1016/j.anr.2014.10.003

PURPOSE: This study was undertaken to evaluate the factors affecting the unused remaining volume of intravenous patient-controlled analgesia (IV PCA) in patients who had undergone laparoscopic gynecologic surgery. METHODS: We retrospectively collected patient records from pre-existing PCA log sheets from 98 patients. Surgical factors and IV PCA-related data including remaining volume, administration duration, early discontinuation (yes or no), and adverse reactions were recorded. Chi-square test, one-way analysis of variance, and multiple linear regression were applied for data analysis. RESULTS: The average age of the 98 patients was 40.0 +/- 8.24 years. The incidence of postoperative nausea and vomiting (PONV) and early discontinuation were not statistically significant among the different surgical groups (p = .540 and p = .338, respectively). Twenty-eight patients wanted discontinuation of IV PCA and the remaining volume was 33.6 +/- 7.8 mL (range 20-55 mL). The significant determinants of remaining volume were whether IV PCA was discontinued due to PONV and duration of surgery (p < .001). The surgical duration was inversely correlated with the remaining volume. CONCLUSION: Early discontinuation of IV PCA due to PONV is a major contributing factor to wastage of medicine. Prevention and treatment of PONV is needed to encourage patients to maintain PCA use for pain control.
Administration, Intravenous/*adverse effects/utilization ; Adult ; Analgesia, Patient-Controlled/*adverse effects/utilization ; Female ; Gynecologic Surgical Procedures/*adverse effects ; Humans ; Laparoscopy/*adverse effects ; Middle Aged ; Pain Management/*adverse effects/utilization ; Pain, Postoperative/drug therapy ; Postoperative Nausea and Vomiting/*chemically induced ; Retrospective Studies ; Young Adult

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Estimation of Effects of Factors Related to Preschooler Body Mass Index Using Quantile Regression Model.

Hee Soon KIM ; Yun Hee PARK ; Hyun Bong PARK ; Su Hee KIM

Asian Nursing Research.2014;8(4):293-299. doi:10.1016/j.anr.2014.07.005

PURPOSE: The purpose of this study was to investigate Korean preschoolers' obesity-related factors through an ecological approach and to identify Korean preschoolers' obesity-related factors and the different effects of ecological variables on body mass index and its quantiles through an ecological approach. METHODS: The study design was cross-sectional. Through convenience sampling, 241 cases were collected from three kindergartens and seven nurseries in the Seoul metropolitan area and Kyunggi Province in April 2013 using self-administered questionnaires from preschoolers' mothers and homeroom teachers. RESULTS: Results of ordinary least square regression analysis show that mother's sedentary behavior (p < .001), sedentary behavior parenting (p = .039), healthy eating parenting (p = .027), physical activity erelated social capital (p = .029) were significant factors of preschoolers' body mass index. While in the 5% body mass index distribution group, gender (p = .031), preference for physical activity (p = .015), mother's sedentary behavior parenting (p = .032), healthy eating parenting (p = .005), and teacher's sedentary behavior (p = .037) showed significant influences. In the 25% group, the effects of gender and preference for physical activity were no longer significant. In the 75% and 95% group, only mother's sedentary behavior showed a statistically significant influence (p < .001, p = .012 respectively). CONCLUSION: Efforts to lower the obesity rate of preschoolers should focus on their environment, especially on the sedentary behavior of mothers, as mothers are the main nurturers of this age group.
Adult ; *Body Mass Index ; Child, Preschool ; Cross-Sectional Studies ; Female ; *Health Behavior ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; *Models, Statistical ; Mothers ; Obesity/*epidemiology ; *Parenting ; Questionnaires ; Regression Analysis ; Republic of Korea/epidemiology ; Risk Factors ; Social Environment

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Effects of Autogenic Training on Stress Response and Heart Rate Variability in Nursing Students.

Seung Joo LIM ; Chunmi KIM

Asian Nursing Research.2014;8(4):286-292. doi:10.1016/j.anr.2014.06.003

PURPOSE: This study was undertaken to confirm the effects of autogenic training (AT) on stress response and heart rate variability in nursing school students experiencing stress related to clinical training. METHODS: The study was carried out from September 2012 to April 2013 in a quasi-experimental nonequivalent control group using a pretest-posttest design. The participants were 40 nursing students in their third year at either of two nursing colleges. All consented to participate. Nineteen nursing students at one college were assigned to the experimental group and underwent the 8-week AT program, and the other 21 were assigned to the control group and did not undergo any training. Stress response was assessed by questionnaire and HRV was measured three times, that is, before the program, at the end of the program, and 6 months after the end of the AT program. RESULTS: A significant time/group interaction was found for stress response (F = 4.68, p = .012), a subjective indicator. However, no significant interaction was found for the objective indicators of heart rate variability, normalized low frequency (F = 2.59, p = .090), normalized high frequency (F = 2.59, p = .090), or low frequency to high frequency ratio (F = 1.38, p = .257). CONCLUSION: The results suggest that AT provides an acceptable approach to stress reduction in nursing students.
*Adaptation, Psychological ; Autogenic Training/*methods ; Case-Control Studies ; Heart Rate/*physiology ; Humans ; Questionnaires ; Stress, Psychological/*rehabilitation ; Students, Nursing/*psychology ; Treatment Outcome

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Experiences Living with Fatigue in Iranian Veterans Chemically Injured by Sulfur Mustard Gas: A Phenomenological Study.

Soheil Najafi MEHRI ; Abbas EBADI ; Majideh HERAVI KARIMOOI ; Mahshid FOROUGHAN ; Hedayat SAHRAEI

Asian Nursing Research.2012;6(4):181-186.

PURPOSE: Fatigue affects the quality of life. Evidence shows that the phenomenon of fatigue is experienced differently depending on the type of disease and its consequences. The aim of the study was to explicate the meanings of the experience of living with fatigue in chemically injured veterans. METHODS: The hermeneutic phenomenology approach was used in this study, with an emphasis on Van Mennen's viewpoint and approach. According to Van Mennen, six overlapping dynamic activities are recommended to conduct a phenomenological study. During unstructured interviews, the participants were asked to describe their daily living experiences with fatigue. The participants were individuals who were chemically injured due to exposure to mustard gas. After examining every statement in the interview text, extractions of the meaning units, clustering, and themes were performed. RESULTS: The data explication was based on the third to sixth stages of Van Mennen's approach. The experience living with fatigue was classified into four essential themes: fatigue as a chronic condition, as an unstable and affected situation, as a physical condition of the entire individual, and as a mental condition of the entire individual. CONCLUSION: Due to unique social interactions and pathogenicity, victims of mustard gas experience fatigue differently than patients with other chronic diseases.
Chronic Disease ; Fatigue ; Humans ; Interpersonal Relations ; Mustard Gas ; Qualitative Research ; Quality of Life ; Sulfur ; Veterans

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