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: Quality indicators of the National Endoscopy Quality Improvement Program (NEQIP) and outcome measures of endoscopy in the National Cancer Screening Program (NCSP) in Korea are not clear. We evaluated the quality indicators of the revised NEQIP and outcome measures of endoscopy at different types of healthcare facilities participating in the NCSP. MATERIALS AND METHODS: This study was conducted between March and August 2018 in primary, secondary, and tertiary healthcare facilities that perform endoscopy as a part of the NCSP. Representative endoscopists completed a questionnaire for quality indicators of the NEQIP and provided data on outcome measures for endoscopy. RESULTS: Quality indicators of the NEQIP were mostly acceptable. However, the quality indicators for annual volume of esophagogastroduodenoscopy (EGD) and colonoscopy, training for endoscopy quality improvement by endoscopy nursing staff, colonoscopy reports, documentation of pathologic lesions, quality of endoscopy reprocessing areas, and completion of endoscopy reprocessing education programs were suboptimal. For outcome measures of EGD, the number of photo-documentations and total procedure time were higher at tertiary healthcare facilities than at other facilities (p<0.001 and p=0.023, respectively). For the outcome measures of colonoscopy, colonoscopy completion rate and waiting times for colonoscopy were significantly higher at tertiary healthcare facilities than at other facilities (both p<0.001). CONCLUSION: Outcome measures of endoscopy should be included as quality indicators of NCSP. However, universal outcome measures for all types of healthcare facilities should be established because performance levels of some outcome measures differ among individual healthcare facility types.
Colonoscopy ; Delivery of Health Care ; Early Detection of Cancer ; Education ; Endoscopy ; Endoscopy, Digestive System ; Gastroscopy ; Humans ; Korea ; Mass Screening ; Nursing Staff ; Outcome Assessment (Health Care) ; Quality Improvement ; Tertiary Healthcare

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: 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 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: 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 examine the effects of simulation-based education on nursing knowledge, anxiety, and clinical performance ability in nursing students before their first clinical practice. METHODS: Third-year university students who had not yet entered their first clinical practice were recruited to participate in the study. Nineteen students formed the experimental group and participated in simulation-based education for 7 sessions. The 19 students in the control group were provided with clinical practice orientation in the form of traditional lectures. Outcome measures assessed nursing knowledge, clinical practice anxiety, and clinical performance ability. Data were collected before and immediately after the simulation-based education and after six weeks of clinical practice. RESULTS: Nursing knowledge and clinical anxiety were not statistically significant between the groups. However, there was a significant improvement in the clinical performance abilities of the experimental group. Among the subcategories, the ability to apply the nursing process and the ability to educate and cooperate were shown to maintain significant differences from the control group by the end of the six weeks of clinical practice. CONCLUSION: The simulation prior to nursing students’ first clinical practice could be useful to improve clinical performance ability. Nursing educators should consider building programs to reduce anxiety and improve performance ability through simulations.
Anxiety ; Clinical Competence ; Education ; Humans ; Lectures ; Nursing Process ; Nursing ; Outcome Assessment (Health Care) ; Students, Nursing

PURPOSE: This study evaluates the efficacy of a Self-Care Reinforcement Program (SCRP) based on the Selection Optimization Compensation (SOC) model, in socially vulnerable elderly women with metabolic syndrome. METHODS: This study adopts a pretest-posttest nonequivalent control group design. The participants were 64 socially vulnerable elderly Korean women with metabolic syndrome (experimental group: 31, control group: 33). Participants' body composition analysis, nutrient intake, risk factors of metabolic syndrome, depressive symptoms, and social network were measured. Data were analyzed with an independent t-test; statistical significance levels were set at p<.05. The SCRP, including metabolic syndrome education, nutritional education, exercise, and social network, was performed three times a week for 8 weeks. RESULTS: There were statistically significant differences between the experimental and control groups in terms of systolic blood pressure, diastolic pressure, fasting blood sugar, triglycerides, sodium intake, depressive symptoms, and social networks. CONCLUSION: The SCRP is effective and can be recommended as a community health nursing intervention for socially vulnerable elderly women with metabolic syndrome.
Aged ; Blood Glucose ; Blood Pressure ; Body Composition ; Community Health Nursing ; Compensation and Redress ; Depression ; Depressive Disorder ; Education ; Fasting ; Female ; Humans ; Korea ; Nutrition Assessment ; Risk Factors ; Self Care ; Social Networking ; Sodium ; Triglycerides ; Vulnerable Populations

PURPOSE: The goal was to use electronic health records to identify factors and outcomes associated with falls among patients admitted to hematology units. METHODS: This retrospective case-control study included data from a tertiary university hospital. Analysis was done of records from 117 patients with a history of falls and 201 patients with no history of falls who were admitted to the hematology unit from January 1, 2013 to December 31, 2014. Risk factors were analyzed using hierarchical logistic regression; patient outcomes were analyzed using multiple logistic regression, Cox proportional hazards regression, and multiple linear regression. RESULTS: Clinical factors such as self-care nursing (OR=4.47, CI=1.64~12.11), leukopenia (OR=6.03; CI=2.51~14.50), and hypoalbuminemia (OR=2.79, CI=1.31~5.96); treatment factors such as use of narcotics (OR=2.06, CI=1.01~4.19), antipsychotics (OR=3.05, CI=1.20~7.75), and steroids (OR=4.51, CI=1.92~10.58); and patient factors such as low education (OR=3.16, CI=1.44~6.94) were significant risk factors. Falls were also associated with increased length of hospital stay to 21.58 days (p < .001), and healthcare costs of 17,052,784 Won (p < .001). CONCLUSION: These findings can be a resource for fall prevention education and to help develop fall risk assessment tools for adults admitted to hematology units.
Accidental Falls ; Adult ; Antipsychotic Agents ; Case-Control Studies ; Education ; Electronic Health Records ; Health Care Costs ; Hematology ; Humans ; Hypoalbuminemia ; Length of Stay ; Leukopenia ; Linear Models ; Logistic Models ; Narcotics ; Nursing ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Self Care ; Steroids