PURPOSE: Myocardial infarction can occur due to known risk factors and lifestyle choices. The difficulties that patients experience after discharge can lead to readmission and nonadherence to lifestyle change. The purpose of this study was to analyze the difficulties experienced by patients after hospitalization due to myocardial infarction and to identify the predictors of readmission and unchanged lifestyles. METHODS: The study used a mixed-methods design across 106 patients who had experienced a first episode of acute myocardial infarction. The data were collected from two patient interviews and the patients' medical records. A logistic regression was used to predict unchanged lifestyle and readmission. RESULTS: In the first interview, 74.5% of the patients reported receiving information prior to discharge. Six months after discharge, 80.2% mentioned that they had changed their lifestyles, but only 59.4% reported that their health had improved, and 75.5% continued to have concerns regarding their health. Patients described difficulties with regard to psychological problems, family dynamics, professional issues, problems with managing cardiovascular symptoms, and complications associated with hospital interventions. A follow-up assessment revealed that 12.3% of patients had been readmitted for cardiovascular disease. CONCLUSIONS: The analysis revealed significant predictors of readmission amongst patients with hypertension and three-vessel disease. Specifically, the number of people in the household, per capita income, and a lack of information/education provided at discharge as well as problems related to mental health after discharge predicted unchanged lifestyle. An educational program might be advantageous to clarify doubts and involve patients in their own disease management.
Activities of Daily Living ; Adult ; Attitude to Health/ethnology ; Female ; Follow-Up Studies ; Health Education/methods ; Healthy Lifestyle ; Humans ; Male ; Middle Aged ; Myocardial Infarction/ethnology/psychology/*therapy ; Patient Readmission/statistics & numerical data ; Portugal/ethnology ; Risk Factors ; Self Care

PURPOSE: The purpose of this study was to explore how traditional ritual practices are incorporated into the context of contemporary healthcare. METHODS: An ethnographic study was conducted, using observations and interviews with 27 first-time mothers and 3 nurses at a postpartum nursing center in Taipei, Taiwan. RESULTS: Nursing routines, policies and care provision at the center affected the way traditional ritual practices were conducted. New mothers in this study constructed their everyday activities at the center by incorporating and modifying the ritual practices inside and outside the postpartum nursing center setting. CONCLUSIONS: Social changes have an influence on traditional postpartum ritual practices so a postpartum nursing center becomes a choice for postpartum women. Thus, health care professionals should value their own functions and roles at the postpartum nursing center since the new mothers regard them as the primary support resource to help them recover from giving birth. Therefore, they need to re-examine their practices from the postpartum women's perspective to provide better support and sensitive care to postpartum women and their families.
Adult ; Ambulatory Care Facilities/trends ; Attitude of Health Personnel ; Education, Nonprofessional ; Female ; Humans ; Length of Stay ; Medicine, Chinese Traditional/trends ; Mothers/education/psychology ; Nurse's Role ; Nursing Process ; Obstetric Nursing/*trends ; Postnatal Care/*trends ; Postpartum Period/*ethnology ; Taiwan/ethnology

INTRODUCTIONThe 12-item Expectations Regarding Aging (ERA-12) instrument measures expectations that individuals have about how their health and cognitive function will be when they age. To date, primarily assessed among older adults in Western settings, expectations regarding ageing have been associated with physical activity and healthcare seeking behaviour. It has been suggested that it may be possible to develop interventions that promote positive expectations about ageing. Assessment of expectations regarding ageing among today's middle-aged population would allow for earlier interventions to help give them positive (but realistic) ageing expectations, and age successfully. We assess the reliability and validity of ERA-12 for middle-aged Singaporeans.

MATERIALS AND METHODSA questionnaire that included ERA-12 was administered to 1020 patients aged 41 to 62 years attending 2 SingHealth polyclinics in Singapore. Data from 981 respondents who completed the ERA-12 instrument were analysed. ERA-12's construct validity was determined using Exploratory Factor Analysis (EFA), and through its correlation with depressive symptoms, and self-rated health and education. Internal consistency reliability was assessed using Cronbach's alpha.

RESULTSEFA confirmed that the ERA-12 consisted of 3 factors (each with 4 items)--expectations regarding physical health, mental health and cognitive function, together explaining 64% of the variance in ERA-12 total score with high factor loadings (range, 0.6 to 0.8). The ERA-12 total score was positively correlated with self-rated health (r = 0.13) and education (r = 0.19), and negatively correlated with depressive symptoms (r = -0.25). Cronbach's alpha exceeded 0.7 for ERA-12 overall, and for each subscale.

CONCLUSIONERA-12 can be used to evaluate expectations regarding ageing not only among elderly populations in the West, but also among middle-aged Singaporeans.

Adult ; Aging ; psychology ; Attitude to Health ; ethnology ; Cognition ; Cross-Sectional Studies ; Cultural Competency ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Singapore ; Surveys and Questionnaires

AIMThe aim of this survey was to compare Chinese natives and foreign inhabitants in Chengdu, China, with respect to: (1) attitudes towards dental appearance, (2) subjective orthodontic treatment need, and (3) the main factors influencing orthodontic treatment need.

METHODOLOGYA total of 522 subjects, including 227 foreign inhabitants and 295 Chinese natives in Chengdu participated in the survey. A simple random sampling method was adopted and a face-to-face interview was conducted at some public sites using a questionnaire. Data was entered by two persons synchronously using Epidata 3.0, and SPSS 13.0 was used to analyze these data.

RESULTS89.0% of foreign inhabitants were satisfied with their teeth compared to only 46.8% of Chinese natives. Females were more dissatisfied with their teeth than males. Chinese natives put improving appearance as the top priority (55.9%) for seeking orthodontic treatment; however, in foreign inhabitants, the main reason for seeking treatment was to improve masticatory function (44.1%), followed by "to be pretty" (35.2%). The importance of well-aligned teeth and self-perception of psychosocial impact of malocclusion were the same two main factors influencing subjective orthodontic treatment need (P < 0.05) in foreign inhabitants and Chinese natives. Subjective orthodontic treatment need between the two target groups was significantly different (P < 0.05).

CONCLUSION(1) It was very common that Chinese natives were dissatisfied with their dental appearance, and their subjective orthodontic treatment needs were high. (2) There were some differences in orthodontic treatment motives between the two target groups. (3) There were differences in subjective orthodontic treatment needs between foreign inhabitants and Chinese natives. However, the prominent influential factors were almost the same. There may be benefit to understanding subjective orthodontic needs of different races.

Adolescent ; Adult ; Asian Continental Ancestry Group ; psychology ; Attitude to Health ; ethnology ; China ; Culture ; Emigrants and Immigrants ; psychology ; Esthetics, Dental ; Female ; Humans ; Interpersonal Relations ; Male ; Malocclusion ; psychology ; Mastication ; physiology ; Middle Aged ; Motivation ; Needs Assessment ; Orthodontics, Corrective ; psychology ; Patient Acceptance of Health Care ; Personal Satisfaction ; Self Concept ; Sex Factors ; Young Adult

PURPOSE: The purposes of this methodologic paper are to (1) describe theoretical background in conducting research across different cultures; (2) address measurement issues related to instrument administration; and (3) provide strategies to deal with measurement issues. METHODS: A thorough review of the literature was conducted. A theoretical background is provided, and examples of administering instrument in studies are described. RESULTS: When applying an instrument to different cultures, both equivalence and bias need to be established. Three levels of equivalence, i.e., construct equivalence, measurement unit equivalence, and full score comparability, need to be explained to maintain the same concept being measured. In this paper, sources of bias in construct, method, and item are discussed. Issues related to instrument administration in a cross-cultural study are described. CONCLUSION: Researchers need to acknowledge various group differences in concept and/or language that include a specific set of symbols and norms. There is a need to question the philosophical and conceptual appropriateness of an assessment measure that has been conceptualized and operationalized in a different culture. Additionally, testing different response formats such as narrowing response range can be considered to reduce bias.
Attitude of Health Personnel/ethnology ; Attitude to Health/ethnology ; Bias (Epidemiology) ; Communication Barriers ; *Cross-Cultural Comparison ; Data Collection/*methods/standards ; Humans ; Interviews as Topic/methods/standards ; Nursing Assessment ; Nursing Research/*methods/standards ; Philosophy, Nursing ; Psychometrics ; Reproducibility of Results ; Research Design/standards ; Researcher-Subject Relations/psychology ; Transcultural Nursing/*methods/standards ; Translating

PURPOSE: This cross-sectional survey was undertaken to examine the differences of BSE (breast-self examination) performance and health beliefs between Korean and Korean-American women and to identify which factors influence the BSE based on the HBM variables. METHOD: The study subjects were recruited from both Korea(189 women) and Cleveland in Ohio, USA(146 women). The HBM variables were measured using a reliable and valid Health Belief Model Scale. The subjects were also asked whether or not they did a BSE in the last year. RESULT: The Korean-American women who performed the BSE was statistically higher than that of Korean women. Regarding to the BSE-related health belief, the scores of benefits, confidence, and health motivation was significantly higher in Korean-American. After controlling for living places, age, education, and job, barriers and confidence variables significantly explained the BSE performance of Korean and Korean-American women. CONCLUSION: There was a differences in BSE-related health belief and performance between Korean and Korean-American women. Among health belief variables, barriers and confidence were core variables predicting the BSE performance of Korean and Korean-American women together.
Adult ; Aged ; Asian Americans/*psychology ; Attitude to Health/*ethnology ; Breast Neoplasms/*psychology ; Breast Self-Examination/*psychology ; Female ; Humans ; Korea/ethnology ; Middle Aged

PURPOSE: The purpose of this study was to explore the experiences of gastric cancer couples in Korea and to generate a substantive theory integrating the experiences of gastric cancer survivors and their spouses as a whole. The specific aims of this study were to explore major problems gastric cancer couples faced and how they resolved these problems, focusing on inter-relational dynamics within the couples and on similarities and differences between the couples. METHODS: This was a secondary analysis study using grounded theory techniques. The study used the data of 11 married couples which was collected from in-depth interviews from two primary studies. The unit of analysis was dyads of gastric cancer survivors and their spouses. RESULT: The basic social psychological process that emerged from the analysis was "taking charge of their health." Major categories involved in this process were identified as 1) adjusting to new diets, 2) reinforcing physical strength, 3) seeking information, 4) strengthening Ki, 5) lowering life-expectations, and 6) going their separate ways. These six categories represent major strategies in overcoming critical problems that occurred in day-to-day experiences. In terms of the process, the first five categories characterize the earlier stage of the process of "taking charge of their health," while "going their separate ways" indicates the later stage and also the beginning of their separate ways: "pursuing spiritual life" for the survivors, and "preparing for the future" for the spouses. CONCLUSIONS: The results of this study will help design family care for the people with gastric cancer by providing in-depth understanding and insight on the lives of gastric cancer couples.
*Adaptation, Psychological ; Adult ; Attitude to Death/ethnology ; Attitude to Health/*ethnology ; Female ; Grief ; Health Knowledge, Attitudes, Practice ; Humans ; Internal-External Control ; Interpersonal Relations ; Korea ; Male ; Marriage/psychology ; Middle Aged ; Models, Psychological ; Nursing Methodology Research ; Qualitative Research ; Questionnaires ; Self Care/psychology ; Social Support ; Spirituality ; Spouses/education/*ethnology ; Stomach Neoplasms/*ethnology ; Survivors/*psychology

PURPOSE: This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider. METHODS: In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist. RESULTS: The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on weekends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist. CONCLUSION: The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.
Adult ; Attitude to Health/*ethnology ; Chicago ; Child ; Child, Preschool ; Clinical Competence/standards ; Continuity of Patient Care/standards ; Cultural Diversity ; Dental Care for Children/economics/*utilization ; Emigration and Immigration ; Female ; Focus Groups ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility/standards ; Health Services Needs and Demand ; Hispanic Americans/education/*ethnology ; Humans ; Mexico/ethnology ; Mothers/education/*psychology ; Multivariate Analysis ; Nursing Methodology Research ; Poverty/economics/*ethnology ; Puerto Rico/ethnology ; Questionnaires

PURPOSE: Professional nursing ethics is a living, dynamic set of standards for nurses'professional moral behavior. Furthermore, in daily clinical nursing training, nursing students are constantly confronted with decisionmaking that is moral in nature. The aim of this study was to identify the perceived ethical attitudes in the clinical training process of senior nursing students using Q-methodology to offer basic strategies for nursing ethics education and thereby improve patients'care. METHODS: Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty-seven participants in a university rated 38 selected Q-statements on a scale of 1-9. The collected data were analyzed using pc-QUNAL software. RESULTS: Principal component analysis identified 3 types of ethical attitudes in nursing students in Korea. The categories were labeled Sacred-life, Science-realistic and Humane-life. Sacred-life individuals think that a life belongs to an absolute power (God), not a man, and a human life is a high and noble thing. Science-realistic individuals disagreed that allowing an induced abortion or embryo (human) duplication is unethical behavior that provokes a trend, which takes the value of a life lightly; most of them took a utilitarian position with respect to ethical decisions. Humane-life individuals exhibit a tendency toward human-centered thought with respect to ethical attitudes. CONCLUSION: This study will be of interest to educators of students of nursing and hospital nursing administrators. Also, the findings may provide the basis for the development of more appropriate strategies to improve nursing ethics education programs.
Adaptation, Psychological ; Analysis of Variance ; *Attitude of Health Personnel/ethnology ; Clinical Competence/standards ; Decision Making ; *Education, Nursing, Baccalaureate/ethics/standards ; *Ethics, Nursing/education ; Factor Analysis, Statistical ; Health Knowledge, Attitudes, Practice ; Humanism ; Humans ; Interprofessional Relations/ethics ; Korea ; Morals ; Needs Assessment ; Nursing Methodology Research/methods ; Patient Rights/ethics ; Philosophy, Nursing ; *Q-Sort ; Religion and Psychology ; Students, Nursing/*psychology ; Value of Life

PURPOSE: The purpose of this study is to identify the role adaptation process experienced by head nurses. METHODS: Data were collected from 10 head nurses with in-depth interviews about their actual experiences. All the interviews were recorded and transcribed. The collected data were analyzed by the grounded theory methodology of Strauss and Corbin. RESULTS: The core category was identified as "weighing and balancing," and the role adaptation process was divided into six stages by time sequence: inquiring, approaching to others, bringing people into their fold, working with conviction, avoiding conflicts, and settling. CONCLUSION: The results of this study yield useful information for top mangers of nursing to identify, by stages, the demands of the head nurses in their role adaptation process. The findings of this study contributes to developing programs that facilitates the head nurses' role adaptation.
*Adaptation, Psychological ; Adult ; *Attitude of Health Personnel/ethnology ; Avoidance Learning ; Conflict (Psychology) ; Female ; *Hospitals, General/organization & administration ; Humans ; Interprofessional Relations ; Korea ; Leadership ; Models, Nursing ; Models, Psychological ; Needs Assessment ; Nurse Administrators/education/organization & administration/*psychology ; *Nurse's Role ; Nursing Methodology Research ; Nursing Staff, Hospital/organization & administration/psychology ; Nursing, Supervisory/organization & administration ; Philosophy, Nursing ; Power (Psychology) ; Professional Competence/standards ; Qualitative Research ; Questionnaires ; Self Efficacy