RESUMEN

BACKGROUND: Mild cognitive impairment (MCI) and Alzheimer's disease (AD) are screened to distinguish whether the cognitive decline in older adults is attributed to pathological causes rather than normal aging. OBJECTIVE: The purpose of this review was to analyze the diagnostic performance of the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) in screening for MCI and AD. METHODS: Electronic searches were performed on MEDLINE, EMBASE, CINAHL, and PsycArticles databases using the following keywords: dementia and ADAS-Cog. The Quality Assessment of Diagnostic Accuracy Studies-2 was used to check the risk of bias in the diagnostic studies. RESULTS: We reviewed 14 studies, including 3,875 patients who met the selection criteria. In 2,624 MCI patients from nine studies, the pooled sensitivity of ADAS-Cog was 0.80 (95% confidence interval [CI], 0.68-0.88), the pooled specificity was 0.84 (95% CI, 0.75-0.90), and the area under the curve of summary receiver-operating characteristic curves (SROC AUC) was 0.89 (SE = 0.03). In 2,517 AD patients from 10 studies, the pooled sensitivity and pooled specificity were 0.91 (95% CI, 0.86-0.95) and 0.93 (95% CI, 0.88-0.95), respectively, and the sROC AUC was 0.97 (SE = 0.01). Although sub-analyzed according to age and years of education, there was no significant difference in the predictive validity of the ADAS-Cog. CONCLUSION: The ADAS-Cog has high predictive validity as a screening tool in both MCI and AD and has better diagnostic performance in patients with AD. When early screening for AD is desired, ADAS-Cog is a first-stage screening tool that can be initially employed.

Asunto(s)

RESUMEN

BACKGROUND: Binge eating behavior is highly likely to progress to an eating disorder, with female students particularly at risk. OBJECTIVE: This study aimed to verify the effect of a binge eating behavior management program, based on rational emotive behavior therapy (REBT), on binge eating behavior and related cognitive and emotional factors among female college students. METHOD: The study, conducted from November 1 to December 2, 2016, involved a pretest-posttest design and nonequivalent control group. The sample included 24 and 22 first- to third-year students, from a college in South Korea, in the experimental and control groups, respectively. Data were collected using self-esteem, covert narcissism, perfectionism, body dissatisfaction, anxiety, depression, and binge eating scales and analyzed via frequency analysis, χ2 tests, t tests, and analysis of covariance. RESULTS: The results indicated that the REBT-based binge eating behavior management program exerted positive effects on participants' self-esteem, reducing covert narcissism, body dissatisfaction, anxiety, depression, and binge eating. However, there was no significant difference in perfectionism, although the experimental group's mean score decreased from pretest to posttest. CONCLUSIONS: Based on the results, the program was considered to be effective, and is expected to be useful in preventing the development of eating disorders among female college students by treating binge eating behavior and related cognitive and emotional factors. This intervention could ultimately contribute to the improvement of female college students' health and quality of life.

RESUMEN

AIMS AND OBJECTIVES: To examine the level of self-care behaviours among patients with diabetic foot ulcers and identify factors related to their self-care behaviours. BACKGROUND: This study focused on the self-care behaviours of patients diagnosed with diabetic foot ulcers, a complication of diabetes. DESIGN: A cross-sectional study design was adopted. METHODS: From July-August 2018, 131 outpatients and inpatients with diabetic foot ulcers were given a survey questionnaire regarding self-care behaviours and expected related factors at two Korean hospitals. In this study, self-care behaviours were diabetes management and diabetic foot care. Demographic, disease-related and laboratory characteristics were collected. The data were analysed in terms of descriptive statistics, a t test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. STROBE checklist was used as the guideline for this study. RESULTS: Moderate levels of self-care behaviours were found. The stepwise multiple regression analysis revealed that diabetes management was significantly related to perceived family support, experience of diabetic education, perceived stress, a problem-focused coping style, experience of hospitalisation and comorbidity. Furthermore, diabetic foot care was significantly associated with the experience of diabetic education, perceived family support, and serum level of erythrocyte sedimentation rate and haemoglobin A1C. CONCLUSIONS: Perceived family support was the main factor affecting diabetes management, and diabetic foot care was greatly affected by the experience of diabetic education. It is necessary to develop diabetes education programmes and nursing interventions to increase family support to improve the self-care behaviours of patients with diabetic foot ulcers. RELEVANCE TO CLINICAL PRACTICE: Self-care behaviours among patients with diabetic foot ulcers are important, as they affect healing of the wound and the quality of life. Further development of family-based diabetes education or programmes is recommended to promote the self-care behaviours of patients with diabetic foot ulcers.

Asunto(s)

RESUMEN

AIMS AND OBJECTIVES: To explain and predict family empowerment in families of children with special needs. BACKGROUND: Family empowerment of families of children with special needs can be explained using the Double ABCX model. Although constant stressors such as parenting stress and family demands can have negative effects on family empowerment, family resources and parenting efficacy can mediate the negative effect through effective coping strategies. DESIGN: A cross-sectional research design was employed. METHODS: A survey was conducted with 240 parents of children with special needs. Upon exclusion of four responses deemed inadequate to the statistics process, 236 responses were selected for the analysis. Based on the items used in the previous research, we used the scale of family demands 38, the scale of parenting stress 24, the scale of parenting efficacy 37, the scale of pattern of organisation 30, the scale of communication process 16 and the scale of family empowerment 32. RESULTS: In families of children with special needs, parenting stress had a negative effect on parenting efficacy and family resources, namely, pattern of organisation and communication process. Family needs had a positive effect on parenting efficacy. Parenting stress and family demands influenced family empowerment through parenting efficacy and family resources (pattern of organisation and communication process), while parenting efficacy contributed to family empowerment. CONCLUSIONS: This study empirically analysed the usefulness of the Double ABCX model in predicting family empowerment. Family resource factors (organisation pattern and communication process) and perception or judgement factors (such as parenting efficacy) were found to mediate the negative impact of various stressors experienced by families of children with special needs. RELEVANCE TO CLINICAL PRACTICE: The study findings suggest that clinical practice and management should focus on providing efficient intervention methods to lower stress in families of children with special needs. Reinforcing factors contributing to family empowerment, such as parenting efficacy, organisation pattern and communication process, will alleviate families' stress, resulting in a positive educational and developmental impact on children with special needs.

Asunto(s)

RESUMEN

OBJECTIVES: To introduce research that presents scientific evidence regarding the effects of mantra and mindfulness meditation techniques and yoga on decreasing blood pressure (BP) in patients who have hypertension. METHODS: A literature search was performed to identify all studies published between 1946 and 2014 from periodicals indexed in Ovid Medline, EMBASE, CINAHL, PsycINFO, KoreaMed, and NDSL by using the following keywords: "hypertension," "blood pressure," "psychotherapy," "relaxation therapy," "meditation," "yoga," and "mind-body therapy." The Cochrane's Risk of Bias was applied to assess the internal validity of the randomized controlled trial studies. Thirteen studies were analyzed in this meta-analysis by using Review Manager 5.3. RESULTS: Among 510 possible studies, 13 met the selection criteria. Seven examined meditation, and six examined yoga. The meta-analysis indicated that meditation and yoga appeared to decrease both systolic and diastolic BP, which were within similar baseline ranges, and the reduction was statistically significant; however, some results showed little difference. After an in-depth analysis of those results, BP range and patient age were revealed as the factors that affected the different results in some reports. In particular, meditation played a noticeable role in decreasing the BP of subjects older than 60 years of age, whereas yoga seemed to contribute to the decrease of subjects aged less than 60 years. CONCLUSIONS: While acknowledging the limitations of this research due to the differences in BP and the participants' ages, meditation and yoga are demonstrated to be effective alternatives to pharmacotherapy. Given that BP decreased with the use of meditation and yoga, and this effect varied in different age groups, scientifically measured outcomes indicate that these practices are safe alternatives in some cases.

Asunto(s)

RESUMEN

PURPOSE: The purpose of this study was to identify the effect of predictive factors related to family strength and develop a structural equation model that explains family strength among married working women. METHODS: A hypothesized model was developed based on literature reviews and predictors of family strength by Yoo. This constructed model was built of an eight pathway form. Two exogenous variables included in this model were ego-resilience and family support. Three endogenous variables included in this model were functional couple communication, family stress and family strength. Data were collected using a self-report questionnaire from 319 married working women who were 30~40 of age and lived in cities of Chungnam province in Korea. Data were analyzed with PASW/WIN 18.0 and AMOS 18.0 programs. RESULTS: Family support had a positive direct, indirect and total effect on family strength. Family stress had a negative direct, indirect and total effect on family strength. Functional couple communication had a positive direct and total effect on family strength. These predictive variables of family strength explained 61.8% of model. CONCLUSION: The results of the study show a structural equation model for family strength of married working women and that predicting factors for family strength are family support, family stress, and functional couple communication. To improve family strength of married working women, the results of this study suggest nursing access and mediative programs to improve family support and functional couple communication, and reduce family stress.

Asunto(s)

RESUMEN

OBJECTIVE: This study attempted to show evidence of exercise programs as intervention to decrease depressive symptoms and to improve quality of life and self-esteem in older people. DESIGN: Systematic review of randomized controlled trials. DATA SOURCES: Electronic databases of KoreaMed, Korea Scientific and Technological Intelligence Center, Korean Society of Nursing Science, Korean Academy of Psychiatric Mental Health Nursing, Ovid-Medline and Embase were searched up to May 25th, 2012 for relevant articles. REVIEW: We searched studies of randomized controlled trials involving exercise programs administered to participants aged 65 years or over. Of 461 publications identified, 18 met the inclusion criteria for the meta-analysis. Quality assessment of the studies utilized Cochrane's Risk of Bias. RESULTS: Exercise therapy in older people was effective, as evidenced by a decrease in depressive symptoms [standardized mean difference (SMD) -0.36; 95% confidence interval (CI) -0.64, -0.08], and improvements in quality of life (SMD 0.86; 95% CI 0.11, 1.62) and self-esteem (SMD 0.49; 95% CI 0.09, 0.88). The changes were significant statistically, with no heterogeneity. CONCLUSIONS: Exercise programs in older people are effective in improving depressive symptoms, quality of life and self-esteem. Development and efficient use of tailored exercise programs for elderly people is a prudent strategy.

Asunto(s)

RESUMEN

The purpose of this study was to review potential, physiological, hormonal and neuronal mechanisms that may mediate the sleep changes. This paper investigates the literatures regarding the activity of the hypothalamic-pituitary-adrenal (HPA) axis, one of the main neuroendocrine stress systems during sleep in order to identify relations between stress and sleep disorder and the treatment of stress-induced insomnia. Sleep and wakefulness are regulated by the aminergic, cholinergic brainstem and hypothalamic systems. Activation of the HPA and/or the sympathetic nervous systems results in wakefulness and these hormones including corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), cortisol or corticosterone, noradrenaline, and adrenaline, are associated with attention and arousal. Stress-related insomnia leads to a vicious circle by activating the HPA system. An awareness of the close interaction between sleep and stress systems is emerging and the hypothalamus is now recognized as a key center for sleep regulation, with hypothalamic neurontransmitter systems providing the framework for therapeutic advances. An updated understanding of these systems may allow researchers to elucidate neural mechanisms of sleep disorder and to develop effective intervention for sleep disorder.

RESUMEN

PURPOSE: Purpose of this study was to investigate the status of depression in academic high school students and path analysis model for exploring the mediating role of entrapment to depression in relation to academic stress and perceived social support. METHODS: Measurements were four reliable questionnaires measuring academic stress, social support, entrapment, and depression. Data were collected from students in 17 high schools in Seoul. RESULTS: Students (n=5,346) completing the questionnaires indicated depression & entrapment from academic stress. Depression was more prevalent in girls, those whose parents' household income was less than two million won, who did not live with father or mother or both due to divorce, separation, or death, and those who smoked or used alcohol. Entrapment was more prevalent in students similar to cases of depression and in seniors. According to the proposed path model, 48.6% of depression was explained by academic stress, social support, and entrapment. The indirect effect of entrapment as a mediator between academic stress and depression was verified and larger than the direct effect of academic stress on depression. CONCLUSION: Considering levels of depression and entrapment demonstrated by these students, better mental health programs with diverse strategies should be developed for their psychological well-being.

Asunto(s)

RESUMEN

This study described the levels of anger, anger expression, and suicidal ideation in Korean adolescents. Data from 18,752 adolescents were collected using a self-report questionnaire. Anger, anger expression, and suicidal ideation exhibited significant differences according to school level and gender. The group with higher anger and anger expression showed a higher average suicidal ideation score than that of the group with lower anger and anger expression, suggesting that school-based programs which alleviate anger may be needed to decrease suicidal ideation among Korean adolescents.

Asunto(s)

RESUMEN

PURPOSE: The purpose of this study was to identify the relationship among quality of life, family coherence, family hardiness, and family resources of the family care-giver caring for a cancer patient. METHOD: Data was collected by questionnaires from 137 families with a cancer patient at a General Hospital and Government Cancer Hospital. Data was analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. RESULTS: The score of quality of life showed a significant positive correlation with the score of the level of family sense of coherence, family hardiness, and family resources. The most powerful predictor of quality of life was sense of coherence and the variance was 30%. A combination of sense of coherence and family resources account for 34 % of the variance in quality of life of the family care-giver caring for a cancer patient. CONCLUSION: The results showed that family sense of coherence, hardiness, and family resources were significant influencing factors on the quality of life of the family care-giver caring for a cancer patient.

Asunto(s)

RESUMEN

PURPOSE: The purpose of this study was to identify the factors influencing symptom self management (SSM) in the patient with a chronic mental disorder. METHOD: Data was collected by questionnaires from 204 chronic mental disorders in an outpatient clinic in a General Hospital and Public Mental Health Centers in Seoul and Kyunggi Province. The data was analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. RESULTS: The score of SSM showed a significantly positive correlation with the score of the level of self efficacy (SE) (r=.33, p=.00), social support (SS) (r=.27, p=.00), self care agency (SCA) (r=.36, p=.00) and daily living ability (DLA) (r=.34, p=.00). The score of DLA showed a significantly positive correlation with the score of level of SE (r=.46, p=.00), SS (r=.51, p=.00), and SCA (r=.52, p=.00). The most powerful predictor of SSM was SCA (14%). A combination of SCA, DLA, and SS account for 20% of the variance in SSM. CONCLUSION: This study suggests that SCA, DLA, and SS are significant influencing factors on SSM in patients with chronic mental disorders.

Asunto(s)

RESUMEN

PURPOSE: This study was designed to examine the effects of an assertive training program on interpersonal relations, and psychiatric symptoms in patients with a mental disorder. METHOD: The study employed a quasi experimental design. The subjects included 44 patients with a mental disorder, 20 in the experimental group, and 24 in the control group. Data was collected using structured questionnaires over a 3 month period. RESULTS: There were greater significant increases in scores of interpersonal relations and content of communication in the experimental group than the control group. Also, there was a greater significant decrease in the score of psychiatric symptoms in the experimental group than the control group. CONCLUSION: Assertive training has an effect on increasing content of communication and decreasing psychiatric symptoms.

Asunto(s)

RESUMEN

BACKGROUND: Health promotion among those with chronic illness has been proposed as a strategy to contain health care cost and enhance quality of life (QOL), but little research has been done in Korea on QOL focused on health promotion of patients with chronic cardiovascular disease (CCVD). OBJECTIVES: This study was designed to estimate a structural model to represent the QOL of patients with CCVD, on the basis of a literature review and Pender's health promotion model (HPM). METHODS: Data were collected by questionnaire from 436 patients with CCVD in a university hospital in Seoul from August 2001 to July 2002. Data analysis included descriptive statistics and covariance structural analysis. RESULTS: As the fit of the hypothetical model to the data was only moderate, it was modified by excluding 10 paths and including free parameters. The modified model with path showed a good fit to the empirical data (chi = 508.12, p = .001, GFI = .95, AGFI = .93, NFI = .98, NNFI = .98, RMSEA = .04). Health-promoting behavior (HPB) and self-efficacy were found to have a significant direct effect on QOL. Health perception, self-esteem, perceived barriers to action, and preference were found to have indirect effects on QOL. The variables of this model explain 63% of the variance in QOL. DISCUSSION: The modified model is considered appropriate to explain and predict QOL of patients with CCVD. Therefore, it can effectively be used as a reference model for further studies and to suggest directions in nursing practice.

Asunto(s)

RESUMEN

PURPOSE: The purpose of this study was to identify the relationship among perceived stress, ways of coping, and health promoting behaviors in patients with chronic cardiovascular disease(CCVD). METHOD: Data was collected by questionnaires from 436 patients with CCVD in a General Hospital in Seoul. The data was analyzed using descriptive statistics, Pearson correlation coefficients, and stepwise multiple regression. RESULT: The health promoting behavior showed a significant positive correlation with self-efficacy and social support. Also, the health promoting behavior showed a significant negative correlation with perceived stress and symptoms of stress. The stepwise multiple regression analysis revealed that the most powerful predictor of health promoting behaviors was symptoms of stress. CONCLUSION: A combination of symptoms of stress, social support, self-efficacy, and perceived stress account for 41% of the variance in health promoting behaviors of patients with CCVD. Data from this study suggest that symptoms of stress, social support, ways of coping, and perceived stress are significant influencing factors on health promoting behaviors of patients with CCVD.

Asunto(s)

RESUMEN

PURPOSE: The purpose of this study was to identify the factors influencing file-up family stress in the family with a family member having a chronic mental illness. METHOD: Data was collected by questionnaires from 365 families with a member having a chronic mental illness, in an outpatient clinic of a General Hospital and Government Psychiatric Hospital in Seoul. The data was analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. RESULT: The score of file-up stress showed a significantly negative correlation with the score of level of hardiness (r=-.31, p=.00), family support (r=-.13, p=.00), family cohesion (r=-.25, p=.00), and sense of coherence (r=-.26, p=.00). The most powerful predictor of file-up stress was family hardiness and the variance was 11.1%. A combination of hardiness, family support, and sense of coherence account for 14.8 % of the variance in file-up stress of the family with a member having a chronic mental illness. CONCLUSION: This study suggests that family support, hardiness, cohesion, and sense of coherence are significant influencing factors on file-up stress in the family with a member having a chronic mental illness.

Asunto(s)

RESUMEN

PURPOSE: This study was designed to construct a structural model for symptom management of life of the patients with chronic fatigue. The hypothetical model was developed based on the literature review and Self-regulating Model. METHOD: Data were collected by questionnaires from 252 patients with chronic fatigue in the 8 community from December 2002 to April 2003 in Seoul. Data analysis was done with SAS for descriptive statistics and PC-LISREL Program for Covariance structural analysis. RESULT: The fit of the hypothetical model to the data was moderate, thus it was modified by excluding 4 path and including free parameters and 3 path to it. The modified model with path showed a good fitness to the empirical data(chi2=318.11, p=0.0, GFI=.98, AGFI=.98, NNFI=.95, RMSR=.03, RMSEA=.05). The symptoms of stress, self-efficacy, and present fatigue level were found to have significant direct effect on symptom management of the patients with chronic fatigue. The ways of coping, perceived stress, and fatigue symptom were found to have indirect effects on symptom management of the patients with chronic fatigue. CONCLUSION: The derived model is considered appropriate in explaining and predicting symptom management of the patients with chronic fatigue. Therefore, it can effectively be used as a reference model for further studies and suggested direction in nursing practice.

Asunto(s)

RESUMEN

PURPOSE: This study was designed to construct a structural model for explaining negative outcomes of anger in female adolescents. METHOD: Data was collected by questionnaires from 199 female adolescents ina female high school in Seoul. Data analysis was done with SAS for descriptive statistics and a PC-LISREL Program for Covariance structural analysis. RESULT: The fit of the hypothetical model to the data was moderate, thus it was modified by excluding 7 paths and adding free parameters to it. The modified model with the paths showed a good fit to the empirical data(chi2=5.62, p=.69, GFI=.99, AGFI=.97, NFI=.99, NNFI=1.01, RMSR=.02, RMSEA=.00). Trait anger, state anger, and psychosocial problems were found to have a significant direct effect on psychosomatic symptoms. State anger, psychosocial problems, and learning behaviors were found to have direct effects on depression of female adolescents. CONCLUSION: The derived model is considered appropriate for explaining and predicting negative outcomes of anger in female adolescents. Therefore, it can effectively be used as a reference model for further studies and is a suggested direction in nursing practice.

Asunto(s)

RESUMEN

PURPOSE: This study focused on analysing the workload of visiting nurses based on a health center. METHOD: A Prospective descriptive analysis of self-records for workload data from 115 visiting nurses during 4 weeks was done. In addition, a cross-sectional analysis of linked data to grasp the priority of visiting nursing services from 155 visiting nurses at the 25 health centers in Seoul. RESULT: Time allocation that was performed on all nursing workload of visiting nurses was identified as follows: First, the inside workload of the health center took up 60% of all visiting nurse activities. Second, providing direct nursing care(caseload) took up 25%. Third, outside nursing activities excluding the caseload provided in the health center took up 15% of all working time. Fourth, the core works to have a high priority among visiting nursing activities were family health assessment, planning and evaluation of a visiting nursing program, personal health assessment, and so forth. CONCLUSION: The workload of a visiting nurse suggests that the caseload of visiting nurses in a health center needs to be increased. Also, our results will contribute to baseline data used to establish a proper visiting nurses infrastructure based on the demand of visiting nursing services.

RESUMEN

PURPOSE: The purpose of this study was to identify the relationship among problem related drinking, perceived stress, ways of coping, and symptoms of stress of the college women. METHOD: Data was collected by questionnaires from 436 the College Women in S City. It was analyzed using descriptive statistics, Pearson correlation coefficients. RESULT: Three point forty -four of the subject had problem-related drinking, 92.43% were experienced alcohol drinking. The level of perceived stress(M=1.48) showed moderate, and symptoms of stress(M=1.34) showed below. The problem-related drinking showed significant positive correlation with perceived stress(r=.10, p=.03), emotion-oriented coping(r=.13, p=.00), and symptoms of stress(r=.23, p=.03). CONCLUSION: Data from this study suggest that perceived stress, ways of coping, and symptoms of stress are significant influencing factors on problem-related drinking in the Female University Students.