Comparative study between depression in Korean elderly with mild cognitive impairment and normal cognitive function.

This cross-sectional comparative study compares differences in depression in the elderly with mild cognitive impairment and those with normal cognitive function in a community. Study subjects were drawn from elderly people visiting one particular public health center in Seoul, South Korea and included 81 people with mild cognitive impairment and 81 with normal cognitive function who were matched based on age, sex, education, and daily living activities. Study variables, including cognitive function, activities of daily living, instrumental activities of daily living, and depression, were measured with standardized instruments. Collected data were statistically analyzed with Student's paired t-test and χ(2) test. The results showed no significant differences between these groups in terms of depression. Therefore, in community practice settings, nurses should understand that depression is not a manifestation of cognitive impairment and should develop effective nursing strategies to assess depression while considering other factors including age, sex, education, and daily living activities.

Depression among community-dwelling older adults in Korea: a prediction model of depression.

The purpose of this study was to test a hypothesized model for use in explaining the factors that influence depression among older adults dwelling in Ansan City in Korea. A cross-sectional community-based survey was done using face-to-face private interviews. A hypothesized model was tested using path analysis. Of the 32 hypothesized paths in the structural model, 13 were significant. Gender (beta = -.14, P = .24), income (beta = -.21, P < .00), education (beta = -.14, P = .10), activities of daily living (ADL; beta = -.29, P < .00), and somatic symptoms (beta = .29, P < .00) accounted for the incidence of depression (beta = .06, P < .00), representing 28% of the variance in depression. The fit of the model to the data was supported.

Validity and reliability of Sleep Quality Scale in subjects with obstructive sleep apnea syndrome.

OBJECTIVE: The present study aimed to evaluate the validity and reliability of Sleep Quality Scale (SQS) in subjects with obstructive sleep apnea syndrome (OSAS). METHODS: The known group technique was used for construct validity. The study sample was composed of 40 persons with OSAS and 37 normal subjects. OSAS was defined as an apnea-hypopnea index (AHI) of > or =5 plus an Epworth Sleepiness Scale (ESS) score of >10. Control group was composed of subjects who had no history of depression and sleep problems as identified by self-report and polysomnography. A Cronbach's alpha coefficient was used for internal consistency. RESULTS: The total SQS score of the OSAS subjects was significantly higher than that of the normal subjects. The SQS score homogeneity was high with a Cronbach's alpha coefficient of 0.90 in all subjects, 0.87 in the OSAS subjects, and 0.70 in the normal subjects. CONCLUSION: SQS was confirmed to be an instrument with validity and high reliability for measuring sleep quality in OSAS subjects.

[A study on the depression, somatic symptom, activities of daily living for the elderly women in an urban area].

PURPOSE: The purpose of this study was to investigate the relationships among depression, somatic symptoms, and activities of daily living of elderly women in urban areas. METHOD: After obtaining participant's consent forms, a one-time, face-to-face, and private interview was conducted with each participant from Sep, 2006 to Jan, 2007 by trained graduate-level students. The questionnaire consisted of K-GDS, PHQ-15, Barthel Index, and Instrumental Activity of Daily Living. The collected data was analyzed with the SPSS/PC 12.0 program, which was used for frequency, percentage, mean, standard deviation, Pearson correlation coefficients, and multiple regression. RESULTS: The major findings of this study were as follows 1) 34.1% of participants belonged to the depression group. 2) There were significant relationships between depression and monthly income, somatic symptoms, ADL, IADL, and number of chronic disease. 3) Significant factors influencing depression were somatic symptoms, ADL, and monthly income. CONCLUSION: The results of this study give useful information for designing interventions and program development for appropriate depression management and care for elderly women.

Critical thinking ability of associate, baccalaureate and RN-BSN senior students in Korea.

The purpose of this study was to compare the critical thinking ability of students enrolled in associate, baccalaureate, and Registered Nurse-Bachelor of Science in Nursing (RN-to-BSN) programs in Korea. The participants were 301 undergraduate nursing students. The instrument used for this study was the Watson & Glaser Critical Thinking Appraisal (WGCTA). The data were analyzed using descriptive statistics, t-test, and analysis of variance with Scheffe's multiple comparison. The average critical thinking ability score was 41.59. Bachelor of Science in Nursing (BSN) students scored significantly higher on critical thinking than the other 2 groups. Students < or = 22 years of age scored higher than the other age groups on critical thinking. This study provides preliminary evidence that the length and content of an educational program is as important as its focus on enabling students to develop their critical thinking abilities. This finding suggests a need to infuse critical thinking activities early in existing secondary school curricula as a way of encouraging students to develop their thinking abilities earlier.

Short-term incidence rate of hypertension in Korea middle-aged adults.

OBJECTIVES: Despite recent increasing trends in cardiovascular morbidities and mortality in Asia, studies on short-term changes in cardiovascular risks remain limited. This study estimated 2-year incidence rates of hypertension in middle-aged Korean adults aged 40-69 years, and investigated the impact of baseline levels of blood pressure, body mass index, and other conventional risk factors on the progression to hypertension. METHODS: Blood pressures of participants were evaluated twice with a 2-year interval, measured by mercury sphygmomanometer according to the standardized protocol. Hypertension was defined when either the systolic and diastolic blood pressures were greater than 140 and 90 mmHg, respectively, or when a participant was treated with antihypertensive medications. RESULTS: The crude 2-year incidence (calculated per 100) of hypertension was 12.2; 13.0 for men and 11.6 for women. For those who had higher blood pressure at baseline examination, incidence rates were two-fold or five-fold higher compared with those with optimal blood pressure. Older age and overweight were also major predictors for hypertension, even in Koreans with a low serum cholesterol level. CONCLUSION: This is the first investigation of short-term incidence rates of hypertension in Asia. The results are consistent with the recently reported increasing trends in cardiovascular mortality and morbidity in Asia.

[Prevalence and associated factors of excessive daytime sleepiness in adults].

PURPOSE: The purpose of the present study was to identify prevalence of excessive daytime sleepiness(EDS) and its associations with sleep habits, sleep problems, depression, subjective health status and obesity in community dwelling adults. METHOD: Data was collected from adults aged 20-59 years by random sampling. Subjects completed a questionnaire which was composed of the Epworth Sleepiness Scale, Center for Epidemiologic Studies Depression Scale, and questions that included items about sleep habits, sleep problems, subjective health status and sociodemographic characteristics. Height and weight were measured for calculation of body mass index. The statistical analyses was based on 3,302 adults (51.5% males and 48.5% females). Descriptive statistics, univariate logistic regression and multiple logistic regression were used. RESULT: The prevalence of EDS was 17.1%. Multiple logistic regression showed that the associated factors of EDS were depression, obesity, dissatisfaction with sleep time, irregular sleep, and habitual snoring. Depression was the most significant associated factor(adjusted odds ratio for severe depression=2.27, 95% Confidence Interval=1.73-2.96). CONCLUSION: EDS is a common symptom in adults. Our finding suggested that persons with a complaint of EDS should be completely assessed for depression and obesity as well as sleep problems.

Development of the sleep quality scale.

Sleep quality affects health and the overall quality of life. As the factors that influence sleep quality and their relative importance vary among individuals, a self-report method is essential. Although various questionnaires have been used to assess sleep quality, few all-inclusive assessment scales have been developed. Therefore, the purpose of this study was to develop an instrument for measuring sleep quality and to study its validity and reliability. A Sleep Quality Scale (SQS) was developed using item analysis and factor analysis on items with content validity. SQS, composed of 28 items and six factors, accounted for 62.6% of the total variance. The difference of SQS score between insomniacs and normal subjects confirmed the construct validity (t = -13.8, P = 0.000). Concurrent validity was identified by the significant correlation of SQS with the Pittsburgh Sleep Quality Index (r = 0.72, P = 0.000). The Cronbach's alpha coefficient was 0.92 for internal consistency and the correlation coefficient was 0.81 for test-retest reliability at a 2-week interval. The developed SQS was therefore confirmed to be a valid and reliable instrument for the comprehensive assessment of sleep quality.

Critical thinking dispositions and skills of senior nursing students in associate, baccalaureate, and RN-to-BSN programs.

This study investigated the critical thinking dispositions and skills of senior nursing students. Study participants were students enrolled in associate (n = 137), baccalaureate (n = 102), and RN-to-BSN (n = 66) programs accredited by the Korean Ministry of Education. The California Critical Thinking Disposition Inventory (CCTDI) and California Critical Thinking Skills Test (CCTST) were used. A comparison of the CCTDI scores revealed a statistically significant difference between the students enrolled in different programs (F = 4.159, p = 0.017), as did a comparison of the CCTST scores (F = 24.205, p < 0.0001). Within the total sample (n = 305), the relationship between CCTDI and CCTST scores was significant (r = 0.305, p = 0.000). Developments in medical technology, the growing number of older adults and patients with chronic illnesses, and the demand for high-quality nursing care have led to various, increasingly complex, professional, legal, and educational issues within the nursing workplace. Therefore, nurses need creativity and critical thinking skills to make the decisions required of them in their nursing practice. In line with this, when conducting a survey of the effectiveness of nursing education, the necessity of critical thinking skills cannot be overlooked. In fact, the National League for Nursing Accrediting Commission (NLNAC) (1999) and American Association of Colleges of Nursing (AACN) (1998) require the concept of critical thinking be included as one of the core elements of curricula and that it be measured as an outcome when evaluating nursing education. In 1998, during the evaluation of colleges of nursing conducted by the South Korean Council for University Education, several universities presented the fostering of critical thinking as one of the terminal learning goals of nursing education based on the idea that critical thinking is important not only in the nursing workplace, but also in nursing education. To evaluate the effectiveness of Korea's current nursing education curriculum, focus was placed on current students in South Korea's three systems of nursing education. Each curriculum's effectiveness can be evaluated by indexing critical thinking dispositions and skills. This article intends to offer insight into the first steps necessary in reorganizing nursing education by comparing these evaluations of each of the three systems. To this end, we conducted a comparative study of the critical thinking dispositions and skills of students in 3-year associate degree (ADN), 4-year baccalaureate (BSN), and 5-year RN-to-BSN programs. The RN-to-BSN program requires students to finish a separate 2-year program after the initial 3-year ADN program.

[Effects of a drug misuse and abuse prevention program on knowledge, attitude, and preventive behaviors related to drug misuse and abuse, and depression in low-income elderly women].

PURPOSE: This study was conducted to determine the effects of a drug misuse and abuse prevention program on knowledge, attitude, and preventive behaviors related to drug misuse and abuse, and depression in low-income elderly women in the urban area. METHOD: The design of this study was a nonequivalent control group pretest-posttest design. The subjects consisted of 26 in the experimental group and 23 in the control group. The program was performed for about 1 hour, once a week for 5 weeks. Data was analyzed by the SAS(ver.8.02) computer program, and it included descriptive statistics, Fisher's exact test, Mann-Whitney U test, Wilcoxon signed ranks test, and ANCOVA. RESULT: There were statistically significant differences in knowledge, attitude, and preventive behaviors related to drug misuse and abuse, and depression between the experimental group and the control group. CONCLUSION: This study showed that this prevention program of drug misuse and abuse is appropriate for low-income elderly women, Therefore this program is recommended as a nursing intervention strategy for the elderly.

Prevalence of insomnia and its relationship to menopausal status in middle-aged Korean women.

Although the prevalence of insomnia and the association of insomnia with menopause have been well reported, not much work has been conducted in population-based research on insomnia and menopause in Korea. The purpose of the present report was to determine overall and different prevalence of insomnia by menopausal status, and the relationship between insomnia and menopause in a population-based sample of middle-aged Korean women. A total of 96.1% of 2497 randomly selected middle-aged Korean women participated. Insomnia was defined as occurring three times a week or more in the previous month. Subjects were categorized into three groups: premenopause, perimenopause, and postmenopause. The overall prevalence of insomnia in middle-aged Korean women was 14.3%. The most common symptom of insomnia was difficulty maintaining sleep (9.7%), followed by difficulty initiating sleep (7.9%), and early morning awakening (7.5%). Multiple logistic regression analysis revealed that menopause was independently associated with insomnia after adjusting for confounding factors such as age, income, and depression. Perimenopause was significantly associated with a dramatic increase in the risk of insomnia, but there was no significant association for postmenopause. The major finding is that insomnia is significantly associated with the menopausal transition. The prevalence of insomnia increases significantly by the transition from premenopause to perimenopause, but not to postmenopause. A further prospective study is needed to investigate the influence of menopause on insomnia.

Prevalence of restless legs syndrome and associated factors in the Korean adult population: the Korean Health and Genome Study.

The present study was purposed to identify the prevalence of restless legs syndrome (RLS) and its associated factors in the Korean adult population. Among a total of 9939 participants derived from the Korean Health and Genome Study, 12.1% of subjects (men, 8.5%; women, 15.4%) suffered from RLS. Factors independently related with RLS were older age and frequent fatigue in both men and women.

Relationship between trait-anger and sleep disturbances in middle-aged men and women.

OBJECTIVE: The present study was performed to determine whether high levels of trait-anger (T-Anger) are independently associated with sleep disturbances and quantitative and qualitative measurements of sleep in middle-aged adults. METHODS: Enrolled in the study were 2404 men and 2291 women derived from the Korean Health and Genome Study (KHGS), which is an ongoing population-based prospective study. The Spielberger Trait Anger Scale was used to measure T-Anger. RESULTS: Sleep disturbances, including difficulty in initiating and maintaining sleep (DIS and DMS, respectively) and early morning awakening (EMA), significantly increased with increasing levels of T-Anger (P<.05 by test for trend). Nonrestorative feelings in the morning and excessive daytime sleepiness were also strongly associated with higher levels of T-Anger. After adjusting for other potential risk factors, the high and/or moderate T-Anger showed 40% to 70% increases in the odds for sleep disturbances. CONCLUSION: The present study provides evidence that high levels of T-Anger are independently associated with symptoms of disturbed sleep in middle-aged adult population.

[A study on health concern, self-rated health, health status, and health promotion behavior of elderly women in urban area].

PURPOSE: This study was conducted to examine the relationship among health concern, self-rated health, health status, and health promotion behavior of elderly women in urban areas. METHOD: The subjects of this study consisted of 271 Korean elderly women over 65 years. The data was collected through personal interviews using questionnaires from March to May of 2003. The data was analyzed by the SPSS (ver.10.0) computer program, and it included descriptive statistics, t-test, one way ANOVA, and the pearson correlation coefficient. RESULT: There was a significant positive correlation between self-rated health and health status. Health promotion behavior related to all health concerns, self-rated health, and health status. CONCLUSION: This study showed that strategies of elderly care intervention to put in practice health promoting behavior is needed to improve quality of life in elderly women. In addition, health education appropriate for health maintenance and health promotion must be done for daily living to maintain well-being for the rest of their lives.

[A study on depression, stress, and social support in adult women].

PURPOSE: This study was conducted to examine the relationship among Depression, Stress, and Social support in Korean Adult Women. METHOD: The subjects of this study consisted of 2,503 Korean Adult Women from 20 to 64 years. The data was collected through personal interviews from March to May of 2001 using questionnaires. The data was analyzed by the SPSS(ver.10.0) computer program, and it included descriptive statistics, t-test, one way ANOVA, the pearson correlation coefficient, and Stepwise multiple regression. RESULT: The level of depression, stress, and social support were 16.22 for depression, 27.43 for stress, and 87.48 for social support. There was a significant difference in social support according to residence area, age, level of education, marital status, type of family, religion, income, and job. There was a significant positive correlation between stress and depression, a significant negative correlation between stress and social support, and social support and depression. Stress and social support were significant predictors (29.6%) of depression. CONCLUSION: This study showed that thorough nursing assessment of variables related to social support is needed for development of nursing intervention strategies. Further studies need to be conducted for group comparisons according to the life cycle of Korean women.

[Influencing factors on quality of life of middle-aged women living in rural area].

PURPOSE: This study was to investigate the factors influencing quality of life of middle-aged women in rural area, to provide the basic data for health promoting intervention in order to improve quality of life. METHOD: The subjects were 469 middle-aged women by 40-64 from 7 rural areas in Gyeonggi-do, Jeolla-do and Gyeongsang-do. Data collection was conducted by using 6 questionnaires. RESULT: There were significant differences in the quality of life by age, educational level, marital status, religion, family pattern, and economic level. There were positive relationships between quality of life and health perception, social support, and negative relationships between quality of life and depression and stress. Stepwise Multiple Regression Analysis for quality of life revealed that the most powerful predictor was depression. Depression, health perception, social support, stress and economic level explained 51.5% of the variance. CONCLUSION: Depression, health perception, social support, stress and economic level were related with quality of life of middle-aged women in rural area. Therefore, it is necessary to develop the nursing intervention these psycho-social aspects to increase the quality of life.

[The lived experience of a student transferring into the nursing program].

PURPOSE: This study attempted to describe the essential structure of the lived experience of a students transferring into the nursing program. METHOD: The data was collected from 14 graduates and undergraduates who enrolled in nursing school as transfer students. The analysis of the data was made by phenominological analytic method suggested by Colaizzi(1978). RESULT: In this study, 6 essential themes were extracted: 'Constant anxiety of being a stranger', 'Feeling of constant burden', 'Thankfulness of a clinical practice group', 'Being supportive with each other between transferring students', 'Pleasure of studying a desired major', 'Feeling the responsibility of own choice of a new major'. CONCLUSION: With rapidly increasing number of transferring students, the significance of this study in the field of nursing is that by understanding the transferring experience of nursing students, it describes the need of systematic and emotional support for transferring students.

[The development of certificates criteria and curriculum in home healthcare nurse specialist program].

PURPOSE: To make a contribution to raising the quality of nursing and home healthcare services through reviewing the present state of home healthcare nurse specialist training institutions and education programs and creating concrete measures to establish high-quality education courses. METHOD: International comparative study of accreditation criteria and curriculum in home healthcare nurse specialist program. RESULT: The Authorization Standards of home healthcare nurse training institutions consists of 8 items, 23 evaluation criteria and 72 evaluation indexes. Proposal to develop a specialist training program: Curriculum. Modify and complement a present homecare nurse education program. Curriculum 1. Designate two forms of certification. The first certification has been granted the authority to serve as a manager and open a home healthcare agency to nurses having masters degrees and clinical experience for five years. The second certification is allowed to perform general home healthcare after having completed a short term training course. Currculum 2. To meet increasing demands, granting a certification to perform home healthcare to registered nurses having clinical experience of more than three years. CONCLUSION: These results can be utilized in the home healthcare educational program for raising the quality of nurses and home healthcare services.