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1.
Cochrane Database Syst Rev ; 2: CD004871, 2024 02 28.
Artículo en Inglés | MEDLINE | ID: mdl-38415786

RESUMEN

BACKGROUND: Massage is widely used for neck pain, but its effectiveness remains unclear. OBJECTIVES: To assess the benefits and harms of massage compared to placebo or sham, no treatment or exercise as an adjuvant to the same co-intervention for acute to chronic persisting neck pain in adults with or without radiculopathy, including whiplash-associated disorders and cervicogenic headache. SEARCH METHODS: We searched multiple databases (CENTRAL, MEDLINE, EMBASE, CINAHL, Index to Chiropractic Literature, trial registries) to 1 October 2023. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing any type of massage with sham or placebo, no treatment or wait-list, or massage as an adjuvant treatment, in adults with acute, subacute or chronic neck pain. DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. We transformed outcomes to standardise the direction of the effect (a smaller score is better). We used a partially contextualised approach relative to identified thresholds to report the effect size as slight-small, moderate or large-substantive. MAIN RESULTS: We included 33 studies (1994 participants analysed). Selection (82%) and detection bias (94%) were common; multiple trials had unclear allocation concealment, utilised a placebo that may not be credible and did not test whether blinding to the placebo was effective. Massage was compared with placebo (n = 10) or no treatment (n = 8), or assessed as an adjuvant to the same co-treatment (n = 15). The trials studied adults aged 18 to 70 years, 70% female, with mean pain severity of 51.8 (standard deviation (SD) 14.1) on a visual analogue scale (0 to 100). Neck pain was subacute-chronic and classified as non-specific neck pain (85%, including n = 1 whiplash), radiculopathy (6%) or cervicogenic headache (9%). Trials were conducted in outpatient settings in Asia (n = 11), America (n = 5), Africa (n = 1), Europe (n = 12) and the Middle East (n = 4). Trials received research funding (15%) from research institutes. We report the main results for the comparison of massage versus placebo. Low-certainty evidence indicates that massage probably results in little to no difference in pain, function-disability and health-related quality of life when compared against a placebo for subacute-chronic neck pain at up to 12 weeks follow-up. It may slightly improve participant-reported treatment success. Subgroup analysis by dose showed a clinically important difference favouring a high dose (≥ 8 sessions over four weeks for ≥ 30 minutes duration). There is very low-certainty evidence for total adverse events. Data on patient satisfaction and serious adverse events were not available. Pain was a mean of 20.55 points with placebo and improved by 3.43 points with massage (95% confidence interval (CI) 8.16 better to 1.29 worse) on a 0 to 100 scale, where a lower score indicates less pain (8 studies, 403 participants; I2 = 39%). We downgraded the evidence to low-certainty due to indirectness; most trials in the placebo comparison used suboptimal massage doses (only single sessions). Selection, performance and detection bias were evident as multiple trials had unclear allocation concealment, utilised a placebo that may not be credible and did not test whether blinding was effective, respectively. Function-disability was a mean of 30.90 points with placebo and improved by 9.69 points with massage (95% CI 17.57 better to 1.81 better) on the Neck Disability Index 0 to 100, where a lower score indicates better function (2 studies, 68 participants; I2 = 0%). We downgraded the evidence to low-certainty due to imprecision (the wide CI represents slight to moderate benefit that does not rule in or rule out a clinically important change) and risk of selection, performance and detection biases. Participant-reported treatment success was a mean of 3.1 points with placebo and improved by 0.80 points with massage (95% CI 1.39 better to 0.21 better) on a Global Improvement 1 to 7 scale, where a lower score indicates very much improved (1 study, 54 participants). We downgraded the evidence to low-certainty due to imprecision (single study with a wide CI that does not rule in or rule out a clinically important change) and risk of performance as well as detection bias. Health-related quality of life was a mean of 43.2 points with placebo and improved by 5.30 points with massage (95% CI 8.24 better to 2.36 better) on the SF-12 (physical) 0 to 100 scale, where 0 indicates the lowest level of health (1 study, 54 participants). We downgraded the evidence once for imprecision (a single small study) and risk of performance and detection bias. We are uncertain whether massage results in increased total adverse events, such as treatment soreness, sweating or low blood pressure (RR 0.99, 95% CI 0.08 to 11.55; 2 studies, 175 participants; I2 = 77%). We downgraded the evidence to very low-certainty due to unexplained inconsistency, risk of performance and detection bias, and imprecision (the CI was extremely wide and the total number of events was very small, i.e < 200 events). AUTHORS' CONCLUSIONS: The contribution of massage to the management of neck pain remains uncertain given the predominance of low-certainty evidence in this field. For subacute and chronic neck pain (closest to 12 weeks follow-up), massage may result in a little or no difference in improving pain, function-disability, health-related quality of life and participant-reported treatment success when compared to a placebo. Inadequate reporting on adverse events precluded analysis. Focused planning for larger, adequately dosed, well-designed trials is needed.


Asunto(s)
Cefalea Postraumática , Radiculopatía , Adulto , Femenino , Humanos , Masculino , Dolor de Cuello/etiología , Dolor de Cuello/terapia , Cuello , Masaje , Adyuvantes Inmunológicos
2.
Chron Respir Dis ; 16: 1479972318775422, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-29742914

RESUMEN

The quality of life of patients with chronic obstructive pulmonary disease (COPD) decreases significantly as the disease progresses; those with severe COPD are affected most. This article investigates predictors of the disease-specific and generic health-related quality of life (HRQL) in patients with severe COPD. This multicentre prospective cross-sectional study enrolled 80 patients with severe COPD. At enrolment, all patients completed a disease-specific instrument, the St George's Respiratory Questionnaire (SGRQ), and a generic instrument, the Short Form 36 Health Survey Questionnaire (SF-36). The data were analyzed by Pearson's correlation and multiple linear regression. The mean age of the patients was 66 ± 8 years; 93% were males. The SGRQ and SF-36 scores were not influenced by age or sex. Depression, dyspnea, the number of exacerbations, and exercise capacity significantly predicted the total SGRQ score ( p < 0.05). Depression was the strongest determinant of the total SGRQ score. The SF-36 physical component summary scores were related to depression, dyspnea, and the number of exacerbations ( p < 0.05). In comparison, the SF-36 mental component summary scores were related to depression and anxiety ( p < 0.05). Depression is a significant determinant of both the disease-specific and generic HRQL in patients with severe COPD. Screening and early intervention for depression in patients with severe COPD could improve the HRQL.


Asunto(s)
Depresión/psicología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/psicología , Calidad de Vida , Anciano , Ansiedad/psicología , Estudios Transversales , Progresión de la Enfermedad , Disnea/etiología , Disnea/psicología , Tolerancia al Ejercicio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Encuestas y Cuestionarios , Brote de los Síntomas
3.
J Phys Ther Sci ; 28(10): 2722-2726, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27821922

RESUMEN

[Purpose] To explore data on functioning in the medical records of patients with stroke by linking them to the ICF. [Subjects and Methods] The admission and discharge summaries of patients' electronic medical records (EMRs) were investigated. Information on functioning included in the summaries were mapped into the ICF. Each of the linked categories of ICF was analyzed using frequency and percentage analysis. [Results] Thirty stroke patients' records were evaluated. A total of 1,832 items on functioning in the EMRs were found to be linked to eighty-five categories of the ICF. The majority of those categories (52.9%) belonged to the body function domain, whereas only 8.2% were environment factors. Categories in the domain of activity and participation, and body structure were found to be 22.4% and 16.5% respectively. In each domain, the most frequently found categories were muscle power function (b730), structure of brain (s110), walking (d450), and products or substances for personal consumption (e110). [Conclusion] It was found that the admission and discharge summary in the current medical records of patients with stroke contained much noticeable information on functioning and the data on functioning may be linked to the ICF. Further study is needed to adapt ICF in Korean clinical settings.

4.
Age Ageing ; 44(3): 397-403, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25548124

RESUMEN

OBJECTIVE: to examine the effects of nurse-led, problem-solving therapy (PST) on coping, self-efficacy and depressive symptoms for patients with chronic obstructive pulmonary disease (COPD) using a randomised controlled trial. SUBJECTS: a total of 254 patients with COPD were recruited, screened and randomly allocated into the intervention group with nurse-led PST or the comparison group with usual care. A total of 151 patients (intervention = 78 and comparison = 73) completed the study for 6 months. METHODS: the nurse-led PST was an individualised and patient-centred intervention to improve patients' problem-solving skills related to symptom management and lifestyle modification. Twelve telephone-based PST sessions were provided to the intervention group, while the control group received usual care from their primary care providers. RESULTS: there were no group differences of post-test scores in problem-oriented coping, self-efficacy and depressive symptoms between the two groups. However, despite the lack of group differences, the nurse-led PST was effective for clinically depressed patients with COPD, who experienced decreased depressive symptoms (mean difference = 6.8, P = 0.009) and increased self-efficacy (mean difference = -0.6, P = 0.041) in the intervention group (n = 12). CONCLUSION: the nurse-led PST offered to patients with COPD did not demonstrate any different effects compared with usual care over 6 months; however, a subgroup analysis with clinically depressed subjects showed improved self-efficacy and decreased depressive symptoms in the intervention group.


Asunto(s)
Adaptación Psicológica , Depresión/prevención & control , Solución de Problemas , Enfermedad Pulmonar Obstructiva Crónica/enfermería , Autoeficacia , Anciano , Depresión/etiología , Femenino , Humanos , Masculino , Enfermedad Pulmonar Obstructiva Crónica/psicología , Conducta de Reducción del Riesgo
5.
Nurs Health Sci ; 17(4): 516-25, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26275164

RESUMEN

The purpose of this study was to compare the effects of Korean mindfulness-based stress reduction (K-MBSR), walking, and patient education regarding diabetes mellitus (DM) on stress response, glycemic control, and vascular inflammation in patients with diabetes mellitus. A cluster randomized trial including 56 adults with diabetes mellitus (K-MBSR group = 21, walking group = 18, patient education group = 17) was conducted between 13 July and 14 September 2012. The questionnaire included the Diabetes Distress Scale and Perceived Stress Response Inventory. Fasting blood samples were used to measure levels of cortisol, blood glucose, plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (t-PA). There were no statistically significant differences between the effects of K-MBSR, walking, and patient education on stress, glycemic control, or vascular inflammation. However, in the K-MBSR and walking groups, significant reductions in the levels of serum cortisol and PAI-1 were observed. A significant reduction in psychological responses to stress was observed in the walking and patient education groups. Longitudinal studies could provide better insight into the impact of K-MBSR, walking, and patient education on health outcomes in adults with diabetes mellitus.


Asunto(s)
Diabetes Mellitus Tipo 2/psicología , Ejercicio Físico/fisiología , Atención Plena/métodos , Educación del Paciente como Asunto/métodos , Estrés Psicológico/prevención & control , Adulto , Anciano , Análisis de Varianza , Actitud Frente a la Salud , Glucemia/análisis , Distribución de Chi-Cuadrado , China , Análisis por Conglomerados , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/rehabilitación , Escolaridad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Medición de Riesgo , Población Rural , Factores Socioeconómicos , Resultado del Tratamiento , Caminata/fisiología
6.
Lung ; 192(2): 243-9, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24395127

RESUMEN

PURPOSE: Patients with chronic obstructive pulmonary disease (COPD), which is predicted to be the third most common cause of death worldwide by 2020, often suffer from depression, one of the most common and modifiable comorbidities of COPD. This study assessed the prevalence of depression in patients with COPD and the association of depression with disease severity. METHODS: This was a multicenter, prospective cross-sectional study of 245 patients with stable COPD. Disease severity was assessed using two scales: the global initiative for chronic obstructive lung disease (GOLD) stage and BODE index. Depression was measured using the Centers for Epidemiologic Studies Depression (CES-D) scales. Data were analyzed using descriptive statistics, Spearman correlation, and multivariate logistic regression. RESULTS: Depression defined as a CES-D score of 24 and higher was observed in 17.6 % of patients with COPD. The prevalence of depression increased with disease severity based on the BODE quartile (r = 0.16; P = 0.014). By contrast, no difference was observed in the prevalence of depression among the severity groups using the GOLD staging system (r = - 0.01; P = 0.898). Elementary school graduates were more likely to experience depression than graduates of high school and above [odds ratio (OR) = 3.67; 95 % confidence interval (CI) 1.37-9.85] and patients in BODE quartile II were more likely to experience depression than those with BODE quartile I (OR = 2.5; 95 % CI  1.04-6.06). CONCLUSIONS: Depression was associated with disease severity according to the BODE quartile in patients with COPD. BODE quartile II was a significant predictor of depression. Screening patients with a high risk of depression and proactive intervention for those patients are needed.


Asunto(s)
Depresión/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Anciano , Distribución de Chi-Cuadrado , Estudios Transversales , Depresión/diagnóstico , Depresión/psicología , Femenino , Humanos , Modelos Logísticos , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Valor Predictivo de las Pruebas , Prevalencia , Estudios Prospectivos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , República de Corea/epidemiología , Factores de Riesgo , Índice de Severidad de la Enfermedad
7.
Nurs Health Sci ; 16(1): 78-83, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23682708

RESUMEN

The aim of this study was to identify related factors of low levels of self-efficacy in patients with Chronic Obstructive Pulmonary Disease (COPD). A cross-sectional research design used descriptive statistics, χ(2) test, t-test, and binary logistic regression. Two hundred and forty-five patients with COPD were recruited from five hospitals in South Korea. The COPD Self-Efficacy Scale, the Bristol COPD Knowledge Questionnaire, Personal Resource Questionnaire 2000, BODE index, and the International Physical Activity Questionnaire short version were utilized to assess self-efficacy, disease-related knowledge, social support, disease severity, and physical activity, respectively. The BODE index, affect-oriented coping, and duration since diagnosis of COPD were included as significant predictors of self-efficacy. These findings suggest possible screening methods to identify patients with low levels of self-efficacy and future intervention targeting for these patients would strengthen the efficiency of an intervention.


Asunto(s)
Adaptación Psicológica , Conocimientos, Actitudes y Práctica en Salud , Enfermedad Pulmonar Obstructiva Crónica/psicología , Autoeficacia , Apoyo Social , Anciano , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Esfuerzo Físico , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/terapia , Calidad de Vida , República de Corea , Autoinforme , Índice de Severidad de la Enfermedad , Clase Social , Encuestas y Cuestionarios
8.
Eur J Cardiovasc Nurs ; 23(1): 1-10, 2024 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-37130335

RESUMEN

AIMS: To determine the effectiveness of non-pharmacological interventions on sleep outcomes among patients with coronary artery disease and recognize pertinent characteristics that potentially affect the effectiveness of such interventions. METHODS AND RESULTS: Relevant studies conducted before 27 April 2022 were identified through four core electronic databases using terms related to coronary artery disease, sleep outcomes, and randomized controlled trials. Two authors independently conducted study selection, data extraction, and risk-of-bias assessment. Meta-analysis, sub-group analysis, publication bias analysis, and sensitivity analysis were conducted using R version 4.2.2. Of the 4755 retrieved articles, 42 studies were selected for systematic review and 30 studies were included in the meta-analysis. The findings of this study revealed that non-pharmacological interventions significantly improved self-reported sleep quality (standardized mean difference = -0.85, 95% confidence interval -1.08, -0.63), but had no effects on objectively measured sleep efficiency and duration. Regarding the types of interventions involved, environmental control was the most effective in improving self-reported sleep quality, followed by relaxation, self-care behaviour management, and relaxation and cognitive/psychological complex interventions. Through subgroup analysis, we did not find any covariates that were significantly related to self-reported sleep quality. CONCLUSION: Non-pharmacological interventions have been shown to play beneficial roles in improving self-reported sleep quality among patients with coronary artery disease. Additional studies are required to elucidate the effect of non-pharmacological interventions on objectively measured sleep outcomes and to characterize their optimal frequencies and durations. REGISTRATION: PROSPERO CRD42022366851.


Asunto(s)
Enfermedad de la Arteria Coronaria , Trastornos del Sueño-Vigilia , Humanos , Enfermedad de la Arteria Coronaria/terapia , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/terapia , Depresión , Sueño
9.
Asian Nurs Res (Korean Soc Nurs Sci) ; 18(1): 51-59, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38307162

RESUMEN

PURPOSE: Evidence on non-pharmacological interventions for adolescents with type 1 diabetes is unclear. This review aimed to evaluate the effectiveness of non-pharmacological intervention in adolescents with type 1 diabetes. METHODS: We conducted a search on databases from November 11 to 19, 2022, for randomized controlled trials for the effects of non-pharmacological intervention in adolescents with type 1 diabetes. To identify recent research trends, we included studies published from 2017 to November 2022. The risk of bias was assessed using the Cochrane risk-of-bias tool 2.0. To estimate the effect size, a meta-analysis was performed using RevMan 5.4 program and R Studio. RESULTS: A total of 45 studies were included in the systematic review. Among those, 30 studies were included in the meta-analysis. Non-pharmacological interventions were significantly effective in improving Glycated hemoglobin (HbA1c) (standardized mean difference [SMD] = -0.26, 95% confidence interval [CI]: -0.42, -0.09), quality of life (SMD = 0.44, 95% CI: 0.13 to 0.76), and anxiety (SMD = -0.91, 95% CI: -1.26, -0.56). Subgroup analysis showed that duration of intervention was not a covariate related to HbA1c levels. CONCLUSIONS: Non-pharmacological interventions have shown effectiveness in improving the HbA1c, quality of life, and anxiety in adolescents with type 1 diabetes. Future studies with more rigorous methodology are needed to confirm and strengthen the validity of these findings. Additionally, attention to changes in the lipid profile and self-care motivation among adolescents with type 1 diabetes is warranted. TRIAL REGISTRATION NUMBER: Prospective Register of Systematic Reviews (CRD42022382190).


Asunto(s)
Diabetes Mellitus Tipo 1 , Humanos , Adolescente , Diabetes Mellitus Tipo 1/terapia , Calidad de Vida , Hemoglobina Glucada , Ansiedad , Autocuidado
10.
Child Health Nurs Res ; 30(1): 17-30, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38302269

RESUMEN

PURPOSE: This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes. METHODS: A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed. RESULTS: The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified. CONCLUSION: The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.

11.
Asian Nurs Res (Korean Soc Nurs Sci) ; 18(2): 114-124, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38677472

RESUMEN

PURPOSE: Providing continuous self-care support to the growing diabetes population is challenging. Strategies are needed to enhance engagement in self-care, utilizing innovative technologies for personalized feedback. This study aimed to assess the feasibility of the Automated Personalized Self-Care program among type 2 diabetes patients and evaluate its preliminary effectiveness. METHODS: A parallel randomized pilot trial with qualitative interviews occurred from May 3, 2022, to September 27, 2022. Participants aged 40-69 years with type 2 diabetes and HbA1c ≥ 7.0% were recruited. The three-month program involved automated personalized goal setting, education, monitoring, and feedback. Feasibility was measured by participants' engagement and intervention usability. Preliminary effectiveness was examined through self-care self-efficacy, self-care behaviors, and health outcomes. Qualitative interviews were conducted with the intervention group. RESULTS: A total of 404 patients were screened. Out of the 61 eligible patients, 32 were enrolled, resulting in a recruitment rate of 52.5%. Retention rates at three months were 84.2% and 84.6% in the intervention and control groups, respectively. Among the intervention group, 81.3% satisfied adherence criteria. Mobile application's usability scored 66.25, and participants' satisfaction was 8.06. Intention-to-treat analysis showed improvements in self-measured blood glucose testing, grain intake, and HbA1c in the intervention group. Qualitative content analysis identified nine themes. CONCLUSION: Feasibility of the program was verified. A larger randomized controlled trial is needed to determine its effectiveness in self-care self-efficacy, self-care behaviors, and health outcomes among type 2 diabetes patients. This study offers insights for optimizing future trials assessing clinical effectiveness. TRIAL REGISTRATION: Clinical Research Information Service, KCT0008202 (registration date: 17 February 2023).


Asunto(s)
Diabetes Mellitus Tipo 2 , Autocuidado , Humanos , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/psicología , Persona de Mediana Edad , Proyectos Piloto , Femenino , Masculino , Autocuidado/métodos , Anciano , Adulto , Estudios de Factibilidad , Autoeficacia , Aplicaciones Móviles
12.
J Man Manip Ther ; 21(2): 103-12, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-24421620

RESUMEN

OBJECTIVES: The aim of this study was to conduct a cross-cultural comparison of the factors that influence patient satisfaction with musculoskeletal physiotherapy care in Australia and Korea. METHODS: Prospective studies were conducted in Australia and Korea. Patient satisfaction data were collected using the MedRisk Instrument for Measuring Patient Satisfaction with Physical Therapy Care (MRPS) from a total of 1666 patients who were attending clinics for physiotherapy treatment of a musculoskeletal condition. Exploratory factor analysis was conducted to identify factors determining patient satisfaction in each cohort. RESULTS: A four-factor solution for the MRPS was found for the Australian and Korean data sets, explaining 61 and 55% of the variance respectively. Communication and respect, convenience and quality time and person-focused care were factors common to both countries. One factor unique to Korea was courtesy and propriety. For both cultures, global patient satisfaction was significantly but weakly correlated with the outcome of treatment. CONCLUSIONS: The interpersonal aspect of care, namely effective communication and respect from the therapist, appears to be the predominant and universal factor that influences patient satisfaction with physiotherapy care, although other culturally specific factors were identified. Physiotherapists can maximize patient satisfaction with care by addressing those features that uniquely contribute to patient satisfaction in the cultural context in which they are working.

13.
Asian Nurs Res (Korean Soc Nurs Sci) ; 17(5): 259-268, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37952878

RESUMEN

PURPOSE: Preventing diabetic complications involves regular outpatient follow-up and maintaining low variability in hemoglobin A1c (HbA1c) levels. This study investigated the factors associated with diabetic complications, with a specific focus on the impact of regular outpatient follow-up and HbA1c variability, among patients with type 2 diabetes. METHODS: The study design was secondary data analysis of electronic medical records from a university hospital in Korea. It included patients aged 40-79 with type 2 diabetes who were prescribed diabetes medication within three months of their first HbA1c test by an endocrinologist and were followed up for at least five years. Follow-up regularity, adjusted standard deviation of HbA1c levels, and diabetic complication indices were collected. Data were analyzed using the Chi-square test, independent t-test, repeated measures analysis of variance, and multiple regression analysis. RESULTS: The study included 1566 patients. Lower follow-up regularity was observed in patients of older age, with comorbidities, diabetic complications, insulin treatment, a history of hospitalization, lower baseline estimated glomerular filtration rate (eGFR) and total cholesterol (TC), and higher HbA1c variability. Higher HbA1c variability was observed in younger patients without comorbidity but with insulin treatment, a history of hospitalization, higher baseline blood glucose (BG), HbA1c, TC, and triglyceride levels. HbA1c variability had the strongest influence on BG and HbA1c levels at the five-year follow-up. Baseline eGFR and TC were the most influential factors for their respective levels at the five-year follow-up. Follow-up regularity significantly affected BG, HbA1c, eGFR, and TC at five-year follow-up. CONCLUSIONS: It has been shown that several variables besides regular follow-up and HbA1c variability have an influence. However, these are the two that can be corrected through nursing intervention and are important, so intervention on these is important.


Asunto(s)
Complicaciones de la Diabetes , Diabetes Mellitus Tipo 2 , Insulinas , Humanos , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hemoglobina Glucada , Estudios de Seguimiento , Pacientes Ambulatorios , Complicaciones de la Diabetes/complicaciones , Estudios Retrospectivos , Glucemia/análisis
14.
Artículo en Inglés | MEDLINE | ID: mdl-21822442

RESUMEN

Objective. Body trunk measurement for human plays an important diagnostic role not only in conventional medicine but also in Sasang constitutional medicine (SCM). The Sasang constitutional body trunk measurement (SCBTM) consists of the 5-widths and the 8-circumferences which are standard locations currently employed in the SCM society. This study suggests to what extent a comprehensive training can improve the reliability of the SCBTM. Methods. We recruited 10 male subjects and 5 male observers with no experience of anthropometric measurement. We conducted measurements twice before and after a comprehensive training. Relative technical error of measurement (%TEMs) was produced to assess intra and inter observer reliabilities. Results. Post-training intra-observer %TEMs of the SCBTM were 0.27% to 1.85% reduced from 0.27% to 6.26% in pre-training, respectively. Post-training inter-observer %TEMs of those were 0.56% to 1.66% reduced from 1.00% to 9.60% in pre-training, respectively. Post-training % total TEMs which represent the whole reliability were 0.68% to 2.18% reduced from maximum value of 10.18%. Conclusion. A comprehensive training makes the SCBTM more reliable, hence giving a sufficiently confident diagnostic tool. It is strongly recommended to give a comprehensive training in advance to take the SCBTM.

15.
J Korean Acad Nurs ; 52(5): 535-549, 2022 Oct.
Artículo en Coreano | MEDLINE | ID: mdl-36373469

RESUMEN

PURPOSE: The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects. METHODS: The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus. RESULTS: The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences. CONCLUSION: The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients' self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.


Asunto(s)
Diabetes Mellitus Tipo 2 , Aplicaciones Móviles , Humanos , Autocuidado/métodos , Autoeficacia
16.
Artículo en Inglés | MEDLINE | ID: mdl-36141593

RESUMEN

The International Classification of Functioning Disability and Health (ICF) was approved in 2001 and, since then, several studies reported the increased interest about its use in different sectors. A recent overview that summarizes its applications is lacking. This study aims to provide an updated overview about 20 years of ICF application through an international online questionnaire, developed by the byline authors, and sent to each World Health Organization Collaborating Centers of the Family of International Classifications (WHO-FIC CCs). Data was collected during October 2020 and December 2021 and descriptive content analyses were used to report main results. Results show how, in most of the respondent countries represented by WHO-FIC CCs, ICF was mainly used in clinical practice, policy development and social policy, and in education areas. Despite its applications in different sectors, ICF use is not mandatory in most countries but, where used, it provides a biopsychosocial framework for policy development in health, functioning and disability. The study provides information about the needs related to ICF applications, that can be useful to organize targeted intervention plans. Furthermore, this survey methodology can be re-proposed periodically to monitor the use of the ICF in the future.


Asunto(s)
Personas con Discapacidad , Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud , Evaluación de la Discapacidad , Humanos , Encuestas y Cuestionarios , Organización Mundial de la Salud
17.
Geriatr Nurs ; 32(6): 408-17, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-22055639

RESUMEN

The goal of this study was to examine the unique contributions of sleep disturbance to depression in patients with chronic obstructive pulmonary disease (COPD) after controlling for other contributing variables, including patient characteristics, self-efficacy, and physical activity. One hundred thirty-one outpatients diagnosed with COPD from 3 hospitals in South Korea participated in the study. Data were collected from March to June 2010 and analyzed with descriptive statistics, Pearson correlation, and hierarchical multiple regression using the SPSS WIN program. The level of depression reported in this study was 13.84. Sleep disturbance, not living with a spouse, and self-efficacy were all predictors of depression and accounted for 45% of the variance. These findings show the need to screen routinely for sleep disturbance in patients with COPD and support potential benefits of interventions to enhance self-efficacy and quality of sleep in reducing depression in COPD patients.


Asunto(s)
Depresión/etiología , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Trastornos del Sueño-Vigilia/etiología , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Depresión/epidemiología , Depresión/psicología , Femenino , Humanos , Masculino , Estado Civil , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/psicología , Análisis de Regresión , República de Corea/epidemiología , Factores de Riesgo , Autoeficacia , Trastornos del Sueño-Vigilia/epidemiología , Trastornos del Sueño-Vigilia/psicología , Encuestas y Cuestionarios
18.
J Korean Acad Nurs ; 51(2): 173-187, 2021 Apr.
Artículo en Coreano | MEDLINE | ID: mdl-33993124

RESUMEN

PURPOSE: To compare the effects of education only and exercise training combined with education on fall knowledge, fall efficacy, physical activity, and physical function in adults aged 70 years or older residing in elderly residential facilities. METHODS: A three-group pre- and post-test design was utilized: education only (EO; n = 23), education and TheraBand (ET; n = 22), and education and walking (EW; n = 22). Fall education was provided for all three groups. In addition, TheraBand exercise training was provided for the ET and a walking exercise for the EW. Data were collected from November 1st, 2017 to February 15th, 2019 and analyzed with χ² test, paired t-test, and one-way ANOVA using IBM SPSS/WIN ver. 22.0. RESULTS: Compared with the EO, the ET and the EW were more effective in terms of fall efficacy, physical activity, and lower extremity muscle strength. The EW showed higher improvement in walking abilities than the EO and the ET. CONCLUSION: Exercise training combined with education is more effective in preventing falls among community-dwelling adults aged 70 years or older. When considering fall prevention programs for older adults, both TheraBand and walking exercise training combined with education can be chosen based on the participant's physical status. Aggressive strategies to improve daily walking are required to maintain walking abilities among community-dwelling adults aged 70 years or older.


Asunto(s)
Accidentes por Caídas/prevención & control , Terapia por Ejercicio/métodos , Ejercicio Físico , Educación del Paciente como Asunto , Equilibrio Postural , Anciano , Femenino , Anciano Frágil , Humanos , Masculino , Fuerza Muscular , Instituciones Residenciales , Caminata
19.
J Korean Acad Nurs ; 50(4): 541-553, 2020 Aug.
Artículo en Coreano | MEDLINE | ID: mdl-32895341

RESUMEN

PURPOSE: In spite of the recent application of a general infection control method, central line-associated infections is still relatively high in Korea. Central line bundle with Chlorhexidine gluconate (CHG) tegaderm dressing was reported to be effective in reducing catheter colonization and central line-associated bloodstream infections (CLABSI). Therefore, this study aimed to examine the incidences of catheter colonization occurrence and CLABSI while using Tegaderm vs. CHG Tegaderm dressings. METHODS: We used a descriptive design. 400 patients who had central venous catheters were selected from four hospitals in the Korean National Healthcare-associated Infections Surveillance System. Of all subjects, 200 used Tegaderm™ (Tegaderm group), and the remaining 200 used CHG Tegaderm (CHG Tegaderm group) dressing at the catheter insertion site. Data were analyzed using the χ² test or Fisher's exact test, t-test, and logistic regression analysis using SPSS WIN 21.0. RESULTS: In the Tegaderm and CHG Tegaderm groups, CLABSI incidences were 5.89 and 1.79 per 1,000 catheter-days, catheter colonization incidences were 3.93 and 1.43 per 1,000 catheter-days, and central line bundle compliance rates were 26.0% and 49.0%, respectively. Catheter colonization risk factors were 'reinsertion after failure' and 'Tegaderm dressing' at the central line insertion site. CLABSI risk factors were 'incomplete performance of 7 central line bundle items' and 'Tegaderm dressing' at the central line insertion site. CONCLUSION: A further prospective study is needed to examine the effects of central line bundle with CHG Tegaderm dressing, avoiding central line reinsertion after failure, and improving the bundle compliance in reducing catheter colonization and CLABSI.


Asunto(s)
Antiinfecciosos Locales/química , Vendajes , Infecciones Relacionadas con Catéteres/diagnóstico , Clorhexidina/análogos & derivados , Sepsis/diagnóstico , Anciano , Anciano de 80 o más Años , Antiinfecciosos Locales/uso terapéutico , Infecciones Relacionadas con Catéteres/epidemiología , Infecciones Relacionadas con Catéteres/microbiología , Infecciones Relacionadas con Catéteres/prevención & control , Catéteres Venosos Centrales , Clorhexidina/química , Clorhexidina/uso terapéutico , Femenino , Hongos/aislamiento & purificación , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Grampositivas/aislamiento & purificación , Humanos , Incidencia , Modelos Logísticos , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Sepsis/epidemiología , Sepsis/microbiología
20.
J Korean Acad Nurs ; 50(1): 66-80, 2020 Feb.
Artículo en Coreano | MEDLINE | ID: mdl-32131074

RESUMEN

PURPOSE: This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection. METHODS: This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ² test, Fisher's exact test, Mann-Whitney U test, t-test, and generalized estimation equations (GEE). RESULTS: There were significant differences between the two groups regarding SEE (χ²=13.53, p=.009), PA (χ²=9.51, p=.049), functional status (χ²=10.55, p=.032), and 6MWD (χ²=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=-2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component. CONCLUSION: The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.


Asunto(s)
Neoplasias Pulmonares/psicología , Calidad de Vida , Autoeficacia , Adulto , Anciano , Disnea/patología , Tolerancia al Ejercicio , Femenino , Humanos , Neoplasias Pulmonares/cirugía , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Factores de Tiempo , Caminata
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