The Relationship Between Pain and Quality of Life Among Adults With Knee Osteoarthritis: The Mediating Effects of Lower Extremity Functional Status and Depression.

Pain, lower extremity functional status, and depression have been associated with quality of life among patients with knee osteoarthritis (KOA). However, little is known about the manner in which these factors influence quality of life. The present study examined the mediating effects of lower extremity functional status and depression on the relationship between pain and quality of life among adults with KOA. A descriptive cross-sectional study was conducted among 135 adults with KOA who visited an orthopaedic outpatient clinic in Korea. The participants responded to the Numeric Rating Scale, Lower Extremity Functional Scale, Beck Depression Inventory, and the Korean version of the World Health Organization Quality of Life-BREF. Mediation analysis was conducted using the PROCESS macro for SPSS. The serial mediating effects of lower extremity functional status and depression on the relationship between pain and quality of life were significant. These findings suggest that the assessment and management of lower extremity functional status and depression are important means by which the quality of life of adults with painful KOA can be improved.

Interaction and main effects of physical and depressive symptoms on quality of life in Korean women seeking care for rectal prolapse: a cross-sectional observational study.

Purpose: Rectal prolapse is still a relatively understudied medical condition, especially in women, whereas physical symptoms, depressive symptoms, and quality of life (QOL) in women with pelvic organ prolapse have been steadily studied. This study aimed to examine the interaction and main effects of physical and depressive symptoms on physical and mental QOL of women seeking care for rectal prolapse in Korea. Methods: Ninety-two women with rectal prolapse were recruited from a colorectal surgery clinic of a tertiary teaching hospital in Gwangju, Korea. Physical symptoms related to rectal prolapse (pelvic organ prolapse distress, POPD; colorectal-anal distress, CRAD; and urinary distress, UD), depression, and QOL were measured. The data were analyzed using descriptive statistics, Pearson correlation coefficient, and two-way analysis of variance. Results: The interaction between POPD symptoms and depressive symptoms (F=4.51, p=.037) affected physical QOL. The interaction between POPD (F=9.66, p=.003) and CRAD symptoms (F=7.48, p=.008), respectively, and depressive symptoms affected mental QOL. Depressive symptoms had a significant main effect on the physical QOL in the CRAD (F=6.22, p=.014) and UD (F=6.01, p=.016) groups and on mental QOL in the UD group (F=24.54, p<.001). Conclusion: Physical and depressive symptoms should be considered together to improve the QOL in women with rectal prolapse. Nursing interventions and medical treatments to decrease rectal prolapse-related physical and depressive symptoms are required to improve QOL in women with symptomatic rectal prolapse.

Associations among daytime sleepiness, depression and suicidal ideation in Korean adolescents.

The aim of this study was to examine the effects of daytime sleepiness on depression and suicidal ideation in adolescent high-school students. A survey of 538 high school students aged 16-17 years attending two academic schools was conducted. The Epworth Sleepiness Scale (ESS), the Beck Depression Inventory and the Scale for Suicide Ideation were used to assess subjects' daytime sleepiness, depression and suicidal ideation. The mean score for daytime sleepiness was 8.52, which indicates a sleep deficit. Significant positive correlations were found between daytime sleepiness and depression, between daytime sleepiness and suicidal ideation and between depression and suicidal ideation. Gender and depression were significant predictors of suicidal ideation, accounting for 48% of the variance in this measure. Depression acts as a mediator of the relationship between daytime sleepiness and suicidal ideation. High school students in Korea generally have insufficient sleep time and feel sleepy during the day; insufficient sleep during adolescence may be associated with depression and suicidal ideation.

Subjectivity About Sexual Ethics Among Korean Undergraduate Students Using Q Methodology.

PURPOSE: Most undergraduate students are in the phase of gaining mental and physical autonomy from their parents as they expand their worlds. The ways that sexual ethics are established during this time may have an important influence on healthy lifestyles and the maintenance of social order. This study aims to determine a typology of undergraduate students' sexual ethics and the characteristics that compose the types. METHODS: Q methodology, which analyzes the subjectivity of each type of attitude, was used. The 44 selected Q statements from 43 participants were classified into the shape of a normal distribution using a 9-point scale. The collected data were analyzed using the PC-QUANL program. RESULTS: The results revealed three discrete groups of students with respect to sexual ethics: traditional absolute purity type, open-minded compromise type, and rational responsibility type. CONCLUSIONS: The results of this study indicate that different approaches to educational programs on sexual ethics are recommended for undergraduate students based on the three types studied.

[Validity and Reliability of Korean Version of the Spiritual Care Competence Scale].

PURPOSE: The aim of this study was to examine the validity and reliability of the Korean Version of the Spiritual Care Competence Scale (K-SCCS). METHODS: A cross-sectional study design was used. The K-SCCS consisted of 26 questions to measure spiritual care competence of nurses. Participants, 228 nurses who had more than 3 years'experience as a nurse, completed the survey. Confirmatory factor analysis was used to examine the construct validity and correlations of K-SCCS and spiritual well-being (SWB) were used to examine the criterion validity of K-SCCS. Cronbach's alpha was used to test internal consistency. RESULTS: The construct and the criterion-related validity of K-SCCS were supported as measures of spiritual care competence. Cronbach's alpha was .95. Factor loadings of the 26 questions ranged from .60 to .96. Construct validity of K-SCCS was verified by confirmatory factor analysis (RMSEA=.08, CFI=.90, NFI=.85). Criterion validity compared to the SWB showed significant correlation (r=.44, p<.001). CONCLUSION: The findings suggest that K-SCCS serves as an appropriate measure of spiritual care competence with validity and reliability. However, further study is needed to retest the verification of the factor analysis related to factor 2 (professionalisation and improving the quality of spiritual care) and factor 3 (personal support and patient counseling). Therefore, we recommend using the total score without distinguishing subscales.

Moral distress in critical care nurses: a phenomenological study.

AIM: To explore and understand moral distress from the perspective of and as experienced by critical care nurses in Korea. BACKGROUND: The concept of moral distress among critical care nurses must be more broadly explored using a qualitative approach. DESIGN: Giorgi's phenomenological research approach was used. METHODS: A purposive sampling was used to select 14 critical care nurses. In-depth face-to-face interviews were performed in Korea from March 2012-December 2013. FINDINGS: Five main themes of moral distress emerged: (1) ambivalence towards treatment and care (notably prioritizing work tasks over human dignity, unnecessary medical treatments and the compulsory application of restraints); (2) suffering resulting from a lack of ethical sensitivity; (3) dilemmas resulting from nurses' limited autonomy in treatments; (4) conflicts with physicians; and (5) conflicts with institutional policy. CONCLUSION: Staff shortages are aggravated by high staff turnover caused by ethical suffering. The resulting lack of staff can, in turn, give rise to added ethical conflicts as part of a vicious circle, leading to decreased patient satisfaction.

Changes in how ICU nurses perceive the DNR decision and their nursing activity after implementing it.

This study investigated the perceptions and attitudes of ICU nurses towards the 'do not resuscitate' (DNR) decision and changes in their nursing activities after implementation of the DNR decision in South Korea. A data survey was conducted in South Korea between August and October 2008, with a convenience sample of 252 ICU nurses who had more than one year of clinical experience. The data were collected via a self-administered questionnaire. Most of the nurses perceived the necessity of the DNR decision in cases where there would be no chance of patient recovery despite massive efforts. Very few of the nurses' activities changed, either passively or actively, after implementation of the DNR decision. Moreover, the findings of this research provide suggestions for the future direction of the DNR decision and ethical nursing guidelines in South Korea. Further investigations are needed for the development of decision-making skills and intervention guidelines for end-of-life nursing.

Depression, symptoms and the quality of life in patients on hemodialysis for end-stage renal disease.

BACKGROUND: End-stage renal disease (ESRD) is a progressive, debilitating, chronic illness requiring nursing and medical interventions. The goal of this study was to explore the level of depression experienced by patients receiving hemodialysis (n = 146), and to compare the symptoms with the quality of life (QoL) between patients that were depressed and those that were not depressed. METHODS: For this descriptive, cross-sectional survey, participants aged 18 and above were recruited from three different regions in the Republic of Korea. The level of depression, symptoms and QoL of the participants were measured by questionnaires from October to December 2006. The data was analyzed with descriptive statistics, the chi(2) and t test using the SPSS WIN 14.0 program. RESULTS: The prevalence of depression (PHQ-9) among the participants was 25.34%. There were more symptoms reported in the depressed group of patients than in those that were not depressed. In addition, the QoL was not as good in the depressed group when compared to patients that were not depressed. CONCLUSION: Therefore, the evaluation for depression may be an important part of the management of patients with ESRD. Further research is needed to understand the causal relationship between depression and health outcomes.

Predictors of mammography uptake in Korean women aged 40 years and over.

AIM: This paper is a report of a study performed to identify the predictors of mammography uptake for Korean women according to the stage of change, as determined by the transtheoretical model. BACKGROUND: Although breast cancer is the most common female cancer in South Korea, its early detection rate here is low when compared with other developed countries. The transtheoretical model can be used to facilitate health promotion based on individual health behaviour and to devise stage-tailored interventions. METHOD: The participants were a convenience sample of 920 women aged > or =40 years between December 2005 and February 2006. A cross-sectional design was used in which participants completed a questionnaire that consisted of measures of the transtheoretical model. To provide a standard of measure, the variables were converted from raw scores to standard scores and then to T scores (mean = 50, sd = 10). Logistic regression analysis was then used to estimate predictors of the stage of maintenance of mammography uptake. FINDINGS: The most frequent stage of mammography uptake was 'contemplation'. Predictors of mammography uptake included decisional balance, commitment to regular screening and avoiding contact with the healthcare system. Commitment to regular screening and breast self-examination were strongly related to mammography maintenance. CONCLUSION: The results of this study can be used for the development of theory-based and empirically supported mammography uptake intervention strategies and programmes directed towards women aged > or =40 years.