A New Self-management Scale with a Hierarchical Structure for Patients with Type 2 Diabetes

Purpose@#The aims of this study were to develop a new instrument for measuring self-management with a hierarchical structure [the Diabetes Self-Management Scale (DSMS)] in patients with type 2 diabetes, and evaluate its psychometric properties. @*Methods@#The DSMS instrument was developed in three phases: (1) conceptualization and item generation; (2) content validity and pilot testing; and (3) field testing of its psychometric properties. A convenience sample of 473 participants was recruited in three university hospitals and one regional health center, South Korea. @*Results@#Exploratory and confirmatory factor analyses yielded two second-order component models explaining the common variance among six first-order factors. Principal axis factoring with a varimax rotation accounted for 60.88% of the variance. Confirmatory factor analysis of the hierarchical structure revealed the following fit indices: χ2/df = 1.373, standardized root-mean-square residual = .050, goodness-of-fit index = .935, incremental fit index = .975, comparative fit index = .974, and root-mean-square error of approximation = .039. All Cronbach' α values for internal consistency exceeded the criterion of .70. All of the intraclass correlation coefficients for test–retest reliability exceeded .70 except that for the taking-medication subscale. The components of the DSMS were moderately correlated with the comparator measures of self-efficacy and health literacy administered for convergent validity. @*Conclusion@#The DSMS is a new instrument for measuring the complex nature of self-management in patients with type 2 diabetes, comprising 17 items scored on a five-point Likert scale. The DSMS exhibits satisfactory psychometric properties for five reliability and validity metrics, and so is a suitable instrument to apply in both research and clinical practices.

Low Body Mass Index for Early Screening of Adolescent Idiopathic Scoliosis: A Comparison Based on Standardized Body Mass Index Classifications

Purpose@#Scoliosis is a common musculoskeletal problem in adolescents. This study aimed to identify the prevalence of adolescent idiopathic scoliosis (AIS) and its associated factors among Korean adolescents. The prevalence of thin individuals among students with AIS was compared based on body mass index (BMI) classifications. @*Methods@#This study was a secondary data analysis and used the 2016 Korean National Health Examination for School Students data. Data from 16,412 students were analyzed using descriptive statistics, Chi-square tests, and logistic regression analysis. @*Results@#The prevalence of AIS was higher in women (3.8%) than in men (1.6%), and a higher school year was a risk factor for AIS in both sexes. In woman adolescents, scoliosis was associated with thinness; however, the risk of AIS was inversely associated with overweight/obesity in both sexes. The prevalence of thin woman students with scoliosis differed based on the criteria used: 3.3% by the World Health Organization criteria and 14.3% by the International Obesity Task Force criteria. @*Conclusion@#The prevalence of thin students with scoliosis could increase by up to four times depending on the BMI criteria. For early screening of thin people at risk of AIS among female students, the criterion of International Obesity Task Force should be used as it is more permissive of thinness. This is also because of the underestimation of AIS prevalence when using the BMI Z score of the World Health Organization cutoff.

A New Self-management Scale with a Hierarchical Structure for Patients with Type 2 Diabetes

Purpose@#The aims of this study were to develop a new instrument for measuring self-management with a hierarchical structure [the Diabetes Self-Management Scale (DSMS)] in patients with type 2 diabetes, and evaluate its psychometric properties. @*Methods@#The DSMS instrument was developed in three phases: (1) conceptualization and item generation; (2) content validity and pilot testing; and (3) field testing of its psychometric properties. A convenience sample of 473 participants was recruited in three university hospitals and one regional health center, South Korea. @*Results@#Exploratory and confirmatory factor analyses yielded two second-order component models explaining the common variance among six first-order factors. Principal axis factoring with a varimax rotation accounted for 60.88% of the variance. Confirmatory factor analysis of the hierarchical structure revealed the following fit indices: χ2/df = 1.373, standardized root-mean-square residual = .050, goodness-of-fit index = .935, incremental fit index = .975, comparative fit index = .974, and root-mean-square error of approximation = .039. All Cronbach' α values for internal consistency exceeded the criterion of .70. All of the intraclass correlation coefficients for test–retest reliability exceeded .70 except that for the taking-medication subscale. The components of the DSMS were moderately correlated with the comparator measures of self-efficacy and health literacy administered for convergent validity. @*Conclusion@#The DSMS is a new instrument for measuring the complex nature of self-management in patients with type 2 diabetes, comprising 17 items scored on a five-point Likert scale. The DSMS exhibits satisfactory psychometric properties for five reliability and validity metrics, and so is a suitable instrument to apply in both research and clinical practices.

Low Body Mass Index for Early Screening of Adolescent Idiopathic Scoliosis: A Comparison Based on Standardized Body Mass Index Classifications

Purpose@#Scoliosis is a common musculoskeletal problem in adolescents. This study aimed to identify the prevalence of adolescent idiopathic scoliosis (AIS) and its associated factors among Korean adolescents. The prevalence of thin individuals among students with AIS was compared based on body mass index (BMI) classifications. @*Methods@#This study was a secondary data analysis and used the 2016 Korean National Health Examination for School Students data. Data from 16,412 students were analyzed using descriptive statistics, Chi-square tests, and logistic regression analysis. @*Results@#The prevalence of AIS was higher in women (3.8%) than in men (1.6%), and a higher school year was a risk factor for AIS in both sexes. In woman adolescents, scoliosis was associated with thinness; however, the risk of AIS was inversely associated with overweight/obesity in both sexes. The prevalence of thin woman students with scoliosis differed based on the criteria used: 3.3% by the World Health Organization criteria and 14.3% by the International Obesity Task Force criteria. @*Conclusion@#The prevalence of thin students with scoliosis could increase by up to four times depending on the BMI criteria. For early screening of thin people at risk of AIS among female students, the criterion of International Obesity Task Force should be used as it is more permissive of thinness. This is also because of the underestimation of AIS prevalence when using the BMI Z score of the World Health Organization cutoff.

Development and Psychometric Evaluation of the Korean Version of the Cultural Competence Scale for Clinical Nurses

PURPOSE: To develop and psychometrically test the Korean version of the Cultural Competence Scale for Nurses (K-CCSN). METHODS: A multi-phase questionnaire development method was used to develop the scale from November 2012 to April 2013. The item pool was generated based on literature review, existing scales and in-depth interviews. The content validity was evaluated twice by an expert panel. The scale validation was conducted with a convenience sample of 456 general hospital nurses recruited from five general hospitals and a nursing college in the Seoul Metropolitan Area of South Korea. The construct-related and criterion-related validity and internal consistency reliability of the scale were tested. RESULTS: The 33-item K-CCSN comprised four subscalesdcultural awareness, cultural knowledge, cultural sensitivity and cultural skillsdexplaining 53.96% of the total variance. The criterion-related validity was supported by a known-group comparison. The reliability analysis showed an acceptable-to-high Cronbach's alpha in total and for subscales ranging from .879 to .932. CONCLUSION: This preliminary evaluation of psychometric scale properties demonstrated acceptable validity and reliability. The K-CCSN is able to provide scientific and empirical data regarding the cultural competence of clinical nurses. However, further studies are needed to test the applicability of the scale in different settings and contexts.

Review of Self-Administered Instruments to Measure Cultural Competence of Nurses-Focused on IAPCC & CCA / 간호행정학회지

PURPOSE: As Korean society has rapidly become multicultural in the last few decades, it is essential for nurses to become culturally competent to provide effective care for ethnically and culturally diverse populations. Considering the advantages of standardized instrument, there is a need to evaluate current cultural competence instruments to assess adaptability to Korean nurses. METHODS: Using Macdowell's instrument evaluation guideline, a review and evaluation was done of the Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals (IAPCC) and Cultural Competence Assessment (CCA), which were both developed based on cultural competence theoretical models and have been commonly used in nursing research. Two other Korean instruments were also evaluated. RESULTS: The instruments reviewed have limitations in reliability and validity, as well as cultural background and development process, for measurement of cultural competence in Korean nurses. CONCLUSION: The results of this study indicate that it is necessary to discuss and agree on a definition of what cultural competence is and to develop instruments to measure cultural competence in Korean nurses.

A Study on Gender Differences in Influencing Factors of Office Workers' Physical Activity

PURPOSE: The purpose of this study was to determine gender differences in effects of self-efficacy, exercise benefits and barriers, and demographic factors on the physical activity. METHODS: Seventy sedentary office workers, 35 male and 35 female, from a major airline company, completed a questionnaire from March 28 to April 5, 2012. Steps and body mass indices were measured using a CW-700/701 (Yamax) pedometer and Inbody 720 (Biospace), respectively. Data were analyzed using t-test, chi2-test, multiple linear regression, and simultaneous quantile regression. RESULTS: For male workers, exercise self-efficacy had a significant effect on physical activity, but only when respondents were at 10%(3,431 steps/day, p=.018) and 25%(4,652 steps/day, p=.044) of the physical activity distribution. For female workers, marital status was significantly related to physical activity, but only when respondents were at 10% (3,537 steps/day, p=.013) and 25%(3,862 steps/day, p=.014) of the physical activity distribution. CONCLUSION: Quantile regression highlights the heterogeneous effect of physical activity determinants among office workers. Therefore intervention strategies for increasing physical activity should be tailed to genders as well as physical activity levels.

A Study on Factors Affecting Cultural Competency of General Hospital Nurses / 간호행정학회지

PURPOSE: As Korea has been rapidly transformed to be a multicultural society, it becomes essential for nurses to develop cultural competency. The purpose of this descriptive study was to assess the cultural competency level of general hospital nurses and to examine its contributing factors adopting ecological model. METHOD: A convenience sample of 327 nurses from six general hospitals in Seoul metropolitan area was recruited between November 14 to 28, 2011. Cultural competency was measured using the Korean version of the Caffrey Cultural Competence in Healthcare Scale (CCCHS) and Cultural Competence Assessment(CCA). Hierarchical multiple regression analysis was performed to assess the influence of intrapersonal, cultural-experience, and organizational factors on cultural competency. RESULTS: Mean cultural competency in this study was 2.57(+/-0.43). Cultural competency was associated with job position (p=.044) at the intrapersonal level. At the cultural experience level, foreign language classes experience (p=.005), fluency in a foreign language (p=.000), experience of working with foreign health care professionals (p=.000) were associated cultural competency. At the organizational level, training program (p=.000), job description (p=.002), health education materials (p=.016), insufficient job control (p=.000), and interpersonal conflicts (p=.011) showed significant difference. Foreign language class experience, foreign language fluency, experience of working with foreign health care professionals, and job control were the most consistent predictors of cultural competence and explained 20.4% of the total variance in the proposed ecological model. CONCLUSIONS: The findings suggest that to enhance cultural competency in general hospital nurses, cultural experience and organizational factors need to be more fully considered than intrapersonal factors.

Risk factors for musculoskeletal symptoms in aviation maintenance technicians / 대한산업의학회지

OBJECTIVES: To identify risk factors for musculoskeletal symptoms in aviation maintenance technicians in order to provide basic information for intervention programs to prevent and manage musculoskeletal symptoms for these technicians. METHODS: Between October 18 and 25, 2004, 286 aviation maintenance technicians answered a self-administered questionnaire, which included general characteristics, Karasek's Job Content Questionnaire for psychosocial characteristics, and work-related characteristics. The musculoskeletal symptoms were evaluated using the National Institute of Occupational Safety and Health (NIOSH) surveillance criteria. Statistical analysis included means and standard deviation, x2-test, t-test, and logistic regression. RESULTS: A quarter (25.8%) of the workers reported musculoskeletal symptoms in more than one body region. The prevalence of symptoms was 12.9% in the lower back, 10.2% in the shoulders, 9.4% in the legs/foots, 9% in the neck, 5.9% in the hands/wrists/fingers, and 2.7% in the arms/elbows. General characteristics were not found to influence musculoskeletal symptoms, except that workers practicing regular exercise reported fewer lower back symptoms (p=.038). Low social support (p=.001), and low supervisory support (p=.000) were significant factors for increased musculoskeletal symptoms whereas decisions latitude, psychological job demands, and co-worker support were not found to have significant associations, with the exception of low decision latitude which was significantly associated with increased legs/foots symptoms (p=.034). More than two thirds (69.6%) of the workers whose perceived physical load was very high complained of symptoms. This rate was eight times higher than for workers whose perceived load was very low (p=.000). The workers highly exposed to both physical and psychosocial risk factors were more likely to report musculoskeletal symptoms than workers highly exposed to only one of these factors (p=.000). The odds ratios for very high-perceived physical load (OR 13.9) and low supervisory support (OR 2.9) were clearly increased. CONCLUSIONS: The results of this study suggest that consideration for perceived physical load and psychosocial characteristics as important determinants is necessary to prevent musculoskeletal symptoms in aviation maintenance technicians. To develop effective intervention programs to prevent musculoskeletal symptoms, a comprehensive and systematic approach should be the basic premise. Such an intervention program should consist of ergonomic, managerial and behavioral interventions to reduce physical load and psychosocial factors.

Relationship between Low Back Pain and Physical Characteristics in Flight Attendants

BACKGROUND: Low back pain (LBP) is known to be the significant reason for absenteeism and can develop long-term disability. So the airline authorities have made an effort to reduce the incidence of LBP by applying their physical standards. As a LBP Prevention Program, Airline A has provided health education, counseling and physical examinations. The purpose of this study is to analyze the relationship between LBP and physical characteristics, age and work duration, and this result will provide basic information for improving the LBP Prevention Program. METHOD: The subjects were the 585 flight attendants who had undergone regular physical check-ups with Airline A Medical Center from October 2000 to September 2001. We reviewed their absence records and physical characteristics, age and work duration. These data were analyzed statistically by the t-test and Lositic regression. RESULT: The LBP history group accounted for 18% of the study group. The male LBP history group had the more thin waist than the no history group. There were no differences (P<0.05) between LBP and other male and female physical characteristics. The age and work duration of male LBP history group was lower than the no history group (P<0.05). But the female comparison revealed that only the work experience in the LBP history group was lower than the No history group (P<0.05). Waist, age, work duration was analyzed statistically by logistic regression. Only female's work experience was significant. The fewer work experience was the more LBP. CONCLUSION: The results of this study suggest LBP is associated with work experience rather than physical characteristics. This is the first step toward improving a LBP Prevention Program for the cabin crew. It will be useful to conduct another review to assess various other reasons, such as psychosocial job factors, duration of work disability and muscle strength, related to LBP.

Medical Problems in Civil Airline Pilots: A 6-Year Review

No abstract available.