Effect of a Mind-Body Therapeutic Program for Infertile Women Repeating In Vitro Fertilization Treatment on Uncertainty, Anxiety, and Implantation Rate

PURPOSE: The study aimed to develop a mind-body therapeutic program and evaluate its effects on mitigating uncertainty, anxiety, and implantation rate of second-trial in vitro fertilization (IVF) women. METHODS: This study employed a nonequivalent control group nonsynchronized design. The conceptual framework and program content were developed from a preliminary survey of eight infertile women and the extensive review of the literature. Program focuses on three uncertainty-induced anxieties in infertile women: cognitive, emotional, and biological responses. To evaluate the effect of the intervention, the infertile women with unknown cause preparing for a second IVF treatment were sampled at convenience (26 experimental and 24 control). RESULTS: The experimental group in the study showed greater decrease in uncertainty and anxiety in premeasurements and postmeasurements than the control group did. However, no statistically significant differences in the implantation rate between groups were observed. CONCLUSION: This study is meaningful as the first intervention program for alleviating uncertainty and anxiety provided during the IVF treatment process. The positive effects of the mind-body therapeutic program in alleviating both uncertainty and anxiety have direct meaning for clinical applications.

Nutritional Risk and Physical Activity on Quality of Life in Patients with Colorectal Cancer

PURPOSE: This study aimed to investigate nutritional risk, physical activity, and quality of life (QoL) and the interaction of these factors in colorectal cancer patients. METHODS: Participants were colorectal cancer patients receiving follow-up treatment at the colorectal cancer outpatient clinic of Severance Hospital in Seoul. Participants were recruited from October 25 to November 30, 2010. The survey questionnaire consisted of Nutritional Risk Score (NRS), International Physical Activity Questionnaire (IPAQ) and Functional Assessment of Cancer Therapy - scales for Colorectal Cancer (FACT-C). RESULTS: NRSs were significantly higher in patients with low BMI (F=18.63, p<.001) and those who were underwent colorectal surgery within 1 month (F=5.96, p<.001). Physical activity level of the participants was 28.96METs. Lower nutritional risk was associated with a higher QoL (r= - .34, p<.001). In a multiple regression analysis, the predictors of QoL were the age, economic status, and nutritional risk of the patient (R2=40.0%). CONCLUSIONS: Targeted tailored nursing interventions are needed to assess nutritional risks in order to improve colorectal cancer patients' QoL.

Development and Validation of a Scale for the End of Life Caregiving Appraisal

PURPOSE: End-of-life caregiving experiences can be complex. Family members experience physical and mental suffering as they anticipate their impending loss. Healthcare providers should be able to provide good quality of end-of-life (EOL) care and support for primary EOL caregivers. Studies have highlighted the role of healthcare providers providing information in the EOL situation to caregivers of chronic disease patients. This has resulted in the development of the End-of-life Caregiving Experience Appraisal Scale (EOLCAS) presented in this paper. The purposes of this study were to develop a scale that can evaluate the experiences of EOL caregivers, and to test the reliability and validity of this scale. METHODS: The scale domains were derived from systematic review of 35 relevant studies. We then examined its content validity with nurse scholars and clinicians using content validity index. To examine construct validity, a total of 175 caregivers from tertiary hospital setting in Korea participated in this study from December 2007 to May 2008. For the construct validity, factor analysis was utilized. RESULTS: The scale was composed of 32 items with four subscales: two negative appraisals (physical suffering and burden), one positive appraisal (maturation), and one neutral appraisal (social support pursuit). In this sample, the Cronbach's alpha for the entire scale was .84 indicating adequate reliability. However, Cronbach's alpha of subscales was varied. CONCLUSION: Nurses and other healthcare professionals could use the EOLCAS to assess the experiences of EOL caregivers to understand their experience in the EOL and enhance their quality of life although psychometrics of EOLCAS shows limited findings.

Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients

PURPOSE: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. METHODS: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. RESULTS: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. CONCLUSION: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.

A Meta Analysis on the Effects of Exercise on Bone Mineral Density among Middle-aged and Older Women

PURPOSE: This study was to examine the effectiveness of exercise for bone mineral density (BMD). METHODS: Four investigators reviewed English articles from Pub Med and CINAHL, selecting randomized controlled trials on exercise programs for middle-aged and older women. Out of 25 studies identified, 14 that satisfied with the inclusion criteria were included in the meta-analysis. The quality of the studies was assessed using recognized methods and the effect size was calculated as a Hedges' g using Comprehensive Meta-analysis Version 2.0. Primary outcomes were changes in BMD at femoral neck, trochanter, and lumbar spine. Subgroup analysis included changes in BMD according to exercise style. RESULTS: Weight bearing exercise was effective (Q = 20.1, p > .05, ES = 0.32), and resistance exercise was effective in case of comparing to pre and post intervention (Q = 4.15, p = .98, ES = 0.14). At the femoral neck, 9 study groups were homogeneous and the experimental groups demonstrated a positive effect on BMD (Q = 19.5, p > .05, ES = 0.33). In contrast, marked heterogeneity (Q = 33.3, p < 0.01) was apparent in 7 study groups evaluating trochanter. CONCLUSION: These findings suggest that weight bearing is effective for BMD of the femoral neck, and is relevant to the non-pharmacological treatment of bone loss for middle-aged and older women.

Evaluation of a Complementary Cyber Education Program for a Pathophysiology Class / 한국의학교육

PURPOSE: The goal of this study was to develop and evaluate a complementary cyber education program for a required pathophysiology class for nursing students. METHODS: The cyber education program comprised electronic bulletin boards, correspondence material storage, an announcement section, a report submission section, reference sites, and statistics on learning rates. Twelve online lectures complemented five lectures in the classroom. To evaluate the course's educational effectiveness, we performed an online objective questionnaire and an open questionnaire survey anonymously, and compared the complementary cyber education program with traditional classroom education. RESULTS: The complementary cyber education program effected significant improvements in scores for importance with regard to major, clarity of goals and education plans for courses, professor readiness, preciseness and description of lectures, amount and efficiency of assignments, and fairness in appraisal standards compared with the traditional classroom education group. CONCLUSION: This study indicates that a complementary cyber education program provides nursing students with the flexibility of time and space, the newest information through updated lectures, efficient motivational aids through intimacy between the lecturer and students, and concrete and meaningful tasks. The complementary cyber education course also increased student effort toward studying and student satisfaction with the class.

Knowledge and Attitude Regard to Cord Blood of Early Postpartum Women after Donating Cord Blood or Storing Cord Blood / 여성건강간호학회지

PURPOSE: There is increasing necessity of using cord blood cell worldwide. In order to improve the effectiveness of cord blood's usage in Korea, the study of knowledge and attitude regarding cord blood is needed. METHODS: As descriptive correlation study, data was collected from 212 early postpartum women who stored or donated cord blood from 2007 April to July. Data was analyzed using chi-square-test, t-test, ANOVA, and logistic regression. RESULTS: Total score of knowledge and attitude of early postpartum women who donated cord blood was higher than who stored. According to the source of education and the source of influence toward decision of using cord blood, early postpartum women who educated or influenced by mass media showed difference in attitude. Job status and income, and attitude of cord blood were the predictor of cord blood donation. CONCLUSION: Attitude regard to cord blood affect to usage of cord blood, and the attitude and knowledge of cord blood in early postpartum women who donated it higher than who stored.

Effects of Artemisia A. Smoke(Ssukjahun) on Menstrual Distress, Dysmenorrhea, and Prostaglandin F2alpha / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify effects of Artemisia A. Smoke(Ssukjahun) on primary dysmenorrhea. METHOD: This study was a pretestposttest design with a nonequivalent control group. Data were collected from May 1, 2007 to May 27, 2008. A total of 40 women with dysmenorrhea participated in the study. Among them, 20 women were assigned to an experimental group and the other 20 to a control group. Artemisia A. Smoke(Ssukjahun) was provided daily for 4 days, starting 7 days prior to next expected menses in the experimental group. The instruments used in this study included MDQ (Moos' Menstrual Distress Questionnaire) by Kim (1995), Visual Analogue Scale by Keele (1948), and PGF2alpha by urine. RESULT: The results of this study are as follows; The experimental group was lower than the control group in the degree of menstrual distress (t=5.25, p=0.000), intensity of dysmenorrhea (t=7.71, p=0.000), and prostaglandin F2alpha levels (t=4.56, p=0.000). CONCLUSION: Artemisia A. Smoke (Ssukjahun) was proved as an effective nursing intervention to reduce dysmenorrhea in young women. Its convenience and accessibility may make it a useful intervention in nursing practice and education.

Impact of Life Style Characteristics on Prevalence Risk of Metabolic Syndrome

PURPOSE: The goal of this study was to evaluate the impact of life style characteristics on the prevalence risk of metabolic syndrome (MS). METHODS: A total of 581 adults were recruited from a cardiovascular outpatient clinic. A newly developed comprehensive life style evaluation tool for MS patients was used, and patient data related to the MS diagnosis were reviewed from the hospital records. RESULTS: The overall prevalence of MS was 53.2%, and the mean of MS score was 2.6 for patients at a cardiovascular outpatient clinic (78% of the patients had hypertension). Dietary habits among the life style characteristics had significant influence on the prevalence risk of MS and MS scores. And also interestingly, the classification and regression tree (CART) model suggested that the high prevalence risk groups for MS were older adults (61.5< or =age<79.4), and adults between 48.5 and 61.5 yr of age with bad dietary habits. CONCLUSION: This study indicates that nurses should focus on dietary habits of patients (especially patients classified as high prevalence risk for MS) for improvement and prevention of MS prevalence risk.

Development of an Eye Care Protocol for ICU Patients / 기본간호학회지

PURPOSE: The purpose of this study was to develop an eye care protocol for intensive care unit (ICU) patients. METHOD: A systematic review was conducted to develop an eye care protocol for ICU patients. Searches were performed using computerized databases (CINAHL, MEDLINE, EBM Review) and citation search from 1996 to January 2007. For the keywords, "eye care", and "randomized controlled trial" were used to identify experimental studies regarding eye care for ICU patients. After reviewing the collected studies, a preliminary eye care protocol algorithm was created. Then, content validity was examined with ophthalmologists and ICU nurses. RESULTS: Six studies were included to serve as a basis for framing of the preliminary algorithm. The final eye care protocol was completed after verifying the preliminary algorithm's content validity. The final eye care protocol was organized in the following manner: 3 items in the assessment stage, 7 items in the no-risk stage, 4 items in the low-risk stage, and 5 items in the high-risk stage. CONCLUSION: The results indicate that, for ICU patients, nurses can broaden their knowledge regarding ocular diseases, as well as improve their practice-based eye care nursing performance.

Development of a Stress Scale for Korean Nursing Students / 간호학회지

PURPOSE: The purpose of this study was to develop a stress measurement scale for Korean nursing students. METHODS: Sixty preliminary items were selected by classifying 229 basic items extracted via literature review and Q-sorting method. In order to verify the reliability and validity of the preliminary instrument, data were collected from 617 nursing students in 2 colleges of nursing in Korea. RESULTS: As a result of the item analysis, 58 items were selected. They consisted of 2 types of stress which were college-based stress (38 items) and clinical-based stress (20 items). Ten factors in college-based stress and four factors in clinical-based stress were extracted by factor analysis, and each had a total variance of 63.01%, and 64.93%. Cronbach's Alpha of those 58 items were .937 in college-based stress and .922 in clinical-based stress, which was high. CONCLUSION: This paper is meaningful in a way that it has developed a tool capable of measuring stress for nursing students, which reflects the characteristics of our country. It is recommended for further study to re-verify the relevance and stability of this measurement.

Knowledge, Perception & Practice of Eye Care Nursing among Nurses in Intensive Care Units / 기본간호학회지

PURPOSE: The purpose of this study was to identify levels of knowledge, perception, and practice of eye care as part of nursing care in the ICU. METHOD: A descriptive, cross-sectional study design was used. The participants in this study were 269 registered nurses working in the ICUs of five university hospitals in Seoul, Korea. Between November 2005 and December 2005, data were collected using a semi-structured questionnaire developed by the researchers, and analyzed using the SPSS Program. RESULTS: In general, levels of knowledge of nursing care for the eyes were moderate among ICU nurses, but levels of perception of nursing care for the eyes were very high. Of the respondents, 61.7% reported that they would consult a doctor whenever they found an eye problem. Only 42.4% nurses answered that they provide eye care as part of the daily routine and 43.9% nurses responded that they cleanse the eye lids with wet saline gauze. In regression analysis, the practice of eye care as part of nursing was significantly influenced by perception of nursing care for the eyes, and knowledge of interventions for nursing care for the eyes. CONCLUSION: These results suggest that education on care of the eyes for ICU nurses and the development of a standardized eye care protocol should be done to improve quality of nursing care in the ICU.

The Use of Propensity Score Matching for Evaluation of the Effects of Nursing Interventions / 간호학회지

BACKGROUND: Nursing intervention studies often suffer from a selection bias introduced by failure of random assignment. Evaluation with selection bias could under or over-estimate any intervention's effects. PS matching (PSM) can reduce a selection bias through matching similar Propensity Scores (PS). PS is defined as the conditional probability of being treated given the individual's covariates and it can be reused to balance the covariates of two groups. PURPOSE: This study was done to assess the significance of PSM as an alternative evaluation method of nursing interventions. METHOD: An intervention study for patients with some baseline individual characteristic differences between two groups was used for this demonstration. The result of a t-test with PSM was compared with a t-test without matching. RESULTS: The level of HbA1c at 12 months after baseline was different between the two groups in terms of matching or not. CONCLUSION: This study demonstrated the effects of a quasi-random assignment. Evaluation using PSM can reduce a selection bias impact that affects the result of the nursing intervention. Analyzing nursing research more objectively to reduce selection bias using PSM is needed.

The Use of Propensity Score Matching for Evaluation of the Effects of Nursing Interventions / 간호학회지

BACKGROUND: Nursing intervention studies often suffer from a selection bias introduced by failure of random assignment. Evaluation with selection bias could under or over-estimate any intervention's effects. PS matching (PSM) can reduce a selection bias through matching similar Propensity Scores (PS). PS is defined as the conditional probability of being treated given the individual's covariates and it can be reused to balance the covariates of two groups. PURPOSE: This study was done to assess the significance of PSM as an alternative evaluation method of nursing interventions. METHOD: An intervention study for patients with some baseline individual characteristic differences between two groups was used for this demonstration. The result of a t-test with PSM was compared with a t-test without matching. RESULTS: The level of HbA1c at 12 months after baseline was different between the two groups in terms of matching or not. CONCLUSION: This study demonstrated the effects of a quasi-random assignment. Evaluation using PSM can reduce a selection bias impact that affects the result of the nursing intervention. Analyzing nursing research more objectively to reduce selection bias using PSM is needed.

The Effects of a Comprehensive Life Style Modification Program on Glycemic Control and Stress Response in Type 2 Diabetes / 간호학회지

PURPOSE: This study was to evaluate the effects of a comprehensive life style modification program on glycemic control and stress response in type 2 diabetes. METHOD: The participants(n=34) with type 2 diabetes were divided into either a usual care(control) or treatment(experimental) group. The experimental group(n=21) received a program that was based on a comprehensive life style modification protocol at a weekly meeting for 16 weeks. They also participated in individually prescribed exercise and diet along with stress management and self monitoring. The participants were followed for 6 months, during which postprandial glucose, HbA1C, and stress response inventory were measured. RESULT: The experimental group showed a significant lower postprandial glucose and stress response compared to those of the control group. However, there was no significant change in the HbA1C value in either group. CONCLUSIONS: These results suggest that a type 2 diabetes comprehensive lifestyle modification program may lead to clinical improvement in glycemic control and reduce the stress response.

Effects of Walking Exercise Program for Health Status in Patients on Continuous Ambulatory Peritoneal Dialysis / 대한신장학회잡지

BACKGROUND: It is necessary to exercise in Continuous Ambulatory Peritoneal Dialysis (CAPD) patients but it's difficult because of their physical condition and little motivation. The purpose of this study was to evaluate the effects of the walking exercise program on health status in CAPD patients. METHODS: A nonequivalent control group with pre- and post-test was designed to examine the effects of the program. Data collection was done from December, 2002 to June, 2003. The study participants were selected according to the criteria among the patients who were receiving CAPD at the department of Kidney Center, NIHC Ilsan hospital. The walking exercise program was consisted of an exercise education protocol, an exercise prescription, and a counselling protocol based on a framework of self-efficacy promotion. The exerciser group which was composed of 19 participants was educated based on an exercise education protocol and carried out walking exercise for two to four times a week upon taking verbal persuasion biweekly through telephone or face-to-face interview for 12 weeks, while 17 participants in control group were received no intervention. RESULTS: There was significant differences between two groups; the exerciser group showed better physical function (p=0.03), higher VO2 max (p=0.01) and higher serum albumin level (p=0.02) than the results of control group. However, there were no differences in lipid metabolism. CONCLUSION: The walking exercise program was found to have an effect to increase health status of CAPD patients. The results provided evidences for the importance of continuous physical activity in CAPD patients.

An Analysis of Trends in Exercise-Related Studies in Nursing and Non-Nursing Fields in Korea / 기본간호학회지

PURPOSE: This study was done to analyze the trends in excercise-related research in nursing and non nursing research studies published in Korea. METHOD: Two hundred and ten research studies published in Korea between January, 1990 and December, 2002 were analyzed according to the criteria of methological characteristics, pattern of excercise-related program, and measurement index of exercise effect. RESULTS: There were twice many papers from nursing compared to other fields, and many experimental studies in nursing were done with more variety than in non nursing fields. Aspects of exercise pattern, such as excercise type, duration, and frequency, exercise-intervention pattern, and applying theory were especially included. When patterns of excercise therapy and index of exercise effect were analyzed, each researcher used their own unique excercise contents and intervention patterns(excercise time per week, exercise duration at each time period, excercise, intervention time, and etc). CONCLUSION: For the importance of exercise therapy to health improvement and the proper suggestion of exercise therapy on the basis of this research, meta-analysis of exercise effect are needed, and with this analysis, intervention patterns of exercise, development of standard exercise therapy, and identification of exercise effects are required.

A Meta-Analysis of the Effects of Exercise Programs on Glucose and Lipid Metabolism and Cardiac Function in Patients with TypeII Diabetes Mellitus / 간호학회지

PURPOSE: This study was a systematic review and meta-analysis of the effects of exercise programs in patients with type II diabetes mellitus. METHOD: Two investigators systematically searched and reviewed English articles from PUBMED from 1988 to 2004, selecting randomized controlled trials on structured exercise programs for DM patients. Out of 87 studies identified, a meta analysis was done for eleven studies which satisfied inclusion criteria and focused on glycemic indices, lipid indices, and cardiac function indices. RESULTS: The means and standard deviations were compared for experimental groups that received exercise-only or exercise and diet programs and control groups that received no intervention or only diet education. The groups were considered homogeneous as the p value of the Q score in each variable group was over 0.05. The experimental groups demonstrated a moderate positive effect on HbA1c and VO2max (d=0.55 & 0.5), and a small positive effect on fasting blood glucose and cholesterol (d=0.38 & 0.27) compared to the control groups. HDL and LDL cholesterol levels, however, showed a very low positive effect (d=0.11 & 0.12) in the experimental groups. Aerobic exercise was more beneficial than resistance exercise on HbA1c (d=0.59 vs 0.28) in the groups. CONCLUSIONS: Regular exercise has a positive effect on HbA1c, fasting blood glucose, total cholesterol, HDL cholesterol, LDL cholesterol, and VO2max in Type 2 diabetic patients.

Development of a Health Information Web Site Evaluation Categories with Items for Diabetes Mellitus / 대한의료정보학회지

OBJECTIVE: The purpose of this study was to develop a health information web site evaluation categories with items for diabetes mellitus in order to offer verified health information, and to propose directions for development of web sites. METHODS: A preliminary evaluation categories with items was developed using domestic and foreign web site evaluation standards for health information and through a review of the literature. The evaluation categories with items was composed of 'evaluation for web site attributes' and 'evaluation for content information on diabetes mellitus'. Through expert validity tests and a feasibility test of the preliminary tool, the health information Web site evaluation tool for diabetes mellitus was finalized. RESULTS: This evaluation categories with items included 'evaluation for web site attributes' and 'evaluation for content information on diabetes mellitus'. 'Evaluation for web site attributes' included 8 categories with 28 items. The 'evaluation for content information on diabetes mellitus' included 7 categories with 40 items. 'Evaluation component for content' and 'evaluation of category content' included 4 items on 'accuracy', 6 on 'harmfulness' and 3 on 'comprehensibility'. CONCLUSION: From this study guidelines are propose for providing health information for diabetes mellitus, so that health information providers will be able to offer consumers verified good quality health information themselves.

The Effects of a Physical Activity Reinforcement Program on Exercise Compliance, Depression, and Anxiety in Continuous Ambulatory Peritoneal Dialysis Patients / 간호학회지

PURPOSE: This study was to evaluate the effects of a physical activity reinforcement program on exercise compliance, depression, and anxiety in continuous ambulatory peritoneal dialysis(CAPD) patients. METHOD: A nonequivalent control group with a pre-post test was designed. Data collection was done from December, 2002 to June, 2003 at a hoapital. The degree of depression and anxiety of the patients was assessed by the score of SCL-90-R, and exercise compliance was measured by exercise period, frequency, time and intensity. The experimental group was composed of 19 participants who were educated based on an exercise education protocol and carried out walking exercises two to four times a week after hearing verbal persuasion biweekly through the telephone or a face-to-face interview for 12 weeks, while 17 participants in control group received no intervention. RESULT: 1. The experimental group showed significant improvement in self-efficacy of exercise compliance (U=79.00, p=.01), exercise period (x2=20.84, p=.00), exercise frequency (x2=9.03, p=.01), exercise time (x2=9.03, p=.01) and exercise intensity (x2=11.09, p=.00) compared to those of the control group. 2. The experimental group showed a lower depression score (U=84.50, p=.01) than the results of the control group. 3. However, there were no changes in anxiety level compared to the control group. CONCLUSION: The physical activity reinforcement program was found to have an effect on exercise compliance and the depression score of CAPD patients. The results provided evidence for the importance of physical activity and verbal persuasion in CAPD patients.