Effects of a supportive program on uncertainty, anxiety, and maternal-fetal attachment in women with high-risk pregnancy

Purpose@#The purpose of this study was to identify the effects of a supportive program on uncertainty, anxiety, and maternal-fetal attachment in high-risk pregnant women. @*Methods@#The participants were 59 high-risk pregnant women admitted to the maternal-fetal intensive care unit. The control group (n=30) received usual treatment and antenatal care, while the experimental group (n=29) received an additional supportive program. Uncertainty, anxiety, and maternal-fetal attachment were measured in both groups prior to the intervention and at 3 days and 10 days (or at discharge) after the intervention. Data were analyzed with the t-test, chi-square test, repeated-measures analysis of covariance, and the Greenhouse-Geisser correction in SPSS version 23.0. @*Results@#A supportive program including information provision, nutritional care, emotional care, and exercise care was developed and its effectiveness was tested. All variables except women’s length of stay were found to be homogeneous the between experimental and control groups in the pre-test. Length of stay was calculated as a covariate for testing hypotheses. There was a significant difference in state anxiety over time between the two groups, while there were no differences in uncertainty or maternal-fetal attachment. @*Conclusion@#A supportive program was identified as an effective nursing intervention on state anxiety in high-risk pregnant women during their stay in the maternal-fetal intensive care unit. It is suggested that nurses could apply this program to alleviate high-risk pregnant women’s state anxiety, and that this program could be modified to be more effective on uncertainty and maternal-fetal attachment in high-risk pregnant women.

Influence of Stress, Social Support and Lifestyle on Health-related Quality of Life in Middle Aged Women

PURPOSE: Purpose of this study was to investigate the effects of stress, social support, and lifestyle on health-related quality of life among middle-aged women. METHODS: One hundred forty three-middle aged women were recruited and completed questionnaires regarding their stress, social support, lifestyle and health-related quality of life. Data was analyzed by using descriptive statistics, t-test, ANOVA, and multiple regression. RESULTS: Regression model was statistically significant (F=24.80, p<.001) with 46% of adjusted R2. Stress showed to be a major factor influencing health-related quality of life in middle-aged women (p<.001) and the presence of chronic illness (p=.011) was noted as next in the result of a multiple regression analysis. CONCLUSION: The results suggest that nursing professionals should include strategies to reduce stress and to consider helping women with chronic illness when developing a health promotion program to increase health related quality of life for middle-aged women.

Influence of Urinary Dysfunction on Quality of Life in Women with Cervical Cancer after Radical Hysterectomy

PURPOSE: This study was conducted to identify the quality of life (QOL) and the influence of urinary dysfunction on QOL in women with cervical cancer after radical hysterectomy. METHODS: A secondary analysis was conducted using data collected for a previous study of Chun et al. and the same subjects of a group of 157 cervical cancer patients. Novel data from the EORTC QLQ-C30 and QLQ-CX24 were used in addition to the results of urinary dysfunction from the previous study. Descriptive analysis of EORTC QLQ-C30 and QLQ-CX24 results and a multiple regression analysis were conducted to explore the influence of urinary dysfunction on global QOL. RESULTS: Subjects showed low QOL especially for social, physical and role function in the EORTC QLQ-C30 as well as the QLQ-CX24. Intensity of urinary dysfunction (p<.001) as well as daily life distress due to urinary dysfunction (p<.001) were the most significant factors affecting QOL in women with cervical cancer after radical hysterectomy. CONCLUSION: Results suggest that oncology nurses should pay attention to the relatively low QOL of post-hysterectomy patients. They should also consider the influence of urinary dysfunction on QOL when developing nursing intervention programs to increase the QOL for women with cervical cancer after radical hysterectomy.

Development of Lower Extremity Lymphedema Nursing Practice Protocol for Patients Following Gynecologic Cancer Treatment

PURPOSE: This study aimed to develop and evaluate the lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment. METHODS: Thirteen web-sites were searched for eligible clinical practice guidelines (CPGs) and eleven databases were searched to identify evidence to develop a lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment. RESULTS: Based on the inclusion and exclusion criteria, eight CPGs and ninety-six studies, two guidelines and eight studies were identified as evidence. The protocol development group consisted of ten experts who have at least five years' experience in the related area. A lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment was developed including forty-three recommendations in five domains. Significant differences were found in nurses' pre and post knowledge and confidence on lower extremity lymphedema prevention and management. CONCLUSION: Nurses and other professionals could utilize this evidence based lower extremity lymphedema nursing practice protocol and apply it to patients undergoing gynecologic cancer treatment.

Prevalence of Metabolic Syndrome and Its Components in Adult Women

PURPOSE: The purpose of this study was to investigate the prevalence of metabolic syndrome and diagnostic components in adult women. METHODS: The subjects of this study were 12,016 women that were aged twenty years or older and underwent an annual health check-up for National Health Insurance Service (NHIS) from 2009 to 2013. Data including blood pressure, waist circumstance, fasting glucose, triglyceride, and high density lipoprotein cholesterol (HDL-C) were received from the NHIS. This data was analyzed through the use of descriptive statistics, χ2-test, and multiple logistic regression. RESULTS: The prevalence of metabolic syndrome and diagnostic components increased with age. In the five diagnostic components of the metabolic syndrome, the prevalence of low HDL-C was highest in 20s to 40s. The prevalence of high blood pressure was highest in the people aged fifty or older. The risk of metabolic syndrome in 2013 was higher in women with abnormal diagnostic component of metabolic syndrome in 2009 and highest in women with abnormal waist circumstance in 2009. CONCLUSION: There was a need to investigate the prevalence of metabolic syndrome components according to age. Education on metabolic syndrome was required for those that had one or two abnormal diagnostic components. The risk of abdominal obesity related to metabolic syndrome needs to be emphasized. Moreover the education for management of abdominal obesity also needs to be emphasised.

Effects of a Sleep Improvement Program Combined with Aroma-Necklace on Sleep, Depression, Anxiety and Blood Pressure in Elderly Women

PURPOSE: The purpose of this study was to evaluate the effectiveness of a sleep improvement program combined with an aroma-necklace on sleep, depression, anxiety, and blood pressure in elderly women living at home. METHODS: A program consisting of a four-week (one hour per week) sleep improvement intervention plus use of an aroma-necklace, was developed based on Cox's Interaction Model of Client Health Behavior. 70 elderly women were assigned to the experimental (n=35) or control group with no intervention (n=35). Data from 62 participants (32 in the experimental and 30 in the control) were analyzed using the SPSS 21.0 program. Women in the experimental group were instructed to constantly wear the aroma necklace filled with marjoram and orange oil until the program was completed. Sleep quality, sleep duration, sleep satisfaction, depression, anxiety, and blood pressure were measured to identify the effectiveness of the program. RESULTS: Significant group differences were found in sleep quality (t=-5.10, p<.001), sleep duration (z=-3.10, p=.002), sleep satisfaction (z=-4.13, p=<.001), depression (t=2.53, p=.015), and anxiety (z=-2.47, p=.014). No differences were found in the systolic or diastolic blood pressure. CONCLUSION: The results indicate that a sleep improvement program combined with an aroma-necklace was effective in improving sleep disturbances in elderly women living at home. Nurses may contribute to improving sleep among elderly women by applying this program to aged women living in various environments.

Health Promotion Behavior in Colorectal Cancer Patients and General Adults

PURPOSE: This study was designed to identify the differences of individual disease related characteristics, behavior-specific cognitions and affect, health promoting behavior between colorectal cancer patients and the general public. METHODS: Seventy newly diagnosed colorectal cancer patients and 72 healthy adults from the general population were recruited and asked to complete a questionnaire on their disease related characteristics, behavior specific cognitions and affect, health promoting behavior from April to September 2011. Independent two sample t-test analysis was used to compare the two groups. RESULTS: There were significant differences in family history of colon polyps or colorectal cancer, history of colon polyps lifetime tobacco usage, amount of daily smoking, frequencies of alcohol consumption over a year, constipation, interval of bowel movements, perceived benefits, perceived barriers, self-efficacy, self-esteem, perceived health status, health locus of control, and health promotion behaviors between the two groups. CONCLUSION: This study suggests that nursing professionals need to consider family history of colon polyp or colorectal cancer, history of colon polyps, tobacco usage, alcohol consumption, constipation and frequency of bowel movements in developing a colorectal cancer prevention program. Strategies to increase health promotion behavior and behavior-specific cognitions and affect factors including perceived benefit, perceived barriers, self-efficacy, self-esteem, perceived health status, health locus of control should be included in colorectal cancer prevention programs.

Frequency, Intensity and Daily Life Distress of Urinary Dysfunction in Women with Cervical Cancer after Radical Hysterectomy

PURPOSE: This study was done to identify frequency, intensity of urinary dysfunction and daily life distress in women after a radical hysterectomy for cervical cancer. METHODS: One hundred and fifty seven women who had undergone a radical hysterectomy and one hundred and sixty five women as healthy controls completed questionnaires on intensity of urinary dysfunction and daily life distress caused by urinary dysfunction. RESULTS: Women with cervical cancer showed higher frequency of urinary dysfunction than healthy controls. Major urinary dysfunction for women with cervical cancer in order of frequency were night-time incontinence (odds ratio=10.39, p<.001), difficulty in starting urination, weak urine stream and sense of incomplete emptying of bladder. The highest score on intensity was difficulty in starting urination, followed by urgency, weak urine stream, daytime frequency and sense of incomplete emptying. Night-time incontinence was the urinary symptom causing the most daily life distress for cervical cancer women followed by difficulty in starting urination, urgency, sense of incomplete emptying, and night-time frequency. CONCLUSION: Results suggest that nurses should address the potential postoperative urinary complications and develop long term interventions to decrease urinary dysfunction and daily life distress for women who have had a radical hysterectomy for cervical cancer.

Effect of Structured Information on Immediate Preoperative Anxiety and Uncertainty for Women Undergoing Laparoscopic Hysterectomy

PURPOSE: Purpose of this study was to identify the effect of structured information on immediate preoperative anxiety and uncertainty for women undergoing total laparoscopic hysterectomy. METHODS: Sixty women who were admitted for total laparoscopic hysterectomy were recruited at a university hospital in Gyeonggi-do from June to October 2014. Thirty women were assigned to either the experimental or the control group. Women in the experimental group were provided structured information, which consisted of visual and auditory materials about surgical preparation and process, practical experience on devices such as IV-PCA pump and Inspiro-meter and actual experience on route to go to the operating room. State-anxiety, uncertainty, and blood pressure and pulse rate as biological indicators were measured before and after the intervention to examine the effect. RESULTS: Significant group differences were found on state anxiety, uncertainty, including ambiguity, inconsistency, and unpredictability at the holding area. There was a significant difference on pulse rate in the operating room between the two groups. CONCLUSION: Findings demonstrated that the structured information provided for women undergoing laparoscopic hysterectomy preoperatively was effective on immediate preoperative anxiety and uncertainty. Nurses may contribute to decreasing patients' anxiety and uncertainty by utilizing this structured information preoperatively.

Problems with Bone Health and the Influencing Factors of Bone Mineral Density in Women across the Life Cycle

PURPOSE: This study was conducted to identify the problem of bone health and potential influencing factors of bone mineral density (BMD) for women across the life cycle of menopause. METHODS: Complex sampling design data analysis was performed on the fifth Korea National Health and Nutrition Examination Survey 2010 in order to identify the problems with bone health, BMD and its influencing factors in 3,499 women who answered the menopausal status. Women's life cycle was categorized by premenopausal, postmenopausal, and elderly. RESULTS: 35.1% of premenopausal women, 73.3% of postmenopausal women, and 96.0% of elderly women had problems with bone health that were related to low BMD. Influencing factors of BMD were residential area, alcohol drinking, and body mass index (BMI) for premenopausal women; age, residential area, education, marital status, income, and BMI for postmenopausal women; and age, education, and BMI for elderly women. CONCLUSION: Problems with bone health required to be considered as a major health problem in all women regardless their life cycle. Interventions to maximize BMD need to be developed by considering its influencingfactors across the women's life cycle.

Factors Influencing Desired Postnatal Weight Loss in Women after Birth

PURPOSE: The purpose of this study was to identify factors influencing desired postnatal weight loss in women after birth. METHODS: With correlational survey design, 191women of the study participants completed questionnaires on their desired postnatal weight loss and related factors, and body and health concerns during their hospitalization after birth. Data were collected from February to May, 2011. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and multiple linear regression. RESULTS: The women's gestational weight gain, pre-pregnant BMI, body concerns, expected time to reach the desired weight after birth and health concerns were identified as factors influencing desired postnatal weight loss in women after birth. The model explained 68% of the variance. CONCLUSION: Results suggest that nurses in women's health care should consider women's gestational weight, pre-pregnant BMI and their body concerns, health concerns and expected time to reach the desired weight after birth when developing weight management program for women after birth.

Prioritization of Research Topics of Korean Oncology Nurses

PURPOSE: The aim of this study was to determine the prioritization of research topics by Korean oncology nurses. METHODS: A descriptive and cross-sectional survey was conducted via the website of the Korean Oncology Nursing Society, with participation sought by email from all of its members. RESULTS: Overall, 'pain' and 'quality of life' were the most important among the 74 topics, 'cancer prevention' was ranked 47th, while 'informatics' and 'telehealth' were ranked 62nd and 72nd, respectively. Korean oncology nursing research needs to be expanded to include community-based cancer prevention. In addition, research on informatics and telehealth in the oncology nursing area is necessary given the current dramatic changes in the implementation of information technology in medical services. CONCLUSION: These findings may contribute toward the development of a Korean oncology nursing research agenda and the provision of information to funding agencies with respect to setting the priorities of oncology nursing research.

Influence of Childbirth Experience and Postpartum Depression on Quality of Life in Women after Birth

PURPOSE: The purpose of this study was to identify influence of childbirth experience and postpartum depression on quality of life in women after birth. METHODS: Two hundred and eleven postpartum women were asked to complete the questionnaires on their childbirth experience during their admission and on their postpartum depression and quality of life between one to three weeks after birth. Initial data were collected from February 1 to May 30, 2011 at two obstetric hospitals in Busan, Korea. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and hierarchical multiple regression. RESULTS: The women's childbirth experience and postpartum depression were identified as factors influencing quality of life after birth. The model explained 50% of the variables. CONCLUSION: Results suggest that childbirth educators should include strategies to increase a positive childbirth experience and to decrease postpartum depression in their education programs in order to improve women's quality of life.

Incidence of Osteoporosis and Falls and Predictors of Fracture Risk in Postmenopausal Women

PURPOSE: The purpose of this study was to investigate the incidence of osteoporosis and falls and their consequences, and to identify predictors of fracture risk in the postmenopausal women. METHODS: A total of 687 postmenopausal women were recruited through a stratified convenience sampling. A structured questionnaire was used to obtain osteoporosis and fall history and details of their most recent fall. To predict fracture risk factors, we collected demographic and physical health variables related osteoporosis and fall. Fracture risk was measured by FRAX(R) to calculate 10-year probability of major osteoporotic and hip fracture. RESULTS: The prevalence of osteoporosis was 22.1%, and 66.4% of them had treatments for osteoporosis. The incidence of falls during the past year was 19.2% and 38.6% of those who fell suffered consequent fractures. Women with history of osteoporosis and falls were significant predictors of 10-year probability of major osteoporotic and hip fracture. Other significant predictors were history of fracture, chronic disease, surgical menopause, lower BMI, poorer perceived health and no job. CONCLUSION: It appears that history of osteoporosis and falls are main predictors of fracture risk. Nursing assessment should be performed by detail history taking for osteoporosis, fall, chronic disease, and fracture to screen fracture risk group among postmenopausal women.

Seoul Teacher's Satisfaction with and Needs for Health Examination and Health Promotion Programs

PURPOSE: The purpose of this study was to investigate Seoul teacher's satisfaction with and needs for health examination and health promotion programs. METHODS: The participants were 3,186 teachers in Seoul. Data were collected through an on-line survey system from November 16 to December 7, 2008. Collected data were analyzed by descriptive statistics, t-test, ANOVA, and Scheffe's test using PASW 18.0 program. RESULTS: Teacher's satisfaction with teacher health examination was low and needs for detailed tests of cancer and vocal cord disorders were high. Teacher's satisfaction with teacher health promotion programs was low and needs for stress management, exercise and vocal cord protection program were high. CONCLUSION: Vocal cord disorders should be included in teacher health examination and vocal cord protection program should be provided for teacher's health promotion. Stress management and exercise program should also be provided for teacher's health promotion.

Effect of Depression and Anxiety on Symptoms in Thyroid Cancer Patients Undergoing Radioactive Iodine (I131) Therapy

PURPOSE: This study was to identify the symptom severity, interference and their psychological predictors in thyroid cancer patients hospitalized for radioactive iodine administration. METHODS: One hundred seventy-seven thyroid cancer patients admitted to the isolation room for Iodine (I131) therapy were recruited. Subjects were asked to complete the questionnaire on core symptoms, thyroid cancer symptoms, interference, depression and state anxiety in the evening after receiving radioactive iodine therapy. Data was analyzed using frequency, percentage, mean, Pearson's correlation, and multiple regression with SPSS vs. 19. RESULTS: Lack of appetite, drowsiness, sleep disturbance, fatigue, and nausea were the 5 most core symptoms. More than 20% of patients experienced moderate to severe thyroid cancer symptoms including feeling cold, hoarseness, swallowing difficulty, and feeling hot. More than 30% of subjects experienced moderate to severe interferences in mood, general activity, and 22% in walking. Depression and state anxiety were identified as predictors of core symptoms, thyroid symptom severity and interference. CONCLUSION: Nursing interventions to reduce the symptom severity and interference need to be developed by considering thyroid cancer patients' depression and anxiety when hospitalized in the isolation room for radioactive iodine administration.

Effects of a One Session Spouse-Support Enhancement Childbirth Education on Childbirth Self-Efficacy and Perception of Childbirth Experience in Women and their Husbands

PURPOSE: This study was conducted to evaluate the effect of a one-session spouse-support enhancement childbirth education on childbirth self-efficacy and perception of childbirth experience. METHODS: The design of this study was a nonequivalent control group pretest-posttest experiment. The participants in the study were 31 couples in the experimental group and 30 in the control group. The experimental couples were provided with one session on spouse-support enhancement childbirth education the night before delivery. Data were collected at two hours after delivery using the Childbirth Self-Efficacy Inventory (CBSEI) and perception of childbirth experience scale. Data were analyzed using PASW statistics 18 program. Frequencies, percentage, mean, chi2 test, t-test were used for data analysis. RESULTS: Childbirth self-efficacy significantly increased in the experimental group as compared to the control group, but there was no significant difference in perception of childbirth experience in the experimental group compared to the control group. CONCLUSION: The results suggest that a one-session childbirth education has beneficial effects on enhancing childbirth self-efficacy in pregnant couples. A one-session spouse-support enhancement childbirth education is recommended as an effective nursing intervention to promote couple's childbirth self-efficacy and it is also recommended that modifications of program to promote women's childbirth experience should be considered.

Effect of Sexual Education Program on Female College Student's Sexual Knowledge and Sexual Autonomy

PURPOSE: The purpose of this study was to evaluate the effect of the sexual education program on female college students' sexual knowledge and sexual autonomy. METHODS: The integrative 5-week (15 hour) sexual education program reflecting control and coping aspects of sexual autonomy was developed based on self-determination theory. 59 female students were assigned to the experimental (n=29) and the control group (n=30). Students completed the sexual knowledge and the sexual autonomy questionnaires at prior to the program, right after and 10 weeks after the completion of the program. Independent t-test were used to test the effectiveness of the program. RESULTS: Significant group differences were found on sexual autonomy score right after and 10weeks after the completion of the program. No significant group differences were found on sexual knowledge at any time after the program completion. CONCLUSION: The results indicate that the 5-week Sexual Education Program was effective in increasing female college students' sexual autonomy. Nursing professors majoring women's health nursing may contribute to improving college students' sexual autonomy by opening the sexual education program as a general elective curriculum. Strategies to improve sexual knowledge need to be considered for better effectiveness of the program.

Effectiveness of PLISSIT Model Sexual Program on Female Sexual Function for Women with Gynecologic Cancer

PURPOSE: The purpose of this study was to evaluate the effectiveness of the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model sexual program on female sexual function for women with gynecologic cancer. METHODS: The integrative 6-hr (two hours per session) program reflecting physical and psychosocial aspects of women's sexuality was developed based on Annon's PLISSIT model. Participants were 61 women with cervical, ovarian, or endometrial cancer. Of them, 29 were assigned to the experimental group and 32 to the control group. The women completed the Female Sexual Function Index (FSFI) including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain. Independent t-test and repeated measured ANOVA were used to test the effectiveness of the program. RESULTS: Significant group differences were found on FSFI sub-domain scores including sexual desire, arousal, lubrication, orgasm, and satisfaction but not pain. Significant time differences were found on all domains except for pain in the experimental group repeated measured ANOVA. CONCLUSION: The results indicate that the three-week PLISSIT model sexual program is effective in increasing sexual function for women with gynecologic cancer. Nurses may contribute to improving women's sexual function by utilizing the program. Strategies to relieve sexual pain need to be considered for greater effectiveness of the program.

Student Experience and Satisfaction with Clinical Nursing Practice in Women's Health Nursing / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify students' experiences of performance and their satisfaction with clinical nursing practice in Women's health nursing. METHODS: Data was collected using questionnaire consisting of 104; 89,; and 82 nursing activities with 12; 10; and 7 domains for delivery floor, obstetric, and gynecologic wards retrospectively. Five hundred ninety nursing students from 10 four year and one three year colleges, were recruited and selected for data collection. RESULTS: Site specific core nursing activities among top 15 items of performed experience were: interpreting fetal monitoring; massage for pain reduction; breathing technique; perineal pad change; non stress test; manual check for uterine contraction; and position change for the delivery floor. Experiences of clinical nursing practice for the obstetric ward and the gynecologic ward were identified and ranked as well. Observation of delivery, measurement & test during labor and observation of anesthesia and operation were the highest ranked activity domains of satisfaction for delivery floor, obstetric and gynecologic wards retrospectively. CONCLUSION: Discussions are needed to standardize curriculum for clinical practice in women's health nursing initiated at the level of Korean Society of Womens' Health Nursing by reflecting this result. Strategic approaches are emphasized in order to enhance a collaboration between clinical fields and colleges.