Characteristics of Aerobic Exercise as Determinants of Blood Pressure Control in Hypertensive Patients: A Systematic Review and Meta-Analysis.

PURPOSE: The purpose of this study was to evaluate the effect on blood pressure (BP) and heart rate (HR) according to aerobic exercise characteristics in adults with hypertension using a systematic review and meta-analysis. METHODS: The related researches were selected from PubMed, EMBASE, Cochrane library, CINAHL, PsycINFO, SPORTDiscus and 5 domestic databases up to September 4, 2019. To estimate the effect size, random effect models were used to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on BP and HR. RESULTS: A total of 37 RCTs with 1,813 samples were included. Aerobic exercise was found to significantly reduce systolic BP (WMD, - 8.29 mmHg; 95% CI, - 10.12 to - 6.46), diastolic BP (WMD, - 5.19 mmHg; 95% CI, - 6.24 to - 4.14) and HR (WMD, - 4.22 beats/min; 95% CI, - 5.36 to -3.09). In detail, systolic BP and diastolic BP were significantly decreased in all groups of exercise types, frequency and duration. Systolic BP and diastolic BP were significantly decreased in the moderate and vigorous-intensity group. Exercise characteristics with the most dramatical change in systolic BP were water-based training, moderate-intensity, 3 times a week and 8 to 11 weeks of duration. In diastolic BP, the greatest effect size was over 24 weeks of exercise. CONCLUSION: Moderate aerobic exercise, especially water-based exercise can be an important part of lifestyle modification for hypertensive patients. Also, it can be recommended in a variety of clinical settings for lowering BP and HR. However, there is insufficient evidence that low-intensity exercise is effective in lowering BP.

Literature Review for the Effects of Physical Activity on Musculoskeletal Outcomes in Community-dwelling Older Adults.

PURPOSE: The purpose of this study was to review the effects of physical activity on musculoskeletal outcomes in older Koreans. METHODS: Experimental studies were retrieved from the search engines (PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed). The selected studies for analysis were 27 articles of musculoskeletal outcomes (gait, muscle strength, flexibility, balance, grip strength, endurance, body fat, and weight) from 515 articles. RESULTS: The most common type of physical activity was a resistance exercise. There were significant improvements in gait (71.4%), muscle strength (86.7%), flexibility (63.6%), balance (72.2%), grip strength (71.4%), endurance (71.4%), body fat (57.1%), and weight (28.6%). The activity programs that apply over 150 minutes a week showed greater improvement of 69.5% than 65.0% from those did not meet the guidelines totally. CONCLUSION: Based on the review, we conclude that regular physical activity in the elderly may improve the musculoskeletal outcomes. To be more effective programs, it is necessary to meet the guidelines of 150 minutes a week or 30 minutes of moderate-intensity activities on 5 days per week for the elderly.

Relationship between Physical activity and Cardiovascular Outcomes in the Korean Elderly: Review of Experimental Studies.

PURPOSE: The purpose of this study was to review the relationship between physical activity and cardiovascular outcomes in the Korean elderly. METHODS: Experimental studies were located using PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed. The selected studies for analysis were 20 articles of cardiovascular outcomes (total cholesterol, triglyceride, high density lipoprotein (HDL), low density lipoprotein (LDL), blood pressure, and pulse rate) from 515 articles. RESULTS: One-group pretest-posttest design was the most common. The main physical activity was an aerobic exercise. Five of 14 studies reported a significant improvement of total cholesterol. Four of 14 studies found relationship between exercise and triglyceride. Eight of 12 studies reported a significant improvement of HDL, whereas 3 of 9 studies reported a significant improvement of LDL. In over 60% of selected studies, reported significant improvement of blood pressure. CONCLUSION: Based on the review, it suggests that regular physical activity of the elderly may improve cardiovascular outcomes.

[Effects of rotated endotracheal tube fixation method on unplanned extubation, oral mucosa and facial skin integrity in ICU patients].

PURPOSE: The study was done to compare effects of two endotracheal tube (ET tube) fixation methods (rotated fixation versus conventional) on unplanned extubation and skin integrity for orally intubated patients in intensive care units. METHODS: The research design was a non-equivalent control group with repeated measures design. Participants were 80 patients; 40 participants assigned to each group. ET tube for the experimental participants fixed with rotated method every morning. Unplanned extubation was assessed by bedside nurses using the unplanned extubation report form. Oral mucosa and facial skin integrity were assessed using oral assessment guide and facial skin integrity assessment guide at day 3, 7, 10 and 14. RESULTS: There was no difference in the unplanned extubation rate between the two groups. Oral mucosa impairment scores for the rotated fixation method were significantly lower at day 7 (p=.044), 10 (p=.048) and day 14 (p=.037). Also facial skin integrity impairment scores for the same group were significantly lower at day 7 (p=.010), 10 (p=.003), and 14 (p=.002). CONCLUSION: Results of the study suggest that the rotated fixation method is effective for these patients, to prevent impairment of oral mucosa and facial skin integrity. Further research is needed to prevent unplanned extubation.

Perceived health, life satisfaction, and cardiovascular risk factors among elderly Korean immigrants and elderly Koreans.

Acknowledging that changes in sociocultural environment influence health status, the purpose of this study was to compare perceived health, life satisfaction, and cardiovascular health in elderly Korean immigrants and elderly Koreans. In this cross-sectional study, a convenience sample of 88 elderly Korean immigrants and 295 elderly Koreans 65 and older were recruited from Korean communities in the United States and Korea. Respondents' perceived health was measured by self-assessment; life satisfaction was self-assessed using a dichotomous scale of general satisfaction with life; and cardiovascular health status was surveyed by self-report of major diagnosed cardiovascular risk factors (i.e., hypertension, hyperlipidemia, diabetes mellitus) and body mass index measurement for obesity. Despite having better perceived health and life satisfaction, elderly Korean immigrants also had higher prevalence of cardiovascular risk factors. The findings provide health care providers with useful information for effective health assessment of minority immigrants.

Health-related quality of life in women with breast cancer in Korea: do sociodemographic characteristics and time since diagnosis make a difference?

PURPOSE/OBJECTIVES: To describe whether levels of health-related quality of life (HRQOL) differ by sociodemographic characteristics and time since breast cancer diagnosis in women in Korea. DESIGN: A descriptive, cross-sectional study of women with breast cancer. SETTING: An outpatient clinic of one large hospital in Seoul, Republic of Korea. SAMPLE: A convenience sample of 244 women with breast cancer after mastectomy. METHODS: Study participants completed sociodemographic characteristics and HRQOL questionnaires. Medical charts were reviewed to determine time since breast cancer diagnosis. MAIN RESEARCH VARIABLES: Sociodemographic characteristics (age, marital status, employment status, education, monthly household income, and religion), time since diagnosis, and HRQOL. FINDINGS: The psychological well-being domain scored the lowest among domains of HRQOL. Women who are younger, married, unemployed, highly educated, or religious, with higher monthly household income or with greater than one year elapsed time since diagnosis, had higher HRQOL. CONCLUSIONS: Study findings will be useful to establish priorities in planning nursing interventions to enhance HRQOL in care of women with breast cancer. IMPLICATIONS FOR NURSING: Nursing interventions can be provided to Korean women with breast cancer who are not religious, who are older, single or widowed, or employed, with lower education level, with lower monthly household income, or with one year or less elapsed time since breast cancer diagnosis.

Depressive symptoms in community-dwelling elderly Korean immigrants and elderly Koreans: cross-cultural comparison.

Depression among minority older adults is a prevalent underrecognized medical illness. Changes in cultural norms and social conditions because of immigration have a significant influence on mental health. The purpose of this study was to assess the interrelationships between acculturation, geographical location, gender, and depressive symptoms in community-dwelling elderly Korean immigrants and elderly Koreans. In this cross-sectional study, a convenience sample of 88 elderly Korean immigrants and 295 elderly Koreans was recruited separately from senior centers and senior apartments. Depressive symptoms were assessed with the Korean Geriatric Depression Scale-Short Form and acculturation with years of living in the United States. Acculturation had no significant relationship with depressive symptoms (r = 0.01, p = 0.94). Depressive symptoms were highly present in both elderly Korean immigrants and elderly Koreans. The prevalence of depressive symptoms was higher in women. This study provides baseline data for development of culturally specific, community-based intervention programs for better management of mental health of elderly Korean immigrants.

Feasibility and effects of a tai chi self-help education program for Korean gastric cancer survivors

PURPOSE/OBJECTIVES: To determine the feasibility of conducting a study of a tai chi self-help education program in Korean adults with gastric cancer and to describe the effects of a six-month tai chi self-help education program on depression, health-related quality of life (HRQOL), and immune markers. DESIGN: One-group, pre- and post-test design. SETTING: Outpatient clinics of two large hospitals in the Republic of Korea. SAMPLE: Convenience sample of 33 Korean adults with gastric cancer diagnoses after gastrectomy. METHODS: The Korean gastric cancer survivors participated in a 24-week tai chi self-help education program. The participants completed the Center for Epidemiologic Studies-Depression (Korean version) and the Functional Assessment of Cancer Therapy-General (Korean version) for HRQOL and provided blood samples for immune markers. All measurements were conducted at baseline and at one week following the 24-week intervention. MAIN RESEARCH VARIABLES: Feasibility was determined as the percentage of participants completing the 24-week protocol. Preliminary data on depression, HRQOL, and immune markers were obtained. FINDINGS: The dropout rate was 36.4%; 21 of 33 survivors participated in the tai chi self-help education program for 24 weeks. No complications or injuries occurred to the participants during the program. No significant differences were noted in depression, HRQOL, and immune markers before and after the intervention. CONCLUSIONS: Tai chi exercise, in combination with a self-help program, can be safe and feasible for Korean gastric cancer survivors. This feasibility study did not show that the tai chi self-help education program improves depression, HRQOL, and immune markers in Korean gastric cancer survivors. IMPLICATIONS FOR NURSING: Additional studies are needed to determine the long-term impact relative to usual care.

A Study on Exercise Performance and Its Relating Factors in Middle-aged Women.

PURPOSE: This study was done to identify practical exercise performance and to define the factors related to exercise performance in middle-aged women. METHODS: The researchers collected data from 206 middle-aged women, ages 40 to 59. The measurements used were a scale for degree of exercise performance, and self-efficacy scale, affect, perceived barriers and benefits related exercise, body-shape perception, and the youngest child's education stage. The data were analyzed with SPSS/WIN 17.0 and SAS program using t-test, ANOVA, and stepwise multiple regression. RESULTS: Exercise performance showed significant differences according to body-shape perception (F=5.45, p<.01), the youngest child's education stage (F=4.44, p<.05). Exercise performance had a significant strong positive relation with self-efficacy (r=.616), a moderate relation with self-rated health (r=.428) and with affect related exercise (r=.519), a mild relation with perceived benefits (r=.339) and with social support (r=.239), and a negative mild relation with perceived barriers (r=-.330) with 99% significance. Self-efficacy, affect, perceived barriers, and the youngest child's education stage explained 46.4% of a variance in exercise performance in middle-aged women. The factor most influencing was self-efficacy related exercise at 37.9% of the variance. CONCLUSION: We can conclude that self-efficacy, affect, perceived barriers, and the youngest child's education stage should be considered as important factors for developing program of middle-aged women.

Evaluation of the Korean Version of Physical Activity Scale for the Elderly (K-PASE).

PURPOSE: The purpose of this study was to develop a Korean version of Physical Activity Scale for the Elderly (K-PASE) from PASE and to evaluate the validity and reliability of the K-PASE. This scale was originally developed by Washburn et al. (1993). A valid and reliable physical activity scale for the elderly is needed to assess accurately physical activity of the elderly, because there has been no valid and reliable physical activity scale for the elderly in Korea. METHODS: The K-PASE was developed from PASE through linguistic validation and cultural adaptation for use with this population. Convenient sampling was used to recruit participants. Reliability was evaluated by conducting the test-retest and convergent validity was evaluated by Pearson correlation. RESULTS: Test-retest reliability, assessed over a 2 week interval, was r=.94. Convergent validity was established by correlating the K-PASE scores between related variables which were the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) and hand-grip strength. Scores of the K-PASE had a low significant correlation with TMIG-IC (r=.246, p<.001), and hand-grip strength (r=.251, p<.001). The mean score of physical activity of Korean elderly assessed by the K-PASE was 96.5. CONCLUSION: We conclude that the K-PASE is a reliable and valid instrument to assess physical activity for Korean elderly.

Comparison of body composition, handgrip strength, functional capacity, and physical activity in elderly Koreans and Korean immigrants.

Immigration to a foreign country has a significant impact on a person's health status and health management behavior. The purpose of this pilot study was to examine body composition (body mass index and muscle area of the mid-upper arm and mid-calf), handgrip strength, functional capacity, and physical activity in elderly Koreans and Korean immigrants. In this cross-sectional study, a convenience sample of 87 elderly Korean immigrants and 294 elderly Koreans were recruited from senior centers and senior apartments in the United States and Korea. Compared with elderly Koreans, elderly Korean immigrants had higher mid-calf muscle area (p = 0.06), handgrip strength (p = 0.01), and functional capacity (p = 0.01) and less physical activity (p < 0.01). Older men were more physically active and had more muscle areas, greater handgrip strength, and better functional capacity than older women, whereas older women had higher BMI scores than older men. This study provides motives for the development of health promotion intervention studies (e.g., culturally relevant exercise programs incorporating strength training). Future studies could identify culturally relevant strategies to promote physical activity in elderly Korean immigrants and especially elderly Korean women in both groups.

Prevalence and predictors of geriatric depression in community-dwelling elderly.

PURPOSE: This study aimed to examine the relationship between depressive mood and physical and socio-environmental variables of community-dwelling elderly. METHODS: This study was designed as a cross-sectional descriptive survey. The setting was two elderly welfare centers and two public health centers in Korea. The subjects were recruited by public announcement and participated after giving their written informed consent. A total of 295 participants were included in the final analysis. The Korean version of the short form of Geriatric Depression Scale (SGDS-K), Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) of activities of daily living (ADL) and a socio-demographic questionnaire were administered to participants. Hand-grip strength was measured with a hand dynamometer. RESULTS: The prevalence of depression among the subjects was 63%. Of the elderly, 21% had severe depressive symptoms. The mean depression score was 6.21 (SD = 3.83) and it was higher in women than in men. In the regression analysis, perceived health status alone had an accountability of 17.3% to depression. When TMIG-IC was added, this increased to 22.6%. Additionally, when hand-grip strength and social activities were input, it increased to 25.2%. Therefore, perceived health status was a significant and powerful factor explaining depression among the Korean elderly. CONCLUSION: In this research, perceived health status was the most powerful predictor of elderly depression. TMIG-IC, hand-grip strength and social activities also predicted Korean elderly depression. These factors should be considered when the program is developed for elderly people with depression. [Asian Nursing Research 2009;3(3):121-129].

[Factors influencing quality of life in patients with gastrointestinal neoplasms].

PURPOSE: The purpose of this study was to identify the factors influencing quality of life after analyzing the relationship between depression, health promotion and quality of life in patients with gastrointestinal neoplasms. METHODS: The subjects of this study were 63 people who underwent treatments from 2 general hospitals in Seoul and Daejeon and had no recurrence in stages I & II of gastrointestinal neoplasms. Data was collected from March 1 to April 30, 2006. A questionnaire consisting of Center for Epidemiologic Studies Depression (CES-D), Health Promoting Lifestyle Profile II (HPLP II) and Functional Assessment of Cancer Therapy-Colorectal (FACT-C) was given. The collected data was analyzed with the SPSS program which was used for descriptive statistics, Pearson correlation coefficients and hierarchical multiple regression. RESULTS: The major findings of this study were as follows: 1) There was a significant relationship between depression (r=-.639, p=.000), health promotion (r=.407, p=.001) and quality of life. 2) Significant factors were depression (F=-4.091, p=.000) and health promotion (F=2.375, p=.021) that explained 46% of quality of life (F=10.022, p=.000). CONCLUSION: Cancer patients experienced extreme depression which led to a negative effect on quality of life. Health promotion was an important variable to the quality of life and it gave the patients motivation for having a will and belief for better health.

Epidemiology of needlestick and sharps injuries among professional Korean nurses.

Although needlestick and sharps injuries (NSI) are known to affect professional nurses at high rates, most studies depend on officially reported data and few have been undertaken in Korea. Thus, we surveyed a large cross-section of nurses from a hospital in Gangneung (response rate, 97.9%). Four hundred thirty-two incidents of NSI were reported by 263 nurses (79.7%) in the previous 12-month period (average, 1.31 events/nurse/year). Syringe needles were the most common devices, affecting 67.3% and comprising 52% of all NSI events. Sixty percent of all NSI events involved contaminated devices. Opening an ampoule or vial was the most common cause (affecting 35.2% of all nurses and accounting for 15.9% of all NSI events). Logistic regression indicated that nurses working in "other" departments were 5.4 times more likely to suffer any NSI (odds ratio [OR] = 5.4; 95% confidence interval [95% CI] = 2.0-15.2; P < .05) and 4.7 times more likely to incur a syringe-needle injury than nurses in intensive care units or inpatient departments (OR = 4.7; 95% CI = 2.0-11.6; P < .05). Younger-than-average nurses (< 27 years) were 4.5 times more likely to suffer NSI (OR = 4.5; 95% CI = 1.7-12.6; P < .05) and 3.1 times more likely to incur a syringe-needle injury (OR = 3.1; 95% CI = 1.4-7.0; P < .05). Working mixed shifts also increased the risk of any NSI (OR = 4.0; 95% CI = 1.7-10.4; P < .05) or syringe-needle NSI (OR = 4.4; 95% CI = 2.0-10.1; P < .05). Overall, our study suggests that NSI are common among Korean hospital nurses and represent a significant occupational burden for this large Asian demographic. Intervention and preventive strategies to help reduce their NSI exposures are urgently required in this country.

Hand dermatitis among Korean nursing students.

We used a previously validated questionnaire survey, which was translated into Korean and given to 270 students from a university-based nursing school in Seoul. A total of 202 questionnaires were received. The students' hand dermatitis prevalence ranged from 6.9% in the first year to 22.9% in the fourth year. Logistic regression indicated that students with systemic allergies were 4.2 times as likely to suffer from hand dermatitis. Year of study and living arrangements were also shown to have statistically significant correlations with hand dermatitis. Overall, this study suggests that hand dermatitis might be less prevalent among Korean nursing students when compared with their international counterparts. However, the identification of systemic allergies as a significant risk factor was consistent with previous reports from other countries.

Epidemiology of musculoskeletal symptoms among Korean hospital nurses.

We investigated the epidemiology of musculoskeletal symptoms (MSS) among a complete cross-section of 330 nurses from a large Korean hospital, by means of a questionnaire survey (response rate: 97.9%). The prevalence of MSS at any body site was 93.6%, with symptoms most commonly reported at the shoulder (74.5%), lower back (72.4%), neck (62.7%), lower legs (52.1%) and hand/wrist (46.7%). Logistic regression indicated that nurses who undertook manual handling of patients were 7.2 times as likely to report MSS (OR 7.2, 95%CI 1.2-42.3, P = .0275), while nurses suffering from periodic depression experienced a 3.3-fold MSS risk (OR 3.3, 95%CI 1.3-8.3, P = .0104). Overall, our study suggests that Korean nurses incur a very high MSS burden when compared internationally. A greater commitment is needed to improve physical conditions, occupational tasks and psychosocial work issues among nurses in this country.

Musculoskeletal symptoms among Korean nursing students.

We investigated the epidemiology of Musculoskeletal Symptoms (MSS) among Korean nursing students using a validated, questionnaire survey. Among 202 students, the prevalence of MSS at any body site ranged from 69.0% to 77.1% (overall rate: 73.3%). MSS was most commonly reported at the shoulder (46.0%), followed by the lower back (39.1%), neck (35.6%), feet (25.2%) and lower legs (23.8%). Logistic regression analysis indicated that students who undertook regular exercise were only half as likely to report an MSS at any body site (OR 0.5, 95% CI 0.2 - 0.9, P = 0.0350). Increasing body weight was also correlated with a decreased likelihood of MSS (OR 0.04, 95% CI 0.002 - 0.9, P = 0.0460). Overall, our study has shown that Korean nursing students report a high prevalence of MSS, when compared to their international counterparts. Their MSS burden is roughly comparable with Korean workers, in a variety of occupations. Further investigations will now be required to elucidate the contributory factors for nursing students' MSS in Korea, as elsewhere.