Effectiveness of Non-pharmacological Interventions for Adolescents With Type 1 Diabetes in the Last Five Years: A Systematic Review and Meta-analysis

Purpose@#Evidence on non-pharmacological interventions for adolescents with type 1 diabetes is unclear. This review aimed to evaluate the effectiveness of non-pharmacological intervention in adolescents with type 1 diabetes. @*Methods@#We conducted a search on databases from November 11 to 19, 2022, for randomized controlled trials for the effects of non-pharmacological intervention in adolescents with type 1 diabetes. To identify recent research trends, we included studies published from 2017 to November 2022. The risk of bias was assessed using the Cochrane risk-of-bias tool 2.0. To estimate the effect size, a meta-analysis was performed using RevMan 5.4 program and R Studio. @*Results@#A total of 45 studies were included in the systematic review. Among those, 30 studies were included in the meta-analysis. Non-pharmacological interventions were significantly effective in improving Glycated hemoglobin (HbA1c) (standardized mean difference [SMD] = −0.26, 95% confidence interval [CI]: −0.42, −0.09), quality of life (SMD = 0.44, 95% CI: 0.13 to 0.76), and anxiety (SMD = −0.91, 95% CI: −1.26, −0.56). Subgroup analysis showed that duration of intervention was not a covariate related to HbA1c levels. @*Conclusions@#Non-pharmacological interventions have shown effectiveness in improving the HbA1c, quality of life, and anxiety in adolescents with type 1 diabetes. Future studies with more rigorous methodology are needed to confirm and strengthen the validity of these findings. Additionally, attention to changes in the lipid profile and self-care motivation among adolescents with type 1 diabetes is warranted.

Automated Personalized Self-care Program for Patients With Type 2Diabetes Mellitus: A Pilot Trial *

Purpose@#Providing continuous self-care support to the growing diabetes population is challenging. Strategies are needed to enhance engagement in self-care, utilizing innovative technologies for personalized feedback. This study aimed to assess the feasibility of the Automated Personalized Self-Care program among type 2 diabetes patients and evaluate its preliminary effectiveness. @*Methods@#A parallel randomized pilot trial with qualitative interviews occurred from May 3, 2022, to September 27, 2022. Participants aged 40e69 years with type 2 diabetes and HbA1c ! 7.0% were recruited. The three-month program involved automated personalized goal setting, education, monitoring, and feedback. Feasibility was measured by participants' engagement and intervention usability. Preliminary effectiveness was examined through self-care self-efficacy, self-care behaviors, and health outcomes. Qualitative interviews were conducted with the intervention group. @*Results@#A total of 404 patients were screened. Out of the 61 eligible patients, 32 were enrolled, resulting in a recruitment rate of 52.5%. Retention rates at three months were 84.2% and 84.6% in the intervention and control groups, respectively. Among the intervention group, 81.3% satisfied adherence criteria.Mobile application's usability scored 66.25, and participants' satisfaction was 8.06. Intention-to-treat analysis showed improvements in self-measured blood glucose testing, grain intake, and HbA1c in the intervention group. Qualitative content analysis identified nine themes. @*Conclusion@#Feasibility of the program was verified. A larger randomized controlled trial is needed to determine its effectiveness in self-care self-efficacy, self-care behaviors, and health outcomes among type 2 diabetes patients. This study offers insights for optimizing future trials assessing clinical effectiveness.

Healthcare coaching program for youth with type 1 diabetes in South Korea: a pilot study

Purpose@#This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes. @*Methods@#A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed. @*Results@#The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified. @*Conclusion@#The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.

Factors Associated with Diabetic Complication Index among Type 2 Diabetes Patients: Focusing on Regular Outpatient Follow-up and HbA1c Variability

Purpose@#Preventing diabetic complications involves regular outpatient follow-up and maintaining low variability in hemoglobin A1c (HbA1c) levels. This study investigated the factors associated with diabetic complications, with a specific focus on the impact of regular outpatient follow-up and HbA1c variability, among patients with type 2 diabetes. @*Methods@#The study design was secondary data analysis of electronic medical records from a university hospital in Korea. It included patients aged 40–79 with type 2 diabetes who were prescribed diabetes medication within three months of their first HbA1c test by an endocrinologist and were followed up for at least five years. Follow-up regularity, adjusted standard deviation of HbA1c levels, and diabetic complication indices were collected. Data were analyzed using the Chi-square test, independent t-test, repeated measures analysis of variance, and multiple regression analysis. @*Results@#The study included 1566 patients. Lower follow-up regularity was observed in patients of older age, with comorbidities, diabetic complications, insulin treatment, a history of hospitalization, lower baseline estimated glomerular filtration rate (eGFR) and total cholesterol (TC), and higher HbA1c variability. Higher HbA1c variability was observed in younger patients without comorbidity but with insulin treatment, a history of hospitalization, higher baseline blood glucose (BG), HbA1c, TC, and triglyceride levels. HbA1c variability had the strongest influence on BG and HbA1c levels at the five-year follow-up. Baseline eGFR and TC were the most influential factors for their respective levels at the five-year follow-up. Follow-up regularity significantly affected BG, HbA1c, eGFR, and TC at five-year follow-up. @*Conclusions@#It has been shown that several variables besides regular follow-up and HbA1c variability have an influence. However, these are the two that can be corrected through nursing intervention and are important, so intervention on these is important.

Influence of Nurses’ General and Job-related Characteristics, Nursing Practice Environment, and Grit on the Intent to Stay among Operating Room Nurses / 간호행정학회지

Purpose@#This study aimed to examine the influence of nurses’ general and job-related characteristics, nursing practice environment, and grit on the intent to stay of operating room nurses. @*Methods@#This descriptive study focused on 198 operating room nurses employed in university hospitals at Busan metropolitan city and Kyungnam district, with a minimum of six months of experience in the operating room. Data were collected between February 16, 2022 and May 25, 2022, using self-report questionnaires and analyzed using SPSS 21.0. @*Results@#The average of operating room nurses' intent to stay was 5.01, indicating a high intent to stay. Positive correlations were found between grit(r=.58, p<.001) and nursing practice environment(r=.36, p<.001) with intent to stay. Grit(β=.52, p<.001) and nursing practice environment(β=.13, p=.035) significantly influenced the intent to stay and explained 35% of the variance in the intent to stay. @*Conclusion@#The findings of this study suggest that strengthening nurses’ grit and providing a healthy practice environment may help increase their intent to stay. Developing a grit-enhancing program, especially one that fosters enthusiasm and perseverance toward long-term goals, can improve operating room nurses’ psychological resources and enhance their willingness to stay.

Influence of Teamwork, Role Conflict, and Delegation Preparedness on Job Satisfaction among Nurses Working in Integrated Nursing Care Wards / 간호행정학회지

Purpose@#This study aimed to identify the factors influencing job satisfaction among nurses working in integrated nursing care wards. @*Methods@#The study participants were 196 nurses working in integrated nursing care wards at four general hospitals and one tertiary hospital. Data were collected using structured questionnaires from April 11 to 25, 2022, through an online survey. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation, and stepwise multiple regression with SPSS/WIN 26.0. @*Results@#The factors influencing job satisfaction of participants were team structure (β=.32, p<.001), role conflict regarding nursing practice (β=-.24, p<.001), mutual support (β=.23, p<.001), master's degree or higher(β=.16, p=.004), and spousal presence (β=.15, p=.005). @*Conclusion@#The findings of this study suggest that the tasks and roles of team members should be clarified, and a supportive team culture of mutual cooperation should be fostered to improve the job satisfaction of nurses working in the integrated nursing ward. In addition, it is necessary to reduce role conflict by providing support focused on allocating tasks that can strengthen the role of professional nurses.

Consistency of 1-day and 3-day average dietary intake and the relationship of dietary intake with blood glucose, hbA1c, BMI, and lipids in patients with type 2 diabetes

Purpose@#This study aimed to determine the consistency of 1-day and 3-day average dietary intake using the 24-hour diet recall method and to investigate the relationship of diet intake with physiological indicators potentially associated with diabetic complications in patients with diabetes. @*Methods@#This study conducted a secondary data analysis using pretest data of a nursing intervention study entitled “Development of deep learning based AI coaching program for diabetic patients with high risk and examination of its effects (PNUH, IRB No. 05-2021-030).” Data were analyzed through descriptive analysis, one-way repeated-measures analysis of variance, and Pearson correlation coefficients using SPSS 26.0. @*Results@#The average total daily calorie intake over 3 days was 1,494.48±436.47 kcal/day: 1,510.90±547.76 kcal/day on the first day, 1,414.22±527.58 kcal/day on the second day, 1,558.34±645.83 kcal/day on the third day, showing significant differences (F=3.59, p=.031). The correlation coefficient between the 1-day and 3-day average dietary intake was 0.41–0.77 for each nutrient and 0.62–0.80 for each food group. Vegetable intake showed negative correlations with body mass index (BMI; r=-.19, p=.023) and triglycerides (r=-.18, p=.036), whereas dairy intake was positively associated with low-density lipoprotein-cholesterol (LDL; r=-0.18, p=.034) and triglycerides (r=.40, p<.001). @*Conclusion@#This study demonstrated that 1-day dietary intake was highly correlated with 3-day average dietary intake using the 24-hour diet recall method. Food groups showed significant associations with physiological indicators of potential diabetic complications such as BMI, triglycerides, and LDL levels. Further studies are needed to improve the knowledge base on the relationships between physiological indicators and food groups.

Nutritional Intake and Postoperative Pulmonary Complications among Lung Cancer Patients who Underwent Pulmonary Resection

Purpose@#The aim of this study was to examine the nutritional intake status of the lung cancer patients who underwent pulmonary resection and to analyze the relationship between the status of the nutritional intake and the occurrence of postoperative pulmonary complications. @*Methods@#This study was a secondary analysis to determine whether the changes in the nutritional intake after surgery were related to pulmonary complications. Data of a total of 89 patients were included in the analysis and the nutritional intake status was confirmed using a 24-hour dietary recall method. The data were analyzed by descriptive statistics, chi-square or Fisher’s exact test, and ANOVA using the SPSS WIN 26.0 program and word clouds were generated using the R software program. @*Results@#Overall, a decrease in the postoperative nutritional intake was observed in the patients who underwent pulmonary resection, except for the intake of fat. The pulmonary complications were identified to be associated with BMI and the presence of comorbidity. Twenty-three out of 74 patients with vitamin E levels below the Estimated Average Requirements developed pulmonary complications after surgery. @*Conclusion@#Lung cancer patients who underwent pulmonary resection generally have difficulty in acquiring appropriate nutritional intake and need balanced nutritional management. Future investigations on the impact of increased vitamin E intake on postoperative pulmonary complications may provide better insight into the relationship between vitamin E intake and pulmonary complication among patients who underwent pulmonary resection.

Comparison of the Effects of Education Only and Exercise Training Combined with Education on Fall Prevention in Adults Aged 70 Years or Older Residing in Elderly Residential Facilities

Purpose@#To compare the effects of education only and exercise training combined with education on fall knowledge, fall efficacy, physical activity, and physical function in adults aged 70 years or older residing in elderly residential facilities. Method: A three-group pre- and posttest design was utilized: education only (EO; n = 23), education and TheraBand (ET; n = 22), and education and walking (EW; n = 22).Fall education was provided for all three groups. In addition, TheraBand exercise training was provided for the ET and a walking exercise for the EW. Data were collected from November 1st, 2017 to February 15th, 2019 and analyzed with χ2 test, paired t-test, and one-way ANOVA using IBM SPSS/WIN ver. 22.0. @*Results@#Compared with the EO, the ET and the EW were more effective in terms of fall efficacy, physical activity, and lower extremity muscle strength. The EW showed higher improvement in walking abilities than the EO and the ET. @*Conclusion@#Exercise training combined with education is more effective in preventing falls among community-dwelling adults aged 70 years or older. When considering fall prevention programs for older adults, both TheraBand and walking exercise training combined with education can be chosen based on the participant’s physical status. Aggressive strategies to improve daily walking are required to maintain walking abilities among community-dwelling adults aged 70 years or older.

Comparison of the Effects of Education Only and Exercise Training Combined with Education on Fall Prevention in Adults Aged 70 Years or Older Residing in Elderly Residential Facilities

Purpose@#To compare the effects of education only and exercise training combined with education on fall knowledge, fall efficacy, physical activity, and physical function in adults aged 70 years or older residing in elderly residential facilities. Method: A three-group pre- and posttest design was utilized: education only (EO; n = 23), education and TheraBand (ET; n = 22), and education and walking (EW; n = 22).Fall education was provided for all three groups. In addition, TheraBand exercise training was provided for the ET and a walking exercise for the EW. Data were collected from November 1st, 2017 to February 15th, 2019 and analyzed with χ2 test, paired t-test, and one-way ANOVA using IBM SPSS/WIN ver. 22.0. @*Results@#Compared with the EO, the ET and the EW were more effective in terms of fall efficacy, physical activity, and lower extremity muscle strength. The EW showed higher improvement in walking abilities than the EO and the ET. @*Conclusion@#Exercise training combined with education is more effective in preventing falls among community-dwelling adults aged 70 years or older. When considering fall prevention programs for older adults, both TheraBand and walking exercise training combined with education can be chosen based on the participant’s physical status. Aggressive strategies to improve daily walking are required to maintain walking abilities among community-dwelling adults aged 70 years or older.

The Incidences of Catheter Colonization and Central Line-Associated Bloodstream Infection According to Tegaderm vs. Chlorhexidine Gluconate (CHG)-Tegaderm Dressing

Purpose@#In spite of the recent application of a general infection control method, central line-associated infections is still relatively high in Korea. Central line bundle with Chlorhexidine gluconate (CHG) tegaderm dressing was reported to be effective in reducing catheter colonization and central line-associated bloodstream infections (CLABSI). Therefore, this study aimed to examine the incidences of catheter colonization occurrence and CLABSI while using Tegaderm vs. CHG Tegaderm dressings. @*Methods@#We used a descriptive design. 400 patients who had central venous catheters were selected from four hospitals in the Korean National Healthcare-associated Infections Surveillance System. Of all subjects, 200 used Tegaderm TM (Tegaderm group), and the remaining 200 used CHG Tegaderm (CHG Tegaderm group) dressing at the catheter insertion site. Data were analyzed using the c 2 test or Fisher’s exact test, t-test, and logistic regression analysis using SPSS WIN 21.0. @*Results@#In the Tegaderm and CHG Tegaderm groups, CLABSI incidences were 5.89 and 1.79 per 1,000 catheter-days, catheter colonization incidences were 3.93 and 1.43 per 1,000 catheter-days, and central line bundle compliance rates were 26.0% and 49.0%, respectively. Catheter colonization risk factors were ‘reinsertion after failure’ and ‘Tegaderm dressing’ at the central line insertion site. CLABSI risk factors were ‘incomplete performance of 7 central line bundle items’ and ‘Tegaderm dressing’ at the central line insertion site. @*Conclusion@#A further prospective study is needed to examine the effects of central line bundle with CHG Tegaderm dressing, avoiding central line reinsertion after failure, and improving the bundle compliance in reducing catheter colonization and CLABSI.

Applying Extended Theory of Planned Behavior for Lung Cancer Patients Undergone Pulmonary Resection: Effects on Self-Efficacy for Exercise, Physical Activities, Physical Function, and Quality of Life

PURPOSE@#This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection.@*METHODS@#This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ² test, Fisher's exact test, Mann–Whitney U test, t-test, and generalized estimation equations (GEE).@*RESULTS@#There were significant differences between the two groups regarding SEE (χ²=13.53, p=.009), PA (χ²=9.51, p=.049), functional status (χ²=10.55, p=.032), and 6MWD (χ²=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=−2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component.@*CONCLUSION@#The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.

Applying Extended Theory of Planned Behavior for Lung Cancer Patients Undergone Pulmonary Resection: Effects on Self-Efficacy for Exercise, Physical Activities, Physical Function, and Quality of Life

PURPOSE: This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection.METHODS: This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ² test, Fisher's exact test, Mann–Whitney U test, t-test, and generalized estimation equations (GEE).RESULTS: There were significant differences between the two groups regarding SEE (χ²=13.53, p=.009), PA (χ²=9.51, p=.049), functional status (χ²=10.55, p=.032), and 6MWD (χ²=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=−2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component.CONCLUSION: The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.

Applying Extended Theory of Planned Behavior for Lung Cancer Patients Undergone Pulmonary Resection: Effects on Self-Efficacy for Exercise, Physical Activities, Physical Function, and Quality of Life

PURPOSE@#This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection.@*METHODS@#This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ² test, Fisher's exact test, Mann–Whitney U test, t-test, and generalized estimation equations (GEE).@*RESULTS@#There were significant differences between the two groups regarding SEE (χ²=13.53, p=.009), PA (χ²=9.51, p=.049), functional status (χ²=10.55, p=.032), and 6MWD (χ²=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=−2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component.@*CONCLUSION@#The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.

The Effects of Utilizing Smartphone Application Peer Support on Health Behavior and Body Mass Index among Breast Cancer Survivors

PURPOSE: This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS). METHODS: A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA. RESULTS: At the completion of SAPS significant differences were found between groups in motivation for exercise (t=−3.24, p=.005), physical activity (t=−4.15, p<.001), total calorie intake (t=3.42, p=.002), calories from fat (t=−3.01, p=.005), intake of vegetables (t=−2.83, p=.008), and BMI (t=5.21, p<.001). Significant differences in BMI (t=4.13, p<.001) remained up to 3 months after SAPS completion. No significant differences was shown between groups in self-efficacy for exercise, either immediately after or 3 months after SAPS. CONCLUSION: The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.

Development of the Korean version of ICF e-Learning tool

PURPOSE: The aim of the study was to develop a Korean version of an ICF e-Learning tool (KICF e-Learning tool). METHODS: The process of translation and adaptation of the ICF e-Learning tool was followed: two translators developed the Korean versions independently, and a consensus version of the translation was then produced. An expert committee, which was composed of five experts from physiotherapy, occupational therapy, speech pathology, and social welfare, reviewed the consensus Korean version to make a beta version of the tool. A field test was conducted to determine if the Korean version of the tool was easy to understand and suitable to use in ICF learning. Feedback from the field test were used for the final adaptation of the KICF e-Learning tool. RESULTS: One-hundred and twenty-six volunteers (40 males and 76 females) were invited to examine the KICF e-Learning tool. The participants reported various levels of ICF knowledge from none to very good. Forty-eight participants reported no knowledge of ICF. The majority of participants (n=84) reported that Korean terms or expression in the tool were easy to understand and one-hundred fourteen participants would recommend the tool to another person. The Korean cases would be helpful for a Korean audience to study the ICF using the tool. CONCLUSION: The KICF e-Learning tool was developed and is ready for use by the public for the consistency of ICF education. On the other hand, development of an advanced module will be needed.

Functioning Characteristics of Patients with Neck Pain: ICF Concept Based

PURPOSE: This study examine the functioning level and quality of life (QoL) of people with non-specific neck pain and neck pain with radiculopathy using the neck disability index (NDI), functional rating index (FRI), and short form of health survey 36 (SF-36) and each of linked lCF code lists of those scales. METHODS: Each item of the NDI, FRI, and SF-36 were linked conceptually to the ICF code, and the lCF code lists of those scales were produced as iNDI, iFRI, and iSF-36, respectively. Seventy-nine patients with neck pain filled the instruments and its linked ICF code lists. The subjects were divided into two groups based on the diagnosis, non-specific neck pain (Group1), and neck pain with radiculopathy (Group2). A group comparison was performed using an independent t-test. The Pearson correlation coefficient was also used to analyze the relationships between each scale and the linked ICF code list. RESULTS: The participants in Group 2 experienced more difficulties in their daily activities than those in Group 2 when examined in NDI and FRI (p<0.05). This result was also found consistently in the ICF code lists, iNDI and iFRI (p=0.05). On the other hand, the QoL did not show a difference between groups (p=0.06). A strong correlation was observed between the instruments and linked ICF code lists: NDI and iNDI (r=0.90), FRI and iFRI (r=0.91), and SF-36 and iSF-36 (r=−0.61). CONCLUSION: These findings suggest that the concept of each item in NDI and FRI could be linked to the ICF codes when examining patients with neck pain, but the items of SF-36 were found to be linked and expressed in ICF.

The Effects of Utilizing Smartphone Application Peer Support on Health Behavior and Body Mass Index among Breast Cancer Survivors

PURPOSE@#This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS).@*METHODS@#A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA.@*RESULTS@#At the completion of SAPS significant differences were found between groups in motivation for exercise (t=−3.24, p=.005), physical activity (t=−4.15, p<.001), total calorie intake (t=3.42, p=.002), calories from fat (t=−3.01, p=.005), intake of vegetables (t=−2.83, p=.008), and BMI (t=5.21, p<.001). Significant differences in BMI (t=4.13, p<.001) remained up to 3 months after SAPS completion. No significant differences was shown between groups in self-efficacy for exercise, either immediately after or 3 months after SAPS.@*CONCLUSION@#The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.

Comparison of Effects of Oral Health Program and Walking Exercise Program on Health Outcomes for Pregnant Women

PURPOSE: To compare the effects of the Interaction Model of Client Health Behavior (IMCHB)-based oral health program (OHP) and walking exercise program (WEP) on oral health behaviors, periodontal disease, physical activity, and psychological indicators (depression, stress, and quality of life) in pregnant women. METHODS: A nonequivalent control group pretest-posttest design was adopted to compare the effects of a 12-week OHP and WEP on pregnant women (n=65). Pregnant women were randomly assigned to the oral health group (OHG; n=23), walking exercise group (WEG; n=21), or control group (CG; n=21). Data were analyzed by the χ2-test, Fisher's exact test, Scheffe test, and repeated measures ANOVA, using the Statistical Package for the Social Sciences for Windows (version 21.0). RESULTS: The OHG and WEG showed significant improvements in oral health behaviors, periodontal disease, and psychological indicators as compared to the CG. The WEG showed significant improvement in physical activity as compared to the OHG and CG. CONCLUSION: These findings indicate that the IMCHB-based OHP and WEP were effective in improving periodontal disease, physical activity, and psychological indicators. However, further studies are needed to identify the positive effects of the OHP and WEP on birth outcomes.

Development and Effects of Social Learning Theory Based Eye-Health Program for Preschoolers

PURPOSE: The purpose of this study was to develop an eye-health program based on social learning theory (EPST) of preschoolers and evaluate its effectiveness. METHODS: A nonequivalent control group pre-post test design was utilized and 141 six-year-old preschoolers and their parents participated (experimental group=69, control group=72) in the study. The EPST in this study included eye-health education and eye exercises. Attention, memory, replay, motivation, reinforcement, and self-efficacy were used as interventional strategies. To examine the effectiveness of EPST, proficiency in eye-health activities, refractive power, and visual acuity were measured before and after the intervention. Data were analyzed with SPSS WIN 21.0 using the Shapiro-Wilk test, χ2-test, Mann-Whitney U test and Wilcoxon signed rank test. RESULTS: Following the intervention, eye-health activities, refractive power, and visual acuity significantly improved in the experimental group compared to the control group. CONCLUSION: The results of this study suggest that EPST is effective in improving eye-health activities, refractive power, and visual acuity in preschoolers, and its wider implementation in educational institutions will promise improved eye-health among preschoolers.