Associations of depression and anxiety with cardiovascular risk among people living with HIV/AIDS in Korea / 한국역학회지

OBJECTIVES@#As HIV/AIDS is becoming a chronic disease, the risk of developing cardiovascular disease (CVD) among people living with HIV/AIDS is rising. Anxiety and depression, which are common among people living with HIV/AIDS, have been linked with CVD. This study investigated the risk of CVD in people living with HIV/AIDS and explored the effects of depression and anxiety on CVD risk. @*METHODS@#Data were collected for 457 people enrolled in the Korea Cohort HIV/AIDS study after 2010. Framingham risk scores were calculated to quantify the 10-year risk of developing CVD. Depression and anxiety variables were re-coded as a single combined variable. Multivariable logistic regression analysis was performed, adjusting for age, body mass index, low-density lipoprotein (LDL) cholesterol, triglycerides (TG), duration of human immunodeficiency virus (HIV) positivity after entry into the cohort, and depression/anxiety. @*RESULTS@#Participants with both depression and anxiety were 2.28 times more likely than those with neither depression nor anxiety to have moderate/high-risk CVD risk. The 10-year risk of developing CVD was affected by LDL cholesterol, TG, age, and duration of HIV infection. LDL cholesterol and TG levels change according to the duration of HIV infection, and metabolic disorders affect the risk of CVD. Thus, a longer duration of HIV infection is associated with a higher risk of developing CVD. @*CONCLUSIONS@#Screenings for depression and anxiety need to be provided regularly to assess the severity of those symptoms. To help decrease their risk of developing CVD, people living with HIV/AIDS should be offered behavioral modification interventions aimed at developing healthy lifestyle habits.

Associations of depression and anxiety with cardiovascular risk among people living with HIV/AIDS in Korea / 한국역학회지

OBJECTIVES@#As HIV/AIDS is becoming a chronic disease, the risk of developing cardiovascular disease (CVD) among people living with HIV/AIDS is rising. Anxiety and depression, which are common among people living with HIV/AIDS, have been linked with CVD. This study investigated the risk of CVD in people living with HIV/AIDS and explored the effects of depression and anxiety on CVD risk. @*METHODS@#Data were collected for 457 people enrolled in the Korea Cohort HIV/AIDS study after 2010. Framingham risk scores were calculated to quantify the 10-year risk of developing CVD. Depression and anxiety variables were re-coded as a single combined variable. Multivariable logistic regression analysis was performed, adjusting for age, body mass index, low-density lipoprotein (LDL) cholesterol, triglycerides (TG), duration of human immunodeficiency virus (HIV) positivity after entry into the cohort, and depression/anxiety. @*RESULTS@#Participants with both depression and anxiety were 2.28 times more likely than those with neither depression nor anxiety to have moderate/high-risk CVD risk. The 10-year risk of developing CVD was affected by LDL cholesterol, TG, age, and duration of HIV infection. LDL cholesterol and TG levels change according to the duration of HIV infection, and metabolic disorders affect the risk of CVD. Thus, a longer duration of HIV infection is associated with a higher risk of developing CVD. @*CONCLUSIONS@#Screenings for depression and anxiety need to be provided regularly to assess the severity of those symptoms. To help decrease their risk of developing CVD, people living with HIV/AIDS should be offered behavioral modification interventions aimed at developing healthy lifestyle habits.

A Comparison of the Prevalence of Cardiovascular Disease and Lifestyle Habits by Disability Status and Type of Disability in Korean Adults: A Propensity Score Matching Analysis

Purpose@#This study was conducted to evaluate the prevalence and lifestyle habits of cardiovascular disease (CVD) according to the type of disability in Korean adults compared to adults without disability. @*Methods@#This study was secondary data analysis using the National Health check-up database from 2010 to 2013. Among the total 395,627 adults aged 30~80, the physically disabled (n=21,614) and the mentally disabled (n=1,448) who met the diagnosis criteria were extracted and compared with non-disabled (n=372,565) through 1:2 propensity score matching for nine characteristics. @*Results@#Prior to matching, the prevalence of CVD was 34.4% in individuals without disabilities, accounting for 53.8% in those with physical disabilities and 22.4% in those with mental disabilities, showing significant differences between groups (p<.001). After matching, compared to the individuals without disability, those with physically disabled had significantly higher prevalence of CVD and the average number of CVD (p<.001). The prevalence of hypertension, diabetes, and vascular disease was significantly higher in the physically disabled (p<.05). Drinking was significantly higher in the non-disabled than in the physically and mentally disabled, and smoking was more in the non-disabled than in the mentally disabled. Physical activity was found to be significantly less in both the physically and mentally disabled than in the non-disabled (p<.01). @*Conclusion@#It is necessary to confirm the differences in the prevalence of CVD risk factors and lifestyle according to the type of disability, suggesting the development and verification of health promotion programs including physical activity for CVD prevention in the disabled with CVD risk factors.

A Comparison of the Prevalence of Cardiovascular Disease and Lifestyle Habits by Disability Status and Type of Disability in Korean Adults: A Propensity Score Matching Analysis

Purpose@#This study was conducted to evaluate the prevalence and lifestyle habits of cardiovascular disease (CVD) according to the type of disability in Korean adults compared to adults without disability. @*Methods@#This study was secondary data analysis using the National Health check-up database from 2010 to 2013. Among the total 395,627 adults aged 30~80, the physically disabled (n=21,614) and the mentally disabled (n=1,448) who met the diagnosis criteria were extracted and compared with non-disabled (n=372,565) through 1:2 propensity score matching for nine characteristics. @*Results@#Prior to matching, the prevalence of CVD was 34.4% in individuals without disabilities, accounting for 53.8% in those with physical disabilities and 22.4% in those with mental disabilities, showing significant differences between groups (p<.001). After matching, compared to the individuals without disability, those with physically disabled had significantly higher prevalence of CVD and the average number of CVD (p<.001). The prevalence of hypertension, diabetes, and vascular disease was significantly higher in the physically disabled (p<.05). Drinking was significantly higher in the non-disabled than in the physically and mentally disabled, and smoking was more in the non-disabled than in the mentally disabled. Physical activity was found to be significantly less in both the physically and mentally disabled than in the non-disabled (p<.01). @*Conclusion@#It is necessary to confirm the differences in the prevalence of CVD risk factors and lifestyle according to the type of disability, suggesting the development and verification of health promotion programs including physical activity for CVD prevention in the disabled with CVD risk factors.

Lifestyle-related predictors affecting prediabetes and diabetes in 20-30-year-old young Korean adults / 한국역학회지

OBJECTIVES@#To investigate lifestyle-related predictors of prediabetes and diabetes in young adults aged 20–39 years using data from the 2014-2016 Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#This study is a cross-sectional, secondary analysis using the KNHANES data. Participants were classified into normal group (fasting plasma glucose [FPG] <100 mg/dL and/or hemoglobin A1c [HbA1c] <5.7%), prediabetes group (FPG 100-125 mg/dL and/or HbA1c 5.7-6.4%), and diabetes group (FPG ≥126 mg/dL and/or HbA1c ≥ 6.5%). The data were statistically analyzed using SPSS software. @*RESULTS@#Out of 4,190 participants, 27.7% of men and 16.3% of women were in the prediabetes group and 1.4% of men and 1.3% of women were in the diabetes group. Logistic regression confirmed that age and obesity are predictors of prediabetes and diabetes in both men and women. Additionally low physical activity and low education level are predictors of prediabetes in men and women, respectively (p<0.05). @*CONCLUSIONS@#This study has found that age and increased obesity are predictors of elevated blood glucose in young men and women in their 20s and 30s. A strategy to lower obesity by promoting physical activity in men in their 30s is essential to prevent metabolic syndrome and progression to prediabetes.

Lifestyle-related predictors affecting prediabetes and diabetes in 20-30-year-old young Korean adults / 한국역학회지

OBJECTIVES@#To investigate lifestyle-related predictors of prediabetes and diabetes in young adults aged 20–39 years using data from the 2014-2016 Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#This study is a cross-sectional, secondary analysis using the KNHANES data. Participants were classified into normal group (fasting plasma glucose [FPG] <100 mg/dL and/or hemoglobin A1c [HbA1c] <5.7%), prediabetes group (FPG 100-125 mg/dL and/or HbA1c 5.7-6.4%), and diabetes group (FPG ≥126 mg/dL and/or HbA1c ≥ 6.5%). The data were statistically analyzed using SPSS software. @*RESULTS@#Out of 4,190 participants, 27.7% of men and 16.3% of women were in the prediabetes group and 1.4% of men and 1.3% of women were in the diabetes group. Logistic regression confirmed that age and obesity are predictors of prediabetes and diabetes in both men and women. Additionally low physical activity and low education level are predictors of prediabetes in men and women, respectively (p<0.05). @*CONCLUSIONS@#This study has found that age and increased obesity are predictors of elevated blood glucose in young men and women in their 20s and 30s. A strategy to lower obesity by promoting physical activity in men in their 30s is essential to prevent metabolic syndrome and progression to prediabetes.

Effects of Spouse-Participated Health Coaching for Male Office Workers with Cardiocerebrovascular Risk Factors

Purpose@#This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers. @*Methods@#A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers’ stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email. @*Results@#After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention. @*Conclusion@#To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.

Effects of a Daily Life-Based Physical Activity Enhancement Program for Middle-Aged Women at Risk for Cardiovascular Disease

PURPOSE@#The purpose of this study was to examine the effects of a daily life-based physical activity enhancement program performed by middle-aged women at risk for cardiovascular disease.@*METHODS@#This study used a randomized control group pretest-posttest design. Middle-aged women aged 45 to 64 were recruited from two outpatient cardiology departments, and randomly assigned to an experimental group (n=28) and a control group (n=30). For the experimental group, after providing one-on-one counseling and education, we provided customized text messages to motivate them in daily life. To monitor the practice of physical activity, they also used an exercise diary and mobile pedometer for 12 weeks. Subjects' physical activities (MET-min/week) were measured using the International Physical Activity Questionnaire (IPAQ). Their physiological data were obtained by blood tests using a portable analyzer, and the data were analyzed using the SPSS 21.0/WIN program.@*RESULTS@#There were significant differences in exercise self-efficacy, health behavior, IPAQ score, body fat, body muscle, and fasting blood sugar between the two groups. However, there were no significant differences in total cholesterol, hemoglobin A1c, high-density lipoprotein cholesterol, and waist-to-hip ratio.@*CONCLUSION@#Strengthening physical activity in daily life without being limited by cost burden and time and space constraints. Therefore, it is essential to motivate middle-aged women at risk for cardiovascular disease to practice activities that are easily performed in their daily lives.

Concept Analysis of Health Literacy for Patients with Cardiovascular Disease using Hybrid Model

PURPOSE: The purpose of this study is to provide a clear definition of the health literacy for patients with cardiovascular disease by analyzing the dimensions and properties using Hybrid concept analysis.METHODS: The concept of health literacy of patients with cardiovascular disease was analyzed according to the cyclic process of theoretical phase-field work phase-final analysis phase presented in the Hybrid model. We reviewed 26 literatures and conducted in-depth interviews with 13 patients with cardiovascular disease.RESULTS: The concept of health literacy in cardiovascularpatients is derived from two dimensions and five attributes. Literacy skills, health information search ability and health information utilization skills were derived as attributes in the individual functional dimension, while active communication with the medical team and utilization of health information support resources were derived at the interrelational dimension. It is defined as the individualized and integrated ability of an individual to explore and utilize the various health information needed to make appropriate health decisions during the chronic course after diagnosis of cardiovascular disease, to communicate proactively with medical staffs and to utilize support resources.CONCLUSION: This study will contribute to the development and related research of health literacy measurement tools that can be used in cardiovascular nursing practice based on the attributes and indicators of health literacy for patients with cardiovascular disease.

Effects of a Daily Life-Based Physical Activity Enhancement Program for Middle-Aged Women at Risk for Cardiovascular Disease

PURPOSE: The purpose of this study was to examine the effects of a daily life-based physical activity enhancement program performed by middle-aged women at risk for cardiovascular disease. METHODS: This study used a randomized control group pretest-posttest design. Middle-aged women aged 45 to 64 were recruited from two outpatient cardiology departments, and randomly assigned to an experimental group (n=28) and a control group (n=30). For the experimental group, after providing one-on-one counseling and education, we provided customized text messages to motivate them in daily life. To monitor the practice of physical activity, they also used an exercise diary and mobile pedometer for 12 weeks. Subjects' physical activities (MET-min/week) were measured using the International Physical Activity Questionnaire (IPAQ). Their physiological data were obtained by blood tests using a portable analyzer, and the data were analyzed using the SPSS 21.0/WIN program. RESULTS: There were significant differences in exercise self-efficacy, health behavior, IPAQ score, body fat, body muscle, and fasting blood sugar between the two groups. However, there were no significant differences in total cholesterol, hemoglobin A1c, high-density lipoprotein cholesterol, and waist-to-hip ratio. CONCLUSION: Strengthening physical activity in daily life without being limited by cost burden and time and space constraints. Therefore, it is essential to motivate middle-aged women at risk for cardiovascular disease to practice activities that are easily performed in their daily lives.

Effects of Spouse-Participated Health Coaching for Male Office Workers with Cardiocerebrovascular Risk Factors

PURPOSE: This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers.METHODS: A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers' stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email.RESULTS: After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention.CONCLUSION: To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.

A Survey on Nurses' Perception, Satisfaction, and Needs related to Continuing Education / 간호행정학회지

PURPOSE: This study was conducted to investigate perception, satisfaction and needs for continuing education for nurses in Korea. METHODS: Participants were selected 1,106 using disproportional stratified sampling for the 110,601 members of the 10 affiliated organizations of the Korean Nurses Association and 873 nurses participated in the online survey. Data were collected from February 2 to 27, 2015, and analyzed using the SPSS/WIN 24.0 program. Descriptive statistics, independent t-test, One-way ANOVA, and Scheffé test were conducted. RESULTS: The perception of continuing education averaged 0.69 on a scale of 1, satisfaction with continuing education was 3.66 out of 5, and need for continuing education was 4.33 out of 6. Perception, satisfaction and needs for continuing education showed significant differences depending on age, marriage, education, work department, type of work and clinical career, while perception and satisfaction differed more among type of institution and the affiliated groups. CONCLUSION: For the development of continuing education for nurses, it is necessary to establish an integrated information system for nurse continuing education and to develop various education programs for career development.

Impact of Uncertainty on the Quality of Life of Young Breast Cancer Patients: Focusing on Mediating Effect of Marital Intimacy

PURPOSE: The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients. METHODS: This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis. RESULTS: Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (β=-.39, p=.013) and 4 sub-scales of QoL were also affected by uncertainty. Among the 4 sub-scales of QoL, physical well-being (PWB) (β=.17, p=.026), social well-being (SWB) (β=.49, p=.010), and functional well-being (FWB) (β=.38, p=.009) were affected by marital intimacy but emotional well-being (EWB) was not affected by it. The mediating effect of marital intimacy on the impact of uncertainty on QoL was confirmed. Marital intimacy showed a significant indirect effect on PWB (β=-.07, p=.024), SWB (β=-.19, p=.008), and FWB (β=-.15, p=.005), and it means that marital intimacy has a partial mediating effect on the impact of uncertainty on PWB, SWB, and FWB. CONCLUSION: Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.

Impact of Uncertainty on the Quality of Life of Young Breast Cancer Patients: Focusing on Mediating Effect of Marital Intimacy

PURPOSE@#The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients.@*METHODS@#This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis.@*RESULTS@#Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (β=-.39, p=.013) and 4 sub-scales of QoL were also affected by uncertainty. Among the 4 sub-scales of QoL, physical well-being (PWB) (β=.17, p=.026), social well-being (SWB) (β=.49, p=.010), and functional well-being (FWB) (β=.38, p=.009) were affected by marital intimacy but emotional well-being (EWB) was not affected by it. The mediating effect of marital intimacy on the impact of uncertainty on QoL was confirmed. Marital intimacy showed a significant indirect effect on PWB (β=-.07, p=.024), SWB (β=-.19, p=.008), and FWB (β=-.15, p=.005), and it means that marital intimacy has a partial mediating effect on the impact of uncertainty on PWB, SWB, and FWB.@*CONCLUSION@#Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.

Experiences of Overcoming Alcoholism in Alcoholics' Female Spouses Using Al-Anon

PURPOSE: The aim of this study is to investigate and elucidate actual experiences of alcoholics' spouses using familial social gatherings. METHODS: A total of nine women whose alcoholic husbands were attending Al-Anon meetings held in Y Cathedral in S District of Seoul were included in this study. Data collection of this study was conducted through in-depth interviews with participants from September 24 to November 30, 2015. Data analysis was conducted at the same time as the data collection, and analysis was performed according to the method suggested by Colaizzi(1978). RESULTS: We categorized the participants' experiences into five themes including ‘Trapped in a Deep Dark Tunnel’, ‘Life of Walking in an Endless Tunnel’, ‘Reaching a Dead End’, ‘Walking towards a Ray of Light’, ‘Finding Oneself on a Strange Path’. CONCLUSION: The results of this study provide an understanding of the essential structure of the life experiences of alcoholic spouses using familial social gatherings.

Class Experience of the Students on 『Pregnancy, Delivery and Puerperium』 Nursing Course through Flipped Learning: Mixed Method Research

PURPOSE: The purpose of this study was to examine the applicability of a flipped learning course in Women's Health Nursing for nursing students. METHODS: A total of 200 senior nursing students participated in flipped learning class of pregnancy, delivery and postpartum area, which included team-based learning and self-reflection for 8 weeks. One group pre-post test design was adopted and the changes in learning motivation and satisfaction were examined. In addition, reflective journals of the students were analyzed by making a qualitative content analysis. RESULTS: Students showed a significant increase in score of learning motivation in the posttest (t=-4.47, p<.001). They had a mean of 3.90 in learning satisfaction out of possible five points. As a result of content analysis, three themes were selected: ‘Improved attitude toward active learning’, ‘Burden caused by excessive workload’, and ‘Valuing to the team-based activity’ To be specific, six sub-themes were selected, with three positive and three negative categories: ‘improved class attention and understanding’, ‘positive class participation by preparing lessons in advance’, ‘peer interactions through discussion’, ‘A lot of time and effort consuming’, ‘stress caused by the burden of preparing lessons’, and ‘difficulties in cooperative activities’. CONCLUSION: This study supports and confirms that the flipped learning can be a creative instructional model of positive teaching-learning strategy in clinical nursing courses to enhance students' learning motivation.

Impact of Nursing Organizational Culture Types on Innovative Behavior and Job Embeddedness Perceived by Nurses / 간호행정학회지

PURPOSE: The aim of this study was to determine the impact of nursing organizational culture types on innovative behavior and job embeddedness among clinical nurse. METHODS: For this study a descriptive correlational study design was used. Participants were 293 nurses who had more than one year work experience. They were recruited from two university hospitals, one in Seoul and one in Gyeonggi province in 2016. Collected data were analyzed using SPSS/WIN 21.0 statistics program. RESULTS: Hierarchy-oriented culture was the highest type of organizational culture perception and innovation-oriented culture, the lowest. Multiple linear regression analyses showed that, when age and total clinical experience were adjusted for, innovation-oriented culture perception was the most significant factor influencing innovative behavior, followed by task-oriented culture and relation-oriented culture in that order (R²=.33, F=24.50, p<.001). Relation-oriented culture perception was the factor most influencing job embeddedness, followed by task-oriented culture and innovation-oriented culture in that order (R²=.48, F=55.98, p<.001). CONCLUSION: More systematic and sustained organizational efforts are required to improve the hierarchy-oriented culture highly perceived by nurses and to emphasize innovation-oriented, relation-oriented and task-oriented organizational culture to increase innovative behavior and job embeddedness among clinical nurses.

Development and Effects of a Heart Health Diary for Self-Care Enhancement of Patients with Heart Failure

PURPOSE: The purpose of this study was to develop a heart health diary to promote self-care ability among patients with heart failure (HF), and to identify the diary's effect on self-care adherence, self-efficacy, and physical activity. METHODS: A randomized control-group pretest-posttest design was adopted using block randomization. A calender-typed health diary was developed and it included a self-care checklist and education information on HF management. The experimental group were given guided counseling and education for 8 weeks and wrote a daily health diary during that period. Data were collected from the outpatient department of a tertiary medical center from February to April 2016. To verify the hypotheses, data for the experimental group (n=28) and control group (n=33) were analysed using the independent t-test with SPSS/WIN 21.0. RESULTS: At the end of 8 weeks the experimental group had significantly higher scores for self-care adherence (t=-2.48, p =.016) and exercise related self-efficacy (t=-3.44, p =.001) compared to the control group. CONCLUSION: The findings show that the application of a patient-directed heart health diary is an effective nursing intervention for improving HF patients' self-care adherence and exercise self-efficacy. Strategies to promote dietary self-efficacy are necessary along with further studies including repeated research with an increasing intervention period. Healthcare providers need to encourage the utilization of a health diary for HF patients as a tool for evaluation and for implementation that leads to self-care.

Impact of DISC Behavioral Styles on Job Satisfaction and Clinical Competencies among Newly Hired Nurses / 간호행정학회지

PURPOSE: In this study, behavioral styles of Dominance, Influence, Steadiness, and Conscientiousness (DISC) were examined and differences in job satisfaction and clinical competence among newly hired nurses were explored. METHODS: For this explanatory correlational research, 176 newly hired clinical nurses were recruited from three university hospitals and one general hospital located in Seoul and Gyeonggi province. Data were collected in August, 2013 though self-report questionnaires. RESULTS: The distribution of behavioral styles was 11.4%, 42%, 29% and 17.6% for Dominance, Influence, Steadiness, and Conscientiousness respectively. DISC behavioral styles were associated with sub-areas of job satisfaction such as professional position and doctor-nurse relationship. DISC behavioral styles were significantly associated with the total score for clinical competence and sub-areas of data collection, basic nursing skills, critical thinking, education and leadership, and attitudes toward professional development and practical skills. Multiple linear regression analysis showed that DISC behavioral styles predicted clinical competence (Adj. R2=.14, F=9.42, p<.001). CONCLUSION: A focus on cultivating influential and steady behavioral styles among newly hired nurses can be helpful in improving job satisfaction and clinical competence. There is a need to improve interpersonal relationships through a deeper understanding of each person's behavioral style based on the analysis of DISC behavioral styles.

Risk Factoretailored Small Group Education for Patients with First-time Acute Coronary Syndrome

PURPOSE: The purpose of this study was to evaluate the effects of a risk factoretailored small group education on anxiety and depressive symptoms, self-efficacy and self-care compliance in patients with first-time acute coronary syndrome (ACS) for 12-month follow-up. METHODS: A quasi-experimental pretest and post-test design was used. Patients were recruited from a national university hospital from 2010 to 2011 in Korea. The group education consisted of a 60-minute long video developed using multimedia contents including voice-recorded texts, flash animation, and video clips, with nurses' dialogue. The intervention group (n = 34) participated in group education using the multimedia video in a small group of patients with similar risk factors, and received periodic telephone counseling and text messages. The control group (n = 40) received usual care and counseling upon request. RESULTS: Depressive symptoms decreased, and self-efficacy and self-care compliance in the areas of medication, exercise, and healthy diet practice significantly increased in patients in the intervention group, compared with those in the control group. CONCLUSIONS: Risk factoretailored small group education and periodic text message were an effective strategy for decreasing depression, and increasing self-efficacy and long-term compliance with lifestyle changes in patients with first-time ACS. We suggested that risk factoretailored small group education need to be given for first-time ACS patients for psychological support and behavioral change in clinical practice. It is also comparable to individual approach to encourage psychological and behavioral change.