The purpose of this study was to evaluate the psychometric quality and feasibility of measurements for screening dysphagia in older adults to identify the 'right tool' for nurses to use in nursing homes.

A systematic review was done. Electronic databases were searched for studies related to dysphagia screening measurements. A checklist was used to evaluate the psychometric quality and applicability. Tools were evaluated for feasible incorporation into routine care by nurses.

29 tools from 31 studies were identified. Dysphagia screening tools with an acceptable validity and reliability had sensitivity between 68% and 100% and specificity between 52% and 100%. The Gugging Swallowing Screen (GUSS) and the Standardized Swallowing Assessment (SSA) were the tools with high psychometric quality, especially with high sensitivity, that nurses could perform feasibly to identify the risk and to grade the severity of dysphagia and aspiration of nursing home residents.

Results show that GUSS and SSA are reliable and sensitive tools for screening dysphagia which nurses can use in nursing homes. Further research is needed to examine feasibility of screening with identified tools, and also, to establish effective and standardized protocols for these tools so they can be effectively incorporated into routine care.

The purpose of this study was to measure the level of expectations regarding aging (ERA) and identify relationship between ERA and physical activity of middle aged adults.

Participants were middle aged adults who resided in the community in three cities in Korea. Data were collected using questionnaires that contained items on individual characteristic, International Physical Activity Questionnaires (IPAQ), and behavior-specific cognitive factors including ERA-12. Hierarchical multiple regression was conducted to examine whether ERA would predict physical activity by controlling other factors.

The mean age of the participants was 51.1±6.9 years. The mean score for ERA (possible range=0 to 100) was 40.04±14.31. More than half of the participants (62.6%) were not engaged in health promoting physical activity. Gender, employment status and exercise confidence were associated with level of physical activity (F=7.14, p<.001, R²=.36). After controlling for individual factors and behavior-specific cognitive factors, ERA was independently related to physical activity (F=7.19, p<.001, R²=.38).

The results demonstrate that individuals' belief about aging has effects on physical activity in Korean middle aged adults. Thus, nursing interventions which focused on ERA could help enhance physical activity in middle aged adults.

This study was conducted to examine effects of a cardiocerebrovascular disease (CVD) prevention education program on knowledge, self-efficacy and health behavior among postmenopausal middle-aged women.

A non-equivalent control group pretest-posttest design was used. Participants were 53 postmenopausal middle-aged women who registered in two community culture centers in G metropolitan city. Experimental group (n=26) received a CVD prevention education program 8 times over 8 weeks. Knowledge, self-efficacy and health behavior of the participants were examined with self-report structured questionaries. Data were collected between October 15 and December 11, 2013, and were analyzed using chi-square test, Fisher's exact test, independent t-test, and analysis of covariance with SPSS/PC version 21.0.

After the intervention the experimental group showed significant increases in the knowledge of CVD symptoms (p<.001) and CVD risk factors (p<.001), level of self-efficacy (p=.028) and health behavior (p<.001) compared to the control group. However, no significant difference was found between groups for knowledge of CVD prevention (p<.133).

Results suggest that a CVD prevention education program can be an effective strategy to improve knowledge on CVD symptoms and risk factors, self-efficacy and health behavior for postmenopausal middle-aged women.

This study was done to determine whether muscle strength training programs have an impact on improving symptoms of urinary incontinence (UI) and physical function among elderly women with UI who reside in long-term care facilities.

A randomized controlled trial was conducted. Participants had to be over 65 years, score over 15 score on the mini-mental state examination, and be able to walk alone or with an assistant. Seventy residents were randomly allocated to either the training group (n=35) or control group (n=35). The program consisted of 50 minutes, twice a week for 8 weeks, and included Kegel's exercise, Thera-band training and indoor walking. Main outcomes were UI symptoms, peak vaginal pressure and physical functions measured with timed up and go test (TUG), one leg standing test (OLST), activities of daily living (ADL) and grip strength. Changes in outcome measurements were calculated from baseline to 4 weeks and to 8 weeks using repeated measures ANOVA.

There were significant differences in peak vaginal pressure (p<.001), TUG (p<.001), OLST (p=.012) and grip strength (p<.001) in the interaction between groups and time.

Future studies are suggested to confirm the effect of muscle strength training in long-term care facilities where elderly women with UI reside.

This study was conducted to examine the effect of oral care with an aroma solution on oral status and oral cavity microorganism growth in elderly patients with stroke.

A non-equivalent control group, with a pretest-posttest design was used in this study. The participants were assigned to the experimental group (n=30) that received oral care with an aroma solution or the control group (n=31) that received 0.9% saline solution. To identify the effect of the experimental treatments, objective/subjective assessments of oral status and oral cavity microorganism growth were performed using the oral assessment guide, oral perception guide, and oral swab culture. Data were analyzed using Chi-square test, Fisher's exact test, and t-test with the SPSS version 21.0 program.

The objective oral status was significantly lower in the experimental group than in the control group (t= -3.64, p<.001). There was no significant difference between the subjective oral status of the experimental group and control groups (t= -1.24, p=.109). Oral microorganism growth was significantly lower in the experimental group than in the control group (t= -7.39, p<.001).

These findings indicate that special mouth care using an aroma solution could be an effective oral health nursing intervention for elderly patients with stroke.

The purpose of this study was to verify effects of the Empowering A Self-Efficacy (EASE) program on self-efficacy, self-management, and child attitude toward illness in children with epilepsy.

This was a quasi-experimental study with a non-equivalent control group pre-post test design. Participants were 10 to 15 year old children with epilepsy (11 in the experimental group and 10 in the control group) who were registered at one hospital in S city. The experimental group received the EASE program for 3 weeks. In the first week, a group meeting lasting 570 minutes was conducted on a single day. Over the next two weeks, telephone counselling was conducted twice a week. Data were analyzed using SPSS 18.0.

There was a significant difference of pre-post evaluation of the epilepsy self-management scores in the experimental group. However, differences between the experimental group and the control group for seizure self-efficacy and child attitude toward illness were not significant.

This is the first study in Korea to develop and evaluate an intervention program for children with epilepsy. Further studies are needed to confirm the effects of the EASE program.

This study was designed to construct and test structural equation modeling on healthy menopausal transition in middle-aged women in order to identify variables affecting healthy menopausal transition.

Participants, 276 women, 45 to 60 years of age, with menopausal symptom score higher than 5 on the Korean version of Menopause Rating Scale, were recruited in three cities and one county of Gyeongnam Province. Research data were collected via questionnaires and analysed using SPSS version 18.0 and AMOS version 20.0.

After confirmatory factor analysis, one of the observed variables was excluded due to relatively low factor loading. The model fit indices for the hypothetical model were suitable for the recommended level: GFI=.93, CFI=.92, RMSEA=.05. Self-efficacy, self-differentiation, and menopausal symptoms explained 67.7% of variance in menopausal transition, and self-differentiation was the most influential factor for menopausal transition. Self efficacy and menopausal symptoms explained 9.6% of variance in menopausal management, although "menopausal symptoms" was not significant.

These results suggest that nursing interventions to improve self-differentiation, self efficacy, menopausal management and decrease menopausal symptoms are critical for healthy menopausal transition in middle-aged women. Continued development of a variety of community-based nursing interventions to facilitate healthy menopausal transition is suggested.

The purpose of this study was to investigate factors that influence sexual intercourse among middle school students in South Korea.

Using statistics from the 8th (2012) Korea Youth Risk Behavior Web-based Survey, hierarchical logistic regression analysis was conducted. The study sample comprised 37,297 middle school students aged primarily 12 to 15.

The significant predictors of sexual intercourse were grade, ever smoking, ever drinking, habitual or purposeful drug use, economic status, weekly allowance, cohabitation with family, and type of school.

The results suggest that intensified sex education is needed not only in the 1st grade of middle school, but also in the upper grades of elementary school. Sexual health interventions for high-risk groups may be needed, given the factors predicting sexual intercourse.

This study was done to investigate the motivational, physical and affective benefits of exergaming in community dwelling older adult women.

The research design was a nonequivalent control group pre-test and post-test design. Sixty-one older adult women over the age of 65 were recruited from 6 community senior centers to participate in the 8 week exercise intervention or control group. Six centers were divided into one of three groups: exergame, qigong exercise, or control. The exergame and the qigong exercise group received 16 sessions, scheduled twice a week, with each session lasting 50 minutes. Test measures were completed before and after the 8 week intervention period for all participants. Measures included: Grip strength, chair stand, 6 m walking, balance, geriatric depression scale, vitality and intrinsic motivation.

There were significant improvements in the exergame and qigong exercise group for grip strength, chair stand, 6m walking, balance, vitality and intrinsic motivation at the end the 8-week program compared with the control group.

The exergame could be an effective alternative for older adult women to group exercise classes.

This study was done to develop and test a structural model for caregiving experience including caregiving satisfaction and caregiving strain in families providing care for family members with a mental disorder.

The Stress-appraisal-coping model was used as the conceptual framework and the structural equation model to confirm the path that explains what and how variables affect caregiving experience in these families. In this hypothesis model, exogenous variables were optimism, severity of illness and uncertainty. The endogenous variables were self efficacy, social support, caregiving satisfaction and caregiving strain. Data were collected using structured questionnaires.

Optimism and caregiving self-efficacy had significant direct and indirect effects on caregiving satisfaction. Optimism, severity of illness and uncertainty had significant direct and indirect effects on caregiving strain. The modified path model explained effects of optimism on caregiving self-efficacy with social support in the path structure as a mediator. Also, there were direct and indirect effects of optimism and uncertainty on caregiving satisfaction with social support and caregiving self-efficacy in the path structure as a mediators.

Results suggest the need to improve caregiving self-efficacy of these families, establish support systems such as a mental health professional support programs for caregiving self-efficacy. Optimism, severity of illness and uncertainty perceived by families need to be considered in the development of support programs in order to increase their effectiveness.

The purpose of this study was to evaluate the psychometric properties of the Korean version of the Alzheimer's Disease Knowledge Scale (ADKS-K) to determine its applicability to Korean adults.

Cross-cultural validity was performed according to Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). The Kuder-Richardson Formula 20 for internal consistency and Intraclass Correlation Coefficient (ICC) for test-retest reliability were conducted. Content validity, criterion related validity and construct validity were evaluated. The Classical Test Theory (CTT) model and the Item Response Theory (IRT) model were applied in performing the item analysis.

The KR 20 was .71, and the ICC was .90, indicating that the ADKS-K has internal consistency and stability reliability. Thirty items of the ADKS-K had significant Content Validity Ratio (CVR) values, i.e., mean of 0.82 and range of 0.60~1.00. Mean item difficulty and discrimination indices calculated by TestAn program were 0.63 and 0.23, respectively. Mean item difficulty and discrimination indices calculated by BayesiAn program were -0.60 and 0.77, respectively. These tests indicate that ADKS-K has an acceptable level of difficulty and discriminating efficiency.

Results suggest that ADKS-K has the potential to be a proper instrument for assessing AD knowledge in Korean adults.

Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy.

Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses.

At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function.

These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.

The purpose of this study was to report the instrument modification and validation processes to make existing health belief model scales culturally appropriate for Korean Americans (KAs) regarding colorectal cancer (CRC) screening utilization.

Instrument translation, individual interviews using cognitive interviewing, and expert reviews were conducted during the instrument modification phase, and a pilot test and a cross-sectional survey were conducted during the instrument validation phase. Data analyses of the cross-sectional survey included internal consistency and construct validity using exploratory and confirmatory factor analysis.

The main issues identified during the instrument modification phase were (a) cultural and linguistic translation issues and (b) newly developed items reflecting Korean cultural barriers. Cross-sectional survey analyses during the instrument validation phase revealed that all scales demonstrate good internal consistency reliability (Cronbach's alpha=.72~.88). Exploratory factor analysis showed that susceptibility and severity loaded on the same factor, which may indicate a threat variable. Items with low factor loadings in the confirmatory factor analysis may relate to (a) lack of knowledge about fecal occult blood testing and (b) multiple dimensions of the subscales.

Methodological, sequential processes of instrument modification and validation, including translation, individual interviews, expert reviews, pilot testing and a cross-sectional survey, were provided in this study. The findings indicate that existing instruments need to be examined for CRC screening research involving KAs.

This study aimed to develop a “Palliative Care Professional” education program and evaluate its effects on the recognition of good death, palliative care, and the meaning of life for nurses.

It was developed based on the hospice care program for volunteers being used in the Hospice Palliative Care Research Center of S University in Seoul. It was also based on the studies which investigated the educational needs of nurses in palliative care. This program consisted of 5 sessions and 16 content items for 2 weeks. A nonequivalent control group non-synchronized design was utilized and participants were assigned to the experimental group (n= 42) or the control group (n= 44).

The recognition of a good death (F= 11.44, p= .001), palliative care (F= 4.15, p= .045), and the meaning of life (F= 5.12, p= .026) increased more significantly for participants in the experimental group than in the control group. Participants felt that they gained further knowledge in palliative patient management and refined their clinical practice.

The results of the study indicate that this program could serve as a practical program for palliative care nursing in the nursing field and suggests that more attention should be directed to the diverse educational needs of nurses.

This study was done to describe the return to work experience of military officers with cancer.

Individual in-depth interviews with 15 participants were conducted between September 2013 and April 2014. Participants were interviewed 1~4 times; interviews continued until the data became saturated. Data were analyzed using Strauss and Corbin's grounded theory.

The core category emerged as "living a new life after enduring difficulties". The return to work process consisted of four sequential phases: chaos, positive thought formation, behavior practices, and reformation. Action/interaction strategies used by military officers with cancer to resolve enduring difficulties were controlling emotions, accepting reality, prioritizing health, making efforts to improve relationships, and looking for future jobs.

These results will promote understanding of military officers' return to work experience following cancer survival, and will be helpful in developing more effective nursing interventions through enhanced perspectives and insights of practitioners.