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Volume 41(2); April 2011
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Original Articles
Chronic Obstructive Pulmonary Disease in Korea: Prevalence, Risk Factors, and Quality of Life
Young-Mi Jung, Heeyoung Lee
J Korean Acad Nurs 2011;41(2):149-156.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.149
AbstractAbstract PDF
Purpose

This study seeks to examine prevalence, risk factors, and quality of life of Korean adults with Chronic Obstructive Pulmonary Disease (COPD).

Methods

From the database of the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV-1, 2008), the researchers selected 1,458 adults over the age of 45. The original study was a population-based epidemiological survey of health and nutrition with a stratified multistage clustered probability design. Prevalence of COPD was computed on the basis of the sampling weight. Data were analyzed using descriptive statistics, χ2 test, t-test and multiple logistic regression with the SPSS WIN 18.0 and SAS Ver. 9.1 program.

Results

The prevalence of COPD was 18.0% among people older than 45 yr. The prevalence of current smokers was 19.7% in this population and 26.3% in individuals with COPD. Age, gender, education, and smoking levels were found to be risk factors for COPD. Significant difference in quality of life was founded between adults with COPD and the healthy controls.

Conclusion

The results of this study indicate that COPD is a highly prevalent disease in Korea. To reduce the prevalence of COPD and improve health-related quality of life in patients with COPD, nursing interventions must focus on prevention of risk factors.

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Influence of Pre-operative Fasting Time on Blood Glucose in Older Patients
Misuk Hong, Haesang Yoon
J Korean Acad Nurs 2011;41(2):157-164.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.157
AbstractAbstract PDF
Purpose

This study was performed to identify changes in blood glucose at preoperative fasting time in surgical patients over 60 yr.

Methods

Data collection was performed from July, 2008 through July, 2009. Participants consisted of 80 nondiabetic surgical patients. Blood glucose was checked from 3 to 5 times. The 5 times were 2-hr fasting on the pre-operative day (T1, n=80), 8 hr (T2, n=80), 10 hr (T3, n=17), 12 hr (T4, n=34) and 14 hr fasting on the day of the operation (T5, n=29).

Results

Of the patients, 27.5% had a blood glucose level of less than 79 mg/dL at T2; 17.6% at T3; 32.4% at T4; and 17.2% at T5. Mean blood glucose levels were 93.8 mg/dL at T1; 88.4 mg/dL at T2; 91.7 mg/dL at T3; 87.4 mg/dL at T4: and 94.1 mg/dL at T5. Blood glucose was the lowest at T2 (p<.001).

Conclusion

As 17.6-32.4% of the patients showed the blood glucose level of less than 79 mg/dL at 8-14 hr pre-operative fasting, the authors recommend that surgical patients >60 yr-of-age be observed for hypoglycemia during pre-operative fasting of more than 10 hr and that surgical patients >60 yr-of-age with risks for hypoglycemia be scheduled for operation within 10 hr preoperative fasting.

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Effects of a Fall Prevention Program on Physical Fitness and Psychological Functions in Community Dwelling Elders
Myung Soon Kwon
J Korean Acad Nurs 2011;41(2):165-174.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.165
AbstractAbstract PDF
Purpose

This study was done to identify effects of a fall prevention program on physical fitness and psychological functions in community dwelling elders.

Methods

A quasi-experimental study was carried out with a nonequivalent control group pre & post-test design. The program, which included exercises and education, consisted of a 12-week group program and an 8-week self-management program using a health calendar. An experimental group (32) and a control group (21) participated.

Results

There were significant differences in SPPB (t=-3.92, p<.001), TUG test (t=4.94, p<.001), standing with right leg (t=-3.60, p=.001), standing with left leg (t=-3.74, p<.001), front and rear maximum step length test (t=-4.34, p<.001), right-left maximum step length test (t=-2.65, p=.011), and fall efficacy (t=-2.42, p=.019). Fall efficacy, fear of falling and depression showed significant differences following the 12-week exercise program and 8-week self-management program in the experimental group.

Conclusion

Study findings indicate that the fall prevention program is an effective nursing intervention to enhance physical fitness and psychological functions for elders. Using a health calendar, the self-management program was more effective for psychological functions compared to only the group program. Therefore, health providers should develop diversified fall prevention programs which include motivation plans to encourage clients in participating.

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Endotracheal Colonization and Ventilator-associated Pneumonia in Mechanically Ventilated Patients according to Type of Endotracheal Suction System
Kyeong-Sook Cha, Ho-Ran Park
J Korean Acad Nurs 2011;41(2):175-181.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.175
AbstractAbstract PDF
Purpose

This study was conducted to identify endotracheal colonization and the incidence of ventilator-associated pneumonia related to the type of endotracheal suction system.

Methods

The participants in this study were ICU patients hospitalized between October 2009 to March 2010 who used ventilators for over 48 hr with closed (CSS, n=30) or open (OSS, n=32) suction systems. To standardize the pre-intervention suction system, a suctioning protocol was taught to the ICU nurses. Collected data were analyzed using χ2-test, Fisher's exact test, Wilcoxon rank sums test, Wilcoxon test, Log-rank test and Poisson regression.

Results

Endotracheal colonization was higher in OSS than CSS from day 1 to day 8 while using a ventilator and there was a significant difference between the two groups. The CSS reached 50% of endotracheal colonization by the 4th day, whereas for the OSS, it was the 2nd day (p=.04). The incidence of ventilator-associated pneumonia showed no significant difference.

Conclusion

For patients with a high risk of pneumonia, CSS must be used to lower endotracheal colonization.

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Relationship of Daily Activity and Biochemical Variables in the Elderly with Diabetes Mellitus
Ki-Wol Sung
J Korean Acad Nurs 2011;41(2):182-190.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.182
AbstractAbstract PDF
Purpose

This study was done to identify correlates and variables predicting daily activity among elders with Diabetes Mellitus (DM).

Methods

Seventy-six elders registered in the Department of Endocrine Medicine at C university hospital participated in data collection. Data on daily activity and biochemical variables were collected via actigraph accelerator (Actical) and blood tests between September 2009 and July 2010. Data analysis was done using SPSS WIN 15.0 program and included one-way ANOVA, independent t-test, Pearson correlation coefficients, and stepwise multiple regression.

Results

This study showed a positive correlation between daily activity and High Density Lipoprotein Cholesterol (HDL-C) and a negative correlation among Total Cholesterol (TC), Triglyceride (TG), and Low Density Lipoprotein Cholesterol (LDL-C). The variables predicting daily activity were frequency of exercise, HDL-C, and TC. These factors accounted for 40.0% of the variance of daily activity in elders with DM.

Conclusion

The results indicate that it is necessary to improve daily activity to reduce Fasting Blood Glucose (FBG), TC, and TG in elders with DM.

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Estrogen Attenuates the Pressor Response Mediated by the Group III Mechanoreflex
Seung-Ae Park, Jong-Kyung Kim
J Korean Acad Nurs 2011;41(2):191-196.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.191
AbstractAbstract PDF
Purpose

We investigated the effects of group III mechanoreceptors to cardiovascular responses in both pre-menopausal woman and post-menopausal woman during passive ankle dorsiflexion (PAD).

Methods

Twenty healthy volunteers (10 post-menopausal women and 10 pre-menopausal women) were recruited for this study. Stroke volume (SV), heart rate (HR), cardiac output (CO), and total vascular conductances (TVC) were measured continuously throughout the experiment. To stimulate the group III mechanoreceptors, PAD was performed for one minute.

Results

The results showed that mean arterial pressure (MAP) mediated by the mechanoreflex activation was significantly increased in both groups. However, this pressor response was significantly higher in post-menopausal women. This reflex significantly increased both SV and CO in pre-menopausal women, while there were no differences in post-menopausal women. There was no difference in HR in either group. The mechanoreflex significantly decreased TVC in post-menopausal woman, while there was no difference in pre-menopausal woman.

Conclusion

The results indicate that the excessive pressor response mediated by the mechanoreflex occurs due to overactivity of group III mechanorecptors and the mechanism is produced mainly via peripheral vasoconstriction in post-menopausal women.

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The Effect of Treadmill Exercise on Ischemic Neuronal Injury in the Stroke Animal Model: Potentiation of Cerebral Vascular Integrity
Kyoung Ah Kang, Hohyun Seong, Han-Byeol Jin, Jongmin Park, Jongmin Lee, Jae-Yong Jeon, Youn Jung Kim
J Korean Acad Nurs 2011;41(2):197-203.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.197
AbstractAbstract PDF
Purpose

This study was done to identify whether pre-conditioning exercise has neuroprotective effects against cerebral ischemia, through enhance brain microvascular integrity.

Methods

Adult male Sprague-Dawley rats were randomly divided into four groups: 1) Normal (n=10); 2) Exercise (n=10); 3) Middle cerebral artery occlusion (MCAo), n=10); 4) Exercise+MCAo (n=10). Both exercise groups ran on a treadmill at a speed of 15 m/min, 30 min/day for 4 weeks, then, MCAo was performed for 90 min. Brain infarction was measured by Nissl staining. Examination of the remaining neuronal cell after MCAo, and microvascular protein expression on the motor cortex, showed the expression of Neuronal Nuclei (NeuN), Vascular endothelial growth factor (VEGF) & laminin.

Results

After 48 hr of MCAo, the infarct volume was significantly reduced in the Ex+MCAo group (15.6±2.7%) compared to the MCAo group (44.9±3.8%) (p<.05), and many neuronal cells were detected in the Ex+MCAo group (70.8±3.9%) compared to the MCAo group (43.4±5.1%) (p<.05). The immunoreactivity of laminin, as a marker of microvessels and Vascular endothelial growth factor (VEGF) were intensively increased in the Ex+MCAo group compared to the MCAo group.

Conclusion

These findings suggest that the neuroprotective effects of exercise pre-conditioning reduce ischemic brain injury through strengthening the microvascular integrity after cerebral ischemia.

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Development of the Competency Model for Prevention of Adolescent Risk Behavior
Hyun Sook Park, Sun Young Jung
J Korean Acad Nurs 2011;41(2):204-213.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.204
AbstractAbstract PDF
Purpose

This study was done to identify fundamental data on competency reinforcement programs to prevent adolescent risk behavior by developing and examining a competency model.

Methods

In this study, competences on prevention of adolescent risk behavior were identified through competency modeling, and a competency model was developed and tested for validity.

Results

Competences for prevention of adolescent risk behavior defined by the competency model included the following: self-control, positive mutual understanding between parents and adolescents, and positive connectedness with peer group. Validation of the competency model showed the model to be appropriate.

Conclusion

The competency model for prevention of adolescent risk behavior through competency modeling is expected to be the foundation of an integral approach to enhance competency in adolescents and prevent adolescent risk behavior. This kind of approach can be a school-centered, cost-efficient strategy, which not only reduces adolescent risk behavior but also improves quality of adolescent resources.

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Life Experience of Inpatients with Recurrent Breast Cancer
Young Ju Kim
J Korean Acad Nurs 2011;41(2):214-224.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.214
AbstractAbstract PDF
Purpose

Understanding daily life experiences of patients admitted to hospital with recurrent breast cancer.

Methods

The grounded theory method was used for this study.

Results

Consistent comparative analysis was used throughout the study to obtain the results. Results showed that inpatients with recurrent breast cancer experience 'a co-existence of life suffering and fear of death'. The causal condition of this result was determined to be 'patient's response to cancer recurrence (acceptance/despair)', including contextual conditions such as, 'previous experience with cancer treatment', 'patient's current physical condition', and 'treatment methods for recurrent cancer'. Intervening conditions, such as 'a strong will to live', 'family support', 'moral support providers', and action/interaction strategies were found to provide patients with 'a strength to live'. Shown in these results, inpatients with recurrent breast cancer were seen to have a simultaneous 'hope for life and fear of death'.

Conclusion

When providing nursing services to inpatients with recurrent breast cancer, people must recognize there is a notable difference between individual patients' contextual conditions and interactive strategies. Henceforth, proper cognitive nursing must be provided which encourages patients to maintain a strong will to overcome the many hardships of treatment as well as physical nursing, such as management of side effects caused by chemotherapy.

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Psychosocial Adjustment of Low-Income Koreans with Cancer
Myungsun Yi, Eun Young Park, Dal Sook Kim, Young Sook Tae, Bok Yae Chung, Hyang Sook So
J Korean Acad Nurs 2011;41(2):225-235.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.225
AbstractAbstract PDF
Purpose

To describe psychosocial adjustment of low-income Koreans who have cancer.

Methods

Data were collected during 2008 using individual in-depth interviews with 18 Korean people with cancer. The income status of the participants was low, 11 were recipients of the National Basic Livelihood Protection program. Mean age was 58.3 yr and 11 were female. Five participants had stomach cancer, five, colorectal cancer, and four, breast cancer. Data were analyzed using grounded theory methodology.

Results

The core category emerged as 'bearing up alone with double suffering'. 'Poverty and cancer: A double suffering' emerged as a causal condition. The adjustment process consisted of three stages: 'forming a treatment will to live' ,'practicing for the cure',and 'restructuring self and repaying favors'. Each stage indicated action-interaction strategies which were employed to bear up alone with double suffering during the illness process. Self-reflection, parental responsibility, and support from the public sector played important roles in overcoming the double suffering. Two types of consequences were identified: Transcended life and strained life suppressed by poverty and cancer.

Conclusion

The results provide insights into the psychosocial adjustment process for low income Korean with cancer and can be used in developing and implementing efficient home-care services for these people.

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Impact of Pro-environmental Behavior on Dysmenorrhea
Hyun Kyoung Kim
J Korean Acad Nurs 2011;41(2):236-244.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.236
AbstractAbstract PDF
Purpose

In this study the impact of pro-environmental behavior, well-being oriented behavior, and use of cloth menstrual pads on dysmenorrhea in Korean female adults was examined according to the theory of reasoned action.

Methods

A cross-sectional study was conducted with 195 Korean female adults. Data were collected from June to August, 2010 using self-report questionnaires. Data were analyzed using t-test, one-way ANOVA, Pearson correlation coefficients, multiple regression, and logit regression with STATA 10.0.

Results

Pro-environmental behavior explained 48% of well-being oriented behavior. Well-being oriented behavior explained 10% of cloth pad use. Use of cloth pad explained 4% of dysmenorrhea and 5% of menstrual pain. The path through well-being oriented behavior had a significant effect from pro-environmental behavior to cloth pad use.

Conclusion

Use of cloth pad was significantly related with well-being oriented behavior, pro-environmental behavior, social influence, dysmenorrhea, and menstrual pain. The results of this study suggest that pro-environmental strategies can help health care providers diminish clients' menstrual symptoms. Nursing intervention can support pro-environmental behavioral strategies.

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Effect of a Simulation-based Education on Cardio-pulmonary Emergency Care Knowledge, Clinical Performance Ability and Problem Solving Process in New Nurses
Yun Hee Kim, Keum Seong Jang
J Korean Acad Nurs 2011;41(2):245-255.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.245
AbstractAbstract PDF
Purpose

This study was conducted to examine the effects of simulation-based education regarding care in a cardio-pulmonary emergency care as related to knowledge, clinical performance ability, and problem solving process in new nurses.

Methods

An equivalent control group pre-post test experimental design was used. Fifty new nurses were recruited, 26 nurses for the experimental group and 24 nurses for the control group. The simulation-based cardio-pulmonary emergency care education included lecture, skill training, team-based practice, and debriefing, and it was implemented with the experimental group for a week in May, 2009. Data were analyzed using frequency, ratio, chi-square, Fisher's exact probability and t-test with the SPSS program.

Results

The experimental group who had the simulation-based education showed significantly higher know-ledge (t=5.76, p<.001) and clinical performance ability (t=5.86, p<.001) for cardio-pulmonary emergency care compared with the control group who had traditional education but problem solving process was not included (t=1.11, p=.138).

Conclusion

The results indicate that a simulation-based education is an effective teaching method to improve knowledge and clinical performance ability in new nurses learning cardio-pulmonary emergency care. Further study is needed to identify the effect of a simulation-based team discussion on cognitive outcome of clinical nurses such as problem solving skills.

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Meta Analysis of Variables Related to Attention Deficit Hyperactivity Disorder in School-Age Children
Wan Ju Park, Ji Yeong Seo, Mi Ye Kim
J Korean Acad Nurs 2011;41(2):256-268.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.256
AbstractAbstract PDF
Purpose

The purpose of this study was to use meta-analysis to examine recent domestic articles related to attention deficit hyperactivity disorder (ADHD) in school-age children.

Methods

After reviewing 213 articles published between 1990 and 2009 from and cited in RISS, KISS, and DBpia, the researchers identified 24 studies with 440 research variables that had appropriate data for methodological study. SPSS 17.0 program was used. The outcome variables were divided into five types: Inattention, hyperactive impulsive, intrinsic, extrinsic, and academic ability variables.

Results

Effects size of overall core symptoms was 0.47 which is moderate level in terms of Cohen criteria and effects size of overall negative variables related ADHD was 0.27 which is small level. The most dominant variable related to ADHD was obtained from hyperactive-impulsive (0.70). Also academic ability (0.45), inattention (0.37), and intrinsic variables (0.29) had a small effect whereas extrinsic variables (0.13) had little effect on descriptive ADHD study.

Conclusion

The results reveal that ADHD core symptoms have moderate effect size and peripheral negative variables related ADHD have small effect size. To improve the reliability of the meta-analysis results by minimizing publication bias, more intervention studies using appropriate study designs should be done.

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Effects of Carbonated Water Intake on Constipation in Elderly Patients Following a Cerebrovascular Accident
Jae-Hee Mun, Seong Sook Jun
J Korean Acad Nurs 2011;41(2):269-275.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.269
AbstractAbstract PDF
Purpose

This study was done to identify effects of carbonated water intake on constipation in elders who have experienced a cerebrovascular accident (CVA) and are bed-ridden.

Methods

Forty elderly patients with CVA were randomly assigned to one of two groups in a double-blind study. Patients in the experimental group drank carbonated water and those in the control group drank tap water for two weeks. Six patients dropped out during the study period. Data were analyzed by repeated measured ANCOVA and the covariance was the dose of laxatives used for the two weeks.

Results

Frequency of defecation increased significantly and symptoms of constipation decreased significantly for patients in the experimental group.

Conclusion

The study results suggest that the intake of carbonated water is an effective method for the intervention of constipation in elderly patients with CVA.

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Relationship of Prenatal Stress and Depression to Maternal-Fetal Attachment and Fetal Growth
Mi-Kyung Kwon, Kyung-Sook Bang
J Korean Acad Nurs 2011;41(2):276-283.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.276
AbstractAbstract PDF
Purpose

Prenatal depression is associated with potential negative consequences for the mother and infant. The purpose of this study was to examine pregnant women's stress, and depression and their impact on maternal-fetal attachment and fetal growth.

Methods

Data were collected by means of a questionnaire and fetal sonogram from a convenience sample of 166 pregnant women.

Results

Women who have a low educational level, poor health and are dissatisfied with their marriage showed low maternal-fetal attachment. Prenatal depression had significant correlations with length of pregnancy and level of stress. Even though correlation between maternal stress and fetal weight (r=-.15, p=.099) and correlation between maternal depression and maternal-fetal attachment (r=-.13, p=.095) were not statistically significant, the impact of the prenatal psychological state of mothers can not be ignored as it relates to fetal health.

Conclusion

Maternal-fetal attachment and fetal growth can be affected by maternal emotional state, including stress or depression. These findings suggest that primary care nurses in hospitals and public health centers should provide prenatal depression screening and nursing intervention programs for management and prevention of prenatal stress and depression.

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