The study was done to develop a shared decision-making scale for end-of-life patients in Korea.

The process included construction of a conceptual framework, generation of initial items, verification of content validity, selection of secondary items, preliminary study, and extraction of final items. The participants were 388 adults who lived in one of 3 Korean metropolitan cities: Seoul, Daegu, or Busan. Item analysis, factor analysis, criterion related validity, and internal consistency were used to analyze the data. Data collection was done from July to October 2011.

Thirty-four items were selected for the final scale, and categorized into 7 factors explaining 61.9% of the total variance. The factors were labeled as sharing information (9 items), constructing system (7 items), explanation as a duty (5 items), autonomy (4 items), capturing time (3 items), participation of family (3 items), and human respect (3 items). The scores for the scale were significantly correlated among shared decision-making scale, terminating life support scale, and dignified dying scale. Cronbach's alpha coefficient for the 34 items was .94.

The above findings indicate that the shared decision-making scale has a good validity and reliability when used for end-of-life patients in Korea.

The purpose of this study was to explore characteristics of eating behavior according to level of functional status of elders with dementia (EWD), and to examine feeding time, change in food intake and body mass index (BMI) according to eating behavior.

Participants were 149 EWD residing in long-term care facilities located in Seoul or Gyeonggi province and evaluated using the Mini-Mental State Exam-Korean version, Korean version-Activities of Daily Living, and Eating Behavior Scale (EBS). Feeding time, change in food intake, and BMI were also measured. Data were analyzed using SPSS 17.0, specifically descriptive statistics, ANOVA, and Chi-square test.

Participants' mean EBS score was 10.43±6.01 and half of them (54.4%) needed moderate or total assistance while eating. The EBS score was significantly lower for elders with severe dementia compared to those with mild or moderate dementia; and elders with severe ADL dependence compared to those with mild or moderate ADL dependence. Lower EBS scores were related to longer feeding time, a greater the rate of participants with decreased food intake and 'underweight' BMI.

Nursing intervention programs which are designed for EWD are needed to maintain functional eating skills and prevent negative consequences in this population.

This study was done to evaluate the effects of antenatal depression on birth outcomes.

The participants were 255 pregnant women who were followed in a prospective study. Of these, 197 cases were examined included birth weight, Apgar scores at 5 minute, premature contraction, complication of labor, delivery types and laboratory data. Descriptive statistics, ANOVA, Chi square test of linear by linear association, Kruskal Wallis test, Relative Risk, univariate and adjusted multiple logistic regression were used for data analysis with SPSS/Win.

Level of antenatal depression was associated with low birth weight (χ²=7.69, p=.010). High risk pregnancy was a predictor of low birth weight (OR=6.98 [1.21-40.30]) and baby's weight (OR=2.12, [1.05-4.28]). Prepregnancy body mass index (BMI) was a predictor of complications in labor (OR=3.59, [1.03-12.48]). But there were no significant effects of antenatal depression on other birth outcomes.

The results of this study indicate that women with antenatal depression, high risk pregnancy, prepregnancy BMI≥23 kg/M² should be monitored and managed to ensure favorable birth outcomes.

The purpose of this study was to explore the main prerequisite for Korean Advance Directives [KAD] to ensure their better use.

Data were collected from two focus group interviews and individual email responses. Study participants were 5 doctors and 6 nurses. All interview data were transcribed and analyzed using qualitative content analysis.

Three main themes emerged; establishing a philosophy of KAD, protocol to practice KAD, and the KAD document itself. A philosophy is needed to ensure individual needs, consensus to practice AD and identify principle agents. The core of protocol was found to be as follows; 1) process, 2) premise, 3) procedure, 4) contextual preparation, 5) timing, 6) feasibility. Component and feasibility need to be established for the document itself.

For a positive acceptance of KAD in Korean society, a culture sensitive, reality based, and user friendly AD needs to be developed.

This study was based on social-role theory, and purposes were to investigate (1) how depression and health determinants vary with married and employed women, and (2) what factors contribute to depression according to family cycle.

A stratified convenience sample of 765 married and employed women was recruited during May to August 2010. Study variables of depression, socio-demographic threatening factors, psycho-stimulating factors, and social-role related factors were measured via a structured questionnaire.

Prevalence rate for depression was 18.6%, with highest rate (25.4%) from elementary laborers. Greater levels of depression were related to women’s occupation, higher life stress, and poorer health; lower social support and vulnerable personality; higher levels of social-role related stress. From multivariate analysis, women with preadolescents were the most vulnerable to depression affected by occupation, life stress, personality, and parenting stress. These factors (except for occupational class) combined with economic status, social support, and housework unfairness were significant for depression in women with adolescents.

Depression among married and employed women differs by psycho-stimulating and social role relevant factors in addition to occupational class and family life cycle. Female elementary laborers and women with children need to have the highest prioritization for community mental health programs.

The purpose of the study was to understand and explain the essences and structures of the experience of Korean women who have had a spinal cord injury.

The data were collected in 2010 through individual in-depth interviews using open-ended questions. A total of 9 women with spinal cord injuries participated in the study. Each interview lasted about 2 hours. Verbatim transcripts were analyzed using phenomenological analysis.

Five theme clusters emerged from the analysis using Colaizzi's method: frozen mind with rigid body; shame due to restrictions of physical function and dependency; struggle to go back to the previous normal body; disabilities that are noticeable in everyday family life; rebirth by discarding the obsessions of the past. These theme clusters illustrate that although most participants faced very strange and unbearable situations in most aspects of life after the injury, they were empowered finally by finding their hope and by giving new meanings to the current existence.

This study provides deep understanding of women with spinal cord injuries who are relatively alienated from society. Based on the results of the study, health professionals could develop effective nursing interventions to improve quality of life of these women.

To compare and confirm the impact of prepregnancy body mass index on pregnancy outcome in women with a singleton conceived by assisted reproductive technology and spontaneously conceived pregnancy.

A sample of 165 and 247 pregnant women with and without assisted reproductive technology were retrospectively recruited from electronic medical charts of C hospital.

There were significant differences between the two groups for maternal age, paternal age, length of marriage, prepregnancy body mass index, parity, spontaneous abortion experience, and preterm delivery. A prepregnancy body mass index of ≥25 was associated with higher risk for maternal and neonatal complication in the assisted reproductive technology group.

The results indicate that a higher prepregnancy body mass index is associated with increased risks for adverse pregnancy outcomes for women using assisted reproductive technology. So these women need appropriate care to compensate for the risk.

The purpose of the study was to evaluate effectiveness of a peer support program conducted by older community volunteers for older adults living alone.

Thirty volunteers trained as peer supporters were matched with low-income, older adults living alone in the community on gender. Visits occurred on a weekly basis over the 12 month study period, and the volunteers provided peer support for health management to solitary older adults. Data were collected, before the start of the program and again 6 and 12 months after its initialization, from intervention and control groups regarding physical health, general health, mental health, depression, social functioning, and satisfaction with social support. Repeated measures ANOVA was used to analyze data.

By the end of the program, socially isolated older adults in the intervention group had significantly higher scores in physical health and general health than elders in the control group. Significant interaction effects between time and group were found for depression, social functioning, and satisfaction with social support.

The peer support program undertaken by older community volunteers was effective in improving physical health, general health, depression, social functioning, and satisfaction with social support in socially isolated, low-income, older adults.

The purpose of this study was to use meta-analysis to evaluate the variables related to depression in patients who have had a stroke.

The materials of this study were based on 16 variables obtained from 26 recent studies over a span of 10 years which were selected from doctoral dissertations, master's thesis and published articles.

Related variables were categorized into sixteen variables and six variable groups which included general characteristics of the patients, disease characteristics, psychological state, physical function, basic needs, and social variables. Also, the classification of six defensive and three risk variables group was based on the negative or positive effect of depression. The quality of life (ES= -.79) and acceptance of disability (ES=-.64) were highly correlated with depression in terms of defensive variables. For risk variables, anxiety (ES= .66), stress (ES= .53) showed high correlation effect size among the risk variables.

These findings showed that defensive and risk variables were related to depression among stroke patients. Psychological interventions and improvement in physical functions should be effective in decreasing depression among stroke patients.

The purpose of this study was to validate the Needs Assessment Tool for Case Management (NATCM) for use with Korean medical aid beneficiaries.

Psychometric testing was performed with a sample of 645 Korean medical aid beneficiaries, which included 41 beneficiaries who were selected using proportional sampling method, to examine intraclass correlation coefficients (ICC). Data were evaluated using item analyses, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's alpha, and ICC.

Through psychometric testing the final version of NATCM was found to consist of two subscales: 1) Appropriateness of Health Care Utilization (5 items) and 2) Self Care Ability (6 items). The two subscale model was validated by CFA (RMSEA=.08, GFI=.97, and CFI=.93). Internal consistency measured by Cronbach's alpha was .82, and subscale reliability ranged from .79 to .84. The ICC of the NATCM between case managers was .73 and between case managers and health care professionals. .82.

This study suggests that the final version of NATCM is a brief, reliable, and valid instrument to measure needs of Korean medical aid beneficiaries. Therefore, the NATCM can be effectively utilized as an important needs assessment as well as outcome evaluation tool for case management programs in Korea.

This study aimed to evaluate the effectiveness of the empowerment intervention on the levels of self-esteem, interpersonal relationships and adjustment to nursing home life of the Korean nursing home residents.

Participants (n=47) whose period of stay was less than one year were purposefully selected from 3 nursing homes in Korea. The experimental group (n=21) attended 10 weekly hour-long empowerment sessions. The empowerment program comprised two components; group education and group discussion. The control group (n=26) received a two-hour education about health management.

Compared with the control group, the experimental group showed significantly higher mean scores of self-esteem (t=5.51, p<.001), interpersonal relationships (t=2.73, p=.009) and adjustment to nursing home life (t=2.10, p=.041).

Findings of this study suggest that empowerment interventions may be effective in enhancing nursing home residents' self-esteem, interpersonal relationships and adjustment to nursing home life. Future research is needed to determine if such an empowerment program could be used with newly institutionalized elders to speed as well as enhance their adjustment to nursing home life.

The purpose of this cross-sectional study was to examine current status of IT-based medication error prevention system construction and the relationships among system construction, medication error management climate and perception for system use.

The participants were 124 patient safety chief managers working for 124 hospitals with over 300 beds in Korea. The characteristics of the participants, construction status and perception of systems (electric pharmacopoeia, electric drug dosage calculation system, computer-based patient safety reporting and bar-code system) and medication error management climate were measured in this study. The data were collected between June and August 2011. Descriptive statistics, partial Pearson correlation and MANCOVA were used for data analysis.

Electric pharmacopoeia were constructed in 67.7% of participating hospitals, computer-based patient safety reporting systems were constructed in 50.8%, electric drug dosage calculation systems were in use in 32.3%. Bar-code systems showed up the lowest construction rate at 16.1% of Korean hospitals. Higher rates of construction of IT-based medication error prevention systems resulted in greater safety and a more positive error management climate prevailed.

The supportive strategies for improving perception for use of IT-based systems would add to system construction, and positive error management climate would be more easily promoted.

The purpose of this study was to identify the effects of heating on the non-affected hand on blood flow velocity, wound healing, and pain for hand microsurgery patients.

This study was designed using the nonequivalent control group pretest-posttest design. Thirty-nine patients were assigned either to the experimental group (20 patients) or control group (19 patients). Data were analyzed with χ²-test, Fisher's exact test, t-test, and repeated measure ANOVA using SPSS/WIN 17.0 program.

After treatment in this program, blood flow velocity (F=5.13, p=.008) and wound healing (F=4.11, p=.020) improved significantly in the experimental group compared to the control group. But there was no significant improvement in pain in the experimental group compared to the control group (F=2.40, p=.097).

Based upon these results, the non-affected side hand heating was recommended as an independent nursing intervention for the patients who need improvement in blood flow velocity and wound healing such as patients who have microsurgery. As the heating was effective even when applied on the non-affected side, it is the applicable to patients who cannot tolerate any therapy on affected side.

The purpose of this study was to examine risk factors for pathological gambling of horse race participants.

The participants, 508 horse race gamblers, completed the DSM-IV criteria of pathological gambling, Alcohol Use Disorders Identification Test (AUDIT-K) and Symptom Checklist-47-Revision (SCL-47-R). Data were analyzed using t-test, χ²-test, Fisher's exact test, and logistic regression analyses. Behaviors related to horse racing, alcohol abuse, and mental health were analyzed between problem or pathological gamblers compared to recreational gamblers.

The prevalence rates of recreational, problem, and pathological gambling were 36.6%, 39.4%, and 24.0%, respectively. Frequency of gambling (≥4/day), frequency of racetrack visiting (≥3/month), accompaniment (alone), and mental health (SCL-47-R scores) were all associated with increased risks of problem and pathological gambling. Expenditure on betting (≥200,000 won/day) and alcohol abuse (AUDIT-K 8-20 scores) group members had higher levels of gambling pathology than recreational gamblers.

Problem and pathological gambling are highly associated with alcohol abuse and mental health disorders, suggesting that clinicians should carefully evaluate this population.

This study was conducted to evaluate the effect of a one-session spouse-support enhancement childbirth education on childbirth self-efficacy and perception of childbirth experience.

The design of this study was a nonequivalent control group pretest-posttest experiment. The participants in the study were 31 couples in the experimental group and 30 in the control group. The experimental couples were provided with one session on spouse-support enhancement childbirth education the night before delivery. Data were collected at two hours after delivery using the Childbirth Self-Efficacy Inventory (CBSEI) and perception of childbirth experience scale. Data were analyzed using PASW statistics 18 program. Frequencies, percentage, mean, χ² test, t-test were used for data analysis.

Childbirth self-efficacy significantly increased in the experimental group as compared to the control group, but there was no significant difference in perception of childbirth experience in the experimental group compared to the control group.

The results suggest that a one-session childbirth education has beneficial effects on enhancing childbirth self-efficacy in pregnant couples. A one-session spouse-support enhancement childbirth education is recommended as an effective nursing intervention to promote couple's childbirth self-efficacy and it is also recommended that modifications of program to promote women's childbirth experience should be considered.