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Original Articles
Effect of a Physical Activity Promoting Program Based on the IMB Model on Obese-Metabolic Health Outcomes among Obese Older Adults with Knee Osteoarthritis
Kim, Jung-Suk , Kim, Chun-Ja
J Korean Acad Nurs 2020;50(2):271-285.   Published online April 30, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.2.271
AbstractAbstract PDF
Purpose
This study examined the effects of a physical activity promoting program based on the Information-Motivation-Behavioral Skills (IMB) model on physical activity and health outcomes among obese older adults with knee osteoarthritis.
Methods
This study utilized a randomized controlled trial with a convenience sample of 75 obese older adults with knee osteoarthritis in a university hospital. The older adults in the intervention group participated in a 12-week program involving weekly group sessions and monitoring calls with education booklets and video clips for exercise dances, while those in the control group received an usual care. Outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. The intervention effects were analyzed using Mann-Whitney U test and ANCOVA.
Results
The mean age of participants was 74.9 years with 84.0% women. The intervention group at 12 weeks showed significantly greater improvements in self-efficacy for physical activity (F=81.92, p <.001), physical activity amounts (Z=-2.21, p =.044), knee joint function (F=15.88, p <.001), and health-related quality of life (F=14.89, p <.001) compared to the control group. Among obese-metabolic outcomes, the intervention group at 12 weeks showed a significant decrease in visceral fat mass (F=7.57, p =.008) and improvement in high-density level cholesterol (F=9.51, p =.003) compared to the control group.
Conclusion
Study findings support the need for an IMB based physical activity program for promoting physical activity, knee function and health outcomes in obese older adults with knee osteoarthritis. Longitudinal studies are warranted to confirm the persistence of obese-metabolic effects in clinical settings.
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Effectiveness of Health Promotion Program Using Action Planning Strategy for Young Adults
Su Hyun Kim, Min Ji Kim, Sang Hee Kim, So Yeon Kim, Chae Yeon Park, Jee Yun Bang
J Korean Acad Nurs 2019;49(4):461-471.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.4.461
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to evaluate the effectiveness of a health promotion program utilizing action planning strategy for young adults.

Methods

A non-equivalent control group pre-post-test design was used. One hundred three university students participated in the study. Participants in the experimental group (n=51) were provided the health promotion program utilizing action planning strategy for five weeks. The program consisted of weekly sessions that included action planning and group feedback. The control group (n=52) was provided with health information every week for 5 weeks. Program outcomes, including self-efficacy, physical activity health behaviors, total exercise time per week, daily cigarette consumption, frequency of alcohol drinking per month, nutritional health behaviors, and subjective health status, were assessed at baseline and at follow-up after 5 weeks.

Results

The participants in the experimental group demonstrated significant increases in self-efficacy, physical activity health behaviors, weekly exercise time, and nutritional health behaviors and significant decreases in daily cigarette consumption than those in the control group.

Conclusion

The health promotion program utilizing action planning strategy is a brief and effective intervention to promote health behaviors among young adults. Further investigation is warranted to assess the program's effectiveness among other age groups and populations at high risk for chronic illness.

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Comparison of sleep and related variables between young and old adults
Shin Mee Kim, Jin Joo Oh, Mi Soon Song, Yeon Hwan Park
Journal of Nurses Academic Society 1997;27(4):820-830.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.4.820
AbstractAbstract PDF

Sleep is an essential component for health and the quality of life individuals, and is affected by multiple factors. Thereby, sleep impairment is know to be frequent even in health subjects. The purpose of the study is to compare sleep patterns and related factors between healthy young and old adults and to identify aging effects upon sleep in a cross-sectional way. The survey questionnaire was developed by translation and modification of two well-know sleep questionnaires which were originally developed by Monroe(1967) and Ellis, et al.(1982). Discussion with experts and pilot study were completed to finalize the contents of the questionnaire that was used in this study. Results are as follows : 1. Sleep complaints were lower in older adults. 2. The most frequent variables that explain sleep satisfaction were feeling rested in the morning in the older adults and feeling rested and falling asleep within five minutes in the young adults. 3. Regarding sleep-disturbing factors, physical factors were more frequently reported in the older adults and environmental factors are reported more frequently in the young adults. and there was no difference related to the emotional factors between the two groups. 4. Young adults were practiced strategies for better sleep more often than the older adults, and they were mainly in-home activities just before sleep. 5. Sleep patterns which change with aging were as follows : going to bed and waking up earlier ; not staying in the bed long after waking up ; getting harder to fall asleep ; frequent arousal after sleep onset ; getting harder to go back to sleep after arousal during night sleep. From the results of this study, it can be concluded that sleep and related factors of the young and the older adults are different. Also, sleep patterns change with aging and those changes seem to be negative for sleep in the elderly. Repeated studies are needed to establish more concrete information regarding sleep patterns. In addition, further research is needed to develop more reliable, valid, and feasible sleep measure tools, and to develop and evaluate nursing interventions.

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Prevalence and Risk Factors for Diabetes Mellitus and Impaired Fasting Glucose of Adults
Hee Seung Kim, You Ja Ro, Nam Cho Kim, Yang Sook Yoo, Jin Sun Young, Jeong Ah Oh
Journal of Korean Academy of Nursing 2000;30(6):1479-1487.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.6.1479
AbstractAbstract PDF

This study was conducted to draw out prevalence and the risk factors of diabetes mellitus and impaired fasting glucose for adults,(age 30-69). The subjects were 2096 adults, who had regular health examinations between January and December of 1999 at K Hospital in Seoul. The data was analyzed using chi-square test, unpaired t-test and logistic regression. Diabetes Mellitus and impaired fasting glucose were diagnosed by ADA (American Diabetes Association, 1997) criteria. The results were as follows: 1. Mens' prevalence of Diabetes Mellitus was 7.9% and womens' prevalence of Diabetes Mellitus was 3.8%. Mens' prevalence of impaired fasting glucose was 10.4% and womens' prevalence of impaired fasting glucose was 6.5%. Prevalences of Diabetes Mellitus and impaired fasting glucose increased with age. 2. Prevalence of Diabetes Mellitus and impaired fasting glucose of obese subjects (relative body weight>=162) was higher than that of overweight subjects (110<=relative body weight<=119) in men and women. 3. The diagnoses of Diabetes Mellitus and impaired fasting glucose increased with systolic blood pressure and triglyceride. 4. Significant factors associated with diabetes in the logistic regression best gut model were age, relative body weight, systolic blood pressure, triglyceride in men, and systolic blood pressure in women. In conclusion, as age, weight, systolic blood pressure and triglyceride get higher, Diabetes Mellitus and impaired fasting glucose prevalence also increases, porportionally.

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The Study on Health Behavior among Korean Adults
Ae Kyung Kim
Journal of Korean Academy of Nursing 1998;28(4):931-940.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.4.931
AbstractAbstract PDF

This study was done to describe health behavior and determine affecting factors in Korean adults, based on the Health Behavior Assessment tool. The subjects were sample of 298 adults from five cities. The instrument for this study were Health Behavior Assessment tool(30 items, 4scale). Frequency, percentage, t-test, ANOVA, cluster analysis with SPSS program were used to analyze the data. The results of the study are as follows; 1) The average item score for health behavior was 2.56, the highest score on the subscale was limitation of liking(M=3.16), followed by stress management(M=2.98), nutrition(M=2.82), energy conservation(M=2.67). 2) A significant difference between age, sex, perception of health, and health behavior were found. 3) Pattern of health behavior among Korean adults focused on stress management in order to obtain emotional stability, and balance and harmony in dietary life, and energy conservation. Patterns of health behavior in Korean adults is unique in each individual. Therefore nursing intervention skill for health promotion have to be developed based on the health behavior in each individual.

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The Effect of Human Potential Seminars on the Perceived Stigma of Adults with Epilepsy
Eun Ja Kim
Journal of Korean Academy of Nursing 1998;28(4):1003-1012.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.4.1003
AbstractAbstract PDF

The purpose of this research was to identify the effect of human potential seminars on the perceived stigma of adults with epilepsy. the research employed a quasi experimental design and unequivalent control group pre-post design. The test was conducted on 15 adults with epilepsy attending one psychiatric out-patient clinic in Masan City, Korea. The stigma questionnaire was used as a pre-test to these patients. HPS was done ten times for five weeks from May 6, to July 26, 1996. The stigma questionnaire was again given, but this time as a post test. The control group of 14 adults with epilepsy were receiving medication at the same clinic. The human potential seminars were structured by Mcholland(1972) and translated by Lee, Hae Seung(1990). The stigma research tool was modified and revised to be appropriate to Korean culture. It consisted of 15 sentences. The internal consistency was 0.92 with Crombach's alpha. Research results are as follows. 1) To determine the homogeneity of the experimental and control groups. the pre-stigma results were used and democratic-sociologic characteristics, job characteristics and disease related variables were compare. There was no significant difference between the two groups. 2) To identify the relationship between stigma and patient characteristics a pre-test was done. The study used both Mann-whitney U-test and ANOVA test for statistical analysis. The variables related to stigma were the reason of unemployment and age at onset of epilepsy. 3) The test results of the effect of the human potential seminars on stigma in the patients with epilepsy, showed that stigma in the experimental group was lower than in the control group. the statistical method used to determine the difference between pre and post stigma results was the Wilcoxon signed rank test. The test results were statistically significant at the one percent level. 4) As a follow-up evaluation, ten more patients(66.7% of the total) were additionally tested. In order to investigate f the stigmas were different between the pre, post and follow-up, Repeated measure ANOVA was used. The test results showed that the stigma scores were statistically different between the three groups at the one percent level(F=10.076, d.f.=2, p=0.00).

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Development of Health Behavior Assessment Tool of the Korean Adults
Ae Kyung Kim
Journal of Korean Academy of Nursing 1998;28(3):540-549.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.3.540
AbstractAbstract PDF

This study has been designed to develop a health behavior scale. Data were collected through a survey over a period of two period. Subjects who participated in the study were 298 Korean adults. The author used a convenience sampling method. The analysis of the data was done with SPSS PC for descriptive statistics and factor analysis. Initially 34 items were generated from the interview data of twenty one adults and from literature review and survey. This preliminary scale was analyzed for a reliability and validity. The results are as follow: 1. Crombach Coefficient alpha for the 30 items was .7909. 2. Factor analysis was done in order to confirm construct validity and nine factor were extracted from the results. These contributed 54.4% of the variance in the total score. 3. Nine factor label were 'exercise' stress management' 'energy conservation' 'limit in liking' 'selection of food' 'ingestion of natural food' ' health examination' 'relaxation' and 'nutrition'. The author suggest that this scale could be adequately applied in assessing the health behavior of Korean adults. The results of using this scale in a study can contribute to designing an appropriate health promotion strategy.

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The Development & Effect of an Tailored Falls Prevention Exercise for Older Adults
Mee Ock Gu, Mi Yang Jeon, Young Eun
Journal of Korean Academy of Nursing 2006;36(2):341-352.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.2.341
AbstractAbstract PDF
Purpose

This study was conducted to develop and to determine the effect of an tailored falls prevention exercise for older adults.

Method

Subjects consisted of 59 older adults (experimental group : 29, control group : 30) living at nursing homes. Experimental group participated in tailored falls prevention exercise for 16 weeks (3 times a week, 50 min every session). Data were collected before the exercise, 16 weeks and 24 weeks after the beginning of exercise.

Results

1) the experimental group significantly improved the muscle strength of hip extensor and flexor, knee extensor and flexor, ankle dorsiflexor, and plantar flexor compared to the control group. 2) the experimental group significantly decreased the mean time for 10 times chair stand. 3) the experimental group significantly increased the standing time on one leg and the number of heel raise for 30 seconds compared to the control group. In addition more older adults in the experimental group completed the tandem stance and semi-tandem stance for 10 seconds than the control group. 4) The experimental group significantly decreased the mean time of 6m walk and the fall frequency compared to the control group.

Conclusions

This results suggest that tailored falls prevention exercise for older adults can improve muscle strength, static and dynamic balance and decrease the fall frequency of older adults.

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The Relationships among Loneliness, Social Support,and Family Function in Elderly Korean
Ok Soo Kim, Sung Hee Baik
Journal of Korean Academy of Nursing 2003;33(3):425-432.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.3.425
AbstractAbstract PDF
Purpose

To examine the relationships among loneliness, social support, and family function in elderly Korean.

Method

The sample for this study were 290 elderly Korean who were at least 60 years of age. Data were collected by interview using the translated Korean versions of the Revised University of California Los Angels Loneliness Scale(RULS), Family APGAR, and Social Support Questionnaire 6.

Result

Subjects were moderately lonely and had moderately functional families. Means for social support were 1.42 for network size and 4.09 for satisfaction. Subjects who lived with their spouses had a larger number of network members than who did not live with spouses. However, living with spouses was not associated with social support satisfaction. The level of loneliness was related negatively to the level of social support network, social support satisfaction and family function in this study. Social support satisfaction and Family function were the significant predictor of loneliness.

Conclusion

The number of social supporter and satisfaction and family function should be considered in nursing intervention to decrease the level of loneliness in older adults. Further studies and efforts will be needed to reduce the level of loneliness in older adults.

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Transitional Care for Older Adults with Chronic Illnesses as a Vulnerable Population: Theoretical Framework and Future Directions in Nursing
Youn-Jung Son, Mi-Ae You
J Korean Acad Nurs 2015;45(6):919-927.   Published online December 31, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.6.919
AbstractAbstract PDF
Purpose

Effective transitional care is needed to improve the quality of life in older adult patients with chronic illness and avoid discontinuity of care and adverse events. The aim of this article is to provide an overview of the key features, broader implications, and the utility of Meleis' transition theory intended for the transitional care of older adults with chronic illnesses. We present the role of nurse in the context of transitional care and propose future directions to increase the quality of nursing care.

Methods

The online databases Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Science Direct were searched for relevant literature published since 1970 along with textbooks regarding nursing theory.

Results

An evaluation of the usefulness of transition theory based on transitional care in older adult patients with chronic illnesses is provided. Healthy transition should be the expected standard of nursing care for older adults across all healthcare settings.

Conclusion

Nurses need to contribute to the development of transitional care for vulnerable populations; however, transition theory needs to be enhanced through additional theoretical work and repeated evaluations of the applicability in areas of transitional care.

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Effects of a Physical Activity Program using Exergame with Elderly Women
Jungok Yu, Jungsoon Kim
J Korean Acad Nurs 2015;45(1):84-96.   Published online February 15, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.1.84
AbstractAbstract PDF
Abstract Purpose

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

Methods

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.

Results

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.

Conclusion

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

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Update on Irritable Bowel Syndrome Program of Research
Margaret Heitkemper, Monica Jarrett, Sang-Eun Jun
J Korean Acad Nurs 2013;43(5):579-586.   Published online October 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.5.579
AbstractAbstract PDF
Purpose

This article provides an update and overview of a nursing research program focused on understanding the pathophysiology and management of irritable bowel syndrome (IBS).

Methods

This review includes English language papers from the United States, Europe, and Asia (e.g., South Korea) from 1999 to 2013. We addressed IBS as a health problem, emerging etiologies, diagnostic and treatment approaches and the importance of a biopsychosocial model.

Results

IBS is a chronic, functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain and alterations in bowel habit (diarrhea, constipation, mixed). It is a condition for which adults, particularly women ages 20-45, seek health care services in both the United States and South Korea. Clinically, nurses play key roles in symptom prevention and management including designing and implementing approaches to enhance the patients' self-management strategies. Multiple mechanisms are believed to participate in the development and maintenance of IBS symptoms including autonomic nervous system dysregulation, intestinal inflammation, intestinal dysbiosis, dietary intolerances, alterations in emotion regulation, heightened visceral pain sensitivity, hypothalamic-pituitary-adrenal dysregulation, and dysmotility. Because IBS tends to occur in families, genetic factors may also contribute to the pathophysiology. Patients with IBS often report a number of co-morbid disorders and/or symptoms including poor sleep.

Conclusion

The key to planning effective management strategies is to understand the heterogeneity of this disorder. Interventions for IBS include non-pharmacological strategies such as cognitive behavior therapy, relaxation strategies, and exclusion diets.

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Effect of an Integral Care System: a Combination of Oriental and Western Care for Older Adults with Degenerative Arthritis
Jia Lee, Eun Sun Ji
J Korean Acad Nurs 2011;41(1):18-25.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.18
AbstractAbstract PDF
Purpose

This study was done to examine the effect of an integrated care service which included a combination of oriental and western care on health outcomes in elderly patients with degenerative arthritis.

Methods

A prospective comparative design was used. Data were collected from May 1, 2008 to June 30, 2009 from 85 elderly patients with degenerative arthritis in the lower extremities who were followed in a hospital out-patient department for 8 weeks. The integrated care service group (n=36) received a combination of physical therapy, acupuncture, western medicines or herbal medicines, and the western care group (n=49) received physical therapy or western medicines. Functional independence, walking speed, rotation balance, pain intensity, service satisfaction and total medical costs for the two groups were compared at 8 weeks.

Results

Functional independence (t=2.14, p=.036) and walking speed (t=2.51, p=.014) improved significantly in the integrated care group while pain intensity improved significantly in the western care group (t=3.35, p=.002). The integrated care group reported higher scores for service satisfaction (t=2.09, p=.041) and higher medical costs than the western care group (t=2.15, p=.035).

Conclusion

The results suggest that integrated care services are effective modalities to improve mobility and quality of life for elders with degenerative arthritis.

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