The purpose of this study was to investigate the fluid balance of the patients who were either on soft fluid diet or total parenteral nutrition. We studied 19 patients with neurologic disorders and 22 patients with oromaxillary surgery who were admitted to either D university hospital in Choognam or S general hospital in Seoul between May and November 1995. The mean age lor the patients who had oromaxillary surgery was 24 years and their average hospital stay was 9 days. The mean age of the patients with neurologic disorders was 54 years and they were bedridden for average of 71 days. For the maxillary bone surgery patients we did not limit the range of their activities in the ward during data collection period. The patients with neurological disorders were bedridden and did not move around the ward. They were all either on soft fluid diet, or total parenteral nutrition. The findings of this study are as follows; 1) The difference of the triceps skinfold thickness between the baseline and the final measurement was 0.4cm for neurologic patient group and 0.5cm for oromaxillary surgery patient group. The difference was not statistically significant in each group. 2) In the oromaxillary surgery patient group, the daily intake of fluid in the form of pure water, other beverages, fluid diet as well as IV fluid was 4581ml while urine output was 2979ml. The difference between fluid intake and output was statistically significant, indicating that fluid intake was far more than urine output. In neurologic patient group, the daily intake of fluid including water from fluid diet and IV fluid was 2701ml whereas urine output was 2253ml and they were statistically significant. 3) For a more accurate assessment we adjusted the fluid balance based on weight changes during data collection period. In the oromaxillary surgery patient group, the difference between fluid intake and output was 1238ml after weight changes being adjusted. The difference was statistically significant, suggesting fluid overload in this patient group. In neurologic patient group, the difference between fluid intake and output considering weight changes was 124ml. The difference was not statistically significant, suggesting that the fluid intake and output was well balanced in this patient group.
This cross-sectional survey was carried out to assess the decisional balance of Korean women toward mammography screening. A sample of 1, 903 naturally postmenopausal women was selected from the community-based social groups in town or city hall auxiliaries in seven metropolitan areas and six provinces in Korea. The classification of women according to the stage of adoption of mammography was 54.9% in pre-contemplation, 31.9% in contemplation, 7.8% in action, and 5.5% in maintenance. The mean differences of pros, cons, and the decisional balance by the stage of mammography adoption were statistically significant. There were significant mean differences between the stages of adoption according to a woman's experience with and intention for mammography and the pros score, the cons score, and the decisional balance score. Results provide the empirical evidence for the Transtheoretical model. An association between stages of mammography adoption and decisional balance exists.
The purpose of this study was to determine the effect of walk training on leg strength, flexibility, postural stability, balance and gait in home bound elderly women. Eighteen elderly women of the experimental group aged between 70 and 90 years image who have normal vision, hearing and Romberg test. They participated in the 12 week walk training. The subjects of the experimental group practiced walk training 3 times a week for during 12 weeks. During the 40 minute workout, the subjects practiced 5 minutes of warming-up exercises, 30 minutes of conditioning exercises and 10 minutes of a cool-down exercise. The intensity for the conditioning phase was determined by subject' heart rates, which ranged from 60% to 70% of age-adjusted maximum heart rates. The body composition, leg strength, flexibility, postural stability, balance and gait were measured prior to and after the experimental treatment. The body fat, lean body mass, leg strength (ankle dorsiflexor, plantarflexor, inversor and eversir, knee flexor, extensior), flexibility (range of motion of ankle dorsiflexion, plantarflexion, inversion and eversion), and postural stability of the experimental group were significantly greater than those of the control group. Duration of standing on the right foot and that of standing on the left foot of the experimental group was greater than that of the control group. Total balance scores of the experimental group were significantly higher than those of the control group. Among 13 items for balance, the scores of experimental group in balance with eyes closes, turning balance, sternal nudge, neck turning, one leg standing balance and back extension were higher than those of the control group. Total scores of gait of the experimental group were significantly higher than those of the control group following the walking training. Scores of experimental group in step height, step length and walk stance while walking among 9 items for gait were significantly higher than those of the control group. The results suggest that walk training can improve physical fitness for prevention in home bound elderly women.
This study was carried out to assess the perception of decisional balance of Korean subjects about 4
health behaviors and to identify the influencing factor of decisional balance for exercise acquisition,
smoking cessation, mammography screening and Kegel's exercise acquisition. All are representative
health behaviors nurses can intervene in Korea based on the Transtheoretical model.
Convenient samples of 2,484 subjects (191; exercise, 169; smoking cessation, 1903; mammography
screening and 221; Kegel's exercise) were selected from cities and counties over 9 provinces throughout
Korea, and the data was collected from January 1, 1999 to February 29, 2000. The research instrument
were the Decisional Balance Measure for Exercise (Marcus & Owen., 1992), Smoking Cessation (Velicer et
al., 1985), Mammography Screening (Rakowski et al.,1992) and Kegel Exercise (Lim, 1999) and Stage of
Change Measure for Exercise (Marcus et al, 1992), Smoking Cessation (DiClemente et al., 1991),
Mammography Screening (Rakowski et al.,1992) and Kegel's Exercise (Lim, 1999). The data was analyzed
by the SAS Program.
The results are as follows;
1. According to the stage of change measure, 2,484 subjects were distributed in each stage of change
for four health behaviors: 1,233 subjects (49.8%), 745 subjects (30.2%), 113 subjects (4.7%), 156
subjects (6.5%), and 216 (8.7%) belonged to the pre- contemplation stage, contemplation stage,
preparation stage, action stage and maintenance stage. They were all series of stages of change
in their efforts to do health behavior.
2. Factor analysis identified 3 factors (1 of Pros, 2 of Cons) for the exercise, 4 factors for smoking
cessation (2 of Pros, 2 of Cons), 2 factors (1 of Pros, 1 of Cons) for the mammogram screening and
2 factors (1 of Pros, 1 of Cons) for Kegel's exercise of decisional balance.
3. The analysis of variance and multiple comparison analysis showed that for all 4 samples,
the Cons of changing the problem behaviors outweighed the Pros for subjects who were in the
pre- contemplation stage, The opposite was true for subjects in action and maintenance stage.
4. Through the discriminant analysis, it was found that one factor of Pros for exercise, one factor of
Cons for smoking cessation, 1 factor of Cons for mammogram screening and one factor of Cons
for Kegel's exercise were the more influencing factors, than others in discriminating the stages of
change.
Results
are consistent with the applications of the Transtheoretical model, which have been used to
understand how people change health behaviors. This results provide some evidence that subject's report of
his/her health behavior corresponds to beliefs about usefulness of related health behaviors.
The results of this study have implications for patients' health education and health intervention
strategies. The findings of this study give useful information for nursing educators for 4 health behaviors,
especially the factors relating to decision making in the different stages of change.
Every year the number of the elderly increases in Korea thanks to the improvement of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups: 33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.
The purpose of this study was to determine the effect of Korean traditional dance movement training on balance, gait and leg strength in elderly women who are forced to remain at home. Fifteen elderly women of an experimental group between the ages 65 and 75 years who have normal vision and passed the hearing and Romberg test, participated in the 12 weeks' dance movement training. Fourteen subjects of a control group were selected. Korean traditional dance movement training was developed on the basis of Korean traditional dance and music by the authors. It took approximately 50 minutes to perform the dance movement program. The subjects of the experimental group practiced dance training for 3 times a week during 12 weeks. During the 50 minutes workout, the subjects practiced 15 minutes of a warm-up dance, 25 minutes of a conditioning dance, and 10 minutes of a cool-down dance. The intensity for the conditioning phase was between 60% and 65% of age-adjusted maximum heart rates. The balance, gait and leg strength were measured prior to and after the experimental treatment. Total balance scores of the experimental group were significantly higher than those of the control group. Scores of sternal nudge, one leg standing balance and reaching up among 13 items have significantly increased after the dance movement training. Total scores of gait of the experimental group were significantly higher than those of the control group following the korean traditional dance movement training. Scores of experimental group in step height, path deviation and turning while walking among 9 items have increased significantly following 12 weeks of dance movement training. The leg strength of experimental group was significantly higher than those of the control group following the Korean traditional dance movement training. The balance, gait and leg strength have significantly correlated in the experimental group following the Korean traditional dance movement training. The results suggest that Korean traditional dance movement training can improve balance, gait and leg strength in home bound elderly women.
The purpose of this study was to identify causal relationships among variables of transtheoretical model for exercise in the elderly. A predictivel model explaining the stage of change was constructed based on a transtheoretical model. Empirical data for testing the hypothetical model was collected from 198 old adults over 60 years old in a community setting in Seoul, Korea in April and May,1999. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling (LISREL) 8.0 program was used to find the best fit model which predicts causal relationship of variables. The fit of the hypothetical model to the data was X2=132.85. (df=22, p=.000). GFI=.88, NNFI=.35, NFI=.77, AGFI=.59 which was not favorable but the fit of modified model to the data was X2=46.90. (df=27, p=.01).GFI= .95, NNFI=.91, NFI=.92, AGFI=.87) which was more than moderate. The predictable variables of stage of change for exercise of the Korean elderly were helping relationship, self cognitive determination, conversion of negative condition in process of change and efficacy for exercise . These variables explained 68% of stage of change for exercise of the Korean elderly.
This study was performed to explore the effects of a dance therapy on physical and psychological characteristics in the elderly. The design of this study was a non-equivalent pre-post test experiment. The subjects consisted of elderly persons living in a facility located in Suweon and Bucheon. Fifty eight subjects, aged between 65 and 93 years who had normal cognition, sensory function, balance, and resting blood pressure. They underwent tests of balance, flexibility, muscle strength, depression, and anxiety as baseline data before dance therapy, and at 6 th week and at the end of the 12nd week after following dance therapy. Twenty seven elderly persons were assigned to the experimental group and participated with the dance therapy between April and July, 1998. The dance therapy was developed by the author with the help of a dance therapist and a physiatrist. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy was developed by the author with the help of a dance therapist and a physiatrist. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy consists of 50 minutes session, 3 times a week for 12 weeks. One session was consisted of warming-up, expression, catharsis, sharing, and closing stage. The intensity of the dance therapy was at the 40% of age-adjusted maximum heart rates. Data were analyzed with mean, standard deviation, Chi-square test, unpaired t-test, repeated measures ANOVA, and Bonferroni multiple regression using SAS program. 1. The results related to the physical characteristics were as follows : 1) The balance (standing on one leg, walking on the balancing bar), flexibility and muscle strength (knee extensor, knee flexor, ankle plantarflexor and dorsiflexor) of the experimental subjects significantly increased over time more than that of the control subjects. 2) The experimental group had significantly higher score for balance, flexibility, muscle strength of knee extensor, and knee flexor than the control group at the 12nd week after dance therapy. 3) The experimental group had significantly higher score for muscle strength of ankle dorsiflexor and plantarflexor than the control group at the 6th week and the 12nd week after dance therapy. 2. The results related to psychological characteristics were as follows : 1) Scores of Geriatric Depression Scale, Hamilton Depression Rating Scale, and Zung's Self-rating Anxiety Scale of the experimental group were significantly decreased over time more than that of the control group. 2) The experimental group had significantly lower score for depression than the control group at the 12nd week after dance therapy. 3) The experimental group had significantly lower score for anxiety than the control group at eh 6th week and the 12nd week after dance therapy. The findings showed that the dance therapy could be effective in improving the balances, flexibility, and muscle strength of lower limb, and effective in decreasing the depression and anxiety of the elderly. Additional merits of the dance therapy would be inexpensiveness, easy accessibility, and increasing interpersonal relationship. It can be suggested that the dance therapy is effective in the health promotion of the elderly.
PURPOSE: The purpose of this study was to compare the effects of intravenous fluid warming and skin surface warming on peri-operative body temperature and acid base balance of abdominal surgical patients under general anesthesia. METHOD: Data collection was performed from January 4th, to May 31, 2004. The intravenous fluid warming(IFW) group(30 elderly patients) was warmed through an IV line by an Animec set to 37 degrees C. The skin surface warming(SSW) group(30 elderly patients) was warmed by a circulating-water blanket set to 38 degrees C under the back and a 60W heating lamp 40 cm above the chest. The warming continued from induction of general anesthesia to two hours after completion of surgery. Collected data was analyzed using Repeated Measures ANOVA, and Bonferroni methods. RESULTS: SSW was more effective than IFW in preventing hypothermia(p= .043), preventing a decrease of HCO3-(p= .000) and preventing base excess(p= .000) respectively. However, there was no difference in pH between the SSW and IFW(p= .401) groups. CONCLUSION: We conclude that skin surface warming is more effective in preventing hypothermia, and HCO3- and base excess during general anesthesia, and returning to normal body temperature after surgery than intravenous fluid warming; however, skin surface warming wasn't able to sustain a normal body temperature in elderly patients undergoing abdominal surgery under general anesthesia.
The purpose of this study was to determine the effects of a Health Maintenance Program on physical functions and mental health of the elderly in nursing homes.
Sixty elderly(over 65 years old) in a randomized control study participated in a 16-week group-based intervention including functional exercises and health education. The participants were divided into 3 groups(Health Maintenance Program Group, Supportive Music Exercise Group, and Control Group) of 20 elderly each. Data was collected from Dec. 1st, 2005 to Mar. 30th, 2006. Physical function of lower body strength was assessed using a 30-second chair test, flexibility was assessed using a sit-and-reach test, and static balance was assessed by the ability to balance on one leg with open and closed eyes. Depression was assessed using the Korean Form of the Geriatric Depression Scale and self esteem was assessed using Rosenberg's Self Esteem Questionnaire. Data was analyzed by Chi-square test, One-way ANOVA, and Repeated measure two factor analysis.
A Health Maintenance Program significantly increased muscle strength, flexibility and static balance, but depression and self-esteem scores were not significantly changed.
Findings demonstrated that a Health Maintenance Program was more effective on physical function than mental health of the elderly in nursing homes.
This study was amied to identify the effects of a 12 week Korean traditional dance movement program on balance, depression, medical cost, medical institution's utilization and fall among elderly women.
Using a quasi-experimental design, the experimental group was composed of 130 subjects and the control group was composed of 123 subjects. The experimental group participated in a 12 week Korean traditional dance movement program 3 times a week from December 2002 to February 2003. Data was analyzed with descriptive statistics, the chi-square test, paired t-test and t-test.
There was siginificant improvement in balance(right leg p=.000, left leg p=.004), depression(p=.000), and the medical institution's utilization(p=.001) and fall(p=.002) in the experimental group compared to the control group.
A Korean traditional dance movement program improved balance, depression, and decreased fall and medical cost in elderly women. Therefore, we recommend this program be utilized as a health promoting program and falls preventing program for the elderly in the community.
Despite many smoking cessation programs, many patients with CAD continue to smoke or re-smoke. The processes of change and self-change for smoking cessation is emphasized. The purpose of present study was to investigate decisional balances and processes of change according to stages of change for smoking cessation in the patients with CAD.
This descriptive study was performed using the self-reported questionnaires from 157 male patients with CAD who have smoking experiences. The questionnaires consisted of decisional balances toward smoking (pros/cons) and processes of change including 7 factors.
45.2% of the subjects had myocardial infarction and 54.8% for angina pectoris. Major stages of change were maintenance, contemplation, and precontemplation in 62%, 14%, and 18% respectively. The mean score of pros smoking was 31.07 and cons smoking was 32.52. The mean scores of processes of change were high in all 7 factors, especially in self determination. The pros smoking in precontemplation stage was significantly higher than those in other stages. Between contemplation and precontemplation stages, processes of change showed significant differences in stimulus control, self determination, information management, and dramatic relief.
This study suggests that decisional balances and processes of change are stage-specific. As this study, smoking cessation program in the patients with CAD must put priority on the patients group in precontemplation and contemplation stages, and stress self determination and dramatic relief.
The purposes of this study was to develop a comprehensive community-based fall prevention program and to test the effects of the program on the muscle strength, postural balance and fall efficacy for elderly people.
The design of this study was a nonequivalent control group pretest-posttest design. There were 28 participants in the experimental group and 29 in the control group. The program consisted of balance exercises, elastic resistance exercises and prevention education. The program was provided five times a week for 8 weeks and each session lasted 90 minutes. Data were analyzed using χ2-test, independent t-test and paired t-test using the SPSS program.
Muscle strength of the lower extremities, postural balance and fall efficacy scores significantly improved in the experimental group compared to the control group.
These results suggest that this program can improve lower extremity muscle strength, postural balance and fall efficacy in elders. Therefore, this program is recommended for use in fall prevention programs for elders living in the community.
To examine geographical imbalances by analyzing new graduate nurses' migration patterns among regions where they grew up, attended nursing school, and had their first employment and to identify factors related to working in non-metropolitan areas.
The sample consisted of 507 new graduates working in hospitals as full-time registered nurses in South Korea. Migration patterns were categorized into 5 patterns based on sequential transitions of "geographic origin-nursing school-hospital." Multiple logistic regression analysis was conducted to identify factors associated with working in non-metropolitan hospitals.
Nurses who grew up, graduated, and worked in the same region accounted for the greatest proportion (54%). Sixty-five percent had their first employment in the region where they graduated. Nurses tended to move from poor to rich regions and from non-metropolitan to metropolitan areas. Working in non-metropolitan hospitals was related to older age, the father having completed less than 4 years of college education, non-metropolitan origin, non-capital city school graduation, and a diploma (vs. baccalaureate) degree.
Admitting students with rural backgrounds, increasing rural nursing school admission capacities, and providing service-requiring scholarships, particularly for students from low-income families, are recommended to address geographical imbalances.