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16 "Chronic Disease"
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Research Papers
Job Analysis of Nurse Care Coordinators for Chronic Illness Management in Primary Care Settings: Using Developing a Curriculum Process
Hwang, Ju-Hee , Choi, Yong-Jun , Kim, Mi-Sook , Yi, Seng-Eun , Park, Yong-Soon , Kim, Ji-Hyang , Yoon, Ju-Young , Shin, Dong-Soo
J Korean Acad Nurs 2021;51(6):758-768.   Published online December 31, 2021
DOI: https://doi.org/10.4040/jkan.21065
AbstractAbstract PDF
Purpose
This study aimed to conduct a job analysis of nurse carecoordinators and to identify the frequency, importance and difficulty of each task of their job.
Methods
A committee for developing a curriculum (DACUM) was formed and members of the committee defined nurse care coordinators’ jobs and enumerated the duties, tasks and task elements by applying the DACUM technique. Then nurse care coordinators enrolled in the pilot project evaluated the frequency, importance and difficulty of each task.
Results
From the job descriptions of nurse care coordinators, we identified 12 duties and 42 tasks. Each task comprised 1~5 task elements. Among tasks, ‘assess the patient’s general health status’ was carried out most frequently. Nurse care coordinators perceived that ‘check vital signs’ and ‘strengthen patient competence to promote health behaviors’ were more important than all other tasks. The most difficult task was ‘develop professionalism as a nurse care coordinator’.
Conclusion
The nurse care coordinators' roles developed in this study will serve as the key guidelines for human resource management of care coordinators. Further, job specifications for nurse care coordinators need to be developed, which is necessary for designing education and training programs. We also need to integrate primary health care as an essential component in nursing education.
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Validity and Reliability of Korean Version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale
Kim, Sook-Nam , Lee, Hyun-Ju , Kim, So-Young , Lee, Nayoon
J Korean Acad Nurs 2021;51(5):617-629.   Published online October 31, 2021
DOI: https://doi.org/10.4040/jkan.21069
AbstractAbstract PDF
Purpose
The aim of this study was to examine the validity and reliability of the Korean version of the self-efficacy for managing chronic disease 6-item scale (SECD-6-K).
Methods
The English version of the Self-Efficacy for Managing Chronic Disease 6-item Scale first underwent forward and backward translation procedures. The SECD-6-K was then used to collect data from 350 adults diagnosed with chronic diseases. Content, construct, convergent, discriminant, and criterion validity were all evaluated. Reliability was assessed using Cronbach’s α. SPSS 25.0 and the data were analyzed using AMOS 26.0 software.
Results
The SECD-6-K consists of six items in two domains: disease management and health behavior. The results for construct, convergent, and discriminant validity were good. Exploratory factor analysis produced eigen values between 2.27 and 3.28, with factors total explained cumulative variance of 91.1%. Confirmatory factor analysis supported goodness of fit and reliability for the modified SECD-6-K model. The criterion validity also showed significant correlation with both the Patient Health Questionnaire and 12-item Short-Form Health Survey version 2. Finally, reliability was found to be excellent.
Conclusion
This study identified the high reliability and validity of SECD-6-K. The SECD-6-K is an appropriate tool for determining Korean patients’ self-efficacy in managing their chronic conditions. Therefore, this scale may be used in clinical settings as well as in educational and research settings.
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Review Article
Continuity of Care in Chronic Diseases: A Concept Analysis by Literature Review
Hu, Jingjing , Wang, Yuexia , Li, Xiaoxi
J Korean Acad Nurs 2020;50(4):513-522.   Published online August 31, 2020
DOI: https://doi.org/10.4040/jkan.20079
AbstractAbstract PDF
Purpose
This study aimed to utilize concept analysis to obtain a better understanding of the concept of “continuity of care” in chronic diseases.
Methods
The concept of continuity of care was analyzed using the Walker and Avant method. Covering literature in English from 1930 to 2018, the data sources included CINAHL Complete, Academic Search Complete, MEDLINE, PsyARTICLES, Health Source: Nursing/ Academic Edition, Google Scholar, Science Direct, and the Cochrane Library.
Results
A comprehensive definition of concept of continuity of care was developed based on a systematic search and synthesis. The key defining attributes were identified as (a) care over time, (b) the relationship between an individual patient and a care team, (c) information transfer, (d) coordination, and (e) meeting changing needs. The antecedents of continuity of care were having a chronic disease, inexperienced with disease management, a poorly coordinated healthcare system, and medical care limitations. The consequences of continuity of care were decreasing hospital admissions, reducing costs, reducing emergency room visits, improving the quality of life, improving patient satisfaction, and delivering good healthcare.
Conclusion
The thorough concept analysis provides insight into the nature of “continuity of care” in chronic diseases and also helps ground the concept in healthcare.
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Original Articles
Perceived Exercise Self-Efficacy and Exercise Benefits/Barriers of Korean Adults with Chronic Diseases
Yun Hee Shin, Hee Jung Jang
Journal of Korean Academy of Nursing 2000;30(4):869-879.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.4.869
AbstractAbstract PDF

The purpose of this study was to assess the perceived exercise self-efficacy and exercise benefits/barriers of Korean adults with chronic diseases, and the relationship between the two variables. For the study, 249 Korean adults with chronic diseases with ages ranging from 18 to 79 years were recruited from hospitals or health centers in five Korean cities and surrounding rural areas. The research instruments were the scales that researchers psychometrically verified the Exercise Self-Efficacy Scale, developed by Bandura (1997), and the Exercise Benefits/ Barriers Scale, developed by Sechrist, Walker, and Pender(1987). Results of descriptive analysis showed that Korean adults with chronic diseases perceived relatively low exercise self-efficacy and relatively high exercise benefits/ barriers. Exercise self-efficacy was significantly correlated with gender, education, regular exercise, and exercise benefits/barriers was significantly correlated with gender, regular exercise. Pearson correlation coefficient showed the significant relationship between the two variables. Further researches, which are a study to evaluate a causal structure for Pender's Health Promotion Model and an intervention study to increase physical activity of chronic patients, are recommended.

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Effects of a Nurse Presence Program on Suicide Prevention for Elders with a Chronic Disease
Kae Hwa Jo
Journal of Korean Academy of Nursing 2007;37(7):1027-1038.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.7.1027
AbstractAbstract PDF

PURPOSE: The purpose of this study was to identify the effects of a nurse presence program on suicide prevention for elders with chronic disease. METHOD: The subjects were recruited from two different elderly institutions located in D city and K province, Korea. Twenty subjects in the control group received no intervention and nineteen subjects in the experimental group received a nurse presence program. RESULT: There were more significant decreases in suicide ideation, and the cortisol level and increases in life satisfaction in the experimental group compared to the control group. CONCLUSION: According to the above results, a nurse presence program for elders with a chronic disease decreased stressful events like suicide ideation and increased self esteem through therapeutic interaction. These findings suggest that this program can be used as an efficient independent nursing intervention for elders in a critical situation.

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Structural Equation Modeling of Self-Management in Patients with Hemodialysis
Jieun Cha
J Korean Acad Nurs 2017;47(1):14-24.   Published online February 28, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.1.14
AbstractAbstract PDF
Purpose

The purpose of this study was to construct and test a hypothetical model of self-management in patients with hemodialysis based on the Self-Regulation Model and resource-coping perspective.

Methods

Data were collected from 215 adults receiving hemodialysis in 17 local clinics and one tertiary hospital in 2016. The Hemodialysis Self-management Instrument, the Revised Illness Perception Questionnaire, Herth Hope Index and Multidimensional Scale of Perceived Social Support were used. The exogenous variable was social context; the endogenous variables were cognitive illness representation, hope, self-management behavior, and illness outcome. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and structural equation modeling were performed.

Results

The hypothetical model with six paths showed a good fitness to the empirical data: GFI=.96, AGFI=.90, CFI=.95, RMSEA=.08, SRMR=.04. The factors that had an influence on self-management behavior were social context (β=.84), hope and cognitive illness representation (β=.37 and β=.27) explaining 92.4% of the variance. Self-management behavior mediated the relationship between psychosocial coping resources and illness outcome.

Conclusion

This research specifies a more complete spectrum of the self-management process. It is important to recognize the array of clinical resources available to support patients' self-management. Healthcare providers can facilitate self-management through collaborative care and understanding the ideas and emotions that each patient has about the illness, and ultimately improve the health outcomes. This framework can be used to guide self-management intervention development and assure effective clinical assessment.

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Structural Equation Modeling of Self-Management of Liver Transplant Recipients
Mi-Kyeong Jeon, Yeon-Hwan Park
J Korean Acad Nurs 2017;47(5):663-675.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.5.663
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory.

Methods

Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers’ autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program.

Results

The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers’ autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers’ autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management.

Conclusion

The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients.

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Concept Analysis of Volition for Health Behavior Practice in Patients with Chronic Disease
Mi Ja Lee, Min Ju Kim
J Korean Acad Nurs 2016;46(5):687-696.   Published online October 31, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.5.687
AbstractAbstract PDF
Purpose

The purpose of this study was to define and clarify the concept of volition for health behavior.

Methods

For this study the process of Walker & Avant’s concept analysis was used. Seventeen studies from electronic data basses met criteria for selection.

Results

Volition can be defined by the following attributes: 1) planning, 2) maintenance of self-efficacy, and 3) self regulation. The antecedents of volition consisted of: 1) risk awareness, 2) outcome expectation, 3) perceived self-efficacy, and 4) social support. The consequences occurring as a result of volition were: 1) prevention of disability and complications, 2) improvement of functional ability, and 3) enhencement of quailty of life.

Conclusion

Definition and attributes of volition identified by this results can be applied to develop measurements and intervention programs for chronic patients health behavior.

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Factors Influencing Posttraumatic Growth in Fathers of Chronically ill Children
Mi Young Kim
J Korean Acad Nurs 2015;45(6):890-899.   Published online December 15, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.6.890
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify the level of distress and posttraumatic growth in fathers of chronically ill children and also, to identify the relation between characteristics of the fathers and children and their posttraumatic growth and to investigate factors that influence posttraumatic growth.

Methods

In this study, 48 fathers who visited a university hospital in Seoul, Korea and who gave written consent completed the questionnaire between September 23 and November 19, 2013. Data were analyzed using Mann-Whitney U test, Kruskal-Wallis test, Pearson correlation coefficient and stepwise multiple regression.

Results

The level of distress in fathers of chronically ill children was relatively high and the majority of them were experiencing posttraumatic growth. Models including the variable (deliberate rumination, religiousness, optimism) explained 64.3% (F=26.38, p< .001) of the variance for posttraumatic growth. Deliberate rumination (β=.59, p< .001) was the most influential factor.

Conclusion

The findings demonstrate that it is essential for nurses to intervene and facilitate continuously so as to promote posttraumatic growth and relieve distress in fathers of chronically ill children. Furthermore, it is also necessary for nurses to find ways to develop ideal interventions to activate deliberate rumination and offer spiritual care and help maintain optimism in these individuals.

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Influence of Uncertainty and Uncertainty Appraisal on Self-management in Hemodialysis Patients
Hyung Suk Jang, Chang Suk Lee, Young Hee Yang
J Korean Acad Nurs 2015;45(2):271-279.   Published online April 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.2.271
AbstractAbstract PDF
Purpose

This study was done to examine the relation of uncertainty, uncertainty appraisal, and self-management in patients undergoing hemodialysis, and to identify factors influencing self-management.

Methods

A convenience sample of 92 patients receiving hemodialysis was selected. Data were collected using a structured questionnaire and medical records. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlations and multiple regression analysis with the SPSS/WIN 20.0 program.

Results

The participants showed a moderate level of uncertainty with the highest score being for ambiguity among the four uncertainty subdomains. Scores for uncertainty danger or opportunity appraisals were under the mid points. The participants were found to perform a high level of self-management such as diet control, management of arteriovenous fistula, exercise, medication, physical management, measurements of body weight and blood pressure, and social activity. The self-management of participants undergoing hemodialysis showed a significant relationship with uncertainty and uncertainty appraisal. The significant factors influencing self-management were uncertainty, uncertainty opportunity appraisal, hemodialysis duration, and having a spouse. These variables explained 32.8% of the variance in self-management.

Conclusion

The results suggest that intervention programs to reduce the level of uncertainty and to increase the level of uncertainty opportunity appraisal among patients would improve the self-management of hemodialysis patients.

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Validity and Reliability of Korean Version of the Family Management Measure (Korean FaMM) for Families with Children having Chronic Illness
Dong Hee Kim, Yeo Jin Im
J Korean Acad Nurs 2013;43(1):123-132.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.123
AbstractAbstract PDF
Purpose

To develop and test the validity and reliability of the Korean version of the Family Management Measure (Korean FaMM) to assess applicability for families with children having chronic illnesses.

Methods

The Korean FaMM was articulated through forward-backward translation methods. Internal consistency reliability, construct and criterion validity were calculated using PASW WIN (19.0) and AMOS (20.0). Survey data were collected from 341 mothers of children suffering from chronic disease enrolled in a university hospital in Seoul, South Korea.

Results

The Korean version of FaMM showed reliable internal consistency with Cronbach's alpha for the total scale of .69-.91. Factor loadings of the 53 items on the six sub-scales ranged from 0.28-0.84. The model of six subscales for the Korean FaMM was validated by expiratory and confirmatory factor analysis (χ2<.001, RMR<.05, GFI, AGFI, NFI, NNFI>.08). Criterion validity compared to the Parental Stress Index (PSI) showed significant correlation.

Conclusion

The findings of this study demonstrate that the Korean FaMM showed satisfactory construct and criterion validity and reliability. It is useful to measure Korean family's management style with their children who have a chronic illness.

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Degree of Dry Mouth and Factors Influencing Oral Health-related Quality of Life for Community-Dwelling Elders
Myung Sook Park, Se Ang Ryu
J Korean Acad Nurs 2010;40(5):747-755.   Published online October 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.5.747
AbstractAbstract PDF
Purpose

This study was conducted to investigate the degree of dry mouth and oral health-related quality of life and to identify factors contributing to oral health-related quality of life for community-dwelling elders.

Methods

A descriptive correlational study design was used. Participants were 156 older adults from two senior welfare centers. Data were collected on February 21, 22 and 29, 30, 2009 using structured questionnaires. Enter type multiple regression analysis was used to identify factors influencing oral health-related quality of life according to general and oral health characteristics.

Results

There were significant differences in oral health-related quality of life according to living arrangement, insurance, smoking, number of natural teeth, and denture type. The oral health-related quality of life had significant correlations with the number of chronic disease, number of medications, and dry mouth. Factors influencing oral health-related quality of life for community-dwelling older adults were dry mouth, number of chronic disease, and medical aid, which explained about 47.9% of total variance.

Conclusion

These results indicate that in order to promote oral health-related quality of life for older adults, prevention or management of chronic diseases as well as oral health and dry mouth are needed for this population, and especially economically poor elders.

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The Meaning of Illness among Korean Americans with Chronic Hepatitis B
Jin-Hyang Yang, Hae-Ok Lee, Myung-Ok Cho
J Korean Acad Nurs 2010;40(5):662-675.   Published online October 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.5.662
AbstractAbstract PDF
Purpose

This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B.

Methods

The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott.

Results

The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients.

Conclusion

The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one's symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.

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Development of a Questionnaire to Measure Resilience in Children with Chronic Diseases
Dong Hee Kim, Il Young Yoo
J Korean Acad Nurs 2010;40(2):236-246.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.236
AbstractAbstract PDF
Purpose

The purpose of this study was to develop and evaluate a Korean questionnaire to measure resilience in children with chronic illness.

Methods

Item construction was drawn from an extensive review of the literature, existing questionnaires and interviews with parents. Content validity was tested by experts. To further refine the questionnaire and test its reliability and validity, data were collected from the 202 children with asthma, diabetes mellitus or nephrotic syndrome. Corrected items were used to total correlation coefficient and test-retest reliability. Questionnaire testing was conducted using factor analysis, Cronbach's α, and correlation coefficients. Validity of the questionnaire was tested using internal consistency, construct validity, and criterion-related validity.

Results

Components of the questionnaire were in three domains; interpersonal characteristics, characteristics of coping, and intrapersonal characteristics. Factor analysis is showed five factors; positive self-understanding, self-reliance, resourcefulness, perception of positive family relationships, and intimacy. The questionnaire showed a high internal consistency. A significant positive correlation with the Numerical Rating Score and negative correlation with the Child Depression Inventory support the validity of the questionnaire.

Conclusion

This instrument demonstrated high reliability and validity. Therefore, this instrument can contribute to the evaluation of resilience of chronically ill children and to any subsequent intervention as well as to develop a theory for resilience.

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Family Experiences of Living with Chronic Schizophrenic Patients: Application of Parse's Human Becoming Research Methodology
Ok Ja Lee, Young Sook Choi
Journal of Korean Academy of Nursing 2007;37(1):26-34.   Published online February 28, 2007
DOI: https://doi.org/10.4040/jkan.2007.37.1.26
AbstractAbstract PDF
Purpose

This study was aimed at understanding the nature of the suffering of families with patients in mental health nursing homes and hoped to contribute to the rehabilitation process of those with a chronic mental disorder.

Method

Research methodology was based upon Parse's human becoming research methodology.

Results

a) Despite the despair the family feels by the violence caused by their now-institutionalized relative, they also realize anew the importance of their role as protectors b) Although they fear social stigmatization they also try to be supportive, out of guilt feelings; c) They regret their severe rearing style and wish to be more sympathetic, d) They find courage and hope through family therapy, which leads to a better understanding of the illness, e) With hopes of rehabilitation, the family members feel happy and go through an emotional release, by sharing the pain with each other.

Conclusion

Families of nursing home residents share a focus on the process of human-health-universe. This is a positive, ‘human-becoming’ process with which, based on past feelings of despair, fear, resignation, and pain, one can render meaning into his or her experiences in the present in the pursuit of love, conquest, hope, liberty and success.

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Activities of Daily Living of The Elderly with a Chronic Disease and Burden on Family Care-givers
Su Hyang Bang, Hee Jeong Jang
Journal of Korean Academy of Nursing 2007;37(1):135-144.   Published online February 28, 2007
DOI: https://doi.org/10.4040/jkan.2007.37.1.135
AbstractAbstract PDF
Purpose

The purpose of this study was to help families decrease and alleviate the burden on family care-givers taking care of elderly patients.

Method

Data was collected by a questionnaire from 100 family members who were registered in the department of home health care nursing at 4 hospitals of H University Medical Center from September 20 to October 25, 2005. The collected data was analyzed using Mean and Standard Deviation, Pearson Correlation Coefficient, t-test and One-Way ANOVA with the Duncan's test, and Stepwise multiple regression.

Result

The average burden on family care-givers of elderly patients with chronic diseases was 3.31. The social burden was the highest(M=3.68), the lowest was the emotional burden (M=2.95). In ADL of elderly patients with chronic diseases, all 10 questions showed an average point above 2.50. The dependency level of going up and down the stairs was the highest (M=2.88).

Conclusion

This research is necessary for the application of a plan in the social support system in order to reduce the burden on family care-givers who are taking care of elderly patients with a chronic disease.

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