Journal of Korean Academy of Nursing

Development and Evaluation of Motivational Interviewing Pulmonary Rehabilitation Program Based on Self-Determination Theory for Patients with Chronic Obstructive Pulmonary Disease: Jang, Jun Hee , Min, Hye Sook; J Korean Acad Nurs 2023;53(2):191-207. Published online April 30, 2023; DOI: https://doi.org/10.4040/jkan.22093

Abstract PDF: Purpose
This study aimed to develop a motivational interviewing pulmonary rehabilitation program based on self-determination theory to maintain pulmonary rehabilitation-related health behaviors in patients with chronic obstructive pulmonary disease. The program was developed by reviewing the literature on pulmonary rehabilitation guidelines, drawing on the self-determinism theory to establish its contents, recruiting experts to test its validity, and conducting a preliminary survey.
Methods
A quasi-experimental design was used to confirm the effect of the program. The participants were outpatients diagnosed with chronic obstructive pulmonary disease at three general hospitals in Busan. There were 33 subjects: 15 in the experimental group and 18 in the control group. The experimental group performed a motivational interviewing pulmonary rehabilitation program which comprised 11 sessions delivered over 10 weeks. The outcomes were measured using basic psychological needs, dyspnea, 6-minute walking distance, and functional status. Intervention effects were analyzed using repeated-measures ANOVA.
Results
The analysis revealed significant differences between the experimental and control groups in competence among the subdomains of basic psychological needs, dyspnea during exercise, and functional status.
Conclusion
The developed program affects physical conditions and can be applied as an effective clinical nursing intervention to continuously improve the pulmonary rehabilitation behavior of patients with chronic obstructive pulmonary disease.

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Structural Equation Modeling on Successful Aging in Elders with Chronic Obstructive Pulmonary Disease Based on Selection-Optimization-Compensation Strategy: Young Mi Jang, Rhayun Song; J Korean Acad Nurs 2017;47(4):488-498. Published online August 31, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.4.488

Abstract PDF: Purpose
The focus of the study was on the selection-optimization-compensation (SOC) strategy to predict successful aging mediated by dyspnea symptoms in older adults with chronic obstructive pulmonary disease. The model was constructed based on the hypotheses that coping strategy and social support of the elders predict successful aging through the SOC strategies.
Methods
Participants were 218 outpatients with chronic obstructive pulmonary disease recruited for the study. Data collection was done from March 25 to September 11, 2015, and analyzed using SPSSWIN 22.0 and AMOS 21.0.
Results
The hypothetical model appeared to be fit to the data. Seven of eight hypotheses selected for hypothetical model were statistically significant. The SOC strategy has only significant indirect effects through dyspnea symptoms on successful aging. Coping strategy, social support, SOC strategies and dyspnea symptoms explained 62% of variance in successful aging.
Conclusion
The SOC strategies with social support and dyspnea symptoms significantly explained successful aging among patients with chronic obstructive pulmonary disease. Nursing strategies should be focused on social support and coping strategies to optimize SOC strategies so that older adults with chronic obstructive pulmonary disease are able to manage dyspnea symptoms and eventually achieve successful aging.

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Influencing Factors on Fatigue in Patients with Chronic Obstructive Pulmonary Disease: So Youn Bang; Journal of Korean Academy of Nursing 2007;37(6):855-862. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2007.37.6.855

Abstract PDF: PURPOSE: The purpose of this study was to identify the factors influencing fatigue in patients with chronic obstructive pulmonary disease. METHODS: A descriptive correlational study design was used. A convenience sample of 125 subjects was recruited from the outpatient respiratory clinic at a large university hospital. Data was collected from June to October, 2005 using structured questionnaires, an oxygen saturation test, a 6-minute walking test, and a pulmonary function test. RESULTS: Subjects had a slightly low degree of fatigue. The fatigue showed a significant correlation with emotion(r= .589, p= .000), dyspnea(r= .304, p= .001), self-efficacy (r= -.278, p= .002), and symptom experience(r= .238, p= .008). Emotion(34.7%) and dyspnea(5.8%) were significant predictors to explain fatigue. CONCLUSION: This study provides comprehensive understanding of the influencing factors on fatigue in patients with chronic obstructive pulmonary disease. Nursing interventions to decrease negative emotion and dyspnea for management of fatigue is suggested.

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Development of a Scale to Measure Self-Care for Korean Patients with Chronic Obstructive Pulmonary Disease: Jeong Ja Jun, Ae Kyung Kim, Sang Ok Choi, Jung Hee Ae, Mi Kyung Choi, Sun A Jang; Journal of Korean Academy of Nursing 2003;33(1):9-16. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.1.9

Abstract: Purpose
The objective of this study was the development and validation of a scale to measure the self-care of patients with chronic obstructive pulmonary disease(COPD) in Korea.
Method
Self-care scale was developed based on the self-care activities patients had to carry out in order to manage their COPD. The original scale contained 34 items rated along a five-point Likert scale and was reviewed by 18 professional nurses and 10 Korean patients with COPD for content validity. Subsequently, patients with COPD were asked to complete this 23-item scale and further tests were done with the 125 useable responses.
Result
Factor analysis identified eight factors- “maintaining a clean air way”, “taking medication”, “support from family”, “preventing infection”, “managing symptoms”, “breathing exercising”, and “taking in nutrition”. The internal consistency of the total scale was Cronbach's alpha=0.7226. These eight factors explained 60.8% of total variance. There was correlation among Korean Self-Care Scale score, administration level, and knowledge level but there was no correlation to patients' satisfaction with medical services.
Conclusion
The 23 item questionnaire positively identified 8 areas defined important for COPD patients. Further studies are required to see how these can be integrated into patient education.

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