It is important to evaluate nutritional status of elderly patients receiving dialysis, since wasting and malnutrition are their common problems. This study aims at assessing their nutritional status by the type and duration of dialysis. The nutritional status such as somatic fat and protein storage was evaluated with anthropometric measure including weight/height ratio, triceps skinfold thickness and midarm muscle circumference. It was also measured with albumin, transferrin, C3 and IGF-1 and calroie and protein intakes. The general clinical condition of patients was evaluated with the severity of uremia and metabolic acidosis, which were measured through the levels of serum urea, creatinine and bicarbonateion. The data were analyzed by using t-test, ANOVA, Wilcoxon -rank sums test, Scheffe test, Kruskal -Wallis test and Pearson correlation coefficients. The results are following; 1. There was no significant difference in the calorie and proten intakes by the type and duration of dialysis received. 2. As for the anthropometric measures, no significant difference was found by the type of dialysis in body mass index, triceps skinfold thickness and midarm muscle circumference. Yet these anthropometric measures differed significantly by the duration of dialysis in those elderly patients receiving hemodialysis(HD group), but this finding was not found in those receiving continuous ambulatory peritoneal dialysis(CAPD). 3. Regarding the indicators of uremia and metabolic acidosis, blood urea mtrogen(BUN) and creatinine were lower in the CAPD group than in the HD group, whereas bicarbonate ion was higher in the CAPD group than in the HD group, with no statistical significance. In the HD group, creatinine incresed significantly with the increase of the duration of dialysis. 4. Serum trasferrin and C3 were significantly higher in the CAPD group than in the HD group. However, each of biochmical indices did not show statistical significance by the duration of dialysis in both HD and CAPD groups. 5. Anthropometric measures were significantly associated with dietary intake. Significant correlations were observed between biocarbonate ion, BUN and creatinine. In addition, the correlations between serum protein and albumin and between transferrin and C3 were statistically significant. Yet, IGF-1 revealed no significant correlation with other nutritional indices. The above findings indicate that there were no difference in nutritional status mearsured with protein and calroie intakes between the type and duration of dialysis, but CAPD seems to benefit correcting uremia and metabolic acidosis than HD. Studies of dietary management for dialysis patients need to be pursued in order to improved the quality of aged patients receiving dialysis.
PURPOSE: This study was performed to measure the nursing service quality being used SERVQUAL model and satisfaction that the admitted patients perceived. METHOD: The questionnaire founded on the SERVQUAL was developed and distributed to 300 patients at the three general hospitals in three provincial city, Korea. For data analysis, Cronbach's alpha frequencies, percentages, paired t-test, Pearson Correlation Coefficient were used. RESULT: In expectation, patients most highly perceived the assurance factor that was one among the 5 factors being constituted nursing service. In performance, patients most highly perceived the responsiveness factor. The performance degrees of the 5 factors and 20 attributes being constituted nursing service did not exceed the expectation degree of those. So the calculated figures for nursing service quality of the three subjected hospitals were all minus. In relation of the patients' demographics and nursing service characteristics to their general satisfaction, patients' sex, age, income and the all factors and attributes of nursing service had relation to their general satisfaction. CONCLUSION: It could be concluded that the nursing service quality of the three subjected hospitals was poor and the patients' demographic and nursing service characteristics had relation to their general satisfaction.
PURPOSE: This study was conducted to evaluate the process & outcome of a Health promotion program(Growing Younger & More Active) for the community resident older adults from March to December, 2001. METHOD: A quasi experimental research(one group pretest-posttest design) was used in this study. The subjects were 82 older adults(but 40 older adults 4 weeks after the program). Program had 5 sessions(10 hours) once a week. Data were collected before the program, immediately after & 4 weeks after the program and were analyzed with paired t-test. RESULT: The levels of Satisfaction, Interest & Understanding of the Program were high. Significant differences were found in health knowledge, health promoting behaviors, perceived health status and life satisfaction between before program and immediately after program as well as between before program and 4 weeks after program, but no significant differences in Health attitude. Self efficacy has significant difference only between before program and immediately after program , but no significant differences between before program and 4 weeks after the program. CONCLUSION: This results suggest that a Health promotion program for the community resident older adults developed this study is effective. So this program can be recommended as an effective nursing intervention for the health promotion of the older adults living in community.
The purpose of this study was to analyze the appraising frame and the accreditation system of universities in both Korea and the United Sates, as well as developing a standard plan to appraise 4 year nursing education institutions in Korea. Research design of this study was descriptive comparative research. The results of the research can be divided into six fields, educational purposes, educational courses, students, faculty, facility equipments and administration finance in Korea. Then the results were further categorized into seven fields : mission and governance, faculty, students, curriculum and instruction, resources, educational effectiveness and integrity. Thus Korean appraising frames were suggested to have eight fields of standard. The fields are philosophy and purposes of educational institution, educational courses and instruction, students, faculty, facility equipments, adminstration finance, educational effectiveness and integrity.
PURPOSE: this study was to investigate the perception gap on nursing service between consumers and providers.
METHOD
the questionnaire founded on the SERVQUAL was developed and distributed to 300 patients and 210 nurses at the three subjected general hospitals in three provincial city, Korea during February to March, 2001. For data analysis, Cronbachs' Alpha, frequency, t-test, and paired t-test were used.
RESULT
1. In the gap analysis on the 20 properties constituting nursing service, providers almost all perceived higher than consumer in quality. Among them, the number of properties being statistically significant was 7 in the expectation, 18 in the important and 7 in the performance. 2. In the comparison analysis of the perception gap on the expectation-performance and the important-performance, it turned out that the subjected hospitals had to improve their equipment and facilities immediately. It was suggested a good strategy to strengthen the responsiveness factor and the assurance factor of nursing service.
CONCLUSION
it could be concluded that nurses have to recognize the blind spot of their perception and endeavor to take away the perception gap between consumers and providers.
The theory of unpleasant symptoms is a middle-range theory proposed by Lenz and her colleagues (1997). Analysis and evaluation of this theory was performed using Fawcett (1999) and Fawcett and Downs's (1992) guidelines. Results of the theory analysis and evaluation suggest that the theory of unpleasant symptoms has theoretical and social significance and parsimony. However, a lack of internal consistency was evident. For empirical adequacy of the theory, it is recommended that research be conducted examining the complexities of the interaction effects, reciprocal relationships, and medication effects among physiological, psychologic, and situational factors, symptoms, and performance. The knowledge derived from the research findings should be used in practice for patients experiencing symptoms.
This study was done to evaluate the quality of clinical nursing care using the variables of structure, process, and outcome and to analyze the relationship between the variables. This study also explored which variables are validating indicators to evaluate the quality of nursing care. The results analyzed by multiple regression showed that, generally structural variables did not contribute to the variance in outcome scores, but process variables of nursing care contributed significantly to the outcome variable of patient satisfaction. A combination of structure and process variables more than structural variables alone. Also, patient satisfaction and hospital preference were significantly related to each other. Therefore, if nursing quality evaluation relies solely upon on structural variables such as number of available nurses and workload, it would be inaccurate because process variables of nursing care are strongly related to outcome variables and the two categories of structure and process variables helped to strengthen the relationships. Thus, it is important to focus on variables of structure, process, and outcome together in evaluating nursing care quality.
Previous evaluation studies of the visiting nursing program explained an average change of the participants' health status, without considering socio-ecological characteristics and their impacts. However, these factors must affect individual health problems and lifestyles. For effective and appropriate community based programs, the Geographical Information System(GIS) can be utilized. GIS is a computer-based tool for mapping and analyzing things that happen on earth, and integrates statistical analysis with unique visualization. The purpose of this study was to evaluate visiting nursing care and to advocate the usefulness of planning and evaluating visiting nursing programs using Exploratory Spatial Data Analysis(ESDA) with GIS technology.
One hundred eighty-four elderly participants with cerebrovascular risk factors who lived in 13 areas of one community received visiting nursing care. The data analyzed characteristics of pre-post change and autocorrelation by ESDA using GIS technology.
Visiting nursing care showed an improvement in the participants' lifestyle habits, and family management ability and stress level, while the improvements were different depending on the regions. The change of family management ability and stress level correlated with neighborhoods (Morgan's I= 0.1841, 0.1675).
Community health providers need to consider the individual participant's health status as well as socio-ecological factors. Analysis using GIS technology will contribute to the effective monitoring, evaluation and design of a visiting nursing program.
This study was aimed to examine how subjects' characteristics and nursing service quality influence hospital revisiting intent, to compare perceptions of patients with those of nurses.
The questionnaire was developed and distributed to 300 patients and nurses at six general hospitals in a provincial city, Korea. For data analysis, the SPSS/PC program was used.
The nursing service quality's scores of patients is 3.61, that of nurses is 3.77, and there is a significant difference. The hospital revisiting intent's score of patients is 4.84, that of nurses is 4.61, and there are no significant differences. In subjects' characteristics, patients perceive that the hospital is the only different factor, and place hospital revisiting intent at 3.6%. Nurses perceive that education level and position are different factors, and place hospital revisiting intent at 3.3%. In nursing service quality, patients perceive that 2 attributes explain hospital revisiting intent at 17.8% and 2 factors explain it at 16.5%; whereas, nurses perceive that 2 attributes explain hospital revisiting intent at 15.3% and 3 factors explain it at 12.2%.
There are perception gaps between consumers and providers. So nursing and hospital managers must recognize these facts and provide various marketing strategies to overcome them.
The purpose of this study was to develop an instrument of task performance evaluation for clinical nurses, thus testing the validity and the reliability of the scale.
Data was collected from 84 Head Nurses and 255 General Nurses. A conceptual framework, composed of 4 factors of meaning in task performance evaluation, was identified through review of the relevant literature. A total of 78 items were developed and were used on a five-point likert scale. Through factor analysis, items whose factor loading was below 0.50 were deleted, thus 35 items remained. To test the validity and reliability of the instrument, the SPSS 11.0 windows program was used.
The results of the factor analysis indicated that 4 factors were classified and the cumulative percent of variance was 67.54%. The results of the reliability test indicated that Cronbach's coefficient of the total 35 items was over 0.9176. The results of the factor analysis indicated that factor loadings of all items was over 0.50. Conclusively, the validity and the reliability of the scale were proven.
This study was identified as a tool with a high degree of reliability and validity.
This study was conducted to develop and evaluate a Web-based program for the maternal role of primiparas who use the internet.
The study process was a systems requirements analysis, design and development of a program, program testing by experts, program implementation, and program evaluation by users. A nonequivalent control group non-synchronized design was used. The data was collected from October 5th, 2002 to February 24th, 2003.
1. Based on inquiries into mothers' needs, a Web-based support program was developed. The program was then modified from feedback received from experts. 2. In a sub-scale analysis of mothers' perception of a baby, amenability and persistence was significantly higher in the intervention group. The differences in the mean score of maternal self-confidence and maternal satisfaction were significant. 3. Cyber counseling was done for a total of 73 cases and the most frequent problems for counseling were feeding and nutrition (28.8%), followed by baby care, and health problems.
It was proven that a Web-based support program provided appropriate support to primiparas and was effective in promoting their maternal role. Therefore, this study suggests that a Web-based support program for primiparas can become a powerful nursing intervention on virtually all mother and infant health concerns.
This study was performed to give direction to quality improvement strategies of nursing services by comparing the differences in quality perceptions and satisfaction for nursing services between patients and nurses in small-medium sized general hospitals with 200 beds.
The subjects, who were 150 inpatients and 162 nurses of 4 general hospitals in a community, answered a self-report questionnaire with a SERVQUAL scale.
There were differences between patients' and nurses' expectations and perceptions of nursing service and satisfaction. In the service expectation, the highest factor was ‘the responsiveness’, and in the perceived performance, the highest was the ‘assurance’. In addition, overall patients' perceptions on nursing services showed higher than nurses'. There were positive correlations among the expectations and perceptions on nursing service, and satisfaction. The correlation between perception and satisfaction was higher than the correlation between expectations and satisfaction.
To improve the nursing service quality at small-medium hospitals, strengthening the ‘assurance’ factor and improving the nursing service support system is needed. Also, this study on nurses' perceived nursing service at small-medium sized hospitals should be duplicated.
The purpose of this study was to develop a tool that measures the quality of nursing service, to measure the quality of nursing service perceived by consumers, and to identify the gaps between ideal and actual nursing services.
A questionnaire was developed and distributed to 300 people who had been hospitalized in one of six general hospitals with quality of nursing services in five provincial cities in Korea. For data analysis, the SPSS/WIN(ver 10.0) program was used.
The 20 attributes included in the instrument of quality of nursing service is abstracted into 2 factors : tangibility and intangibility. In quality analysis, 15 of 20 attributes are minus scores, meaning that those nursing services are perceived as generally low. However among the minus scores' attributes, only two attributes are significant statistically. Gaps between importance and performance of the nursing service exists in 19 among 20 attributes.
Nursing service quality (performance-expectation) needs to be improved, and Gaps (importance-performance) reduced. In addition, a tool measuring nursing service quality has to be developed so nurses can deal successfully with the quality and gaps of nursing service perceived by consumers.
The purpose of this study was to evaluate the effect of a constipation reduction program for inpatients.
Subjects were selected in one medical ward of C University Hospital from May, 2001 to November, 2001. Twenty-nine subjects were assigned to an experimental group and 32 subjects to a control group. Data related to the frequency of defecation and to the length and amount of laxative drugs used was collected by a medical record review and data on the degree of constipation was obtained by a self-report using a constipation assessment scale.
More than 90% of the subjects admitted in the department of neurology and one third of total subjects presented with activity limitation and about one fourth of the subjects were fed with a nasogastric tube. There was a significant difference in the degree of constipation, frequency of defecation, and the length and amount of laxative drug use between the two groups.
This program is effective in inpatient's constipation reduction. Further studies need to apply this program in various clinical environments and properly use this program in different clinical settings.
This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs.
The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care.
The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home.
Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.
This study was performed to measure the nursing service perceived value by consumer and providers, and to investigate the relationship among nursing service, general satisfaction and hospital revisiting intent, and to examinate the tools that measures nursing service's reliability, construct validity and usefulness.
The questionnaire was developed and distributed to 300 patients and 210 nurses at three general hospitals. For data analysis, SPSS/PC program was used.
The nursing service perceived value by providers is higher than that by consumers. There are distinctive difference in the expectation, and importance and performance values of the nursing service perceived. In examination of the relationship among nursing service, general satisfaction and hospital revisiting intent, nursing service has a deep relationship with general satisfaction, but doesn't have relationship with hospital revisiting intent. The tool that measures nursing service has a good reliability and construct validity. In analysis on the usefulness between the tools, SERVPERF tool is more useful than SERVQUAL tool.
The nursing service perceived value by consumer is different that by providers, and the tool that measures nursing service has a good reliability and construct validity. The SERVPERF tool is more useful than SERVQUAL tool.
The purpose of this study was to verify effects of the Empowering A Self-Efficacy (EASE) program on self-efficacy, self-management, and child attitude toward illness in children with epilepsy.
This was a quasi-experimental study with a non-equivalent control group pre-post test design. Participants were 10 to 15 year old children with epilepsy (11 in the experimental group and 10 in the control group) who were registered at one hospital in S city. The experimental group received the EASE program for 3 weeks. In the first week, a group meeting lasting 570 minutes was conducted on a single day. Over the next two weeks, telephone counselling was conducted twice a week. Data were analyzed using SPSS 18.0.
There was a significant difference of pre-post evaluation of the epilepsy self-management scores in the experimental group. However, differences between the experimental group and the control group for seizure self-efficacy and child attitude toward illness were not significant.
This is the first study in Korea to develop and evaluate an intervention program for children with epilepsy. Further studies are needed to confirm the effects of the EASE program.
The purpose of this study was to examine effects of the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model sexual health enhancement program on, and development in, sexual function, sexual distress, marital intimacy, and subjective happiness of women with gynecologic cancer and their husbands.
The comprehensive program (4 session, 90 minutes per session) was developed based on the PLISSIT model. Participants were 43 couples, 21 assigned to the experimental group who attended the 4-week program, and 22 to the control group. Sexual function, sexual distress, marital intimacy, subjective happiness of the women, marital intimacy, subjective happiness of husbands were determined by a questionnaire that was completed by the participants before and after the program. The control group received the intervention post experiment. Chi-square test, t-test, Fisher's exact test were used to test the effectiveness of the program.
Post intervention results showed significant differences between the groups for sexual function, sexual distress, and marital intimacy in the women and for subjective happiness in the husbands.
Results indicate that the sexual health enhancement program is effective in improving sexual function, lowering sexual distress, increasing marital intimacy, and subjective happiness in women with gynecologic cancer and their husbands.
This study was done to develop a measurement tool for evaluation of continuing nursing education programs and to verify its validity for effective management and quality of education programs.
The draft of the evaluation measurement was developed from consultation with professionals, focus group interviews targeting groups of nurses, and individual interviews with education program planners. After 6 professionals examined content validity, 46 items were retained. A pilot-survey was conducted to confirm the time required to complete the questionnaire and the level of understanding of general content and each item in the questionnaire. Construct validity was verified through exploratory factor analysis of data from a survey with 44 items completed by 452 nurses and 59 education program planners.
The final evaluation measurement for continuing nursing education programs consisted of 6 evaluation factors and 36 evaluation items. The 6 evaluation factors included identifying program goals and target groups, program planning, performance, operation and management, program outcomes, and program effectiveness.
The evaluation measurement for continuing nursing education programs developed in this study is considered suitable to utilize as an evaluation measurement of the quality of continuing education programs for nurses.
The purpose of this study was to evaluate a self-care program for elders with osteoarthritis managed by primary health care workers, Community Health Practitioners (CHPs), in rural Korea.
The self-care program, consisting of 7 areas, was evaluated with a randomized experimental study for patients over age 60 with osteoarthritis in which 150 participants in the experimental group and 140 in the control group were compared. The self-care program was implemented for six weeks, 2 hours per week, at community health posts by CHPs. Data were collected using an interview questionnaire given by the CHPs and laboratory tests before and after the intervention for both groups. Propensity score matching analysis was done to test effectiveness after controlling for confounding variables.
The intervention group showed a significant decrease in the number of painful joints (
Study results indicate that training and utilizing primary health care workers in rural areas is valuable in increasing the generalization and continuity of intervention programs. As arthritis should be managed life-long, CHP directed self-care programs are useful interventions for rural elders with arthritis to learn self-care management.
The purpose of this study was to identify the effects of the program to promote self management for patients with chronic hepatitis B.
The research was a quasi-experimental design using a non-equivalent control group pre-post test. The participants were 61 patients, 29 in the experimental group and 32 in the control group. A pretest and 2 posttests were conducted to measure main variables. For the experimental group, the self-management program, consisting of counseling-centered activities in small groups, was given for 6 weeks. Data were analyzed using χ2, t-test, and repeated measures ANOVA with PASW statistics program.
There were statistically significant increases in knowledge, self-efficacy, active ways of coping, and self-management compliance but not in passive ways of coping in the experimental group compared to the control group over two different times.
The results of this study indicate that the self-management program is effective in increasing knowledge, self-efficacy, active ways of coping, and self-management compliance among patients with chronic hepatitis B. Therefore, it can be usefully utilized in the field of nursing for patients with chronic disease as a nursing intervention for people with chronic hepatitis B.
Cost-benefit analysis is one of the most commonly used economic evaluation methods, which helps to inform the economic value of a program to decision makers. However, the selection of a correct benefit estimation method remains critical for accurate cost-benefit analysis. This paper compared benefit estimations among three different benefit estimation models.
Data from community-based chronic hypertension management programs in a city in South Korea were used. Three different benefit estimation methods were compared. The first was a standard deterministic estimation model; second, a repeated-measures deterministic estimation model; and third, a transitional probability estimation model.
The estimated net benefit of the three different methods were $1,273.01, $-3,749.42, and $-5,122.55 respectively.
The transitional probability estimation model showed the most correct and realistic benefit estimation, as it traced possible paths of changing status between time points and it accounted for both positive and negative benefits.
The purpose of the study was to understand and describe the hospital workers' experience related to the hospital evaluation program implemented in Korea between 2004 and 2009.
During 2010, data were collected using focus group interviews. Four focus group interviews were held with a total of 28 hospital workers participating. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis.
Nine themes emerged from the analysis: 1) Positive change in the necessity of the evaluation; 2) Improvement in the hospital system, facilities, and human resources; 3) Unity through cooperation among departments; 4) Nursing work overload; 5) Lack of physicians' awareness and responsibilities; 6) Unfair and unrealistic evaluation items; 7) Lack of credibility of the outcome; 8) Shifting responsibility for negative outcomes to the workers; 9) Lack of pragmatic utility.
The results of the study demonstrate that the hospital evaluation program played a key role in improving some work environments and communication among departments. At the same time, they show various negative themes resulting from the context of very authoritarian hospital systems and a connection-oriented society in Korea.
This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses.
The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using χ2-test, factor analysis, and the Analytical Hierarchy Process.
Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order.
PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.