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Review Article
Effects of Reminiscence Therapy on Depressive Symptoms in Older Adults with Dementia: A Systematic Review and Meta-Analysis
Kyungsoo Kim, Jia Lee
J Korean Acad Nurs 2019;49(3):225-240.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.3.225
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to evaluate the effects of reminiscence therapy on depressive symptoms in older adults with dementia using a systematic review and meta-analysis.

Methods

Randomized controlled trials (RCTs) published from January 2000 to January 2018 were searched through Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), Korean Medical Database (KMbase), KoreaMed, PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Ovid MEDLINE. Two researchers independently performed the search, selection, and coding. Comprehensive Meta-Analysis 3.0 was used for meta-analysis, and Review Manager program 5.3 was used for quality assessment.

Results

Out of the 1,250 retrieved articles, 22 RCTs were selected for analysis. The overall effect size of reminiscence therapy for mitigating depressive symptoms in older adults with dementia was -0.62 (95% Cl: -0.92 to -0.31). The effect size was greater in older adults under 80, those with less disease severity, and those for whom the therapy session lasted less than 40 minutes.

Conclusion

Reminiscence therapy is an effective non-pharmacological therapy to improve depressive symptoms in older adults with dementia. Because its effectiveness is also influenced by age, disease severity, and application method, it is necessary to consider treatment designs based on individual characteristics as well as methodological approaches.

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Original Articles
Psychosocial Adjustment in Korean Colorectal Cancer Survivors
Hyejin Sun, Jia Lee
J Korean Acad Nurs 2018;48(5):545-553.   Published online October 31, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.5.545
AbstractAbstract PDF
Purpose

The increasing survival rate of colorectal cancer demands various nursing interventions and continuous care for patients to adapt to their psychosocial daily lives. The purpose of this study was to identify factors associated with psychosocial adjustment in colorectal cancer survivors.

Methods

A cross-sectional descriptive study with face-to-face interviews was conducted of 156 colorectal cancer survivors after surgery visiting an outpatient cancer clinic at a tertiary hospital in S city, Korea. Posttraumatic growth, health-promoting behavior, length of treatment, difficulty in activities of daily living, and having a stoma were entered into the linear regression model.

Results

The strongest factor influencing the level of psychosocial adjustment was health-promoting behavior (β=.33, p<.001), followed by difficulty in activities of daily living (β=-.24, p=.001), posttraumatic growth (β=.20, p=.004), and having a stoma (β=-.19, p=.004).

Conclusion

Nursing interventions for psychosocial adjustment in colorectal cancer survivors need to include the contents for posttraumatic growth, as well as health-promoting behavior, and activities of daily living.

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Symptom Clusters in Korean Patients with Acute Myocardial Infarction
Eunjin Park, Jia Lee
J Korean Acad Nurs 2015;45(3):378-387.   Published online June 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.3.378
AbstractAbstract PDF
Purpose

Acute myocardial infarction (AMI) leads to death if the patient does not receive emergency treatment. Thus it is very important to recognize the symptoms in the early stage. The purpose of this study was to identify clusters of symptoms that represent AMI in Koreans.

Methods

The study used a retrospective, descriptive design with secondary data analysis. Data were abstracted from 725 medical records of AMI patients admitted from June 1, 2006 to August 15, 2014 at a university hospital.

Results

Analysis of the AMI symptoms revealed five symptom clusters; Cluster 1 (n=140): middle chest pain (100%), shortness of breath, and cold sweating, Cluster 2 (n=256): substernal pain (100%), cold sweating, and shortness of breath, Cluster 3 (n=47): substernal pain (95.7%), left arm pain, shortness of breath, cold sweating, left shoulder pain, right arm pain, and the lower neck pain, Cluster 4 (n=212): shortness of breath (28.3%), left chest pain, and upper abdominal pain, and Cluster 5 (n=70): cold sweating (100%), left chest pain, shortness of breath, left shoulder pain, and upper abdominal pain. Length of hospital stay and mortality rate were significantly different according to symptom clusters (F=2.52, p=.040; F=3.62, p=.006, respectively).

Conclusion

Symptom clusters of AMI from this study can be used for AMI patients in order to recognize their symptoms at an early stage. The study findings should be considered when developing educational prevention programs for Koreans with AMI.

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Effects of a Face-to-face Self-management Program on Knowledge, Self-care Practice and Kidney Function in Patients with Chronic Kidney Disease before the Renal Replacement Therapy
Eun Sung Choi, Jia Lee
J Korean Acad Nurs 2012;42(7):1070-1078.   Published online December 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.7.1070
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the effects of a face-to-face self-management educational program on knowledge, self-care practice and kidney function in patients with chronic kidney disease (CKD) before kidney replacement therapy.

Methods

This study employed a nonequivalent control group, non-synchronized design. Data were collected from 61 patients with CKD visiting an outpatient department of nephrology in a university hospital in Seoul, South Korea. The experimental group (n=31) took the pre-test, then after 3 weeks, face-to-face education and individualized consultation (1st intervention), after a week of self-practice, the 1st post-test, followed by re-enforcement education and consultation (2nd intervention), and 4 weeks later, the 2nd post-test. The control group (n=30) took the pre-test and post-tests at 4 and 8 weeks.

Results

Scores for knowledge of CKD and self-care practice over time improved significantly in the experimental group compared to the control group. Kidney function did not improve significantly in the experimental group.

Conclusion

Health care providers can identify various and individualized needs, and provide effective education and consultation through face to face self-management for patients with chronic irreversible illnesses. Nurses can coordinate for these program by designing and providing systematic and effective education.

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Development of an Evaluation Instrument for Service Quality in Nursing Homes
Jia Lee, Eun Sun Ji
J Korean Acad Nurs 2011;41(4):510-519.   Published online August 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.4.510
AbstractAbstract PDF
Purpose

The purposes of this study were to identify the factors influencing service quality in nursing homes, and to develop an evaluation instrument for service quality.

Methods

A three-phase process was employed for the study. 1) The important factors to evaluate the service quality in nursing homes were identified through a literature review, panel discussion and focus group interview, 2) the evaluation instrument was developed, and 3) validity and reliability of the study instrument were tested by factor analysis, Pearson correlation coefficient, Cronbach's α and Cohen's Kappa.

Results

Factor analysis showed that the factors influencing service quality in nursing homes were healthcare, diet/assistance, therapy, environment and staff. To improve objectivity of the instrument, quantitative as well as qualitative evaluation approaches were adopted. The study instrument was developed with 30 items and showed acceptable construct validity. The criterion-related validity was a Pearson correlation coefficient of .85 in 151 care facilities. The internal consistency was Cronbach's α=.95.

Conclusion

The instrument has acceptable validity and a high degree of reliability. Staff in nursing homes can continuously improve and manage their services using the results of the evaluation instrument.

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

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

Methods

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

Results

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

Conclusion

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

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Development of a Multimedia Learning DM Diet Education Program using Standardized Patients and Analysis of Its Effects on Clinical Competency and Learning Satisfaction for Nursing Students
Kyung Sun Hyun, Hyun Sook Kang, Won Ock Kim, Sunhee Park, Jia Lee, Sohyune Sok
J Korean Acad Nurs 2009;39(2):249-258.   Published online April 28, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.2.249
AbstractAbstract PDF
Purpose

The purpose of this study was to develop a multimedia learning program for patients with diabetes mellitus (DM) diet education using standardized patients and to examine the effects of the program on educational skills, communication skills, DM diet knowledge and learning satisfaction.

Methods

The study employed a randomized control posttest non-synchronized design. The participants were 108 third year nursing students (52 experimental group, 56 control group) at K university in Seoul, Korea. The experimental group had regular lectures and the multimedia learning program for DM diet education using standardized patients while the control group had regular lectures only. The DM educational skills were measured by trained research assistants.

Results

The students who received the multimedia learning program scored higher for DM diet educational skills, communication skills and DM diet knowledge compared to the control group. Learning satisfaction of the experimental group was higher than the control group, but statistically insignificant.

Conclusion

Clinical competency was improved for students receiving the multimedia learning program for DM diet education using standardized patients, but there was no statistically significant effect on learning satisfaction. In the nursing education system there is a need to develop and apply more multimedia materials for education and to use standardized patients effectively.

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Predictors of Facility Adaptation in Nursing Home Residents
Hyekyung Lee, Hyang-Yeon Lee, Jia Lee
J Korean Acad Nurs 2009;39(2):177-185.   Published online April 28, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.2.177
AbstractAbstract PDF
Purpose

The purposes of this study were to examine the relationships among activities of daily living, self-efficiency, nursing home care quality and nursing home adaptation, and to identify the influencing factors of nursing home adaptation in nursing home residents.

Methods

The study employed a descriptive correlational design. The data were collected from 148 older adults without dementia by interview from six nursing homes in three cities from February 1, 2008 to February 28, 2008.

Results

Levels of nursing home adaptation in older adult residents were different by type of decision maker of nursing home admission, reason of nursing home admission, type of payment and length of nursing home stay. The nursing home adaptation was significantly correlated with self-efficiency and nursing home care quality. The strongest predictor of nursing home adaptation was type of decision maker of nursing home admission followed by the self-efficiency.

Conclusion

The study suggested that during the decision making period of nursing home admission, older adults should have enough time and careful considerations of their families to decide by themselves in positive ways. Nursing home staff should be able to identify reasons of nursing home admission and demands or expectations of older adults and their families.

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Validity and Reliability of the Korean Version of the Observable Indicators of Nursing Home Care Quality Evaluation Instrument
Jia Lee
J Korean Acad Nurs 2008;38(3):474-482.   Published online June 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.3.474
AbstractAbstract PDF
Purpose

The purposes of this study were; 1) to test the validity and reliability of the Korean version of Rantz's Observable Indicators of Nursing Home Care Quality Instrument (ONHQ) and 2) to evaluate the quality of Korean nursing homes.

Methods

The study employed a three-phase methodological research design. 1) The original instrument of Rantz's ONHQ was translated into Korean and modified by Korean nursing home experts. 2) A pilot study using the modified instrument was done in 20 nursing homes to examine inter-rater reliability. 3) The validity and reliability were tested in 98 nursing homes.

Results

Seven factors were extracted through factor analysis: 'communication', 'care delivery', 'grooming', 'odor', 'environment-basics', 'environment-access', and 'environment-homelike'. These factors explained 86.07% of the total variance. Cronbach's alpha coefficient of the 30 items was .97 indicating a high internal consistency of the instrument. Inter-rater reliability according to Kappa was .82. The average score of nursing home quality was 112.07 indicating an average range of quality level.

Conclusion

The Korean version of the ONHQ was identified as a tool with a high degree of validity and reliability. This tool can be effectively used to assess the quality of nursing homes by professions as well as family members.

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