Skip Navigation
Skip to contents

J Korean Acad Nurs : Journal of Korean Academy of Nursing

OPEN ACCESS

Search

Page Path
HOME > Search
15 "Metabolic syndrome"
Filter
Filter
Article category
Keywords
Publication year
Authors
Research Paper
Development and Evaluation of an Integrated Health Management Program for Psychiatric Patients with Metabolic Syndrome
Kwak, Yun Bock , Kim, Ji Young
J Korean Acad Nurs 2022;52(3):261-277.   Published online June 30, 2022
DOI: https://doi.org/10.4040/jkan.21222
AbstractAbstract PDF
Purpose
This study developed an integrated health management program for metabolic syndrome in psychiatric patients and examined its effects on self-efficacy, healthy lifestyle, physiological indicators, knowledge of metabolic syndrome, attitudes toward healthy behavior, and social support.
Methods
A non-equivalent control group pretest posttest design was used. The participants were 65 psychiatric patients with metabolic syndrome in psychiatric rehabilitation centers, with 33 in the experimental group and 32 in the control group. The experimental group participants engaged in daily mobile application and walking exercises three times a week for more than 40 minutes over 8 weeks, while those in the control group were provided education booklets. The outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. Intervention effects were analyzed using the independent t-test, Mann—Whitney U test, ANCOVA, and Ranked ANCOVA.
Results
The experimental group showed a significant increase in self-efficacy (F = 8.85, p = .004, ηp2 = .13) and knowledge of metabolic syndrome (t = 2.60, p = .012, d = 0.60) compared to the control group. Additionally, the experimental group demonstrated a significant decrease in waist circumference (Z = - 2.34, p = .009, d = 0.58) and body mass index (Z = - 1.91, p = .028, d = 0.47) compared to the control group.
Conclusion
The integrated health management program for psychiatric patients with metabolic syndrome is effective in improving self-efficacy and knowledge of metabolic syndrome and decreasing physiological indicators such as waist circumference and body mass index.
  • 44 View
  • 1 Download
  • 4 Web of Science
Close layer
Original Articles
Effectiveness of Multi Interventional Package on Selected Parameters of Metabolic Syndrome among Women - A Pilot Study
Elizabeth, Attonassary Jose , Aruna, Swaminathan , Mercy, Parayidathil Joseph
J Korean Acad Nurs 2020;50(4):523-532.   Published online August 31, 2020
DOI: https://doi.org/10.4040/jkan.20012
AbstractAbstract PDF
Purpose
The purpose of the study was to compare the effectiveness of multi interventional package (MIP) and lifestyle interventions (LI) on physiological parameters of women with metabolic syndrome, to compare the effectiveness of MIP and LI on biochemical parameters of women with metabolic syndrome and to compare the effectiveness of MIP and LI on socio-psychological parameters of women with metabolic syndrome.
Methods
A quasi experimental nonequivalent control group design with two experimental groups and one control group was used to collect data from 60 self-help group women. Samples were selected by multistage sampling. Reflexology foot massage, dietary modification, moderate intensity exercise and structured education were given to MIP group and dietary modification, moderate intensity exercise and structured education were given to LI group for 12 weeks. Control group received routine care. Demographic and clinical data sheets were used to collect basic information. Knowledge was assessed by a knowledge questionnaire. Physiological (weight, body mass index, waist circumference and blood pressure) and biochemical parameters (HDL, triglycerides and FBS) were assessed before and after the intervention.
Results
The study found significant change in the physiological and biochemical parameters of metabolic syndrome as well as knowledge among the MIP group and LI group compared to the control group (p < .001).
Conclusion
MIP and LI are effective in controlling the parameters of metabolic syndrome. Hence the guidance may be provided to women with metabolic syndrome for adopting necessary lifestyle changes as well as reflexology foot massage to control the physiological and biochemical parameters of metabolic syndrome.
  • 23 View
  • 1 Download
Close layer
Effects of BeHaS Program on Health Behavior, Physiologic Index and Self-Esteem of the Elderly Living Alone with Metabolic Syndrome Based on Community Based Participatory Research
Kim, Jong Im , Kim, Sun Ae , Park, Keumok , Kim, Jiyoung , Lee, Lina , Choi, Si Wan , Ku, Bon Jeong
J Korean Acad Nurs 2020;50(4):571-582.   Published online August 31, 2020
DOI: https://doi.org/10.4040/jkan.19261
AbstractAbstract PDF
Purpose
This study aimed to determine the effects of a 12-week metabolic syndrome BeHaS (Be Happy and Strong) program in elderly people with metabolic syndrome living alone, based on a community-based participatory research (CBPR).
Methods
A nonequivalent control group pre-posttest design was used, and the participants were 43 elderly people living alone (experimental group 24, control group 19). The experimental group received a one-hour program per week and two individual health consultations during 12 weeks. The control group received two sessions about the metabolic syndrome and two individual health consultations. The effects of health behavior, blood pressure, blood sugar levels, abdominal circumference, triglycerides, and self-esteem were evaluated. The data were analyzed using the independent t-test and Mann-Whitney U test.
Results
The health behavior with respect to the metabolic syndrome in the experimental group increased significantly (t = - 3.19, p = .002). Both diastolic blood pressure and abdominal circumference decreased in the experimental group (t = 2.00, p = .028 and t = 3.91, p < .001). No significant differences were observed between the groups in systolic blood pressure, fasting blood sugar levels, triglycerides, and self-esteem.
Conclusion
The 12-week metabolic syndrome BeHaS program using community resources improves the health of elderly people with metabolic syndrome living alone. Based on these findings, further studies on the effectiveness of the metabolic syndrome BeHaS program and the experiences of those who participated in the CBPR are warranted.
  • 18 View
  • 1 Download
  • 2 Web of Science
Close layer
Incidence of Colon Cancer Related to Cigarette Smoking and Alcohol Consumption in Adults with Metabolic Syndrome: Prospective Cohort Study
Ahra Jo, Heeyoung Oh
J Korean Acad Nurs 2019;49(6):713-723.   Published online December 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.713
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the impact of cigarette smoking and alcohol consumption on the incidence of colon cancer in adults with metabolic syndrome.

Methods

This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study (KoGES). The data of a sample of 2,327 adults with metabolic syndrome tracked every two years from 2001 to 2014 were used in this study. Statistical data analyses of the frequency, number of cases per 100,000 person-years, log-rank test, Kaplan-Meier curve, and Cox's proportional hazards regression were performed using IBM SPSS statistics version 24.

Results

During the observation period, the number of colon cancer cases was 46, and the total person-years were 252,444. The incidence of colon cancer was higher in current, over 10 pack-year smokers when compared to non-smokers (hazard ratio=3.38, 95% confidence interval=1.09~8.42).

Conclusion

Excessive and long-term smoking should be avoided to prevent colon cancer, especially in adults with metabolic syndrome, since it might exacerbate the risk factors of colon cancer. Particularly, health professionals need to provide individualized smoking cessation interventions to those at high risk of colon cancer.

  • 27 View
  • 0 Download
  • 12 Web of Science
Close layer
The Effects of a Physical Activity-Behavior Modification Combined Intervention(PABM-intervention) on Metabolic Risk Factors in Overweight and Obese Elementary School Children
Young Ran Tak, Ji Yeon An, Young A Kim, Hae Young Woo
Journal of Korean Academy of Nursing 2007;37(6):902-913.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.6.902
AbstractAbstract PDF

PURPOSE: The purpose of this study was to identify the effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children. METHODS: Thirty-two participants (BMI≥85 percentile or relative obesity≥10) were allocated to the PABM-intervention group and behavior modification only intervention group. The PABM-intervention was composed of exercise intervention consisting of 50 minutes of physical activity(Hip-hop dance & gymbased exercises) twice a week and the behavior modification intervention consisted of 50 minutes of instruction for modifying lifestyle habits (diet & exercise) once a week. Effectiveness of intervention was based on waist circumference, BP, HDL-cholesterol, TG, and fasting glucose before and after the intervention. RESULTS: The proportion of subjects with 1, 2, 3 or more metabolic risk factors were 28.1, 43.8, and 15.6%, respectively. After the 8-week intervention, waist circumference, systolic BP, diastolic BP, and HDL-cholesterol changed significantly(p<.01) in the PABM group. CONCLUSION: This provides evidence that a PABM-intervention is effective in changing metabolic risk factors such as waist circumference, systolic BP, diastolic BP, and HDL-cholesterol in overweight and obese elementary school children.

  • 11 View
  • 0 Download
Close layer
Knowledge, Perception and Health Behavior about Metabolic Syndrome for an at Risk Group in a Rural Community Area
Eui Geum Oh, So Youn Bang, Sa Saeng Hyun, Sang Hui Chu, Justin Y Jeon, Myung Sook Kang
Journal of Korean Academy of Nursing 2007;37(5):790-800.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.5.790
AbstractAbstract PDF
Purpose

This study was to identify knowledge, perception and health behavior about metabolic syndrome for an at risk group in a rural community area.

Methods

A descriptive cross-sectional survey design was used. A total of 575 adults with hypertension, diabetes mellitus, dyslipidemia, and/or abdominal obesity were recruited from 11 rural community health care centers. A questionnaire was developed for this study. Anthropometric measures were measured and blood data was reviewed from the health record.

Results

Knowledge about the metabolic syndrome was low as evidenced by only a 47% correct answer rate. Only 9% of the subjects ever heard about the disease, and 87% answered they do not know the disease at all. 87% of the subjects were not performing regular exercise, 31% drank alcohol more than once a month, 12.5% were current smokers, and 33.6% are did not have a regular health check-up.

Conclusion

Development of systematic public health care programs are needed to prevent future increases in cardiovascular complications and to decrease health care costs. These might include educational programs for the primary health care provider and an at risk group, a therapeutic lifestyle modification program, and a health screening program to identify potential groups.

  • 14 View
  • 1 Download
Close layer
Comparison of the Metabolic Syndrome Risk Factor Prevalence Forty and Fifty Something Women
Hee Seung Kim, Jeong Ah Oh
Journal of Korean Academy of Nursing 2007;37(4):453-458.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.4.453
AbstractAbstract PDF
Purpose

The purpose of this study was to compare metabolic syndrome (MS) risk factor prevalence by obesity and age in middle-aged women.

Method

Two hundred and fifty-one subjects were recruited from the health promotion center of a tertiary care hospital in an urban city. MS was defined by the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults(Adult Treatment Panel III)(ATPIII), and obesity was determined by body mass index(BMI)≥ or = 25kg/m2.

Results

The mean blood pressure, fasting glucose, total cholesterol, and triglyceride were significantly higher in the obese group than in the non-obese group. The prevalence of MS, hypertension, and impaired fasting glucose were significantly higher in the obese group than in the non-obese group. In the forties, blood pressure was significantly higher in the obese group than in the non-obese group. In the fifties, body fat, systolic blood pressure, fasting glucose, total cholesterol, and triglyceride were significantly higher in the obese group than in the non-obese group.

Conclusions

These results show that the nurse should focus on the obese fifty year old female patients for improvement of the MS risk factors.

  • 11 View
  • 0 Download
Close layer
Effects of Walking Exercise on Metabolic Syndrome Risk Factors and Body Composition in Obese Middle School Girls
Young Hae Kim, Young Ok Yang
Journal of Korean Academy of Nursing 2005;35(5):858-867.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.5.858
AbstractAbstract PDF
Purpose

This study was done to determine the effects of walking exercise training(WET) on metabolic syndrome risk factors and body composition in obese middle school girls.

Method

A non-equivalent pretest-posttest experimental design was used. Twenty seven subjects participated in this study from one women's middle school in Busan. The participants were purposely allocated to an experimental group (n=14) and a control group (n=13). The experimental group participated in 30-60 minutes of WET with 55 to 75% of a maximal heart rate six days a week for 12 weeks.

Results

The prevalence of individual risk factors on metabolic syndrome were improved in the experimental group after the intervention. The high waist circumference(WC), high triglyceride(TG), low high density lipoprotein cholesterol(HDL-C), high blood pressure(BP) and high fasting glucose(FG) were 21.4, 21.4, 14.3, 28.6 and 7.2%, respectively. There were significant differences in WC (F=22.24, p<.001), TG (F=5.34, p=0.30), body weight(F=21.99, p<.001), fat mass(F=19.17, p<.001), and % body fat(F=17.93, p<.001) between the experimental and control group after the intervention. However, there were no significant differences in HDL-C, FG and BP between the experimental and control group after the intervention.

Conclusion

These results indicate that WET is effective in decreasing risk factors of the metabolic syndrome and body composition components in obese middle school girls. These findings suggest that WET can be useful as a nursing intervention in the prevention of obesity-related disorders in obese adolescents.

  • 14 View
  • 0 Download
Close layer
Identifying Latent Classes of Risk Factors for Coronary Artery Disease
Eunsil Ju, JiSun Choi
J Korean Acad Nurs 2017;47(6):817-827.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.6.817
AbstractAbstract PDF
Abstract Purpose

This study aimed to identify latent classes based on major modifiable risk factors for coronary artery disease.

Methods

This was a secondary analysis using data from the electronic medical records of 2,022 patients, who were newly diagnosed with coronary artery disease at a university medical center, from January 2010 to December 2015. Data were analyzed using SPSS version 20.0 for descriptive analysis and Mplus version 7.4 for latent class analysis.

Results

Four latent classes of risk factors for coronary artery disease were identified in the final model: ‘smoking-drinking’, ‘high-risk for dyslipidemia’, ‘high-risk for metabolic syndrome’, and ‘high-risk for diabetes and malnutrition’. The likelihood of these latent classes varied significantly based on socio-demographic characteristics, including age, gender, educational level, and occupation.

Conclusion

The results showed significant heterogeneity in the pattern of risk factors for coronary artery disease. These findings provide helpful data to develop intervention strategies for the effective prevention of coronary artery disease. Specific characteristics depending on the subpopulation should be considered during the development of interventions.

  • 29 View
  • 0 Download
Close layer
Review Article
Effects of Dietary and Physical Activity Interventions on Metabolic Syndrome: A Meta-analysis
Guna Lee, Hye-Young Choi, Sook-Ja Yang
J Korean Acad Nurs 2015;45(4):483-494.   Published online August 31, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.4.483
AbstractAbstract PDF
Purpose

This study identified effects of dietary and physical activity interventions including dietary interventions or physical activity interventions alone or combined dietary-physical activity interventions to improve symptoms in metabolic syndrome including abdominal obesity, high triglycerides, low high density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose through meta-analysis.

Methods

Articles on metabolic syndrome X published from 1988 to 2013 were searched through electronic databases, Google Scholar, and reference reviews. Methodological quality was assessed by the checklist, SIGN (Scottish Intercollegiate Guidelines Network).

Results

In the meta-analysis, there were 9 articles reporting 13 interventions with 736 participants. Using random effect models, the dietary and/or physical activity interventions showed a lower mean difference in waist circumference ( - 1.30 cm, 95% CI: - 2.44~ - 0.15, p =.027). The combined dietary-physical activity interventions showed a lower mean difference in waist circumference ( - 2.77 cm, 95% CI: - 4.77~ - 0.76, p =.007) and systolic blood pressure ( - 5.44 mmHg, 95% CI: - 10.76~ - 0.12, p =.044). Additionally, interventions of over 24 weeks yielded a lower mean difference in waist circumference ( - 2.78 cm, 95% CI: - 4.69~ - 0.87, p =.004) and diastolic blood pressure ( - 1.93 mmHg, 95% CI: - 3.63~ - 0.22, p =.026).

Conclusion

The findings indicate that dietary and/or physical activity interventions for metabolic syndrome reduce central obesity with no adverse effects. This finding provides objective evidences for dietary and physical activity management on metabolic syndrome as an efficient intervention.

  • 29 View
  • 0 Download
Close layer
Original Articles
Factors associated with Self-Rated Health in Metabolic Syndrome and Relationship between Sleep Duration and Metabolic Syndrome Risk Factors
Bo Gyeong Lee, Jae Yeon Lee, Sun Ah Kim, Dong Min Son, Ok Kyung Ham
J Korean Acad Nurs 2015;45(3):420-428.   Published online June 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.3.420
AbstractAbstract PDF
Purpose

Purpose was to explore associations between sleep duration and metabolic syndrome (MS) risks, and to determine factors associated with self-rated health (SRH) of adults with MS compared to other adults.

Methods

This is a secondary data analysis based on the Fifth Korea National Health and Nutrition Examination Survey KNHANES V (N=12662). Study instruments included sleep duration, MS risk factors, SRH and health-related quality of life (HRQoL).

Results

Mean age of participants was 43.68±12.26 years. Fifty-eight percent were women, and 18.3% were identified as having MS. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and SRH were significantly different according to sleep duration (p<.05) among all participants. In the non MS group, male gender, younger age (19~30 and 41~50 age brackets) upper income level, sufficient sleep duration, and high density lipoprotein (HDL) were positively associated with SRH, whereas, lower education levels (≤ middle school), glucose level, and waist circumference were negatively associated with SRH (p<.05). In the MS group, lower income, lower education levels (≤ middle school), glucose level, and waist circumference were negatively associated with SRH, whereas, having an occupation was positively associated with SRH (p<.05).

Conclusion

Results suggest that tailored approaches are required for prevention and control of MS and sleep duration of each individual should be considered rather than applying standardized guidelines. However, as sleep quality was not included in the analysis, further investigations regarding influence of sleep quality on MS and SRH and controlling for other lifestyle and health behavior factors are required.

  • 15 View
  • 0 Download
Close layer
Heart Rate Variability and Metabolic Syndrome in Hospitalized Patients with Schizophrenia
Kyunghee Lee, Jeongeon Park, Jeongim Choi, Chang Gi Park
J Korean Acad Nurs 2011;41(6):788-794.   Published online December 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.6.788
AbstractAbstract PDF
Purpose

Reduced heart rate variability significantly increases cardiovascular mortality. Metabolic syndrome increases the cardiac autonomic dysfunction. Recently, increasing cardiovascular mortality has been reported in patients with schizophrenia. This study was done to compare heart rate variability between adults with and without schizophrenia and to compare the relationship of heart rate variability to metabolic syndrome in hospitalized patients with schizophrenia.

Methods

This was a descriptive and correlational study in which 719 adults without schizophrenia and 308 adults with schizophrenia took part between May and June 2008. We measured the following: five-minute heart rate variability; high-frequency, low-frequency, the ratio of low-frequency to high-frequency, and the Standard Deviation of all the normal RR intervals. Data was also collected on metabolic syndrome, abdominal obesity, triglycerides, HDL cholesterol, blood pressure and fasting glucose.

Results

The Standard Deviation of all the normal RR intervals values of heart rate variability indices were 1.53±0.18. The low-frequency and high-frequency values of heart rate variability indices were significantly higher in hospitalized patients with schizophrenia (3.89±1.36; 3.80±1.20) than those in the healthy participants (2.20±0.46; 2.10±0.46). There were no significant differences between the schizophrenic patients with and without metabolic syndrome.

Conclusion

The results of this study indicate that schizophrenia patients have significantly lower cardiac autonomic control, but they have significantly higher low-frequency and high-frequency values than those of healthy adults. Use of antipsychotic drug may affect the autonomic nervous system in schizophrenic patients. Metabolic syndrome was not associated with cardiac autonomic control in schizophrenia patients.

  • 24 View
  • 0 Download
Close layer
Comparison of Cardiovascular Health Status and Health Behaviors in Korean Women based on Household Income
Young-Joo Park, Nah-Mee Shin, Ji-Won Yoon, Jiwon Choi, Sook-Ja Lee
J Korean Acad Nurs 2010;40(6):831-843.   Published online December 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.6.831
AbstractAbstract PDF
Purpose

In this study cardiovascular health status and health behavior of Korean women based on their household income were explored.

Methods

For this cross-sectional study, 91 women residing in the community were recruited to complete survey questionnaires and biophysical tests including blood pressure (BP), body mass index (BMI), body fat rate, waist circumference (WC), and blood chemistry tests.

Results

Compared to non-low income women (NLIW), low income women (LIW) were more likely to be older, less educated, and jobless, and further more LIW were postmenopause and reported having been diagnosed with hypertension or hypercholesterolemia. Significant differences were found in systolic BP, triglyceride level, BMI, body fat rate, and WC between the groups. Two fifths of the LIW had indications for metabolic syndrome. Their 10-yr risk estimate of myocardioal infarction or coronary death demonstrated a higher probability than that of NLIW. Although these significant differences were due to age gap between the groups, advanced age is known to be one of the key characteristics of LIW as well as a non-modifiable risk factor.

Conclusion

Effective community programs for vulnerable women at risk of cardiovascular disease should be based on strategies targeting unhealthy behaviors and modifiable risk factors.

  • 16 View
  • 0 Download
Close layer
Impact of Life Style Characteristics on Prevalence Risk of Metabolic Syndrome
Ji-Soo Yoo, Jeong In Jeong, Chang Gi Park, Se Won Kang, Jeong-Ah Ahn
J Korean Acad Nurs 2009;39(4):594-601.   Published online August 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.4.594
AbstractAbstract PDF
Purpose

The goal of this study was to evaluate the impact of life style characteristics on the prevalence risk of metabolic syndrome (MS).

Methods

A total of 581 adults were recruited from a cardiovascular outpatient clinic. A newly developed comprehensive life style evaluation tool for MS patients was used, and patient data related to the MS diagnosis were reviewed from the hospital records.

Results

The overall prevalence of MS was 53.2%, and the mean of MS score was 2.6 for patients at a cardiovascular outpatient clinic (78% of the patients had hypertension). Dietary habits among the life style characteristics had significant influence on the prevalence risk of MS and MS scores. And also interestingly, the classification and regression tree (CART) model suggested that the high prevalence risk groups for MS were older adults (61.5≤age<79.4), and adults between 48.5 and 61.5 yr of age with bad dietary habits.

Conclusion

This study indicates that nurses should focus on dietary habits of patients (especially patients classified as high prevalence risk for MS) for improvement and prevention of MS prevalence risk.

  • 27 View
  • 0 Download
Close layer
The Analysis of Intervention Studies for Patients with Metabolic Syndrome
Eui Geum Oh, Soo Hyun Kim, Sa Sang Hyun, Myung Sook Kang, So Youn Bang
Journal of Korean Academy of Nursing 2007;37(1):72-80.   Published online February 28, 2007
DOI: https://doi.org/10.4040/jkan.2007.37.1.72
AbstractAbstract PDF
Purpose

This study was to analyze the trend of research on intervention for patients with metabolic syndrome.

Method

Using Pubmed, Medline, and CINAHL search engines, a randomized controlled trial(RCT) researching titles such as “metabolic syndrome”, “intervention”, “lifestyle modification”, or “community-based” were collected. A total of 16 researches were analyzed based on the guidelines of the National Cholesterol Education Program-Adult Treatment Panel(NCEP-ATP III).

Results

1) The total period of the intervention was from 12 to 24 weeks, the frequency was 3 to 5 times per week, and the duration of each session was from 45 to 60 minutes. The types of intervention included exercise, diet, and medication. Among these types, diet was performed most frequently. 2) The outcomes of the intervention was measured with physical aspects such as anthropometric measures, body composition, or biological markers. No studies have evaluated psychosocial outcomes such as quality of life. 3) In terms of effectiveness of the intervention, anthropometric indicators, body composition, or serological markers showed positive effects, whereas results on endothelial or urine indicators were inconsistent.

Conclusion

Methodological research developing comprehensive therapeutic lifestyle modification programs and intervention studies are needed for patients with metabolic syndrome. In addition, effects should be evaluated with multidimensional perspectives.

  • 26 View
  • 0 Download
Close layer

J Korean Acad Nurs : Journal of Korean Academy of Nursing
Close layer
TOP