Patient-centered care is a widely utilized concept in nursing and health care. However, the key components of patient-centered nursing have not yet been reported. Moreover, previous studies on patient-centered care have mostly focused on components of nursing rather than organizational factors. Therefore, a comprehensive understanding of influential factors of patient-centered care is required.
The purpose of this study was to develop a theoretical model based on person-centered care theory, and the relevant literature and to test the developed model with covariance structure analysis in order to determine the causal paths among the variables.
The model fit indices for the hypothetical model were suitable for the recommended level (goodness of fit index=.87, standardized root mean residual=.01, root mean square error of approximation=.06, Tucker-Lewis index=.90, comparative fit index=.92, parsimonious normed fit index=.75). In this study, five of the six paths established in the initial hypothetical model were supported. The variables of teamwork, self-leadership, and empathy accounted for 56.4% of hospital nurses' patient-centered care. Among these, empathy was the strongest predictor of patient-centered care.
These results suggest that it is necessary to use strategies to improve self-leadership and empathy. In addition to enhancing the personal factors of nurses, nursing organizations should strive for effective multidisciplinary cooperation with active support for patient-centered care and openness to change.
With the demanding level of care needed for people with dementia, more Korean families are institutionalizing their relatives with dementia. This presents particular concerns for the Korean culture that values family responsibility for elder care. The purpose of this study was to describe Korean family members' perceptions of stress and satisfaction with care, the caregiving role, the family-staff relations. A purposive sample of 94 family members in 10 long-term care dementia care facilities in Korea participated in the study. Family Perceptions of Care Tool and Family Perceptions of Caregiving Role developed by Maas and Buckwalter (1990) were used to investigate Korean family caregivers' perceptions of care. Findings from the study can be summarized as follows: a) family caregivers showed the lowest satisfaction level for staff management effectiveness, especially for facility's resources available for care, and (b) family caregivers showed the highest stress from staff members' control on caregiving, feeling the same responsibilities after placement, and guilt over their placement. The results contribute to the understanding of Korean family caregivers' perceptions of caregiving and the care relationship after institutionalizing their elderly persons with dementia.
The purpose of this study was to investigate RN-BSN students' clinical nursing competency in order to establish baseline data for developing nursing competency based clinical education for RN-BSN students.
A survey of 1,453 RN-BSN students from 21 nursing schools was conducted using a self administered questionnaire.
The mean score of the clinical nursing competency was 2.93. The scores for competency were shown as 2.91 for nursing management, 2.94 for developing professionalism & legal implementation, 2.95 for critical thinking, 2.96 for teaching & leadership, and data collection, basic nursing care, and communication were above 3.00. The items perceived as insufficient competency were physical examination and observation & monitoring in data collection, cardiopulmonary resuscitation, psycho-social care, spiritual care, hospice in basic nursing care, application of knowledge and theory, formulating nursing diagnosis, nursing care planning in critical thinking, education material development, leadership, delegation in teaching and leadership, analysis of organization, planning, infection control, role & job description, evaluation of nursing activities in nursing management, quality improvement, and research in developing professionalism and legal implementation.
This study will contribute to developing a nursing competency based on clinical education for RN-BSN students who have various education needs and clinical backgrounds.
The purpose of this study was to develop online aging and health management education for undergraduate students and to evaluate its effects analyzing the differences in knowledge and attitude toward aging and the elderly.
An Online aging and health management education program was established through analysis, planning, content framing and production, program application, and evaluation stages. The study sample consisted of 98 undergraduate students in one university in D city. The instruments used were FAQ I for knowledge of aging and a 20 item semantic differential scale for attitude toward aging and the elderly.
The results of this study were as follows. First, undergraduate students' knowledge level was low and attitudes were negative at the baseline. Second, after the class, knowledge scores improved significantly from 14.44 to 20.12. In addition, the attitudes toward elderly and aging changed from negative to a more positive way showing a 23.57 point difference.
This study shows that the online aging and health management education program was an effective educational method to improve knowledge and attitude of aging for the young generation such as college students.
The purposes of this study were to apply data mining tool to nursing specific knowledge discovery process and to identify the utilization of data mining skill for clinical decision making.
Data mining based on rough set model was conducted on a large clinical data set containing NMDS elements. Randomized 1000 patient data were selected from year 1998 database which had at least one of the five most frequently used nursing diagnoses. Patient characteristics and care service characteristics including nursing diagnoses, interventions and outcomes were analyzed to derive the meaningful decision rules.
Number of comorbidity, marital status, nursing diagnosis related to risk for infection and nursing intervention related to infection protection, and discharge status were the predictors that could determine the length of stay. Four variables (age, impaired skin integrity, pain, and discharge status) were identified as valuable predictors for nursing outcome, relived pain. Five variables (age, pain, potential for infection, marital status, and primary disease) were identified as important predictors for mortality.
This study demonstrated the utilization of data mining method through a large data set with stan-dardized language format to identify the contribution of nursing care to patient's health.
The purposes of this study were to develop and test a prediction model for caregiving experiences including caregiving satisfaction and burden in dementia family caregivers.
The stress process model and a two factor model were used as the conceptual frameworks. Secondary data analysis was done with 320 family caregivers who were selected from the Seoul Dementia Management Survey (2014) data set. In the hypothesis model, the exogenous variable was patient symptomatology which included cognitive impairment, behavioral problems, dependency in activity of daily living and in instrumental activity of daily living. Endogenous variables were caregiver's perception of dementia patient's unmet needs, caregiving satisfaction and caregiving burden. Data were analysed using SPSS/WINdows and AMOS program.
Caregiving burden was explained by patient symptomatology and caregiving satisfaction indicating significant direct effects and significant indirect effect from unmet needs. The proposed model explained 37.8% of the variance. Caregiving satisfaction was explained by patient symptomatology and unmet needs. Mediating effect of unmet needs was significant in the relationship between patient symptomatology and caregiving satisfaction.
Results indicate that interventions focusing on relieving caregiving burden and enhancing caregiver satisfaction should be provided to caregivers with high levels of dementia patients' unmet needs and low level of caregiving satisfaction.
The objective of this systematic review was to assess the effects of family support programs on caregiving burden, depression, and stress in family caregivers of people with dementia.
A literature search was conducted of electronic databases to identify randomized controlled studies with family support programs done between 2000 and 2014. Studies published in English and/or Korean were included for the analysis with search strategies adapted from the Cochrane Dementia and Cognitive Improvement Group. Studies were rated for quality assessment by two independent reviewers using the appraisal checklist developed by Cochrane Reviews and Dissemination. Of 8,334 articles identified in the literature search, full texts of 76 articles that met the inclusion criteria were reviewed and 38 were found to include relevant outcomes.
Results from selected studies were pooled in statistical meta-analysis using Review Manager Software and heterogeneity between combined studies was assessed using the Chi-square test. Meta-analysis showed that the effect sizes of family caregiver support programs were small to medium for categories of caregiving burden (Hedge's g= - 0.17, 95% CI= - 0.30~ - 0.04), depression (Hedge's g= - 0.30, 95% CI= - 0.40~ - 0.20), and stress (Hedge's g= - 0.39, 95% CI= - 0.52~ - 0.25).
The review results indicate that a support programs can assist family care-givers in reducing their psycho-emotional distress.
The purpose of this paper was to discuss the need for translation studies in dementia care and current translational endeavors, and to provide recommendations for evolving evidence-based dementia care.
A literature review yielded current evidence and translational efforts.
Dementia care interventions need to be implemented at various service levels. Barriers to translation include evidence gaps, lack of the use of a conceptual framework to explain the implementation process, and unsupportive funding mechanisms for applying innovations.
There is clear evidence of the need for and benefits of evidence-based dementia care for patients with dementia, family caregivers, and care professionals. The urgent need now is finding ways to advance translational activities and facilitate future research into translation science.
This study was done to compare demographic characteristics, comorbidity, and health habits of elders with mild cognitive impairment (MCI) and elders with cognitively normal function (CNF).
Secondary data analysis was conducted using data from the Database of the Seoul Dementia Management Project for 5,773 adults age 60 and above.
The MCI group showed an older age distribution, but there was no significant education difference between the two groups. Elders with MCI had more diabetes and stroke than elders with CNF. In subgroups, the same findings were observed in women, but not in men. While more men with MCI had hypertension compared to men with CNF, there was no significant difference in hypertension between the two groups for women. Elders with MCI, men in particular, had a lower prevalence of obesity than men with CNF. MCI individuals did less exercise compared to individuals with CNF. While there were no significant differences in alcohol consumption and smoking between MCI and CNF groups, the over 80's subgroup with MCI reported more alcohol consumption.
Findings from this study could be helpful in designing community-based dementia prevention programs and health policies to reduce the prevalence of dementia or related cognitive impairments.
The purpose of this study was to develop a prediction model for the characteristics of older adults with depression using the decision tree method.
A large dataset from the 2008 Korean Elderly Survey was used and data of 14,970 elderly people were analyzed. Target variable was depression and 53 input variables were general characteristics, family & social relationship, economic status, health status, health behavior, functional status, leisure & social activity, quality of life, and living environment. Data were analyzed by decision tree analysis, a data mining technique using SPSS Window 19.0 and Clementine 12.0 programs.
The decision trees were classified into five different rules to define the characteristics of older adults with depression. Classification & Regression Tree (C&RT) showed the best prediction with an accuracy of 80.81% among data mining models. Factors in the rules were life satisfaction, nutritional status, daily activity difficulty due to pain, functional limitation for basic or instrumental daily activities, number of chronic diseases and daily activity difficulty due to disease.
The different rules classified by the decision tree model in this study should contribute as baseline data for discovering informative knowledge and developing interventions tailored to these individual characteristics.
The purpose of this study was to examine the effects of interactive pictorial education on community dwelling older Korean adults’ self-efficacy and knowledge for safe medication.
A quasi-experimental, three-group pre- and post-intervention design was used in this study. The interactive pictorial education was designed to suit the learning patterns and psychomotor skills of older adults. The education content, dealing with safe medication, was delivered over three sessions. A total of 136 older adults from local senior centers were assigned to one of the three groups: a) interactive pictorial education plus information booklet (experimental); b) education only with information booklet (conventional); or c) no intervention (control).
Participants receiving interactive pictorial education had significantly higher self-efficacy (F=24.32,
These results suggest that the interactive pictorial education is an innovative approach that provides a means for older adults to learn appropriate medication use to improve their own health. It empowers older adults with different literacy levels to enhance their self-efficacy and knowledge for the safe use of medication.
This study was conducted to develop an education program for safe drug use in the rural elderly and to measure the effect of the program.
This study utilized a nonequivalent control group pretest-posttest design. The subjects of this study consisted of 40 older persons who were more than 65 years old and lived in G and C meon, Y gun, Gyeongsang-bukdo and visited the public health subcenter. Twenty were assigned to the experimental group and 20 to the control group. The education was provided for one and a half hours, once a week for 3 weeks. Data was collected before, right after, and one month after the program.
The first hypothesis was supported(F=79.24, p=0.000) showing that the knowledge scores of the drug use of the experimental group were significantly higher than those of the control group at post education and one month after education. The second hypothesis was supported(F=23.84, p=0.000) showing that the drug misuse and abuse prevention behavior scores in the experimental group were significantly higher than those of the control group at post education and one month after the education.
This study suggests that the education for safe drug use is effective in promoting knowledge and behavior for safe drug use of the rural elderly.