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Research Papers
Effects of a Modified Six-Sigma-Methodology-Based Training Program on Core Competencies in Rehabilitation Nurse Specialists
Gu, Jiayi , Luo, Lan , Li,, Chengjuan , Ma, Sumin , Gong, Fanghua
J Korean Acad Nurs 2023;53(4):412-425.   Published online August 31, 2023
DOI: https://doi.org/10.4040/jkan.22122
AbstractAbstract PDF
Purpose
Nurses play an important role in ensuring patient rehabilitation and are involved in all aspects of multidimensional rehabilitation. Therefore, strengthening rehabilitation nursing education is vital to ascertain high-quality rehabilitation and optimum outcomes. This study examined the effectiveness of a new teaching reform—a modified Six-Sigma-based training program—against a conventional educational program on rehabilitation specialist nurses’ core competencies, post-training performance, and satisfaction.
Methods
A quasi-randomized controlled trial was conducted to assess the effectiveness of the modified training program. We recruited 56 learners from the 2020 training course at the Hunan Rehabilitation Specialist Nurse Training Base as the control group. Sixty learners from the base’s 2021 training course were recruited as the intervention group. Data were collected in a consistent manner from both groups after the training program was implemented.
Results
Those who underwent the modified training program showed better improvement in all core competencies than those who underwent the conventional training program (p < .05); the scores for theoretical knowledge, clinical nursing lectures, reviews, and nursing case management improved significantly following the teaching reform (p < 0.05). Further, overall satisfaction as well as base management and theoretical teaching satisfaction improved significantly (p < .05).
Conclusion
The modified training program strengthens rehabilitation nurses’ base management abilities; enhances their core competencies; expands their interest in and breadth, depth, and practicability of theoretical courses; and updates the teaching methods.
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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
AbstractAbstract 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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Original Articles
Effects of Active Mandibular Exercise for Mouth Opening Limitation Patients after Maxillomandibular Fixation Release: A Non-Randomized Controlled Trial
Hyo Jin Jang, Myung Hee Kim
J Korean Acad Nurs 2018;48(1):26-37.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.1.26
AbstractAbstract PDF
Abstract Purpose

The aim of this study was to evaluate the effects of active mandibular exercise (AME) in patients with limited mouth opening after maxillomandibular fixation (MMF) release.

Methods

The study used a quasi-experimental, nonequivalent control group and a pre test-post test design. Sixty-two patients with Maxillomandibular Fixation Release were assigned to the experimental (n=31) or control group (n=31). The AME was performed in the experimental group for 4 weeks. The exercise AME consisted of maximal mouth opening, lateral excursion and protrusive movement. These movements were repeated ten times a day. After the final exercise of the day, the number of tongue blades used for mouth opening was noted. The effect of AME was evaluated after MMF release at different time intervals: a) immediately, b) after 1 week, c) after 2 weeks, d) after 4 weeks, and e) after 12 weeks. The exercise was assessed using the following criteria: a) mandibular movements, b) pain scores associated with maximal mouth opening, c) discomfort scores associated with range of movement, and d) daily life activities that involve opening the mouth.

Results

The experimental group showed significant improvement regarding the range of mandibular movements (maximal mouth opening (F=23.60, p<.001), lateral excursion to the right side (F=5.25, p=.002), lateral excursion to the left side (F=5.97, p=.001), protrusive movement (F=5.51, p=.001)), pain score (F=39.59, p<.001), discomfort score (F=9.38, p<.001). Daily life activities that involve opening the mouth were more favorable compared to those in the control group.

Conclusion

The AME in patients after MMF release is helpful for increasing mandibular movement range, decreasing pain and discomfort, and improving day life activities that involve opening the mouth. Therefore, AME is highly recommended as an effective nursing intervention.

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The Effect of the Structured Education on the Early Rehabilitation Knowledge and Activity Performance of the C.V.A. Patients
Hei Jin Lee, Hyang Yun Rhee
Journal of Nurses Academic Society 1997;27(1):109-119.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.109
AbstractAbstract PDF

This study had been attempted to set up the strategies of the nursing which can promote the activity performance for early rehabilitation for the patients by examining the effect of the structured patient education on the early rehabilitation knowledge and activity performance of the C.V.A. patients. The study method had been done by investigating the experiment group and control group in advance through the question papers and interview and observation on 65 patients who had been hospitalized at oriental medicine hospital of K Medical Center form July 1st 1995 to the end of Sep, 1995. The analysis of the collected material had been done for the homogeneity test in which general characters of experiment group and control group had been tested by x2 and the homogeneity test of ADL by t-test. To test the hypothesis the t-test had been given for the difference of the early rehabilitation knowledge and activity performance between the two groups and the correlation between early rehabilitation knowledge and activity performance had been tested by Pearson's Correlation Coefficient. The result of the test of the hypothesis is as the below. 1. The 1st hypothesis "The experiment group which had received the structured education should be higher in the early rehabilitation knowledge than the control group" was supported(t=4.45, p=.000). 2. The 2nd hypothesis "The experiment group which received the structured education should be higher in the early rehabilitation activity performance than the control group" was supported(t=2.11, p=.036). 3. The 3rd hypothesis "The higher the early rehabilitation knowledge of the patient the higher the activity performance degree" was rejected(r=.1546, p=.219). In conclusion, the patients who received the structured showed the increase in the degree of early rehabilitation knowledge and activity performance so, it had been judged that education had been prerequisite in increasing the knowledge and activity performance of early rehabilitation.

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Effects of Cardiac Rehabilitation Teaching Program on Knowledge Level and Compliance of Health Behavior for Patients with Myocardial Infarction
Hye Sun Jeong, Hee Seung Kim, Yang Sook Yoo, Jung Soon Moon
Journal of Korean Academy of Nursing 2002;32(1):50-61.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.1.50
AbstractAbstract PDF

PURPOSE: The purpose of this study was to investigate the effects of cardiac rehabilitation teaching program on knowledge level and compliance of health behavior for the patients with myocardial infarction.
METHOD
The subjects were 47 patients 23 were assigned to the experimental group and 24 were for the control. The cardiac rehabilitation teaching program is a individualized teaching program which was delivered to the experimental group during hospitalization period by present researcher. Data were collected through questionnaire surveys for knowledge level and compliance of health behavior from September 15, 1999 to December 31, 2000. The collected data was analyzed by using the SAS program.
RESULTS
1. With regard to the knowledge scores 1) The total knowledge level in the experimental group was significantly higher than in the control group. 2) As to the knowledge domains, nature of disease, risk factors, diet, medication, exercise, and daily activities were significantly higher in score in the experimental group than in the control group. 2. With regard to the compliance of health behavior 1) The average compliance with good health behavior was significantly higher in the experimental group than in the control group. 2) As to the health behavior domains smoking cessation, diet, stress management, regular exercise, and other measures for lifestyle modification were significantly higher in score in the experimental group than in the control group. 3. The pre-treatment knowledge score was positively correlated to the post-treatment knowledge score and post-treatment knowledge score was positively correlated to the post-treatment compliance of health behaviors.
CONCLUSION
The above findings indicate that the cardiac rehabilitation teaching program for the experimental group was effective in increasing level of knowledge and improvement f compliance with good health behavior of patients with myocardial infarction.

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The Study on the Effects of a Respiratory Rehabilitation Program for COPD Patients
Ae Kyung Kim
Journal of Korean Academy of Nursing 2001;31(2):257-267.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.2.257
AbstractAbstract PDF

It is known that a pulmonary rehabilitation program improves dyspnea and exercise tolerence in patients with chronic obstructive pulmonary disease. However, it is also known that although it does not improve pulmonary function. This study was performed to evaluate the effect of a 4 week pulmonary rehabilitation on pulmonary function, gas exchange, and exercise tolerance in patients with chronic obstructive pulmonary disease. The pulmonary rehabilitation programs included breathing exercises, such as pursed-lip breathing and diaphragmatic breathing, upper-limb exercises, and inspiratory muscle training. These activities were performed for 4 weeks in twenty one patients with chronic obstructive pulmonary disease. Pre and post-rehabilitation pulmonary function and exercise capacities were compared after the 4 week period. Results are as follows: 1) Before the rehabilitation, the predicted value of FVC and FEV1 of the patients were 70.3+/-16.7% and 41.1+/-11.9% respectively. These pulmonary functions did not change after pulmonary rehabilitation. 2) Aloility of walking a 6 minute distance (325.29+/-122.24 vs 363.03+/-120.01 p=.01) and dyspnea (p=.00) were significantly improved after rehabilitation. Thus showing that pulmonary rehabilitation for 4 weeks can improve exercise performance and dyspnea in patients with chronic obstructive pulmonary disease.

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The Effects of a Cardiac Rehabilitation Program on Health Behavior Compliance, Cardiovascular Function, and Quality of Life for the Patients with Ischemic Heart Disease
Hyun Sook Jo, Kwang Joo Kim
Journal of Korean Academy of Nursing 2000;30(3):560-570.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.3.560
AbstractAbstract PDF

This study is aimed at developing a cardiac rehabilitation program and enlightening the effects of the program on patient's health behavior compliance, cardiovascular functional capacity, and quality of life. Using a quasi-experimental approach the nonequivalent control group pretest - posttest design was accepted for this study. The subjects of this study consisted of 55 patients with ischemic heart disease at the Cardiac Center of 'G' Hospital located in Inchon from May 1, 1998 to April 30, 1999. The patients were divided into two groups: the experimental group, which participated in the cardiac program with 30 patients and 25 patients of a control group were not involved in the program. There were two phases in the cardiac rehabilitation program: the first phase was a team approach education. It focused on reducing the risk of ischemic heart problems. The second phase was individual training by using a home based exercise program, which was comprised of 8 weeks, three sessions per week, 40-60 minutes per session, and followed by consultation. Every session involved 20-40 minutes of aerobic exercise at 40-60% of heart rate reserve, 11~13 RPE and 10 minutes of warm-up and 10 minutes of cool-down exercises. The experimental tools for the study were the health behavior compliance scale developed by Lee, Yoon-hee (1992), and quality of life scale developed by McGirr et al.(1990). RPPsubmax were measured by the treadmill. The collected data was processed by SPSS and analyzed by X2test and t-test. The results of this study were as follows: 1. The health behavior compliance in experimental group was significantly increased (t=5.091, p=.000) when compared to the control group. 2. RPPsubmax also decreased significantly in the experimental group when compared to the control group(t=-2.109, p=.040). 3. The quality of life significantly improved in the experimental group (t=3.853, p=.000) as compared to the control group. As the above results of this study revealed, the effectiveness of the cardiac rehabilitation program of the study was confirmed. It increased the health behavior compliance for reducing the risk of further coronary events, enhanced the cardiovascular functional capacity, and eventually improved the patient's quality of life.

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Effects of the Inpatient Cardiac Rehabilitation Program on Behavioral Modification and Quality of Life in Patients with Coronary Artery Disease
Rha Yun Song, Hae Jung Lee
Journal of Korean Academy of Nursing 2000;30(2):463-475.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.2.463
AbstractAbstract PDF

The purpose of the study was to identify the effects of inpatient cardiac rehabilitation programs on motivation, the performance of health behavior, and quality of life in patients with coronary artery disease. The subjects consisted of 31 patients who participated in the rehabilitation program during their hospital stay, and were compared with 34 patients who did not participate. The study results are as follows: 1. The mean of cardiac risk factor scores for the subjects was 22.5 (SD = 5.5) at the level of low to moderate risk with some possibility to improve. The physiological and behavioral risk factors for the subjects were also in the normal range or slightly above the normal range. 2. The motivation level to preform health behaviors for both groups was improved after discharge. Also, perceived self-efficacy was significantly higher for the program participants than for the comparison group at the post-test. 3. The performance of cardiac related health behaviors improved for both groups after discharge, but there were no significant differences between the two groups. The program participants reported better performance in most health behaviors at the post-test, but the results failed to reach a statistical significant level. 4. As for motivation and health behavior, the subjects in the both groups showed an improved quality of life after the discharge. In addition, the program participants produced significantly higher scores in health and functioning dimension than the comparison group during the post-test. In conclusion, the study partially supported the effects of the inpatient cardiac rehabilitation program to motivate and improve the quality of life, and provide the need to apply early rehabilitation interventions for the patients after cardiac events. Further study with a longitudinal design is also suggested to verify the effect of cardiac rehabilitation program from hospitalization to discharge and subsequently to fully recover to the level of pre-hospitalized state.

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The Effects of a Community Psychiatric Nursing Program on the Rehabilitation of Home-based Long-term Psychiatric Patients
Sook Lee
Journal of Korean Academy of Nursing 1999;29(5):1103-1112.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.5.1103
AbstractAbstract PDF

In the last few years, psychiatric nurse practitioners have shown a growing an interest in community psychosocial rehabiliation, caring for chronic psychiatric patients as case manager in South Korea. The purpose of this study was to evaluate the effectiveness of a community psychiatric rehabilitation nursing program on self-care actively and quality of life and to suggest this program as an effective nursing intervention in a group of chronic home-based psychiatric patients in a poor town. A nonequivalent control group, pretest-posttest design was used . Of the twenty women that started the program, sixteen finished it. The data were analyzed by the Wilcoxon Rank Sum Test. The program included the process of case management which consisted of four phases: the first was an active case finding and pre-test, the second was home visiting and contracted by phone, the third was group activity therapy of 12 sessions, and the fourth phase was terminal and post-test. The effects of the program were assessed by quality of life and self-care activity. The quality of life and the self-care activity, especially, area of nutrition, elimination, dressing, leisure activity, and follow-up clinic visiting showed greater improvement than those of the control group. The results of this study suggest that this program was effective in improving the quality of life of chronic home-based psychiatric patients.

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Developing a Psychosocial Rehabilitation Model for Persons with Chronic Mental Illness
Hyun Sook Kim
Journal of Korean Academy of Nursing 2007;37(4):490-500.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.4.490
AbstractAbstract PDF
Purpose

The purpose of this study was to identify factors influencing the outcome of psychosocial rehabilitation for persons with chronic mental illness and to suggest a hypothetical model of psychosocial rehabilitation which is based on the relationship between influencing factors and then to test its fitness empirically.

Method

Data was collected from persons with a chronic mental illness using a self-report questionnaire, and from their case managers using an observed rating questionnaire. A total of 220 cases were used in the final analysis, and a hypothetical model was verified through covariance structure analysis using LISREL.

Result

1) The fitness indices of the model were χ2=133.77 (df=48, p=.00), GFI = 0.93, AGFI = 0.87, RMR = 2.32, NNFI = 0.95 and NFI = 0.95. Twelve paths among fifteen proved to be significant. 2) Psychosocial rehabilitation was influenced directly by symptoms, daily living skill and self-concept, and was influenced indirectly by the psychosocial rehabilitation program service. Psychosocial rehabilitation accounted for 32% of variance of these factors.

Conclusion

This study is expected to contribute to understanding the psychosocial rehabilitation phenomena. Besides it will provide basic information for developing strategies of bio-psycho-sociological interventions and evaluations in regard to influential factors of psychosocial rehabilitation.

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The Effects of a Rehabilitation Program on Physical Health, Physiological Indicator and Quality of Life in Breast Cancer Mastectomy Patients
Hyoung Sook Park, Gyoo Yeong Cho, Kyung Yeon Park
Journal of Korean Academy of Nursing 2006;36(2):310-320.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.2.310
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the effects of a rehabilitation program on physical health, physiological indicators and quality of life in breast cancer mastectomy patients.

Methods

The subjects included thirty-one patients with breast cancer (17 in the experimental group and 14 in the control group). The subjects in the experimental group participated in a rehabilitation program for 10 weeks, which was composed of an exercise program, teaching, counseling and support for 2 sessions per week.

Results

There was a significant increase in flexion, internal rotation and external rotation but no significant increase in extension in the experimental group compared to the control group. The total cholesterol, triglyceride, HDL, LDL, and CD56 in the experimental group compared to the control group was not significantly decreased after the rehabilitation program. Compared to the control group, quality of life in the experimental group was significantly improved and fatigue in that group was significantly decreased after the rehabilitation program.

Conclusion

The 10-week rehabilitation program showed a large affirmative effect on physical health, physiological indicators and quality of life in breast cancer mastectomy patients.

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Development of an Integrative Cognitive Rehabilitation Program for Brain Injured Patients in the Post-acute Stage
Hyun Soo Oh, Young Ran Kim, Wha Sook Seo, Yeon Ok Seo
Journal of Korean Academy of Nursing 2005;35(2):270-282.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.2.270
AbstractAbstract PDF
Purpose

This study was conducted to develop a comprehensive cognitive rehabilitation program that can be easily applied to brain injured patients by family members or nurses in community or hospital settings.

Methods

A Systemic literature review design was used. Thirty-three related studies were reviewed.

Result

Based on the results of the literature review, the training tasks for attention were designated to enhancing 4 hierarchical areas, i.e., focused, selective, alternating, and divided attention. On the other hand, the memory rehabilitation tasks mainly consisted of mnemonic skills, such as the association method which helps patients memorize given information by linking together common attributes, the visual imagery method, and self-instruction method. The problem solving rehabilitation program included a task of games or plays which stimulated the patients' curiosity and interest. The training tasks for problem solving were to encourage the process of deriving reasonable solutions for a problematic situation resembling real problems that the patients were faced with in their everyday life.

Conclusion

It is expected that the cognitive rehabilitation program developed from this study could help patients having difficulty in their every day life, due to a reduced cognitive ability resulting from brain injury, to effectively adapt to every day life.

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Effect of East-West Self-help Group Program for Rehabilitation of Post Stroke Clients
Hyun sook Kang, Won ock Kim, Jeong wha Kim, Myoung ja Wang, Joung hee Cho
Journal of Korean Academy of Nursing 2004;34(7):1351-1361.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.7.1351
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the effect of an East-West Self-help program for Rehabilitation of post-stroke patients.

Method

A quasi-experimental design was used. The subjects were 75 post stroke clients(Exp. group : 38, Cont. group:37). The subjects of the experimental group participated in the Self-help group program of six sessions, twice a week, during 6 weeks. The program consisted of health education of stroke, exercise, oriental nursing interventions, and therapeutic recreation. The obtained data were analyzed by using the repeated measure ANOVA of SPSS.

Result

1) The score of rehabilitation self-efficacy increased significantly in the experimental group as compared to the control group. 2) The score of BADL, IADL, amount of use & quality of movement of the affected U/E, and grip power increased significantly in the experimental group as compared to the control group. 3)The level of blood cholesterol decreased significantly in the experimental group as compared to the control group.

Conclusion

Considering these research results, the program is effective in improving functional abilities and self-management ability. Therefore this program could be implemented as a community based self-help group program for post stroke clients.

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Effects of a Comprehensive Rehabilitation Program for Mastectomy Patients
Ok Hee Cho
Journal of Korean Academy of Nursing 2004;34(5):809-819.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.5.809
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the effect of a comprehensive rehabilitation program on physical function, immune response, fatigue and quality of life in mastectomy patients.

Method

The subjects included fifty-five patients with breast cancer (27 in the control group and 28 in the experimental group). The subjects in the experimental group participated in a comprehensive rehabilitation program for10 weeks, which was composed of 1 session of education, 2 sessions of stress management, 2 sessions of exercise, and 1 session of peer support group activity per week.

Result

The results revealed anincrease in shoulder extension, abduction, external rotation, and internal rotation of the affectedupper extremity, and in shoulder extension and abduction of the healthy upper extremity. Also an increase in quality of life and a decrease in fatigue were significantly higher in the experimental group than the control group. However, the results revealed that the natural killer cell ratio of the experimental group increased but there was no significant difference from that of the control group.

Conclusion

The 10-week comprehensive rehabilitation program showed a large affirmative effect on physical function, fatigue and quality of life of breast cancer patients after a mastectomy.

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Rehabilitation for Homeless Adolescent Substance Abusers at a Halfway House in Korea
Myungsun Hyun, Mia Seo
Journal of Korean Academy of Nursing 2003;33(8):1161-1170.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.8.1161
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the effects of a rehabilitation program on hope and self-efficacy in a sample of homeless adolescent substance abusers at a halfway house in Seoul, Korea.

Methods

Five residents of a halfway house were provided with a 16-week rehabilitation program based on a cognitive-behavioral approach. To evaluate the effectiveness of the program, this study used a single-case experimental design with the variables - hope and self-efficacy - being measured at pre-, post-, and follow-up tests.

Results

While three participants showed considerable positive changes in hope and self-efficacy after the program, two participants did not show any positive changes. Despite this lack of consistent patterns in the effectiveness of the rehabilitation program, there was a qualitative change in social status (such as academic and work status) for the participants at the follow-up test.

Conclusion

A rehabilitation program based on a cognitive-behavioral approach may improve the hope and self-efficacy of homeless adolescent substance abusers at a halfway house and help them to reintegrate into society.

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The Effects of Medication and Symptom Management Education Program Based on Self Efficacy Theory for the Psychiatric Patients
Kyung Hee Shon
Journal of Korean Academy of Nursing 2003;33(8):1145-1152.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.8.1145
AbstractAbstract PDF
Purpose

An effective rehabilitation program had been developed for psychiatric patients' self management of medication and symptoms in Korea. The rehabilitation program was designed to allow the patients to understand their illness, cope with their medical regimen, and prevent a relapse by recognizing any of the symptoms when they recur.

Methods

The developed program utilizes the self efficacy method reported by Bandura, it includes manuals and videotapes focusing on real life situations, small group discussions, and telephone coaching. This study investigated the effects of this program with respect to various predictable variables in psychiatric rehabilitation. Thirty eight patients were selected for this study, 18 in the experimental program and 20 as controls.

Results

The results showed that the subjects who attended this educational program reported significantly more improvement in attitude toward medication compliance (p=0.033), and significantly less relapse warning symptom scores (p=0.000) than the controls.

Conclusion

This program may be a useful psychoeducational resource for professionals in the field of clinical practice in psychiatry.

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Effects of TES Program on Exercise Capacity, Self-Efficacy and Patient Compliance in Patients with Myocardial Infarction
Jina Choo, Mae Ja Kim, Kyung Pyo Hong
Journal of Korean Academy of Nursing 2003;33(7):905-916.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.7.905
AbstractAbstract PDF
Purpose

This study aimed to develop a TES program to improve exercise capacity to promote patient compliance to the prescribed exercise, and to test the feasibility of the program.

Method

The 8-week TES program consisted of three components : exercise training, self-efficacy enhancement and social support. Using the matching of gender, age, and the left ventricular ejection fraction, thirty one subjects were consecutively assigned to either TES group (n=15, 52+7 years) or Control group (n=16, 58+11 years) 3 weeks after MI. With the exception of exercise compliance (only after the TES program), the exercise capacity and exercise self-efficacy were both measured both before and after the 8-week TES program.

Result

The VO2peak (p= .043), anaerobic threshold (p= .023) and exercise duration (p= .015) improved in TES group compared to Control group after 8 weeks. The cardiac exercise self-efficacy (p= .036) was significantly higher in TES group than Control group. There was a significant increase of exercise compliance(p= .005) in TES group compared to Control group.

Conclusion

The 8-week TES program improved the exercise capacity, exercise self-efficacy and exercise compliance. A appropriately implemented TES program in cardiovascular nursing practice may promote healthy behavioral modification and, therefore, contributing to reduce the risk of mortality and morbidity in MI patients.

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The Effects of a Pulmonary Rehabilitation Program for Chronic Obstructive Pulmonary Disease Patients
Suk Jung Han
Journal of Korean Academy of Nursing 2003;33(7):1008-1017.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.7.1008
AbstractAbstract PDF
Purpose

This study was designed to investigate the effects of a pulmonary rehabilitation program for patients with COPD.

Method

37 subjects, who had a FEV1/FVC below 70%, participated. 18 were assigned to the experimental group and 19 to the control group. The program consisted of individualized education program and exercise program for 6weeks, 3times a week. Data was collected through questionnaire surveys of general characteristics, anxiety and depression, blood tests for lactic acid and cardiopulmonary exercise tests, and also using bicycle ergometer, for exercise capacity. As for data analyses, paired and unpaired t-test and x2-test were adopted using an SPSS program.

Result

The result revealed that the increase in VT, peak VO2, VEmax, HRmax and Wmax, at the maximal exercise, were significantly high in the experimental group. However, the anxiety and depression scores were not significantly high in the experimental group.

Conclusion

The pulmonary rehabilitation program was effective in increasing cardiopulmonary endurance in patients with COPD. Accordingly, we should seriously consider an individualized pulmonary rehabilitation program as a nursing intervention.

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Meta-analysis on the Effectiveness of Pulmonary Rehabilitation Program on Exercise Capacity/Tolerance and General Health Status
Hyun Soo Oh
Journal of Korean Academy of Nursing 2003;33(6):743-752.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.6.743
AbstractAbstract PDF
Purpose

This study was conducted to combine the effects of pulmonary rehabilitation program (PRP) on exercise capacity/tolerance and general health status of COPD patients based on the primary research results examined the effects of PRP.

Method

Seventeen studies were selected by the sampling criteria established to include the studies that reported enough statistics necessary to conduct meta-analysis.

Result

According to the study results, the most effective indicators for exercise capacity/tolerance were exercise time (such as cycling time or treadmill walking time) and ground walking distance within given time (6 minutes or 12 minutes), whereas effects on such indicators as VE and VO2 were not statistically significant. PRP induced significant effect on patients' general health status, frequently measured by physical, psycho-emotional, and holistic indicators, the enhancement on psycho-emotional dimension resulted from PRP was more prominent than those of the other dimensions. From the results, it was noted that the place where PRP was given and the contents of PRP exercised their influence on the outcome variables. Which body part was trained was also one of the important factors that influence on the patients' perception of dyspnea during exercise as well as on exercise capacity/tolerance.

Conclusion

PRP including exercise training significantly improved the exercise capacity and general health status of COPD patients.

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Effects of a Short-term Home-based Pulmonary Rehabilitation Program in Patients with Chronic Lung Disease
Eui Geum Oh, Sun Hee Kim, Hee Ok Park, So Yon Bang, Chun Hwa Lee, So Hee Kim
Journal of Korean Academy of Nursing 2003;33(5):570-579.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.5.570
AbstractAbstract PDF
Purpose

The purpose of this study is to exam the effects of a short-term pulmonary program on lung function, exercise tolerance, and quality of life in chronic lung patients.

Method

Randomized controlled pre-post test design was used. The outcome measures were forced expiratory volume in one second (FEV1, % predicted), 6 min walking distance (6MWD), Borg score after 6MWD, and Chronic Respiratory Disease Questionnaire (CRDQ). Experimental group performed the 4-week home-based pulmonary rehabilitation program composed of inspiratory muscle training, upper and lower extremity exercise, relaxation, and telephone visit. Patients in control group were only given education about self-management strategies. Thirty four patients with moderate-to-severe respiratory impairment were recruited, and 28 patients (19 in experiments, 15 in control) completed the study.

Result

Significant improvements in lung function, exercise tolerance, and health related quality of life were found only in the experiment group.

Conclusion

This study yielded evidence for the potential and beneficial effects of home-based pulmonary rehabilitation program in patients with moderate to severe chronic lung disease. The program could be adequately utilized for improvement of health related quality of life in chronic lung patients.

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The Effects of Self-Efficacy Promoting Cardiac Rehabilitation Program on Self-Efficacy, Health Behavior, and Quality of Life
Kyung Ja Song
Journal of Korean Academy of Nursing 2003;33(4):510-518.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.4.510
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Background

Ischemic heart disease results from athesclerotic changes of the coronary artery. These changes are aggravated by hypercholesterolemia, smoking, obesity, lack of exercise, coronary-prone personality, and stress. Because these risk factors affect not only the prevalence of the ischemic heart disease but also recurrence of the disease, cardiac rehabilitation programs were introduced to help patients with ischemic heart disease reduce risk factors. Diverse cardiac rehabilitation programs are needed to motivate participation in cardiac rehabilitation and to enhance patients' quality of life.

Objectives

To examine the effect of a self-efficacy promoting cardiac rehabiltation program on self-efficacy, health behavior and quality of life of patients with ischemic heart disease.

Methods

Data were collected from 45 hospitalized ischemic heart disease patients. Medical records were reviewed to obtain demographic and clinical characteristics. Data regarding self-efficacy, health behavior, and quality of life were obtained from interviews using structured questionnaires. The nonequivalent control group non-synchronized design was used to conduct this study. One session of conventional group education was given to patients in the control group while they were in the hospital. Patients in the experimental group participated in a newly developed cardiac rehabilitation program. It focused on strengthening selfefficacy with four self-efficacy sources - performance accomplishment, vicarious experiences, verbal persuasion and physical status using two individualized in-hospital education sessions and four weekly telephone counseling follow-up calls after discharge.

Results

Four weeks after discharge, the increment of total self-efficacy score was significantly higher in the experimental group than in the control group (p<.01). There was also a significant difference in the total quality of life scores increments between the two groups (p<.01). However, no significant changes were noted in the increments of total health behavior scores between the two groups.

Conclusion

A cardiac rehabilitation program focusing on promoting self-efficacy was effective in improving self-efficacy, and quality of life of patients with ischemic heart disease.

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The Effect of a Movie-Based Nursing Intervention Program on Rehabilitation Motivation and Depression in Stroke Patients
Hye Kyung Kwon, Sook Ja Lee
J Korean Acad Nurs 2017;47(3):345-356.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.345
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Abstract Purpose

The aim of this study was to develop and measure the effect of a movie-based-nursing intervention program designed to enhance motivation for rehabilitation and reduce depression levels in stroke patients.

Methods

The study used a quasi-experimental, nonequivalent control group and a pretest-posttest design. The 60 research subjects were assigned to the experimental (n=30) or control group (n=30). The movie-based nursing intervention program was provided for the experimental group during 60-minute sessions held once per week for 10 weeks. The program consisted of patient education to strengthen motivation for rehabilitation and reduce depression, watching movies to identify role models, and group discussion to facilitate therapeutic interaction.

Results

After 10 weeks of participation in the movie-based nursing intervention program, the experimental group's rehabilitation motivation score was significantly higher, F=1161.54 (within groups df=49, between groups df=1), p<.001, relative to that observed in the control group. In addition, the experimental group's depression score was significantly lower relative to that observed in the control group, F=258.97 (within groups df=49, between groups df=1), p<.001.

Conclusion

The movie-based nursing intervention program could be used for stroke patients experiencing psychological difficulties including reduced motivation for rehabilitation and increased depression during the rehabilitation process.

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Effectiveness of Self-efficacy Promoting Vestibular Rehabilitation Program for Patients with Vestibular Hypofunction
Hyun Jung Lee, Smi Choi-Kwon
J Korean Acad Nurs 2016;46(5):710-719.   Published online October 31, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.5.710
AbstractAbstract PDF
Purpose

In this study an examination was done of the effect of self-efficacy promoting vestibular rehabilitation (S-VR) on dizziness, exercise selfefficacy, adherence to vestibular rehabilitation (VR), subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness in patients with vestibular hypofunction.

Methods

This was a randomized controlled study. Data were collected 3 times at baseline, 4 and 8 weeks after beginning the intervention. Outcome measures were level of dizziness, exercise self-efficacy, and level of adherence to VR. Subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness were also obtained. Data were analyzed using Windows SPSS 21.0 program.

Results

After 4 weeks of S-VR, there was no difference between the groups for dizziness, subjective and objective vestibular functions. However, exercise self-efficacy and adherence to VR were higher in the experimental group than in the control group. After 8 weeks of S-VR, dizziness (p =.018) exercise self-efficacy (p <.001), adherence to VR (p <.001), total-dizziness handicap inventory (DHI) (p =.012), vision analysis ratio (p =.046) in the experimental group differ significantly from that of the control group. The number of patients with recurring dizziness were higher in the control group than in the experimental group (p <.001).

Conclusion

The results indicate that continuous 8 weeks of S-VR is effective in reducing dizziness, and improving exercise self-efficacy, subjective vestibular function and adherence to VR. Objective vestibular function and vestibular compensation were also improved in the experimental group at the end of 8 weeks of S-VR.

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Analyses of Studies on Cardiac Rehabilitation for Patients with Cardiovascular Disease in Korea
Yeoungsuk Song
J Korean Acad Nurs 2009;39(3):311-320.   Published online June 29, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.3.311
AbstractAbstract PDF
Purpose

This study was to analyze research reports published in Korea on cardiac rehabilitation for patients with cardiovascular disease.

Methods

Based on inclusion criteria, 19 research reports were included in this review. Published year of selected articles was between 1996 and 2008. Nineteen studies were analyzed by guidelines of the cardiac rehabilitation programs done by the American Heart Association (AHA) and Scottish Intercollegiate Guidelines Network (SIGN).

Results

The characteristics of patients were mostly of ischemic heart disease, 50-59 yr old, and male. Educational sessions were administered twice, and each lesson lasted less than 30 min. Exercise was done 3 times per week for 6 weeks. Most educational content were about risk factors, but there was no information, such as coping with feelings. Most exercise was performed as ROM, treadmill, and cycle ergometer. A large percentage of outcome indicators were health behavior, hemodynamic changes, and exercise capacity. There was more 'no effect' than 'positive effect' in trait anxiety and depression, whereas similar in physiologic domain.

Conclusion

Various types of cardiac rehabilitation in Korea were performed by researchers. Therefore, we need to develop the standard protocol, to add psychosocial intervention, and to study cost effectiveness of cardiac rehabilitation.

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The Effects of Psychosocial Rehabilitation Programs on the Levels of Self-Efficacy for Mentally Disabled Persons
Hyun Sook Park, Sung-Woo Bae, Yi Young Kim
J Korean Acad Nurs 2008;38(5):704-711.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.704
AbstractAbstract PDF
Purpose

This study investigated the effects of psychosocial rehabilitation programs provided by a psychosocial rehabilitation center on the levels of self-efficacy for mentally disabled persons. We followed the study subjects for 2 yr in order to examine whether the psychosocial rehabilitation programs had a positive impact on their levels of self-efficacy.

Methods

There were 18 subjects in the experimental group and they received all the psychosocial rehabilitation services available at the psychosocial rehabilitation center for 2 yr. In the comparison group, there were 17 participants who voluntarily refused to participate in the psychosocial rehabilitation programs.

Results

The results indicated that the psychosocial rehabilitation programs were effective in increasing the levels of the self-efficacy total score and specific self-efficacy score.

Conclusion

The overall study results indicated that psychosocial rehabilitation programs provided by a psychosocial rehabilitation center had a positive impact on increasing the levels of self-efficacy for mentally disabled persons.

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Effects of an Inpatient Pulmonary Rehabilitation Program on Dyspnea, Exercise Capacity, and Health Related Quality of Life for Patients with Chronic Lung Disease
Chang Kwan Lee
Journal of Korean Academy of Nursing 2007;37(3):343-352.   Published online April 30, 2007
DOI: https://doi.org/10.4040/jkan.2007.37.3.343
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the effects of an inpatient pulmonary rehabilitation program on dyspnea, exercise capacity, and health related quality of life in inpatients with chronic lung disease.

Method

This quasi experimental study was designed with a nonequivalent control group pre-post test time series. Twenty three patients were assigned to the experimental group and nineteen to the control group. The inpatient pulmonary rehabilitation program was composed of upper and lower extremity exercise, breathing retraining, inspiratory muscle training, education, relaxation and telephone contacts. This program consisted of 4 sessions with inpatients and 4 weeks at home after discharge. The control group was given a home based pulmonary rehabilitation program at the time of discharge. The outcomes were measured by the Borg score, 6MWD and the Chronic Respiratory Disease Questionnaire(CRQ).

Results

There was a statistically significant difference in dyspnea between the experimental group and control group, but not among time sequence, or interaction between groups and time sequence. Also significant improvements in exercise capacity and health related quality of life were found only in the experimental group.

Conclusion

An Inpatient pulmonary rehabilitation program may be a useful intervention to reduce dyspnea, and increase exercise capacity and health related quality of life for chronic lung disease patients.

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The Effects of a Recovery Education Program on Rehabilitation Motivation, Symptoms, and Function for Schizophrenic Patients
Yi Young Kim, Hyun Sook Park, Kyung Min Park
Journal of Korean Academy of Nursing 2006;36(3):542-550.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.542
AbstractAbstract PDF
Purpose

This study investigated the effects of a recovery education program on rehabilitation motivation, symptoms, and function for schizophrenic patients.

Method

The study employed a quasi-experimental design. Participants for the study were 27 patients with schizophrenia, 14 in the experimental group and the other 13 in the control group. Data were analyzed by using the SPSS/WIN 11.5 program with Fisher's exact test, t-test, and Repeated measures ANOVA.

Results

After a 7 week intervention, participants in the recovery education program group reported increased rehabilitation motivation and function scores, which was significantly different from those in the control group.

Conclusion

A recovery education program was effective improving rehabilitation motivation and function for schizophrenic patients. Therefore, this program is recommended as a rehabilitation strategy for schizophrenic patients.

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