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Research Papers
Psychometric Properties of the Fall Risk Perception Questionnaire-Short Version for Inpatients in Acute Care Hospitals
Choi, Jeeeun , Lee, Sujin , Park, Eunjin , Ku, Sangha , Kim, Sunhwa , Yu, Wonhye , Jeong, Eunmi , Park, Sukhee , Park, Yusun , Kim, Hye Young , Kim, Sung Reul
J Korean Acad Nurs 2024;54(2):151-161.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23127
AbstractAbstract PDF
Purpose
Patients’ perception of fall risk is a promising new indicator for fall prevention. Therefore, a fall risk perception questionnaire that can be used rapidly and repeatedly in acute care settings is required. This study aimed to develop a short version of the fall risk perception questionnaire (Short-FRPQ) for inpatients.
Methods
For the psychometric measurements, 246 inpatients were recruited from an acute care hospital. The construct (using confirmatory factor analysis and discriminant validity of each item), convergent, and known-group validities were tested to determine the validity of the Short-FRPQ. McDonald’s omega coefficient was used to examine the internal consistency of reliability.
Results
In the confirmatory factor analysis, the fit indices of the Short-FRPQ, comprising 14 items and three factors, appeared to be satisfactory. The Short-FRPQ had a significantly positive correlation with the original scale, the Korean Falls Efficacy Scale-International, and the Morse Fall Scale. The risk of falls group, assessed using the Morse Fall Scale, had a higher score on the Short-FRPQ. McDonald’s omega coefficient was .90.
Conclusion
The Short-FRPQ presents good reliability and validity. As patient participation is essential in fall interventions, evaluating the fall risk perception of inpatients quickly and repeatedly using scales of acceptable validity and reliability is necessary.
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Effects of a Health Partnership Program Using Mobile Health Application for Male Workers with Cardiovascular Risk Factors in Small and Medium Enterprises: A Randomized Controlled Trial
Kim, Eun Jin , Hwang, Seon Young
J Korean Acad Nurs 2024;54(1):44-58.   Published online February 29, 2024
DOI: https://doi.org/10.4040/jkan.23090
AbstractAbstract PDF
Purpose
This study aimed to apply a health partnership program using commercially available mobile health apps to improve cardiovascular risk factors in male employees and verify its effectiveness.
Methods
Using a randomized control group pretest-posttest design, male employees with cardiovascular risk factors from five small and medium-sized workplaces were randomly assigned to an experimental group (n = 32) and a control group (n = 31). The experimental group was encouraged to use three mobile health apps for 12 weeks to acquire the necessary cardiovascular disease-related information and practice strengthening training, walking, and diet management appropriate to their level. They also received feedback on their weekly activities and motivational text messages from health partners. Hypotheses were tested using the SPSS WIN 22.0.
Results
The experimental group showed a significant difference compared to the control group in terms of their perception of mobile health app (p < .05), self-efficacy for exercise and diet, self-management partnership, and cardiovascular disease prevention health behavior (p < .001). In particular, there were significant decreases in the body mass index, ratio, serum fasting blood sugar, total cholesterol, and triglyceride in the experimental group (p < .001); however, there was no significant difference in high-density lipoprotein-cholesterol.
Conclusion
Intervention using mobile apps based on partnership with health managers is effective in improving the objective cardiovascular risk index in male employees; therefore, such intervention should be continuously used as a useful lifestyle modification strategy in the workplace.
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Incidence and Risk Factors of Dyslipidemia after Menopause
Jeong, Ihn Sook , Yun, Hae Sun , Kim, Myo Sung , Hwang, Youn Sun
J Korean Acad Nurs 2022;52(2):214-227.   Published online April 30, 2022
DOI: https://doi.org/10.4040/jkan.21188
AbstractAbstract PDF
Purpose
This study was aimed at investigating the incidence and risk factors of dyslipidemia in menopausal women using a Korean community-based longitudinal study.
Methods
The subjects were 245 postmenopausal women without dyslipidemia who had participated in the Ansan-Ansung cohort study from 2001~2002 (baseline) to 2015~2016 (seventh follow-up visit). The dyslipidemia incidence was measured as incidence proportion (%) and incidence rate per 100 person-years. The predictors of developing dyslipidemia were analyzed with Cox’s proportional hazard model.
Results
The incidence of new dyslipidemia during the follow-up period was 78.4% (192 patients), and 11.9 per 100 person-years. Mean duration from menopause to developing dyslipidemia was 5.3 years in new dyslipidemia cases. The triglyceride/high density lipoprotein (TG/HDL-C) ratio at baseline (hazard ratio = 2.20; 95% confidence interval = 1.39~3.48) was independently associated with developing dyslipidemia.
Conclusion
Dyslipidemia occurs frequently in postmenopausal women, principally within five years after menopause. Therefore, steps must be taken to prevent dyslipidemia immediately after menopause, particularly in women with a high TG/HDL-C ratio at the start of menopause.
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Incidence and Predictors of Cataract among People with Type 2 Diabetes Mellitus: Using Secondary Data Analysis from the Ansan Cohort of the Korean Genome and Epidemiology Study
Jeong, Ihn Sook , Lee, Eun Joo , Kim, Myo Sung , Yu, Jung Ok , Yun, Hae Sun , Jeong, Jeong Hee , Hwang, Youn Sun 6
J Korean Acad Nurs 2022;52(1):24-35.   Published online February 28, 2022
DOI: https://doi.org/10.4040/jkan.21081
AbstractAbstract PDF
Purpose
This study investigated the incidence and risk factors of cataract in people with diabetes mellitus (DM) using data from Ansan cohort of the Korean Genome and Epidemiology Study (KoGES).
Methods
Data from a total of 329 patients with type 2 DM without cataract who participated in Ansan cohort of the KoGES from baseline survey (2001–2002) to fifth follow-up visit (2011–2012) were examined. The characteristics of the subjects were analyzed with frequency and percentage, and mean and standard deviation. Cataract incidence was measured as incidence proportion (%). For risk factors of cataract, hazard ratio (HR) and 95% confidence interval (CI) were obtained using the Cox proportional hazard model.
Results
The cataract incidence over a 10-year follow-up period was 19.1% (15.1 in males and 25.8 in females), and mean age at the incidence of cataract was 63.48 years (61.58 years in males and 65.31 years in females). Age (HR=1.09, 95% CI=1.05–1.13) and HbA1c (HR=1.21, 95% CI=1.07–1.37) or the duration of DM (HR=1.05, 95% CI=1.00–1.09) were found to be independently associated with cataract development.
Conclusion
Cataract development in people with DM is common, and its likelihood increases with age, HbA1c, and the duration of DM. Considering negative effect of cataract on their quality of life and economic burden, nurses should identify people with DM at a higher risk of cataract development, and plan individual eye examination programs to detect cataract development as early as possible.
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Development of a Diabetic Foot Ulceration Prediction Model and Nomogram
Lee, Eun Joo , Jeong, Ihn Sook , Woo, Seung Hun , Jung, Hyuk Jae , Han, Eun Jin , Kang, Chang Wan , Hyun, Sookyung
J Korean Acad Nurs 2021;51(3):280-293.   Published online June 30, 2021
DOI: https://doi.org/10.4040/jkan.20257
AbstractAbstract PDF
Purpose
This study aimed to identify the risk factors for diabetic foot ulceration (DFU) to develop and evaluate the performance of a DFU prediction model and nomogram among people with diabetes mellitus (DM).
Methods
This unmatched case-control study was conducted with 379 adult patients (118 patients with DM and 261 controls) from four general hospitals in South Korea. Data were collected through a structured questionnaire, foot examination, and review of patients’ electronic health records. Multiple logistic regression analysis was performed to build the DFU prediction model and nomogram. Further, their performance was analyzed using the Lemeshow–Hosmer test, concordance statistic (C-statistic), and sensitivity/specificity analyses in training and test samples.
Results
The prediction model was based on risk factors including previous foot ulcer or amputation, peripheral vascular disease, peripheral neuropathy, current smoking, and chronic kidney disease. The calibration of the DFU nomogram was appropriate (χ2 = 5.85, p = .321). The C-statistic of the DFU nomogram was .95 (95% confidence interval .93~.97) for both the training and test samples. For clinical usefulness, the sensitivity and specificity obtained were 88.5% and 85.7%, respectively at 110 points in the training sample. The performance of the nomogram was better in male patients or those having DM for more than 10 years.
Conclusion
The nomogram of the DFU prediction model shows good performance, and is thereby recommended for monitoring the risk of DFU and preventing the occurrence of DFU in people with DM.
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Original Articles
Effects of Spouse-Participated Health Coaching for Male Office Workers with Cardiocerebrovascular Risk Factors
So Hee Kang, Seon Young Hwang
J Korean Acad Nurs 2019;49(6):748-759.   Published online December 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.748
AbstractAbstract PDF
Purpose

This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers.

Methods

A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers' stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email.

Results

After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention.

Conclusion

To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.

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Path Analysis for Delirium on Patient Prognosis in Intensive Care Units
Sunhee Lee, Sun-Mi Lee
J Korean Acad Nurs 2019;49(6):724-735.   Published online December 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.724
AbstractAbstract PDF
Purpose

This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model.

Methods

This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24.

Results

In the final model, admission via emergency department (B=.06, p=.019), age over 65 years (B=.11, p=.001), unconsciousness (B=.18, p=.001), dependent activities (B=.12, p=.001), abnormal vital signs (B=.12, p=.001), pressure ulcer risk (B=.12, p=.001), enteral nutrition (B=.12, p=.001), and use of restraint (B=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (B=.06, p=.038), hospital length of stay (B=5.06, p=.010), and discharge to another facility (not home) (B=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium.

Conclusion

The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.

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Effects of an Integrated Physical Activity Program for Physically Inactive Workers - Based on the PRECEDE-PROCEED Model -
Hye-Jin Kim, Jina Choo
J Korean Acad Nurs 2018;48(6):692-707.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.6.692
AbstractAbstract PDF
Abstract Purpose

We aimed to examine the effects of an integrated physical activity (PA) program developed for physically inactive workers on the theoretical basis of the PRECEDE-PROCEED model.

Methods

Participants were 268 workers in three departments of L manufacturing unit in South Korea. The three departments were randomly allocated into integration (n=86) (INT), education (n=94) (ED), and control (n=88) (CT) groups. The INT group received self-regulation, support, and policy-environmental strategies of a 12-week integrated PA program, the ED group received self-regulation strategies only, and the CT group did not receive any strategies. After 12 weeks, process evaluation was conducted by using the measures of self-regulation (autonomous vs. controlled regulation), autonomy support, and resource availability; impact evaluation by using PA measures of sitting time, PA expenditure, and compliance; and outcome evaluation by using the measures of cardiometabolic/musculoskeletal health and presenteeism.

Results

Among process measures, autonomous regulation did not differ by group, but significantly decreased in the CT group (p=.006). Among impact measures, PA compliance significantly increased in the INT group compared to the CT group (p=.003). Among outcome measures, the changes in cardiometabolic/musculoskeletal health and presenteeism did not differ by group; however, systolic blood pressure (p=.012) and a presenteeism variable (p=.041) significantly decreased only in the INT group.

Conclusion

The integrated PA program may have a significant effect on increases in PA compliance and significant tendencies toward improvements in a part of cardiometabolic health and presenteeism for physically inactive workers. Therefore, occupational health nurses may modify and use it as a workplace PA program.

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Assessment of Gestational Age using New Ballard Examination in High-Risk Infants
Young Mee Ahn, Sang Mi Lee
Journal of Korean Academy of Nursing 2002;32(2):176-185.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.2.176
AbstractAbstract PDF

PURPOSE: Knowing the accurate GA is critical in nursing care of high-risk newborns. A descriptive study was performed to examine the reliability and clinical applicability of the new Ballard examination (NBE) in high-risk infants. METHOD: A NBE was performed to measure GA by assessing the neuromuscular and physical maturity in the course of physical examination of a convenient sample of 50 high-risk infants. RESULTS: 1) There was a highly correlation between both the GA by LMP (GA-LMP) and GA by NBE (GA-NBE) (r = .894, p = .000) 2) There was a greater positive relationship in neuromuscular maturity than physical maturity in the GA-NBE of the high-risk newborn (r = .657 versus r = .915, p<. 05). 3) The high-risk infants were thoes with congenital anomalies, prematurity, and RDS(Respiratory Distress Syndrome). Male infants showed a higher neuromuscular maturity, compared to female infants. 4) There was a positive correlation between neuromuscular, physical, total maturity, GA-LMP and GA-NBE in the birth weight, 1 minute Apgar score. CONCLUSION: The study supports the reliability an clinical relevance of NBE in assessment of the accurate GA in high-risk infants.

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Effects of Motivation-Enhancing Program on Health Behaviors, Cardiovascular Risk factors, and Functional status for Institutionalized Elderly Women
Rhayun Song, Kyung Ja June, You Ja Ro, Chun Gill Kim
Journal of Korean Academy of Nursing 2001;31(5):858-870.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.5.858
AbstractAbstract PDF

This study was to compare changes in health behaviors, motivational factors, cardiovascular risk factors, and functional status (SIP) after implementing the 6-month motivation-enhancing program to institutionalized elderly women.
METHODS
Sixty-four elderly women participated. Face to face interviews with blood sampling and anthropometric assessment were conducted at the pretest, 10 weeks and 6 months during the program.
RESULTS
1. The program participants showed significantly better health behaviors over 6 months. The mean motivational level was also significantly improved, especially for perceived benefits, perceived barriers, and emotional salience. 2. The mean of cardiovascular risk factors for the participants was 21.8 at the level of low to moderate risk. After completing the program, total risk score was significantly decreased to 18.7 at 10 weeks, and further to 17.7 at 6 months. A significant reduction was also found in HDL and LDL-cholesterol levels, blood pressure, obesity, inactivity, and stress. 3. The functional status (SIP) was 11% at the baseline and significantly changed in positive direction at 10 weeks (M=9.3) and at 6 month (M=6.3). The significant improvement was also found in physical and psychosocial dimensions and sleep/rest dimension.
CONCLUSION
The motivation enhancing program was effective to reduce cardiovascular risks and to improve the functional status of institutionalized elderly women by motivating them to perform better health behaviors.

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Prevalence and Risk Factors for Diabetes Mellitus and Impaired Fasting Glucose of Adults
Hee Seung Kim, You Ja Ro, Nam Cho Kim, Yang Sook Yoo, Jin Sun Young, Jeong Ah Oh
Journal of Korean Academy of Nursing 2000;30(6):1479-1487.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.6.1479
AbstractAbstract PDF

This study was conducted to draw out prevalence and the risk factors of diabetes mellitus and impaired fasting glucose for adults,(age 30-69). The subjects were 2096 adults, who had regular health examinations between January and December of 1999 at K Hospital in Seoul. The data was analyzed using chi-square test, unpaired t-test and logistic regression. Diabetes Mellitus and impaired fasting glucose were diagnosed by ADA (American Diabetes Association, 1997) criteria. The results were as follows: 1. Mens' prevalence of Diabetes Mellitus was 7.9% and womens' prevalence of Diabetes Mellitus was 3.8%. Mens' prevalence of impaired fasting glucose was 10.4% and womens' prevalence of impaired fasting glucose was 6.5%. Prevalences of Diabetes Mellitus and impaired fasting glucose increased with age. 2. Prevalence of Diabetes Mellitus and impaired fasting glucose of obese subjects (relative body weight>=162) was higher than that of overweight subjects (110<=relative body weight<=119) in men and women. 3. The diagnoses of Diabetes Mellitus and impaired fasting glucose increased with systolic blood pressure and triglyceride. 4. Significant factors associated with diabetes in the logistic regression best gut model were age, relative body weight, systolic blood pressure, triglyceride in men, and systolic blood pressure in women. In conclusion, as age, weight, systolic blood pressure and triglyceride get higher, Diabetes Mellitus and impaired fasting glucose prevalence also increases, porportionally.

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A Study on the Circadian Blood Pressure Rhythm of Diabetic Patients
Hwa Soon Kim, Wha Sook Suh
Journal of Korean Academy of Nursing 2000;30(3):741-749.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.3.741
AbstractAbstract PDF

This study was performed to investigate the relationship between reversed circadian blood pressure and risk factors of peripheral vascular disease in non-insulin-dependent diabetes mellitus (NIDDM) subjects. The subjects in this study were 18 NIDDM patients who were hospitalized in a medical unit of an university medical center located in Incheon, Korea, between November, 1998 and March, 1999. Blood pressure was measured with a mercury sphygmomanometer by 2 trained examiners every 2 hours during 24 hours. NIDDM subjects were divided into a dipper group and non-dipper group. Dippers are defined as those who show a mean nighttime blood pressure(BP) drop of more than 10% compared with daytime BP. Non-dippers are defined as those who show a mean nighttime BP drop of less than 10%, or an elevation in BP compared with daytime BP. Daytime BP included values obtained between 6 a.m. and 10 p.m. Night time BP included values obtained between 10 p.m. and 6 a.m. Data was analyzed by SPSS/PC package. Chi-square( 2) test was used for the comparison of sex between The dipper group and non-dipper group. Mann-Whitney test was used for comparisons of values of the risk factors of peripheral vascular disease and the frequency of complications of diabetes between the dipper group and non-dipper group. The results are as follows. There were no significant differences in daytime systolic, diastolic, and mean blood pressures between the dipper group and non-dipper group. However, night time systolic, diastolic, and mean blood pressures in the non-dipper group were significantly nigher than those in the dipper group (p=.021). There were no differences in sex, age, body, weight, duration of diabetes, serum lipid levels, BUN and HbA1c between the two groups. On the contrary, 87.5% of non-dipper group subjects showed having hypertension, 30% of dipper group subjects showed having hypertension and this difference was statistically significant (p=.018). All of the non-dipper group subjects (N=8) showed having at least one diabetic complication. However, 40% of the dipper group subjects (N=10) showed having no diabetic complication at all and this difference was also statistically significant (p=.049). There were no significant differences in frequency of nephropathy, neuropathy and retinopathy between the dipper group and non-dipper group.

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Lifestyles Effects on Stroke Risk in Different Regions in Korea
Smi Choi-Kwon, Eun Kyung Kim, Mi Yang Jeon
Journal of Korean Academy of Nursing 1998;28(3):729-738.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.3.729
AbstractAbstract PDF

BACKGROUND AND PURPOSE: Stroke is a leading cause of death in Korea. Early measurement to prevent stroke are extremely important since it has no cure. Korean might have different risk factors since their dietary habit and socio-economical status differ from most western countries. However, the risk factors for stroke in Korea have not yet been identified. Moreover, the lifestyle of health Korean adults has not been investigated. In this study we investigate the life of health adults living in Seoul and rural areas and compare the life style of the two. METHODS: One hundred seventy one subjects were studies. Among the subjects studied, 128 were from Seoul, the other 43 were from the country area. The age of the subjects was limited to over 40 years. Blood pressure, fast blood sugar, and cholesterol were measured. The subjects' height, weight, body mass index total body fat, skinfolds thickness of triceps, subscapular and abdomen were measured to determine obesity. Using a structured interview, we assessed : sodium intake, physical activity and exercise, consumption of vegetables, fat, fish and fruits. The results of the two groups were compared. RESULTS: There were no statistical differences in age and education between the two groups of subjects. The mean age of the subjects were 66 years old. The subjects residing in rural areas had a higher intake of sodium(p<0.05), lower physical active(P<0.05), and higher BMI and body fat(p<0.05) as compared to the subjects in Seoul. Subjects with hypertension were between 24% and 33% and the prevalence of hypertension was the highest was the highest when compared to the prevalence of DM, or hypercholesterolemia. However, the prevalence of hypertension, DM, hypercholesterolemia, were not significantly different in these areas. CONCLUSION: our results show that subjects living in rural areas eat more salty food, exercise less and tend to be obese. The finding of this study lead to speculation that Korean living in rural areas have less information about the effects diet of diet on health than city dwellers do. General health and nutrition education programs aimed at the prevention of stoke and other such conditions for rural area Korean may close the risk factor gap between rural and urban dwellers.

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Nursing Students' Perceptions on Diet and as Environmental Factors Related to Cancer Risk Factors
Hae Kyung Lee, Seong Joo Cheon, Mi Hye Hwang, Soon Rim Suh
Journal of Korean Academy of Nursing 1998;28(1):193-200.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.1.193
AbstractAbstract PDF

The purpose of this study was to identify how students majoring in nursing perceive cause of cancers and the effects of diet for preventing cancers. Data for the study were collected by 651 nursing students, who were registered in the second and third year in three technical colleges and third and fourth year in two universities. The research instruments included items on general characteristics of subjects, items about the degree of perception of the frequency of cancer onset and items on the perception of mortality, risk factors, preventive diets, knowledge, and high risk factor for cancer in specific body areas. The findings of this study are as follows : 1. Almost all subjects(92.8%) reported that the frequency of cancer onset increases and that it is 93.9% for people over 40. Degree of perception about cancer mortality was low at 33.0%. 2. As far as the perception of risk factors for cancer onset was concerned, smoking, stress, heredity, family history, and alcohol were rated high, over 80.0%. Risk factor in clouding, virus, hormones, pesticides were rated as low. 3. As to the perception of risk factor for body area as associated with diet salted and scorched food were rated at 44.5% for stomach cancer, alcohol, 50.4% for liver cancer, smoking, 72.8% for lung cancer, pregnancy times, 25.3%, and marriage age, 23.0% for uterine cancer, and no delivery experience, 40% for breast cancer. 4. The knowledge score for cancer was between 12 and 36, with a mean score of 26.75(SD=4.13). There was a statistically significant difference between experience in caring for cancer patients during clinical practice and knowledge score(t=3.09, p=.002).

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Correlations between Weight, Body Mass Index(BMI) and Risk Factors of Coronary Artery Disease in Men and Women in their Forties and Fifties
Hee Seung Kim, Hye Sun Jeong, Kyung Sil Han
Journal of Korean Academy of Nursing 1998;28(1):184-192.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.1.184
AbstractAbstract PDF

This study was done to examine the correlations between weight, BMI and risk factors of coronary heart disease in men and women in their forties and fifties. The subjects were 412 adults, who had regular health examinations between January and December of 1996 at S-Hospital in Seoul. The data were analyzed using ANOVA, Scheffe test, and Pearson correlation coefficient. The results are as follows : 1. The men between 50 and 59 years of age had higher levels for BMI, weight, systolic blood pressure, diastolic blood pressure, total cholesterol, LDL-cholesterol, triglyceride, fasting blood sugar, plasminogen activator-1, and hemoglobin A1C than the group of women in their forties. Yet, HDL-cholesterol was lower than in the former group. 2. In the group of men in their forties, weight was significantly correlated to diastolic blood pressure(r=.22), LDL-cholesterol(r=.20), plasminogen activator inhibitor-1(r=.35) HDL-cholesterol(r=-.19). Their BMI was significantly corrected to systolic blood pressure(r=.27), diastolic blood pressure(r=.33), total cholesterol(r=.23), LDL-cholesterol(r=.26), plasminogen activator-1(r=.36) and HDL-cholesterol(r=-.25). 3. As for the group of women in their forties weight was significantly correlated to systolic blood pressure(r=.20), diastolic blood pressure(r=.22), triglyceride(r=.32), plasminogen activator inhibitor-1(r=.30) and HDL-cholesterol(r=-.37). Their BMI was significantly correlated to diastolic blood pressure(r=.25) triglyceride(r=.47), plasminogen activator-1(r=.35), fibrinogen(r=.27) and HDL-cholesterol(r=-.47). 4. In the group of men in their fifties, weight was significantly correlated to total cholesterol(r=.32), LDL-cholesterol(r=.29), plasminogen activator inhibitor-1(r=.26). Their BMI was significantly correlated to systolic blood pressure(r=.24), diastolic blood pressure(r=.22), total cholesterol(r=.34), LDL-cholesterol(r=.32), and plasminogen activator-1(r=.25). 5. In the group of women in their fifties, weight was significantly correlated to diastolic blood pressure(r=.33), total cholesterol(r=.21), LDL-cholesterol(r=.20), plasminogen activator inhibitor-1(r=.43) and HDL-cholesterol(r=-.21). Their BMI was significantly corrected to systolic blood pressure(r=.25), diastolic blood pressure(r=.40), total cholesterol(r=.24), LDL-cholesterol(r=.24), triglyceride(r=.22), and HDL-cholesterol(r=-.30). The above findings indicate that the BMI was more predictive than weight as a risk factor for coronary artery disease for men and women in their forties and fifties.

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Comparison of Cardiovascular Risk Profile Clusters Among Industrial Workers
Seon Young Hwang, Ji Hyun Lee
Journal of Korean Academy of Nursing 2005;35(8):1500-1507.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.8.1500
AbstractAbstract PDF
Purpose

The purpose of this study was to identify subgroups of the physical and behavioral risk profiles for cardiovascular disease among industrial workers, and to examine predicting factors for the subgroups.

Sample and Methods

Health records of 2,616 male and female workers aged 19-56 years who were employed in an airplane manufacturing industry were analyzed. Data were analyzed using the Latent class cluster analysis.

Results

Four different clusters (two high-risk groups, one low-risk group, and one normal group) were found and these clusters were significantly different by age, gender, and work type (p<.05). The two high-risk groups had higher chances of drinking alcohol, elevated BMI, FBS, total cholesterol, having hypertension, and were significantly older, and had relatively high chances of being day workers rather than other groups. The low-risk group had higher chances of drinking alcohol, higher BMI and total cholesterols compared to normal group, and highest portions of current smokers and shift workers in the four clusters and their mean BP was within prehypertension criteria.

Conclusion

Industrial nurses should guide the lifestyle behaviors and risk factors of the high risk groups for CVD and need to intervene early for behavioral change for the low-risk group who are young and shift workers. Age, and work environment should be considered in planning for targeted preventive interventions for industrial workers.

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Risk Factors for Falls among the Community-Dwelling Elderly in Korea
Kyeong Yae Sohng, Jung Soon Moon, Hae Hiang Song, Kwang Soo Lee, Young Sook Kim
Journal of Korean Academy of Nursing 2004;34(8):1483-1490.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1483
AbstractAbstract PDF

Community-based centres were surveyed to determine the frequency of and risk factors for falls among elderly Koreans. We examined fall-related risk factors, including physiological and physical health, psychosocial functions, self-reported physical capacity and activity, vision, and the use of medication, among 351 elderly people aged 65 years or older, with ambulatory. Forty-two per cent of elderly Korean subjects reported at least one episode of falling in the previous 12 months, 38% of whom had consequences that required either the attention of a physician or hospitalization.

Factors significantly associated with an increased risk of falling were a restricted activity during the previous five years (adjusted OR 1.3), use of alternative therapy (adjusted OR 2.7), low knee flexor and extensor-muscle strength (adjusted OR 1.21 and 1.20), and poor balance with closed eyes (adjusted OR 8.32).

We conclude that falls among older persons living in the community are common in Korea and that indicator of bad health and frailty or variables directly related to neuromuscular impairment are significant predictors of the risk of falling.

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Risk Factors for Sexual Behaviors in Girl's High School Students
Jung Nam Sohn
Journal of Korean Academy of Nursing 2004;34(3):430-439.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.3.430
AbstractAbstract PDF
Purpose

The purpose of this study was to examine risk factors for sexual behaviors in Korean female high school students.

Method

Data was collected by a written questionnaire from June 22 to July 18, 2002 from 522 girls, who were stratified samples from a target population of 63,375 11th grade students from 200 regular high schools and 70 vocational high schools in Seoul, Korea. We conducted multiple regression analysis using the SAS pc+ program.

Result

Risk factors for intimate behaviors were association with boy friends, differential association, family attachment, and family abuse experience. These variables cause 68% of intimate behaviors. Risk factors for sexual experiences were differential association, association with boy friend, and family attachment. These variables cause 14% of sexual experiences.

Conclusion

Efforts to reduce sexual behaviors in girls should include the possible role of peers and develop peer leader programs.

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Maternal Transition in Mothers with High Risk Newborns
Hyun Jeong Shin
Journal of Korean Academy of Nursing 2004;34(2):243-251.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.2.243
AbstractAbstract PDF
Purpose

The purpose of this study was a comprehensive understanding about maternal transition in mothers with high risk newborns according to the degree of situational meaning.

Method

A methodological triangulation that combines qualitative and quantitative methods was used. The situational meaning of a high risk newborn mother was identified using a Family Meaning Attribution Scale. According to the degree of situational meaning, in-depth interviews were conducted at 3 time periods postpartum : between 3-10 days after childbirth, around the time of the newborn's discharge, and between 10-12 weeks after childbirth. Quantitative data was analyzed using descriptive statistics and t-test. Qualitative data was analyzed using Tutty, Rothery, & Grinnell's methodology.

Result

The average score of the situational meaning in high the risk newborn mother was 53.57(possible score is between 0-96) and the average score of each item was 1.67. A Maternal transition process in the mother that has a positive situational meaning was conceptualized in three distinctive phases : confusion, accepting, and shaping phases. The Maternal transition process in the mother that has a negative situational meaning was also conceptualized in three distinctive phases : avoiding, conflicting, and accepting phases.

Conclusion

It is necessary that the nurses provide high risk newborn mothers with individualized care considering both the situational meaning that is attributed to them and the maternal transition phase that they are faced with.

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Situational Meaning and Maternal Self-esteem in Mothers with High Risk Newborn
Hyun Jeong Shin
Journal of Korean Academy of Nursing 2004;34(1):93-101.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.1.93
AbstractAbstract PDF
Purpose

This study was designed to explore the relationship of situational meaning with maternal self-esteem in mothers with high risk newborn.

Method

The subjects of this study were 82 mothers with high risk newborn. Data were collected using a translated Family Meaning Attribution Scale and Maternal Self-Report Inventory. Data were analyzed using descriptive statistics, t-test, Pearson Correlation Coefficients and Stepwise Multiple Regression.

Result

The average score of the situational meaning in high risk newborn mothers was 64.01(possible score is between 0-96) and the average score of each item was 1.98. The average score of the maternal self-esteem in high risk newborn mothers was 81.96(possible score is between 26-104) and the average score of each item was 3.15. No significant differences were found in situational meaning according to general characteristics except whether it was a planned pregnancy or not. No significant differences were found in maternal self-esteem according to general characteristics except disease or admission experience during pregnancy. There was significant positive correlation between situational meaning and maternal self-esteem.

Conclusion

It is necessary for nurses to provide high risk newborn mothers with care for improving situational meaning that is attributed to the mothers. It can be helpful to improve maternal self-esteem and in the end it will facilitate the maternal transition in mothers with high risk newborn.

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Evaluation of a Community-Based Program for Breast Self-Examination Offered by the Community Health Nurse Practitioners in Korea
Chung Yul Lee, Hee Soon Kim, Il Sun Ko, Ok Kyung Ham
Journal of Korean Academy of Nursing 2003;33(8):1119-1126.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.8.1119
AbstractAbstract PDF
Background

Breast cancer is the most common form of cancer among Korean women. Only 14% of urban women and 10% of rural women in Korea, however, participated in breast cancer screening behavior in 1998 (Korean Ministry of Health & Welfare, 1999).

Purpose

The aim of this study was to evaluate the effect of community-based breast self-examination (BSE) education programs in Korea.

Methods

First, breast cancer risk appraisals were done with 1,977 rural women. Of the 1,977 women, nearly 30% (n= 494) had a higher or equal to borderline risk of developing breast cancer. This quasi-experimental study was conducted to target these women with a high or equal to borderline risk of breast cancer. The risk appraisal feedback and breast self-examination education were used as an intervention for breast cancer prevention and early detection.

Results

After a 3-month follow-up, 30.5% of the women in the intervention group performed regular BSE compared to 10.2% of women in the control group. The mean knowledge score related to breast cancer and BSE was significantly higher for the women in the intervention group than that in the control group.

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Screening for High Risk Population of Dementia and Development of the Preventive Program Using Web
Jung Soon Kim, Ihn Sook Jeong, Yoon Jin Kim, Sun Kyung Hwang, Byung Chul Choi
Journal of Korean Academy of Nursing 2003;33(2):236-245.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.2.236
AbstractAbstract PDF
Purpose

This study was to develop a screening model for identifying a high risk group of dementia and to develop and evaluate the web-based prevention program.

Method

It was conducted in 5 phases. 1) Data were collected from dementia patients and non-dementia patients in a community. 2) A screening model of the high risk population was constructed. 3) The validity test was performed and the model was confirmed. 4) Four weeks-prevention program was developed. 5) The program was administered, and evaluated the effects.

Result

The model consisted of age, illiteracy, history of stroke and hypercholesterolemia. The program was designed with 12 sessions, group health education using web-based individual instruction program, and 12 sessions of low-intensity physical exercise program. After the completion, their self-efficacy, and health behaviors in experimental group were significantly improved over those in the control group. The perceived barrier in the treatment group is significantly decreased.

Conclusion

The screening model developed is very simple and can be utilized in diverse community settings. And the web based prevention program will encourage individual learning and timely feedback, therefore it can facilitate their active participation and promote health management behaviors at home.

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A Comparative Study on the Predictive Validity among Pressure Ulcer Risk Assessment Scales
Young Hee Lee, Ihn Sook Jeong, Seong Sook Jeon
Journal of Korean Academy of Nursing 2003;33(2):162-169.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.2.162
AbstractAbstract PDF
Purpose

This study was to compare the predictive validity of Norton Scale(1962), Cubbin & Jackson Scale(1991), and Song & Choi Scale(1991).

Method

Data were collected three times per week from 48-72hours after admission based on the four pressure sore risk assessment scales and a skin assessment tool for pressure sore on 112 intensive care unit(ICU) patients in a educational hospital Ulsan during Dec, 11, 2000 to Feb, 10, 2001. Four indices of validity and area under the curve(AUC) of receiver operating characteristic(ROC) were calculated.

Result

Based on the cut off point presented by the developer, sensitivity, specificity, positive predictive value, negative predictive value were as follows : Norton Scale : 97%, 18%, 35%, 93% respectively; Cubbin & Jackson Scale : 89%, 61%, 51%, 92%, respectively; and Song & Choi Scale : 100%, 18%, 36%, 100% respectively. Area under the curves(AUC) of receiver operating characteristic(ROC) were Norton Scale .737, Cubbin & Jackson Scale .826, Song & Choi Scale .683.

Conclusion

The Cubbin & Jackson Scale was found to be the most valid pressure sore risk assessment tool. Further studies on patients with chronic conditions may be helpful to validate this finding.

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Analysis of Direct Nursing Activity and Patient Outcomes Related to Graded Fee of Nursing Management for Inpatient
Seong Hi Park
Journal of Korean Academy of Nursing 2003;33(1):122-129.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.1.122
AbstractAbstract
Purpose

The purpose of this study is to examine the difference of direct nursing activity and patient outcomes as mortality rate, complication rate, readmission rate and length of stay related to graded fee of nursing management for inpatient.

Method

The subjects of this study were 44 general hospitals with more than 500 beds. Data totaled to 86,044 claims provided to inpatients in Jan. 2001 requested by an electronic data interchange from a Health Insurance Review Agency. The data was analyzed by SPSS win(ver.10.0) and statistical methods used were frequency, one-way ANOVA, χ2-Test and regression.

Result

Synthetic judgment through performance index and 95% confidence interval, direct nursing activity showed to provided adequate quality of nursing care on 2nd, 3rd, 4th and 6th nursing degree. Also, patient outcomes showed difference by graded fee of nursing management for inpatient. Mortality rate of 2nd was the lowest with P.I. 67.9, 3rd, 5th, 6th, 4th in order. In case of complication rate, 2nd, 3rd and 4th were lower than other nursing degree. Readmission rate of 4th and 5th was the lowest. Length of stay of 2nd was the shortest with P.I. 88.3, 3rd, 4th, 5th, 4th, 6th in order.

Conclusion

The findings from this study showed that, the higher nurse-to-patient ratio, the greater amount of direct nursing care activity for the patient. Also, the more direct nursing activities influenced a lower mortality rate, complication rate and readmission rate, shorter length of stay.

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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.

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Factors Predicting the Interface Pressure Related to Pressure Injury in Intensive Care Unit Patients
Ji Seon Shine, Soo Jin Kim, Ji Hyun Lee, Mi Yu
J Korean Acad Nurs 2017;47(6):794-805.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.6.794
AbstractAbstract PDF
Abstract Purpose

Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure.

Methods

A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression.

Results

The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (±14.90), 41.15 (±16.04), 53.44 (±24.67), and 54.33 (±22.80) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ≥70 years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ≥36.5oC (OR 3.12, 95% CI: 1.17~8.17); age ≥70 years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ≥36.5oC (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area.

Conclusion

Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.

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Characteristics and Risk Factors for Falls in Tertiary Hospital Inpatients
Eun-Ju Choi, Young-Shin Lee, Eun-Jung Yang, Ji-Hui Kim, Yeon-Hee Kim, Hyeoun-Ae Park
J Korean Acad Nurs 2017;47(3):420-430.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.420
AbstractAbstract PDF
Abstract Purpose

The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls.

Methods

Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis.

Results

Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls.

Conclusion

The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.

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Ecological Correlates of Cardiovascular Disease Risk in Korean Blue-collar Workers: A Multi-level Study
Won Ju Hwang, Yunhee Park
J Korean Acad Nurs 2015;45(6):857-867.   Published online December 15, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.6.857
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to investigate individual and organizational level of cardiovascular disease (CVD) risk factors associated with CVD risk in Korean blue-collar workers working in small sized companies.

Methods

Self-report questionnaires and blood sampling for lipid and glucose were collected from 492 workers in 31 small sized companies in Korea. Multilevel modeling was conducted to estimate effects of related factors at the individual and organizational level.

Results

Multilevel regression analysis showed that workers in the workplace having a cafeteria had 1.81 times higher CVD risk after adjusting for factors at the individual level (p=.022). The explanatory power of variables related to organizational level variances in CVD risk was 17.1%.

Conclusion

The results of this study indicate that differences in the CVD risk were related to organizational factors. It is necessary to consider not only individual factors but also organizational factors when planning a CVD risk reduction program. The factors caused by having cafeteria in the workplace can be reduced by improvement in the CVD-related risk environment, therefore an organizational-level intervention approach should be available to reduce CVD risk of workers in small sized companies in Korea.

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Trend Analysis in the Prevalence of Type 2 Diabetes According to Risk Factors among Korean Adults: Based on the 2001~2009 Korean National Health and Nutrition Examination Survey Data
Young-Ju Kim, Myoung-Nam Lim, Dong-Suk Lee
J Korean Acad Nurs 2014;44(6):743-750.   Published online December 31, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.6.743
AbstractAbstract PDF
Purpose

The objective of this study was to provide a trend analysis of the prevalence of diabetes relative to the socioeconomic, lifestyle, and physiologic risk factors among Korean adults aged over 30 years for a 10-year period using data from the Korean National Health and Nutrition Examination Survey.

Methods

Prevalence difference and the slope index of inequality were calculated for each risk factors using binomial regression by considering the repeated cross-sectional features of the data. The prevalence ratio and the relative index of inequality were calculated using log-binomial regression. Linear trend tests were performed using SAS 9.2.

Results

Crude prevalence of diabetes increased over the 10-year period, and was higher for men than for women. It was very high for adults 60 years or over, consistently increasing over time. The prevalence among unemployed men, women with higher level of stress, women with hypertension, and adults with serum triglyceride levels over 135 mg/dL increased over the 10-year period in comparison with the respective control group.

Conclusion

Considering the rapid economic development and associated lifestyle changes in Korea, action should be taken to control the prevalence of diabetes by both preventing and consistently monitoring these identified risk factors using a public-health approach.

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A Path Analysis on Factors Influencing Second Primary Cancer Screening Practices in Stomach, Colon, and Breast Cancer Survivors
Young Hee Yang
J Korean Acad Nurs 2014;44(2):139-148.   Published online April 30, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.2.139
AbstractAbstract PDF
Purpose

This study was conducted to identify the factors influencing second primary cancer (SPC) screening practice by examining the relationships of physical symptoms, knowledge and attitudes regarding SPC screening, perceived risk, primary cancer type, and demographic factors of cancer survivors.

Methods

Participants were 308 survivors of stomach, colon, or breast cancer recruited from 2 university hospitals in Korea. Data were collected using a questionnaire and analyzed using IBM SPSS 21.0 and AMOS 18.0.

Results

The proportion of participants taking all cancer screenings according to national guidelines was 40%. They had moderate knowledge and a relatively positive attitude regarding SPC screening and high cancer risk perception. The participants had taken fewer SPC screenings after than before cancer diagnosis. The factors influencing cancer risk perception were age, physical symptoms, knowledge regarding SPC and primary cancer type (stomach). The factors influencing SPC screening practice were age, gender, economic status, knowledge regarding SPC screening, and primary cancer types (colon).

Conclusion

It is important for clinical professionals to recognize that survivors of cancer are susceptible to another cancer. Education on SPC screening for these survivors should focus on communicating with and encouraging them to have regular cancer screenings.

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