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Research Papers
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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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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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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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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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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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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Risk Factors for Pediatric Inpatient Falls
Myung Sook Cho, Mi Ra Song, Sun Kyung Cha
J Korean Acad Nurs 2013;43(5):595-604.   Published online October 15, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.5.595
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify risk factors for pediatric inpatients falls.

Methods

The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers.

Results

In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls.

Conclusion

These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.

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Effects of Tai Chi on Fall Risk Factors: A Meta-Analysis
Moonkyoung Park, Rhayun Song
J Korean Acad Nurs 2013;43(3):341-351.   Published online June 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.3.341
AbstractAbstract PDF
Purpose

This study was done to analyze the effects of Tai Chi on fall-related risk factors through meta-analysis of randomized clinical trials published in English and Korean between 2000 and 2010.

Methods

Using health related database and hand search of references and Google, 28 randomized studies were collected from doctoral dissertation and published peer reviewed articles. The Comprehensive Meta-analysis version 2.0 was used for the analysis.

Results

The effect sizes for Tai Chi for 3 months were significant with ES=0.54 for static balance, ES=0.24 for dynamic balance, ES=0.69 for balance measured by scale, and ES=0.40 for flexibility, ES=0.48 for muscle strength, ES=0.71 for ADL, and ES=0.37 for fear of falling. Also, the effect sizes of Tai Chi for 6 months were significant for most fall-related variables. The 6 month data for flexibility was not analyzed since only one study was published.

Conclusion

The analysis of studies of randomized clinical trials indicate that Tai Chi is effective in improving balance, flexibility, muscle strength, activities of daily living, and fear of falling when applied for 3 or 6 months. The findings provide the objective evidence to apply Tai Chi as a fall preventive intervention.

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Risk Factors Influencing Probability and Severity of Elder Abuse in Community-dwelling Older Adults: Applying Zero-inflated Negative Binomial Modeling of Abuse Count Data
Mi Heui Jang, Chang Gi Park
J Korean Acad Nurs 2012;42(6):819-832.   Published online December 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.6.819
AbstractAbstract PDF
Purpose

This study was conducted to identify risk factors that influence the probability and severity of elder abuse in community-dwelling older adults.

Methods

This study was a cross-sectional descriptive study. Self-report questionnaires were used to collect data from community-dwelling Koreans, 65 and older (N=416). Logistic regression, negative binomial regression and zero-inflated negative binomial regression model for abuse count data were utilized to determine risk factors for elder abuse.

Results

The rate of older adults who experienced any one category of abuse was 32.5%. By zero-inflated negative binomial regression analysis, the experience of verbal-psychological abuse was associated with marital status and family support, while the experience of physical abuse was associated with self-esteem, perceived economic stress and family support. Family support was found to be a salient risk factor of probability of abuse in both verbal-psychological and physical abuse. Self-esteem was found to be a salient risk factor of probability and severity of abuse in physical abuse alone.

Conclusion

The findings suggest that tailored prevention and intervention considering both types of elder abuse and target populations might be beneficial for preventative efficiency of elder abuse.

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Risk Factors and Features of Critically Ill Patients with Deep Vein Thrombosis in Lower Extremities
Hwasoon Kim, Ok Min Cho, Hyo Im Cho, Ju Yeun Kim
J Korean Acad Nurs 2012;42(3):396-404.   Published online June 12, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.3.396
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify the features, risk scores and risk factors for deep vein thrombosis in critically ill patients who developed deep vein thrombosis in their lower extremities.

Methods

The participants in this prospective descriptive study were 175 adult patients who did not receive any prophylactic medication or mechanical therapy during their admission in the intensive care unit.

Results

The mean age was 62.24 (± 17.28) years. Men made up 54.9% of the participating patients. There were significant differences in age, body mass index, and leg swelling between patients who developed deep vein thrombosis and those who did not have deep vein thrombosis. The mean risk score was 6.71(± 2.94) and they had on average 4.01(± 1.35) risk factors. In the multiple logistic regression, body mass index (odds ratio= 1.14) and leg swelling (odds ratio= 6.05) were significant predictors of deep vein thrombosis.

Conclusion

Most critically ill patients are in the potentially high risk group for deep vein thrombosis. However, patients who are elderly, obese or have leg edema should be closely assessed and more than one type of active prophylactic intervention should be provided.

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Depression and Risk Factors in Patients with Crohn's Disease
Ok-Hee Cho, Yang-Sook Yoo, Suk-Kyun Yang
J Korean Acad Nurs 2012;42(2):207-216.   Published online April 30, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.2.207
AbstractAbstract PDF
Purpose

This study was conducted to determine the risk factors among patients with depression with Crohn's disease.

Methods

Data were collected by questionnaire from 276 patients who were diagnosed with Crohn's disease at a tertiary hospital located in Seoul. Measurements included patients' demographic characteristics, clinical characteristics, depression level, and health-related quality of life. Data were analyzed using t-test, χ2-test, Wilcoxon rank sum test, and logistic regression analyses.

Results

The incidence rate of depression (BDI-II≥14scores) was 31.9% (n=88). Univariate analysis revealed that being a woman, school graduation status, economic status (low), BMI(<18.5Kg/m2), disease duration (≥3 years), CDAI (≥150 scores), frequency of hospital admission (≥2), extra-intestinal manifestation (arthralgia, stomatitis), administration of 5-aminosalicylic acid, and disease related quality of life (SIBDQ<50 scores) were associated with depression. Multivariate analysis revealed that economic status (low), school graduation status, and quality of life (SIBDQ<50 scores) were more likely to report high level of depression.

Conclusion

Future research should consider managing depression as an essential component of comprehensive care for patients with Crohn's disease. In addition, further research is needed to develop strategies to better improve quality of life among patients with Crohn's disease who are depressed.

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Chronic Obstructive Pulmonary Disease in Korea: Prevalence, Risk Factors, and Quality of Life
Young-Mi Jung, Heeyoung Lee
J Korean Acad Nurs 2011;41(2):149-156.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.149
AbstractAbstract PDF
Purpose

This study seeks to examine prevalence, risk factors, and quality of life of Korean adults with Chronic Obstructive Pulmonary Disease (COPD).

Methods

From the database of the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV-1, 2008), the researchers selected 1,458 adults over the age of 45. The original study was a population-based epidemiological survey of health and nutrition with a stratified multistage clustered probability design. Prevalence of COPD was computed on the basis of the sampling weight. Data were analyzed using descriptive statistics, χ2 test, t-test and multiple logistic regression with the SPSS WIN 18.0 and SAS Ver. 9.1 program.

Results

The prevalence of COPD was 18.0% among people older than 45 yr. The prevalence of current smokers was 19.7% in this population and 26.3% in individuals with COPD. Age, gender, education, and smoking levels were found to be risk factors for COPD. Significant difference in quality of life was founded between adults with COPD and the healthy controls.

Conclusion

The results of this study indicate that COPD is a highly prevalent disease in Korea. To reduce the prevalence of COPD and improve health-related quality of life in patients with COPD, nursing interventions must focus on prevention of risk factors.

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Risk Factors for Surgical Site Infections in Patients Undergoing Craniotomy
Kyeong-Sook Cha, Ok-Hee Cho, So-Yeon Yoo
J Korean Acad Nurs 2010;40(2):298-305.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.298
AbstractAbstract PDF
Purpose

The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative surgical site infections (SSIs) after craniotomy.

Methods

This study was a retrospective case-control study of 103 patients who had craniotomies between March 2007 and December 2008. A retrospective review of prospectively collected databases of consecutive patients who underwent craniotomy was done. SSIs were defined by using the Centers for Disease Control criteria. Twenty-six cases (infection) and 77 controls (no infection) were matched for age, gender and time of surgery. Descriptive analysis, t-test, χ2-test and logistic regression analyses were used for data analysis.

Results

The statistical difference between cases and controls was significant for hospital length of stay (>14 days), intensive care unit stay more than 15 days, Glasgrow Coma Scale (GCS) score (≤7 days), extra-ventricular drainage and coexistent infection. Risk factors were identified by logistic regression and included hospital length of stay of more than 14 days (odds ratio [OR]=23.39, 95% confidence interval [CI]=2.53-216.11) and GCS score (≤7 scores) (OR=4.71, 95% CI=1.64-13.50).

Conclusion

The results of this study show that patients are at high risk for infection when they have a low level of consciousness or their length hospital stay is long term. Nurses have to take an active and continuous approach to infection control to help with patients having these risk factors.

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Work-related Stress and Risk Factors among Korean Employees
Eun Sook Choi, Yeongmi Ha
J Korean Acad Nurs 2009;39(4):549-561.   Published online August 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.4.549
AbstractAbstract PDF
Purpose

Work-related stress and risk factors among Korean employees were identified in this study.

Methods

Data were obtained from employees aged 20 to 64 using the Korean Working Conditions Survey 2006 (KWCS). Multiple logistic regression analysis using SAS version 9.1 was performed to examine risk factors of work-related stress by gender.

Results

The age-adjusted prevalence of work-related stress among male and female employees was 18.4% and 15.1% respectively. After adjustments for multiple variables among both male and female employees, there was a significant relationship between work-related stress and risk factors including education, company size, work time, ergonomic risks, biological·chemical risks, and job demands. The significant variables for male employees were housework load, occupational class, and shift work, and for female employees, type of employment.

Conclusion

There is a need to develop and support intensive stress management programs nationally giving consideration to work-related stress associated with working time, physical working environment, and job demands. Based on gender specific approaches, for male employes, stress management programs should be developed with consideration being given to occupational class and shift work. For stress management programs for female employees, consideration needs to be given to permanent employment status, specifically those in small companies.

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Factors explaining Quality of Life in Individuals with Coronary Artery Disease
In Sook Park, Rhayun Song, Sukhee Ahn, Hee Young So, Hyun Li Kim, Kyung Ok Joo
J Korean Acad Nurs 2008;38(6):866-873.   Published online December 31, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.6.866
AbstractAbstract PDF
Purpose

The study was done to compare quality of life by gender, and to identify factors which explain quality of life in individuals with coronary artery disease.

Methods

For the survey, 91 individuals (53 men and 38 women) agreed to participate in the study. Cardiovascular risk factors, systolic blood pressure, body mass index, total cholesterol, triglyceride, high density lipoprotein-cholesterol, and low density lipoprotein-cholesterol, health behavior as well as quality of life, were measured. Descriptive statistics, t-test, correlation and hierarchical multiple regression with SPSS WIN 12.0 were used to analyze the data.

Results

Significant gender differences were found for education, smoking status, chronic disease, perceived health status, and quality of life within sub-dimensions. Hierarchical regression analysis showed gender (men), age, perceived health status, cardiovascular risk scores, and health behaviors together explained 40.2% (adjusted R2) of variance in quality of life.

Conclusion

As the factors explaining quality of life in individuals with coronary artery disease have been identified as gender (men), age, perceived health status, and health behaviors, health promotion programs designed for this population should focus on these factors for effective behavioral modification, and consequent improvement in quality of life.

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The Analysis of Type D Personality Research as a Psychosocial Risk Factor in Cardiovascular Disease for Elders with a Chronic Disease
Eun Kyeung Song, Youn Jung Son
Journal of Korean Academy of Nursing 2008;38(1):19-28.   Published online February 28, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.1.19
AbstractAbstract PDF
Purpose

The purpose of this paper was to examine the relationship between type D personality and cardiovascular disease, and to suggest future research directions.

Methods

A literature search was conducted from the following nine databases: 1) MEDLINE, 2) CINAHL, 3) Pubmed Unrestricted, 4) PsycINFO, 5) KISS, 6) RICHIS, 7) RISS4U, and 8) Nanet. The combinations of the words, "type D personality", "personality", "heart", "cardiovascular", and "coronary" were used for keyword searches to find relevant articles. Twenty eight studies were identified.

Results

Type D personality has been associated with increased morbidity and mortality in patients with established cardiovascular disease. Type D patients are also at increased risk for impaired quality of life, and seem to benefit less from medical and invasive treatment.

Conclusion

There is substantial evidence for a relationship between type D personality and clinical outcomes related to cardiovascular disease. Randomized clinical trials are needed to further evaluate the value of controlling type D personality to improve survival and reduce morbidity in patients with cardiovascular disease. Accumulating evidence from this analysis indicates the urgent need to adopt a personality approach in order to optimize the identification of patients at risk for stress related cardiac events.

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Risk Factors for Nosocomial Urinary Tract Infection in the Intensive Care Unit with a Positive Urine Culture and Foley Catheterization
Seong Mi Yu, Kyung Yeon Park
Journal of Korean Academy of Nursing 2007;37(7):1149-1158.   Published online December 31, 2007
DOI: https://doi.org/10.4040/jkan.2007.37.7.1149
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the risk factors for a nosocomial urinary tract infection in intensive care units with a foley catheterization which showed a positive urine culture.

Method

Three-hundred eighty-seven patients were included in the study. A retrospective review of the electrical medical record system's databases and medical record sheets in hospitalized patients from January 2003 to December 2003 was used. The collected data was analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis.

Result

The frequency of the participants' nosocomial urinary tract infection was 72.9%. Significant risk factors for a nosocomial urinary tract infection were ‘age’, ‘place of catheter insertion’, ‘frequency of catheter change’, and ‘duration of catheterization’. These variables explained 18.4% of variance in the experience of nosocomial urinary tract infection in intensive care units with foley catheterization.

Conclusion

Medical personnel can decrease the incidence of a nosocomial urinary tract infection by recognizing and paying attention to the duration of catheterization, frequency of catheter change, and place of catheter insertion. As a result, specific and scrupulous strategies should be developed to reflect these factors for decreasing nosocomial urinary tract infections.

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A Study on Health Behavior in People at Risk for a Cerebrovascular Accident
Mi Sook Song, Young Soon Byeon, Kyoung Sook Lim, Ji Won Oak
Journal of Korean Academy of Nursing 2007;37(7):1091-1097.   Published online December 31, 2007
DOI: https://doi.org/10.4040/jkan.2007.37.7.1091
AbstractAbstract PDF
Purpose

This study was done to survey health behaviors in people at risk for a Cerebrovascular Accident(CVA).

Method

From November 21 to December 29, 2005, a questionnaire survey was conducted with 171 people at risk for a Cerebrovascular Accident(LDL of above 130 mg/dl & homocysteine of above 15.0 micromol/L). Their physical composition was measured and blood was collected.

Results

1. Of the subjects, 34.5% were smokers, 61.4% were drinkers, 56.7% did not exercise regularly, 57.3% did not control their weight, 26.9% preferred eating meat, and 32.2% preferred salty food. 2. The gender was different between smoking status(χ2=10.734, p=.001), and drinking status(χ2=7.185, p=.007), and the age was different between smoking statusχ2=6.656, p=.010), and drinking status(χ2=10.722, p=.001). The HbA1C level was different for regular exercise(χ2= 4.824, p=.028) and the HDL-cholesterol was different for meat-eating preference(χ2=7.928, p=.005). The observance of troubling signs was different for a salty food preference(χ2=4.313, p=.038).

Conclusion

It is necessary to develop programs for taking care of people at risk for a Cerebrovascular Accident and test the effects of the programs in order to reduce the risk factors of CVA and enhance health behavior promotion.

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Factors Affecting the Severity of Urinary Incontinence and the Quality of Life of Women with Urinary Incontinence
Hyun Soo Oh, Mi Kyung Kim
Journal of Korean Academy of Nursing 2005;35(3):469-477.   Published online June 30, 2005
DOI: https://doi.org/10.4040/jkan.2005.35.3.469
AbstractAbstract PDF
Purpose

This study was conducted to investigate the factors that affect the severity of urinary incontinence and the quality of life of women with urinary incontinence.

Methods

An exploratory correlation research design was applied and the sixty women who responded that they currently experience involuntary urine leakage at least once per week were invited to participate in the study.

Results

According to the study results, the factors that significantly contribute to the severity of urinary incontinence were age, number of parity, and number of normal deliveries. Other influencing factors, such as obesity, menopausal state, hysterectomy, and number of episiotomies, were not significant to predict the severity of urinary incontinence. Urinary incontinence frequency per week and duration of experiencing urinary incontinence were shown to be factors that significantly affect quality of life.

Conclusion

In women above 60 years old, multiparity, and multiple experiences of vaginal delivery tended to present a higher level of severity of urinary incontinence. In addition, women with higher frequencies of urinary incontinence per week and a longer duration of urinary incontinence showed a lower level of quality of life.

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