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Original Articles
Reliability and Validity of Korean Version of Nursing Students’ Anxiety and Self-Confidence with Clinical Decision Making Scale
Mi Yu, Young Eun, KA White, KyungJa Kang
J Korean Acad Nurs 2019;49(4):411-422.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.4.411
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to adapt, modify, and validate the Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale (NASC-CDM©) for Korean nursing students.

Methods

Participants were 183 nursing students with clinical practice experience in two nursing colleges. The construct validity and reliability of the final Korean version of the NASC-CDM© were examined using exploratory and confirmatory factor analyses and testing of internal consistency reliability. For adaptation and modification, the instrument was translated from English to Korean. Expert review and a cross-sectional survey were used to test the instrument's validity.

Results

The Korean version of the NASC-CDM© (KNASC-CDM) was composed of 23 items divided into four dimensions: (i) Listening fully and using resources to gather information; (ii) Using information to see the big picture; (iii) Knowing and acting; and (iv) Seeking information from clinical instructors. The instrument explained 60.1% of the total variance for self-confidence and 63.1% of the variance for anxiety; Cronbach's α was .93 for self-confidence and .95 for anxiety.

Conclusion

The KNASC-CDM can be used to identify anxiety and self-confidence in nursing students’ clinical decision-making in Korea. However, further research should be done to test this instrument, as it is classified differently from the original NASC-CDM© version.

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An experimental study on the impact of an agreement on the means to achieve nusing goals in the early postpartum period of primiparous mothers and enhance their self-confidence and satisfaction in maternal role performance
Young Eun Lee, Young Soo Ha
Journal of Nurses Academic Society 1992;22(1):81-115.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1992.22.1.81
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The problem addressed by this study was to determine the effect of nurse-patient agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers. It was hypothesized that the experimental treatment would result in hegher self-confidence and satisfaction in maternal role performance. This Purpose was to contribute to the planning of nursing care to enhance self-confidence and satisfaction in maternal role performance and to the development of relevant nursing theory. Especially, the early postpartum period is crucial toward in recovery from childbirth and attainment of the maternal role. Maternal role attaintment is a complex social and cognitive process of stimulus-response accomplished by learning. Most women attain the maternal role successfully. But, some primiparous mothers experience difficulties in attainment of the maternal role due to lack of experience and knowledge. Self-confidence and satisfaction in maternal role performance are important factors in attainment and adjustment to the maternal role(Mercer, 1981a, 1981b ; Lederman, Weigarten, and Lederman, 1981 : Bobak and Jensen 1985). Nursing is defined as behaviors of nurses and patients that attain nursing goals through action, reaction, interaction, and transaction. For attainment of nursing goals, active participating transactions must occur by agreement on the means to achieve those goals through nurse-patient mutual goal setting and establishment of their active relationships(King, 1981, Ha, 1977). Based on King's theory of goal attainment(1981), this study was planned as a non-equivalent control group, non-synchronized quasi-experimental design using agreement on the means to achieve nursing goals in early postpartum as the experimental treatment. The data were collected from July 20 to Sep. 1, 1991 by questionnaires with 60 primiparous mothers planing to breast feed after normal deliveries at W hospital in Pusan, Korea. The subjects were divided into a control group(conventional group)-those admitted from July 20 to Aug. 12 and an experimental group(agreement group)-those admitted from Aug. 13 to Sep. 1. The instrument for agreement on the means to nursing goals in the early postpartum period included five steps-identification of disturbances of problems through action, reaction, and interaction with primiparous mothers ; mutual early postpartal nursing goal setting ; exploration of the means to achieve goals ; agreement on the means (self-care, early maternal-infant contact, performance of mothering behavior, and communicating about the infant's behavior and health condition) ; implementation of the means. This instrument was developed on the basis of King's elements that lead to transactions in nurse-patient interactions. Lederman et al's(1981) scale for Confidence in ability to cope with tasks of motherhood and Lederman et al's(1981) scale for Mother's satisfaction with motherhood and infant care were used to measure-confidence and satisfaction in maternal role performance with the subjects immediately after admission and on the day of discharge. Self-care performance in the experimental group was measured by self-evaluation tool developed by the investigator from the literature concerned. The tools to measure self-confidence and satisfaction in maternal role performance, and the tool to measure self-evaluation of self-care performance were tested for internal reliability. Cronbach's Alphas were 0.94, 0.94, and 0.63. The data were analysed by using in S. P. S. S. computerized program and included percentage, x2-test, t-test, ANOVA, and Pearson Correlation Coefficient. The conclusions obtained from this study are summarized as follows : 1. The degree of self-confidence in maternal role performance of the total subjects group measured before the experimental treatment was above average with a mean score of 2.77(range 2.14-3.64). Out of 14 items, those with relatively high mean scores were 'I would like to be a better mother than I am'(3.95), and 'I know that my baby wants most of the times'(2.28), 'When the baby cries, I can tell what she/he wants'(2.37), and 'I have confidence in my ability to care for the baby'(2.50). That is, the self-confidence of primiparous mothers was considerably high in mothering, but rather low in activities concerning the infant care and understanding of the infant behavior. The degree of satisfaction in maternal role performance of the total subjects group measured before the experimental treatment was high with a mean score of 3.18(range 1.92-3.92). Out of 13 items, those with relatively high mean scores were 'I an glad I had this baby now'(3.75), 'I play with the baby between feeding when s/he is awake and quiet'(3.67), and 'I enjoy being a mother'(3.27). Those with low mean scores were 'I and upset about having too many responsibilities as a mother'(2.78), 'it bothers me to get up for the baby at night'(2.82). and 'I get annoyed if the baby frequently interrupts my activities'(2.82), That is, the satisfaction of primiparous mothers was considerably high in mothering and infant care, but rather low in restraints in time or on the mother's self accomplishment and development. 2. Agreement on the means to achieve nursing goals in the early postpartum period included process of mutual goal setting, exploration of the means to achieve goals, and ahreement in concret means to achieve goals based on the mothers' condition, concerns, self-perception of the nurse-patient interactions. In the process of agreement, there was agreement that the means to achieve goals should be through trust and establishment of active relationships with the nurse through identification of problems according to planned nursing goals and active interaction, such as explanations, teaching, changing of opinions, acceptance or rejection of explanations, and proposing of questions. Therefore agreement on the means to achieve nursing goals in the early postpartum period appears to be an effective nursing intervention for primiparous mothers. 3. The degree of self-confidence in maternal role performance of the experimental group was higher than that of the control group(t=3.95, p<0.01). Out of 14 items those with higher score in the experimental group were 'I would like to be a better mother than I am'(t=1.93, p<0.05), 'I know that my baby wants most of the times'(t=2.75, p<0.01), 'When the baby, I can tell what she/he wants'(t=2.10, p<0.05), 'I have confidence in may ability to care for the baby'(t=3.72, p<0.01), 'I trust my own judgement in deciding how to care for the baby'(t=1.93, p<0.05)m 'I feel that I know my baby and what to do for him/her'(t=2.44, p<0.01), 'I am concerned about being able to meet the baby's needs(t=2.87, p<0.01), 'I know wat my baby likes and dislikes'(t=3.26, p<0.01), 'I dont's know to care for the baby as well as I should'(t=2.07, p<0.05), and 'I am unsure about whether I give enough attention to the baby'(t=3.04, p<0.01). That is, the degree of self-confidence in mothering, activities concerning infant care, and understanding of infant behavior of the experimental group was higher than that of the control group. Therefore, the first hypothesis, that the degree of self-confidence in maternal role performance of the experimental group would be higher than that of the control group, was supported(t=3.95, p<0.01). 4. The degree of satisfaction in the maternal role performance of the experimental group was higher than that of the control group(t=2.31, p<0.05). Out of 13 items, those with higher score in the experimental group were 'I am glad I had this baby now' (t=2.29, p<0.05), 'I enjoy taking care of the baby'(t=2.49, p<0.01), 'It is boring for me to care for the baby and do the same things over and over'(t=2.87, p<0.01), 'I am unhappy with the amount of time I have for activities other than childcare'(t=2.51, p<0.01), and 'When bathing and diapering the baby, I would like to be dong something else'(t=2.43, p<0.01). That is , the degree of satisfaction in mothering, infant care, and restraints in time of on the mother's self accomplishment and development in the experimental group was higher than that of the control group. Therefore, the second hypothesis, that the degree of satisfaction in maternal role performance of the experimental group would be higher than that of the control group, was supported(t=2.31, p<0.05). 5. The third hypothesis, that the higher the degree of satisfaction in maternal role performance, the higher the degree of self-confidence in maternal role performance in the experimental group, was supported(r=0.57, p<0.01).

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A Study of the Effects of Health Contract on the Performance Level for Activity of Daily Living in the Hemiplegic Patients
Byoung Eun Kim, Hyang Yun Rhee
Journal of Nurses Academic Society 1991;21(1):63-78.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1991.21.1.63
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The purpose of this study was to test the effects of health contract on the performance level for activity of daily living(ADL) in the hemiplegic patients. A quasi-experimental research for health contract, which was approved as an effective method of nursing intervention, was attempted to increase the performance of the hemiplegic patients' ADL. As a purpose sample, 69 hemiplegic patients hospitalized at Oriental medicine hospital of K university were taken and divided into the experimental group and the control group by means of random assignment. After Contracting with the experimental group, they were reinforced everyday for 20 minutes. The experimental group and the control group were observed and interviewed for five times at the in interval of 3~4 days by the trained nurses for this research. The data Collected through above mentioned methods were compute analyzed by t-test and ANOVA according to the purpose of this study. The data collected trough above mentioned methods were computer analyzed by t-test and ANOVA according to the purpose of this study. Strate increased the performance level for ADL than the Control group" was supported(t=2.96, df=52.76, p=.004). Sub Hypothesis 1,2,4,5, : "The hypothesis that the experimental group with health contract will demonstrate increased the performance level for eating(t=2.29, df=42.70, p=.027), personal hygiene and grooming(t=4.04, df=43.10, p=.000), dressing(t=3.32, df=67, p=.001) and undressing(t=3.47, df=48.44, p=.001) than the control group" was supported. Sub Hypothesis 3.6 : "The hypothesis that the experimental group with health contract will demonstrate increased the performance level for toiletting(t=.19, df=67, p=.849) and mobilization(t=.30, df=67, p=.765) than the control group" was not supported. The conclusion can be that the positive relationship between the nurses and the patient results in the desired performance level for ADL in the hemiplegic patients.

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A Study on the Disturbing Factors Which Work against Therapeutic Atmosphere and Environment on Hospital Wards as Perceived by Patients and Nurses
Young Hae Kim, Myoung Eun Han
Journal of Nurses Academic Society 1997;27(1):178-188.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.178
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As a descriptive survey, this study was attempted to get basic data necessary to recognize the factors that disturb the therapeutic atmosphere of hospital wards as perceived by nurses and hospitalized patients, to identify differences between the perceptions of the nurses and of patients. The subjects, 159 patients in Pusan National Hospital and 68 nurses working there were sampled between March 18 and April 13, 1996. The tool used to measure the disturbing factors was an amended form of the one developed by Kim, Mae Ja(1983). The differences between each subject's score for each factor were analyzed using means and SD, and the highest 3 items above the mean score for each factor were collected and compared. The results are described below : 1. Subject's perception of main disturbing factors : patients reported that the main factors were 'loss of role and economic trouble', 'the prognosis of disease', 'the change of daily life' but nurses replied that the main factors were 'the prognosis of disease', 'the communication trouble with the medical team and interpersonal relationships'. 'The change of daily life' was not a perceived factor by nurses, but ranked third by patients. 2. Subject's perception degree of each disturbing factor : (1) among the items related to interpersonal relationship, the patient group reported that the worst disturbance was due to severely ill patients in the same room' but the nurse group regarded 'greed to monopolize wheelchairs or other supplies' as the worst disturbance. (2) among the items related to physical factors, the patient group regarded 'limitations to wash their body, physical pain and limitations in physical activity' as the worst disturbance, but the nurse group regarded 'physical pain', and 'limitations to activity or change of appearance' as the worst disturbance. (3) among the items related to the change of daily activity, the patient group regarded 'the boredom of hospitalization or in favorable diet' as the worst disturbance, but the nurse group regarded 'too much noise or unclean room' as the worst disturbance. (4) among the items related to the communication trouble with medical team, the patient group regarded 'the ignorance of their disease due to poor information, the inability to understand the language of the medical team or the difficulty in seeing physician in time' as the worst disturbance, but the nurse group regarded 'the inability to trust physicians and physician's poor attention to patients' as the worst disturbance.

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A Study on Attitude of Ethical Dilemmas in Clinical Nurses
Ju Hee Kim, Soo Yeon Ahn, Ji Yoon Kim, Ju Yeon Chung, Ji Mee Kim, Sun Ha Choi, Young Eun Kwon, Mi Young Chon, Myoung Hee Kim
Journal of Nurses Academic Society 1995;25(3):496-509.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1995.25.3.496
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This study was conducted to identify the attitude of ethical dilemmas in hospital nurses. Ethical dilemmas were categorized into four areas: human life area, clients area, nursing practice area, and nurses-co-worker area. 354 nurses working in clinical settings were selected in Seoul and Kangwon area. Data were gathered from 26, June to 10, July, 1994 by structured guestionnaires. Descriptive statistics were employed to analyze the data. The results obtained from data were as follows: 1) In human life area mean score was 3.03. This area showed remarkabale individual differences between utilitarian and deonto-logical position. 2) In clients area mean score was 3.94. It means that nurses tend to take a deonto-logical position. 3) In nursing practice area mean score was 3.41. It means that nurses tend to take a slightly deontological position. 4) In nurses-co-worker area mean score was 3. It means that nurses tend to take a deont-ological position. To conclude, clinents area, nursing practice area, and nurses-co-worker area taken deontological position. Most nurse's primary concern was the 'welfare of the patients' which is to fundamental ethical professional practice. But nurses experienced more ethical dilemmas in human life area than others. Therefore, nurses should be prepared to make independent decision that based on bio-ethics and professional ethics.

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Patient-Nurse Collaboration in Nursing Practice: A Korean Study
Dal Sook Kim, Young Eun, Hesook Suzie Kim
Journal of Korean Academy of Nursing 2002;32(7):1054-1062.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.7.1054
AbstractAbstract PDF

INTRODUCTION: Consumerism is prevailing value in Korean society, while there has been little concern about it especially in Korean nursing society even though there has been an increasing emphasis on patients' participation in decisions concerning health care and nursing as an ideal in the literature. OBJECTIVES AND METHODS: The study with survey method was carried out to examine the nature of collaboration between patient and nurse in nursing practice in Korea through a replication of the studies carried out in US, Norway, Finland, an Japan (Kim et al., 1993) and to revise and test Kim's explanatory model of collaborative decision making in nursing practice from the Korean perspectives. RESULTS & CONCLUSIONS: Both patients and nurses as groups exhibited pro-consumerist attitudes regarding collaboration in health care, while there were significant differences in attitudes and perceptions of patients and nurses. These findings are similar to those of Kim et al.' s study carried out in US, Norway, Finland, and Japan. Nurses as a group compared to patients held stronger health-care consumerist attitudes and beliefs in general. However, the Korean nurses seem to hold a weaker attitude for challenging professional authority. And the Korean patients compared to the nurses seem to hold stronger belief in the patient's right to information, as found in US, Finland, and Japan. Regarding the nurse patient collaborative attitude in decision making, it revealed that one third or more of the patients as a group believe in the patients' right to be informed of decisions that nurses make for their patients, while another one third or more of them believe in the patients' right for advisory role and joint role in nursing care decision making. This result for the patients is very similar as those found in US, Norway, Finland, and Japan. However, the attitude for the nurses held stronger agreement with patients' to be informed of decision making that nurses make than the patients' right for advisory and joint role. The nurses have weaker belief in patients' self determination on their care than the patients. The results of path analyses confirmed the explanatory models that tested two explanatory models examining the factors contributing to the differences in the attitudes of patients and nurses. The path model for nurses identified nurses' lengths of experience as the important factor explaining attitudes regarding challenging professional authority and the patient's rights for information. The path model for patients identified the level of education as the most significant factor that explains patients' attitudes regarding the rejection of general authority, challenging professional authority, and the patient's right for participation in decision making.

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The Evaluation of a Health Promotion Program for the Community resident Older Adults
Mee Ock Gu, Young Sil Kang, Eun Sim Kim, Hoang Lan Ahn, Hyun Sook Oh, Young Eun
Journal of Korean Academy of Nursing 2002;32(3):384-394.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.3.384
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PURPOSE: This study was conducted to evaluate the process & outcome of a Health promotion program(Growing Younger & More Active) for the community resident older adults from March to December, 2001. METHOD: A quasi experimental research(one group pretest-posttest design) was used in this study. The subjects were 82 older adults(but 40 older adults 4 weeks after the program). Program had 5 sessions(10 hours) once a week. Data were collected before the program, immediately after & 4 weeks after the program and were analyzed with paired t-test. RESULT: The levels of Satisfaction, Interest & Understanding of the Program were high. Significant differences were found in health knowledge, health promoting behaviors, perceived health status and life satisfaction between before program and immediately after program as well as between before program and 4 weeks after program, but no significant differences in Health attitude. Self efficacy has significant difference only between before program and immediately after program , but no significant differences between before program and 4 weeks after the program. CONCLUSION: This results suggest that a Health promotion program for the community resident older adults developed this study is effective. So this program can be recommended as an effective nursing intervention for the health promotion of the older adults living in community.

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The Trend of Korean Nursing Research with the LISREL
Nan Young Lim, Hyun Sook Kang, Sung Eun Lee, Yeon Ok Suh, Young Eun Kwon
Journal of Korean Academy of Nursing 2001;31(2):221-231.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.2.221
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This study was conducted by analyzing all 33 articles based on the LISREL, published from January 1991 to March 1999 in Korea. The analyses consisted of the publication date of articles, principal dependent variables, subjects of the research, adequacy of sampling, adequacy of research purposes and
results
, accordance between theoretical model and hypothetical model, fit measures, theoretical base of model modification, and adequacy of conclusion. The results were as follows : The thesis of 33 articles in total were outnumbered as 25 (75.8%) to 8 (24.2%) research articles. As for a sex classification of the subjects, 45.5% of the research were conducted around a female group of subjects, while 54.5% were done for both sex, The range of the sample size was 105 to 803, and the average was 259 subjects. A single theoretical variable was measured for each measurement variable, any difference between variables was hardly found in 8 articles (24.2%), and 19 articles (57.6%) did not consider any measurement error. To analyze if the representative has been considered while collecting the data, most data were collected by a convenient sampling. Seven articles (21.2%) were seen with a sign of a representative. Questionnaires were used in a majority (31 articles) of the data collecting process. Only 2 articles (6.1%) were measured with a physiologic index simultaneously. 14 articles (42.2%) were centered on theory development, 10 articles on theory synthesis, and 9 articles on theory test. The research purposes and results were consistent in 25 articles (75.5%) and 8 articles (24.2%) were inconsistent. The quality of life and health promotion behavior were the concepts most frequently studied as a dependent variable, and 7 articles centered on them. In applied theories a health promotion model was used on 4 articles (12.1%), while role theory and stress-coping models were in 3 articles respectively. The articles were analyzed to see if the hypothetical model was elaborated and tested by the theoretical model. Twenty-five articles proved to be rationale for the inconsistencies. Also, 56.5% proposed hypotheses were supported among the subject articles, and 30 articles (90.0%) suggested a revised model. Path coefficient (17 articles) and theoretical adequacy (17 articles) were the standards mostly used. In conclusion, the principal factors were obtained from the research are to be considered as the principes of LISREL application. First, a model has to be established on a theoretical base rather than empirical results dependent on the data. The results are also required to be globally interpreted. Secondly, at least 200 samples are necessary to satisfy the need. Third, more than 3 measurement variables are to be adjusted to a single theoretical variable; the measurement errors must be suggested as well. Finally, normal distribution characteristics of the data and the estimation method need to be reported. Based on the research result, the follows are suggested; Systematic criteria on the LISREL application and procedure need to be developed Agreement form is required to report the results of research using the LISREL

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The Development of a Continuing Nursing Care Program for Cancer Patients after Discharge
In Soo Kwon, Young Eun
Journal of Korean Academy of Nursing 2001;31(1):81-93.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.1.81
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The purpose of this study was to develop a continuing nursing care program for cancer patients and the caregivers staying at their home and to test its effects on patients' symptom distress, caregiver burden, and satisfaction of life. The continuing nursing care program was based on the homecare needs of cancer patients, and was provided by three clinical nurses who took care of the patients while they were hospitalized. The program consisted of discharge education about selfcare using education materials(book and handout) and provisions of direct care. These were counselling and education during which visiting patients' home one week after discharge and telephone counseling two weeks after discharge. Counseling by telephone was always available during the research period. A quasi-experimental research design was used to test the effects of the program. Subjects for this study were 53 cancer patients discharged from the hospital and caregivers. These subjects were assigned to an experimental group (n=23) receiving continuous nursing care, or to a control group (n=30) not receiving continuous nursing care. Data from control group was collected first to protect from contamination. Data collection was done from October of 1998 to February of 2000. The collected data was analysed using mean, t-test, and chi-square test computed by SPSS software. The summary of results was as follows: 1) The symptom distress was a little decreased at posttest, but there were no significant differences between the experimental and the control group in symptom distress. 2) The score of caregiver burden was significantly decreased in experimental group at posttest, but no differences in control group. 3) There were no significant differences between the experimental and control group in the satisfaction of life. 4) The score of satisfaction of continuing nursing care program in experimental group at posttest was 2.321 of 3. In conclusion, even though this study did not obtain evidence of effectiveness of continuing nursing care program on patients, such as. It is still expected to be effective by a more improved program. Therefore we want to give some suggestions for further studies. 1) It is needed to make a communication channel with the patient's doctor to response promptly and appropriately to patient's conditions. 2) The research is necessary on patients in terminal stage or early stage of cancer diagnosis who have many nursing needs. 3) It is needed to readjust the roles and job assignment of clinical nurse to implement effectively as a program provider.

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A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness
Kyung Sook Choi, Young Eun
Journal of Korean Academy of Nursing 2000;30(1):122-136.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.1.122
AbstractAbstract PDF

Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands' care for their wives through a qualitative research into husbands' experience.
Method
1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won.
Method
2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied.
Result
1. Husbands' burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband's burden correlated with the age of the patients, numbers in the family, therapy methods, patient's level of discomfort, patient's disease severity, patient's level of dependence and the husband's understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands' burden is explained in 22.5% by husband's recognition of level of severity and husbands' age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient's level of discomfort, patient's disease severity, patient's level of dependence and husband's understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients' experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands' identification of housework and husbands' concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients' to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands' companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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The Homecare Needs of Cancer Patients
In Soo Kwon, Young Eun
Journal of Korean Academy of Nursing 1999;29(4):743-754.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.4.743
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The purpose of this descriptive study was to identify the homecare needs of patients with cancer and to provide a basis of interventions. One hundred and two patients at one general hospital in Gyeongnam responded to a questionnaire developed on the basis of care needs perceived by nurse caring for hospitalized patients with cancer. The questionnaire was a Likert type 5 point scale with 56 items on five need categories ; 1) informational 2) physical care 3) emotional care 4) socioeconomic care and 5) special care needs. Internal consistency of this questionnaire was Cronbach's alpha=.9101 for total items. The data was collected from March 1st to May 31th, 1998, by tow graduate nurses. In the data analysis, mean & standard deviation were calculated to identify the degree of care need of each item, and the t-test & ANOVA were done to determine the effects of patients' demographic background on their care needs. The findings are summarized as follows ; 1) The mean score of total of need items was 3.048. Of the four need categories the highest score was informational at 3.4, followed by emotional care, 3.063, physical care, 2.623, and socioeconomic care, 2.599. 2) In the informational and category there were four subcategories with 19 items. Medication and pain control had the highest score, 3.755 ; second was diet and exercise, 3.613 ; third was disease and treatment process, 3.337 ; and last was personal hygiene and infection prevention at 2.687. 3) In the physical care need category there was nine items, IV infusion for nutrition and management of treatment complication was above 3.2 points and the remaining items were in the 2.847-2.070 score ranges. 4) In the emotional care need category there were seven items. The highest need was in support for relationships with health personnel, 3.673. The need for support of religions beliefs and support fir having a religion were low at about 2 points. 5) In the socioeconomic care need category there were six items. Support for medical insurance expansion and financial support were above 3 points. Legal support and support for caring of children were low in the care needs. 6) In the special care need category the there were 15 items. Informational need about immunization and informational need about effects of disease on growth and development were high, above 4.1 points. Need for decubitus care and prevention, sitz bath and incontinence care were low, below 2 points. 7) There were significant differences in degree of care need according to admission rate, education level, marital status, religion and caregiver's religion. In conclusion, homecare needs perceived by hospitalized patient's with cancer was moderate, but informational need was higher than direct care needs, leading to the conclusion that the provision of sufficient information to patients with cancer at discharge is needed. Nursing interventions should be developed considering the patient's background.

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A Study of the Relationships among Health Promoting Behaviors, Health Locus of Control(HLOC), and Response Patterns to HLOC in Korean Elderly
Young Eun, Mee Ok Gu
Journal of Korean Academy of Nursing 1999;29(3):625-638.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.3.625
AbstractAbstract PDF

The purpose of this study was to identify the relationships among health promoting behaviors, Health Locus of Control(HLOC), and response patterns to Hloc in Korean elderly. The sample was composed of 162 healthy elderly ranging in age from sixties to eighties. The instruments foe this study were modified Health Promoting Lifestyle Profile (45 items, 4 scales), and Multidimensional Health Locus of Control (18 items). For the in data analysis, SPSS PC+program was utilized for descriptive statistics, Pearson correlation, t-test, ANOVA, and Stepwise multiple regression. The results of the study are as follows: 1. The total mean score for the HPLP was 2.411(range 1-4), and the mean scores on the subscales were 3.324 for nutition, 2.709 for interpersonal support, 2.495 for exercise, 2.225 for health responsibility, 2.205 for exercise, 2.225 for health responsibility, 2.205 for self actualization, 2.026 for stress management. 2. The mean scores patterns of the HLOC identified eight types, pure internal, pure powerful others, pure chance, double external, believers in control, yea sayer, nay sayer and complex control, the "believers in control"was the largest group(22.8%), and "yea sayer" was the next largest group(17.9%). The "nay ayer"(5%) was the smallest group. 3. Demographic variables, such as education, economic status, religion and the perception of the health status showed strong connections to health promoting behaviors. 4. Demographic variables, such as education, economic status, religion and the perception of the health status showed strong connections to health promoting behaviors. 5. The HLOC-I and health promoting behavior were correlated positively(r=.165, P=.017), but the HLOC-P, the HLOC-C and the health promoting behavior were not correlated at the level of statistical significance. 6. There was not significant difference in health promoting behavior depending on the response patterns of the HLOC(F=1.171, P=.108). But, There were significant differences in two subscales of health promoting behavior : exercise(F=3.279, P=.002), and stress management (F=3.165, P=.003). 7. Education, the perception of the health and economic status explained 21.0% of the variance for health promoting behaviors. These results suggest that several demographic factors are important factors in predicting the level of health promoting behaviors in elderly. So to enhance the health promoting behaviors, nurses should use the different nursing strategies depending on the demographic characters of the elderly.

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A Study on the Consciousness and Preventive Strategies of Adolescent Drug Abuse: The Center of Chun Nam Area
Chung Sun Park, Chong Young Eun, Mi Young Jeong
Journal of Korean Academy of Nursing 1999;29(1):127-138.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.1.127
AbstractAbstract PDF

This study was done to examine consciousness and preventive strategies of adolescent drug abuse. This study design was descriptive survey. The data were collected from 1,830 students from 32 middle and high schools from November 11 to December 20, 1997, using questionnaires. The data were analyzed using SAS computer programs. The study results are as follows : Most of adolescent get the information on narcotics and drug abuse from TV, newspaper, magazine and advertisement. Some of them(48.8%) have received education on drug prevention. However, respondents(49.3%) answered unsatisfactory on preventive education. 69.2% of respondents do not know the legal regulation on alcohol and cigarette. The survey on the degree of cognition on drug abuse shows the serious results : cigarette(79.1%), alcohol(74.1%), bonds(55.1%), gas(49.8%), excitants(48.5%), narcotics(29%), marihwana(27.8%) and, diuretics(21.9%). The situation of adolescent drug abuse is also serious in the order of alcohol 38.2%, cigarette 14.3%, marihwana 9.4%.

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A Study on the Health Promoting Behavior Depending on the Response Patterns of HLOC in Korea Adults
Mee Ock Gu, Young Eun
Journal of Korean Academy of Nursing 1998;28(3):739-750.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.3.739
AbstractAbstract PDF

The purpose of this study was to identify the response patterns of Health Locus of Control(HLOC) and to analysis of the health promoting behaviors depending on the response patterns of HLOC in Korean adults. The sample was composed of 300 healthy adults ranged from twenties to seventies to seventies. In data analysis, SPSS PC+ program was utilized for descriptive statistics, person correlation, ANOVA and cluster analysis. The results of the study were as follow : 1. The average score of Hloc in Korean were HLOC-I : 24.12(range 6-30), HLOC-P : 21.72, HLOC-C : 17.46. 2. The total mean score of the health promoting behavior scale was 2.50 (range 1-4), and the mean score on the subscales were ; self actualization 2.60, health responsibility 2.14, exercise 2.28, nutrition 3.16, interpersonal support 2.74, stress management 2.15. 3. The HLOC-I and health promoting behavior were correlated positively(r=0.184, p=0.001), and the HLO-C and the health promoting behavior were correlated negatively(r=-0.102, p=0.039). The HLOC-P and the health promoting behavior weren't correlated in the level of statistical significance. 4. The response patterns of HLOC in Korean adults were identified 6 types, such as pure internal, pure chance, believers in control, yea sayer, nay sayer, and complex control. The type of believers in control and the type of yea sayer were subdivided in two different types. The believers in control was the largest group(33.67%), and yea sayer was the next large group(26.33%). The pure chance and the complex control type was the smallest groups. 5. There was a significant difference in health promoting behavior depending on the response patterns of HLOC(F=2.67, p=0.010). There were also significant differences in 4 subscales of health promoting behavior : self actualization(F=3.12, P=0.038), nutrition(F=5.08, p=0.000), and interpersonal support?(F=2.26, p=0.029). These results suggest that the response patterns of HLOC is the important factor to predict the level of health promoting behavior in Korean adults.

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Nurse's Perception in the Homecare Needs of Cancer Patient
In Soo Kwon, Young Eun
Journal of Korean Academy of Nursing 1998;28(3):602-615.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.3.602
AbstractAbstract PDF

The purpose of this descriptive study was to identify th homecare needs of the discharged patient with cancer as perceived by nurses caring hospitalized cancer patients. At two hospitals in Gyeognam, 74 nurse responded to an open-ended questionnaire consisting of four need categories; 1) educational and information need, 2) physical need, 3) emotional need, 4) social need. Respondents were asked to list above ten needs of cancer patient in each category. Two researchers analyzed the data by content analysis method. The finds are summarized as follows; 1) A total of 1,417 need items were generated by nurses. The largest number of needs were in the educational and information need category(475 items, 36.3%). Physical (414 items, 31.6%), emotional (237 items ,18.1%) need were the second, third largest, and social(184 items, 14.0%) need made up the smallest category. 2) In the educational and informational need category, there were seven subcategories of prognosis, diet and exercise, medication and pain, wound care, folk remedy, personal hygiene, comfort. The need items related to prognosis of cancer accounted for almost a half(48.2%) of the total. 3) In the physical need category, there were ten subcategories of personal hygiene, skin and tissue, nutrition, side effect on treatment, exercise, pain, elimination, equipment, comfort and safety, others. The largest number of needs were in subcategory of the personal hygiene982 items, 19.8%). 4) In the emotional need category, there were four subcategories of emotional support related to disease, emotional support related to routine life, spiritual support, maintenance of relationship with nurse and doctor. The largest number of need were in subcategory of the emotional support related to disease(96 item, 40.5%). 5) In the social need category, there were five subcategories of support for social life, household management, legal support, the use of volunteer service, financial support. The largest number of needs were in support for social life subcategory(58 item, 31.5%).

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Korean Immigrant Women's Meanings of Breast, Breast Cancer, and Breast Cancer Screenings
Eunyoung Eunice Suh
Journal of Korean Academy of Nursing 2006;36(4):604-611.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.4.604
AbstractAbstract PDF
Purpose

Koreans are one of the fastest growing Asian populations in the U.S. since 1960s. In Korean immigrant women (KIW), breast cancer was reported as the most frequently diagnosed cancer. However, their screening rates for breast cancer are lower than national guidelines; it is assumed that underlying cultural schemas of breast, breast cancer, and its screening modalities exist and need to be studied. This study was aimed to investigate cultural meanings of breast, breast cancer, and breast cancer screenings in KIW.

Methods

Using cultural models theory from cognitive anthropology, naturalistic qualitative methodology was utilized. Three focus group interviews with fifteen KIW were conducted. Thematic analysis with constant comparison technique was performed eliciting units of meaning, categories, and themes.

Results

The cultural schema of the meaning of breast is “mother who is breast-feeding her baby,” with two themes of “balance in size,” and “shyness.” Regarding breast cancer, three themes, i.e., “indifference,” “fear,” and “uncertainty” are emerged. “Lack of information about screening modalities” is the overarching schema with reference to breast cancer screenings.

Conclusions

The findings of this study demonstrate unique cultural models of KIW related to breast cancer and its screenings, which are critical to understand and penetrate their barriers to breast cancer screening.

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The Development & Effect of an Tailored Falls Prevention Exercise for Older Adults
Mee Ock Gu, Mi Yang Jeon, Young Eun
Journal of Korean Academy of Nursing 2006;36(2):341-352.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.2.341
AbstractAbstract PDF
Purpose

This study was conducted to develop and to determine the effect of an tailored falls prevention exercise for older adults.

Method

Subjects consisted of 59 older adults (experimental group : 29, control group : 30) living at nursing homes. Experimental group participated in tailored falls prevention exercise for 16 weeks (3 times a week, 50 min every session). Data were collected before the exercise, 16 weeks and 24 weeks after the beginning of exercise.

Results

1) the experimental group significantly improved the muscle strength of hip extensor and flexor, knee extensor and flexor, ankle dorsiflexor, and plantar flexor compared to the control group. 2) the experimental group significantly decreased the mean time for 10 times chair stand. 3) the experimental group significantly increased the standing time on one leg and the number of heel raise for 30 seconds compared to the control group. In addition more older adults in the experimental group completed the tandem stance and semi-tandem stance for 10 seconds than the control group. 4) The experimental group significantly decreased the mean time of 6m walk and the fall frequency compared to the control group.

Conclusions

This results suggest that tailored falls prevention exercise for older adults can improve muscle strength, static and dynamic balance and decrease the fall frequency of older adults.

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Validity and Reliability of Korean Version of the Spiritual Care Competence Scale
Mi Ja Chung, Youngrye Park, Young Eun
J Korean Acad Nurs 2016;46(6):871-880.   Published online December 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.6.871
AbstractAbstract PDF
Purpose

The aim of this study was to examine the validity and reliability of the Korean Version of the Spiritual Care Competence Scale (K-SCCS).

Methods

A cross-sectional study design was used. The K-SCCS consisted of 26 questions to measure spiritual care competence of nurses. Participants, 228 nurses who had more than 3 years'experience as a nurse, completed the survey. Confirmatory factor analysis was used to examine the construct validity and correlations of K-SCCS and spiritual well-being (SWB) were used to examine the criterion validity of K-SCCS. Cronbach's alpha was used to test internal consistency.

Results

The construct and the criterion-related validity of K-SCCS were supported as measures of spiritual care competence. Cronbach's alpha was .95. Factor loadings of the 26 questions ranged from .60 to .96. Construct validity of K-SCCS was verified by confirmatory factor analysis (RMSEA=.08, CFI=.90, NFI=.85). Criterion validity compared to the SWB showed significant correlation (r=.44, p<.001).

Conclusion

The findings suggest that K-SCCS serves as an appropriate measure of spiritual care competence with validity and reliability. However, further study is needed to retest the verification of the factor analysis related to factor 2 (professionalisation and improving the quality of spiritual care) and factor 3 (personal support and patient counseling). Therefore, we recommend using the total score without distinguishing subscales.

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Prerequisite for Korean Advance Directives: From the View of Healthcare Providers
Shin Mi Kim, Sun Woo Hong, Young Eun, Su Jin Koh
J Korean Acad Nurs 2012;42(4):486-495.   Published online August 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.4.486
AbstractAbstract PDF
Purpose

The purpose of this study was to explore the main prerequisite for Korean Advance Directives [KAD] to ensure their better use.

Methods

Data were collected from two focus group interviews and individual email responses. Study participants were 5 doctors and 6 nurses. All interview data were transcribed and analyzed using qualitative content analysis.

Results

Three main themes emerged; establishing a philosophy of KAD, protocol to practice KAD, and the KAD document itself. A philosophy is needed to ensure individual needs, consensus to practice AD and identify principle agents. The core of protocol was found to be as follows; 1) process, 2) premise, 3) procedure, 4) contextual preparation, 5) timing, 6) feasibility. Component and feasibility need to be established for the document itself.

Conclusion

For a positive acceptance of KAD in Korean society, a culture sensitive, reality based, and user friendly AD needs to be developed.

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Effects of an Elder Health Promotion Program using the Strategy of Elder Health Leader Training in Senior Citizen Halls
Mee Ock Gu, Young Eun, Eun Sim Kim, Hwang Ran Ahn, In Soo Kwon, Hyun Sook Oh, Young-Sil Kang, Myun Sook Jung, So Young Choi, Kyung Mi Sung, Hye Yeon Kang
J Korean Acad Nurs 2012;42(1):125-135.   Published online February 29, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.1.125
AbstractAbstract PDF
Purpose

This study was conducted to develop and test the effects of an elder health promotion program and apply strategies for elder health leader training sessions with elders at senior citizen halls.

Methods

A nonequivalent control group pretest-posttest design was used. Participants were 49 elders at a senior citizen hall (intervention: 27, control: 22). The elder health promotion program consisted of health education and exercise. A professional leader led the program for 4 weeks, and then an elder health leader and research assistant led for 8 weeks (total 12 weeks). Scales for elder health promoting behaviors, perceived health status, life satisfaction and senior citizen hall capability were used and physical fitness levels were measured. Data were collected between April 21 and July 28, 2010 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANOVA with SPSS/WIN 12.0.

Results

Health promoting behaviors, physical fitness, perceived health status, and senior citizen hall capacity were significantly better in the experimental group after the intervention compared to the control group.

Conclusion

Study findings indicate that elder health promotion programs applying strategies of elder health leader training are effective and can be recommended as nursing interventions for health promotion of these elders.

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Development and Effectiveness of a Spiritual Care Education Program for Nursing Students - Based on the ASSET Model
Mi Ja Chung, Young Eun
J Korean Acad Nurs 2011;41(5):673-683.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.673
AbstractAbstract PDF
Purpose

This study was done to develop a spiritual care education program (SCEP) for nursing students to help increase their awareness of the essence of spirituality in care so as to enable them to promote spiritual well-being and spiritual care competence.

Methods

The participants were assigned to an experimental group (n=42) or a control group (n=39). From August to October 2009, the experimental group participated in the SCEP, which were held 2 hours a week for 6 weeks. The data were analyzed using χ2-test, Fisher's exact probability test, paired t-test, t-test with the SPSS WIN 17.0 statistics program.

Results

The experimental group had a higher mean score for spirituality, spiritual well-being and spiritual care competence than the control group. Significant differences were found between the experimental group and the control group.

Conclusion

The results of this study indicate that the SCEP was effective in improving spirituality, spiritual well-being and spiritual care competence for nursing students.

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Barriers to Health Behaviors in Male and Female Elderly People in Korea
Young Eun, Mee Soon Song, Mee Ock Gu
Journal of Korean Academy of Nursing 2008;38(2):332-343.   Published online April 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.2.332
AbstractAbstract PDF
Purpose

This study was done to investigate the practice level of 14 health behaviors between male (N=139) and female (N=175) elderly and to identify the barriers to each health behavior of elderly people in Korea.

Methods

Data were collected from 314 elderly people (65 yr and older) living in metropolitan, urban, and rural areas. Descriptive statistics, χ2-test and ordinal logistic regression were used in data analysis using the SPSS Win 15 version.

Results

1) The performances were different in some health behaviors between male and female elderly people. Male elderly showed better performances in balanced diet, regular exercise, and more than 30 min of exercise, while female elderly showed better performances in restriction of fat and cholesterol, restriction on alcohol, and smoking. There were no differences in stress management and health prevention behaviors between the two groups. 2) The common significant barriers in health behaviors of the elderly in Korea were the lack of habit and physical discomfort. However, the lack of perceived benefit was a significant barrier in male elderly. Lack of time and lack of family support were significant barriers in female elderly people in Korea.

Conclusion

These results suggest that tailored strategies should be developed considering the gender difference to reduce the main barriers of each health behavior in order to improve the health status of elderly people.

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Role-Identity of Home Care Nurse Practitioners
Sung Jae Kim, Myung Sun Yi, Young Eun, Moon Hee Ko, Joo Hyun Kim, Dong Ok Kim, Haeng Mi Son, Kyung Sook Choi
Journal of Korean Academy of Nursing 2006;36(1):103-113.   Published online February 28, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.1.103
AbstractAbstract PDF
Introduction

It is important to understand the nature of the identity through the live experiences of Home Care Nurse Practitioner(HCNP) because the role identity of a professional is constructed by continuous social interactions, This study aims to understand the construction of the role identity of HCNP.

Method

Data was collected from 12 hospital based HCNPs. This study involved two focus group discussion sand four in-depth individual interviews. The main question was “what is the role of HCNP?” The debriefing notes and field notes were analyzed using consistent comparative data analysis method.

Result

First, Home care (HC) is a small clinic. HCNP brings it to home to provide various services. Second, HC is the real nursing and HCNP is the ‘genuine’ nurse who actualizes the essence of nursing in practice. Third, HC is empowering activity to promote self-care ability of the patients and their caregivers. Forth, HC is like the dish-spinning required high-level mastery and HCNP is an expert who provides the most appropriate services to the patients.

Conclusion

HCNPs have the role identity as a highly qualified professional who delivers services from hospital to home, actualizes the essence of nursing in practice, empowers the patients and their caregivers to have self-efficacy to recover, and offers the most appropriate nursing care.

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Review
A Review of Exercise Interventions for Fall Prevention in the Elderly
Mee Ock Gu, Mi Yang Jeon, Hee Ja Kim, Young Eun
Journal of Korean Academy of Nursing 2005;35(6):1101-1112.   Published online October 31, 2005
DOI: https://doi.org/10.4040/jkan.2005.35.6.1101
AbstractAbstract PDF
Purpose

This study was done to suggest directions for developing exercise interventions for fall prevention in the elderly in Korea in the future.

Method

Twenty five articles for fall prevention exercises were reviewed and analyzed.

Result

84.0% of subjects were older adults age 65 and older living in the community. The most frequently performed interventions were lower limb strength and balance exercises together 43.3%, group exercise 70.0%, exercise 3 times/week 60.0%, 60 min per session 36.7%, duration of 12 weeks and 1 year 23.3% each. The most frequently used outcome variables were static balance 84.0%, lower limb muscle strength 72.0%, dynamic balance 56.0 %, and falls 56.0 %. The effect of exercise interventions on fall prevention was inconclusive. Lower limb strength exercises with resistance were effective for increasing muscle strength. Balance exercises with various movements for balance were effective for increasing balance.

Conclusion

Exercise interventions for fall prevention is recommended for older adults with risk factors of falling. The desirable type of exercise intervention is lower limb strength and balance exercise together.

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