Eun Kyoung Yun

A comparison of physical health status, self-esteem, family support and health-promoting behaviours between aged living alone and living with family in Korea

AIMS This study examined and compared the physical health status, self-esteem, family support and health-promoting behaviours between aged living alone and the aged living with family. BACKGROUND As the Korean population ages, the number of older people living alone is steadily rising. Previous studies have been conducted to define the factors affecting the health of older people. However, research studies focused on the impact of family support, which potentially affects the overall health of older people, have been rarely conducted. DESIGN This was a comparative descriptive design. METHODS The survey included a set of four questionnaires. All measures were self-administered. In the data analysis, descriptive statistics were used to analyse the demographic characteristics. The Chi-square test and independent t-test were used to examine the differences between the aged living alone and the aged living with family. RESULTS The physical health status (t=-40·85, p<0·001), self-esteem (t=-26·75, p<0·001), family support (t=-16·46, p<0·001) and health-promoting behaviours, specifically exercise (t=-15·86, p<0·001) and nutrition (t=-17·29, p<0·001), of the aged living with family were higher than that of the aged living alone. CONCLUSIONS This study shows that the aged living with family exhibited better physical health status, self-esteem and health-promoting behaviours than the aged living alone. RELEVANCE TO CLINICAL PRACTICE Clinical practice should be focused on emotional support with family or society for Korean aged, especially the aged living alone. Also, the practice should be adjusted to encourage the health-promoting behaviour for them as well.

Strategy development for the implementation of telenursing in Korea.

This study aimed to evaluate the feasibility of telenursing, to analyze the issues that should be considered for the development of telenursing in the future, and to provide efficient strategies for the implementation of telenursing in Korea. The authors used the Delphi survey method and a strengths, weaknesses, opportunities, and threats analysis. A total of 30 experts and specialists in the field of nursing informatics and telemedicine contributed to a three-round Delphi survey. The results of the study suggest that telenursing can potentially be implemented in Korea. However, to implement telenursing in Korea, it is necessary to identify telenursing specialties, to construct an infrastructure within which telenursing can function, to develop a business model, and to integrate strategies with government plans to develop the e-health industry. The issues that emerged as important requirements for the successful introduction of telenursing were classified as systematic, economic, societal, or technical. Issues such as driving force, target market, and expense sharing were examined in detail from both ideal and realistic points of view. The results of this study will enable health professionals to appreciate the feasibility of implementing telenursing in Korea. In addition, the study suggests that telenursing could be used efficiently in a variety of environments as a practical strategy to improve healthcare in Korea.

A Dyadic Approach to Infertility Stress, Marital Adjustment, and Depression on Quality of Life in Infertile Couples

Purpose: This study was conducted to examine the level of infertility stress, marital adjustment, depression, and quality of life in infertile couples and assess the actor and partner effects in these areas using the actor–partner interdependence model. Design: Cross-sectional study. Method: Participants were 121 infertile couples. After pilot study, data were collected from November 2012 to March 2013 using the following questionnaires: the Fertility Quality of Life, Fertility Problem Inventory, Revised Dyadic Adjustment Scale, and Beck Depression Inventory. Findings: There was a gender difference in infertility stress, depression, and quality of life. Infertility stress had actor and partner effects on the quality of life. Marital adjustment had an actor effect on the quality of life for the wives. Depression had actor and partner effects on quality of life for the wives, but only an actor effect for the husbands. Conclusion: This study found that there were actor and partner effects of infertility stress, marital adjustment, and depression on the quality of life in infertile couples. These findings may help nurses be aware of such effects and can be used as a baseline data in the development of nursing interventions for infertile couples.

[Non-linear System Dynamics Simulation Modeling of Adolescent Obesity: Using Korea Youth Risk Behavior Web-based Survey].

PURPOSE The purpose of this study was to develop a system dynamics model for adolescent obesity in Korea that could be used for obesity policy analysis. METHODS On the basis of the casual loop diagram, a model was developed by converting to stock and flow diagram. The Vensim DSS 5.0 program was used in the model development. We simulated method of moments to the calibration of this model with data from The Korea Youth Risk Behavior Web-based Survey 2005 to 2013. We ran the scenario simulation. RESULTS This model can be used to understand the current adolescent obesity rate, predict the future obesity rate, and be utilized as a tool for controlling the risk factors. The results of the model simulation match well with the data. It was identified that a proper model, able to predict obesity probability, was established. CONCLUSION These results of stock and flow diagram modeling in adolescent obesity can be helpful in development of obesity by policy planners and other stakeholders to better anticipate the multiple effects of interventions in both the short and the long term. In the future we suggest the development of an expanded model based on this adolescent obesity model.Purpose: The purpose of this study was to develop a system dynamics model for adolescent obesity in Korea that could be used for obesity policy analysis. Methods: On the basis of the casual loop diagram, a model was developed by converting to stock and flow diagram. The Vensim DSS 5.0 program was used in the model development. We simulated method of moments to the calibration of this model with data from The Korea Youth Risk Behavior Web-based Survey 2005 to 2013. We ran the scenario simulation. Results: This model can be used to understand the current adolescent obesity rate, predict the future obesity rate, and be utilized as a tool for controlling the risk factors. The results of the model simulation match well with the data. It was identified that a proper model, able to predict obesity probability, was established. Conclusion: These results of stock and flow diagram modeling in adolescent obesity can be helpful in development of obesity by policy planners and other stakeholders to better anticipate the multiple effects of interventions in both the short and the long term. In the future we suggest the development of an expanded model based on this adolescent obesity model.

Longitudinal Effects of Body Mass Index and Self-Esteem on Adjustment From Early to Late Adolescence: A Latent Growth Model

Background: Mental and physical development during adolescence is a factor that may affect quality of life in adulthood. Purpose: The aims of this study were to investigate the developmental trajectories of body mass index (BMI), self-esteem, and adjustment among students from early to late adolescence and to examine the longitudinal relationships among these variables. Methods: Data from 2006 to 2012 were collected from the Korean Welfare Panel Study. Of the initial sample of 521 students, 487 completed a validated questionnaire measuring BMI, self-esteem, and adjustment. Latent growth curve modeling analyses were conducted to examine the relationships among the variables. Results: Univariate linear growth models showed a significant increase in BMI and significant declines in both self-esteem and adjustment across three time points from childhood to adolescence. The goodness of fit of the multivariate conditioned model supported the validity of the proposed longitudinal model (comparative fit index = .93, root mean square error of approximation = .08). Change in BMI was significantly linked with change in adjustment (&bgr; = .18, p < .05) but not with change in self-esteem, whereas change in self-esteem exerted a statistically significant effect on change in adjustment (&bgr; = .47, p < .001). Conclusions/Implications for Practice: Our findings indicate that BMI and self-esteem are key determinants of student adjustment in school settings. Therefore, future health education interventions should focus on enhancing the positive physical and mental self-concepts of students, which should improve health and social behavior among students and subsequently afford a better quality of life for these students in adulthood.

Effects of stress appraisal on the quality of life of adult patients with multiple myeloma and their primary family caregivers in Korea

Modern treatment for multiple myeloma (MM) has improved disease control and prolonged survival; thus, maintenance of quality of life (QoL) is considered a great concern for MM patients and their caregivers. The purpose of this study was to identify dyadic associations between stress appraisal and the QoL of patients with MM and their caregivers in Korea.

Model for Unplanned Self Extubation of ICU Patients Using System Dynamics Approach

PURPOSE In this study a system dynamics methodology was used to identify correlation and nonlinear feedback structure among factors affecting unplanned extubation (UE) of ICU patients and to construct and verify a simulation model. METHODS Factors affecting UE were identified through a theoretical background established by reviewing literature and preceding studies and referencing various statistical data. Related variables were decided through verification of content validity by an expert group. A causal loop diagram (CLD) was made based on the variables. Stock & Flow modeling using Vensim PLE Plus Version 6.0 b was performed to establish a model for UE. RESULTS Based on the literature review and expert verification, 18 variables associated with UE were identified and CLD was prepared. From the prepared CLD, a model was developed by converting to the Stock & Flow Diagram. Results of the simulation showed that patient stress, patient in an agitated state, restraint application, patient movability, and individual intensive nursing were variables giving the greatest effect to UE probability. To verify agreement of the UE model with real situations, simulation with 5 cases was performed. Equation check and sensitivity analysis on TIME STEP were executed to validate model integrity. CONCLUSION Results show that identification of a proper model enables prediction of UE probability. This prediction allows for adjustment of related factors, and provides basic data do develop nursing interventions to decrease UE.

A retrospective analysis to identify the factors affecting infection in patients undergoing chemotherapy.

PURPOSE This study compares the performance of the logistic regression and decision tree analysis methods for assessing the risk factors for infection in cancer patients undergoing chemotherapy. METHOD The subjects were 732 cancer patients who were receiving chemotherapy at K university hospital in Seoul, Korea. The data were collected between March 2011 and February 2013 and were processed for descriptive analysis, logistic regression and decision tree analysis using the IBM SPSS Statistics 19 and Modeler 15.1 programs. RESULTS The most common risk factors for infection in cancer patients receiving chemotherapy were identified as alkylating agents, vinca alkaloid and underlying diabetes mellitus. The logistic regression explained 66.7% of the variation in the data in terms of sensitivity and 88.9% in terms of specificity. The decision tree analysis accounted for 55.0% of the variation in the data in terms of sensitivity and 89.0% in terms of specificity. As for the overall classification accuracy, the logistic regression explained 88.0% and the decision tree analysis explained 87.2%. CONCLUSIONS The logistic regression analysis showed a higher degree of sensitivity and classification accuracy. Therefore, logistic regression analysis is concluded to be the more effective and useful method for establishing an infection prediction model for patients undergoing chemotherapy.

Telenursing in Korea

Development of science and information and telecommunications technology has gradually improved our quality of life. With the health service market being no exception, greater attention is being given to the application of information and communication technology by health-care providers aiming to provide more detailed, customized and personalized health-care services in an efficient and effective manner. One such method is telenursing, which refers to the use of telecommunication technology in nursing to enhance patient care.7 Through this system, nurses monitor patients’ data and analyze their condition, and then suggest nursing advice which will potentially enhance patients’ ability to achieve and maintain their health and wellness.