Eunmi Ham

Risk Factors for Female Urinary Incontinence among Middle-Aged Korean Women

OBJECTIVE The aim of this study was to investigate risk factors for urinary incontinence (UI) in middle-aged (35-64 years) Korean women. METHODS This was a cross-sectional, case-control study using a structured self-administered questionnaire. To identify the unadjusted associations of each potential risk factor with prevalence of UI, univariate logistic regression analyses were used. A multiple logistic regression model was then constructed with only those variables that were significantly associated with the UI (p < 0.05) in the univariate analyses. Multivariate logistic regression analysis was used to determine adjusted odds ratios (OR) and 95% confidence intervals (CI). RESULTS Of 608 community-dwelling women included in the analyses, 259 (42.6%) met the definition of UI (at least once a month or the amount of more than a few drops lost during the past 12 months). A multivariate regression model was constructed that included the eight variables of age, body mass index (BMI), number of vaginal deliveries, menstrual status, hysterectomy, present hormone use, hypertension, and diabetes mellitus (DM). Obesity (BMI > 25 kg/m(2)), being postmenopausal, having two or more vaginal deliveries, having a history of hysterectomy, and being a current user of hormones increased the odds of having UI. CONCLUSIONS Obesity as defined using Asian-Pacific criteria was a strong risk factor for middle-aged Korean womens UI. More than one vaginal birth caused increased odds of having stress or mixed UI. Hysterectomy, menopause, and hormone replacement were also significant risk factors.

Factors Affecting Preparation Stage to Quit Smoking in Men

PURPOSE This study was done to investigate factors affecting preparation stage to quit smoking in men. METHODS Based on data from the Community Health Survey conducted in Chungbuk Province in 2008, we estimated rates and odds ratio (OR) of smoking cessation intention for 2,639 men who were current smokers. Multivariate logistic regression analyses were used to identify factors affecting preparation stage to quit smoking. RESULTS Among current male smokers, the rate of smoking cessation intention was 17.1%. The OR of factors affecting smoking cessation was as follows: Compared to men with middle school education, the OR for rate of smoking cessation intention in men with high school education was 1.47 (p=.018), and for college or higher, 1.55 (p=.017). Compared to being single, the OR for cohabitation after marriage was 1.61 (p=.011) and living alone after marriage, 2.23 (p=.005). The OR for attempt to quit smoking, exposure to secondhand smoke and participation in smoking education were 6.80 (p<.001), 1.32 (p=.020) and 1.69 (p=.005), respectively. CONCLUSION Results of this study show that it is necessary to decrease exposure to secondhand smoke and to increase participation in smoking cessation education targeting current smokers to move them from precontemplation or contemplation stage to preparation stage.

Perceptions about cancer-related fatigue among cancer patients using Q methodology

PURPOSE Cancer-related fatigue (CRF) is a common subjective feeling and disabling symptom complex experienced by patients with cancer. This study aimed to identify the subjective perceptions of Korean patients with cancer about CRF to help the development of basic intervention strategies for these patients. METHODS Q methodology was used to examine the subjective perceptions of patients with cancer about CRF. Thirty-one patients with cancer, hospitalized at a university hospital in Seoul, Korea, were recruited into this study and classified 41 selected Q statements using a nine-point scale. Data were analysed using PC-QUANL for Windows. RESULTS Data analysis revealed that distinct perceptions about CRF do exist among Korean patients with cancer. Three types of perceptions were identified: dominant self-reliance, positive-conformist and self-deprecating exhaustion. These three types explained 53.0% of the variance (40.2%, 8.2% and 4.6%, respectively). CONCLUSIONS This study identified three types of perceptions about CRF among Korean patients with cancer. These findings provide baseline data to develop customised interventions for caring strategies. This study also informs health professionals in other countries about the perceptions of Korean patients with cancer about CRF.

Collaborative web-based nursing practice learning system

Nurses collaborate with other medical professionals including doctors, lab technicians, and other nurses to provide patient care. Especially, the nurses often work as a team to take care of multiple patients. However, it is fairly often for the team members to work at different time in different location as they are assigned to work in different shifts. Traditionally, the nurses keep the written patient records for the others to review and also have brief face-to-face meetings as one shift ends and the next shift starts. This process tends to be one-way communication from the nurses, who collected and/or analyzed the patient information, to other nurses in the same team without much opportunity to feedback or clarification. Although, this approach works well for the experienced nurses, the novice nurses or the nursing students in the internship settings require fairly long time to get used to it. To remedy this problem, we are developing a web-based nursing practice collaborative system, which can also act as an in-practice learning system to enable better communication and also group decision making. We designed the system to facilitate collaborative learning by a team of nurses through helping each other to work toward to achieve the goal of best nursing care.

Learning to generate an ontology-based nursing care plan by virtual collaboration

We describe how a web-based collaboration system is used to generate a document by referring ontology within a specific subject area. We have chosen nursing science as the target subject area as the nurses collaboratively plan and apply necessary treatments to the patients. The planning process involves coming up with a set of decisions and activities to perform according to the knowledge embedded in the nursing subject ontology. The nurses copiously record the patient conditions, which they observed, and also the ensuing reasoning outcome in the form of the diagnoses. Nursing care plan is a representative document, which is generated during the application of nursing processes. The plan includes general patient information, medical history, one or more goals of the nursing care plan, nursing diagnoses, expected outcomes of the care, and possible nursing interventions. We are developing a collaborative nursing care plan generation system, where several nurses can record and update the collected factual information about the patients and then come up with the most appropriate nursing diagnoses, outcomes, and interventions. The nursing care plan generation system is designed to double as a learning aid in order for the nurses by allowing them to observe what others do during the plan generation process. Eventually, the nurses are expected to share the same semantics of each ontology as they repeat the ontology-based decision makings.

Role of Irrational Beliefs and Anger Rumination on Nurses’ Anger Expression Styles

The aim of this study was to identify whether certain cognitive factors, such as irrational beliefs and anger rumination, affect nurses’ anger expression styles. A total of 335 nurses employed at four tertiary hospitals in Korea completed surveys between July 29 and September 25, 2015. The surveys included Shortened General Attitude and Belief Scale, the Korean Version of the Anger Rumination Scale, and the State-Trait Anger Expression Inventory–Korean version. Results revealed that higher levels of irrational beliefs and anger rumination were associated with more anger-in and anger-out, and less anger-control expressions. Findings indicate that the presence of specific cognitive characteristics could lead to maladaptive anger expressions. Active consideration of these cognitive risk factors is essential when developing anger-management programs for nurses.

Patient modeling using mind mapping representation as a part of nursing care plan

Nursing care plan reports are one of the most important documents in the application of nursing processes. In this paper, we describe how a text discourse analysis and an information extraction system can be used to convert a traditional nursing care plan into a mind mapping representation. Mind mapping is a process to allow the nurses to focus on the patients rather than on a disease process. Mind mapping encourages the nurses to maintain a holistic view of the patient. A mind mapping representation refers to a visual picture of a patient at the center with various nursing care related information visually linked to the patient’s form. Our goal is to develop visually browsable models of the patients to aid in the nursing process education and also help the nurses focus on the patients in the actual care settings.

Identifying text discourse structure of the narratives describing psychiatric patients’ defense mechanisms

Psychiatric nursing care plans include the narratives describing the defense mechanisms exhibited by the patients. These narratives form the basis for generating psychodynamic analysis, which is one of the key diagnosis outcomes about the patients. However, it is fairly difficult for the novice nurses to correctly identify the type of defense mechanism based on the observations that they made while caring for the patients. One of the main reasons for the high error rate is the lack of uniform terminology. That is, inconsistencies in the definitions and conceptualizations of defenses. Furthermore, there is lack of sufficient examples showing the wide variety of cases from which the novice nurses to learn. We developed a prototype text discourse analysis system, which assigns one or more text discourse categories to each clause in the defense mechanism narratives. The initial evaluation of the prototype system resulted in correctly identifying 85% of the defense mechanisms in the test data set. The output from the text discourse analysis system is fed into a database to augment the definition of the defense mechanisms and also to be used as a learning tool for the novice nurses.

Computer-Mediated collaborative visual learning system to generate evidence-based nursing care plans

For the nurses to provide quality patient care, the nurses need to generate an accurate and reliable nursing care plan. To prepare a nursing care plan, the nurses need to follow a number of steps starting from the data collection stage and ending with the nursing diagnoses, outcome, and intervention selection stage. Many nurses are responsible for many patients. The patients come and go. The nurses in many critical settings work in the three eight-hour shifts. Therefore, it is essential and necessary for many nurses to share the generation and the use of the nursing care plan. Instead of text-based nursing care plan, we are developing a visual system to represent patient state and the corresponding diagnosis through collaborations amongst the nurses. By using this system, the novice nurses learn from what others do.

Developing collaborative virtual learning community for the korean community health practitioners

Community Health Post workers are mainly registered nurses. They provide first-level primary health care to the numerous underserved rural communities in Korea. The primary goal of our project is to provide technological foundation for the community health practitioners to form a virtual community that collaboratively solves problems and learns to improve their patient caring and treatment skills. The main enabling technology is a collaboratively maintained knowledge management system, which assists the community health practitioners to make appropriate diagnoses and also to determine the corresponding expected outcomes and interventions to perform given the patients symptoms. The knowledge management system includes a knowledge base, which is converted from the standardized nursing process guidelines. In addition, the knowledge management system is also used as a case retrieval system so that the community health practitioners can compare the current case in progress with the similar prior cases. We have developed a prototype system and finished a preliminary evaluation of the system.