Misoon Song

The effects of an integrated health education and exercise program in community-dwelling older adults with hypertension: A randomized controlled trial

OBJECTIVE the aim of this study was to examine the effectiveness of HAHA (Healthy Aging and Happy Aging) program, which is an integrated health education and exercise program for community-dwelling older adults with hypertension. METHODS older adults with hypertension from one senior center were randomly allocated to experimental (n=18) or control group (n=22). Experimental group received health education, individual counseling and tailored exercise program for 12 weeks. RESULTS the mean ages were 71 years (experimental group) and 69 (control group). After the intervention, systolic blood pressure of experimental group was significantly decreased than that of control group. Scores of exercise self-efficacy, general health, vitality, social functioning, and mental health in SF-36 were statistically higher than those of control group. CONCLUSION the HAHA program was effective in control of systolic blood pressure and improving self-efficacy for exercise and health-related quality of life.

Barriers to and facilitators of self‐management adherence in Korean older adults with type 2 diabetes

AIM The aim of this study was to identify the barriers to and facilitators of self-management adherence in Korean older adults with type 2 diabetes. DESIGN AND METHODS Qualitative data collected from 24 participants in three focus groups who had previously taken part in a diabetes self-management education programme in a community setting were analyzed using an interpretive method. RESULTS The barriers to adherence to self-management included ageing-related physical and psychological changes, restrictions related to specific cultural factors, lack of self-discipline and poor understanding of self-management. Facilitators of self-management were knowing the benefits of and having a system to reinforce self-management, being the master of oneself by reshaping historical life habits and family support. The perceived barriers and facilitators differed with gender as a result of the characteristics of Korean culture. CONCLUSIONS This study identified the major barriers to and facilitators of self-management adherence specific to Korean older adults with diabetes, which can be used to develop better diabetes self-management education programmes for this population. RELEVANCE TO CLINICAL PRACTICE Korean nurses working with Korean older adults with diabetes can utilize the findings of this study to structure better tailored and culturally appropriate self-management programmes specific to older adults.

An evaluation of Web-based education as an alternative to group lectures for diabetes self-management.

This study evaluated the efficacy of Web-based diabetes self-management education for newly diagnosed patients with type II diabetes as an alternative to group lectures. Using a non-equivalent control group, pretest-post-test design, the participants in the Web group (n = 15) took part in a Web-based diabetes self-management program, while those in the lecture group (n = 16) attended 3 h of group lectures provided by health-care professionals specializing in diabetes care. The outcome variables were measured at the baseline (T0), and 6 weeks (T1) and 3 months (T2) after the interventions. The glycosylated hemoglobin (HbA1c) percentage and diabetes care knowledge in the Web group improved significantly from T0 to T1, while the diabetes care behavior improved significantly from T0 to T1 and from T1 to T2. The diabetes care knowledge and diabetes care behavior in the lecture group improved significantly from T0 to T1, but the HbA1c percentage did not change significantly between any times. These results show the potential of the Web-based program as an alternative to group lectures for diabetes self-management education.

Family functioning in the context of chronic illness in women: a Korean study

The aims of this study were to clarify the concept of family functioning in the context of a female family members chronic illness, and to describe the processes by which the housewife copes with the situation. The study applied the hybrid model of concept development, which consists of three phases: theoretical, empirical, and analytic. In the theoretical phase, a working definition of family functioning was established and the dimensions of family functioning and subconcepts were identified through an extensive review of the literature. In the empirical phase, in-depth interviews with members of six normal families and seven families in which the housewife had a long-term diagnosis of rheumatoid arthritis were carried out in order to gain descriptions of family functioning in both contexts, and to assess how the housewife coped with her illness in relation to family functioning. The final analytic phase identified the differences and similarities in family functioning between the normal family and family with a chronically ill housewife. A refined definition of family functioning emerged that identified the concept in terms of a complex set of functional dimensions comprising affective, structural, control, cognitive, and external relationships. The data revealed that family functioning is dynamically changed when the housewife becomes ill with a chronic disease. Three types of adaptation process were identified by which the housewives adapted to family functioning in the context of their chronic illnesses: negotiated, self-accommodating, and separated-enduring. The implications of these findings for research and nursing practice are discussed.

Successful Aging of Korean Older Adults based on Rowe and Kahn's Model: A Comparative Study According to the Use of Community Senior Facilities

PURPOSE This study was conducted to examine the prevalence of successful aging and factors influencing successful aging. METHODS This was a secondary analysis study. Data were analyzed from 10,462 elderly people who participated in the 2011 National Elderly Survey. According to the use of community senior facilities, participants were divided into 4 groups: those who used senior centers (group A, n=580), village senior clubs (group B, n=3,240), both of the 2 facilities (group C, n=339), and neither of the 2 facilities (group D, n=6,303). Cross-tabulation and logistic regression were performed. RESULTS The prevalence of successful aging was highest in group C (20.94%) and lowest in group D (10.41%). The physical & mental function and active engagement domains were highest in group C, while they were lowest in group D. The disease & risk factors domain were highest in group A, while lowest in group B. An educational level of middleschool or higher and income level in the third or higher quintile were significant factors for predicting successful aging in all groups. CONCLUSION These results provide a basis for designing prevention and management programs as interventions to increase the prevalence of successful aging in Korean older adults.

Strategies for enhancing information, motivation, and skills for self-management behavior changes: a qualitative study of diabetes care for older adults in Korea.

Purpose To describe strategies for enhancing information, motivation, and skills related to changes in diabetes self-management behavior among community-dwelling older adults in Korea. Patients and methods A total of five focus group interviews (three separate focus groups) were conducted with 12 older adults with type 2 diabetes and five diabetes educators. Qualitative content analysis was used. Results “One’s own willingness and ability” emerged as a fundamental belief about the strategies for diabetes self-management. Six major themes under three categories were identified. Under the information category, the recurrent themes were: 1) repeatedly offering detailed knowledge regarding self-management, 2) providing information about current health status, and 3) identifying experiential knowledge of blood glucose control. The recurrent themes in the motivation category were: 1) ensuring a positive attitude regarding self-management, and 2) encouragement or feedback from significant others. Furthermore, in the skills category, we found that the following theme emerged: hands-on skills training with numerical standards. Conclusion This study identified six tailored strategies for enhancing information, motivation, and skills for diabetes self-management behavior changes. These strategies can be used in the development of a culturally sensitive diabetes self-management program for older adults.

Trends of Doctoral Dissertations of One College of Nursing in Korea

Purpose: The purpose of this study was to identify the trend of nursing research by analyzing the doctoral dissertations in one college of nursing in Korea. Method: The areas of research, the methodological characteristics, and theories used in the research were explored in all doctoral dissertations (n

Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness

PURPOSE The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. METHODS A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. RESULTS Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. CONCLUSION The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.

Combined exercise training and self-management education for community-dwelling older adults with diabetes in Korea.

This study examined the effect of a combined program of exercise training and self-management education on risk factors for diabetes complications and adherence behavior. A two-group, quasi-experimental study design was used to test the 12-week intervention program with community-dwelling older adults in Korea. Change scores (from baseline to Week 13) of outcome variables were compared between the intervention group (n = 21) and the control group (n = 16). The change scores in triglyceride levels, body weight, body mass index, and diabetes self-management behavior showed significant differences between groups. However, no significant differences were found in A1C and blood pressure change scores between the groups in this sample, in which these characteristics were relatively well controlled at baseline. The results of this study showed some promising synergistic effects of lowering cardiovascular risk factors from combining the two interventions.

Thinking in clinical nursing practice: a study of critical care nurses' thinking applying the think-aloud, protocol analysis method.

PURPOSE The purpose of the paper is to discover the patterns and processes of decision-making in clinical nursing practice. METHODS A set of think-aloud data from five critical care nurses during 40 to 50 minutes of caregiving in intensive care units were obtained and analyzed by applying the procedures recommended by Ericsson and Simon for protocol analysis. RESULTS Four thinking processes before acting were identified to constitute various sorts of thoughts in which the nurses were engaged during patient care: reviewing, validation, consideration, rationalization, and action. In addition, three patterns of sequential streaming of thinking (short, intermediate, long) were identified to reveal various ways the nurses dealt with clinical situations involving nursing tasks and responsibilities. CONCLUSION This study specifies the initial categories of thoughts for each of the processes and various patterns with which these processes are sequentially combined, providing insights into the ways nurses think about problems and address their concerns. The findings suggest that the thinking in clinical practice involves more than focused decision-making and reasoning, and needs to be examined from a broader perspective.