Yaelim Lee

Effects of bilateral passive range of motion exercise on the function of upper extremities and activities of daily living in patients with acute stroke.

[Purpose] To evaluate the effects of early passive range of motion exercise on the function of upper extremities and activities of daily living in patients with acute stroke. [Methods] A total of 37 patients with acute stroke in intensive care units, were assigned to the experimental group (n=19) and control group (n=18). The experimental group performed passive range of motion exercise twice a day, for 4 weeks, immediately after a pretest; the patients in the control group performed the range of motion exercise in the same manner for 2 weeks beginning 2 weeks after the pretest. The functions of upper extremities (edema, range of motion), manual function, and activities of daily living of both groups were measured before and at four weeks after the intervention. [Results] The experimental group showed a significant decrease in the edema of upper extremities compared with the control group. It also showed a significant increase in the range of motion, function of upper extremities, and the activities of daily living compared to the control group. [Conclusion] Passive range of motion exercise in the early stage can improve the function of upper extremities and activities of daily living in patients with acute stroke.

A culturally tailored Internet cancer support group for Asian American breast cancer survivors: A randomized controlled pilot intervention study

Introduction The necessity of culturally competent Internet Cancer Support Groups (ICSGs) for ethnic minorities has recently been highlighted in order to increase its attractiveness and usage. The purpose of this study was to determine the preliminary efficacy of a culturally tailored registered-nurse-moderated ICSG for Asian American breast cancer survivors in enhancing the women’s breast cancer survivorship experience. Methods The study included two phases: (a) a usability test and an expert review; and (b) a randomized controlled pilot intervention study. The usability test was conducted among five Asian American breast cancer survivors using a one-month online forum, and the expert review was conducted among five experts using the Cognitive Walkthrough method. The randomized controlled pilot intervention study (a pre-test and post-test design) was conducted among 65 Asian American breast cancer survivors. The data were analysed using content analysis and descriptive and inferential statistics including the repeated ANOVA. Results All users and experts positively evaluated the program and provided their suggestions for the display, educational contents, and user-friendly structure. There were significant positive changes in the support care needs and physical and psychological symptoms (p < 0.05) of the control group. There were significant negative changes in the uncertainty level of the intervention group (p < 0.10). Controlling for background and disease factors, the intervention group showed significantly greater improvements than the control group in physical and psychological symptoms and quality of life (p < 0.10). Discussion The findings supported the positive effects of ICSGs on support care needs, psychological and physical symptoms, and quality of life.

Stress and Premenstrual Symptoms in Reproductive-Aged Women

Premenstrual symptoms are often reported from reproductive-aged women worldwide. The etiologies of the symptoms are complex (e.g., biological and sociocultural factors), and require an international and multidisciplinary approach. A total of 48 studies were reviewed on how stress and premenstrual symptoms have been defined and measured, and major findings on relational patterns and other associated factors were examined. Subsequently, we discuss several trends and limitations identified from the review. Prospective studies, which use valid assessment measures and consider womens subjective and objective symptoms for several menstrual cycles, are necessary for a valid conclusion. More intervention studies and studies on various populations are needed.

Androgen deficiency syndrome in older people

Purpose: To support nurse practitioners in their encounters with aging male patients with signs and symptoms related to the decline of male sex hormones. Data sources: An electronic search was conducted on studies from 2006 to 2013 from the following databases: PubMed, CINAHL, Scopus, and related health resources websites. The search terms used included male menopause, andropause, androgen deficiency, testosterone deficiency, late‐onset hypo‐gonadism, and testosterone replacement therapy. Relevant studies in English were selected for an integrative review. Conclusions: Androgen deficiency syndrome has been overlooked in clinical settings. However, there has been an increase in health needs related to low testosterone levels. A diagnosis should be made carefully, considering other possible causes of the problems as well as the decision to initiate testosterone treatment (TT) and monitoring. In this article, the current awareness of androgen deficiency syndrome, pathophysiology of aging mens sex organ, clinical presentation, differential diagnoses, diagnostic strategy, clinical management, monitoring, and referral plans are discussed. Implications for practice: The rapidly growing aged population in our society makes androgen deficiency syndrome a growing issue that needs to be understood, adequately diagnosed, and carefully managed by nurse practitioners.Purpose To support nurse practitioners in their encounters with aging male patients with signs and symptoms related to the decline of male sex hormones. Data sources An electronic search was conducted on studies from 2006 to 2013 from the following databases: PubMed, CINAHL, Scopus, and related health resources websites. The search terms used included male menopause, andropause, androgen deficiency, testosterone deficiency, late-onset hypo-gonadism, and testosterone replacement therapy. Relevant studies in English were selected for an integrative review. Conclusions Androgen deficiency syndrome has been overlooked in clinical settings. However, there has been an increase in health needs related to low testosterone levels. A diagnosis should be made carefully, considering other possible causes of the problems as well as the decision to initiate testosterone treatment (TT) and monitoring. In this article, the current awareness of androgen deficiency syndrome, pathophysiology of aging mens sex organ, clinical presentation, differential diagnoses, diagnostic strategy, clinical management, monitoring, and referral plans are discussed. Implications for practice The rapidly growing aged population in our society makes androgen deficiency syndrome a growing issue that needs to be understood, adequately diagnosed, and carefully managed by nurse practitioners.

Consistency and Accuracy of Multiple Pain Scales Measured in Cancer Patients From Multiple Ethnic Groups.

Background: Standardized pain-intensity measurement across different tools would enable practitioners to have confidence in clinical decision making for pain management. Objectives: The purpose was to examine the degree of agreement among unidimensional pain scales and to determine the accuracy of the multidimensional pain scales in the diagnosis of severe pain. Methods: A secondary analysis was performed. The sample included a convenience sample of 480 cancer patients recruited from both the Internet and community settings. Cancer pain was measured using the Verbal Descriptor Scale (VDS), the visual analog scale (VAS), the Faces Pain Scale (FPS), the McGill Pain Questionnaire–Short Form (MPQ-SF), and the Brief Pain Inventory–Short Form (BPI-SF). Data were analyzed using a multivariate analysis of variance and a receiver operating characteristic curve. Results: The agreement between the VDS and VAS was 77.25%, whereas the agreement was 71.88% and 71.60% between the VDS and FPS, and VAS and FPS, respectively. The MPQ-SF and BPI-SF yielded high accuracy in the diagnosis of severe pain. Cutoff points for severe pain were more than 8 for the MPQ-SF and more than 14 for the BPI-SF, which exhibited high sensitivity and relatively low specificity. Conclusion: The study found substantial agreement between the unidimensional pain scales and high accuracy of the MPQ-SF and the BPI-SF in the diagnosis of severe pain. Implications for Practice: Use of 1 or more pain screening tools that have validated diagnostic accuracy and consistency will help classify pain effectively and subsequently promote optimal pain control in multiethnic groups of cancer patients.

Practical guidelines for development of web-based interventions.

Despite a recent high funding priority on technological aspects of research and a high potential impact of Web-based interventions on health, few guidelines for the development of Web-based interventions are currently available. In this article, we propose practical guidelines for development of Web-based interventions based on an empirical study and an integrative literature review. The empirical study aimed at development of a Web-based physical activity promotion program that was specifically tailored to Korean American midlife women. The literature review included a total of 202 articles that were retrieved through multiple databases. On the basis of the findings of the study and the literature review, we propose directions for development of Web-based interventions in the following steps: (1) meaningfulness and effectiveness, (2) target population, (3) theoretical basis/program theory, (4) focus and objectives, (5) components, (6) technological aspects, and (7) logistics for users. The guidelines could help promote further development of Web-based interventions at this early stage of Web-based interventions in nursing.

Issues in Developing and Evaluating a Culturally Tailored Internet Cancer Support Group.

The purpose of this article is to explore practical issues in developing and implementing a culturally tailored Internet Cancer Support Group for a group of ethnic minority patients with cancer—Asian Americans. Throughout the research process of the original study testing the Internet cancer support group, the research team made written records of practical issues and plausible rationales for the issues. Weekly group discussion among research team members was conducted, and the discussion records were evaluated and analyzed using a content analysis (with individual words as the unit of analysis). The codes from the analysis process were categorized into idea themes, through which the issues were extracted. The issues included those in (1) difficulties in using multiple languages, (2) collaboration with the information technology department and technical challenges, (3) difficulties in recruitment, (4) difficulties in retention, (5) optimal timing, and (6) characteristics of the users. Based on the findings, we suggest that researchers plan a workable translation process, check technical needs in advance, use multiple strategies to recruit and retain research participants, plan the right time for data collection, and consider characteristics of the users in the study design.

Physical activities and sleep-related symptoms in 4 major racial/ethnic groups of midlife women.

The purpose of this study was to determine racial/ethnic differences in midlife womens sleep-related symptoms, relationships between their physical activity and sleep-related symptoms, and specific factors associated with their sleep-related symptoms in each racial/ethnic group. This was a secondary analysis of the data from 542 midlife women in the United States. The data were analyzed using descriptive statistics, &khgr;2 tests, analysis of variance, hierarchical multiple linear regression analyses, and logistic regression analyses. The findings indicated that physical activities could improve midlife womens sleep-related symptoms, but the types of physical activities and racially/ethnically different factors associated with sleep-related symptoms need to be considered.

Orthostatic hypotension in older people

Purpose To enhance awareness of orthostatic hypotension (OH) in older populations, and guide primary care nurse practitioners (NPs) in the assessment and management of patients with OH. Data sources Electronic data collection was conducted on studies and reviews that were published between 2005 and 2012 in English, and contained information related to the purpose of this article from following databases: PubMed, Scopus, and MEDLINE. Conclusions OH is a syndrome that is accompanied by unfavorable symptoms such as dizziness, and headaches and can impede the individuals daily activities and quality of life. The prevalence of OH is higher in older people because of comorbidities, polypharmacy, and physiological changes that occur with aging. OH is diagnosed with serial blood pressure measurements and the primary goal of management is to relieve unfavorable symptoms and enhance patient safety. Pharmacological management is considered when nonpharmacological interventions fail. Implications for practice OH is not a problem to be taken lightly as it is highly related to the risk of falling and cardiovascular problems, as well as increasing morbidity and mortality rates. NPs can contribute to improving the quality of life for older adults and reducing adverse consequences by understanding OH and adequately managing it.Purpose: To enhance awareness of orthostatic hypotension (OH) in older populations, and guide primary care nurse practitioners (NPs) in the assessment and management of patients with OH. Data sources: Electronic data collection was conducted on studies and reviews that were published between 2005 and 2012 in English, and contained information related to the purpose of this article from following databases: PubMed, Scopus, and MEDLINE. Conclusions: OH is a syndrome that is accompanied by unfavorable symptoms such as dizziness, and headaches and can impede the individuals daily activities and quality of life. The prevalence of OH is higher in older people because of comorbidities, polypharmacy, and physiological changes that occur with aging. OH is diagnosed with serial blood pressure measurements and the primary goal of management is to relieve unfavorable symptoms and enhance patient safety. Pharmacological management is considered when nonpharmacological interventions fail. Implications for practice: OH is not a problem to be taken lightly as it is highly related to the risk of falling and cardiovascular problems, as well as increasing morbidity and mortality rates. NPs can contribute to improving the quality of life for older adults and reducing adverse consequences by understanding OH and adequately managing it.

Patients' perception and adherence to vaginal dilator therapy: a systematic review and synthesis employing symbolic interactionism

Background Vaginal dilator (VD) therapy is often recommended for women receiving pelvic radiation therapy or experiencing pain and discomfort during intercourse, as well as for women with a congenital malformation of the vagina. VD use has both physical and psychological benefits; however, it often causes pain, discomfort, and adverse emotions, including embarrassment and loss of modesty, which often result in low adherence to therapy. Objectives The aims of this study were to explore the use and adherence of VD therapy in women, identify barriers and facilitators of therapy adherence, and suggest improvement strategies from the theoretical perspective of symbolic interactionism. Methods A systematic review of the literature was conducted using PubMed, CINAHL, and Scopus databases, with no year restrictions. Articles addressing the experience of women using VD therapy, as well as barriers and facilitators of therapy adherence were selected and analyzed. Then, the theoretical perspective of symbolic interactionism was introduced and applied to synthesize the results. Results A total of 21 articles were selected for the review. Most of the reviewed studies explored VD therapy in women who had undergone pelvic radiation therapy for gynecological cancer. Women’s adherence to the therapy ranged between 25% and 89.2%, with great variance in definitions and methods for assessing therapy adherence. Among the five categories of identified barriers to therapy adherence, “unhelpful circumstances” and “negative perceptions toward the VD” were the two most frequently mentioned. The two most frequently reported facilitators of adherence among the six identified categories were “supportive interactions with health care providers” and “risk perception and positive outcome expectancies”. On the basis of the perspective of symbolic interactionism, strategies for strengthening interactions with others (eg, health care providers, significant others, and support groups) are discussed in detail. Conclusion Strategic intervention regarding the decisive factors identified in the review can benefit women by enhancing their experience and adherence to VD therapy.