Yeon Hwan Park

Predictors of Physical Activity in Korean Older Adults: Distinction between Urban and Rural Areas

PURPOSE The aim of this study was to compare the predictors of physical activity between urban and rural dwelling Korean older adults. METHODS This study was a cross-sectional descriptive survey. A self-report questionnaire or face to face interviews were used to collect data from 336 older adults (urban: 129, rural: 207) who visited public health centers or welfare centers in 2008. RESULTS About half of the participants (urban: 50.4%, rural: 47.3%) were classified as the minimally active group. Cognitive function (odds ratio [OR]=1.106, p=.004) and loneliness (OR=0.965, p=.044) were predicting factors for physical activity in rural elderly. Age (OR=0.326, p=.037), gender (OR=2.841, p=.021) and depression (OR=0.799, p<.001) were significant factors predicting physical activity in urban elders. CONCLUSION These findings provide information that is relevant in designing interventions to enhance physical activity in older adults. There is a need to develop effective mutifaceted physical activity interventions that include reducing psychological barriers such as depression, loneliness.

Physical Activity and Sleep Patterns in Elderly Who Visited a Community Senior Center

PURPOSE The purpose of this study was to identify the relationship between physical activity and sleep patterns of the elderly. METHODS The subjects of this study were 154 elderly who visited a community senior center in Korea. Data was collected by an interview and a self reported questionnaire, during the period from June to October, 2006. Physical activity was measured by IPAQ Korean version (2006), and sleep pattern by Korean Sleep Scale A developed by Oh et al. (1998). RESULTS The prevalence of chronic illness in the subjects was 73.4 %. The mean time of vigorous activity was 6.62+/-31.27 minutes/day during the past week. Moderate activity time was 28.85+/-50.31 minutes/day and walking time was 28.85+/-50.3 minutes/day. The total sleep time was 397.63+/-111.53 minutes/day. Physical activity of the elderly significantly correlated with sex, chronic illness, job, and sleep patterns of the elderly. Stepwise multiple regression analysis revealed that the most powerful predictor of sleep pattern was the satisfaction of sleep. A combination of the number of chronic illnesses, moderate physical activities (MET), and total time of sleep accounted for 44.4% of the sleep pattern. CONCLUSIONS Moderate physical activity is more effective than vigorous physical activity for improving the sleep quality of the elderly.

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.

Validation of the Korean Version of the Standardized Swallowing Assessment Among Nursing Home Residents

Proper management and prevention of dysphagia is an urgent need of long-term care for older adults in Korea. However, no screening tools with high sensitivity and accessibility have been validated within Korean nursing home settings. The purpose of this study was to validate a screening tool for nurses to identify dysphagia and aspiration risk in nursing home residents. RNs screened 395 residents from two nursing homes in South Korea using the Korean version of the Standardized Swallowing Assessment (K-SSA). Results were validated against those from the Gugging Swallowing Screen (GUSS). Compared to results from the GUSS, with 9-point and 14-point cutoffs, the K-SSA had a sensitivity of 0.94 and specificity of 0.65 for screening dysphagia and 0.86 sensitivity and 0.71 specificity for screening aspiration risks. The K-SSA demonstrated excellent sensitivity and specificity for screening individuals at risk of dysphagia and aspiration when used by RNs in nursing homes.

Nurses' perceptions and experiences at daycare for elderly with stroke.

Purpose: While adult daycare (ADC) is considered a culturally acceptable model of long-term care in countries with a tradition of family-oriented caregiving, Korea is struggling as soaring needs for ADC outpace qualified staff and regulatory systems. This study aimed to describe Korean daycare nurses’ perceptions of key daycare services and their working experiences with stroke patients and their families. Design: A mixed-method design was used. First, we conducted a cross-sectional descriptive survey to assess Korean nurses’ perceptions about the importance of daycare services. Then focus group interviews were performed to explore the nurses’ experiences at ADC. Methods: Seventy of a total of 96 nurses at ADC that specialized in the care of stroke patients responded to the survey (response rate 72.9%) and rated the importance of 11 key daycare service items on a visual analogue scale (0–10). Using a purposive sampling design, 16 eligible nurses were interviewed as a group. The qualitative data from focus group interviews were analyzed using thematic analysis to classify common themes into larger categories. Findings: Survey data revealed that the nurses perceived “skilled nursing services,”“functional recovery,” and “general health counseling” as the most important daycare service areas. Focus group data resulted in five themes: “Providing the same, standard care,”“Lack of partnership with family caregivers,”“Conflict with other staff: ambiguity of the roles and tasks,”“Lack of proper education and training,” and “Need for quality control and monitoring.” Conclusions: Daycare nurses fully recognized the importance of direct nursing care services that are keys to adequate recovery and rehabilitation of older patients with stroke. However, they experienced substantial barriers to carrying out these services due to role confusion, insufficient number of qualified nursing staff, and lack of partnership with family caregivers. Clinical Relevance: The results provide insight into changing healthcare policy to support daycare nurses in a country with limited resources and regulations. Strategies such as better quality control and monitoring of daycare services, provision of continuing education, and prioritizing key services should be considered as a way to address challenges experienced by daycare nurses.

Violent Experiences and Coping among Home Visiting Health Care Workers in Korea

PURPOSE The purpose of this study was to explore violent experiences of home visiting health care workers in Korea. METHODS This study was a cross-sectional survey. Data were collected using self-report questionnaires from 1,640 health care workers. Data collection was done between September 1, 2009 and June 30, 2010. RESULTS Of the respondents, 70.6% had experienced work-related violence. Shouting (51.9%) was the most common verbal violence, followed by verbalizing sexual remarks to the health care workers (19.0%) and touching the hands (16.5%), the most common acts relating to sexual harassment. Of the respondents who had experienced violence, 50.9% told their peers about the incidents. However, the major reasons why they did not report these incidents was due to the fact that they felt it was useless to file reports and that they expected such incidents to occur as part of their job. The majority of the respondents (86.4%) wanted education on how to deal with such violence at work. CONCLUSION The results of this study indicate that efforts should be made to increase awareness and to minimize violence in the workplace. Also, educational programs should be designed to improve knowledge and to prevent workplace violence.

Development of a Triage Competency Scale for Emergency Nurses

PURPOSE This study aimed to develop a triage competency scale (TCS) for emergency nurses, and to evaluate its validity and reliability. METHODS Preliminary items were derived based on the attributes and indicators elicited from a concept analysis study on triage competency. Ten experts assessed whether the preliminary items belonged to the construct factor and determined the appropriateness of each item. A revised questionnaire was administered to 250 nurses in 18 emergency departments to evaluate the reliability and validity of the scale. Data analysis comprised item analysis, confirmatory factor analysis, contrasted group validity, and criterion-related validity, including criterion-related validity of the problem solving method using video scenarios. RESULTS The item analysis and confirmatory factor analysis yielded 5 factors with 30 items; the fit index of the derived model was good (χ²/df =2.46, Root Mean squared Residual=.04, Root Mean Squared Error of Approximation=.08). Additionally, contrasted group validity was assessed. Participants were classified as novice, advanced beginner, competent, and proficient, and significant differences were observed in the mean score for each group (F=6.02, p=.001). With reference to criterion-related validity, there was a positive correlation between scores on the TCS and the Clinical Decision Making in Nursing Scale (r=.48, p<.001). Further, the total score on the problem solving method using video scenarios was positively correlated with the TCS score (r=.13, p=.04). The Cronbachs α of the final model was .91. CONCLUSION Our TCS is useful for the objective assessment of triage competency among emergency nurses and the evaluation of triage education programs.

Facilitators and barriers to self-management of nursing home residents: perspectives of health-care professionals in Korean nursing homes.

Purpose To explore facilitators and barriers to self-management from the viewpoint of staff taking care of nursing home (NH) residents with chronic diseases in South Korea. Patients and methods A qualitative content analysis was done using the focus group interview method. A total of 23 health-care professionals (16 registered nurses and 7 social workers) were interviewed from three urban NHs, each with more than 100 beds. Results Five facilitators were identified: grouping the residents; the resident’s awareness of his/her current health status; the willingness of residents to engage in self-management; residence in the facility; and support from the staff. Additionally, seven barriers were identified: deterioration of the resident’s health; the dependency expectations of the resident; hesitation in asking for help; difference in expectations between the staff and the resident’s family; insufficient staffing and time; lack of standardized guidelines; and conservative tendencies of the staff due to rigid policies. Conclusion The findings of this study can help health-care professionals recognize the factors that influence self-management and provide direction for registered nurses and other health professionals involved in supporting self-management programs for NH residents.