Journal of Korean Academy of Nursing

Original Articles

Structural Equation Modeling of Self-Management of Liver Transplant Recipients: Mi-Kyeong Jeon, Yeon-Hwan Park; J Korean Acad Nurs 2017;47(5):663-675. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.663

Abstract Purpose

The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory.

Methods

Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers’ autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program.

Results

The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers’ autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers’ autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management.

Conclusion

The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients.

Citations

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Hyeiyeon Im, Hye-Young Jang
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Nam Jo Kim, Myung Kyung Lee
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Mediating Role of Hope Between Social Support and Self-Management Among Chinese Liver Transplant Recipients: A Multi-Center Cross-Sectional Study
Dan Zhang, Nannan Zhang, Hui Chang, Ying Shi, Zijun Tao, Xu Zhang, Qi Miao, Xiaofei Li
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Type D personality, cognitive illness perception, depression, approach coping, and self-management among older adults in long-term care hospitals: Structural equation modeling
Sunki Kim, Mona Choi, JuHee Lee, Heejung Kim, Kijun Song, Hye-Ja Park
Geriatric Nursing.2022; 48: 150. CrossRef
Factors influencing the self-management of kidney transplant patients based on self-determination theory: a cross-sectional study
Mi Kyung Sim, Sun Young Son, Man Ki Ju
Korean Journal of Transplantation.2022; 36(1): 37. CrossRef
Feasibility and preliminary effects of a theory-based self-management program for kidney transplant recipients: A pilot study
Hye Won Jeong, Chi Eun Song, Minjeong An, Lucy E. Selman
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Analysis of mortality prognostic factors using model for end-stage liver disease with incorporation of serum-sodium classification for liver cirrhosis complications
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Medicine.2019; 98(45): e17862. CrossRef
Structural Equation Modeling of Self-Care Behaviors in Kidney Transplant Patients Based on Self-Determination Theory
Hye Won Jeong, Hyang Sook So
Journal of Korean Academy of Nursing.2018; 48(6): 731. CrossRef

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Applying the Flipped Learning Model to an English-Medium Nursing Course: Heeseung Choi, Jeongeun Kim, Kyung-Sook Bang, Yeon-Hwan Park, Nam-Ju Lee, Chanhee Kim; J Korean Acad Nurs 2015;45(6):939-948. Published online December 15, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.6.939

Abstract PDF

Abstract Purpose

An emerging trend in Asian higher education is English-medium instruction (EMI), which uses English as the primary instructional language. EMI prepares domestic students for international leadership; however, students report difficulty in learning, and educators have raised questions concerning the effectiveness of EMI. The flipped learning model (FLM), in which lecture and homework activities for a course are reversed, was applied to an English-medium course offered by a college of nursing in Korea. The aims of this study were to: 1) revise an existing English-medium nursing course using the FLM; 2) explore students’ learning experiences and their acceptance of the FLM; and 3) identify key factors in the success of FLM.

Methods

We used a descriptive, cross-sectional, mixed-methods design and the participants were students at one nursing school in Korea. A series of course development meetings with faculties from the nursing school and the center for teaching and learning were used to develop the course format and content. We conducted course evaluations using the Flipped Course Evaluation Questionnaire with open-ended questions and focus group interviews.

Results

Students (N=75) in a 15-week nursing course responded to a survey after completing the course. Among them, seven students participated in one of two focus groups. Overall, students accepted and favored the flipped learning strategy, and indicated that the method enhanced lecture content and their understanding of it. Factors associated with effective instruction included structured monitoring systems and motivational environments.

Conclusion

The FLM requires sufficient preparation to facilitate student motivation and maximize learning outcomes.

Citations

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Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness: Chorong Park, Misoon Song, Belong Cho, Jaeyoung Lim, Wook Song, HeeKyung Chang, Yeon-Hwan Park; J Korean Acad Nurs 2015;45(2):192-201. Published online April 30, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.2.192

Abstract PDF

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.

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Review Article

Dysphagia Screening Measures for Use in Nursing Homes: A Systematic Review: Yeon-Hwan Park, Hwal Lan Bang, Hae-Ra Han, Hee-Kyung Chang; J Korean Acad Nurs 2015;45(1):1-13. Published online February 27, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.1.1

Abstract PDF

Purpose

The purpose of this study was to evaluate the psychometric quality and feasibility of measurements for screening dysphagia in older adults to identify the 'right tool' for nurses to use in nursing homes.

Methods

A systematic review was done. Electronic databases were searched for studies related to dysphagia screening measurements. A checklist was used to evaluate the psychometric quality and applicability. Tools were evaluated for feasible incorporation into routine care by nurses.

Results

29 tools from 31 studies were identified. Dysphagia screening tools with an acceptable validity and reliability had sensitivity between 68% and 100% and specificity between 52% and 100%. The Gugging Swallowing Screen (GUSS) and the Standardized Swallowing Assessment (SSA) were the tools with high psychometric quality, especially with high sensitivity, that nurses could perform feasibly to identify the risk and to grade the severity of dysphagia and aspiration of nursing home residents.

Conclusion

Results show that GUSS and SSA are reliable and sensitive tools for screening dysphagia which nurses can use in nursing homes. Further research is needed to examine feasibility of screening with identified tools, and also, to establish effective and standardized protocols for these tools so they can be effectively incorporated into routine care.

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Original Articles

Effects of an Empowerment Program on the Adjustment of Older Adults to Nursing Home Life: Aekyung Chang, Yeon-Hwan Park; J Korean Acad Nurs 2012;42(4):559-567. Published online August 31, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.4.559

Abstract PDF

Purpose

This study aimed to evaluate the effectiveness of the empowerment intervention on the levels of self-esteem, interpersonal relationships and adjustment to nursing home life of the Korean nursing home residents.

Methods

Participants (n=47) whose period of stay was less than one year were purposefully selected from 3 nursing homes in Korea. The experimental group (n=21) attended 10 weekly hour-long empowerment sessions. The empowerment program comprised two components; group education and group discussion. The control group (n=26) received a two-hour education about health management.

Results

Compared with the control group, the experimental group showed significantly higher mean scores of self-esteem (t=5.51, p<.001), interpersonal relationships (t=2.73, p=.009) and adjustment to nursing home life (t=2.10, p=.041).

Conclusion

Findings of this study suggest that empowerment interventions may be effective in enhancing nursing home residents' self-esteem, interpersonal relationships and adjustment to nursing home life. Future research is needed to determine if such an empowerment program could be used with newly institutionalized elders to speed as well as enhance their adjustment to nursing home life.

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Development and validation of the Korean Nursing Delirium Scale: Kyoung-Nam Kim, Cheol-Ho Kim, Kwang-Il Kim, Hyun-Jung Yoo, Si-Young Park, Yeon-Hwan Park; J Korean Acad Nurs 2012;42(3):414-423. Published online June 29, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.3.414

Abstract PDF

Purpose

The aims of this study were to develop and test the validity of the Korean Nursing Delirium Scale (Nu-DESC) for older patients in hospital.

Methods

The Korean Nu-DESC was developed based on the Nu-DESC (Gaudreau, 2005), and revised according to nursing records related to signs and symptoms of older patients with delirium (n=361) and the results of a pilot study (n=42) in one general hospital. To test the validity of the Korean Nu-DESC, 75 older patients whom nurses suspected of delirium from 731 older patients from 12 nursing units were assessed by bedside nurses using the Korean Nu-DESC. A Receiver Operating Characteristic Curve of the Korean Nu-DESC was constructed with an accompanying Area Under the Curve (AUC).

Results

Specific examples such as irritable, kidding, sleeping tendency, which were observed by bedside nurses in Korea, were identified in the five features of signs and symptoms of delirium in the instrument. The Korean Nu-DESC was psycho-metrically valid and had a sensitivity and specificity of .81-.76 and .97-.73, respectively. The AUC were .89, .74.

Conclusion

Results of this study indicate that the Korean Nu-DESC is well-suited for widespread clinical use in busy inpatients settings and shows promise as a research instrument.

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Violent Experiences and Coping among Home Visiting Health Care Workers in Korea: In Sook Lee, Kwang Ok Lee, Hee Sun Kang, Yeon-Hwan Park; J Korean Acad Nurs 2012;42(1):66-75. Published online February 29, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.1.66

Abstract PDF

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.

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Predictors of Physical Activity in Korean Older Adults: Distinction between Urban and Rural Areas: Seungmi Park, Yeon-Hwan Park; J Korean Acad Nurs 2010;40(2):191-201. Published online April 30, 2010; DOI: https://doi.org/10.4040/jkan.2010.40.2.191

Abstract PDF

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.

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Task Analysis of the Job Description of Gerontological Nurse Practitioners based on DACUM: Keum Soon Kim, Yeon-Hwan Park, Nan Young Lim; J Korean Acad Nurs 2008;38(6):853-865. Published online December 31, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.6.853

Abstract PDF

Purpose

The aim of this study was to develop and to analyze the task of gerontological nurse practitioners (GNPs) in Korea.

Methods

The definition of GNP and job description was developed based on developing a curriculum (DACUM) by 7 panels who have experienced in DACUM analysis and gerontological nursing. One hundred sixty nurses who were working at long term care facilities were participated. The questionnaire included frequency, importance, and difficulty of duties, tasks, and task elements. The data were collected in November 2006, analyzed by descriptive statistics.

Results

The job description of GNPs in Korea revealed 5 duties, 23 tasks, and 86 task elements. On the all five duties, the highest duty in frequency and in importance was professional nursing care (3.25±0.35, 3.49±0.29). But the highest duty in difficulty was research (3.24±0.46). 'Prevent health problem (3.42±0.43, 3.56±0.33)', 'Teach other staffs (2.83±0.77, 3.39±0.43)', 'Develop the evidence-based standards (2.43±0.76, 3.22±0.43)', 'Develop the self (2.81±0.65, 3.26±0.42)', and 'Participate the team activities' were the highest score in frequency and in criticality of tasks. 'Provide emotional support to older adults and families (3.16±0.41)', 'Counsel older adults and their families (3.14±0.49)', 'Do clinical research (3.32±0.49)', 'Quality insurance (3.25±0.49)', and 'Build collaborative system (3.18±0.47)' were perceived the most difficult tasks.

Conclusion

The political efforts for the legislation of role and task of GNPs were needed.

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Factors Associated with Social Isolation in Older Adults using Senior Welfare Centers: Yeon-Hwan Park, Hee Sun Kang; J Korean Acad Nurs 2008;38(5):712-719. Published online October 30, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.5.712

Abstract PDF

Purpose

The purpose of this study was to investigate the factors associated with social isolation in older adults using a senior welfare center.

Methods

This study was a cross-sectional survey. Data was collected from June to August 2006 using a questionnaire. A total of 248 older adults responded.

Results

About one third (34.9%) of participants responded they felt socially isolated. There were statistically significant differences in living, religion, family and belongingness social support, loneliness, depression, family function, perceived health status, and number of chronic illnesses between socially isolated and non isolated groups. However, factors influencing social isolation were family function (OR=0.954, CI=0.926-0.982), loneliness (OR=1.042, CI=1.002-1.083), depression (OR=1.041, CI=1.002-1.081), and number of chronic illness (OR=1.657, CI=1.153-2.382).

Conclusion

We found that some older adults were feeling socially isolated even though the senior welfare center was a good place to meet people. The findings of this study indicated that older adults suffering from social isolation need special attention and may benefit from interventions which promote health and social interactions. Further studies are needed to develop and evaluate an intervention program for this population.

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