Purpose: The aim of this study was to examine the effects of an Advanced Practice Nurse (APN)-led self-management program on cardiovascular health status among Korean women at risk of developing or progressing cardiovascular disease. Methods: This pilot study used one-group pre- and post- test experimental design. At health fairs in a community, 30 women who had one or more risk factors for metabolic syndrome were recruited and agreed to participate in the study. A total of 25 women completed the study. The intervention consisted of weekly follow-up calls and self-monitoring diary after an hour of individual counseling regarding risk factors, fast walking, and healthy diet tailored to the participants' needs. Physical activity was assessed with the World Health Organization International Physical Activity Questionnaire and a pedometer. Results: Participants showed statistically significant improvements in blood pressure, body mass index, levels of triglyceride, total cholesterol and low density lipoprotein, numbers of metabolic syndrome factors, and the 10-year CV risk estimate after one month of concentrated intervention. In addition, their physical activity behavior significantly improved after the intervention. Conclusion: This APN-led self-management program targeting modifiable risk factors by offering tailored counseling and concentrated support during the transition might be effective in preventing progression to the cardiovascular disease.
Purpose: The purpose of this study was to determine the relationships among health locus of control, resilience, social support, and health promoting behavior in patients with coronary artery diseases. Methods: This study utilized a descriptive correlational design using a survey method. The subjects were 165 coronary artery disease patients at the cardiology out-patient clinic of the C university hospital. Data were collected through Health Locus of Control Scale, Resilience Scale, ENRICHD Social Support Instrument, Health Promoting Lifestyle Profile scale. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and hierarchial regression. Results: There were significant positive bivariate correlations of health promoting behavior with internal health locus of control, doctors health locus of control, resilience and social support respectively, and correlation between resilience and social support. Among predictors, internal health locus of control (${\beta}$=.28), social support (${\beta}$=.28) and resilience (${\beta}$=.25) had statistically significant influences on health promoting behavior. Conclusion: These results proposed that internal health locus of control, social support and resilience have important influences on health promoting behavior. Nursing interventions to enhance internal health locus of control, resilience and social support might be essential for patients with coronary artery disease in order to promote their health behaviors.
Purpose: This study was a qualitative study to explore and understand the adaptation experiences of hemodialysis among women with End-Stage Renal Disease (ESRD) and to develop a substantive theory using the grounded theory method. Methods: Participants were 15 female patients who underwent hemodialysis for ESRD treatment from three general hospitals. The data were collected through in-depth individual interviews. Results: The adaptation experience of participants was emerged as a process of taking care and enduring. There were four adaptation stages as a negative, despair, receptive, and maintenance period in reference to hemodialysis. The causal conditions were a vague expectations of recovery and refusal to undergo hemodialysis. The core phenomenon was that of confinement to dialysis machine. The contextual conditions for this phenomenon were the loss of femininity. They used action/interaction strategies such as transition their life with a focus on hemodialysis, seeking information, and learning how to take care of their body. Through this process, they had a strong will to live or had sustained their life. Conclusion: These results indicate that there is a need for nurses to understand the different steps of adaptation experiences of the given patient population. It is necessary for nurses to support them to lead their life as much normal as possible and improve the adaptation experience of ESRD.
Purpose: This study was to identify the relationship between knowledge, self efficacy, and self care behavior regarding foot care among elderly diabetes mellitus (DM) patients. Methods: The subjects consisted of 146 elderly with DM. The data collected from February to October 2008 were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression. Results: The mean scores of knowledge ($13.21{\pm}1.99$), self efficacy ($2.23{\pm}0.54$), and self care behavior ($2.29{\pm}0.51$) regarding foot care were moderate. The level of knowledge was significantly different according to education about DM (p = .012) and drinking (p = .007). Self efficacy was significantly different according to gender (p = .019), educational level (p = .014), spouse (p = .048), disease period (p = .000), admission of DM (p = .000), complication of DM (p = .001), education of DM (p = .023). Self care behavior was significantly different according to educational state (p = .003), disease period (p = .039), and other disease (p = .000). Significant correlations were found between knowledge and self care behavior (p = .001), self efficacy and self care behavior (p = .000), knowledge and self efficacy(p=.012). Knowledge and self efficacy were a predictor of self care behavior (18.2%). Conclusion: These findings indicate that perceived knowledge and self efficacy may be necessities to improve self care behavior regarding foot care among elderly DM patients. The above mentioned results will be reflected in developing patient educational programs.
Chang, Hoo-Sun;Kim, Hyeon-Chang;Ahn, Song-Vogue;Hur, Nam-Wook;Suh, Il
Journal of Preventive Medicine and Public Health
/
제40권5호
/
pp.411-417
/
2007
Objectives: Although risk factors for coronary artery disease are also associated with increased carotid intima-media thickness (IMT), there is little information available on the asymptomatic, young adult population. We examined the association between multiple cardiovascular risk factors and the common carotid IMT in 280 young Korean adults. Methods: The data used for this study was obtained from 280 subjects (130 men and 150 women) aged 25 years who participated in the Kangwha Study follow-up examination in 2005. We measured cardiovascular risk factors, including anthropometries, blood pressure, blood chemistry, carotid ultrasonography, and reviewed questionnaires on health behaviors. Risk factors were defined as values above the sex-specific 75th percentile of systolic blood pressure, body mass index, total cholesterol/ high-density lipoprotein cholesterol ratio, fasting blood glucose and smoking status. Results: The mean carotid IMT${\pm}$standard deviation observed was $0.683{\pm}0.079mm$ in men and $0.678{\pm}0.067mm$ in women (p=0.567) and the evidence of plaque was not observed in any individuals. Mean carotid IMT increased with an increasing number of risk factors(p for trend <0.001) and carotid IMT values were 0.665 mm, 0.674 mm, 0.686 mm, 0.702 mm, and 0.748 mm for 0, 1, 2, 3, and 4 to 5 risk factors, respectively. The odds ratio for having the top quartile carotid IMT in men with 3 or more risk factors versus 0-2 risk factors was 5.09 (95% CI, 2.05-12.64). Conclusions: Current findings indicate the need for prevention and control of cardiovascular risk factors in young adults and more focus on those with multiple cardiovascular risk factors.
For the estimation of prevalence state of major chronic adult disease and their relationships with drinking and smoking habits in the Korean employees, we analyzed a medical check-up data of 155,799 subjects that was accumulated during the year of 2008. In age and sex distribution of the sample, male subjects were 106,229 and female 51,827 showing the ratio of 2:1 and the majorities were 30s and 40s covering 70.7% of the total. The prevalence rates of major chronic diseases were obesity 29.8% (male 38.3%, female 12.3%), hypertension 4.1%, HBV carrier inactive 3.3%, diabetes mellitus 2.9%, hypothyroidism 1.7% (male 1.3%, female 2.4%), hyperlipidemia 1.1%, hyperthyroidism 1.4% (male 1.1%, female 2.1%), osteoporosis 1.4% (male 1.4%, female 1.4%), anemia 0.9% (male 0.3%, female 2.0%) and renal disease 0.9%. The frequency of and volume of drinking in male group were 4.6 times and 7.5 times higher than female group respectively. The 33.8% of the workers were smoking currently. In the serological tests, all the items such as AST, ALT, ${\gamma}-GTP$, LDH for liver function, Cholesterol, TG, uric acid for hyperlipidemia and BP systolic, Fasting blood sugar, BMI for metabolic syndrome were significantly higher in the more drinking and more smoking groups than other groups (p<0.001). The higher prevalence rates in male group in the liver disease seems to be strongly related with the drinking and smoking habits in male employees. We suggest that employees should rather relying on leisure or hobbies than drinking and smoking for the stress relief.
Gaucher disease type 1 (GD1) is an inherited lysosomal storage disorder caused by deficiency of acid ${\beta}$-glucosidase. The diminished enzyme activity leads to the accumulation of substrates and results in multi-systemic manifestations including hepatosplenomegaly, anemia, thrombocytopenia, and bone diseases. Enzyme replacement therapy (ERT) by infusion of recombinant protein has been the standard treatment for over 20 years. Despite the successful long-term treatment with ERT, several unmet needs remain in the treatment of GD1 such as severe pulmonary and skeletal manifestations. Substrate reduction therapy (SRT) reduces the accumulation of substrates by inhibiting their biosynthesis. Eliglustat, a new oral SRT, was approved in United States and Europe as a first-line therapy for treating adult patients with GD1 who have compatible CYP2D6 metabolism phenotypes. Although eliglustat is not yet available in Korea, introduction and summary of this new treatment modality are provided in this paper by review of literatures. Despite the fact that there are only limited studies to draw resolute conclusions, the current data demonstrated that eliglustat is not inferior to ERT in terms of its clinical efficacy. The approval of eligustat enables eligible adult GD1 patients to have the option of oral therapy although it still needs further studies on long-term outcomes. The individual patient should be assessed carefully for the choice of treatment modality when eliglustat becomes available in Korea. Furthermore, the clinical guidelines for Korean patients with GD1 regarding the use of eliglustat needs to be developed in near future.
From January 1988 to December 1990, 18 adult patients with aortic disease underwent surgical repair using hypothermia and total circulatory arrest. The age at operation ranged from 17 years to 64 years[mean 45.2$\pm$10.7 years]. We disease entities included aortic dissection in 12, aortoannuloectasia in 3 and thoracic aortic aneurysm in 3 cases. Partial cardiopulmonary bypass via femoral vessels along with surface cooling was used upon the induction of deep hypothermia[18~20oC]. Modified Bentall operation was performed in 7 cases, ascending aorta replacement in 6, graft interposition in descending thoracic aorta in 3 and others in 2 cases. The circulatory arrest was maintained for periods of 2 minutes to 86 mimutes[mean 34.7$\pm$5.0 minutes]. Overall hospital mortality was 27.8%[5/18]: brain damage was responsible for the death of 2 patients. 4 patients out of 13 survivors experienced postoperative neurologic dysfunction, which was proved to be self-limited except one case showing left hemiparesis. 12 patients were followed up postoperatively with the mean follow-up period 22.7$\pm$10.1 months. There was no death. No new neurologic problems were observed during follow-up period. All but one patient showing recurrent dissection and aortic regurgitation are in exellent clinical condition. These clinical data suggests that the principle of deep hypothermia and total circulatory arrest can be applied rather safely in adult patients, especially in the treatment of patients with aortic disease, it can be a valuable adjunct with better clinical results.
Diet is important for muscle health and offers a protective effects against the loss of skeletal muscle mass and physical functions with advancing age. We analyzed the relationship between diet, metabolic disease risk, and sarcopenia in Korean female adults using the 2009-2011 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 2038 adult women aged 50-64 years were classified into four groups based on the diagnosis of menopause and sarcopenia. The groups were the non-menopause and non-sarcopenia group (NMNS, n=249), the non-menopause and sarcopenia group (NMS, n=14), the menopause and non-sarcopenia group (MNS, n=1,653), and the menopause and sarcopenia group (MS, n=122). The socio-demographics, anthropometrics, blood profile, and dietary data of the subjects were collected. Those who were in both the sarcopenia groups were more obese (p<0.001), had greater waist circumferences (p<0.001), higher body mass index (p<0.001), and higher obesity rates (p<0.001) after adjustment for covariants. Both the sarcopenia groups also had higher plasma levels of total cholesterol (p<0.001), HbA1c (p=0.001), and vitamin D (p=0.020) than both the non-sarcopenia groups. Both the sarcopenia groups demonstrated a decreased intake of calcium (p=0.05), potassium (p=0.008), and niacin (p=0.008) than both the non-sarcopenia ones. Among the four groups, the NMS group showed the highest levels of total cholesterol, obesity, and lowest intake of micronutrients such as calcium, niacin, and potassium. Thus, muscle mass maintenance through weight control and adequate nutrient intake appears to demonstrate a potential association with preventing sarcopenia in Korean middle-aged women.
Dietary fiber is defined as soluble and insoluble polysaccharide consisted in the plant cell wall-associated fibers naturally occurring in fruits, vegetables, and cereal products, and of isolated fibers that are added to processed foods which are also artificially modified. There are so many difference types of dietary fibers as arabinoxylan, polydextrose chicory, oligosccharide. inulin, pectin, bran, cellulose, ${\beta}$-glucan, resistant starch and some seaweed polymers as alginate. Most of them provide many biological benefits in the intestine, as lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity and some of the gastrointestinal disease like as colon cancer. And also lowering cholesterol levels, improves glycemic and insulin sensitivity to non-diabetic and diabetic persons including immune system. Beside of many benefits, average consumers in developed and under developing countries take far less amounts of dietary fiber that international organization recommended. Adequate intake of dietary fiber is 14g/1,000kcal base using the energy guide line of 2,000kcal/day for women and 26,000 kcal/day for men, dietary intake is 28g/day of adult women and 36g/day for adult men. The mechanisms behind the reported effects of dietary fiber on metabolic health are not fully well established. It is suggested that changes in intestinal viscosity resulting mucus increasing, macro-nutrients absorption, rate of passage of large intestinal, production of short chain fatty acids by fermentation. Production of gut hormones and changes of microbiota in intestine. It is necessary to do more research in this field in the future and combined interdisciplinary works together.
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