• Title/Summary/Keyword: Pre-hypertension

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The Effect of a Self-Regulation Program for Hypertensives in Rural Areas (일부 농촌지역 고혈압 환자의 자가간호 증진과 혈압조절을 위한 자기조절 프로그램 효과)

  • Park, Yeong-Im;Jeon, Myeong-Hui
    • Journal of Korean Academy of Nursing
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    • v.30 no.5
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    • pp.1303-1317
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    • 2000
  • This study was conducted to identify a effect of the comprehensive self-regulation program for hypertensives as a nursing intervention on self-care performance and the physiologic parameters in rural areas. For this purpose, a nonequivalent control group and a pre and post-test quasi- experimental design was used. Fifty-four were evaluated subjects from two Community Health Practitioner Posts in the suburbs of Taejon City. The subjects of the control and experimental groups were matched for age and sex. The self-regulation program developed by author given to the experimental group. The program consisted of group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring, recording of self-care activities, and encouraging and reinforcing self-efficacy. The whole program was carried out from September to November of 1999. The data were analyzed by repeated measure ANCOVA, t-test, and ANCOVA. The results were as follows ; There was significant improvement in the scores on knowledge (F=.68, P=.004), perceived self-efficacy (F=26.39, P=.000), self-care performance (F=26.11, P=.000) of the experimental group compared with those of the control group. There was no significant change on the score of locus of control, perceived benefits and perceived barrier, blood cholesterol level, body weight between two groups (P>.05). From these results, it can be concluded that the self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives in rural area.

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The Effect of the Dietary Approaches to Stop Hypertension (DASH) Diet Education Program on Bone Mineral Density in the Middle-aged Women: A Pilot Study (DASH 식이 교육 프로그램이 중년 여성의 골밀도에 미치는 효과: 예비 조사 결과)

  • Kim, Jung-Ha;ChoiKwon, S-Mi;Park, Yeon-Hwan;Park, Kyung-Ae;Suh, Min-Hee;Lee, Sun-Ock
    • Journal of Korean Biological Nursing Science
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    • v.12 no.3
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    • pp.195-205
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    • 2010
  • Purpose: The purpose of this study was to develop the dietary approaches to stop hypertension (DASH) diet education program tailored to Korean adults and to examine the effect of the DASH diet education program on bone mineral density in middle aged women. Methods: The subjects of this study were 26 middle aged women, pre and post menopause, who attend a church located in Kyung-In district. The DASH group I (n=13) was provided with the DASH diet education program only, while the DASH group II (n=13) was provided with DASH diet education program along with calcium supplements (1 g/day). The DASH diet education program included one lecture on DASH diet, one face to face counseling, and five telephone counseling sessions during the 8 weeks period. Results: The knowledge and subjective compliance level of DASH diet increased significantly in both groups, at 4 and 8 weeks after the intervention. The level of objective compliance of DASH diet in both groups increased over the study period, but it was not significant as compared to those of the baseline. Bone mineral density of both groups decreased at 8weeks as compared to the baseline after the intervention. Conclusion: Although 8weeks of DASH diet education program increased the knowledge and compliance of DASH diet, it was not effective to bring the changes in bone mineral density among the middle aged women.

Evaluation of Nutrition Education for Hypertension Patients Aged 50 Years and Over (만 50세 이상 고혈압 성인 대상 영양교육의 효과 평가)

  • Moon, Eun-Hye;Kim, Kyung-Won
    • Korean Journal of Community Nutrition
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    • v.16 no.1
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    • pp.62-74
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    • 2011
  • This study was designed to implement and evaluate a nutrition education program for hypertensive patients aged between 50 and over. Nutrition education consisted of four sessions and, 35 out of 51 patients completed all education sessions at the public health center. To assess program effectiveness (effectively), data about blood pressure, blood cholesterol, anthropometry, nutrition knowledge, eating behavior and dietary intake were collected before and after nutrition education. Data were analyzed using SAS package (ver. 9.2) and significant difference was evaluated by paired t-test, x2-test and Wilcoxon signed rank test. Blood cholesterol was significantly reduced from 200.7 mg/dL to 188.7 mg/dL after nutrition education, although there were not significant changes in blood pressure or blood triglyceride level. Weight (p < 0.05), % body fat (p < 0.001), BMI (p < 0.05) were significantly reduced, especially in women, after nutrition education. Nutrition knowledge was increased significantly (p < 0.05), and some eating behaviors such as 'having fruits & vegetables for snack' and 'having brown rice, barley rice than white rice' were improved after nutrition education (p < 0.05). Sodium intake was reduced from 3,888.9 mg/day to 3,157.4 mg/day after nutrition education (p < 0.05). Except protein and iron intakes, the nutrient intake of hypertensive patients was much below the recommended level for Koreans. Dietary intakes of most of nutrients were not significantly different between pre-test and post-test. It appeared that nutrition education for the aged hypertensive patients was effective in reducing the percentage of % body fat and BMI, increasing the nutrition knowledge and some dietary behaviors. This nutrition education can be implemented at public health centers or senior centers for hypertensive patients.

Effects of Dietary Education on Low-sodium Diet Adaptation (식생활교육이 저나트륨식 적응에 미치는 영향)

  • Kim, Hae Young;Kim, Juhyeon
    • Journal of the Korean Society of Food Culture
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    • v.29 no.2
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    • pp.212-221
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    • 2014
  • Korean style DASH (Dietary Approaches to Stop Hypertension) and a dietary education program for sodium reduction were developed. Reduced sodium diets (15 and 30% reductions) were developed from general diets for 3 consecutive weeks from Monday through Saturday. Subjects (19 total) were classified into two groups according to dietary education. Experimental period was from June 24 to July 23, 2012. Total sum of adaptation scores for low sodium diets significantly increased in the group that underwent dietary education compared to that without (p<0.05). After the experiment, both groups showed significantly increased values in terms of food group balance, sodium-related nutrition knowledge, attitude, and practice by paired t-test. Especially, group that underwent dietary education showed significantly higher values for attitudes by ANCOVA pre-test as a variation (p<0.01). For the results of the nutrient intake survey, group that underwent dietary education showed significantly increased values for dietary fiber (p<0.01), vitamin A (p<0.001), vitamin K (p<0.001), vitamin C (p<0.01), Folic acid (p<0.001), vitamin B12 (p<0.01), calcium (p<0.01), iron (p<0.05), and zinc (p<0.05) and significantly decreased values for sodium (p<0.05) and chloride (p<0.005). Subjects adapted to reduced sodium diets showed apparent improvements in sodium-related knowledge, attitude, practice and intake of nutrient, and these improvements were even higher in the group that underwent dietary education compared to that without. Thus, adaptation to low sodium diet combined with dietary education can improve dietary habits.

A Study on the Factors Affecting Self-Regulation Program for Hypertensives (본태성 고혈압환자를 위한 자기조절 프로그램 관련요인 연구)

  • Park, Young-Im
    • Research in Community and Public Health Nursing
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    • v.6 no.2
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    • pp.234-249
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    • 1995
  • Essential hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Thus the comprehensive self-regulation program was conducted as a nursing intervention on the promotion self-care 'performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi -experimental research with pre and post test design was used. And the whole program was carried out from October, 1993 to February, 1994. Self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The data was analyzed by experimental stages: the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t -test and F-test, and multiple correlation to determine the variables affecting the effect of program. The results were as follows : 1) Subjects in J company were significantly lower diastolic blood pressure than K company after the program (t=2.39, p=.024). Level of cholesterol was significant difference according to position(t=2.23, p=.034), family history (t=-2.66, p=.013), diagnosis duration, and career(t=2.88, p=.055). Perceived self-efficacy was more significantly increased among the group with family history(t=-3.00, p=.013). 2) Before the program, there were significant positive correlation among the variables: internal-LOC and self-efficacy(r=.3952, p=.015), external-LOC and barriers (r=.6515, p=.000), chance-LOC and Barriers(r=.4133, p=.012). However there were significant negative correlation between internal-LOC and barriers (r=-.3236, p=.041, external-LOC and self -efficacy(r=-.3517, p=.028), self-efficacy and barriers(r=-.6654, p=.000). 3) There were significant relationships between changes in self - care performance and self-efficacy at 5th week (r=.5313, p=.001) and changes in self-efficacy at 9th week(r=.4586, p=.005). 4) After the program, internal health locus of control and perceived benefits showed significant correlation(r=.5673, p=.001, but perceived barriers was negative correlation with perceived self-efficacy (t=-4242, p=.01). From the above results, it can be concluded that the self-regulation program is an effective nursing strategy through the change of variables to promote self-care performance of hypertensives and to increase the self-efficacy. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings.

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An Effect of the Self-Regulation Program for Hypertensives -Synthesis & testing of Orem and Bandura's theory- (본태성 고혈압 환자의 자가간호증진을 위한 자기조절 프로그램 효과 -Orem이론과 Bandura이론의 합성과 검증-)

  • Park, Young-Im;Hong, Yeo-Shin
    • Research in Community and Public Health Nursing
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    • v.5 no.2
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    • pp.109-129
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    • 1994
  • Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

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The Influence of Gender on Clinical Outcomes in Elderly Patients Underwent Coronary Artery Bypass Grafting Surgery

  • Moon, Seong-Min
    • Biomedical Science Letters
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    • v.17 no.4
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    • pp.329-336
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    • 2011
  • The female has previously been shown to be an independent risk factor for mortality and morbidity after coronary artery bypass grafting surgery (CABG). The aim of this retrospective study is to evaluate gender differences of the perioperative outcomes in elderly patients underwent CABG. Data for seventy elderly patients (>70 years) that underwent CABG (between January 2005 and July 2011) were divided into two groups: male patients (n=33, male group) and female patients group (n=37, female group). Heights, body weights, body surface area and coronary artery obstruction rate (right coronary artery territory) in the female group were lower than those of the male group ($P$ <0.05). History of hypertension, hyperlipidemia, congestive heart failure and percutaneous coronary artery intervention in the female group was higher than that of the male group ($P$ <0.05). Total cholesterol and brain natriuretic peptide levels in the female group were higher than those of the male group ($P$ <0.05). Platelet count in the female group was higher than the male group at preoperative (Pre-OP) period ($P$ <0.05). Erythrocyte count, hematocrit and hemoglobin levels in the female group were lower than those of the male group at Pre-OP period ($P$ <0.05). But, erythrocyte count, hematocrit and hemoglobin levels in the female group were higher than those of the Male group at postoperative (Post-OP) period ($P$ <0.05). Left ventricular ejection fraction in the female group was higher than the male group at Post-OP period ($P$ <0.05). Hospital stay length in the female group was higher than the male group ($P$ <0.05). Post-OP bleeding volume and incidence of ventricular premature contraction in the female group were lower than those of the male group ($P$ <0.05). These results suggest that despite female gender have a greater risk factors and require a longer hospitalization than male, there was no significant difference incidence of mortality and complication.

Aorto-Coronary Bypass Graft -A Case Report- (관상동맥 회로술 치험 1예)

  • 이두연
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.297-305
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    • 1979
  • Occlusive coronary artery disease presents a potential threat to a significant population in the United States. According to many case reports, the increasing incidence of coronary artery disease due to atherosclerosis is noted in Korean, recently. Operative vascular procedures have increased steadily in number over the past 20 years in the United States. There have been many isolated case reports about coronary artery surgery, but these had little clinical impact. Nowadays, major three coronary bypass surgery has developed principally at three cardiac centers in the United States since 1967. Among three coronary bypass operation, the aorta-coronary artery saphenous vein bypass graft was first demonstrated by Favolaro and Effler at the Cleveland Clinic in 1967. We experienced one case of coronary artery disease, which was treated successfully by aorta-coronary saphenous vein graft with mild hypothermia under extracorporeal circulation in May, 1977. Saphenous vein was removed from above the knee and was 2.5 mm in diameter. The left ventricle was not vented for the left ventricle was not overdistended. Temporary artificial pace-maker-Medtronic-was implanted for the prevention and treatment of post-operative arrhythmia and heart block in post-operative first day. He is a 57 year old male businessman who had been suffered from hypertension [200 mmHg in systolic pressure] since 4 years ago, who had intermittent conservative treatment at local clinic. He had been afflicted with severe chest pain with choking sensation for 50 days. This symptom was aggravated exposing cold weather, or cold water, but was respond to rest. Pre-operative ECG revealed no any other ischemic sign except sinus bradycardia. Significant S-T segment depression was noted at lead II, AVF after double 5 minutes exercise, indicating positive Master`s test. Serum cholesterol was slight elevated to 253 mg/dl. Final pre-operative diagnosis was made by coronary arteriogram, which showed about 1.0-cm segmental 90 % occlusive atherosclerotic lesion in the proximal part of right coronary artery above the origin of acute marginal artery. Left coronary artery revealed good patency and there was no collateral circulation between right and left coronary artery .Hospital course was not eventful. He was discharged with good result on the post-operative day. He has been free from chest pain for longer than 2 years. And also the arterial flow in the coronary bypass graft is auscultated with the pocket-sized ultrasonic velocity detector, which shows the patency of the coronary bypass graft good.

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Determinant Factors of Mortality in Pre-elderly and Elderly Patients With COVID-19 in Jakarta, Indonesia

  • Thresya Febrianti;Ngabila Salama;Inggariwati;Dwi Oktavia
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.3
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    • pp.231-237
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    • 2023
  • Objectives: This study aimed to identify risk factors associated with coronavirus disease 2019 (COVID-19) mortality in pre-elderly and elderly individuals in Jakarta, Indonesia. Methods: We employed a case-control study design, utilizing secondary data from the Epidemiology Surveillance, Immunization Prevention, and Disease Control Sections of the DKI Jakarta Provincial Health Office, collected from December 2020 to January 2021. The study included 188 cases and an equal number of controls. Cases were COVID-19 patients confirmed to have died, as reported by hospitals and communities and subsequently verified by healthcare workers. Control subjects were patients who completed a 14-day isolation period and had been officially declared recovered by healthcare professionals. The dependent variable was the mortality of COVID-19 patients in the January 2021 period. The independent variables consisted of demographic data (age and sex), clinical symptoms (cough, runny nose, anosmia, diarrhea, headaches, abdominal pain, muscle pain, and nausea/vomiting), and comorbidities (hypertension, heart disease, and diabetes). Multivariate analysis was conducted using multiple logistic regression. Results: The multiple logistic regression analysis revealed several factors associated with COVID-19 fatalities in Jakarta: age of 60 years or older (odds ratio [OR], 4.84; 95% CI, 3.00 to 7.80), male (OR, 2.38; 95% CI, 2.41 to 3.68), dyspnea (OR, 3.93; 95% CI, 2.04 to 7.55), anosmia (OR, 0.13; 95% CI, 0.04 to 0.46), and heart disease (OR, 4.38; 95% CI, 1.04 to 18.46). Conclusions: The control and prevention of COVID-19 among elderly individuals require particular vigilance. When a COVID-19 case is detected within this demographic, prompt treatment and medication administration are crucial to mitigate the presenting symptoms.

Irreversible Hemorrhagic Complication of Recurrent Posterior Reversible Encephalopathy Syndrome in a Patient with Systemic Lupus Erythematosus (전신성 홍반성 낭창 환자에서 재발한 가역적 후두부 뇌병증 증후군의 비가역적 출혈성 합병증)

  • Kim, Ho Kyun;Lee, Hui Joong;Shin, Kyung Min
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.144-148
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    • 2013
  • Although most cases of posterior reversible encephalopathy syndrome (PRES) are reversible, irreversible lesions as a form of hemorrhage or infarction have been described. PRES as a complication of systemic lupus erythematosus (PRES-SLE) is associated with hypertension or use of immunosuppressive agents. We present a case of recurrent atypical PRES-SLE, which showed restricted diffusion in the first manifestation of SLE, resulted in parenchymal hemorrhagic transformations in the recurrent episode.