• Journal of Korean Academy of Nursing
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• v.49 no.3
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• pp.329-339
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• 2019

Purpose: The purpose of this study was to investigate the frequency, patterns, and factors of reversals in decisions about life-sustaining treatment (LST) among older patients with terminal-stage chronic cardiopulmonary disease. Methods: This was a retrospective correlational descriptive study based on medical chart review. De-identified patient electronic medical record data were collected from 124 deceased older patients with terminal-stage cardiopulmonary disease who had made reversals of LST decisions in an academic tertiary hospital in 2015. Data were extracted about the reversed LST decisions, LST treatments applied before death, and patients' demographic and clinical factors. Multivariate logistic regression analysis was used to identify the factors associated with the reversal to higher intensity of LST treatment. Results: The use of inotropic agents was the most frequently reversed LST treatment, followed by cardiopulmonary resuscitation, intubation, ventilator therapy, and hemodialysis. Inconsistency between the last LST decisions and actual treatments occurred most often in hemodialysis. One-third of the reversals in LST decisions were made toward higher intensity of LST treatment. Patients who had lung diseases (vs. heart diseases); were single, divorced, or bereaved (vs. married); and had an acquaintance as a primary decision maker (vs. the patients themselves) were significantly more likely to reverse the LST decisions to higher intensity of LST treatment. Conclusion: This study demonstrated the complex and turmoil situation of the LST decision-making process among older patients with terminal-stage cardiopulmonary disease and suggests the importance of support for patients and families in their LST decision-making process.

• Journal of Korean Academy of Nursing
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• v.50 no.6
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• pp.740-756
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• 2020

Purpose: The purpose of this study was to evaluate the effect on blood pressure (BP) and heart rate (HR) according to aerobic exercise characteristics in adults with hypertension using a systematic review and meta-analysis. Methods: The related researches were selected from PubMed, EMBASE, Cochrane library, CINAHL, PsycINFO, SPORTDiscus and 5 domestic databases up to September 4, 2019. To estimate the effect size, random effect models were used to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on BP and HR. Results: A total of 37 RCTs with 1,813 samples were included. Aerobic exercise was found to significantly reduce systolic BP (WMD, - 8.29 mmHg; 95% CI, - 10.12 to - 6.46), diastolic BP (WMD, - 5.19 mmHg; 95% CI, - 6.24 to - 4.14) and HR (WMD, - 4.22 beats/min; 95% CI, - 5.36 to -3.09). In detail, systolic BP and diastolic BP were significantly decreased in all groups of exercise types, frequency and duration. Systolic BP and diastolic BP were significantly decreased in the moderate and vigorous-intensity group. Exercise characteristics with the most dramatical change in systolic BP were water-based training, moderate-intensity, 3 times a week and 8 to 11 weeks of duration. In diastolic BP, the greatest effect size was over 24 weeks of exercise. Conclusion: Moderate aerobic exercise, especially water-based exercise can be an important part of lifestyle modification for hypertensive patients. Also, it can be recommended in a variety of clinical settings for lowering BP and HR. However, there is insufficient evidence that low-intensity exercise is effective in lowering BP.

• Women's Health Nursing
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• v.26 no.2
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• pp.151-160
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• 2020

Purpose: The purpose of this study was to examine the effects of a video education program in women receiving high-intensity focused ultrasound (HIFU) treatment. Methods: This was a quasi-experimental study with a nonequivalent control group non-synchronized design. The participants were 54 patients who had benign uterine tumors and adenomyosis. The data were collected from June to August 2018. A 10-minute video education program on HIFU and post-procedural care was developed based on the literature. The experimental group was provided the video education program with a question-and-answer session for 10 minutes after viewing the video. The control group received usual care (i.e., verbal instructions on post-procedural self-care). The questionnaire survey was conducted twice: before the educational program and before being discharged from the hospital. Differences in uncertainty, emotions, and self-efficacy among patients were analyzed. Data were analyzed using the chi-square test, Shapiro-Wilk test, paired t-test, and t-test with SPSS version 23.0. Results: The participants in the experimental group showed a decrease in uncertainty (t=4.33, p<.001), improvements in anxiety (t=-4.07, p<.001) and depression (t=-3.55, p<.001), and an enhancement of self-efficacy (t=-4.39, p<.001) compared to the control group. Conclusion: This nursing intervention was effective at reducing uncertainty, improving emotions, and enhancing self-efficacy. This intervention is feasible for use in nursing practice as an aid for patients when considering treatment methods.

• Journal of Korean Academy of Nursing
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• v.27 no.4
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• pp.807-819
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• 1997

The purpose of the study was to identify the effects of a 12-week low-intensity exercise program on muscle strength, flexibility, balance, and cognitive characteristics related to the performance of activity of daily living(ADL). A total of 16 patients who were admitted to the medical unit of a general hospital in ChoongChung province were recruited, eight for the exercise group and eight for the comparison group. Four levels of low-intensity exercise from 'ROM on bed' to 'exercise while walking' were then applied to the exercise group according to their physical condition. During hospitalization, patients in the exercise group performed each level of the prescribed exercise with the researchers until they felt comfortable doing it independently. The researchers also visited the patients' homes after discharge to make sure they could perform the exercise with Theraband in their living environment. The exercise group was contacted by phone once a week to assess the frequency and intensity in which they performed the exercise as well as their physical condition. The subjects in the comparison group participated in measurements for the study without performing the exercise and were contacted by phone after discharge, in a matched time frame with the exercise group, to assess physical condition. Muscle strength, flexibility, balance, cognitive characteristics, and performance of ADL for the two groups were compared at the pretest and the posttest after the low-intensity exercise program by utilizing SPSSWIN and the results are as follows : 1) At the postest, measurements of muscle strengths showed that the strength of the dorsal flexor in the exercise group was significantly higher than in the comparison group. 2) Objective balance for the exercise group was significantly better than for the comparison group as measured by 'standing on one foot' and Tinetti gait and balance control. 3) The exercise group showed significantly higher task self-efficacy than the comparison group. 4) Perceived exertion for ADL for the exercise group was significantly lower than for the comparison group. 5) Improvement of performance of ADL without assistance was significantly higher for the exercise group than the comparison group. The findings suggest that a low-intensity exercise program would be useful for the elderly who show decline in their physical functioning due to hospitalization by partly improving physical strength, task self-efficacy, and performance of ADL. Directions for further research on issues of motivating people to exercise as well as of standardizing various types of exercise were discussed.

• Journal of muscle and joint health
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• v.26 no.1
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• pp.27-34
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• 2019

Purpose: This study was done to analyze nursing assessment and nursing care for pain in the electronic nursing records for the elderly patients with abdominal pain visiting the Emergency Medical Center. Methods: This study is a descriptive study based on nursing records from January to December 2015. A total of 1155 records for elderly patients with abdominal pain were gathered. Results: The mean age of elderly patients whose records were analyzed was 75.2 years. Analysis of nursing records regarding pain management showed that semi-urgent severity (93.7%), direct emergency room visits (58%), and 6.01 hours of emergency room stay (6.01 hours)were the most frequently documented characteristics of the elderly patients with pain complaints. Recording time of nursing assessment for abdominal patients was 1.01 hour; the average pain intensity was 3.97. The mostly used nursing intervention for abdominal pain was medication (65.1%). There was no record of non-pharmacological pain nursing interventions. Conclusion: The results of this study showed that improving knowledge and nursing practice for pain management is much of necessity. In particular, development of the non-pharmacological nursing interventions for pain is needed. Further research is also imperative to develop and evaluate record systems for pain management that can be used in the emergency room.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.2
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• pp.240-254
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• 1999

The purpose of this study was to investigate the effect of exercise therapy and relaxation therapy on catecholamine and heart rate in people in white color jobs and to determine this information the effectiveness of applied exercise therapy and relaxation therapy as a nursing intervention method for stress patients. The subjects were divided into an exercise therapy group, a relaxation therapy group, and control group and the research design was a nonequivalent control group pretest-post test design(exercise therapy : n= 12, relaxation therapy : n=12, control group, the group without any treatment in exercise on relaxation therapy : n=12), The subjects in the exercise therapy group were given a particular intensity for each kp during 30min, bicycle ergometer which is using an LX PE training system before & after 4weeks of training. The exercise therapy that was used was Astrard load method which tested absolute exercise load of heart rate before & after four weeks, and resting heart rate was tested for exercise and relaxation therapy before, after four weeks, and at eight weeks. The results of each kp & absolute exercise load were calculated with the target rate formula(maximal heart rate-rest heart rate) x exercise intensity(%) + rest heart rate so the subjects could continue 60-70% exercise intensity for exercise therapy over eight weeks. The relaxation therapy subjects were trained using a modified Jacobson's relaxation technique for eight weeks. The exercise and relaxation therapy were trained at the following intensity for eight weeks(3times/week, 30min/day) to see changes in catecholamine & heart rates. After eight weeks, statistical analysis of exercise & relaxation therapy were carried out Two-way ANOVA and multiple range test(SNK : Student Newman Keul) were used. The results are as follows : 1. The change of epinephrine & norepinephrine in the exercise therapy, relaxation therapy, and control group was statistically significant at the .05 level after four weeks & eight weeks. Also, exercise therapy was statistically significant at .05 level over that of the control group after 4weeks. 2. The change of heart rate in relaxation therapy was statistically significant at the .05 level, and was statistically significant at the .05 level over that of the exercise therapy and control group. In conclusion, it is obvious that exercise therapy and relaxation therapy should be one of the most effective stress treatment and desirable nursing interventions methods for job stress in people in white color jobs.

• Journal of Korean Biological Nursing Science
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• v.4 no.1
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• pp.85-99
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• 2002

This study was conducted to determine whether low intensity regular exercise following steroid treatment could attenuate steroid-induced muscle atrophy. Thirty-eight Sprague-Dawley rats weighing $165{\sim}175g$ were divided into six groups ; control group(C), dexamethasone administration group(D), sedentary normal saline administration group(C+Se), exercise after normal saline administration group(C+Ex), sedentary group after dexamethasone administration(D+Se), exercise group after dexamethasone administration(D+Ex). Either dexamethasone(5mg/kg) or normal saline was injected for 7days accordingly. Exercise was started at 10m/min on the $10^{\circ}$ grade treadmill and gradually increased up to 15m/min by the 7th day for 60minutes/day($20min{\times}3$). The data were analyzed by Kruskal-Wallis test and Mann-Whitney U test using the SPSS WIN 9.0 program. Body weight, muscle weight and myofibrillar protein content of both plantaris and gastrocnemius, Type I, II muscle fiber cross-sectional area of plantaris, and Type II muscle fiber cross-sectional area of gastrocnemius in D group were significantly lower than those of C group(p<0.05) respectively. Hindlimb muscle weight, myofibrillar protein content of both plantaris and gastrocnemius. Type I muscle fiber cross-sectional area of soleus and Type I, II muscle fiber cross-sectional area of plantaris in D+Ex group tended to increase compared to those of D+Se group. Myofibrillar protein content of both plantaris and gastrocnemius, Type I muscle fiber cross-sectional area of plantaris in D+Ex group tended to increase compared to those of C+Se group. Based on these results, it is suggested that regular low-intensity exercise during recovery period after steroid treatment might facilitate the recovery from steroid-induced muscle atrophy.

• Journal of Korean Academy of Nursing Administration
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• v.7 no.1
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• pp.15-23
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• 2001

This study was a methodological research to develop computerized patient classification system. The subjects of this investigation were 435 inpatients except redundant data and outliers in P University Hospital from January 18, 2000 to January 24, 2000. The data was analyzed by discrimination analysis and adopted discriminant variables were 1) sum of frequency for the nursing activities, 2) the number of nursing activities that do not need to consider intensity of the activities, and 3) total hours of nursing activities that need to consider their intensities. Discriminant function developed by this study classified the patients into 4 groups; class I, 251 ; class II, 125 ; class III, 39 ; class IV, 20. The Hit ratio was 89.23. Based on this study, following suggestions can be made for the future research 1. Inclusive patient classification system, which includes more expanded direct nursing care factors, need to be developed and examined. 2. This developed classification system can be utilized to evaluate patient distribution and to estimate adequate numbers of nursing staffs in each nursing unit.

• Journal of Korean Academy of Nursing
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• v.14 no.1
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• pp.60-68
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• 1984

The main purpose of this study is to observe patterns of pain of surgical patients following surgery The postoperative pain was checked with the interval of every 2 hours from 6 hours to 80 hours after surgery. Graphic rating scale from unidimensional concept of pain and sensory intensity scale and unpleasantness scale from two dimensional concept of pain were used for pain measurement. Thirty two patients were participated in this study in which 22 were undergone upper abdominal surgery, 7 thyroid or neck surgery and 3 other surgeries. The findings obtained from this study were as follows: 1) In all cases of using 3 different pain measurement tools, postoperative pain was markedly decreased since 36 hours after surgery. In case of patient's less cooperation, either sensory intensity scale or graphic rating scale may be chosen for the measurement of pain. 2) Pain amounts measured by sensory intensity scale were highly correlated with those measured by unpleasantness scale in all situations except several situations having few cases included. Unpleasantness scale may be separately used for themeasurement of affective response due to pain. 3) Almost 90% of total amount of analgesics used for relief of pain were used within 36 hours after surgery. 4) Mean frequency of analgesics used by every patient during 80 hours following surgery was 0.84.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.51-64
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• 2001

The purposes of this study were to examine and to predict the affecting factors on exercise participation of Rheumatoid arthritis Patients. The subjects were 161 adult out-patients who visited the hospital for rheumatic disease in H-university. Data were composed of self-reported questionnaire. The conceptual model of this study consisted of that personal characters(age, marriage, education, income), situational characters(pain intensity, fatigue, IADL, depression), behavioral characters(formerly exercise behavior, life-style), and cognitive-perceptional characters(perceived health status, perceived benefit, perceived barrier, perceived self-efficacy) affected directly to exercise participation. Logistic regression analysis was applied for testing model of this study. The results were as follows : 1. Personal characters(education), situational characters(pain intensity), behavioral characters(formerly exercise behavior, life-style), and cognitive characters(perceived barrier, perceived self-efficacy) were significant difference between current exercise participants(127subjects) and non-exercise participants(34). 2. Personal characters(income), situational characters(pain intensity), behavioral characters(life-style), and cognitive-perceptional characters(perceived barrier, perceived self-efficacy) were correlated to exercise participation. 3. Formerly exercise behavior, perceived barrier, and perceived self-efficacy were significant predictor of exercise participation. The logistic equation predicted overall 81.94% of this study subjects 161.