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Aims Although many studies have examined the predictors of medication adherence (MA), further empirical research is required to clarify the best model for predicting MA for older adults with heart failure (HF). Thus, we hypothesized a model in which information (knowledge), motivation (social support and depressive symptoms), and behavioural skills (barriers to self-efficacy) would be associated with MA in patients with HF. Methods and results Using a cross-sectional survey, 153 adults aged ≥ 65 years taking medication for HF were recruited from a university hospital in Korea. Data were collected based on the information–motivation–behavioural skills (IMB) model constructs and MA. In the hypothesized path model, self-efficacy was directly related to MA (β = −0.335, P = 0.006), whereas social support was indirectly related to MA through self-efficacy (β = −0.078, P = 0.027). Depressive symptoms were directly related to MA (β = 0.359, P = 0.004) and indirectly related to MA through self-efficacy (β = 0.141, P = 0.004). The hypothesized MA model showed a good fit for the data. Knowledge, social support, and depressive symptoms accounted for 44.3% of the variance in self-efficacy (P = 0.004). Left ventricular ejection fraction, knowledge, social support, depressive symptoms, and self-efficacy explained 64.4% of the variance in MA (P = 0.004). Conclusion These results confirmed the IMB model's suitability for predicting MA in older adults with HF. These findings may guide and inform intervention programmes designed to alleviate depressive symptoms in older adults with HF and enhance their HF knowledge, social support, and self-efficacy, with the ultimate goal of improving their MA. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to develop and evaluate the effects of a self‐determination theory‐based, nurse‐led, physical activity programme for postmenopausal women with rheumatoid arthritis. Methods: Between December 2019 and April 2020, this randomized controlled trial recruited 62 postmenopausal women with rheumatoid arthritis from a university‐affiliated hospital in South Korea. The intervention group participated in a self‐determination theory‐based, nurse‐led, physical activity programme that consisted of Tai Chi‐based physical activity, a supportive psychosocial strategy, and interactive counselling for 16 weeks, and the control group continued to undergo their usual care. Results: There were statistically significant group‐by‐time interactions in physical activity and perceived sarcopenia, which favoured the intervention group. Additionally, the intervention group showed significant improvements in the perceived therapeutic efficacy of physical activity, grip strength, walking speed, disease activity score, and health‐related quality of life. Conclusions: The programme developed in this study can be an effective and feasible approach for postmenopausal women with rheumatoid arthritis in improving physical activity, selected osteosarcopenic outcomes, and health‐related quality of life. Further research is required to investigate the long‐term effects of this theory‐based programme for postmenopausal women in diverse settings. Summary statement: What is already known about this topic? Tai Chi‐based physical activity has been known to be a component of self‐management for rheumatoid arthritis. What this paper adds? It highlights the efficacy of a theory‐based, nurse‐led, physical activity programme to improve the quality of life of postmenopausal women with rheumatoid arthritis.The evidenced‐based programme could be transferred to postmenopausal women with rheumatoid arthritis in clinical settings. The implications of this paper: The self‐determination theory‐based, nurse‐led, physical activity programme can improve physical and psychosocial outcomes in postmenopausal women with rheumatoid arthritis.Importantly, this nurse‐led and theory‐based programme is expected to be applicable to postmenopausal women with rheumatoid arthritis in clinical settings, including both hospitals and communities. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine a hypothetical model of physical activity (PA) and health outcomes related to sarcopenia in women with rheumatoid arthritis (RA) based on self‐determination theory. Design: Cross‐sectional study. Methods: This study included 214 women diagnosed with RA from the outpatient rheumatology department of a university‐affiliated hospital in South Korea. Data were collected from September 2019 to August 2020 through structured questionnaires and anthropometric measurements and analysed using path analysis to test the hypothesized model. The primary health outcomes were perceived health status and sarcopenia‐related health (thigh circumference, handgrip strength and sarcopenia risk). Results: The final model's fit indices were adequate. Physical activity was directly affected by motivation for PA, while depression, self‐efficacy for PA, health care provider's autonomy support and basic psychological needs satisfaction indirectly affected PA. Physical activity directly affected perceived health status and thigh circumference, while perceived sarcopenia risk and handgrip strength were directly affected by disease activity and age. Patient or Public Contribution: Patients were involved in a questionnaire‐based survey. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To determine the effectiveness of nurse‐led interventions on medication adherence, medication knowledge and clinical outcomes in adults taking medication for metabolic syndrome. Background: Despite the significance of interventions designed to improve medication adherence, a systematic review of nurse‐led intervention studies for metabolic syndrome is lacking. Design: A systematic review and meta‐analysis of randomised controlled trials. Methods: The study was conducted following the PRISMA guidelines checklist. PubMed, EMBASE, PsychINFO, CINAHL, Cochrane CENTRAL and other manual sources were searched in May 2021.The quality assessment was conducted using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Comprehensive Meta‐Analysis 3.0 was used to calculate the pooled effect sizes with 95% confidence intervals. Results: This review included 20 studies of nurse‐led medication adherence interventions in 6017 adults at risk for metabolic syndrome. The pooled effect size using the random effects model indicated that nurse‐led interventions had a significantly moderate impact on enhancing medication adherence and medication knowledge and improving selected clinical outcomes of available studies in nurse‐led intervention groups compared with control groups. Duration of intervention (median 12 weeks), mode of delivery (group vs. individual) and using multiple strategies influenced outcomes of nurse‐led medication adherence interventions. The results revealed that interventions of moderate‐ to high‐quality studies were more likely to show significant improvements in medication adherence than those of low‐quality studies. Conclusion: The meta‐analyses showed that nurse‐led interventions may enhance medication adherence and knowledge and improve clinical outcomes of this population. Relevance to Clinical Practice: The findings may contribute to evidence‐based information about nurse‐led intervention and its selection of appropriate interventions for improving medication adherence in this population. Patient or public contribution: Patients or the public were not directly involved in this review. [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of the Korean version of the Patient Knowledge Questionnaire-Osteoarthritis (PKQ-OA-K). A cross-sectional survey was conducted with 157 adults with osteoarthritis from the outpatient clinic at a university hospital in Korea. The overall correct answer rate for the PKQ-OA-K was 60.4%; notably, the drug therapy subscale had the lowest median score percentage (42.9%). For structural validity, exploratory factor analysis identified the PKQ-OA-K as two-dimensional, explaining 52.4% of the total variance. Confirmatory factor analysis showed that the two-factor model adequately fit the data. The PKQ-OA-K was positively correlated with education level (r = 0.24) and osteoarthritis outcomes (r = 0.17), thus verifying the hypotheses of construct validity. The intraclass correlation coefficient for test-retest reliability was 0.52; alpha was 0.44. The PKQ-OA-K has excellent validity but imperfect reliability for adults with osteoarthritis. This study recommends cautious use of the PKQ-OA-K to assess Korean patients' knowledge of osteoarthritis. [ABSTRACT FROM AUTHOR]

Purpose : This study examined factors influencing the attitudes towards nurse-led defibrillation in the emergency department (ED) and intensive care unit (ICU). Methods : This was a cross-sectional study. A total of 212 nurses in the ED and ICU from three general hospitals responded to the survey. Data were collected between September and October 2015 using structured questionnaires. Independent t-test, Mann-Whitney U test, one-way analysis of variance (ANOVA), Pearson's correlation coefficient, and hierarchical multiple regression were used to analyze factors affecting nurses' attitudes towards nurse-led defibrillation. Results : The mean score of nurses' attitudes towards nurse-led defibrillation was 61.37 of a possible 91. Hierarchical multiple regression showed that nurses' attitudes towards nurse-led defibrillation were significantly affected by their experiences regarding cardiopulmonary resuscitation ( p=.003), knowledge regarding electrocardiogram interpretation and defibrillation ( p=.007), and tenure in ED or ICU ( p=.043). Conclusion : Results indicate that employers should set policies to support nurses in maintaining their careers in the ED or ICU and conduct systematic educational programs for them. This will increase nurses' confidence in performing defibrillation, which will lead to early defibrillation during in-hospital cardiac arrest. Consequently, it can be a strategy to increase the survival rate of cardiac arrest patients. [ABSTRACT FROM AUTHOR]

Aims and objectives: The effects of an individualised nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of 71 older adults living alone were examined. Background: Although a regular dietary meal plan is recommended for improving nutritional status of older adults living alone, little research is done in this field in Korea. Design: A pre‐ and post‐test controlled quasi‐experimental design was used at public health centres. Methods: The intervention group participated in an intensive nutritional education and support programme once a week for 8 weeks with dietary menus provided by home visiting nurses/dieticians; control group received usual care. Dietary habits and nutritional knowledge were assessed using structured questionnaires; nutritional intake status was analysed using Computer Aided Nutritional Analysis Program 5.0. Results: The mean age of participants was 77.6 years, and 81.7% of the participants were women. At 8 weeks, there were significant interactions of group by time for dietary habits, nutritional knowledge and selected nutritional status of protein, iron and vitamins of B2 and C. Changes over time in the mean score of dietary habits and nutritional knowledge were significantly improved in the intervention group compared to the control group. The percentages of normal nutrition intake of protein, iron and vitamins A and C in the intervention group were significantly higher than the control group at 8 weeks. Conclusions: Nutritional education and support programme positively impacted dietary habits, nutritional knowledge and selected nutritional status in older adults living alone, and we highlight the need for community‐based nutritional education and counselling programmes. Relevance to clinical practice: Older adults living alone in a community have relatively poor nutritional status and thus require tailored nutritional intervention according to objective nutritional analysis. It is necessary to link visiting nurses with dieticians in the community to manage effective nutritional programme continuously. [ABSTRACT FROM AUTHOR]

Aims The aims of this study were to identify all available self-administered instruments measuring health literacy in people with diabetes and to determine the current instrument that is the most appropriate for applying to this population in both practice and research. Design A systematic review of measurement properties. Data sources MEDLINE, EMBASE and CINAHL electronic databases from their inception up to 28 March 2016. Review method The methodological quality of each included study was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The reported results for measurement properties in the studies were assessed according to Terwee's quality criteria. Results Thirteen self-administered instruments measuring health literacy in people with diabetes were identified, of which six (44%) were diabetes-specific instruments. The instruments that covered the broadest contents of health literacy were the Health Literacy Scale and Health Literacy Questionnaire. The (test-retest) reliability, measurement error and responsiveness were not evaluated for any instrument, while internal consistency and hypothesis testing validity were the most frequently assessed measurement properties. Conclusions With the current evidence, the Health Literacy Scale may be the most appropriate instrument for patients with diabetes in practice and research. However, the structural validity of this scale needs to be further established, particularly in other language versions. It is also recommended to use the Diabetes Numeracy Test-15 along with the Health Literacy Scale to complement the lack of numeracy measures in the Health Literacy Scale. [ABSTRACT FROM AUTHOR]

Aim The study purpose was to determine factors affecting aging cognitive function of 3,645 community-dwelling older adults in Korea. Methods The Hasegawa Dementia Scale assessed aging cognitive function, blood analyses and anthropometrics assessed cardio-metabolic risk factors, and the Geriatric Depression Scale Short Form Korean Version assessed depressive symptoms. Results Participants with poor aging cognitive function were more likely to be in the late age group (≥75 y) and currently smoking and have a medical history of stroke, high body mass index, and high level of depressive symptoms; they were also less likely to engage in regular meals and physical activities. Conclusion Regular meals and physical activities may be primary factors for clinical assessment to identify older adults at risk for aging cognitive function. With aging, depressive symptoms and other unhealthy lifestyle behaviours should be managed to prevent cognitive function disorders. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to present a systematic review of available published studies that evaluated the measurement properties of self-reported instruments assessing global medication adherence in adults at risk for metabolic syndrome. Methods The authors searched PubMed, EMBASE, PsycINFO, and CINAHL in January 2015 for appropriate studies. The methodological quality (based on reliability, validity, responsiveness, and interpretability) of selected studies was assessed with the COSMIN checklist (Consensus-Based Standards for the Selection of Health Measurement Instruments). Results Of the 44 studies reviewed, 32 used classical test theory, and 14 used self-reported medication adherence instruments. More than half the studies included patients with hypertension, followed by diabetes, dyslipidemia, and increased body mass index. Among the measurement properties, internal consistency, hypothesis testing, and structural validity were frequently assessed items, whereas only 1 study evaluated responsiveness, and none evaluated measurement error. The MMAS-8 (Morisky Medication Adherence Scale–8 items) and the Hill-Bone scale were the most frequently used instruments. They were found to be well validated, with strong evidence for internal consistency and strong positive evidence for reliability, structural validity, hypothesis testing, and criterion validity. Conclusions The MMAS-8 and Hill-Bone scale seem to be well-validated instruments for assessing medication adherence in adults at risk for metabolic syndrome. These findings may assist clinicians with selecting the appropriate instruments for assessing medication adherence in this population. However, further studies might be needed to define concepts to better understand the dimensions of each medication adherence instrument. [ABSTRACT FROM AUTHOR]

Objective This study aimed to examine the effects of an empowerment program for hypertension self-management among rural older adults in South Korea. Design A pretest-posttest controlled design for a 12-month hypertension self-management program with assessments at commencement, 6 months and 12 months. Setting Two subsistence farming areas. Participants Subsistence farmers aged 65 and over: intervention group ( n = 41) and control group ( n = 36). Intervention Twelve-month empowerment program for hypertension self-management. Main outcome measures Self-efficacy, social support, self-care behaviours, blood pressure control and renal function. Results There were significant interactions of group by time for self-efficacy ( P < 0.001) and self-care behaviour ( P = 0.019). Blood pressure control at 12 months also showed a significant improvement in the empowered group compared with the control group (82.8% versus 56.8%, P < 0.014). Other clinical outcomes, including systolic blood pressure ( P = 0.006) and renal function ( P < 0.001), showed significant interactions of group by time. Conclusions The empowerment program was effective for rural older adults with hypertension in South Korea. Further investigation of the relationships among core components of empowerment would be beneficial. [ABSTRACT FROM AUTHOR]

Purpose The purpose of the study was to examine the reliability and validity of the Adherence to Refills and Medications Scale-Korean (ARMS-K) among Korean adults with type 2 diabetes. Methods The Korean translated ARMS-K was back-translated to ensure translation equivalency. A cross-sectional survey was used to evaluate the psychometric properties with exploratory factor analysis for validity and Cronbach’s alpha coefficients for reliability. Results The factor analysis of construct validity identified 3 dimensions of the ARMS-K, explaining 54.7% of the total variance. The internal consistency reliability for the total instrument was acceptable with a Cronbach’s alpha of .801. There was good correlation between the ARMS-K and 8-item Morisky Medication Adherence Scale-Korean version (r = −0.698), indicating that these scales measure theoretically related constructs as evidence of convergent validity. As evidence of known groups validity, there was a significant association between the ARMS-K score and glycemic control (P = .048), indicating that the good glycemic controlled group was more likely to have a higher rate of adherence to refills and medications than the poor glycemic controlled group. Conclusions These results support the cross-cultural applicability of the concepts underlying the ARMS-K. The ARMS-K can be used not only to assess adherence to refills and medications in Koreans with diabetes but also to examine the potential role of adherence to refills and medications in enhanced glycemic control of people with diabetes in a variety of clinical settings. [ABSTRACT FROM AUTHOR]

Aim To examine the mediating role of social support on the relationship of depressive symptoms to medication adherence and self-care activities in Korean adults. Background Recent evidence suggests that higher levels of social support are associated with improved medication adherence and self-care activities; however, the role of social support on the relationship of depressive symptoms to medication adherence and self-care activities is less well understood. Design A cross-sectional survey. Methods The data were collected from 311 Korean adults with type 2 diabetes who were taking hypoglycaemic agents in the period 2012-2013. Depressive symptoms, social support, medication adherence and self-care activities were assessed using structured questionnaires. Multiple regression analysis with adjustment for covariates and the Sobel test were used to examine the mediating effect of social support on the relationship of depressive symptoms to medication adherence and self-care activities. Results There were statistically significant differences by subgroups with and without depressive symptoms in social support, medication adherence and self-care activities of diet, physical activity and stress management. The Sobel test confirmed that social support mediated the effect of depressive symptoms on medication adherence and self-care activities of diet, physical activity and stress management. Conclusion The evidence from this study suggests that social support-enhancing interventions that also manage depressive symptoms may be more timely and effective than interventions that target depressive symptoms alone in promoting adherence to medication adherence and self-care activities in this population. [ABSTRACT FROM AUTHOR]

Bullying is a serious public health problem, and many studies have examined the effect of school-based anti-bullying programs. However, these programs and those outcomes are complex, broad, and diverse. Research is needed into the optimal strategies for these comprehensive programs, which consider both the effectiveness and cost of programs. We performed a meta-analysis of 13 studies using the Comprehensive Meta-Analysis software package to calculate effect size (ES) and the Q statistic. We conducted subgroup analyses to examine the differences based on student grade level, program duration, and program strategy. The pooled ES calculation indicated that school-based anti-bullying programs have a small to moderate effect on victimization. The results of the Q test indicated significant heterogeneity across studies of victimization (Q = 39.625; I2 = 69.7%; p < .001). Studies involving training in emotional control (p < .01), peer counseling (p < .05), or the establishment of a school policy on bullying (p < .05) showed significantly larger ESs on victimization than did studies that did not involve these strategies. Effective school-based anti-bullying programs should include training in emotional control, peer counseling, and the establishment of a school policy on bullying. [ABSTRACT FROM PUBLISHER]

This study examined the prevalence of metabolic syndrome and the risk level of cardiovascular disease ( CVD) in a vulnerable population of 407 subjects in Korea. This descriptive study was a part of the Tailed Health Visiting Service Program, using baseline data from public health centres in Suwon, Korea. The definition of metabolic syndrome was based on the National Cholesterol Education Program criteria, and risk of CVD was estimated according to the Framingham study equation. This study demonstrated that the prevalence of metabolic syndrome was 40.8% higher and the risk of CVD was significantly 3.1 times higher among those with metabolic syndrome than among those without it. Of those with metabolic syndrome, 50.6% overall and 81.1% of men had a high risk for CVD. These findings suggest a need to screen and prevent the risk of CVD in vulnerable populations with metabolic syndrome. [ABSTRACT FROM AUTHOR]

The article focuses on a study that assesses the risk of cardiovascular disease (CVD) by comparing the Framingham and United Kingdom Prospective Diabetes Study (UKPDS) risk equations in Korean adults with type 2 diabetes (T2DM) and metabolic syndrome. It notes that the study was a cross-sectional survey enrolling a convenience sample of more than a hundred of Korean adults with T2DM and metabolic syndrome. Methods and results of the study are offered.

This pilot study was performed to investigate the effects of a community-based intervention ( CBI) on cardio-metabolic risk and self-care behaviour in 92 older adults with metabolic syndrome at public health centres in Suwon, Korea. A prospective, pretest and posttest, controlled, quasi-experimental design was used. The older adults in the intervention group participated in an 8-week intensive lifestyle counselling, whereas those in the control group received usual care. The mean (standard deviation) age of the participants was 71.4 (4.43) years ranging from 60 to 84, and 75.0% of the participants were female. The intervention group at 8 weeks showed significant reduction in waist circumference by −1.35 cm ( P < 0.001) and improved self-care behaviour (+ 5.17 score, P < 0.05) and self-efficacy (+ 4.84 score, P < 0.001) when compared with the control group. The percentages of those who successfully completed the targeted behavioural modification were 71.7% for exercise and 52.2% for dietary control in the intervention group at 8 weeks. This pilot study provided evidence of the beneficial impact of the CBI for Korean older adults with metabolic syndrome. [ABSTRACT FROM AUTHOR]

Objective To examine the psychometric properties of a structured self-reported 8-item Korean-version Morisky Medication Adherence Scale ( MMAS- K) among rural older adults with hypertension. Design Cross-sectional descriptive survey. Setting A rural community comprising three primary health care posts in Gangwon Province, South Korea. Participants Ninety-two older adults with hypertension who received treatment at primary health care posts. Main outcome measures Participants completed an 8-item MMAS- K questionnaire, and the community health practitioners manually measured blood pressure. Factor analysis and correlation coefficient for validity and the Kuder- Richardson alpha coefficient for reliability of the MMAS- K were used, while the association between medication adherence and blood pressure control was determined using Fisher's exact test. Results Internal consistency reliability was acceptable with a coefficient alpha of 0.71. The factor analysis of construct validity identified two dimensions of the 8-item MMAS- K, explaining 52.22% of the total variance. There was a high correlation between the 8-item MMAS- K and the original 4-item MMAS ( r = 0.874), indicating that these scales measure theoretically related constructs for convergent validity. There was a significant association between the 8-item MMAS- K score and blood pressure control ( P < 0.05), indicating that, for the known-groups validity, the controlled blood pressure group was more likely to have higher rate of medication adherence than the poor-control group. Conclusions The findings indicate a positive association between medication adherence and blood pressure control. The 8-item MMAS- K possesses adequate validity and reliability among rural older adults with hypertension. [ABSTRACT FROM AUTHOR]

Purpose: To examine the validity and reliability of the Chronic Disease Self-Efficacy Scale–Korean Version (CDSES-K) in 380 Korean adults with three chronic diseases: arthritis, diabetes, and hypertension. Methods: The Korean translated CDSES-K was back-translated to ensure translation equivalency. A methodological research design was used with exploratory factor analysis for validity and Cronbach’s alpha coefficients for reliability. Results: The factor analysis identified eight CDSES-K factors explaining 72.5% of the total variance. The internal consistency reliability for the total instrument was high with Cronbach’s alpha of .93. Conclusion: The results support the cross-cultural applicability of the concepts underlying the CDSES-K and the self-efficacy transcends across cultures. Implications: The CDSES-K can be used not only to assess self-efficacy in Koreans with chronic diseases but also to examine the potential function of self-efficacy in improvement of self-management behaviors and enhanced health status of people with chronic diseases in a variety of clinical settings. [ABSTRACT FROM PUBLISHER]

Yoo H, Kim CJ, Jang Y, You M-A. International Journal of Nursing Practice 2011; 17: 599-606 Self-efficacy associated with self-management behaviours and health status of South Koreans with chronic diseases Although prior research in Western societies has revealed an association between self-efficacy and both self-management behaviours and better health status, little is known about the applicability of this association in Korean populations. We examined the differences in self-management behaviours and health status among three groups according to the level of self-efficacy (high, moderate and low). We used a descriptive and correlational design, and administrated a questionnaire to 322 Korean patients with diabetes mellitus, hypertension or arthritis at three ambulatory clinics in a university medical centre. We performed the Pearson chi-square test to test for differences in proportions, and the Kruskall-Wallis and Mann-Whitney U-tests for non-parametric measures. The level of self-efficacy was associated with self-management behaviours ( P < 0.05) and with better health status indices ( P < 0.001) except fatigue ( P < 0.277). The mean age (Mean ± standard deviation, 53.71 ± 12.60), the percentage of high level of education (62.4%) and the level of employment (51.4%) were significantly higher in high self-efficacy group than in low self-efficacy group or moderate self-efficacy group. Further study of the potential factors affecting any relationship between self-efficacy and fatigue is recommended. Self-efficacy-enhancing interventions can be beneficial for Korean chronic patients to improve their self-management behaviours and health status. [ABSTRACT FROM AUTHOR]

Muscular dysfunction in rheumatoid arthritis (RA) can affect the quality of life and comorbidities. We enrolled 320 patients with RA, and evaluated their muscle mass, grip strength, and physical performance. Seven (2.2%) and 21 RA patients (6.6%) had sarcopenia, as defined by the European and Asian Working Group for Sarcopenia (EWGS and AWGS), respectively; 54 patients (16.9%) were determined to have low muscle mass with normal muscle function, as defined by the EWGS; 38 patients (11.9%) reported sarcopenia by SARC-F questionnaire. Male sex (odds ratio (OR) 140.65), low body mass index (BMI) (OR 0.41), and use of tumor necrosis factor (TNF) inhibitors (OR 4.84) were associated with a low muscle mass as defined by the EWGS, while male sex, old age, and low BMI were associated with sarcopenia as defined by the AWGS. Old age (OR 1.11), high BMI (OR 1.13), and a high Disease Activity Score 28 (OR 1.95) were associated with sarcopenia as reported on the SARC-F. Male, low BMI, and use of TNF inhibitors were associated with a low muscle mass, while male sex, old age, and low BMI were associated with sarcopenia in patients with long-standing RA. [ABSTRACT FROM AUTHOR]