Search

Background: Over half of the older adults living with dementia have behavioral and psychological symptoms of dementia (BPSD), including sleep disturbance; however, little is known about physiological markers. Salivary cortisol and melatonin have been identified as potential biomarkers of BPSD, with evidence suggesting a relationship between these biomarkers and various behavioral factors, as well as sleep and activity patterns. Objectives: The aim of this study was to investigate the time-dependent changes in salivary cortisol and melatonin levels in older adults with dementia, their relationship with the sleep–wake cycle, and their correlation with BPSD symptoms and behavioral factors. Methods: This observational study conducted in Seoul and Gyeonggi-do, South Korea, used data from 172 older adults with dementia, measuring sleep and activity patterns for 2 weeks using a wearable device, in addition to administering questionnaires for neuropsychiatric and psychological symptoms—the Neuropsychiatric Inventory, Cohen–Mansfield Agitation Inventory, and Cornell Scale for Depression in Dementia. Salivary cortisol and melatonin levels were measured at four time points and divided into four groups based on a dual-trajectory model. Differences among the groups were analyzed using one-way analysis of variance. Results: The participants showed normal but heterogeneous patterns of salivary cortisol and melatonin levels. Dual-trajectory pattern analysis showed that higher levels of melatonin during the daytime were correlated with poor nighttime sleep efficiency and decreased disinhibited behaviors, and higher levels of cortisol at all four time points were associated with decreased physical activity. Discussion: Measuring and analyzing periodic changes in cortisol and melatonin levels can predict various behavioral symptoms (e.g., sleep disturbances, activity counts, and disinhibition) in older adults with dementia. A study with an experimental design is needed to discover the direct physiological interactions between cortisol, melatonin, and these symptoms. [ABSTRACT FROM AUTHOR]

Introduction: The preparation of healthy foods and maintaining a standard body weight and shape may be challenging for people with low vision and blindness (i.e., visual impairments) without the assistance of a sighted person. The purpose of this study was to compare the nutrition-related characteristics of individuals with and without visual impairments. Methods: This study employed four public datasets provided by the Korea National Health and Nutrition Examination Surveys conducted between 2013 and 2016 at 1-year intervals. The selected datasets included a set of questions to assess the health and nutritional status, and 115 items from a food frequency questionnaire for dietary assessment. A total of 260 respondents visual impairments and their counterparts (n = 260) were included in this study. Results: The mean age of individuals with visual impairments was 32.58 years (SD = 9.56) and 67.8% were women. They consumed excessive sodium and insufficient vitamin A, beta-carotene, and calcium, based on the recommendations for Korean adults' nutrition intake. In k -means clustering, two dietary patterns were identified among the respondents with visual impairments: Cluster 1 (n = 33) showed higher consumption of kimchi (t = 2.05, p =.046), beverages (t = 8.78, p <.001), sweets (t = 10.02, p <.001), and oil and nuts (t = 10.20, p <.001) than Cluster 2 (n = 227). Discussion: Robust quantitative research is required to establish the baseline nutrition profile of this marginalized population. The findings of this study support the need for interventions to address the unmet food and nutrition needs of individuals with visual disabilities. Implications for Practitioners: The information and education about healthy eating and balanced nutrient intake should be provided in an accessible format for people with visual impairments in a timely manner. [ABSTRACT FROM AUTHOR]

Purpose: With an increase in the aging population, the number of patients with degenerative spinal diseases undergoing surgery has risen, as has the incidence of postoperative delirium. This study aimed to investigate the risk factors affecting postoperative delirium in older adults who had undergone spine surgery and to identify the associated biomarkers. Methods: This study is a prospective study. Data of 100 patients aged ≥ 70 years who underwent spinal surgery were analyzed. Demographic data, medical history, clinical characteristics, cognitive function, depression symptoms, functional status, frailty, and nutritional status were investigated to identify the risk factors for delirium. The Confusion Assessment Method, Delirium Rating Scale-R-98, and Nursing Delirium Scale were also used for diagnosing delirium. To discover the biomarkers, urine extracellular vesicles (EVs) were analyzed for tau, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), neurofilament light, and glial fibrillary acidic protein using digital immunoassay technology. Results: Nine patients were excluded, and data obtained from the remaining 91 were analyzed. Among them, 18 (19.8%) developed delirium. Differences were observed between participants with and without delirium in the contexts of a history of mental disorder and use of benzodiazepines ( p = .005 and p = .026, respectively). Tau and UCH-L1--concentrations of urine EVs--were comparatively higher in participants with severe delirium than that in participants without delirium ( p = .002 and p = .001, respectively). Conclusion: These findings can assist clinicians in accurately identifying the risk factors before surgery, classifying high-risk patients, and predicting and detecting delirium in older patients. Moreover, urine EV analysis revealed that postoperative delirium following spinal surgery is most likely associated with brain damage. [ABSTRACT FROM AUTHOR]

Patients on home ventilators rely on mechanical ventilation until their death; hence, family caregivers should perform additional caregiving, including tracheostomy, equipment management, and positive pressure ventilation by ambu-bag in emergencies. Therefore, a systematic discharge education program and evaluation of actual caregiver performance are necessary for safe home management. The program consists of suction and tracheostomy management, home ventilator management, emergency management, fundamental caregiving, and video material. To test clinical validity, family caregivers of patients about to be discharged to their homes from S hospital in Seoul, Korea, were selected by convenience sampling with a non-equivalent control group design. Of 18 participants, one refused, one died, and two became unstable after their agreement; therefore, 14 participants were finally included. To compare caregiving performance scores between the groups, we ran repeated measures ANOVA. Intergroup and period interaction of suction (F = 6.08, p =.001) and tracheostomy management (F = 3.00, p =.038) crucial for airway management, showed significant statistical differences. In short, the intervention group showed a faster increase in suction and tracheostomy management than the control group. Home ventilator management (F = 22.53, p <.001), emergency management (F = 12.01, p <.001), and fundamental caregiving (F = 7.88, p <.001) showed significant differences within the group regarding the period. According to the results of the clinical validity test, the discharge education program increased the family caregiver's suction and tracheostomy management performance scores. Further research is needed to demonstrate long-term effects of the program with a larger sample. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the correlations among anti‐Müllerian hormone levels, body mass index and lipid profile in female nurses of reproductive age. Design: This is a descriptive cross‐sectional study that used data from the Korea Nurses' Health Study, based on Nurses' Health Study 3 in the United States. Methods: Participants included 448 female nurses of reproductive age. They provided details about their work experience, shift work, body mass index and history of polycystic ovary syndrome. Serum anti‐Müllerian hormone levels and lipid profile were measured using blood samples. Statistical analysis included quantile regression analysis using STATA 13.0. Data were collected between November 2016 and March 2017 from Module 5 of the Korean Nurses' Health Study. Results: Approximately 12% of the participants were underweight, and roughly one‐tenth were either overweight or obese. Although linear regression showed no relationship between anti‐Müllerian hormone levels and body mass index, quantile regression showed that body mass index, total cholesterol levels and low‐density lipoprotein levels were negatively correlated with anti‐Müllerian hormone levels at the lower tails of the dependent variable. Meanwhile, high‐density lipoprotein levels were positively correlated with anti‐Müllerian hormone at the higher percentiles of anti‐Müllerian hormone levels. Conclusion: These findings suggest the possibility that changes in the lipid profile may influence anti‐Müllerian hormone levels in women with diminished ovarian function, rather than obesity itself. [ABSTRACT FROM AUTHOR]

Background: Adequate levels of vitamin D are important for women of childbearing age as vitamin D helps maintain the pregnancy and ensures proper maternal and fetal bone metabolism and fetal skeletal development. However, vitamin D deficiency is a health problem prevalent in women of all ages, worldwide. This study aimed to determine the current status of serum vitamin D levels and the risk factors for vitamin D deficiency among South Korean nurses of childbearing age. Methods: Serum levels of 25-hydroxyvitamin D (25[OH]D) were measured in 1594 registered nurses aged 20 to 45 years who are participants in an ongoing prospective cohort study of the Korean Nurses' Health Study initiated in 2013. The participants completed surveys about demographic and occupational characteristics and physical and psychological health. We examined associations with vitamin D deficiency through multivariable logistic regression analysis. Results: The average blood 25(OH) D concentration of the participants was 12.92 ng/mL (4.0–63.4 ng/mL), while the prevalence of vitamin D deficiency (< 20 ng/mL) was 89% (1419/1594). Multivariable logistic regression showed that significant risk factors for vitamin D deficiency included month of sampling (there was a lower level of vitamin D deficiency in winter than in spring, summer, or fall), age (women in their 20s had a lower vitamin D level than those in their 30s and 40s), and stress symptoms. Vitamin D levels were not associated with body mass index, physical activity, and depressive symptoms. Conclusions: This study showed a high prevalence of vitamin D deficiency in Korean female nurses. Serum levels of vitamin D were associated with age and season. Vitamin D deficiency should be recognized as one of the primary health concerns among young women. More proactive actions, such as vitamin D supplements and food fortification, are needed to improve vitamin D deficiency in high-risk groups. [ABSTRACT FROM AUTHOR]

Background: Burnout among nurses is a worldwide public health epidemic that adversely affects nurses' quality of life as well as the patient's outcomes. The aim of this study was to evaluate the influence of stress on nurses' burnout and to identify the mediating effects of secondary traumatic stress and compassion satisfaction among clinical nurses in South Korea. Methods: A quantitative, cross-sectional study evaluated the survey data from 10,305 female registered hospital nurses who participated in the Korea Nurses' Health Study (KNHS) Module 5. The survey included a demographic questionnaire and the Professional Quality of Life version 5 (ProQOL 5). Bootstrap analyses (using the PROCESS macro) were employed to evaluate the mediating effect between variables. Results: Stress was significantly associated with burnout and mediated by secondary traumatic stress and compassion satisfaction (βindirect 1 = 0.185, Bootstrap confidence interval (BS CI) [0.175, 0.194]; βindirect 2 = 0.226, BS CI [0.212, 0.241], respectively). In addition, the magnitude of the indirect effects of compassion satisfaction was significantly greater than the magnitude of the indirect effects of secondary traumatic stress (βindirect 1-βindirect 2 = − 0.042, BS CI [− 0.058, − 0.026]). The findings of this study indicate that the positive aspect (compassion satisfaction) of work experiences can offset the negative aspects (secondary traumatic stress), consequently reducing burnout level. Conclusions: Our study findings suggest that a multidimensional approach to assessing nurse burnout and implementation of proper management will improve quality of life for nurses and help maintain positive attitudes and quality of patient care. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the current state of radiation safety education and its influence on nurses’ compliance with safety procedures. Background: Use of radiation in therapy and diagnosis has prolonged and improved millions of lives, but it presents potential hazards for healthcare professionals. Design: A cross‐sectional design. Methods: Participants included 1,672 female nurses of childbearing age who had recently been exposed to radiation‐emitting generators or radiation. Quantitative data were taken from the Korea Nurses’ Health Study, the Korean version of the Nurses’ Health Study conducted in the USA. Confounding variables included sociodemographic factors, duration of employment in a department where work involved radiation, hospital's geographical location, bed size and hospital safety climate. Statistical analyses included descriptive statistics, Spearman's correlation coefficients and multivariable ordinal logistic regression. Results: Half (50.3%) of nurses received no safety training, whereas the other half received some safety training as follows: only once (14.4%), irregularly (10.2%) and regularly (25.1%). Of the six radioactive safety compliance questionnaires, 29.4%, 20.2%, 30.7% and 19.7% complied to none, one, two and more than three, respectively. After controlling for confounding variables, relative to that observed with no safety education, irregular education that occurred more than twice (OR = 1.597, CI = 1.177–2.164) and regular education (OR = 2.223, CI = 1.770–2.792) increased the likelihood that nurses would comply with safety procedures. Conclusions: Low levels of safety education and adherence raise critical concerns regarding nurses’ well‐being. As routine safety education increases safety adherence, healthcare managers and policymakers should emphasise regular safety education. Relevance to clinical practice: Radiation safety education for nurses and their compliance with safety procedures have seldom been discussed in South Korea. However, as nurses’ safety is directly related to the quality of patient care, additional safety education should be provided for hospital nurses to minimise their occupational exposure to harmful radioactive substances in clinical settings. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: This study aimed to examine the effects of a brief stress management intervention on depression, anxiety, suicidal ideation, and aggression among Korean male college students. Design and Methods: In a repeated measures design, participants were assessed before, immediately after, and 3 months after the intervention. Data of 40 experimental and 32 control participants were analyzed using linear mixed models. Findings: There were significant time‐by‐group interaction effects for depression and trait anxiety, but not for state anxiety, suicidal ideation, and aggression. Practice Implications: The intervention has long‐term effects for depression and trait anxiety. Future research should involve a randomized controlled trial on a larger scale. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the effects of an integrated stress management program (ISMP) on college life stress, stress coping, psychological distress, and cortisol among male college students. Design and Methods: Out of 137 initially enrolled students, 99 participants were identified as distressed subjects and randomly assigned to either the ISMP or control group. Ultimately, 84 participants (43: experimental, 41: control) completed pretest‐posttest. The experimental group received eight 2‐hr sessions over 4 weeks. Findings: Stress and psychological distress decreased significantly, whereas stress coping and cortisol did not improve significantly. Practice Implications: Further studies with longer follow‐up periods and physiological interventions are required. [ABSTRACT FROM AUTHOR]

Although behavioral and psychological symptoms of dementia are a global public health challenge, non-pharmacological interventions using information and communication technologies can be an affordable, cost-effective, and innovative solution. This study aimed to examine the effectiveness of non-pharmacological interventions using information and communication technologies on the behavioral and psychological symptoms of dementia and identify potential moderators of intervention effects. Systematic review and meta-analysis of randomized controlled trials. A systematic literature review was conducted using PubMed, CINAHL, PsycINFO, Embase, and the Cochrane Library from May 2022. Randomized controlled trials that examined the effects of non-pharmacological interventions using information and communication technologies on the behavioral and psychological symptoms of dementia were included. A meta-analysis using a random-effects model was performed to calculate the pooled standardized mean differences between overall symptoms and each type of symptom. For moderator analyses, subgroup and meta-regression analyses were performed. Sixteen trials (15 articles) met the eligibility criteria. The interventions were grouped into activity engagement interventions using digital health that provided music and reminiscence therapy, physical exercise, social interaction interventions using social robots, and telehealth-based care aid interventions that provided coaching or counseling programs. Pooled evidence demonstrated that non-pharmacological interventions using information and communication technologies exerted a large effect on depression (SMD = − 1.088, 95% CI − 1.983 to − 0.193, p = 0.017), a moderate effect on overall behavioral and psychological symptoms of dementia (SMD = − 0.664, 95% CI − 0.990 to − 0.338, p < 0.001), and agitation (SMD = − 0.586, 95% CI -1.130 to − 0.042, p = 0.035). No effects on neuropsychiatric symptoms (SMD = − 0.251, 95% CI -0.579 to 0.077, p = 0.133), anxiety (SMD = − 0.541, 95% CI − 1.270 to 0.188, p = 0.146), and apathy (SMD = − 0.830, 95% CI − 1.835 to 0.176, p = 0.106) were reported. Moderator analyses identified the mean age of the participants as a potential moderator of intervention effects. Evidence from this systematic review and meta-analysis suggests that non-pharmacological interventions, using information and communication technologies, were an applicable approach to managing behavioral and psychological symptoms among older adults with dementia, with moderate to large effect sizes. However, evidence on anxiety and apathy is inconclusive due to the limited number of existing randomized controlled trials. Future studies with subgroup analyses are warranted to conclude the most effective types of intervention using information and communication technologies for each type of symptom. Registration: CRD42021258498. [ABSTRACT FROM AUTHOR]