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Purpose: The purpose of the study was to examine the factors associated with diabetes self-care behaviors (DSCB) in people with visual impairment (PVI), including demographics, disease-related characteristics, and psychosocial factors (self-efficacy, depression, and family support). Methods: A descriptive cross-sectional study was conducted. Adults with visual impairment and diabetes were recruited online and through posting notices, and a total of 141 participants were included. Measurements were completed using email and telephone surveys. Multiple linear regression analysis was performed to examine the factors associated with DSCB. Results: Higher self-efficacy and positive family support were significant predictors of better DSCB, whereas higher negative family support was a significant predictor of worse DSCB. Diabetes medication regimen was another major influencing factor on DSCB. However, depression was not associated with DSCB. Conclusion: Diabetes interventions for the visually impaired should have strategies to improve vulnerable areas of diabetes self-care, such as blood glucose monitoring. Health care providers are needed to consider diabetes education programs focused on improving self-efficacy or include family members in interventions to promote DSCB in PVI. Further studies are required to understand the problems and solutions for diabetes self-care in this population.

Background The Internet is considered an important channel for providing health information to older adults. We developed an intervention to improve eHealth literacy in older adults according to the information-motivation-behavioral skills (IMB) theory and Intervention Mapping. This study aimed to analyze the effect of a developed intervention on information, motivation, behavioral skills, and behaviors related to eHealth information in older adults. Methods Forty-six older adults over the age of 65 were recruited from two senior welfare centers in a city in South Korea. We divided the participants into four groups and conducted one intervention per group from March to December 2019. One intervention consisted of 5 sessions and was performed once a week (2 h/1 time) for 5 weeks, culminating in a total lecture time of 10 h. One lecture instructor and two assistant instructors supported the participants in the computer practices. Results Participants’ computer/web knowledge, perceived ease of use, perceived enjoyment, and attitude toward eHealth information showed statistically significant increases. The eHealth literacy efficacy score, searching performance score, and understanding score were also significantly increased. However, there was no significant difference in perceived usefulness. Conclusion The application of the current theory-based methodology can improve the quality of research in eHealth literacy. Additionally, various interventions should be developed and continuously applied to improve eHealth literacy among older adults.

The current study examined characteristics of early-onset and late-onset disability in older adults and identified predictors of health-related quality of life (HRQoL). This is a secondary data analysis of the 2017 national survey in South Korea. Participants were 4,014 older adults with disabilities, who were divided into an early-onset group ( n = 2,229) and late-onset group ( n = 1,785). Data were analyzed using complex sample analyses. Difficulties during outdoor activity and transportation use, self-rated health, and stress were common predictors in both groups. Comorbidity was a significant predictor only in the early-onset group. Use of information technology devices, household income, and perceived social discrimination were significant predictors in the late-onset group. Characteristics and predictors of HRQoL were different between groups, despite sharing common characteristics. It is necessary to improve support systems and health care services for older adults with disabilities. [ Journal of Gerontological Nursing, 48 (3), 37–47.]

Background Rapid response systems (RRSs) are essential components of patient safety systems; however, limited evidence exists regarding their effectiveness and optimal structures. We aimed to assess the activation patterns and outcomes of RRS implementation with/without a real-time automatic alerting system (AAS) based on electronic medical records (EMRs). Methods We retrospectively analyzed clinical data of patients for whom the RRS was activated in the surgical wards of a tertiary university hospital. We compared the code rate, in-hospital mortality, unplanned intensive care unit (ICU) admission, and other clinical outcomes before and after applying RRS and AAS as follows: pre-RRS (January 2013–July 2015), RRS without AAS (August 2015–November 2016), and RRS with AAS (December 2016–December 2017). Results In-hospital mortality per 1000 admissions decreased from 15.1 to 12.9 after RRS implementation (p p Conclusions Real-time AAS based on EMRs might help identify unstable patients. Early detection and intervention with RRS may improve patient outcomes.

Smartphone overdependence (SO) in mothers of preschoolers (MPs) reduces the parenting capacity of MPs. The current study aimed to identify associated factors of SO in MPs through a systematic review and meta-analysis conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using 10 electronic databases. A total of 18 studies met the inclusion criteria. It was confirmed that SO in MPs is a coping strategy used to manage stress during childrearing. Parenting stress, depression, unemployment, and low household income were identified as risk factors that increased SO in MPs. Protective factors that reduced SO in MPs included resilience and parental intelligence. Findings emphasize the need to assess risk factors to prevent SO in MPs. It is suggested that programs to prevent SO in MPs be developed based on results of this study. [ Journal of Psychosocial Nursing and Mental Health Services, 60 (3), 40–47.]

Aim To identify the characteristics of chronic disease interventions for people with visual impairment (PVI) and provide suggestions for future interventions. Background Chronic diseases are more common in PVI than people without visual impairment, and PVI have difficulty managing chronic diseases due to physical, social, and psychological problems associated with visual impairment. However, evidence regarding chronic disease intervention for PVI is limited. Methods This review was guided by the PRISMA methodology. Data were extracted and checked, and each study was evaluated to ensure their methodological quality using appropriate tools based on the study design. Findings were described through a qualitative synthesis, and the above process was carried out by all four researchers. Results 28 studies were selected. The intervention for mental disorders was the most common with about 39.3%, followed by stroke (25.0%), diabetes (17.8%), various chronic diseases (10.7%), chronic pain (3.6%), and scoliosis (3.6%). Most of the intervention was delivered individually, and the place of intervention often depends on the preference or convenience of PVI. A wide range of intervention materials was used, from large print, audio, or braille version reading materials to technology products. Based on the results, the main areas of the outcomes were daily living function, psychological conditions, and quality of life. Conclusions This review identified the components of interventions for PVI and provided intervention strategies. In particular, chronic disease interventions for PVI should be planned by considering how and where appropriate interventions are provided, various available materials, and the problems to be addressed.

AIMS This study aimed to compare the psychometric properties of two measures of eHealth literacy, namely, the Korean versions of the Digital Health Literacy Instrument (K-DHLI) and eHealth Literacy Scale (K-eHEALS), among older adults in South Korea. BACKGROUND Given the usefulness of eHealth information, measures of eHealth literacy have been developed. It is necessary to examine the validity of such tools among older adults who are likely to experience difficulties in using eHealth resources. METHODS A validation study was conducted using the secondary data of 180 older adults in South Korea. Two weeks after they had responded to the K-DHLI and K-eHEALS, 89 of them completed the assessments a second time so that the assessments' test-retest reliability could be examined. Using the collected data, their reliability (i.e. internal consistency, test-retest reliability) and validity (i.e. construct validity and criterion validity) were examined. RESULTS Both tools demonstrated satisfactory internal consistency (α ≥ 0.90, item-total correlation coefficients = .39-.76) as well as good test-retest reliability with intraclass correlation coefficients .77 and .84, respectively. The 21 items of the K-DHLI loaded onto five factors, which accounted for 71% of the variance. The 10 items of the K-eHEALS loaded onto a single factor, which explained 58% of the total variance. The scores of both tools were strongly correlated (r = .63) and positively related to attitudes towards internet health information and subjective health status (r = .23-.50). CONCLUSIONS The findings suggest that the K-DHLI and K-eHEALS are reliable and valid tools that can be used to assess the utilisation of eHealth resources by older adults. IMPLICATIONS FOR PRACTICE The findings can help healthcare providers choose a suitable measure of eHealth literacy when working with older adults.

Purpose This study aimed to understand and describe the diabetes self-management experience of visually impaired people with diabetes. Methods Ten participants were recruited through a website used by the visually impaired from February to March 2020. Data were collected through two focus group interviews conducted in June 2020; each group consisted of five participants. All interviews were recorded with the consent of the participants and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. Results Seven categories were as follows; a two-faced, lifelong companion, an unprepared encounter, struggle to live, love-hate relationship with family, strategies to adapt, lessening attention to self-management, the desire to learn properly. Conclusion It can be concluded that the visually impaired have fewer opportunities for receiving diabetes self-management education than general diabetic patients. Consequently, plans to improve the education available to such patients are required. Additionally, psychological counseling and diabetes education for patients' families are necessary, and improving the perception of medical workers regarding the visually impaired will be prove useful.

Background The preferred devices to access the internet are changing from personal computers to mobile devices, and the number of older adults with or without disabilities is rapidly increasing in an aging society. However, little is known about the moderating effects of disability on mobile internet use among older adults. Objective This study aimed to examine the levels of mobile internet use and factors associated with this use among older adults according to their disabilities. In addition, moderating effects of disability on mobile internet use were investigated. Methods This study consisted of a secondary data analysis using the 2020 Digital Divide Survey conducted in South Korea. The single inclusion criterion was participants being aged 55 years or older; accordingly, 2243 people without disabilities and 1386 people with disabilities were included in the study. Multiple regression analyses considering complex sample designs were conducted to identify mobile internet use factors and to test the moderating effects of disability on mobile internet use. Results Older adults with disabilities used mobile internet less than older adults without disabilities. However, disability status had moderating effects on the relationships between mobile internet use and (1) operational skills regarding mobile devices (B=0.31, P=.004), (2) internet use skills (B=1.46, P Conclusions Although older adults and people with disabilities are considered vulnerable populations regarding technology adoption, disability creates a stronger association between several determinants and actual mobile internet use. Therefore, policy makers and practitioners should pay attention to older adults with disabilities to deliver appropriate information-literacy education. Older adults with disabilities could be the primary beneficiaries of mobile services and new technology.

The purpose of the current study was to compare the factors associated with adults' eHealth literacy, which is vital for health consumers. A secondary data analysis was conducted with data collected from November 2017 to February 2018 for a project on the development of a Korean version of the eHealth Literacy Scale. Participants were recruited through an online survey for young adults ( n = 210, mean age = 25.5 [ SD = 4.7] years) and a face-to-face survey for older adults ( n = 187, mean age = 73.2 [ SD = 4.8] years). Hierarchical multiple regression analyses were used to analyze data and determine eHealth literacy predictors. Older adults held more positive attitudes toward internet health information than young adults (mean = 16.49 [ SD = 2.54] and 17.04 [ SD = 2.41], respectively; p = 0.029); however, eHealth literacy levels were comparable (mean = 30.50 [ SD = 4.62] and 30.95 [ SD = 4.17], respectively; p = 0.305). Attitude toward internet health information was a significant predictor of eHealth literacy in both groups, and age was only a predictor among young adults. These results elucidate predictors of eHealth literacy and inform strategies to improve eHealth literacy among young and older adults. [ Journal of Gerontological Nursing, 46 (8), 46–56.]

Aim The integrated evidence on diabetes self-care behaviors in people with a disability is not commensurate with the growing number of people with both diabetes and a disability. This study aims to identify factors influencing self-care behaviors in adults with diabetes and a disability based on a thorough review of the current evidence. Methods This review followed the Cochrane guidelines for systematic review research and complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. To find eligible articles, five electronic databases-PubMed, Embase, CINAHL, Psych-articles, and the Cochrane Library-were searched, from the beginning of the chronological period covered by each database to June 2017. Four researchers independently conducted study selections, extracted data, and assessed the data quality. Results Twenty studies were reviewed to identify barriers to and facilitators of diabetes self-care behaviors. For people with developmental disabilities, the most prominent facilitator of self-care behaviors was the support they received for the behaviors. For people with visual impairments, that facilitator was the use of helpful assistive devices that take advantage of another sense. The main barriers to self-care behaviors were mobility limitation for people with physical disabilities and lack of accessibility for people with visual impairments. Conclusions This review has identified barriers to and facilitators of diabetes self-care behaviors by type of disability. Healthcare services need to be tailored to these facilitators and barriers, and differentiated by type of disability.