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Purpose: Early detection and management of coronary heart disease (CHD) are embedded into many community health service and primary care practices in western countries. The Framingham CHD risk score has been used to predict CHD and mortality for nearly 20 years, and it has predicted CHD event risk accurately in multiethnic populations. The aim of this study was to access the effect of a 6-month community-based intervention on CHD risk in individuals at high risk. Methods: A randomized controlled trial of individuals with a high 10-year CHD risk were recruited from two communities in China. Individuals in the intervention group (n = 53) received a 3-month group education and a 3-month coaching session. Physical examination and self-report questionnaires were used to collect both pre- and postintervention data on blood pressure, glucose, cholesterol, body mass index, smoking, depression, and health-related quality of life (HRQoL). Results: A total of 102 participants (85.0%) completed the 6-month study. Compared with the usual care group, the intervention group had a 5 mmHg greater reduction in systolic blood pressure (t = 2.01, p = .047), larger declines in glucose (t = −2.49, p = .015), cholesterol (t = −2.44, p = .017), body mass index (t = −2.58, p = .011), and depression (t = −2.05, p = .043), and better reports of HRQoL (t = 3.36, p = .001). No significant group differences in smoking behaviors were reported. Conclusion: A 6-month community-based intervention in a CHD high-risk population improved disease-related risk factors, depression, and HRQoL. Results provide preliminary evidence for primary prevention of cardiovascular disease risk in a community high-risk population. Keywords: coronary heart disease, intervention study, primary prevention

Purpose: The purpose of this study was to validate the Actiwatch with behaviorally determined sleep–wake state in preterm infants and to explore the influence of postmenstrual age on the accuracy of Actiwatch. Methods: A prospective and comparative research design was used. Twenty-four preterm infants with postmenstrual age ranging from 28–38 weeks were studied. The infants were studied for 2 hours between two feedings. Infant's sleep and wake state was measured every 30 seconds using Actiwatch and the Anderson Behavioral State Scale simultaneously. Results: Actiwatch demonstrated high agreement, sensitivity, and predictivity of sleep state, when validated with the Anderson Behavioral State Scale at the setting of high and automatic activity thresholds, and was not influenced by the infant's postmenstrual age. However, lower specificity and predictivity were found in the wake state, and influenced by postmenstrual age. Conclusion: Results of this study suggest that high activity thresholds are the most accurate for determining sleep state in preterm infants, and health care professionals must take the limitations into consideration while using the Actiwatch to assess wake states.

Purpose: This study is to evaluate the psychometric properties of the Korean version of the Self-Efficacy of Evidence-Based Practice (SE-EBP) scale, which was originally developed by Chang and Crowe. The beta-version of the SE-EBP is a modified version of the original SE-EBP, which measures the clinical nurses' confidence in finding, appraising, and implementing evidence into practice. Although the original SE-EBP has been validated, no study has been conducted to validate the Korean version of SE-EBP. Methods: The original scale was translated into Korean through a process of forward and back translation of the original scale. After getting confirmation of the equivalence of the Korean forward translation by the original author, exploratory factor analysis and confirmatory factor analysis of data from 212 clinical nurses were used to test construct validity. Internal consistency was examined using Cronbach α coefficients. For the statistical analysis, STATA version 13.0 software program was used. Results: Exploratory factor analysis of the 28 items revealed three factors with eigenvalues above 1, accounting for 60.2% of the total variance. Confirmatory factor analysis showed good fit of the three-factor structure which was statistically significant (χ2=718.61, df=330, p

To investigate the effect of cardiac knowledge and cardiac self-efficacy on health behaviors after controlling for influences from associating factors of health behaviors in patients with coronary artery diseases (CADs). Methods: A descriptive correlational and cross-sectional design was used. Subjects with CADs were recruited from outpatient clinics of three academic medical centers. The cardiac knowledge, cardiac self-efficacy, and health behaviors were measured by Coronary Heart Disease Awareness and Knowledge Questionnaire, Cardiac Self-Efficacy Scale, and Health-Promoting Lifestyle Profile II respectively. The data collected were statistically analyzed by descriptive statistics, t test, Kruskal-Wallis test, analysis of variance, Pearson's correlation analysis, and the hierarchical multiple regression analysis. Results: A total of 157 subjects were recruited for this study. The mean age of subjects was 59.38 ± 10.04 years, and three-fourths (75.2%) were male. Subjects showed relatively low cardiac knowledge, moderately high cardiac self-efficacy, and moderate level of health behaviors. The overall model significantly explained 48% of variance in health behaviors (F = 14.52, p < .001). Among predictors, age, education, smoking status, experience of receiving patient education, and cardiac self-efficacy significantly affected health behaviors, and cardiac self-efficacy had the greatest effect on health behaviors (β= .39). However, cardiac knowledge had no statistically significant influence on health behaviors after controlling for the other factors. Conclusion: The findings suggested that cardiac self-efficacy was shown to be the most influencing factor on health behaviors but cardiac knowledge had no influence on health behaviors. The nursing interventions tailored on the patient characteristics should be developed in order to improve the health behaviors of patients with CADs.

This study aimed to explore the process of change in the sexual views and attitudes of sexual offenders, in light of their experiences. Methods: Data were collected from six sexual offenders who were accused of sexual offenses. All collected data by in-depth and direct observation were analyzed by Corbin and Strauss' Ground theory methodology. Results: Participants were sexually aroused as a result of their distorted knowledge of sex. They were stimulated by easy access to sex and surrendered to it. Their intervening conditions were legal regulation, voice of conscience and social support. Participants were responding to the problem through strategies. These strategies were: reflecting self, distracting one's attention, and building a stable relationship with a woman. They resulted in stigma of being a sexual offender, alteration in sexual views, confidence and futility. The core variable revealing the essence of the sexual offenders' experiences was reconstructing sound sex values. Conclusion: The results of the study can provide school nurses and sex educators with useful knowledge grounded in actual sexual offense cases, not only to refine the interventions for sexual offenders but also to prevent future sexual offenses.