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Purpose: This study aimed to determine the consistency of 1-day and 3-day average dietary intake using the 24-hour diet recall method and to investigate the relationship of diet intake with physiological indicators potentially associated with diabetic complications in patients with diabetes.Methods: This study conducted a secondary data analysis using pretest data of a nursing intervention study entitled “Development of deep learning based AI coaching program for diabetic patients with high risk and examination of its effects (PNUH, IRB No. 05-2021-030).” Data were analyzed through descriptive analysis, one-way repeated-measures analysis of variance, and Pearson correlation coefficients using SPSS 26.0.Results: The average total daily calorie intake over 3 days was 1,494.48±436.47 kcal/day: 1,510.90±547.76 kcal/day on the first day, 1,414.22±527.58 kcal/day on the second day, 1,558.34±645.83 kcal/day on the third day, showing significant differences (F=3.59, p=.031). The correlation coefficient between the 1-day and 3-day average dietary intake was 0.41–0.77 for each nutrient and 0.62–0.80 for each food group. Vegetable intake showed negative correlations with body mass index (BMI; r=-.19, p=.023) and triglycerides (r=-.18, p=.036), whereas dairy intake was positively associated with low-density lipoprotein-cholesterol (LDL; r=-0.18, p=.034) and triglycerides (r=.40, p

Aims To determine the effectiveness of non-pharmacological interventions on sleep outcomes among patients with coronary artery disease and recognize pertinent characteristics that potentially affect the effectiveness of such interventions. Methods and results Relevant studies conducted before 27 April 2022 were identified through four core electronic databases using terms related to coronary artery disease, sleep outcomes, and randomized controlled trials. Two authors independently conducted study selection, data extraction, and risk-of-bias assessment. Meta-analysis, sub-group analysis, publication bias analysis, and sensitivity analysis were conducted using R version 4.2.2. Of the 4755 retrieved articles, 42 studies were selected for systematic review and 30 studies were included in the meta-analysis. The findings of this study revealed that non-pharmacological interventions significantly improved self-reported sleep quality (standardized mean difference = −0.85, 95% confidence interval −1.08, −0.63), but had no effects on objectively measured sleep efficiency and duration. Regarding the types of interventions involved, environmental control was the most effective in improving self-reported sleep quality, followed by relaxation, self-care behaviour management, and relaxation and cognitive/psychological complex interventions. Through subgroup analysis, we did not find any covariates that were significantly related to self-reported sleep quality. Conclusion Non-pharmacological interventions have been shown to play beneficial roles in improving self-reported sleep quality among patients with coronary artery disease. Additional studies are required to elucidate the effect of non-pharmacological interventions on objectively measured sleep outcomes and to characterize their optimal frequencies and durations. Registration PROSPERO CRD42022366851

Purpose: This study was performed to identify factors related to the occurrence and number of chronic diabetic complications in patients with type 2 diabetes mellitus.Methods: Data were extracted from the Korean National Health Insurance Service-National Health Screening Cohort from 2002 to 2015. Adults 30 years of age or older diagnosed with type 2 diabetes mellitus and prescribed at least one diabetes medication were included. Statistical data analyses were performed using R version 3.5.1.Results: A total of 1,406 subjects were analysed in this study, of which 15.3% did not develop chronic diabetic complications. The most common first complications were eye (17.6%), peripheral vascular (16.7%), neuropathy (15.1%), and cardiovascular diseases (13.6%). Multivariable Cox regression analyses showed that female, older age, and higher body mass index were consistently associated with an increased risk of chronic diabetic complications. There were significant differences in gender, age, residential area, duration of diabetes, body mass index, smoking, and alcohol consumption according to the number of chronic diabetic complications.Conclusion: Female gender, older age, higher body mass index were consistently and significantly associated with the occurrence and number of chronic diabetic complications. Efforts to screen high risk patients and to manage the weight of type 2 diabetes patients are required. Future studies are needed to elucidate the relationship between chronic diabetic complications and recommended physical activity for weight management.

The International Classification of Functioning Disability and Health (ICF) was approved in 2001 and, since then, several studies reported the increased interest about its use in different sectors. A recent overview that summarizes its applications is lacking. This study aims to provide an updated overview about 20 years of ICF application through an international online questionnaire, developed by the byline authors, and sent to each World Health Organization Collaborating Centers of the Family of International Classifications (WHO-FIC CCs). Data was collected during October 2020 and December 2021 and descriptive content analyses were used to report main results. Results show how, in most of the respondent countries represented by WHO-FIC CCs, ICF was mainly used in clinical practice, policy development and social policy, and in education areas. Despite its applications in different sectors, ICF use is not mandatory in most countries but, where used, it provides a biopsychosocial framework for policy development in health, functioning and disability. The study provides information about the needs related to ICF applications, that can be useful to organize targeted intervention plans. Furthermore, this survey methodology can be re-proposed periodically to monitor the use of the ICF in the future.

INTRODUCTION Poor sleep quality in patients with chronic obstructive pulmonary disease (COPD) has been associated with poor health outcomes. However, there is a lack of research on factors associated with sleep disturbance in patients with COPD. OBJECTIVES We investigated patterns of sleep disturbance and factors associated with sleep impairment in patients with COPD. METHODS This was a prospective, multicenter cross-sectional study enrolling a sample of 245 COPD subjects. All patients completed the patient-reported measure, the COPD and Asthma Sleep Impact Scale (CASIS) to assess sleep impairment. The St. George's Respiratory Questionnaire (SGRQ), the 36-item Short-Form health survey (SF-36), Hospital Anxiety and Depression Scale (HADS), and the COPD Self-Efficacy Scale (CSES) were utilized to assess health-related quality of life (HRQL), anxiety/depression and self-efficacy, respectively. RESULTS About 35.1% of the patients reported that they had a bad night's sleep. Univariate analysis showed that the CASIS total score was significantly correlated with the modified Medical Research Council dyspnea scale, SGRQ total score, SF-36 PCS, SF-36 MCS, HADS-A, HADS-D and CSES (all P

Background Disease-specific knowledge is associated with outcomes of patients, but the knowledge level of chronic obstructive pulmonary disease (COPD) patients is known to be low. Objective We measured the level of disease-specific knowledge and defined factors associated with poor disease knowledge in COPD patients. Materials and Methods A cross-sectional survey was performed in five hospitals in South Korea. At enrolment, all patients completed the Bristol COPD Knowledge Questionnaire (BCKQ), Satisfaction with Life Scale (SWLS), Personal Resource Questionnaire (PRQ), St. George's Respiratory Questionnaire (SGRQ), 36-item Short-Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). The data were analyzed via linear regression to identify factors associated with low-level knowledge of COPD. Results A total of 245 COPD patients were enrolled in this study. The mean total BCKQ score was 28.1 (SD, 7.4). The lowest scores were seen for items exploring knowledge of "Oral steroids" and "Inhaled steroids". In univariate analysis, higher level of education (r = 0.17), low income (r = 0.13), the post-bronchodilator FEV1, % predicted (r = -0.24), the post-bronchodilator FEV1/FVC ratio (r = -0.13), SWLS (r = 0.15), PRQ (r = 0.16), SF-36 MCS (r = 0.13), HADS-A (r = -0.17), and HADS-D (r = -0.28) scores correlated with the BCKQ score (all p < 0.05). FEV1 (r = -0.25, p < 0.001) and HADS-D score (r = -0.29, p < 0.001) were significantly associated with the total BCKQ score in multivariate analysis. Conclusion Our Korean patients with COPD lacked knowledge on oral and inhaled steroid treatments. In particular, patients with higher-level lung function and/or depressive symptoms exhibited poorer disease-specific knowledge; such patients may require additional education.

Purpose: This study examine the functioning level and quality of life (QoL) of people with non-specific neck pain and neck pain with ra diculopathy using the neck disability index (NDI), functional rating index (FRI), and short form of health survey 36 (SF-36) and each of linked lCF code lists of those scales. Methods: Each item of the NDI, FRI, and SF-36 were linked conceptually to the ICF code, and the lCF code lists of those scales were pro duced as iNDI, iFRI, and iSF-36, respectively. Seventy-nine patients with neck pain filled the instruments and its linked ICF code lists. The subjects were divided into two groups based on the diagnosis, non-specific neck pain (Group1), and neck pain with radiculopathy (Group2). A group comparison was performed using an independent t-test. The Pearson correlation coefficient was also used to analyze the relationships between each scale and the linked ICF code list. Results: The participants in Group 2 experienced more difficulties in their daily activities than those in Group 2 when examined in NDI and FRI (p

Purpose: The aim of the study was to develop a Korean version of an ICF e-Learning tool (KICF e-Learning tool). Methods: The process of translation and adaptation of the ICF e-Learning tool was followed: two translators developed the Korean ver sions independently, and a consensus version of the translation was then produced. An expert committee, which was composed of five experts from physiotherapy, occupational therapy, speech pathology, and social welfare, reviewed the consensus Korean version to make a beta version of the tool. A field test was conducted to determine if the Korean version of the tool was easy to understand and suitable to use in ICF learning. Feedback from the field test were used for the final adaptation of the KICF e-Learning tool. Results: One-hundred and twenty-six volunteers (40 males and 76 females) were invited to examine the KICF e-Learning tool. The par ticipants reported various levels of ICF knowledge from none to very good. Forty-eight participants reported no knowledge of ICF. The majority of participants (n=84) reported that Korean terms or expression in the tool were easy to understand and one-hundred fourteen participants would recommend the tool to another person. The Korean cases would be helpful for a Korean audience to study the ICF us ing the tool. Conclusion: The KICF e-Learning tool was developed and is ready for use by the public for the consistency of ICF education. On the other hand, development of an advanced module will be needed.

The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects.The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus.The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences.The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients' self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.

The COVID-19 pandemic provides the opportunity to re-think health policies and health systems approaches by the adoption of a biopsychosocial perspective, thus acting on environmental factors so as to increase facilitators and diminish barriers. Specifically, vulnerable people should not face discrimination because of their vulnerability in the allocation of care or life-sustaining treatments. Adoption of biopsychosocial model helps to identify key elements where to act to diminish effects of the pandemics. The pandemic showed us that barriers in health care organization affect mostly those that are vulnerable and can suffer discrimination not because of severity of diseases but just because of their vulnerability, be this age or disability and this can be avoided by biopsychosocial planning in health and social policies. It is possible to avoid the banality of evil, intended as lack of thinking on what we do when we do, by using the emergence of the emergency of COVID-19 as a Trojan horse to achieve some of the sustainable development goals such as universal health coverage and equity in access, thus acting on environmental factors is the key for global health improvement.

PURPOSE To compare the effects of education only and exercise training combined with education on fall knowledge, fall efficacy, physical activity, and physical function in adults aged 70 years or older residing in elderly residential facilities. METHODS A three-group pre- and post-test design was utilized: education only (EO; n = 23), education and TheraBand (ET; n = 22), and education and walking (EW; n = 22). Fall education was provided for all three groups. In addition, TheraBand exercise training was provided for the ET and a walking exercise for the EW. Data were collected from November 1st, 2017 to February 15th, 2019 and analyzed with χ² test, paired t-test, and one-way ANOVA using IBM SPSS/WIN ver. 22.0. RESULTS Compared with the EO, the ET and the EW were more effective in terms of fall efficacy, physical activity, and lower extremity muscle strength. The EW showed higher improvement in walking abilities than the EO and the ET. CONCLUSION Exercise training combined with education is more effective in preventing falls among community-dwelling adults aged 70 years or older. When considering fall prevention programs for older adults, both TheraBand and walking exercise training combined with education can be chosen based on the participant's physical status. Aggressive strategies to improve daily walking are required to maintain walking abilities among community-dwelling adults aged 70 years or older.

Objective: To assess heart failure (HF) knowledge, adherence to lifestyle recommendations, and quality of life (QOL) among Koreans with HF and identify factors influencing QOL. Methods: A cross-sectional and correlational design was used and a total of 142 Koreans with HF were recruited between April 2012 and September 2013. Data were analyzed using multiple logistic regression with SPSS version 21.0. Results: The mean age of participants was 64.1 ± 7.4 years. A higher proportion of participants were male, married, unemployed, had a high education level, and class I New York Heart Association (NYHA) functional status. A higher proportion of participants had ≥2 comorbidities and the most prevalent comorbidity was diabetes. The mean score of HF knowledge was 6.9 (possible range 0-15) and the most frequent incorrect items were “proper actions to reduce thirst” and “causes of leg swelling” in both better and worse QOL groups. Among the recommended lifestyle, pneumococcal vaccination had the least adherence in both groups. Multiple logistic regression showed that patients in NYHA class I, with a higher left ventricular ejection fraction, who had knowledge of “amount of fluid intake a day” and consumed more than moderate alcohol tended to have better QOL. Conclusion: More active interventions targeting HF knowledge in proper actions to reduce thirst, causes of leg swelling, and the amount of fluid intake per day are required. Patients with HF in more serious condition need special attention regarding the risk of worse QOL. The role of alcohol consumption in QOL among HF patients in Korea needs further exploration.

Background Disease-specific knowledge is associated with outcomes of patients, but the knowledge level of chronic obstructive pulmonary disease (COPD) patients is known to be low. Objective We measured the level of disease-specific knowledge and defined factors associated with poor disease knowledge in COPD patients. Materials and Methods A cross-sectional survey was performed in five hospitals in South Korea. At enrolment, all patients completed the Bristol COPD Knowledge Questionnaire (BCKQ), Satisfaction with Life Scale (SWLS), Personal Resource Questionnaire (PRQ), St. George’s Respiratory Questionnaire (SGRQ), 36-item Short-Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). The data were analyzed via linear regression to identify factors associated with low-level knowledge of COPD. Results A total of 245 COPD patients were enrolled in this study. The mean total BCKQ score was 28.1 (SD, 7.4). The lowest scores were seen for items exploring knowledge of “Oral steroids” and “Inhaled steroids”. In univariate analysis, higher level of education (r = 0.17), low income (r = 0.13), the post-bronchodilator FEV1, % predicted (r = −0.24), the post-bronchodilator FEV1/FVC ratio (r = −0.13), SWLS (r = 0.15), PRQ (r = 0.16), SF-36 MCS (r = 0.13), HADS-A (r = −0.17), and HADS-D (r = −0.28) scores correlated with the BCKQ score (all p < 0.05). FEV1 (r = −0.25, p < 0.001) and HADS-D score (r = −0.29, p < 0.001) were significantly associated with the total BCKQ score in multivariate analysis. Conclusion Our Korean patients with COPD lacked knowledge on oral and inhaled steroid treatments. In particular, patients with higher-level lung function and/or depressive symptoms exhibited poorer disease-specific knowledge; such patients may require additional education.

Purpose In spite of the recent application of a general infection control method, central line-associated infections is still relatively high in Korea. Central line bundle with Chlorhexidine gluconate (CHG) tegaderm dressing was reported to be effective in reducing catheter colonization and central line-associated bloodstream infections (CLABSI). Therefore, this study aimed to examine the incidences of catheter colonization occurrence and CLABSI while using Tegaderm vs. CHG Tegaderm dressings. Methods We used a descriptive design. 400 patients who had central venous catheters were selected from four hospitals in the Korean National Healthcare-associated Infections Surveillance System. Of all subjects, 200 used Tegaderm™ (Tegaderm group), and the remaining 200 used CHG Tegaderm (CHG Tegaderm group) dressing at the catheter insertion site. Data were analyzed using the χ² test or Fisher's exact test, t-test, and logistic regression analysis using SPSS WIN 21.0. Results In the Tegaderm and CHG Tegaderm groups, CLABSI incidences were 5.89 and 1.79 per 1,000 catheter-days, catheter colonization incidences were 3.93 and 1.43 per 1,000 catheter-days, and central line bundle compliance rates were 26.0% and 49.0%, respectively. Catheter colonization risk factors were 'reinsertion after failure' and 'Tegaderm dressing' at the central line insertion site. CLABSI risk factors were 'incomplete performance of 7 central line bundle items' and 'Tegaderm dressing' at the central line insertion site. Conclusion A further prospective study is needed to examine the effects of central line bundle with CHG Tegaderm dressing, avoiding central line reinsertion after failure, and improving the bundle compliance in reducing catheter colonization and CLABSI.

Aim To evaluate the nutritional status of older adults with dementia who were living in long-term care settings. Methods As a secondary analysis, this study used the data from the Nationwide Survey on Dementia Care in Korea that was conducted between December 1, 2010, and August 31, 2011, which surveyed 3472 older adults with dementia, aged ≥60 years (mean age: 81.24 years), who were residing in 248 randomly selected long-term care settings in South Korea. Twenty-three different variables that related to the participants' demographics, diseases, and functional and nutritional characteristics were selected. The nutritional status was assessed by using the Mini Nutritional Assessment (MNA). Descriptive statistics, an ANOVA, and a chi-squared test were used to analyze the data. Results The mean MNA score of the participants was 17.90. The malnutrition rate was 38.4% (n = 1333), with 54.7% (n = 1900) of the participants at risk for malnutrition. The largest population with malnutrition resided in long-term care hospitals (47.9%), followed by nursing homes (34.1%), and group homes (25.9%). Being older and female, while exhibiting higher cognitive impairment, more neuropsychiatric symptoms, higher functional dependency, and a higher number of disabilities, were associated with poor nutritional status. Conclusion The nutritional status of older adults with dementia who were living in long-term care settings in South Korea was poor and associated with multiple factors. Paying special attention to recognizing, assessing, preventing, and treating malnutrition in this population is necessary.

Background/Aims: In patients with chronic obstructive pulmonary disease (COPD), the extent of physical activity (PA) is correlated with disease severity and prognosis. However, factors associated with low-level PA in elderly COPD patients are not known. We assessed the levels of PA and clinical factors associated with low-level of PA in elderly COPD patients. Methods: This was a secondary analysis of a multicenter, prospective study of 245 patients with COPD. Among them, 160 patients with 65 years or more were included. Three PA groups were defined with respect to daily activity time (low, moderate, and high). Health related quality of life (HRQL) was measured using St. George’s respiratory questionnaire (SGRQ) and 36-item short-form health survey. Anxiety and depression status were assessed employing the hospital anxiety and depression scale (HADS). Multivariate logistic regression was performed to iden tify independent predictors of low-level PA in elderly COPD patients. Results: Of all the 160 patients, 103 (64.4%) engaged in low-level PA. Upon uni variate analysis, a decreased exercise capacity (6-minute walk test < 250 m), an increased dyspnea (the modified medical research council [MMRC] dyspnea scale ≥ 2), a decreased HRQL (total SGRQ score), and a presence of depression (HADS-D ≥ 8) were significantly associated with low-level PA. Upon multivariate analysis, an MMRC grade ≥ 2 (hazard ratio [HR], 2.550; p = 0.034), and HADS-D ≥ 8 (HR, 2.076; p = 0.045) were independently associated with low-level PA in elderly COPD patients. Conclusions: Two-thirds of elderly patients with COPD reported low-level of PA. More severe dyspnea and a presence of depression were independently associated with low-level PA in elderly COPD patients.

PURPOSE: The purpose of this study was to identify relationships of periodontal disease and health related quality of life (HRQoL) in pregnant women. METHODS: The participants in this study were 129 pregnant women. Data were collected using questionnaires of characteristics of the participants and subjective perception of periodontal disease and a dentist's assessment of periodontal disease. Data were analyzed using descriptive statistics, correlation, and hierarchical multiple regression. RESULTS: The physical QoL showed significant negative correlation with subjective perception of periodontal disease (r=-.21, p=.013). Mental QoL had significant negative correlations with subjective perception of periodontal disease (r=-.32, p

INTRODUCTION Although sleep problems have an important impact on daily life and health outcome measures in patients with chronic obstructive pulmonary disease (COPD), patterns of sleep disturbance in patients with mild-moderate COPD remain unknown. OBJECTIVE The aim of this study was to investigate patterns of sleep disturbance and factors associated with sleep impairment in patients with mild-moderate COPD. METHODS This prospective cross-sectional study enrolled 148 male patients with COPD. At enrolment, all patients completed a disease-specific sleep measure, the COPD and Asthma Sleep Impact Scale (CASIS) to assess sleep impairment. Health-related quality of life (HRQL) was measured using the St. George's Respiratory Questionnaire (SGRQ) and the 36-item Short-Form health survey (SF-36). Anxiety and depression status were assessed using the Hospital Anxiety and Depression Scale (HADS). Self-efficacy was measured by the COPD Self-Efficacy Scale (CSES). RESULTS The mean age of the subjects was 67 years [standard deviation (SD) = 8.11]. The proportion of patients who indicated that they had a bad night's sleep was 33.1%. Univariated analysis showed that CASIS score was significantly correlated with the modified Medical Research Council (mMRC) dyspnea scale, SGRQ, SF-36 Physical Component Summary, SF-36 Mental Component Summary, HADS-anxiety, HADS-depression and CSES scores (all P

PURPOSE This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS). METHODS A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA. RESULTS At the completion of SAPS significant differences were found between groups in motivation for exercise (t=-3.24, p=.005), physical activity (t=-4.15, p

[Purpose] To explore data on functioning in the medical records of patients with stroke by linking them to the ICF. [Subjects and Methods] The admission and discharge summaries of patients’ electronic medical records (EMRs) were investigated. Information on functioning included in the summaries were mapped into the ICF. Each of the linked categories of ICF was analyzed using frequency and percentage analysis. [Results] Thirty stroke patients’ records were evaluated. A total of 1,832 items on functioning in the EMRs were found to be linked to eighty-five categories of the ICF. The majority of those categories (52.9%) belonged to the body function domain, whereas only 8.2% were environment factors. Categories in the domain of activity and participation, and body structure were found to be 22.4% and 16.5% respectively. In each domain, the most frequently found categories were muscle power function (b730), structure of brain (s110), walking (d450), and products or substances for personal consumption (e110). [Conclusion] It was found that the admission and discharge summary in the current medical records of patients with stroke contained much noticeable information on functioning and the data on functioning may be linked to the ICF. Further study is needed to adapt ICF in Korean clinical settings.

Purpose: To explore the functioning information in the current medical records for patients with stroke using the comprehensive Inter national Classification of Functioning, Disability and Health (ICF) coreset for Stroke. Methods: Physical therapists, who have more than 3 years of clinical experience in neurologic therapeutic area, filled out the coreset for Stroke based on their patients` medical records, and an interview was conducted for them. Each of the categories in the coreset was ana lyzed using frequency and percentage analysis. Results: A total of ninety patients with stroke were evaluated. Five categories of neuromusculoskeletal and movement functions in the body function domain were rated as having problems in over 90% of the patients. Four categories of the body structure domain were found as having a problem in over 73% of patients. In the domain of activity and participation, eight categories related to function of domestic lives, areas of major life and mobility were identified as having a problem for more than 90% of those patients. In the environ mental factors, a category of health professionals was documented as facilitator in 87% of patients whilst nine categories, including products and technology, physical geography, services, systems and policies, were rated as barriers by more than 10% of patients. Conclusion: The current medical records of patients with stroke contain functioning information. Information regarding body function, and activity and participation was mainly focused on rehabilitation services. It is suggested that environmental factors should be includ ed to understand patients` life situation which may have impact on patients` functioning.

Purpose: The purpose of this study was to investigate the overview of the use of the ICF in Korea. Methods: An integrative literature review from its publication in 2001 to May, 2015 was conducted; studies published from 2001 to May, 2015 were searched using RISS, KISS, DBpia, KoreaMed, PubMed, and ISI databases. For inclusion in the review, a study had to be published as a scientific article, must have participation of Korean researchers and developed in Korea, and should provide use of ICF. Results: A total of 108 publications were identified, and 89 studies met the inclusion criteria. Most eligible studies were related to clini cal fields (n=41) and areas with the disabled (n=32). Interestingly, several studies showed how to use and/or adapt ICF in clinical prac tice e.g. reviews and case studies, whereas in the area of the disabled, descriptive studies reported ICF concepts comparing with the cur rent disability policies and laws in Korea. The usage of ICF was found to be at various levels: introducing the ICF concept and model, col lecting data using the ICF checklist, coresets, as well as ICF codes itself and presenting results in the ICF framework, developing measure ment tools based on ICF concepts. Conclusion: Since introduction of the ICF in 2001, the use of the ICF in Korea has increased in different professionals as well as in levels of its applications.

Purpose This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection. Methods This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ² test, Fisher's exact test, Mann-Whitney U test, t-test, and generalized estimation equations (GEE). Results There were significant differences between the two groups regarding SEE (χ²=13.53, p=.009), PA (χ²=9.51, p=.049), functional status (χ²=10.55, p=.032), and 6MWD (χ²=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=-2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component. Conclusion The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.

The quality of life of patients with chronic obstructive pulmonary disease (COPD) decreases significantly as the disease progresses; those with severe COPD are affected most. This article investigates predictors of the disease-specific and generic health-related quality of life (HRQL) in patients with severe COPD. This multicentre prospective cross-sectional study enrolled 80 patients with severe COPD. At enrolment, all patients completed a disease-specific instrument, the St George’s Respiratory Questionnaire (SGRQ), and a generic instrument, the Short Form 36 Health Survey Questionnaire (SF-36). The data were analyzed by Pearson’s correlation and multiple linear regression. The mean age of the patients was 66 ± 8 years; 93% were males. The SGRQ and SF-36 scores were not influenced by age or sex. Depression, dyspnea, the number of exacerbations, and exercise capacity significantly predicted the total SGRQ score ( p < 0.05). Depression was the strongest determinant of the total SGRQ score. The SF-36 physical component summary scores were related to depression, dyspnea, and the number of exacerbations ( p < 0.05). In comparison, the SF-36 mental component summary scores were related to depression and anxiety ( p < 0.05). Depression is a significant determinant of both the disease-specific and generic HRQL in patients with severe COPD. Screening and early intervention for depression in patients with severe COPD could improve the HRQL.

Purpose: The purpose of this study was to assess psychometric properties of the Korean version of the Stroke Impact Scale 3.0 (K-SIS 3.0) in patients with stroke. Methods: Patients with stroke longer than 3 months were invited to participate in the study at specialized rehabilitation centers in Busan. Information on patients was collected using Mini-Mental State Examination (MMSE), Modified Bathel Index (MBI), Beck Depres sion Index (BDI), WHODAS 2.0-12 item, and K-SIS. Floor and ceiling effects of each domain of K-SIS were examined. The internal consis tency of each domain of the K-SIS was calculated using Cronbach`s α. Correlation between K-SIS and each scale was assessed using Spearman`s correlation coefficient. Results: Ninety subjects participated in the study. The K-SIS was found to have excellent internal consistency (Cronbach`s α=0.93). Each domain of the consistency ranged from 0.86 to 0.94, except the emotion (α=0.51). Significant correlations were observed between MMSE and domains of memory and thinking, and communication (r=0.48 and 0.52 respectively). BDI was negatively related to domains of emotion, ADL, mobility, and participation (r=-0.43, -0.49, -0.52 and -0.33 respectively). Specific daily activity (MBI) and general func tioning (WHODAS 2.0) were also found to be closely related to the domains of ADL, mobility, and participation (ranging from r=-0.41 to r=-0.59). No ceiling and floor effect was observed. Conclusion: Excellent reliability and validity of K-SIS were obtained in the study and it could be suggested that K-SIS may be used for patients with stroke for collection of information on functioning in the clinical context.

The purpose of this study was to compare the effects of Korean mindfulness-based stress reduction (K-MBSR), walking, and patient education regarding diabetes mellitus (DM) on stress response, glycemic control, and vascular inflammation in patients with diabetes mellitus. A cluster randomized trial including 56 adults with diabetes mellitus (K-MBSR group = 21, walking group = 18, patient education group = 17) was conducted between 13 July and 14 September 2012. The questionnaire included the Diabetes Distress Scale and Perceived Stress Response Inventory. Fasting blood samples were used to measure levels of cortisol, blood glucose, plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (t-PA). There were no statistically significant differences between the effects of K-MBSR, walking, and patient education on stress, glycemic control, or vascular inflammation. However, in the K-MBSR and walking groups, significant reductions in the levels of serum cortisol and PAI-1 were observed. A significant reduction in psychological responses to stress was observed in the walking and patient education groups. Longitudinal studies could provide better insight into the impact of K-MBSR, walking, and patient education on health outcomes in adults with diabetes mellitus.