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Depressive symptoms are substantial among stroke survivors and their caregivers in poststroke management. Optimism and social support are known to protect against depressive symptoms. However, little is known about how optimism and social support contribute to depressive symptoms among stroke survivor-caregiver dyads. The study's purpose was to examine actor and partner effects of optimism on depressive symptoms through perceived social support among stroke survivors and caregiver dyads in the chronic stage of rehabilitation.Stroke survivors and caregivers (N = 105 dyads) completed the survey at 2 years of follow-up after the first stroke. Depressive symptoms, optimism, and perceived social support were assessed using the Center for Epidemiologic Studies-Depression, the Life Orientation Test, and the Interpersonal Support Evaluation List. The Actor-Partner Interdependence Model Extended to Mediation analysis was used to test the indirect effect of optimism on depressive symptoms through perceived social support.Higher optimism was significantly associated with lower depressive symptoms for caregivers (direct actor effect, -0.6844; 95% confidence interval [CI], -0.9844 to -0.3844) and stroke survivors (direct partner effect, -0.4189; 95% CI, -0.0789 to -0.0889). Perceived social support availability significantly mediated the association between optimism and depressive symptoms for stroke survivors (indirect effect, -0.1957; 95% CI, -0.3923 to -0.0670). Caregiver perceived social support availability was also a significant mediator between caregivers' optimism and stroke survivors' depressive symptoms (indirect effect, 0.1658; 95% CI, 0.0559-0.3128).Intervention improving dyad members' optimism and social support would be beneficial to improve depressive symptoms of the stroke survivors and caregivers in chronic stroke management.

Purpose Children in migrant villages in Kyrgyzstan have a high incidence of anemia and need effective health promotion programs. The purpose of this study was to evaluate a pilot study of a health promotion project for infants and toddlers based on community participation. Methods This was a retrospective study conducted to evaluate the effectiveness of the project. The project was carried out by nurses at a public health center, community health workers, and local residents in a migrant village. After the operational system of the project was established, health assessments, child-care education, provision of vouchers for iron supplements, and activities to improve residents' awareness were conducted during 6 months among 100 children, of whom 85 were finally analyzed. Results In international health projects, close cooperation of the project team with community residents and health workers is important. Access to the community-based program was feasible in the socially and economically poor migrant village, and improvements were shown in children's anemia and awareness of health care. Conclusion By focusing on the effective aspects of this preliminary project, plans to utilize community health workers and promotion strategies can be added to the main project to improve health promotion among children in this area.

Background: Depressive symptoms are a common psychological outcome in post-stroke management among stroke survivors and their caregivers. Optimism and social support are known to protect against depressive symptoms. However, little is know about how optimism and perceived social support contribute to depressive symptoms among stroke survivor-caregiver dyads. The purpose of this study was to examine the mediating effect of perceived social support on the relationship between optimism and depressive symptoms among stroke-survivor and caregiver dyads. Methods: A total of 105 stroke survivor and caregiver dyads completed a survey two years after first stroke. Depressive symptoms, optimism, and perceived social support were assessed using the Center for Epidemiologic Studies-Depression, the Revised Life Orientation Test, and the Interpersonal Support Evaluation List. The dyadic actor-partner interdependence mediation analysis with distinguishable dyads was used to test the mediation effect on dyadic data. Results: Stroke survivors (mean age 58.7 years, 56% male) and their caregivers (mean age 56.7 years, 61% female) reported similar levels of depressive symptoms, optimism, and perceived social support,. Figure 1 presents the results. Individuals with higher levels of optimism had higher levels of perceived social support. Higher levels of optimism in caregivers were significantly associated with lower levels of depressive symptoms of both caregivers and stroke survivors. Perceived social support significantly mediated the relationship between optimism and depressive symptoms for stroke survivors. Caregivers’ perceived social support was also a significant mediator between caregivers’ optimism and stroke survivors’ depressive symptoms. Conclusion: The findings suggest that interventions to improve dyad members’ social support would be beneficial to improve depressive symptoms of dyad members even for those who have lower levels of optimism.

Background The purpose of this study was to identify patterns of depressive symptom trajectory and examine the associations of the symptom trajectory with caregiving burden, family function, social support, and perceived health status of caregivers of stroke survivors during the first year of caregiving after discharge from rehabilitation center. Methods Caregivers of stroke survivors completed a survey of depressive symptoms, caregiving burden, family function, perceived availability of social support, and perceived health status at postdischarge and 1 year. Patterns of depressive symptom trajectory (ie, symptom-free, symptom relieved, symptom developed, and persistent symptom groups) were identified by grouping depressive symptoms based on 2 assessments using the Center for Epidemiologic Studies-Depression. Repeated-measures analysis of variance and multinomial logistic regression were used to examine the associations. Results Of the 102 caregivers, 57.8% were symptom-free, 20.6% experienced persistent depressive symptoms, 11.8% relieved depressive symptoms, and 9.8% developed depressive symptoms. There were significant changes in family function (Wilks λ = 0.914, P = .038) and perceived health status (Wilks λ = 0.914, P = .033) among the groups during the first year of caregiving. The persistent symptom group reported the highest level of burden and the lowest level of family function and perceived availability of social support at both assessment times. Compared with symptom-free caregivers, caregivers with persistent depressive symptoms were 7 times more likely to have fair/poor health rather than excellent/very good health at 1 year (odds ratio, 7.149; P = .012). Conclusion Caregivers with persistent depressive symptoms are the most vulnerable to negative psychosocial outcomes and poor perceived health status during the first year of caregiving from discharge for stroke survivors.

Background Recently, despite the high prevalence of fatigue in patients, there is a lack of research on the quality of life (QoL) in unexplained fatigue patients, indicating that they are not properly diagnosed and treated. The aim of this study was to compare fatigue severity and QoL between patients with explained and unexplained fatigue. Methods The study consisted of 200 Korean adults who complained of fatigue without underlying disease. Fatigue Severity Scale, Short Form Health Survey-36 version 2 (SF-36v2), and Beck Depression Inventory-II (BDI-II) self-questionnaires were administered. Participants were dichotomized to two groups, namely, patients with unexplained or explained fatigue, sorted according to laboratory examination results. The chi-square test, t-test, and Wilcoxon rank-sum test were used, and analysis of covariance was calculated after adjusting for age, sex, body mass index, smoking status, and physical component summary (PCS) of SF-36v2 or BDI-II. Results PCS of SF-36v2 between the two groups showed significant difference. Compared to patients with explained fatigue, those with unexplained fatigue showed lower physical component scores of QoL. Conclusion QoL of patients with unexplained fatigue could largely diminish than those with explained fatigue. The primary clinician should be aware of poor QoL in patients with unexplained fatigue to identify who is in need of more attention and intervention.

The purpose of this methodological study was to examine the reliability and validity of a translated Korean version of the job embeddedness that modified by Reitz. The translated scale was pilot tested and then administered for 258 nurses. Exploratory factor analysis were utilized to assess the fact...

Atrial fibrillation (AF) is a common cardiac arrhythmia associated with poor health-related quality of life (HRQoL). However, the factors influencing HRQoL in patients with AF are not well understood. The purpose of integrative review was to investigate the factors affecting HRQoL in patients with AF based on the six domains of Ferrans and colleagues’ HRQoL model. A total of 23 relevant articles published between January 2000 and March 2018 were identified using four databases and analyzed in this study. Our review showed that the HRQoL in patients with AF was consistently lower than both healthy individuals and patients with other cardiovascular diseases. The most common factor associated with HRQoL in patients with AF was anxiety-specific to AF in the symptoms domain, followed by frequency and severity of symptoms and the New York Heart Association functional class. This study highlights that monitoring and assessing patients’ symptoms is vital for improving HRQoL in patients with AF. Disease-specific and cross-culturally validated tools can allow healthcare professionals to provide tailored interventions for patients with AF.

Despite over 10 years of support from government health programs and health organizations, children in migrant villages in Kyrgyzstan remain a public concern owing to high incidence rates of preventable diseases such as anemia. An effective community health promotion program is needed but there is a lack of knowledge of community barriers and health factors affecting children's health in these migrant villages. The purpose of this study was to conduct a community health needs assessment to develop strategies for a child health promotion program in these migrant villages. This study conducted using a mixed method that included literature review, reginal statistics, focus group and key person interviews, and a community survey. The analysis method was descriptive statistics for the questionnaires, and content analysis for the interviews. Results showed the following priorities for child health promotion: strengthening health care provider capacity, overcoming resource shortages, managing child health and preventable diseases, improving public hygiene, promoting a healthy lifestyle, and empowering school health. The strategies were identified: capacity building of health workers, increasing community participation and raising child health awareness, and supporting child health promotion services. These findings will help guide the implementation of a child health promotion program.

Purpose: The purpose of this study is to investigate changes in health promoting life style and weight control behavior among nursing students during their two years of college, and to identify the relationship between the changes and their perceived health status. Methods: The subjects were 264 female students in a three-year nursing college in Seoul, Korea. Data was analyzed by paired t-test, Wilcoxon signed-rank test, and multiple logistic regression using SPSS ver.21. Results: Of the six sub-categories regarding health promoting life style, five except spiritual growth showed improvement after two years, but their perceived health status did not change significantly. The number of students who engaged in weight control behavior increased, but there was no change in the number of students who engaged both in weight control and in diet. The group which recorded high scores in perceived mental health status showed 1.2 times greater positive changes in health promoting lifestyle (OR=1.202, p=.023). Conclusion: The results showed although health promoting behavior changed positively throughout the nursing curriculum, physical activities were still low and few students used constructive methods to control their weight. Therefore, it is recommended that nursing colleges build specific programs into their curriculum to correct students’ undesirable health promoting behavior.

Aim This study compared health-related quality of life in patients with early to mid-stage chronic kidney disease. Methods This study utilized a comparative descriptive design. Patients receiving continuous ambulatory peritoneal dialysis were recruited from a hospital in Korea. Information from patients with stage 3 and 4 chronic kidney disease was obtained from Korean national survey data. A total of 75 pairs were matched using the propensity score method. Health-related quality of life was compared using the European Quality of Life–5 Dimensions questionnaire. Results Only 4% of patients with stage 3 or 4 chronic kidney disease are aware of their disease. These patients have decreased mobility and ability to perform their usual activities (χ2 = 10.77, P = 0.001; χ2 = 7.22, P = 0.007, respectively). However, they have lower levels of anxiety and depression than patients undergoing continuous ambulatory peritoneal dialysis (χ2 = 13.37, P

Purpose This study was conducted to identify the relationship between symptom clusters and quality of life (QOL) in patients with stages 2 to 4 chronic kidney disease (CKD) in Korea. Methods Using self-reported questionnaires, data were collected from 143 patients who underwent treatment for CKD at one hospital in Korea. The 17-item Patient Outcome Scale was used to measure symptoms, and the 36-item Short Form Health Survey Instrument Version 2 (SF-36v2) was used to measure the QOL. Data were analyzed using factor analysis to draw symptom clusters. Results Among five symptom clusters, the energy insufficiency and pain cluster was found to have the highest prevalence and greatest severity. The severity of symptom clusters showed negative correlations with both physical and mental component summary (PCS and MCS) scores. Elderly patients scored low on PCS, whereas younger patients in their 30s and 40s scored low on MCS. Negative correlations were found between symptom clusters and PCS as well as MCS. The severity of symptoms and QOL had stronger relationships with subjective perception of symptoms and psychological factors than with objective clinical indicators. Conclusion As the effects of physical and psychological symptoms on the QOL in patients with stages 2 to 4 CKD were identified in this study, nurses should develop strategic nursing plans focused on symptom clusters and patients' subjective perception of symptoms rather than objective clinical indicators in order to improve the QOL in patients with CKD.

Aim This study was conducted to explore first experiences of high-fidelity simulation training in Korean nursing students, in order to develop and establish more effective guidelines for future simulation training in Korea. Methods Thirty-three junior nursing students participated in high-fidelity simulation training for the first time. Using both qualitative and quantitative methods, data were collected from reflective journals and questionnaires of simulation effectiveness after simulation training. Descriptive statistics were used to analyze simulation effectiveness and content analysis was performed with the reflective journal data. Results Five dimensions and 31 domains, both positive and negative experiences, emerged from qualitative analysis: (i) machine–human interaction in a safe environment; (ii) perceived learning capability; (iii) observational learning; (iv) reconciling practice with theory; and (v) follow-up debriefing effect. More than 70% of students scored high on increased ability to identify changes in the patient's condition, critical thinking, decision-making, effectiveness of peer observation, and debriefing in effectiveness of simulation. Conclusion This study reported both positive and negative experiences of simulation. The results of this study could be used to set the level of task difficulty in simulation. Future simulation programs can be designed by reinforcing the positive experiences and modifying the negative results.

Purpose: The purpose of this study is to examine the effects of a resistance band training program on body composition, physical fitness, and health promotion behavior in nursing students. Method: This study has a one-group pretest-posttest design to examine the change in body composition, physical fitness, and health-promoting lifestyle profile after participation in the resistance band training program. Training consisted of hands-based exercises using an elastic resistance band for ten weeks. Participants performed the resistance band training two days per week with a sports trainer, and 30 minutes self-training three days per week. The participants were 21 freshmen in nursing. Results: Mean age of the participants was 20.9 years, and 61.9% were not satisfied with their body shape. After the training program, muscle mass, muscular endurance, and balance of the body were significantly improved. In health promoting lifestyle profile, categories of physical activity, health responsibility, and stress management showed a significant increase. Conclusion: Results of this study suggested that exercising with a resistance band improved body composition, physical fitness, and health promoting behavior in the nursing students. We propose that resistance band training should be suitable for those who have the environment with limitation of time and space.

In this study, learner satisfaction was described, and factors influencing satisfaction with team-based learning were identified. This was a cross-sectional, descriptive survey study. Two separate 2 h team-based, learning sessions, consisting of preparation, readiness assurance, and application, were given to a cohort of 139 second year nursing students in 2010 and 263 students in 2011, respectively. At the end of the learning sessions, participants completed a self-administered questionnaire regarding their learning experience. Nursing students were generally satisfied with team-based learning. Multiple regression analysis revealed that the learning process significantly affected learner satisfaction compared to pre-assignment, course content, peer evaluation, and team activity. According to these results, team-based learning facilitators should organize and conduct team-based learning activities, while also considering instructional design factors, to help students learn effectively.

The purpose of this study was to describe learner perception, expected competence, and factors influencing satisfaction with team-based learning in a nursing course. Four-hour TBL sessions were given in a structured three-phase sequence for a cohort of 139 second-year nursing students. TBL was found to be an effective instructional strategy inducing team learning and self-directed learning. Nursing educators should improve TBL quality by focusing on the student team learning process.

Smoking is a major risk factor for not only the occurrence of myocardial ischaemia but also recurrences of vascular stenosis. This study aimed to evaluate health-promoting lifestyles and abstinence rate after a smoking cessation programme. Sixty-two smokers who had undergone percutaneous coronary intervention were randomly assigned to either the experimental or control group. The experimental group (n = 30) received 10 phone counselling sessions and 21 short message service messages for abstinence and coronary disease prevention, whereas the control group (n = 32) received only the standard education. After the intervention, 14 members of the experimental group had switched to a non-smoking status, confirmed biochemically; moreover, their physical activity and stress management scores increased significantly. However, self-efficacy of smoking cessation was not reflected in the cotinine levels. Thus, it is necessary not only to increase self-efficacy but also to determine the factors that affect the success of smoking cessation so that they can be included in the intervention. Our results suggest that phone counselling and short message service messaging might be important tools for the realization of smoking cessation and lifestyle changes among patients who have undergone percutaneous coronary intervention.

We identified how the health of the growing Korean-Chinese (KC) female immigrant population differed from comparable domestic women. Using propensity score matching, we selected 227 women recruited from Korea and China; perceived health status, female cancer screening behaviors, and the Health Promoting Lifestyle Profile II were investigated. The KC women in Korea had the lowest levels of physical and mental health as well as health promoting lifestyles, but performed female cancer screenings better than other women. Considering their vulnerability, the hosting country should provide accessible health services at reasonable fees for KC women in Korea to enhance their health.

This study aimed to compare the drinking behavior and health promoting lifestyle between Korean (n

kim m.j., lee s.j., ahn y.-h. & lee h. (2011) Lifestyle advice for Korean Americans and native Koreans with hypertension. Journal of Advanced Nursing 67(3), 531–539. Abstract Aim. This paper is a report of a comparison of advice on lifestyle given by healthcare providers and subsequent action by recipients between Korean Americans and native Koreans with hypertension. Background. High blood pressure is controllable by having a healthy lifestyle, such as weight control, dietary change, exercise, low-sodium diet, alcohol restriction and smoking cessation, and by taking medication. Healthcare providers play an important role in teaching individuals with hypertension on healthy lifestyles. Method. This descriptive comparative study was conducted with a convenience sample of 100 Korean Americans and 100 native Koreans with hypertension. They were interviewed between May 2003 and June 2004 on the advice they received from healthcare providers on lifestyle and their subsequent action in terms of taking medication, weight control, dietary change, exercise, low-sodium diet, smoking cessation, alcohol restriction and tension reduction. Nutrient profiles were examined using the 24-hour dietary recall method. Findings. Korean Americans received advice on lifestyle less than did native Koreans, but more Korean Americans followed healthy lifestyle advice on dietary change and exercise than did native Koreans (P

Purpose: The purpose of this study was to compare the effects of nursing simulations between multi-mode simulation and simulation on nursing students` nursing competency, satisfaction, and simulation participation experience in nursing care for patients with dyspnea. Method: Subjects were 107 junior nursing students in R College of Nursing in Seoul from June to November in 2009. Students were allocated to either a Multi-mode simulation group or a simulation group. The multi-mode simulation consisted of standardized patients combined with Vital Sim, comparing the group. Result: The Multi-mode simulation group reported higher levels of nursing competency (p

PURPOSE: The purpose of this study was to compare health promotion lifestyles and self-esteem of nursing students in Korea and China. METHODS: With a descriptive comparative design, a total of 305 Korean and 317 Chinese nursing students were recruited. The health promotion lifestyles was measured by Walker's Health-promoting Lifestyle Profile II instrument and self esteem was measured by Rosenberg's self esteem instrument. Data were analyzed by descriptive statistics and multiple regression. RESULTS: Korean students showed significantly higher levels of health responsibility, nutritional habit, interpersonal relations, and spiritual growth compared with Chinese students, but physical activity was higher in Chinese students. The factors influencing health promotion lifestyle were self-esteem, nation, and satisfaction of school life. The levels of health promotion lifestyles positively correlated with self-esteem in Korean and Chinese nursing students. CONCLUSION: Nurse educators should consider to develop health-promoting activities and programs reflecting curricular and cross-cultural perspectives.

Purpose: This study investigated critical thinking disposition and clinical competency of senior nursing students in 3 nursing colleges whose education methods were different; lecture based education, partially problem based learning (PBL) applied education or whole problem based learning applied education. Method: Participants were 399 diploma nursing students, and 92 undergraduate nursing students. The instruments used for this study were critical thinking disposition scales and clinical competency scales. Results: There was no statistical difference on critical thinking disposition except healthy skepticism between the 3 colleges. Clinical competency of the lecture based college was the highest. A significant positive correlation between critical thinking disposition and clinical competency were found in students whose scores of critical thinking disposition were greater than the median. Conclusion: This finding indicates that there is a need for further research on diverse nursing students who are studying by a various methods, prior to acceptance of a paradigm shift in nursing education from conventional lecture based methods to PBL applied methods.

This paper describes the effects of a comprehensive lifestyle modification program (CLMP) on glycemic control and body composition in patients with type 2 diabetes. Methods: This study was performed from October 2003 to April 2005, and used an experimental design with random assignment. The experimental group (n = 25) received CLMP for 4 months and follow-up sessions for 9 months. CLMP included nurse-led education on exercise and diet, and counseling on stress management and self-monitoring of their diabetic health. The control group (n = 23) received a 1-hour educational session on diabetic diet at the beginning of the study. Glucose level and body composition were measured in both groups a total of five times: at baseline (pre-intervention) and at 0, 3, 6 and 9 months post intervention. Results: Repeated-measures ANOVA showed that there were statistically significant differences in fasting blood sugar and HbA1c levels between the two groups (both p < .05). Both groups demonstrated statistically significant changes in body composition over time, but there was no significant difference in the pattern of change between the two groups. Conclusion: CLMP is a useful program, and its multiple approaches by nurses as the leaders and coordinators appear to have positive and synergistic roles in improving and maintaining stable glucose level and body composition in patients with type 2 diabetes.

Title. Dietary acculturation and diet quality of hypertensive Korean Americans Aim. This paper is a report of a study to describe the dietary acculturation of hypertensive and normotensive Korean Americans and native Koreans by comparing dietary pattern and diet quality. Background. Dietary acculturation is a major factor that influences the risks for cardiovascular disease in immigrants. Nurses play a key role in educating immigrants about dietary acculturation. Limited studies have examined dietary acculturation of Korean immigrants with hypertension. Method. A descriptive study of hypertensive and normotensive Korean Americans and native Koreans (n = 398) was conducted in 2003–04, using the 24-hour dietary recall method. Dietary pattern was measured by consumption frequency of Korean, American and common food, and eating outside the home. Diet quality was measured by the revised version of the Diet Quality Index. Findings. Korean Americans showed greater consumption of American food, common food and fast food, and ate away from home more often than native Koreans. Overall Diet Quality Index scores were not statistically significantly different between the two groups after matching. Compared with native Koreans, Korean Americans consumed lower amounts of sodium, potassium, vegetables and fruits, and energy from carbohydrates. Hypertensive Korean Americans consumed fewer vegetables and fruits, and less sodium and potassium than hypertensive native Koreans. No statistically significant differences were found between hypertensive and normotensive Korean Americans in dietary acculturation. Conclusion. Dietary acculturation of immigrants is a common phenomenon regardless of the country from which they immigrate. Healthcare professionals should consider the advantages and disadvantages of dietary acculturation in health promotion for immigrants.

Smoking is a major risk factor for not only the occurrence of myocardial ischaemia but also recurrences of vascular stenosis. This study aimed to evaluate health-promoting lifestyles and abstinence rate after a smoking cessation programme. Sixty-two smokers who had undergone percutaneous coronary intervention were randomly assigned to either the experimental or control group. The experimental group (n = 30) received 10 phone counselling sessions and 21 short message service messages for abstinence and coronary disease prevention, whereas the control group (n = 32) received only the standard education. After the intervention, 14 members of the experimental group had switched to a non-smoking status, confirmed biochemically; moreover, their physical activity and stress management scores increased significantly. However, self-efficacy of smoking cessation was not reflected in the cotinine levels. Thus, it is necessary not only to increase self-efficacy but also to determine the factors that affect the success of smoking cessation so that they can be included in the intervention. Our results suggest that phone counselling and short message service messaging might be important tools for the realization of smoking cessation and lifestyle changes among patients who have undergone percutaneous coronary intervention.

The aim of this study was to examine the effects of a 6-month intensive lifestyle modification intervention on metabolic parameters and carotid intima-media thickness (IMT) in patients with type 2 diabetes mellitus. Fifty-eight subjects with type 2 diabetes mellitus were randomly assigned to the intervention group or the control group. The subjects in the intervention group participated in a 16-week intensive lifestyle modification program and subsequent monthly meetings during the 6-month study period. Control subjects received basic dietary education and usual care. Anthropometric data, metabolic parameters, and carotid IMT were examined before the intervention and after 6 months. Lifestyle modification intervention group patients showed a significant reduction in HbA1c (-1.0% +/- 1.3% vs +0.1% +/- 1.2%, P = .002), fasting blood glucose (-1.6 +/- 1.5 vs +0.3 +/- 2.5 mmol/L, P = .001), and 2-hour postprandial plasma glucose (-2.1 +/- 2.5 vs +0.8 +/- 4.4 mmol/L, P = .003) compared with control patients after 6 months. Body weight (-2.0 +/- 2.6 vs +0.2 +/- 1.7 kg, P = .001), body mass index (-0.8 +/- 1.0 vs 0.0 +/- 0.8 kg/m2, P = .003), and systolic blood pressure (-8.2 +/- 15.9 vs +0.4 +/- 14.1 mm Hg, P = .041) were significantly decreased in the intervention group. A significantly reduced carotid mean IMT progression was seen in the intervention group after 6 months (-0.040 +/- 0.136 vs +0.083 +/- 0.167 mm, P = .007). Changes in HbA1c (r = 0.34, P = .028), fasting plasma glucose (r = 0.31, P = .045), and 2-hour postprandial plasma glucose (r = 0.37, P = .015) correlated with the mean carotid IMT change after adjustment for age and sex. In conclusion, a 6-month intensive lifestyle modification intervention in patients with type 2 diabetes mellitus resulted in improved glycemic control and decreased progression of carotid IMT.

Purpose: The aim of this study was to examine the associations between depression, anxiety, hostility and fighting spirit among patients with stomach, colorectal or breast cancer. Materials and Methods: 223 patients, diagnosed as with stomach, colorectal or breast cancer, undergoing chemotherapy or follow up care, were the subjects of the study. The study design was cross-sectional at the time of the survey. The degrees of depression, anxiety and hostility of the patients were assessed by the SCL-90-R scores, and the fighting spirit was measured by the Mental Adjustment to Cancer (MAC) scale score. Results: The scores of anxiety and hostility of the patients at younger age were higher than those at older age (p＜0.01). The patients with metastasis were more depressed than those without it (p＜0.01). There was a negative association between depression and fighting spirit (p＜0.001). Conclusion: The study showed the more depressed cancer patients had lower fighting spirit score, which was known to be one of the most active psychosocial contributorsin adjusting to cancer and survival.

This study compared health-related quality of life in patients with early to mid-stage chronic kidney disease.This study utilized a comparative descriptive design. Patients receiving continuous ambulatory peritoneal dialysis were recruited from a hospital in Korea. Information from patients with stage 3 and 4 chronic kidney disease was obtained from Korean national survey data. A total of 75 pairs were matched using the propensity score method. Health-related quality of life was compared using the European Quality of Life-5 Dimensions questionnaire.Only 4% of patients with stage 3 or 4 chronic kidney disease are aware of their disease. These patients have decreased mobility and ability to perform their usual activities (χ(2) = 10.77, P = 0.001; χ(2) = 7.22, P = 0.007, respectively). However, they have lower levels of anxiety and depression than patients undergoing continuous ambulatory peritoneal dialysis (χ(2) = 13.37, P 0.001). The European Quality of Life-5 Dimensions utility scores do not differ between the two patient groups.The results of this study suggest that more effective management programs are needed to improve health-related quality of life in patients at all stages of chronic kidney disease. Educational intervention in asymptomatic patients is important to increase awareness and early detection of chronic kidney disease.

Purpose: The purpose of this study was to identify health behavior and risk factors for chronic kidney disease (CKD) in Korean patients with diabetes. Methods: This study was a secondary analysis of the Fourth Korean National Health and Nutritional Examination Survey (2007-2009). Of the 24,871 participants, 1,239 aged over 19 years with diagnosis of diabetes were included. Stratified and cluster variables in the analysis-plan file for a weighted, complex sample were analyzed. CKD was confirmed by the estimated glomerular filtration rate level of 15.0 -59.9 mL/min/1.732 m(2). Odds ratios between the variables and CKD were calculated using logistic regression analysis with adjustment for gender, age, educational background, income, and duration of diagnosis. Results: The results showed that 14.7% of participants with diabetes were accompanied with CKD. The risk of developing CKD in those who made efforts to take proper nutrition but failed was 1.76 times higher than those taking nutrition properly. In those who used to smoke compared to their nonsmoking counterparts, the risk was 2.06 times higher; in those who did not do vigorous exercise compared to those who did, the risk was 2.12 times higher; in those with hypertension than those without, the risk was 2.4 times higher; and in those with anemia compared to those without, the risk was 2.32 times higher. Only 19% of the participants received health education for diabetes, which did not affect the incidence of CKD. Conclusion: Since renal functions are affected by lifestyle factors, it is critical for healthcare professionals to provide diabetic patients with health education focused on changing their behavior so that it is conducive to health. It is also necessary to consider that diabetes education should be made more available and provided more effectively to these patients. Copyright (C) 2013, Korean Society of Nursing Science. Published by Elsevier. All rights reserved.

This study was conducted to explore first experiences of high-fidelity simulation training in Korean nursing students, in order to develop and establish more effective guidelines for future simulation training in Korea.Thirty-three junior nursing students participated in high-fidelity simulation training for the first time. Using both qualitative and quantitative methods, data were collected from reflective journals and questionnaires of simulation effectiveness after simulation training. Descriptive statistics were used to analyze simulation effectiveness and content analysis was performed with the reflective journal data.Five dimensions and 31 domains, both positive and negative experiences, emerged from qualitative analysis: (i) machine-human interaction in a safe environment; (ii) perceived learning capability; (iii) observational learning; (iv) reconciling practice with theory; and (v) follow-up debriefing effect. More than 70% of students scored high on increased ability to identify changes in the patient's condition, critical thinking, decision-making, effectiveness of peer observation, and debriefing in effectiveness of simulation.This study reported both positive and negative experiences of simulation. The results of this study could be used to set the level of task difficulty in simulation. Future simulation programs can be designed by reinforcing the positive experiences and modifying the negative results.

This study was conducted to identify mental health status, post-traumatic stress disorder (PTSD), and psychophysiological change in female North Korean refugees. Data were collected using questionnaires and symptom checklists that measured PTSD and the psychosomatic state of the subjects. As many as 97 subjects, who had settled in and around Seoul, South Korea, were selected by snowball sampling. Mental health and PTSD levels of the participants were above a moderate level. We conclude that health care professionals need to provide female North Korean defectors with services to improve mental health and make the sociocultural transition successfully.