Search

Objective To compare pressure injury (PI) incidence based on repositioning intervals and support surfaces in acute care settings. Methods This pragmatic, quasi-experimental trial recruited a total of 251 critically ill patients who were at low or moderate risk for PI development. Participants were assigned to three interventions: a 2-hour repositioning interval using an air mattress, a 2-hour repositioning interval using a foam mattress, or a 3-hour repositioning interval using a foam mattress. Data were collected by nurses every shift over the course of 14 days. Pressure injury incidence was analyzed using a χ2 test. Results There were no statistically significant differences in PI incidence between the groups with a 2-hour repositioning interval. However, the PI incidence in the group using a foam mattress with a 3-hour repositioning interval was significantly lower than in the group using an air mattress with a 2-hour repositioning interval (odds ratio, 0.481; 95% confidence interval, 0.410-0.565). Conclusions The findings showed that PIs decreased when the repositioning interval was extended from every 2 hours to every 3 hours while using foam mattresses. This study suggests that a 3-hour repositioning interval using a foam mattress could be applied to reduce the risk of PI development for patients at low or moderate risk.

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.

BackgroundMany older adults prefer to live alone in their own homes, with age-related issues in physical movement, regardless of their cultural background. Importantly, however, to identify the features of successfully ageing in place (AIP), and foster independent living among these individuals, this study explored their level of self-confidence to live alone and its related factors.MethodsWe conducted a cross-sectional study using secondary data from an earlier study with older adults living alone in South Korea recruited by convenience sampling methods (N = 936, mean age = 77.1 years, 76.1% female). Data regarding the general, health-related, and social characteristics as well as self-confidence to live alone were collected via face-to-face interviews in 2019. Self-confidence to live alone was measured with a numeric rating scale of 0 to 10.ResultsThe average self-confidence score to live alone was 6.59. A regression analysis showed that mould exposure at home, depression, emergency department visits, and loneliness hinder self-confidence to live alone. Meanwhile, such self-confidence was facilitated by independency in instrumental activities of daily living (IADL), interactions with family members, social service utilisation, and social support.ConclusionsThis study suggests that healthcare providers need to consider the importance of self-confidence to live alone and influencing functional, mental, social, and environmental factors to promote quality of life as well as successful AIP for older adults living alone. Further, self-confidence to live alone could be a new practical index in the field of health and ageing to screen the successful AIP of older adults living alone.

Background Animal-assisted therapy (AAT) can ameliorate diverse health problems in older adults. However, applications of AAT have been limited because of the lack of intervention guidelines for older adults. Aims This study aimed to explore applications of AAT to older adults, analyze its health effects, and provide evidence for future interventions. Methods A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data were analyzed based on both a narrative synthesis and a meta-analysis specifically for depression. Results A total of 47 studies were selected for analysis. About 45% focused on older adults with diseases such as dementia, and 57.4% selected dog(s) as an intervention animal. About 34.0% delivered interventions once a week, and the behavioral outcome domain was the most frequently investigated. The meta-analysis showed that the effect sizes of the AAT group were -1.310 (95% CI [-1.900, -.721]). Linking evidence to action This review provides evidence for AAT as an intervention in the physiological, psychosocial, cognitive, and behavioral domains of older adults. When planning interventions for older adults, nurses should consider intended health outcomes, appropriate therapeutic animals, and the consequent intervention contents.

This review aimed to provide information on ways to improve eHealth literacy in older adults by assessing current studies examining eHealth literacy. To achieve the aim, this review focused on what theories or theoretical frameworks were used in the studies, what factors were related to eHealth literacy, and what outcome variables were used in eHealth literacy interventions for older adults. Five electronic databases were searched to identify eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions was followed to select relevant studies, and narrative synthesis was performed. Among a total of 27 studies, 13 described theories or theoretical frameworks. Credibility in Internet health information, knowledge, and experience were identified as modifiable factors related to eHealth literacy. The most frequently used outcome variable was eHealth literacy efficacy. Nurses who are interested in improving eHealth literacy in older adults should consider appropriate theoretical frameworks and multiple factors influencing eHealth literacy.

Purpose To describe and compare the levels of pain severity and pain interference, pain catastrophizing, and associated factors between elderly Koreans living in South Korea and Korean Americans living in the United States with chronic pain. Methods An exploratory, comparative design was used for this study. A total of 270 individuals (138 Koreans living in South Korea and 132 Korean Americans living in the United States), aged more than 65 years, with self-reported chronic pain, and defined as at least 3 months of persistent musculoskeletal pain, is included. Outcome variables were pain severity, pain interference, and pain catastrophizing. Multivariate linear regression was conducted to examine factors associated with the outcome variables. Results In multivariate analysis, Korean Americans had higher levels of pain severity and pain catastrophizing than Koreans. Depressive symptoms, sleep quality, and health-related quality of life were significant factors for pain severity, pain interference, and pain catastrophizing for both groups. Among those factors, health-related quality of life was the most significant factor for predicting pain severity and pain interference, whereas depressive symptoms were the most significant factor for predicting pain catastrophizing for both groups. Conclusions Intra-ethnic differences in pain severity and pain catastrophizing were found between elderly Koreans living in South Korea and Korean Americans living in the United States. Clinical relevance Because unfamiliar sociocultural and environmental factors may influence the pain responses, cultural differences and language barriers should be taken into account in pain research and management strategies for Asian immigrants in the United States. Psychological factors, including depressive symptoms, sleep quality, and health-related quality of life, should also be considered in chronic pain management for both elderly Koreans and Korean Americans.

Background Irritable bowel syndrome is a common functional gastrointestinal disorder that negatively affects all aspects of life. With the widespread use of the internet, internet-delivered cognitive behavioral therapy has been developed and applied to control symptoms and improve the quality of life of those with irritable bowel syndrome. However, few studies have systematically reviewed the effectiveness of internet-delivered cognitive behavioral therapy on irritable bowel syndrome. Objective This study aimed to systematically review studies that examined the use of internet-delivered cognitive behavioral therapy in patients with irritable bowel syndrome and to evaluate the effects of internet-delivered cognitive behavioral therapy on the improvement of symptom severity, quality of life, psychological status, and cost-effectiveness. Methods This meta-analysis involved the search of 6 databases for relevant publications. From the 1224 publications identified through database searches, 9 randomized controlled trials were finally included in the analysis. Results The internet-delivered cognitive behavioral therapies including exposure-based cognitive behavioral therapy, cognitive behavioral therapy for self-management, and cognitive behavioral therapy for stress management were provided in 5 to 13 sessions for 5 to 10 weeks. Internet-delivered cognitive behavioral therapy had medium-to-large effects on symptom severity (standardized mean difference [SMD] –0.633; 95% CI –0.861 to –0.4304), quality of life (SMD 0.582; 95% CI 0.396-0.769), and cost-effectiveness (–0.372; 95% CI –0.704 to –0.039) at postintervention. The effects on symptom severity remained over time even after the intervention, short-term follow-up (SMD –0.391; 95% CI –0.560 to –0.221), and long-term follow-up (SMD –0.357; 95% CI –0.541 to –0.172). There was no significant difference in psychological status, including anxiety and depression, in those with irritable bowel syndrome compared to the controls during the postintervention period. Conclusions This review demonstrates that internet-delivered cognitive behavioral therapy could be a cost-effective intervention for improving symptoms and the quality of life in patients with irritable bowel syndrome. However, studies are still insufficient regarding the use of internet-delivered cognitive behavioral therapy in these patients; therefore, more high-quality studies are required in the future.

BACKGROUND Irritable bowel syndrome is a common functional gastrointestinal disorder that negatively affects all aspects of life. With the widespread use of the internet, internet-delivered cognitive behavioral therapy has been developed and applied to control symptoms and improve the quality of life of those with irritable bowel syndrome. However, few studies have systematically reviewed the effectiveness of internet-delivered cognitive behavioral therapy on irritable bowel syndrome. OBJECTIVE This study aimed to systematically review studies that examined the use of internet-delivered cognitive behavioral therapy in patients with irritable bowel syndrome and to evaluate the effects of internet-delivered cognitive behavioral therapy on the improvement of symptom severity, quality of life, psychological status, and cost-effectiveness. METHODS This meta-analysis involved the search of 6 databases for relevant publications. From the 1224 publications identified through database searches, 9 randomized controlled trials were finally included in the analysis. RESULTS The internet-delivered cognitive behavioral therapies including exposure-based cognitive behavioral therapy, cognitive behavioral therapy for self-management, and cognitive behavioral therapy for stress management were provided in 5 to 13 sessions for 5 to 10 weeks. Internet-delivered cognitive behavioral therapy had medium-to-large effects on symptom severity (standardized mean difference [SMD] –0.633; 95% CI –0.861 to –0.4304), quality of life (SMD 0.582; 95% CI 0.396-0.769), and cost-effectiveness (–0.372; 95% CI –0.704 to –0.039) at postintervention. The effects on symptom severity remained over time even after the intervention, short-term follow-up (SMD –0.391; 95% CI –0.560 to –0.221), and long-term follow-up (SMD –0.357; 95% CI –0.541 to –0.172). There was no significant difference in psychological status, including anxiety and depression, in those with irritable bowel syndrome compared to the controls during the postintervention period. CONCLUSIONS This review demonstrates that internet-delivered cognitive behavioral therapy could be a cost-effective intervention for improving symptoms and the quality of life in patients with irritable bowel syndrome. However, studies are still insufficient regarding the use of internet-delivered cognitive behavioral therapy in these patients; therefore, more high-quality studies are required in the future.

The current study aimed to explore the factor structure of the Korean version of the Revised University of California Los Angeles loneliness scale for the Korean older adult population. Analyses were based on a cross-sectional cohort of 1,041 community-dwelling older adults (age ≥65 years) living alone in one Korean city. Exploratory factor analysis (EFA) was conducted to determine the underlying structure of the scale, and confirmatory factor analysis (CFA) was used to ascertain the validity of the outcomes. For reliability, Cronbach's alpha was computed. Based on EFA and CFA results, a two-factor structure was found. The first factor reflected “intimate loneliness” and the second “relational loneliness.” Derived factors demonstrated satisfactory reliability (>0.8). The two factors of loneliness identified in this study could be considered when attempting to treat loneliness among older adults. Nevertheless, future studies should confirm the findings of this study and evaluate aspects of validity beyond factorial validity to further support the conceptual separation of the two identified factors. [ Research in Gerontological Nursing, 14 (6), 305–316.]

Visual impairment can lead to limited accessibility and activities and a decreased quality of life. This study aimed to test a hypothetical model based on the International Classification of Functioning, Disability, and Health to predict the health-related quality of life (HRQOL) of people with visual impairment. Data from 202 people with visual impairment were collected from August 2020 to November 2020 via telephone or e-mail. The overall fitness indices of the model for physical HRQOL (Normed χ2=2.076, GFI=.878, TLI=.900, CFI=.928, RMSEA=.073) and the model for mental HRQOL (Normed χ2=2.232, GFI=.884, TLI=.904, CFI=.932, RMSEA=.078) complied with the recommended criteria of structural equation model fitness, indicating that the models were appropriate for predicting the HRQOL of people with visual impairment. The socioeconomic status, multimorbidity, perceived environmental barriers, and activity limitation/participation restriction directly affected the participants’ physical HRQOL. Moreover, depression, disability identity, and activity limitation/participation restriction directly affected participants’ mental HRQOL. Age, socioeconomic status, depression, social support, and perceived environmental barriers affected the participants’ physical and mental HRQOL by means of activity limitation/participation restriction. The findings of the study suggest that the strategies aimed at increasing the activity/participation of people with visual impairment will be helpful in improving their HRQOL. Based on the results of this study, nursing intervention programs and services for people with visual impairment should be developed and implemented to provide more comprehensive care for this group and expand nursing science.

Background Frailty is a health challenge related to adverse health outcomes in older adults. Older women are more likely to be frail than older men. However, few studies have reviewed the effectiveness of interventions for older women with frailty is scant. Objective: This systematic review aimed to explore the properties of interventions and to investigate their effectiveness in preventing the progression of frailty in older women with pre-frailty or frailty. Methods Narrative synthesis was conducted to identify the contents, outcome variables, and findings of the interventions. Then, a meta-analysis was performed to evaluate the effectiveness of exercise interventions on grip strength, sit-and-reach, sit-to-stand, and timed up and go tests. Results Twenty-six studies were selected, including 14 randomized controlled trials and 12 quasi-experimental studies. These studies implemented exercise (96.2%), nutrition (15.4%), hormone replacement (7.7%), toileting strategies (3.8%), and laughter interventions (3.8%). The selected studies assessed physical, psychological (11.5%), and cognitive health (11.5%), as well as quality of life (19.2%). The meta-analysis found significant effects of aerobic and resistance exercise interventions on the sit-to-stand (SMD = 1.30, 95% CI [0.70, 1.90], p < 0.001) and timed up and go scores (SMD = -0.56, 95% CI [-0.93, -0.19], p = 0.003). Conclusion Exercise interventions are essential to improve physical health, in particular mobility, in older women with pre-frailty or frailty. Future studies should consider theoretical frameworks and evaluate psychological and cognitive health as well as quality of life to develop and provide effective interventions to prevent the progression of frailty in older women.

Diabetes requires self-management, such as the use of insulin, oral antidiabetic drugs, diet, and exercise, for maintaining blood glucose. To promote self-management of older people with diabetes, family support is considered an important factor. However, older people living alone lack family support and have a lower health-related quality of life (HRQOL) than those living in families. The purpose of this study was to assess HRQOL and the factors that affect it between older people with diabetes living alone and those living in families. We performed secondary data analysis using the data of Korea National Health and Nutrition Examination Survey (KNHANES) 2017–2019. In total, 973 people with diabetes aged 65 years or older answered all questions about HRQOL. Complex sample analysis was performed. Each dimension of HRQOL was significantly lower in people living alone than those living in families. Restricted activity, bedridden, number of comorbidities, and perceived health status significantly predicted HRQOL in patients living alone. Health insurance, age, economic activity, unmet medical service needs, restricted activity, bedridden, number of comorbidities, perceived health status, and suicidal ideation significantly predicted HRQOL in patients living in families. This study indicated how differences in HRQOL exist between older patients with diabetes living alone and those living in families. This data will be useful in developing educational programs in the future, and it will be helpful when dealing with people living alone who have diabetes.

Background Chronic pain is one of the most common health problems for older adults worldwide and is likely to result in lower quality of life. Living in a different culture may also influence chronic pain and quality of life in older adults. The purpose of this study was to explore how multifaceted elements affect chronic pain and quality of life in older Koreans living in Korea and in older Korean–Americans (KAs) living in the USA. Methods We conducted a secondary data analysis of data from 270 adults aged 65 years or over (138 Koreans and 132 KAs). We compared the effects of multifaceted elements on pain and quality of life by testing structural equation models (SEMs) for each group, using a maximum likelihood estimation and bootstrapping. Results SEMs for both Korean and KAs showed that age and depressive symptoms directly affected quality of life. The number of comorbidities and depressive symptoms had mediating effects on quality of life through chronic pain in both groups. In older Koreans only, perceived financial status directly affected quality of life. In older KAs only, sleep quality indirectly affected quality of life through chronic pain. Conclusion The data showed that multimorbidity and depressive symptoms play critical roles for explaining chronic pain in older Koreans and KAs and ultimately negatively influence quality of life. Future intervention program to improve quality of life in older adults with chronic pain should consider the different cultural aspects affecting quality of life for Koreans and KAs.

BACKGROUND The Internet use rate of older adults, who were considered underprivileged in the digital world, is steadily increasing. Specifically, the Internet is considered an important channel for providing health information to older adults, who are the largest consumers of medical services. However, due to factors such as technical difficulties, lack of learning opportunities, and deterioration of eHealth literacy, the Internet is not usually a common factor of delivering health information to older adults. Therefore, we developed an intervention program to improve eHealth literacy in older adults according to the information-motivation-behavioral skills (IMB) theory and Intervention Mapping. OBJECTIVE This study aimed to analyze the effect of developed intervention on information, motivation, behavioral skills, and behaviors related to eHealth information in older adults. METHODS This study applied a single group pretest–posttest design. The participants were 46 older adults over the age of 65 recruited from two senior welfare centers in a city in South Korea. We divided the participants into 4 groups and conducted 4 interventions in the computer room of the Senior Welfare Center from March to December 2019. One intervention was performed once a week (2 hours/1 time) for 5 weeks, and the total lecture time was 10 hours. The instructors were all researchers involved in the development of this intervention, and the instructors for each intervention consisted of one lecture instructor and two assistant instructors who supported the participants in the computer practices. RESULTS Participants’computer/web knowledge (χ²= 60.04, P CONCLUSIONS Our findings suggest that the application of the current theory based methodology can improve the quality of research in developing eHealth information literacy interventions. Additionally, it is necessary to develop and continuously apply various interventions to improve eHealth information literacy among older adults. Finally, measures to improve the Internet environment for older adults should be considered.

To investigate chronotype categories and social jetlag among nursing students and to identify associations between rhythm asynchrony and participants' physical and psychological health, academic performance and quality of life.Social jetlag refers to the asynchrony between chronotypes and social working hours, resulting in a misalignment of biological and social time. Recent studies have reported possible changes in psychosocial functioning owing to social jetlag. Therefore, the present study investigated chronotypes and the extent of social jetlag among nursing students.A cross-sectional study was conducted in 2015 with a sample of 346 nursing students in two universities in Korea.Social jetlag and quality of life were measured with the Munich Chronotype Questionnaire and the abbreviated version of the World Health Organization Quality of Life Scale, respectively, in the year 2015. Data analysis was mainly based on a multiple regression to identify social jetlag's influence on students' quality of life.Average social jetlag was 1 hr - 36 min. Social jetlag was negatively correlated with chronotype, academic performance and quality of life. A multiple regression analysis revealed that social jetlag, a positive emotional state, recovery resilience and depressive symptoms affected students' quality of life. These variables accounted for 41.7% of the variance in quality of life.Results suggest that decreases in social jetlag and depressive symptoms, as well as increases in the positive emotional state and recovery resilience, enhance students' quality of life.目的: 调查护生的睡眠类型与社会时差,确认不同节奏与参与人员的身心健康之间以及学业成绩和生活质量之间的关系。 背景: 社会时差是指睡眠类型与社会工作时间不同步,导致生物时间和社会时间错位。最近的研究表明,由于社会时差,社会心理功能可能发生变化。因此,本研究调查了护生的时型和社会时差的反应程度。 设计: 2015年对韩国两所大学的346名护生进行横断面研究 方法: 社会时差和生活质量分别用用慕尼黑时间类型问卷和2015年世界卫生组织生活质量简表来衡量的。数据分析主要是基于多元回归来确定社会时差对学生生活质量的影响。 结果: 平均社会时差在36分钟到1个小时左右,社会时差与睡眠类型、学习成绩和生活质量呈负相关。多元回归分析显示,社会时差、积极的情绪状态、恢复弹性和抑郁症状都会影响学生的生活质量。这些变量占影响生活质量差异变量的41.7% 结论: 结果表明减少社会时差和缓解抑郁症状,增加积极情绪状态和恢复弹性能提高学生的生活质量。.

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.

To improve the low health-related quality of life (HRQOL) of the elderly with diabetes in South Korea, multidimensional factors affecting their HRQOL need to be explored with a theoretical understanding. This chapter aimed to describe the development of a situation-specific theory for explaining HRQOL in the Korean elderly with type 2 diabetes. Using an integrative approach, the Health-Related Quality of Life in South Korean Older Adults with Type 2 Diabetes (HIKOD) theory was developed.

The number of elderly people living alone worldwide is increasing, and the responsibility of the state in this context is emerging. This study aimed to develop a community-based integrated service (CBIS) model of health and social care for older adults living alone. The model was designed based on a literature review of previous community care models and per older adults&rsquo, health and daily life needs. Thereafter, feedback on the integrated model was taken from older adults living alone by conducting a survey (n = 1023) and focus group interviews, after which the opinions of the Public type Health Management Promotion Council were considered and content validity was confirmed. The model, comprising eight healthcare services and five social care services, was tested on 22 older adults for two weeks to assess its feasibility and preliminary efficiency. Each service included screening, assessment, providing service, evaluation, and quit. Participants rated their overall satisfaction with the services as 9 out of 10. Care navigators reported feeling comforted and discovered their own sense of being while providing the services. We believe that the CBIS model may foster independence among community-dwelling older adults living alone, thereby improving their quality of life through &ldquo, aging in place.&rdquo

Pain catastrophizing is a notable concept associated with change in chronic pain interference and depression. Sleep quality is also one of the important factors affecting geriatric depression. This study examined the mediating effects of chronic pain interference and sleep quality on the relationship between pain catastrophizing and depression. This study is a secondary data analysis that analyzed a total of 138 older Korean adults with chronic pain. The participants were selected from a single elderly daycare center in a city in South Korea. Also, the multiple regression analysis and PROCESS macro with bootstrapping were used. The results revealed that chronic pain interference and sleep quality mediated the relationship between pain catastrophizing and depression, respectively. Furthermore, chronic pain interference and sleep quality sequentially and dually mediated the effect of pain catastrophizing on depression. In the management of depression in the elderly, persistent complaints of pain should not be disregarded, irrespective of the intensity of their chronic pain. Psychological intervention is needed to alleviate negative thoughts about chronic pain and to increase the ability to cope with chronic pain. In addition, it is important to assess sleep patterns and to develop interventions to improve sleep quality, because depression in the elderly could appear as a symptom of a sleep problems.

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.

Objectives This study aimed to evaluate the components of test-retest reliability including time interval, sample size, and statistical methods used in patient-reported outcome measures in older people and to provide suggestions on the methodology for calculating test-retest reliability for patient-reported outcomes in older people. Design This was a systematic literature review. Data sources MEDLINE, Embase, CINAHL, and PsycINFO were searched from January 1, 2000 to August 10, 2017 by an information specialist. Review methods This systematic review was guided by both the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and the guideline for systematic review published by the National Evidence-based Healthcare Collaborating Agency in Korea. The methodological quality was assessed by the Consensus-based Standards for the selection of health Measurement Instruments checklist box B. Results Ninety-five out of 12,641 studies were selected for the analysis. The median time interval for test-retest reliability was 14days, and the ratio of sample size for test-retest reliability to the number of items in each measure ranged from 1:1 to 1:4. The most frequently used statistical methods for continuous scores was intraclass correlation coefficients (ICCs). Among the 63 studies that used ICCs, 21 studies presented models for ICC calculations and 30 studies reported 95% confidence intervals of the ICCs. Additional analyses using 17 studies that reported a strong ICC (>0.09) showed that the mean time interval was 12.88days and the mean ratio of the number of items to sample size was 1:5.37. Conclusions When researchers plan to assess the test-retest reliability of patient-reported outcome measures for older people, they need to consider an adequate time interval of approximately 13days and the sample size of about 5 times the number of items. Particularly, statistical methods should not only be selected based on the types of scores of the patient-reported outcome measures, but should also be described clearly in the studies that report the results of test-retest reliability.

This study explored the psychosocial risk profiles and various characteristics associated with profile membership among Korean older adults living alone.Our analyses were based on a cross-sectional cohort of 1030 community-dwelling older adults (≥ 65 years) living alone in one Korean city. Latent profile analysis was used to identify psychosocial risk profiles across a wide range of psychosocial dimensions (depressive symptoms, suicidal ideation, cognitive dysfunction, loneliness, and perceived social support). We then explored the characteristics associated with distinct profiles by conducting bivariate and regression analyses.The three-profile was selected as the best solution: a group with high cognitive dysfunction, high loneliness, and low social support (profile 1), a group with low psychological risks and high social support (profile 2), and a group with high depression and high suicidal ideation (profile 3). Regression analyses showed that a lower frequency of interaction with neighbors or families, a greater frailty score, and lower quality of life were significantly associated with profile 1 or profile 3 than with profile 2 (p.05). Further, being male and having a poorer nutritional status was more significantly related to profile 3 than profile 2 (p.05).Findings provide evidence for healthcare professionals when developing interventions to prevent and reduce these psychosocial risks for older individuals living alone. In particular, factors associated with profile membership identified in the study may facilitate more tailored interventions.

Background Although bed rest is recommended after spinal anesthesia to prevent the occurrence of post-dural puncture headache, current literature suggests that periods of bed rest did not prevent headache as well as increase the risk of other complications such as backache. However, information is scarce regarding an appropriate period of bed rest following a dural puncture. Aim The aim of this study was to compare the incidence of post-dural puncture headache and backache after different periods of bed rest following spinal anesthesia. Methods This study was a pragmatic, parallel-group, blinded, and randomized controlled trial (trial registration number KCT0001797). A total of 119 patients who underwent surgery under spinal anesthesia participated in this study from December 2013 to June 2014. The participants were randomly allocated to three groups: the immediate mobilization group (n = 45), 4-hour bed rest group (n = 40), and 6-hour bed rest group (n = 34). The severity of headache and backache was measured using the Dittmann scale and a visual analogue scale, respectively. Data were collected for 5 consecutive days postoperatively by one researcher blind to the group allocation. Results No significant difference in the incidence of headache among the three groups was detected. However, the incidence of backache in the 6-hour bed rest group was higher and was significantly more severe than the other groups. Linking Evidence to Action Bed rest after spinal anesthesia did not prevent the occurrence of headache and increased the incidence of patients experiencing a backache and, therefore, is not recommended. The findings provide information for establishing evidence-based nursing practices for patients after a dural puncture.

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.]

Objectives The aim of this study was to identify gender differences in the health status, community service needs, and quality of life of older adults living alone in an urban city in South Korea. Methods A cross-sectional descriptive correlational design was used. The study sampled 1023 older adults (≥65 years) living alone in S* City, during the period from August to October in 2018. Trained interviewers conducted face-to-face interviews with the participants, using the UCLA Loneliness Scale, Short Form Geriatric Depression Scale – Korean version, ENRICHD Social Support Instrument (ESSI), the Mini-Mental State Examination Standard Version (MMSE-2SV), and Health-Related Quality of Life (EQ-5D). Results 77.8% were women and the mean age was 77.38 years (men = 74.65, women = 78.16). Women had lower socioeconomic and health status than men. Men felt more lonely, depressed, and had suicidal thoughts more frequently than women. Women had more needs regarding care, residential environment, movement, connection, and emergency services than men. In men, depressive symptoms, suicidal thoughts, loneliness, and right-hand grip strength were identified using the EQ-5D. The EQ-5D was also used to explain depressive symptoms, suicidal thoughts, cognitive function, and physical activity in women. Conclusion Health status and community service needs were dependent on gender; therefore interventions should be tailored according to gender. Our research found that to decrease depression and suicidal thoughts, improve physical health, and enhance quality of life for older adults living alone, interventions need to be designed to decrease male loneliness and to enhance female cognitive function.

This study investigated whether sociodemographic, health behavioral, biomedical, and health status factors are associated with the awareness and treatment status of hypertension. Data were analyzed from 13 180 adults with hypertension in a nationally representative sample collected from 2007 to 2015 through the Korean National Health and Nutrition Examination Survey. Among hypertensive Korean adults, only 65.2% were aware of their condition and being treated with antihypertensive medications. Younger age was identified as an important barrier to diagnosis and treatment of hypertension. Although there were slight differences between participants aged

Aim The purpose of this study was to develop the Diabetes Self-Management Behavior for Older Koreans (DSMB-O). This scale is based on the seven relevant domains that have been identified by the American Association of Diabetes Educators (AADE) and is adjusted for sociocultural and age-related characteristics. Methods Four phases were used to develop of the DSMB-O as a criterion-referenced measure. In phases 1 and 2, the DSMB-O adopted the AADE’s seven domains and established a self-report questionnaire using a small number of items that are applicable to older Koreans. In phase 3, the DSMB-O was formulated with 16 preliminary items, including seven subitems. By assessing the content validity, 14 items (including five subitems) were selected. The final phase involved evaluating the DSMB-O’s psychometric properties, including test–retest reliability, content validity, and criterion-related validity, using data from 150 older Koreans with type 2 diabetes. Results The coefficients of agreement and Cohen's Kappa for the test–retest reliability test ranged from 0.32 to 1.0 and −0.07 to 1.0, respectively. For the content validity, the values of both the item- and scale-level content validity indices were 1.0. The scores from the DSMB-O were positively correlated with the scores from the Korean version of the Summary of Diabetes Self-Care Activities Questionnaire. Conclusion The DSMB-O is short and easy for older Koreans to use, as well as having acceptable levels of reliability and validity. Hence, the DSMB-O can be a useful tool to evaluate diabetes self-management behaviors in older Koreans with type 2 diabetes.

본 연구에서는 자살중재효과척도(SIRI-2)를 한국어로 번안하고 신뢰도와 타당도를 검증하였다. 2, 3, 4학년 간호대학생 127명을 대상으로 신뢰도 분석을 진행하고 각 집단별 비교와 자살예방교육 실시전후를 비교하는 가설검증법으로 타당도를 평가하였다. 한국판 SIRI-2(K-SIRI-2)의 24개 모든 문항은 전문가에 의해 내용타당도가 확보되었으며, 신뢰도 검증 결과, 내적 일관성 계수 0.84, 검사-재검사 상관관계 r=0.98로 높은 신뢰도를 나타내었다. 2학년 학생집단과 4학년 학생집단 간의 그룹비교에서도 자살예방관련 교과과정을 더 많이 이수한 4학년 집단의 K-SIRI-2 점수가 유의하게 낮아(t=2.89, p=0.005), 분별타당도가 있는 것으로 나타났으며, 4학년 학생들을 대상으로 자살예방교육인 ｢보고듣고말하기｣ 교육을 제공한 후 사전 점수와 사후 점수를 비교하는 가설검증 결과 교육 이후 K-SIRI-2 점수가 유의하게 낮아짐으로써, 구성타당도 역시 입증되었다. 이러한 결과는 K-SIRI-2가 국내에서 활용하기에 적합한 것을 의미하며, 추후 국내 여러 기관에서 시행되는 상담자를 대상으로 하는 자살중재 프로그램에 대한 교육 효과를 측정하는 데 널리 확장되어 사용될 수 있으리라 생각된다.

The aims of the study were to investigate the levels of depression and to identify the predictors of depression among older adults in 3 different environments based on their primary place of leisure time activity, including their homes, small community halls, and senior welfare centers. A convenience sample of 833 older adults participated in the study. Instruments for measuring functional independence, social support, life satisfaction, and depression were used. The data were analyzed using a one-way analysis of variance (ANOVA) and multiple hierarchical regressions. The level of depression in older adults at home was significantly greater than the level of depression in those in both small community halls and senior welfare centers. Life satisfaction was the strongest negative predictor of depression in older adults both at home and in senior welfare centers, whereas employment status was the one in those in small community halls. Across the 3 groups, poor subjective health was the strongest positive predictor of depression. The levels of depression and predictors differed among the settings. Nurses should have a thorough understanding of these differences when planning effective strategies for managing depression in older adults.