Purpose This study examines the factors influencing 30-day in-hospital mortality in elderly patients with community-acquired pneumonia (CAP) and compares them to those in adult patients.
Methods This secondary analysis used discharge data from the Korea Disease Control and Prevention Agency, covering the period from January 1, 2020, to December 31, 2022. Statistical methods included χ² tests, t-tests, the Cox proportional hazards model for calculating adjusted hazard ratios (HR), and Kaplan-Meier analysis. Results: The study found that older age (Adjusted HR=2.40, 95% CI=2.01-2.85, p<.001) and Emergency Room admissions (Adjusted HR=2.24, 95% CI=1.94-2.59, p<.001) are significantly associated with increased mortality in elderly patients. Other contributing factors include residency area (Adjusted HR=1.73, 95% CI=1.04-2.87, p=.035), hospital setting (Adjusted HR=1.34, 95% CI=1.05-1.70, p=.017), and the number of hospital beds (Adjusted HR=1.27, 95% CI=1.11-1.46, p=.001).
Conclusion These findings underscore the importance of improving community health screenings and developing respiratory infection prevention programs for elderly patients, especially those in high-risk areas.
Objective: To evaluate the effect of remote health interventions on self-management of hypertension.
Methods We systematically searched the literature for studies published in English in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Cochrane Central Register of Controlled Trials. The database was used to search for relevant studies with full text and evaluate the remote health interventions for hypertension self-management versus usual care for hypertension. RevMan 5.4 was used for data analysis.
Results A total of 19 studies eventually met our inclusion criteria. The results showed that the remote health interventions group could significantly reduce the levels of SBP (MD=5.67, 95% CI=4.12-7.22, p<.001) and DBP (MD=1.88, 95% CI=1.16- 2.60, p<.001), compared with usual care group, it also significantly improving the patient's quality of life (SMD=0.84, 95% CI=0.32- 1.37, p=.002), reduce waist circumference (MD=2.39, 95% CI=0.35-4.44, p=.020) and BMI (MD=0.49, 95% CI=0.06-0.91, p=.020), and significantly increasing the physical activity of patients (SMD=0.19, 95% CI=0.06- 0.31, p=.004). No obvious publication bias was found in this meta-analysis.
Conclusion This study showed that remote health interventions for self-management can significantly improve patients’ quality of life with hypertension and better BP control than usual care. Further studies could be assess the long-term clinical effectiveness and economic evaluation of remote health interventions for self-management.
Purpose This secondary data analysis study examined adults’ levels and networks of obesity-related health behaviors according to the life cycle stage.
Methods Participants included 5,203 adults aged 19–79 years who participated in the third year of the eighth Korea National Health and Nutrition Examination Survey (2021). Life cycle stages were divided into young, middle-aged, and older adult groups. Obesity status was classified based on a body mass index of 25 kg/m2. Selected obesity-related health behaviors included alcohol abstinence, not smoking, proper sleep, eating breakfast, fruit intake, vegetable intake, not eating out, aerobic physical activity, walking, and weight training. Obesity-related health behavior networks were analyzed for density, inclusiveness, degree, and degree/closeness/betweenness centrality using social network analysis.
Results Participants’ obesity rate was 37.6%, with the highest rate observed in the older adult group (39.2%). In all life cycle stages, the non-obese group had a higher density and average degree in the obesity-related health behavior network than the obese group. The young adult group showed higher centrality for vegetable intake, not smoking, alcohol abstinence, and proper sleep. The middle-aged group generally had higher centrality for health behaviors, whereas the older adult group had lower overall centrality for health behaviors, especially proper sleep and physical activity-related behaviors.
Conclusion There were differences in the levels and network structures of obesity-related health behaviors according to the life cycle stage, indicating a need for differentiated obesity-management strategies according to the life cycle stage.
Purpose This study aimed to identify latent classifications based on trajectories of change in depressive symptoms among multicultural adolescents in middle and high school and to identify factors that influence classification.
Methods This study used six time-point data from the Multicultural Adolescents Panel Study (MAPS) conducted by the National Youth Policy Institute (NYPI). We longitudinally analyzed data from 2014 to 2019, which corresponds to the participants' middle and high school years. Latent Growth Curve Modeling (LGCM) was used to analyze the depressive developmental trajectories of multicultural youth in middle and high school. Latent Class Growth Modeling (LCGM) was used to determine the number and shape of latent classes according to the type of depression among multicultural adolescents. We applied multinomial logistics regression analysis to explore the predictors of each class.
Results A model with three latent classes was identified: (1) low-decreasing class (intercept=13.34, slope=-0.07, 37.9%), (2) moderate-increasing class (intercept=17.76, slope=0.41, 47.6%), (3) high-increasing class (intercept=23.22, slope=0.44, 14.5%). Multinomial logistic regression showed multicultural adolescents who were male, experienced high acculturative stress and social withdrawal, and had low self-esteem, life satisfaction, and family support tended to belong to either the moderate-increasing or high-increasing class.
Conclusion These findings suggest that preliminary assessments of gender, acculturation stress, self-esteem, life satisfaction, social withdrawal, and family support among multicultural adolescents may be valuable for developing tailored mental health programs.
Purpose The purpose of this study was to evaluate the validity and reliability of the Korean version of the Health Literacy Assessment Tool (K-HLAT-8) for Korean adults.
Methods The survey was conducted from April 1, 2020 to May 30, 2020 at a university hospital, a university, and one community picnic area with adults who understood the purpose of the study and voluntarily agreed to participate. A total of 220 adults participated in this study. After forward and backward translation of the original version of the Health Literacy Assessment Tool 8 (HLAT-8) into Korean, construct validity (confirmatory factor analysis), convergent validity, and reliability were evaluated. Convergent validity was confirmed through the correlation between the K-HLAT-8 and the Self-As Carer Inventory (SCI).
Results Construct validity, evaluated using confirmatory factor analysis, showed good fit. The K-HLAT-8 showed a positive correlation with the SCI score. In terms of internal consistency, Cronbach’s α of the K-HLAT-8 was 0.85. For test-retest reliability, the intraclass correlation coefficient (ICC) was .99 (95% CI: 0.97~0.99).
Conclusion The reliability and validity were confirmed, so K-HLAT-8 can be applied to evaluate the health literacy of Korean adults. Furthermore, these assessment results should be used as basic data to implement programs that can improve health literacy.
Purpose The pervasive integration of smartphones into adolescents’ daily lives has resulted in a concerning upsurge in smartphone dependency among high school students. Due to the diverse types and severity levels of smartphone dependency, there is a critical need for research to explore its heterogeneity. This study aimed to identify latent profile of smartphone dependency in high school students based on the four subdomains of smartphone dependency: disturbance of adaptive functions, virtual life orientation, withdrawal, and tolerance. In addition, we explored how emotional and behavioral difficulties differ according to the profiles.
Methods We used data from 2,195 Korean high school students from the Korean Children and Youth Panel Survey 2018. Latent profile analysis (LPA) was performed to identify smartphone dependency latent profile. Statistical analysis including chi-square test, Analysis of Variance (ANOVA), and ranked Analysis of Covariance (ANCOVA) confirmed differences in smartphone use characteristics and emotional-behavioral difficulties according to the classified latent profile.
Results LPA identified four distinct latent profiles of smartphone dependency among high school students; 1) Underdependent type, 2) Moderate type, 3) Habitual user type, and 4) Virtual space dependent type. The results of ranked ANCOVA, controlling for gender, geographical location, economic status, parental smartphone dependency, and relational variables, revealed that habitual user type exhibited significantly higher rates of attention deficit hyperactivity disorder, social withdrawal, and depressive symptoms compared to other types.
Conclusion The identification of these profiles provides a foundation for developing tailored intervention programs for adolescents with different levels and patterns of smartphone dependency.
Purpose The purpose of this study was to evaluate the validity and reliability of the Korean version of the Diabetes Acceptance and Action Scale-Revised (DAAS-R) for Korean patients with type 2 diabetes.
Methods The survey was conducted from September 1, 2021, to September 30, 2021, through a survey institution for patients diagnosed with diabetes who understood the purpose of the study and voluntarily agreed to participate. A total of 231 individuals with type 2 diabetes participated in this study. After performing forward and backward translations of the original version of the Diabetes Acceptance and Action Scale-Revised (DAAS-R) into Korean, its constructive validity (confirmatory factor analysis), concurrent validity and reliability were assessed. Concurrent validity was confirmed through the correlation between acceptance and action, quality of life, diabetes self-stigma, and experiential avoidance.
Results Construct validity, measured using confirmatory factor analysis, showed a good fit. The DAAS-K was positively correlated with acceptance and action, quality of life, and negatively correlated with diabetes self-stigma and experiential avoidance. As for internal reliability, the Cronbach’s α of the DAAS-K was .95.
Conclusion The DAAS-K can be applied to assess diabetes acceptance and action in Korean patients with type 2 diabetes and to compare the levels of psychological flexibility of patients with diabetes internationally.
Purpose The purpose of this study is to identify factors associated with smoking relapse within 6 months after quit attempts among inpatients of a university hospital.
Methods The subjects of this study were 572 inpatients of the National University Hospitals in Daejeon & Sejong who had enrolled in the smoking cessation service provided by the Daejeon·Sejong Tobacco Control Center and attempted to quit smoking. The data used in the study were extracted from the Smoking Cessation Service Integrated Information System. The Kaplan-Meier method and Cox Proportional hazards model were used to identify variables associated with smoking relapse within 6 months.
Results The smoking relapse rate within 6 months was 76.7%, and variables associated with relapse included the absence of supporters for quitting smoking (hazard ratio [HR]=1.42, 95% confidence interval [CI]=1.00-2.02), nicotine dependence (HR=1.09, 95% CI=1.03-1.15), the use of prescription medications (including varenicline or bupropion) (HR=3.99, 95% CI=1.83-8.71), and the number of consultations (HR=0.67, 95% CI= 0.63-0.70).
Conclusion As a result of the study, the number of consultations showed the strongest correlation with abstinence within 6 months. This implies that it is necessary to increase the counseling participation rate of the subjects so that smoking cessation counseling can be continued after discharge, and it is also required to provide support education to guardians during hospitalization for effective smoking relapse prevention.
Purpose The purpose of this study is to analyze the factors that affect the performance of infection control of multidrug-resistant organisms (MDROs) by nurses in intensive care units (ICU) in general hospitals.
Methods Participants were 105 ICU nurses from 6 general hospitals. The questions for the survey performed were based on the theory of planned behavior, such as attitude towards infection control of MDROs, subjective norms, perceived behavioral control, intention, and performance.
Results In the relationship between subjective norms towards infection control of MDROs and performance, intention showed a significant complete mediating effect; and in the relationship between perceived behavioral control and performance, intention showed a partial mediating effect. The attitude towards infection control of MDROs was excluded from the mediating effect verification because there was no significant correlation between intention and performance.
Conclusion The results of this study suggest that department atmosphere and perceived behavior control promotion programs should be developed to enhance subjective norms in order to promote the performance of infection control of MDROs.
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Purpose The purpose of this study is to find a nursing intervention plan by classifying the body pain areas of the Korean aged and analyzing related factors. Methods: This study performed the latent class analysis, cross-analysis, and one-way ANOVA using the SPSS 25, M-plus 7.0 program on 4,388 older adults aged 65 or over using the data from the 2020 Aging Research Panel. Results: As a result of the Latent Class Analysis, participants divided into four groups. Group 1 was the 'shoulder and low back pain group' with high shoulder and back pain, group 2 was the 'upper body pain group' with severe pain in the arms, wrists and fingers and chest, group 3 was the 'lower pain focused group' with high pain in the legs and knees, and finally, group 4 was the 'general low pain group' with low pain overall. The result of the study shows that the group that did not exercise regularly, the female group, and the low socioeconomic status group have more pain in general. The upper body central pain group showed a low level of life satisfaction. Conclusion: This study discusses various nursing interventions for the prevention of chronic pain, especially for the aged female group who has diverse body pain areas, the aged with low socioeconomic status, and the aged who do not exercise.
Purpose Untreated depression in adolescents affects their entire life. It is important to detect and intervene early depression in adolescence considering the characteristics of adolescent’s depressive symptoms accompanied by internalization and externalization. The aim of this study was to identify latent classes of depressive symptom trajectories of adolescents and determinants of classes in Korea.
Methods: The three time-point (2018~2020) data derived from the Korean Children and Youth Panel Survey 2018 were used (N=2,325). Latent Growth Curve Modeling (LGCM) was conducted to explore the depressive symptom trajectories in all adolescents, and Latent Class Growth Modeling (LCGM) was conducted to identify each latent class. Multinomial logistic regression analysis was performed to confirm the determinants of each latent class.
Results: The LGCM results showed that there was no statistically significant change in all adolescents' depressive symptoms for 3 years. However, the LCGM results showed that four latent classes showing different trajectories were distinguished: 1) Low-stable (intercept=14.39, non-significant slope), 2) moderate-increasing (intercept=19.62, significantly increasing slope), 3) high-stable (intercept=26.30, non-significant slope), and 4) high-rapidly decreasing (intercept=26.34, significantly rapidly decreasing slope). The multinomial logistic regression analysis showed that the significant determinants (i.e., gender, self-esteem, aggression, somatization, peer relationship) of each latent class were different.
Conclusion: When screening adolescent’s depression, it is necessary to monitor not only direct depression symptoms but also self-esteem, aggression, somatization symptoms, and peer relationships. The findings of this study may be valuable for nurses and policy makers to develop mental health programs for adolescents.
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Purpose The purpose of this study is to demonstrate the mediating effect of happiness in the relationship between internet addiction, depression and suicidal ideation among adolescents from multicultural families.
Methods 1,065 adolescents from multicultural families who participated in the 16th (2020) Adolescent Health Behavior Survey were selected as the final subjects for the study, and were analyzed with descriptive statistics, independent t-test, ANOVA, Pearson’s correlation coefficient, and stepwise multiple regression.
Results There was a fully mediating effect of happiness in the relationship between internet addiction and suicidal ideation of the adolescents from multicultural families (F=6.65, p<.001). There was a partial mediating effect of happiness in the relationship between depression and suicidal ideation of the adolescents from multicultural families (F=10.01, p<.001).
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Purpose The purpose of this study was to develop the Self-Care Non-adherence Risk Assessment Scale (SCNRAS) for patients with chronic illness in South Korea. Methods This study was conducted from April to July, 2020 and utilized a convenience sampling method to recruit 336 patients with chronic illness from three hospitals located in South Korea. The content, factorial structure, item-convergent/discriminant validity, convergent validity, internal consistency reliability, and test-retest reliability of the scale were evaluated. The data were analyzed using exploratory and confirmatory factor analyses, Pearson’s correlation coefficient, Cronbach’s ⍺, and intra-class correlation coefficient. Results The exploratory and confirmatory factor analyses yielded six-factors. Convergent validity was demonstrated using measures of defining issues. Internal consistency reliability and test-retest reliability were found to be acceptable, as indicated by a Cronbach’s ⍺ of .65~.81 and an intra-class correlation coefficient of .93~.98. The Self-Care Non-adherence Risk Assessment Scale for patients with chronic illness is a new instrument that comprehensively measures the knowledge, skill, physical function status, access to health care, social support, motivation, and confidence. It comprises 18 items scored on a 5-point Likert scale. The validity and reliability of the scale were verified. Conclusion: The scale developed through this study is expected to screen those who need nursing intervention early by predicting the self-care non-adherence risk group.
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Purpose The purpose of this study is to determine the results of a meta-analysis of impulsivity variables related to self-destructive behavior of South Korean adolescents.
Methods A meta-analysis was carried out according to the Cochrane guidelines criteria and the quality of the studies was evaluated using the JBI checklist. 2,333 studies were collected through the databases of RISS, KISS, and DBpia on ‘impulsivity’ published from 2000 to 2020.
Self-destructive behavior-related variables were largely categorized into three areas (addiction, violence, and delinquency), and six subgroups.
Results Using the correlations with impulsivity in the final 53 papers, 231 self-destructive behavior-related variables were identified. The social delinquency showed the closest relationship with impulsivity (ES=0.34, 95% CI: 0.23~0.43, p<.001), followed by addictive behavior (ES=0.28, 95% CI: 0.24~0.32, p<.001), personal delinquency (ES=0.28, 95% CI: 0.23~0.32, p<.001), violence against others, violence against self, and substance addiction. These effects were identified as ranging from magnitudes of 0.23 to 0.27 based on the criteria of Cohen.
Conclusion To improve the reliability of the results of meta-analysis, more studies on the impulsivity of adolescents should be carried o