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Cho E, Lee H, Shin J, Kim S, Heo SJ, Park H, Seok JW. Salivary Cortisol and Melatonin, Sleep, and Behavioral Patterns in Older Adults Living With Dementia. Nurs Res 2024; 73:E11-E20. [PMID: 38112608 DOI: 10.1097/nnr.0000000000000709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND Over half of the older adults living with dementia have behavioral and psychological symptoms of dementia (BPSD), including sleep disturbance; however, little is known about physiological markers. Salivary cortisol and melatonin have been identified as potential biomarkers of BPSD, with evidence suggesting a relationship between these biomarkers and various behavioral factors, as well as sleep and activity patterns. OBJECTIVES The aim of this study was to investigate the time-dependent changes in salivary cortisol and melatonin levels in older adults with dementia, their relationship with the sleep-wake cycle, and their correlation with BPSD symptoms and behavioral factors. METHODS This observational study conducted in Seoul and Gyeonggi-do, South Korea, used data from 172 older adults with dementia, measuring sleep and activity patterns for 2 weeks using a wearable device, in addition to administering questionnaires for neuropsychiatric and psychological symptoms-the Neuropsychiatric Inventory, Cohen-Mansfield Agitation Inventory, and Cornell Scale for Depression in Dementia. Salivary cortisol and melatonin levels were measured at four time points and divided into four groups based on a dual-trajectory model. Differences among the groups were analyzed using one-way analysis of variance. RESULTS The participants showed normal but heterogeneous patterns of salivary cortisol and melatonin levels. Dual-trajectory pattern analysis showed that higher levels of melatonin during the daytime were correlated with poor nighttime sleep efficiency and decreased disinhibited behaviors, and higher levels of cortisol at all four time points were associated with decreased physical activity. DISCUSSION Measuring and analyzing periodic changes in cortisol and melatonin levels can predict various behavioral symptoms (e.g., sleep disturbances, activity counts, and disinhibition) in older adults with dementia. A study with an experimental design is needed to discover the direct physiological interactions between cortisol, melatonin, and these symptoms.
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Cho E, Min D. Use of physical restraints on older adults in South Korean nursing homes: a multicenter study. Sci Rep 2024; 14:394. [PMID: 38172205 PMCID: PMC10764948 DOI: 10.1038/s41598-023-50897-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 12/27/2023] [Indexed: 01/05/2024] Open
Abstract
In this study, we aimed to examine the current status of physical restraint use and ascertain factors affecting the rate of usage of physical restraints on older adults in South Korean nursing homes. For this purpose, we conducted a secondary analysis of data from 190 registered nurses employed at 62 nursing homes. Logistic regression analysis was used to identify the factors affecting the use of restraints in nursing homes. The rate of using physical restraints was 79.5%. Nursing homes were found to use 90.7% and 91.3% less restraint when the work environment was better (odds ratio [OR]: 0.093, 95% confidence interval [CI]: 0.023-0.368) and mixed (OR: 0.087, 95% CI: 0.087-0.100), respectively. Nursing homes owned by corporations were 9.796 times more likely to use physical restraints than those owned by local governments (OR: 9.796, 95% CI: 1.473-65.158). Therefore, improving nurses' work environment and introducing regulations and education that enable the entrusted doctors or nurses to make decisions regarding restraint use, monitoring, and removal, regardless of nursing home ownership type, are necessary.
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Affiliation(s)
- Eunhee Cho
- Yonsei University College of Nursing & Mo-Im Kim Nursing Research Institute, Seoul, Republic of Korea
| | - Deulle Min
- Department of Nursing, College of Medicine, Wonkwang University, 460, Iksandae-ro, Iksan, Jeonbuk, 54538, Republic of Korea.
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Eltaybani S, Igarashi A, Cal A, Lai CKY, Carrasco C, Sari DW, Cho E, Haugan G, Bravo JD, Abouzeid NA, Wachholz PA, Isaramalai SA, Dawood SS, Pappas Y, Abd El Moneam AAEG, Rodríguez AB, Alqahtani BA, Pereira CLN, Jenssen CRS, Yu DSF, Ahmed FR, Mendes FRP, Randhawa G, Ahmed HAESH, Suzuki H, Prambudi H, Avci IA, Waluyo I, Nurbaeti I, Vseteckova J, Horne JK, Liu JY, Ingstad K, Kashiwabara K, Grant L, Abd El Moniem MM, Sakka M, Abdelgawad ME, Subu MA, Kentzer N, Almadani NA, Tomas-Carus P, Rodrigues Garcia RCM, Indarwati R, Maneerat S, Chien WT, Amamiya Y, Cavalcanti YW, Yamamoto-Mitani N. Long-term care facilities' response to the COVID-19 pandemic: An international, cross-sectional survey. J Adv Nurs 2024; 80:350-365. [PMID: 37452500 DOI: 10.1111/jan.15785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/01/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023]
Abstract
AIMS To (i) assess the adherence of long-term care (LTC) facilities to the COVID-19 prevention and control recommendations, (ii) identify predictors of this adherence and (iii) examine the association between the adherence level and the impact of the pandemic on selected unfavourable conditions. DESIGN Cross-sectional survey. METHODS Managers (n = 212) and staff (n = 2143) of LTC facilities (n = 223) in 13 countries/regions (Brazil, Egypt, England, Hong Kong, Indonesia, Japan, Norway, Portugal, Saudi Arabia, South Korea, Spain, Thailand and Turkey) evaluated the adherence of LTC facilities to COVID-19 prevention and control recommendations and the impact of the pandemic on unfavourable conditions related to staff, residents and residents' families. The characteristics of participants and LTC facilities were also gathered. Data were collected from April to October 2021. The study was reported following the STROBE guidelines. RESULTS The adherence was significantly higher among facilities with more pre-pandemic in-service education on infection control and easier access to information early in the pandemic. Residents' feelings of loneliness and feeling down were the most affected conditions by the pandemic. More psychological support to residents was associated with fewer residents' aggressive behaviours, and more psychological support to staff was associated with less work-life imbalance. CONCLUSIONS Pre-pandemic preparedness significantly shaped LTC facilities' response to the pandemic. Adequate psychological support to residents and staff might help mitigate the negative impacts of infection outbreaks. IMPACT This is the first study to comprehensively examine the adherence of LTC facilities to COVID-19 prevention and control recommendations. The results demonstrated that the adherence level was significantly related to pre-pandemic preparedness and that adequate psychological support to staff and residents was significantly associated with less negative impacts of the pandemic on LTC facilities' staff and residents. The results would help LTC facilities prepare for and respond to future infection outbreaks. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Sameh Eltaybani
- Global Nursing Research Center, The University of Tokyo, Tokyo, Japan
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
| | - Ayse Cal
- Department of Nursing, School of Health Sciences, Ankara Medipol University, Ankara, Turkey
| | - Claudia K Y Lai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong SAR
| | - Cristina Carrasco
- Neuroimmunophysiology and Chrononutrition Research Group, Department of Physiology, Faculty of Sciences, University of Extremadura, Badajoz, Spain
| | | | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University, College of Nursing, Seoul, South Korea
| | - Gørill Haugan
- Norwegian University of Science and Technology, Department of Public Health Nursing, Trondheim, Norway
- Nord University, Faculty of Nursing and Health Science, Levanger, Norway
| | - Jorge D Bravo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre(CHRC), Universidade de Évora, Évora, Portugal
| | - Nesreen A Abouzeid
- Department of Medical Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
- Department of Medical Surgical Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | | | | | - Shaimaa Samir Dawood
- Gerontological nursing department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Yannis Pappas
- Institute for Health Research, University of Bedfordshire, luton, UK
| | | | - Ana Beatriz Rodríguez
- Neuroimmunophysiology and Chrononutrition Research Group, Department of Physiology, Faculty of Sciences, University of Extremadura, Badajoz, Spain
| | | | - Catarina Lino Neto Pereira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | | | - Doris S F Yu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Fatma Refaat Ahmed
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Felismina Rosa P Mendes
- Departamento de Enfermagem, Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Évora, Portugal
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, luton, UK
| | | | - Haruno Suzuki
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
| | - Hery Prambudi
- An Nasher Institute of Healh Sciences, Cirebon, Cirebon West Java, Indonesia
| | - Ilknur Aydin Avci
- Department of Public Health Nursing, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Imam Waluyo
- Padma Kumara Foundation and Consultant International, Collaboration Physiotherapy School YAB, Jakarta, Indonesia
| | - Irma Nurbaeti
- Faculty of Health Sciences, Universitas Islam Negeri Syarif Hidayatullah, Jakarta, Indonesia
| | - Jitka Vseteckova
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
| | | | - Justina Yw Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong SAR
| | - Kari Ingstad
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | | | - Louise Grant
- Faculty of Health and Social Sciences, University of Bedfordshire, Luton, UK
| | | | - Mariko Sakka
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Muhammad Arsyad Subu
- University of Sharjah, Sharjah, United Arab Emirates
- Universitas Binawan, Jakarta, Indonesia
| | - Nichola Kentzer
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
| | - Noura A Almadani
- Community health nursing department, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Pablo Tomas-Carus
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | | | - Retno Indarwati
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Sonthaya Maneerat
- Prapokklao Nursing College, Faculty of Nursing, Praboromarajchanok Institute, Chantaburi, Thailand
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Yuko Amamiya
- Department of Nursing, Faculty of Healthcare Sciences, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | | | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
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Cho E, Yang M, Jang J, Cho J, Kang B, Jang Y, Kim MJ. A mobile app to predict and manage behavioral and psychological symptoms of dementia: Development, usability, and users' acceptability. Digit Health 2024; 10:20552076241249277. [PMID: 38698833 PMCID: PMC11064751 DOI: 10.1177/20552076241249277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/08/2024] [Indexed: 05/05/2024] Open
Abstract
Objective: Non-pharmacological interventions are considered the first-line treatment for behavioral and psychological symptoms of dementia (BPSD); however, traditional approaches have shown only small effect sizes. Mobile technology offers an opportunity to improve BPSD assessment and management in people living with dementia (PLWD). We aimed (1) to develop a mobile application (app) featuring a real-time BPSD diary, machine-learning-based BPSD prediction, and individualized non-pharmacological care programs, including therapeutic use of music and reminiscent content, and (2) to test its usability, acceptability, and preliminary efficacy among PLWD and caregivers. Methods: An Android-based app was developed through the following three phases: (1) needs assessment, (2) software development and initial testing with experts, and (3) beta-testing with end users who were dyads of PLWD and caregivers. The preliminary efficacy, usability, and acceptability of the app were assessed using validated BPSD questionnaires and face-to-face interviews with the dyads. Logs of the dyads' program participation (i.e., types, time, and duration), BPSD diaries, and engagement levels of PLWD were also collected through the app. Results: Five dyads created BPSD diaries (range: 22-48) over 3 weeks. Overall, the BPSD symptoms decreased after the beta-testing period. Each dyad participated in the care programs for 106-204 min, during which music alone was most frequently used. Engagement levels ranged from 3.38 to 4.94 (out of 5). Conclusions: The app was deemed usable, acceptable, and feasible for PLWD and caregivers. The upgraded app will be further tested and can be easily implemented at home or in the community.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
| | - Minhee Yang
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Korea
| | - Jiyoon Jang
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Korea
| | - Jungwon Cho
- College of Nursing, Yonsei University, Seoul, Korea
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
| | | | - Min Jung Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
- College of Nursing, Gachon University, Seoul, Korea
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Cho E, Kim EY, Lee KH, Kim HR, Choi S, Yoon YS, Kim E, Heo SJ, Jung SY, Jang J. The effects of special nursing units in nursing homes on healthcare utilization and cost: A case-control study using propensity score matching. Int J Nurs Stud 2023; 147:104587. [PMID: 37741258 DOI: 10.1016/j.ijnurstu.2023.104587] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/09/2023] [Accepted: 08/10/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Most nursing homes in South Korea lack professional nursing services, resulting in transporting residents to hospitals for mild health problems and nursing treatment needs. While the number of nursing homes has increased, the number of registered nurses working in nursing homes has declined. In 2019, the Korean Ministry of Health and Welfare and the National Health Insurance Service launched the Special Nursing Units in Nursing Homes, a pilot nurse-led model, to resolve the lack of health and nursing services in nursing homes by mandating registered nurses' minimum staffing levels and protecting their scope of practice. OBJECTIVE This study explored the effects of the Special Nursing Units model in Nursing Homes on healthcare utilization and cost among nursing home residents. DESIGN A comparative effectiveness research design using propensity score matching. SETTING(S) Eighteen nursing homes were selected based on the region and number of beds. PARTICIPANTS There were 323 matched-pairs of residents from the case and control groups. METHODS Nursing homes with more than 30 beds were recruited nationwide, with 18 nursing homes being selected based on the region and number of beds. The case group included 323 older adults receiving professional nursing services by registered nurses under the Special Nursing Units model in Nursing Homes for more than six months consecutively in 18 nursing homes between April and December 2019. We matched control participants using propensity score matching with health insurance and long-term care data. We analyzed the differences in healthcare utilization and cost changes between the case and control groups using generalized estimating equations. RESULTS The groups were not statistically different in baseline demographic or health-related characteristics. There were 26 (8.1%) and 30 (9.3%) deaths in the case and control groups, respectively, during the six months of the model, which was not statistically different (p = .576). The case group showed statistically significant decreases in healthcare utilization and costs, including hospitalization frequency (p = .008), length of stay (p = .002), and hospitalization costs (p = .003); outpatient visit frequency (p = .003) and costs (p < .001); and home healthcare frequency (p < .001) and cost (p < .001) than the control group. CONCLUSIONS Professional nursing services by registered nurses under the Special Nursing Units model in Nursing Homes decreased healthcare utilization and costs. A nurse-led model in nursing homes, which includes mandating the minimum staffing levels of registered nurses and protecting their scope of practice, promises to improve resident health outcomes.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Eun-Young Kim
- Dong-A University College of Nursing, Busan, South Korea.
| | - Kyung Hee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | | | - Seonhwa Choi
- Yonsei University, College of Nursing and Brain Korea 21 FOUR project, Seoul, South Korea
| | - Yea Seul Yoon
- Yonsei University, College of Nursing and Brain Korea 21 FOUR project, Seoul, South Korea
| | - EunKyo Kim
- Yonsei University, College of Nursing and Brain Korea 21 FOUR project, Seoul, South Korea
| | - Seok-Jae Heo
- Yonsei University College of Medicine Division of Biostatistics Department of Biomedical Systems Informatics, Seoul, South Korea
| | - Se Young Jung
- Dong-A University College of Nursing, Busan, South Korea
| | - Jiyoon Jang
- Yonsei University, College of Nursing and Brain Korea 21 FOUR project, Seoul, South Korea
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Sachar M, Lin BM, Wong V, Li W, Huang V, Harris J, Ezzedine K, Cho E, Qureshi AA. Association between acetaminophen use and vitiligo in US women and men. Australas J Dermatol 2023; 64:e348-e351. [PMID: 37688423 PMCID: PMC10840899 DOI: 10.1111/ajd.14152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 05/30/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND/OBJECTIVES Exposure to chemical phenols, which can act as tyrosine analogues and result in anti-melanocyte autoimmunity, has been associated with vitiligo. Acetaminophen (N-acetyl-p-aminophenol) is an over-the-counter analgesic of phenolic origin. The risk of vitiligo with systemic exposure to acetaminophen has not yet been evaluated. METHODS We examined the risk of vitiligo with regular use acetaminophen in women, the Nurses' Health Study (NHS) and in men, the Health Professionals Follow-up Study (HPFS). Regular acetaminophen use was asked biennially from 1990 in NHS and from 1986 in HPFS, and the year of clinician-diagnosed vitiligo was asked retrospectively in 2012 in the cohorts. RESULTS In NHS, a total of 161 vitiligo cases were identified during a follow-up of 571,724 person-years; in HPFS, a total of 183 vitiligo cases were identified during a follow-up of 680,313 person-years. Regular use of acetaminophen was associated with an increased vitiligo risk in NHS but not HPFS. The multivariable relative risk (RR) was 1.52 (95% confidence interval [CI] 1.03-2.25) in NHS and 1.09 (95% CI 0.76-1.55) in HPFS. The higher risk of vitiligo was similar by duration of acetaminophen use in women; the multivariable RRs were 1.47 (95% CI 0.98-2.21) for acetaminophen use under 5 years, and 1.78 (95% CI 1.11-2.84) for acetaminophen use over 5 years. CONCLUSIONS Acetaminophen may be associated with a higher risk of vitiligo in women.
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Affiliation(s)
- M Sachar
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - B M Lin
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Massachusetts Eye and Ear Infirmary, Department of Otolaryngology, Boston, Massachusetts, USA
| | - V Wong
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - W Li
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - V Huang
- Department of Dermatology, University of California, Davis, California, USA
| | - J Harris
- Department of Dermatology, University of Massachusetts, Worcester, Massachusetts, USA
| | - K Ezzedine
- Department of Dermatology, Mondor Hospital (AP-HP), Paris Est Créteil University, Créteil, France
| | - E Cho
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - A A Qureshi
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
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Armstrong G, Haregu T, Cho E, Jorm AF, Batterham P, Spittal MJ. Transition to a first suicide attempt among young and middle-aged males with a history of suicidal thoughts: A two-year cohort study. Psychiatry Res 2023; 328:115445. [PMID: 37666006 DOI: 10.1016/j.psychres.2023.115445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/21/2023] [Accepted: 08/26/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION Although many studies have examined the risk and protective factors associated with suicidal behavior, little is known about the probability of transition from suicidal thoughts to suicidal attempts and the factors that distinguish those who have suicidal thoughts from those who progress to a suicide attempt. OBJECTIVES To determine the probability and predictors of transition to a suicide attempt among young and middle-aged males with a history of suicidal thoughts but no prior history of attempting suicide. METHODS We used data from the first two waves of the Australian Longitudinal Study on Male Health, approximately two years apart. We followed the cohort of males aged 18-55 years who, at wave 1, reported a lifetime history of suicidal ideation but no history of a prior suicide attempt. We report transition probabilities to a first suicide attempt at Wave 2 and used logistic regression models to examine baseline predictors of transition to a first suicide attempt over the two-year period among males aged 18 years and older. RESULTS From the 1,564 males with suicidal thoughts at wave 1,140 participants (8.9%; 95% CI:7.6,10.5) reported to have had their first suicide attempt in the two-year period. In multivariate analyses, males aged 30-39 (OR=0.31; 95% CI: 0.16,0.60), 40-49 (OR=0.47; 95% CI:0.24,0.91) and 50-55 (OR=0.31; 95% CI: 0.13,0.73) all had lower odds of a first suicide attempt compared to males aged 18-29 years. The odds of a first suicide attempt were significantly higher for males who were: living in inner regional areas (ref: major cities) (OR=2.32; 95% CI: 1.33,4.04); homosexual or bisexual (OR=2.51; 95% CI: 1.17,5.36); working night shift as their main job (OR=1.75; 95% CI: 1.05,2.91); and, living with a disability (OR=1.99; 95% CI: 1.07,3.65). Clinical indicators such as symptoms of depression and illicit substance use were not significant predictors of transition to a first suicide attempt in multivariate models, nor were indicators of social connection. CONCLUSION We estimated that 8.9% of Australian males aged 15-55 years with a history of suicidal thoughts and no prior history of suicide attempts will progress to a first suicide attempt within two-years. Neither psychological distress, illicit substance use nor social connection indicators were correlated with transition to a first suicide attempt. Rather, it was socio-demographic indicators that were associated with transition to a first suicide attempt.
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Affiliation(s)
- G Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - T Haregu
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - E Cho
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - A F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - P Batterham
- National Centre for Epidemiology and Population Health, Canberra, Australia
| | - M J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Lee J, Cho E, Kim H, Lee KH, Kim E, Ye BS. The development and evaluation of a self-efficacy enhancement program for older adults with mild cognitive impairment. Appl Nurs Res 2023; 73:151726. [PMID: 37722794 DOI: 10.1016/j.apnr.2023.151726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/03/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE The aims of this study were to develop a self-efficacy enhancement program and to evaluate its effect on cognitive function, dementia knowledge, self-efficacy, depression, and dementia preventive behaviors in older adults (age ≥ 65 years) with mild cognitive impairment (MCI). METHODS This equivalent control group pretest-posttest study was conducted at a tertiary hospital in Seoul, South Korea. Older adults with MCI were randomly allocated to an experimental (EG, n = 16) or control group (CG, n = 16). The EG underwent an 8-week intervention (weekly 60-min session) utilizing self-efficacy enhancement strategies; the CG received usual care. The intervention was comprised of physical, cognitive, and emotional activities and was followed by 4-week maintenance during which both groups engaged in self-learning at home with a dementia preventive guidebook. Outcome data were evaluated at the pretest and 8, 10, and 12 weeks later. This study adhered to the CONSORT guidelines. RESULTS There were significant differences in cognitive function, dementia knowledge, self-efficacy, and dementia preventive behaviors, but not in depression between the two groups over the time. Regarding cognitive function subdomains, significant differences were observed in visuospatial/executive, attention, language, and delayed recall. CONCLUSION The integrated intervention consisting of physical, cognitive, and emotional activities was effective in improving cognitive function, dementia knowledge, self-efficacy, and dementia preventive behaviors. This suggests that this program can be utilized as an educational program to prevent dementia in older adults with MCI in dementia support centers, public health centers, clinics, and hospitals. TRIAL REGISTRATION KCT0006094 in the Clinical Research Information Service. Retrospectively registered 23 April 2021, https://cris.nih.go.kr/cris/search/listDetail.do.
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Affiliation(s)
- Jungeun Lee
- Hanseo University, Dept. of Nursing, School of Health Science, (31692) 46 Hanseo 1-ro, Haemi-myun, Seosan-si, Chungcheongnam-do, Republic of Korea.
| | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, (03722), 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Heejung Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, (03722), 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Kyung Hee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, (03722), 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Eosu Kim
- Department of Psychiatry, Yonsei University, College of Medicine, (03722), 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University, College of Medicine, (03722), 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
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Cho E, Lee KH, Kang B, Jang J, Shin J, Eltaybani S, Yamamoto-Mitani N, Kim MJ. Perceived Work Environment, Educational Status, Staffing Levels, and Work Outcomes in Long-Term Care Settings During COVID-19. J Am Med Dir Assoc 2023; 24:1600-1605. [PMID: 37696496 DOI: 10.1016/j.jamda.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVES Coronavirus disease (COVID-19) has severely affected older residents in long-term care (LTC) settings. However, care workers' perceptions of their work environment and potential impact on their work outcomes during the pandemic is not well known. This study examined associations between care staff's perceived work environment, educational status, and facility staffing levels and work outcomes of care staff in LTC settings during the COVID-19 pandemic. DESIGN This study employed a cross-sectional, observational, correlational design. SETTING AND PARTICIPANTS A total of 207 care staff were conveniently recruited from 30 LTC settings in South Korea. METHODS The perceived work environment, educational status of care staff, and facility staffing levels (ie, beds-to-registered nurse [RN] and beds-to-nursing assistant [NA] or care worker ratios), as well as their work outcomes (ie, general and COVID-19 specific outcomes) were collected using questionnaires. Multivariable binary logistic regressions were conducted, controlling for the characteristics of care staff (ie, age, sex, occupation, and career length) and facilities (ie, location, bed size, ownership, and residents' disease and care profiles). RESULTS Approximately 45% of the participants were either NAs or care workers, and 38% were RNs. More than half (53.14%) perceived their work environment to be good. LTC staff who perceived their work environment to be poor were more likely to be dissatisfied with their work [odds ratio (OR) 20.88), experience high burnout (OR 8.63), intend to leave the facility within a year (OR 5.00), and experience increased overtime work (OR 3.58) and work-life imbalance (OR 1.93) due to COVID-19. CONCLUSIONS AND IMPLICATIONS LTC work environments should be improved and government-led initiatives for ensuring such improvements should be implemented to enable a better response to future public health crises and maintain the quality of care for and safety of residents in LTC settings.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Kyung Hee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Jiyoon Jang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Jinhee Shin
- Woosuk University College of Nursing, Wanju-Gun, Jeollabuk-do, South Korea
| | - Sameh Eltaybani
- Department of Gerontological Home Care and Long-term Care Nursing, University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, University of Tokyo, Tokyo, Japan
| | - Min Jung Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea.
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Zhang Y, Cho E, Lee H, Jung HY, Unruh MA, Braun RT, Yu J. Nursing Homes' Use of Contract Direct Care Staff Before and During the COVID-19 Pandemic. J Am Med Dir Assoc 2023; 24:1610-1611. [PMID: 37699530 DOI: 10.1016/j.jamda.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 09/14/2023]
Affiliation(s)
- Yutong Zhang
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Eunhee Cho
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Hana Lee
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Hye-Young Jung
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Mark A Unruh
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Robert Tyler Braun
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Jiani Yu
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA.
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Cho E, Min D, Heo SJ, Lee K, Kim H. Effects of registered nurses' staffing levels, work environment and education levels on nursing home residents' quality of life and nurse outcomes. J Clin Nurs 2023; 32:6494-6503. [PMID: 36932041 DOI: 10.1111/jocn.16689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/23/2022] [Accepted: 02/20/2023] [Indexed: 03/19/2023]
Abstract
AIMS AND OBJECTIVES To examine the effects of registered nurse staffing levels, work environment and education levels on the residents' quality of life and nurses' job dissatisfaction, burnout and turnover intention. BACKGROUND Registered nurse staffing status and work environment are suboptimal in nursing homes worldwide. Nursing home care aims to maximise residents' quality of life. However, evidence on the impact of registered nurse staffing levels, work environment and education levels on the residents' quality of life and nurse outcomes in nursing homes is limited. DESIGN This is a cross-sectional observational study. METHODS A total of 513 residents and 117 registered nurses from 39 nursing homes in South Korea participated in surveys. The main measures included registered nurses' staffing levels, work environment, education levels, residents' quality of life, registered nurses' job dissatisfaction, burnout and turnover intention. We analysed data using the generalised estimating equations and reported the study using the STROBE checklist. RESULTS Overall, the residents' quality-of-life score was 13.7 ± 2.6 (out of 17). Residents in nursing homes with a higher number of registered nurses or with work environment evaluated as 'mixed' or 'better' (compared with 'poor') had a higher quality of life. Regarding nurse outcomes, 74.4% of the registered nurses were dissatisfied with their current jobs, 12.0% had burnout and 18.8% had a turnover intention. Registered nurses working in 'mixed' or 'better' work environment were less likely to have job dissatisfaction. Registered nurses' education levels did not have a statistically significant effect on the resident and nurse outcomes. CONCLUSIONS Registered nurse staffing levels and work environment should be considered important for improving residents' quality of life and nurses' job satisfaction. RELEVANCE TO CLINICAL PRACTICE Regulation and policy reforms are needed to increase the registered nurse staffing levels and to create a good work environment in nursing homes. PATIENT OR PUBLIC CONTRIBUTION Nursing home residents and registered nurses participated in the surveys of this study. Registered nurses facilitated resident recruitment by identifying and introducing the study to residents who were eligible for study participation. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Korea
| | - Deulle Min
- Department of Nursing, College of Medicine, Wonkwang University, Iksan, Korea
| | - Seok-Jae Heo
- Department of Biostatistics and Computing, Yonsei University Graduate School, Seoul, Korea
| | - Kyoungeun Lee
- Department of Nursing, Tongmyong University, Busan, Korea
| | - Hyejin Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
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Cho E, Kim S, Heo SJ, Shin J, Hwang S, Kwon E, Lee S, Kim S, Kang B. Machine learning-based predictive models for the occurrence of behavioral and psychological symptoms of dementia: model development and validation. Sci Rep 2023; 13:8073. [PMID: 37202454 DOI: 10.1038/s41598-023-35194-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/14/2023] [Indexed: 05/20/2023] Open
Abstract
The behavioral and psychological symptoms of dementia (BPSD) are challenging aspects of dementia care. This study used machine learning models to predict the occurrence of BPSD among community-dwelling older adults with dementia. We included 187 older adults with dementia for model training and 35 older adults with dementia for external validation. Demographic and health data and premorbid personality traits were examined at the baseline, and actigraphy was utilized to monitor sleep and activity levels. A symptom diary tracked caregiver-perceived symptom triggers and the daily occurrence of 12 BPSD classified into seven subsyndromes. Several prediction models were also employed, including logistic regression, random forest, gradient boosting machine, and support vector machine. The random forest models revealed the highest area under the receiver operating characteristic curve (AUC) values for hyperactivity, euphoria/elation, and appetite and eating disorders; the gradient boosting machine models for psychotic and affective symptoms; and the support vector machine model showed the highest AUC. The gradient boosting machine model achieved the best performance in terms of average AUC scores across the seven subsyndromes. Caregiver-perceived triggers demonstrated higher feature importance values across the seven subsyndromes than other features. Our findings demonstrate the possibility of predicting BPSD using a machine learning approach.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Sujin Kim
- Department of Nursing, Yong-In Arts and Science University, Gyeonggi-do, Korea
| | - Seok-Jae Heo
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Jinhee Shin
- College of Nursing, Woosuk University, Jeollabuk-do, Korea
| | - Sinwoo Hwang
- Korea Armed Forces Nursing Academy, Daejeon, Korea
| | - Eunji Kwon
- Korea Armed Forces Nursing Academy, Daejeon, Korea
| | | | | | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Cho C, Ji M, Cho E, Yi S, Kim JG, Lee S. Chronic voluntary wheel running exercise ameliorates metabolic dysfunction via PGC-1α expression independently of FNDC5/irisin pathway in high fat diet-induced obese mice. J Physiol Sci 2023; 73:6. [PMID: 37041517 DOI: 10.1186/s12576-023-00864-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
Exercise is an effective intervention to ameliorate metabolic diseases including obesity and insulin resistance, but the mechanisms involved in the metabolic amelioration have not yet been fully elucidated. This study aimed to determine whether AMPK-SIRT1-PGC-1α-FNDC5/Irisin-UCP1 expression is activated and whether metabolic dysfunction is ameliorated by chronic voluntary wheel running (VWR) in high-fat diet (HFD) induced obese mice. C57BL6J mice were randomly assigned into three groups at the age of 7 weeks for 10 weeks: normal chow diet (CON) group, HFD group, and HFD + VWR group. Chronic VWR ameliorates metabolic parameters and leads to increases in the expression of PGC-1α in the gastrocnemius muscle in HFD-induced obese mice. In contrast, the expression of AMPKα, SIRT1, and FNDC5, or circulating irisin levels did not lead to alteration. Improvement of metabolic health was partly mediated via PGC-1α expression by chronic VWR, but not FNDC5/Irisin pathway in HFD-induced obese mice.
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Affiliation(s)
- Chaeeun Cho
- Department of Human Movement Science, Graduate School, Incheon National University, Incheon, Republic of Korea
| | - Minje Ji
- Department of Human Movement Science, Graduate School, Incheon National University, Incheon, Republic of Korea
| | - Eunhee Cho
- Department of Human Movement Science, Graduate School, Incheon National University, Incheon, Republic of Korea
| | - Seon Yi
- Department of Life Science, College of Life Sciences and Bioengineering, Incheon National University, Incheon, Republic of Korea
| | - Jae Geun Kim
- Department of Life Science, College of Life Sciences and Bioengineering, Incheon National University, Incheon, Republic of Korea
| | - Sewon Lee
- Division of Sport Science, College of Arts & Physical Education, Incheon National University, Bldg# 16, Room# 423, (Songdo-Dong) 119 Academy-Ro, Yeonsu-Gu, Incheon, South Korea.
- Sport Science Institute, College of Arts & Physical Education, Incheon National University, Incheon, Republic of Korea.
- Health Promotion Center, College of Arts & Physical Education, Incheon National University, Incheon, Republic of Korea.
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Kim Y, Lee MJ, Choi M, Cho E, Ryu GW. Exploring nurses' multitasking in clinical settings using a multimethod study. Sci Rep 2023; 13:5704. [PMID: 37029189 PMCID: PMC10082008 DOI: 10.1038/s41598-023-32350-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 03/26/2023] [Indexed: 04/09/2023] Open
Abstract
Nurses often multitask in the process of managing patient care and communicating with healthcare providers simultaneously within a limited time, which can negatively affect patient care and safety. In this multimethod research, we conducted a time and motion study to record nursing activities using eye trackers for 23 participants (9 nurses and 14 patients). The frequency and duration of single and multitasking activities were analyzed. Additionally, we conducted focus group interviews (FGIs) with 12 nurses (2-5 nurses per group) to further investigate their multitasking experience. The total duration of the eye tracker recordings was 3,399 min. Daily nursing activities comprised 23.7%, 21.1%, and 12.5% of scheduled medication, documentation, and monitoring and measurement, respectively. Among these activities, nurses mostly carry out scheduled medication, monitoring, and measurement together. Three themes emerged in the FGIs: "Being involved in every little task regarding patient care," "Getting swamped by the complexity of symptoms and problems of the patients at a given time," and "Getting interrupted at work too often." Nurses performed multiple activities while cooperating with other healthcare providers and providing care to patients. It is important to create an environment where nurses can focus on essential nursing activities to improve patient safety.
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Affiliation(s)
- Yoojin Kim
- National Evidence-Based Healthcare Collaborating Agency, Seoul, South Korea
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Mi Ja Lee
- Severance Hospital, Yonsei University Health System, Seoul, South Korea
| | - Mona Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Gi Wook Ryu
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea.
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea.
- Department of Nursing, Hansei University, 30 Hanse-Ro, Gunpo-Si, Gyeonggi-Do, 15852, South Korea.
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Cho E, Kim MJ, Yang M, Jang J, Cho J, Lee JY. Symptom-specific non-pharmacological interventions for behavioural and psychological symptoms of dementia: protocol of an umbrella review of systematic reviews of randomised controlled trials. BMJ Open 2023; 13:e070317. [PMID: 36792326 PMCID: PMC9933668 DOI: 10.1136/bmjopen-2022-070317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION There are various non-pharmacological interventions for dementia care. However, healthcare providers continue to face challenges in determining the most suitable interventions for the behavioural and psychological symptoms of dementia (BPSD), which vary according to individuals. This umbrella review aims to identify and summarise the effective non-pharmacological interventions for each sub-symptom to provide individualised, evidence-based recommendations for clinical practice. METHODS AND ANALYSIS This review follows the guideline of the Cochrane methodology for umbrella reviews. It focuses only on systematic reviews (SRs) with or without a meta-analysis of randomised controlled trials. Five electronic databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO and Cochrane Database, will be searched. The screened SRs will be determined for eligibility by the PICO formulation: (Population) older adults with dementia of any type; (Intervention) all types of non-pharmacological intervention; (Comparison) usual care or other non-pharmacological intervention; and (Outcome) BPSD and its sub-symptoms. The quality of the individual SRs will be appraised using A Measurement Tool to Assess Systematic Reviews 2. The overlap of primary studies will also be considered by eliminating an old-date SR conducted by the same authors with the same interest and calculating the Corrected Covered Area. Data will be extracted according to the pre-determined formula, which will organise non-pharmacological interventions according to the sub-symptoms of BPSD and not according to the type of intervention. ETHICS AND DISSEMINATION Since this is a review paper, ethical approval is not required. The findings of this review will be disseminated through publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42022340930.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Yonsei University, Seoul, Korea (the Republic of)
| | - Min Jung Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Yonsei University, Seoul, Korea (the Republic of)
| | - Minhee Yang
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Korea (the Republic of)
| | - Jiyoon Jang
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Korea (the Republic of)
| | - Jungwon Cho
- College of Nursing, Yonsei University, Seoul, Korea (the Republic of)
| | - Ji Yeon Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Yonsei University, Seoul, Korea (the Republic of)
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Cho E, Shin J, Seok JW, Lee H, Lee KH, Jang J, Heo SJ, Kang B. The effectiveness of non-pharmacological interventions using information and communication technologies for behavioral and psychological symptoms of dementia: A systematic review and meta-analysis. Int J Nurs Stud 2023; 138:104392. [PMID: 36434931 DOI: 10.1016/j.ijnurstu.2022.104392] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 11/01/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Although behavioral and psychological symptoms of dementia are a global public health challenge, non-pharmacological interventions using information and communication technologies can be an affordable, cost-effective, and innovative solution. OBJECTIVES This study aimed to examine the effectiveness of non-pharmacological interventions using information and communication technologies on the behavioral and psychological symptoms of dementia and identify potential moderators of intervention effects. DESIGN Systematic review and meta-analysis of randomized controlled trials. METHODS A systematic literature review was conducted using PubMed, CINAHL, PsycINFO, Embase, and the Cochrane Library from May 2022. Randomized controlled trials that examined the effects of non-pharmacological interventions using information and communication technologies on the behavioral and psychological symptoms of dementia were included. A meta-analysis using a random-effects model was performed to calculate the pooled standardized mean differences between overall symptoms and each type of symptom. For moderator analyses, subgroup and meta-regression analyses were performed. RESULTS Sixteen trials (15 articles) met the eligibility criteria. The interventions were grouped into activity engagement interventions using digital health that provided music and reminiscence therapy, physical exercise, social interaction interventions using social robots, and telehealth-based care aid interventions that provided coaching or counseling programs. Pooled evidence demonstrated that non-pharmacological interventions using information and communication technologies exerted a large effect on depression (SMD = -1.088, 95% CI -1.983 to -0.193, p = 0.017), a moderate effect on overall behavioral and psychological symptoms of dementia (SMD = -0.664, 95% CI -0.990 to -0.338, p < 0.001), and agitation (SMD = -0.586, 95% CI -1.130 to -0.042, p = 0.035). No effects on neuropsychiatric symptoms (SMD = -0.251, 95% CI -0.579 to 0.077, p = 0.133), anxiety (SMD = -0.541, 95% CI -1.270 to 0.188, p = 0.146), and apathy (SMD = -0.830, 95% CI -1.835 to 0.176, p = 0.106) were reported. Moderator analyses identified the mean age of the participants as a potential moderator of intervention effects. CONCLUSIONS Evidence from this systematic review and meta-analysis suggests that non-pharmacological interventions, using information and communication technologies, were an applicable approach to managing behavioral and psychological symptoms among older adults with dementia, with moderate to large effect sizes. However, evidence on anxiety and apathy is inconclusive due to the limited number of existing randomized controlled trials. Future studies with subgroup analyses are warranted to conclude the most effective types of intervention using information and communication technologies for each type of symptom. REGISTRATION CRD42021258498.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
| | - Jinhee Shin
- College of Nursing, Woosuk University, Jeollabuk-do, Republic of Korea.
| | - Jo Woon Seok
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea.
| | - Hyangkyu Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
| | - Kyung Hee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
| | - Jiyoon Jang
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea.
| | - Seok-Jae Heo
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
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Shin J, Cho E. Patterns and risk factors of cognitive decline among community-dwelling older adults in South Korea. Arch Gerontol Geriatr 2023; 104:104809. [PMID: 36152626 DOI: 10.1016/j.archger.2022.104809] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 02/07/2023]
Abstract
Dementia prevalence is increasing worldwide. Thus, the global impact of cognitive impairment and dementia have become significant public health issues. This study assessed the patterns of and investigated risk factors associated with cognitive decline over time in community-dwelling Korean adults (age ≥65 years). We enrolled 1,369 older adult respondents without cognitive decline in the baseline survey of the Korean Longitudinal Study of Aging (2006-2016) in South Korea. The risk of first-ever mild-to-moderate or severe cognitive decline during the 10-year follow-up (2006-2016) was comparatively evaluated between the cognitive decline group (comprising participants with mild-to-moderate or severe cognitive decline; n = 728) and the normal cognition group (participants without a cognitive decline event; n = 641). The cognitive decline-free survival rates for up to ten years were measured using Kaplan-Meier analysis. The generalized estimation equations model was used to analyze changes in K-MMSE over time from 2006 to 2016. The adjusted Cox proportional hazards model revealed that increased age, female, lower education level, no religious status, and living in a small city were factors that were associated with a higher risk of cognitive decline, as were health-related factors, including lower handgrip strength, a higher number of chronic diseases, and depressive symptoms. Regular exercise, non-drinking status, and active social engagements reduced the risk of cognitive decline. The identified risk factors could facilitate the development of cognitive decline-prevention programs incorporating individualized risk-modification interventions to prevent cognitive decline in older adults.
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Affiliation(s)
- Jinhee Shin
- College of Nursing, Woosuk University, Jeollabuk-do, Republic of Korea
| | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea.
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Kim MJ, Fritschi C, Cho E. SYMPTOMS CONTRIBUTING TO SLEEP PROBLEMS IN OLDER ADULTS WITH TYPE 2 DIABETES. Innov Aging 2022. [PMCID: PMC9770485 DOI: 10.1093/geroni/igac059.1775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Sleep problems are common in older adults. Those with diabetes are more vulnerable to sleep disorders since diabetes-specific symptoms can interfere with sleep quality. Yet little is known which diabetes symptoms most strongly affect sleep in older adults. This study aimed to examine the associations between diabetes symptoms and sleep and to identity the symptoms that most strongly disrupt sleep in older adults in the United States. Diabetes symptoms were assessed using the Diabetes Symptom Checklist-Revised. Sleep impairment and sleep disturbance were self-reported using The Patient-Reported Outcomes Measurement Information System. Demographic (age, sex, race/ethnicity) and other variables (body mass index, depressive symptoms, diabetes duration, glycemic control) were also assessed. Multivariate regression analyses were used with standardized coefficients. A total of 82 adults aged ≥ 60 years were included (mean age = 68.32 ± 5.29 years, White 76.83%, female 56.1%). After controlling for demographic and other variables, increased hypoglycemia (β = .35), hyperglycemia (β = .38), fatigue (β = .65), cognitive (β = .48), and ophthalmologic (β = .25) symptoms and neurological pain (β = .42) significantly increased sleep impairment. Of these, fatigue was the strongest contributor to sleep impairment. Similarly, increased hyperglycemia symptoms (β = .30), fatigue (β = .34), and neurological pain (β = .37) significantly increased sleep disturbance while neurological pain was the strongest contributor. To improve sleep quality of older adults with diabetes, their diabetes symptoms should be comprehensively assessed, and potential contributor to poor sleep such as increased fatigue and neurological pain should be addressed.
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Affiliation(s)
- Min Jung Kim
- College of Nursing, Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Cynthia Fritschi
- University of Illinois Chicago, Chicago, Illinois, United States
| | - Eunhee Cho
- College of Nursing, Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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Lee JY, Cho E, Kim S, Kim GS, Lee KH, Kim CO. DEVELOPMENT OF A TRANSITIONAL CARE PROGRAM FOR FRAIL OLDER ADULTS BETWEEN HOSPITAL AND HOME. Innov Aging 2022. [PMCID: PMC9766503 DOI: 10.1093/geroni/igac059.2123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Frail older adults particularly need transitional care between hospital and home due to physical function decline and psychological instability after discharge. This study aimed to develop a transitional care for frail older adults in Korea who are discharged home following hospitalization. The Returning Home (Rehome©) program was established through the three phases according to the Medical Research Council’s 2013 guidelines. 1) Identifying the evidence base phase included a systematic review of literature and needs assessments from interviews with frail older adults. The core intervention components (e.g., geriatric assessment, transitional care planning, home visits, phone follow-up, community service liaison, and family engagement) were determined. 2) At the phase of identifying theory, the transition theory was selected and modified to fit the target population in the context of the Korean healthcare system. 3) Phase three was for the modeling process and outcomes. Based on the result from phases 1 and 2, the Rehome program was developed considering clinically applicable strategies. The final Rehome program consisted of a comprehensive geriatric assessment at admission; structured discharge/transitional care planning (e.g., medication review, education for chronic disease management, emergencies, and geriatric syndromes, and community resource) at discharge; a home visit and six phone follow-up calls up to 12 weeks after discharge; and emotional support and engagement of the family during the entire period. The Rehome program showed good content validity. The Rehome as a frailty-focused transitional care program could improve the transition through implementing a tailored intervention that meets the care needs of these vulnerable populations.
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Affiliation(s)
- Ji Yeon Lee
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Eunhee Cho
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Sue Kim
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Gwang Suk Kim
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Kyung Hee Lee
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Chang Oh Kim
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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Jang J, Lee SH, Cho E. THE ASSOCIATION OF LIFESTYLE AND SOCIAL ENGAGEMENT WITH DEMENTIA: A NATIONWIDE POPULATION-BASED COHORT STUDY. Innov Aging 2022. [DOI: 10.1093/geroni/igac059.2791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
As the aging population increases, the number of people with dementia is expected to rise rapidly, resulting in a growing burden on families and society. Delaying and preventing the clinical onset of dementia are significant public health goals. Unhealthy lifestyles and social disengagement have been identified to be modifiable risk factors for all-cause dementia. However, this has not been fully examined in the Korean population. Therefore, this study aimed to determine the association of lifestyle and social engagement with dementia incidence, based on the Korean Longitudinal Study on Aging (KLoSA) database with recently added dementia-related variables (diagnosis, medication administration, and treatment). The study included 5,071 participants; cases are patients diagnosed with dementia from 2010 to 2020 and controls are older adults without dementia. Logistic regression analysis was used to examine the relationship of dementia with lifestyle factors (alcohol consumption, smoking, exercising) and social engagement. Among the lifestyle factors, the current smoking status was associated with an increased risk of dementia (OR = 2.359, p < .05) after controlling the health-related covariates and general characteristics. Furthermore, increased participation in social activities was significantly related with a decreased risk of dementia (OR = 0.575, p < .01). This study highlighted the importance of non-smoking and social engagement in reducing the risk of dementia in later life. Therefore, implementation of interventions that focus on these leading risk factors can significantly reduce the burden of dementia in Korea.
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Affiliation(s)
- Jiyoon Jang
- College of Nursing, Yonsei University , Seoul, Seoul-t’ukpyolsi , Republic of Korea
| | - Sang Hwa Lee
- College of Nursing, Yonsei University , Seoul, Seoul-t’ukpyolsi , Republic of Korea
| | - Eunhee Cho
- College of Nursing, Yonsei University , Seoul, Seoul-t’ukpyolsi , Republic of Korea
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Cho E, Yoon Y, Choi S, Kim E. EFFECTS OF SPECIAL NURSING UNITS IN NURSING HOMES: FOCUSING ON HEALTH OUTCOMES AND SATISFACTION. Innov Aging 2022. [DOI: 10.1093/geroni/igac059.2034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
This quasi-experimental study aimed to evaluate the effectiveness of special nursing units in nursing homes by comparing health outcomes and satisfaction between the general nursing units and special nursing units across nursing homes in South Korea. Surveys—paper, phone, and online—were conducted five times (March, August, and November 2019; June and October 2020) for health outcomes (health pattern changes and the number of residents with new health problems) and four times (March and August–November 2019; June and October 2020) for satisfaction. Descriptive analysis, χ²-test, paired t-test, and McNemar test were performed using the SPSS 25.0 program. The results showed an improvement in the health outcomes of residents in the special nursing units. Regarding health pattern changes, there was a decrease in the number of residents facing problems related to consciousness, cardiovascular function, urination, defecation, and pain and of those with new health problems such as aches, falls, pressure sores, and urinary incontinence. Furthermore, caregivers’ satisfaction in the special nursing units was higher than that of their counterparts in the general nursing units. The results of this study will be used as evidence to expand this special nursing unit’s services in the future.
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Affiliation(s)
- Eunhee Cho
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - YeaSeul Yoon
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Seonhwa Choi
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Eunkyo Kim
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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Kim MJ, Fritschi C, Cho E. FACTORS ASSOCIATED WITH SUBJECTIVE COGNITIVE FUNCTION IN OLDER ADULTS WITH TYPE 2 DIABETES. Innov Aging 2022. [PMCID: PMC9766330 DOI: 10.1093/geroni/igac059.2087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Subjective cognitive decline (SCD) could be an indicator of future cognitive impairment in older adults. Diabetes is a well-known risk factor of cognitive impairment, but little is known whether sleep and psychological problems common in older adults with diabetes can contribute to SCD. The study aimed to investigate whether self-reported sleep (sleep impairment and disturbance) and psychological problems (depressive symptoms and diabetes distress) were associated with subjective cognitive function in adults aged ≥ 60 years with type 2 diabetes. Sleep, depressive symptoms, and subjective cognitive function were self-reported using The Patient-Reported Outcomes Measurement Information System. Diabetes distress was assessed using the Diabetes Distress Scale. Covariates (age, sex, race/ethnicity, body mass index, and diabetes duration) were self-reported, and glycemic control (A1c) was measured using a fingerstick test kit. A total of 82 older adults were included (mean age = 68.32 ± 5.29 years, White 76.83%, female 56.1%). Multivariate regression analyses revealed that, after controlling for covariates and A1c, increased sleep impairment was associated with increased concerns on cognitive function reported by older adults (r = -.47, β = -.56). Increased depressive symptoms were also associated with decreased cognitive function perceived by older adults (r = -.44, β = -.47). Sleep disturbance and diabetes distress were not associated with subjective cognitive function. Sleep impairment and depressive symptoms were the two strongest predictors affecting subjective cognitive function. Improving sleep quality and addressing depressive symptoms could be an effective strategy to prevent SCD and potentially delay severe cognitive impairment in older adults with diabetes.
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Affiliation(s)
- Min Jung Kim
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Cynthia Fritschi
- University of Illinois Chicago, Chicago, Illinois, United States
| | - Eunhee Cho
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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Min D, Cho E, Kim GS, Lee KH, Yoon JY, Kim HJ, Choi MH. Factors associated with retention intention of Registered Nurses in Korean nursing homes. Int Nurs Rev 2022; 69:459-469. [PMID: 35413132 PMCID: PMC9790496 DOI: 10.1111/inr.12754] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/08/2022] [Indexed: 12/30/2022]
Abstract
AIM To identify the factors associated with retention intention among Registered Nurses in South Korean nursing homes. BACKGROUND Although nurses are not mandatory personnel, Korean nursing homes employ Registered Nurses. INTRODUCTION Determining the factors related to Registered Nurses' retention intention is important for their job stability and ensure provision of quality care. METHODS This mixed-methods study employed a sequential explanatory design. A self-reported questionnaire survey was conducted between May 1 and July 3, 2019, with 155 Registered Nurses providing direct care from 37 nursing homes. In-depth qualitative interviews were conducted with 10 participants from August 1 to September 30, 2019. Data were analyzed using multilevel analysis for quantitative study and thematic analysis for qualitative study. RESULTS The participants' average age was 48.48 years. Personal factors related to retention intention were Registered Nurses' role, educational level, and job satisfaction. Institutional factors were ownership, number of beds, and working environment. The qualitative study revealed five themes: "Satisfaction with meaningful relationships," "Potential for professional growth," "Nursing service accompanied by emotional labor," "Poor working environments in nursing homes," and "Unprotected nursing expertise." DISCUSSION A nursing home's work environment is related to the Registered Nurses' retention intention. Most Registered Nurses in Korea received low wages, lacked access to career management programs, and experienced emotional labor. CONCLUSION This study highlighted the personal and institutional factors related to retention intention among Registered Nurses in South Korean nursing homes. IMPLICATIONS FOR NURSING AND NURSING POLICY A law that designates Registered Nurses as an essential nursing home workforce is required. Further, nursing homes should increase the number of Registered Nurses to improve working conditions and thereby job satisfaction. It is also necessary to foster a working environment that facilitates professional development opportunities and job clarity.
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Affiliation(s)
- Deulle Min
- Department of NursingCollege of MedicineWonkwang UniversityIksanRepublic of Korea
| | - Eunhee Cho
- Mo‐Im Kim Nursing Research InstituteYonsei University College of NursingSeoulRepublic of Korea
| | - Gwang Suk Kim
- Mo‐Im Kim Nursing Research InstituteYonsei University College of NursingSeoulRepublic of Korea
| | - Kyung Hee Lee
- Mo‐Im Kim Nursing Research InstituteYonsei University College of NursingSeoulRepublic of Korea
| | - Ju Young Yoon
- College of Nursing and Research Institute of Nursing ScienceSeoul National UniversitySeoulRepublic of Korea
| | - Hyun Joo Kim
- Yonhee Seniors Nursing HomeSeoulRepublic of Korea
| | - Moon Hee Choi
- Korea Social Science Data Archive at Asia Center Seoul National UniversitySeoulRepublic of Korea
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Burgess BL, Cho E, Honigberg L. Neurofilament light as a predictive biomarker of unresolved chemotherapy-induced peripheral neuropathy in subjects receiving paclitaxel and carboplatin. Sci Rep 2022; 12:15593. [PMID: 36114333 PMCID: PMC9481642 DOI: 10.1038/s41598-022-18716-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 08/18/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractManagement of chemotherapy-induced peripheral neuropathy (CIPN) remains a significant challenge in the treatment of cancer. Risk mitigation for CIPN involves preemptive reduction of cumulative dose or reduction of dose intensity upon emergence of symptoms, despite the risk of reduced tumor efficacy. A predictive biomarker for dose-limiting CIPN could improve treatment outcomes by allowing providers to make informed decisions that balance both safety and efficacy. To identify a predictive biomarker of CIPN, markers of neurodegeneration neurofilament-light (NfL), glial fibrillary acidic protein (GFAP), tau and ubiquitin c-terminal hydrolase L1 (UCHL1) were assessed in serum of up to 88 subjects drawn 21 days following the first of 6 treatments with chemotherapeutics paclitaxel and carboplatin. Serum NfL and GFAP were increased with chemotherapy. Further, NfL change predicted subsequent onset of grade 2–3 CIPN during the remainder of the trial (mean treatment duration = 200 days) and trended toward stronger prediction of CIPN that remained unresolved at the end of the study. These results confirm previous reports that serum NfL is increased in CIPN and provide the first evidence that NfL can be used to identify subjects susceptible to dose-limiting paclitaxel and carboplatin induced CIPN prior to onset of symptoms.
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Cho E, Tugendrajch SK, McMillen JC, Proctor EK, Hawley KM. Implementation of Evidence-Based Practices within Treatment-As-Usual and Evidence-Based Practice Initiatives. Adm Policy Ment Health 2022; 49:757-784. [PMID: 35501585 PMCID: PMC11003240 DOI: 10.1007/s10488-022-01197-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2022] [Indexed: 11/25/2022]
Abstract
Publicly funded initiatives are underway to improve implementation of evidence-based practices (EBP) in youth mental health services. However, we know little about the success of these initiatives or about EBP implementation independent of such initiatives. We examined EBP implementation in a treatment as usual (TAU) state and in six states with publicly funded EBP initiatives (EBPIs). In Study 1, we examined providers' use of practices derived from the evidence base (PDEB) and their predictors among 780 providers in a TAU state. In Study 2, we conducted a systematic review of implementation strategies, outcomes, and predictors of EBP use in six state funded EBPIs. Study 1 suggests TAU providers use PDEB alongside practices without consistent research support; provider racial/ethnic minority status, learning theory orientation, and manual use predict greater PDEB use. Study 2 indicates EBPIs employ multiple recommended implementation strategies with variable outcomes across studies and measurement approaches. Predictors of EBP use in EBPIs also varied, though training, setting, and youth age were consistent predictors across studies. While sample differences and inconsistent measurement across studies made direct comparisons somewhat tenuous, rates of PDEB use in the TAU sample appeared similar to those in publicly funded EBPIs. However, two states reported comparisons with TAU samples and found higher EBP implementation under EBPI. Different predictors impacted EBP use in TAU versus EBPIs. Our findings highlight the need for improved evaluation of EBPIs including clear reporting standards for outcomes and more consistent, standardized measurement of EBP use in order to better understand and improve EBPIs.
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Affiliation(s)
- E Cho
- Harvard University, 33 Kirkland St, Cambridge, MA, 02138, USA
| | - S K Tugendrajch
- University of Missouri, 200 South 7th Street, Columbia, MO, 65211, USA
| | - J C McMillen
- University of Chicago, 969 E. 60th Street, Chicago, IL, 60637, USA
| | - E K Proctor
- Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - K M Hawley
- University of Missouri, 204C McAlester Hall, Columbia, MO, 65211, USA.
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Cho E, Cha HG. P01-01 Allergic respiratory diseases linked with AOP caused by chemicals in the workplace. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Lee J, Lee TR, Kim G, Ahn J, Park S, Song KB, Jun E, Oh D, Lee JW, Park Y, Song GW, Byeon JS, Kim B, Lee J, Kim D, Ki CS, Cho E, Choi J. 916P Deep learning-based multimodal ensemble algorithm for multi-cancer detection and classification using cf-WGS. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Kumar R, Kim S, Zhong D, Lu S, Cheng Y, Chen M, Cho E, Clay T, Kang JH, Lee GW, Sun M, Shim BY, Spigel D, Yang TY, Wang Q, Chang GC, Yu G, Wang R, Luo X, Zheng H, Gao R, Kim H. EP08.01-073 AdvanTIG-105: Phase 1b Dose-Expansion Study of Ociperlimab plus Tislelizumab in Patients with Metastatic NSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tran M, Moseley I, George E, Cho E. 691 Psoriasis and psoriatic arthropathy in diverse U.S. adult cohort: All of us research program. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ahmed F, Lim R, Moseley I, Hoang M, Wisco O, Robinson-Bostom L, Qureshi A, Cho E. 227 Socioeconomic predictors of melanoma Breslow thickness at a Rhode Island academic center. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Lee Y, Cho E. Correction: Predictors of patient safety activities among registered nurses and nurse aides in long-term care facilities: cross-sectional study. BMC Geriatr 2022; 22:600. [PMID: 35854229 PMCID: PMC9297650 DOI: 10.1186/s12877-022-03264-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Youran Lee
- Duke University School of Nursing, 307 Trent Drive, Durham, NC, 27710, USA
| | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1 Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, South Korea.
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Hong J, Cho E, Kim H, Lee W, Chun S, Min W. M104 Application and modification of reference change values for delta checks in clinical laboratory. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Shin J, Cho E. Trajectories of depressive symptoms among community-dwelling Korean older adults: findings from the Korean longitudinal study of aging (2006-2016). BMC Psychiatry 2022; 22:246. [PMID: 35395760 PMCID: PMC8991942 DOI: 10.1186/s12888-022-03905-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 04/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression among older adults is an important public health concern associated with increased risk of suicide and decreased physical, cognitive, and social functioning. This study identified trajectories of depressive symptoms and investigated predictive variables of group-based trajectory modeling among Korean community-dwelling older adults. METHODS Participants comprised 2016 community-dwelling Korean adults over 65 years. Data from the years 2006-2016 of the Korean Longitudinal Study of Aging, a nationally representative panel survey that has been conducted every two years since 2006, were used. We employed a group-based trajectory modeling analysis to identify depressive symptom trajectories. Multinomial logistic regression analysis was conducted to identify predictors of each class of depressive symptoms. RESULTS Five depressive symptom trajectory groups were identified: Group 1, "None" (28.9%); Group 2, "Slowly worsening" (24.3%); Group 3, "Rapidly worsening" (17.5%); Group 4 "Improving" (12.4%); and Group 5, "Persistently severe" (16.9%). Older adults followed five distinct depressive symptom trajectories over 10 years. Mini-Mental State Examination scores, number of chronic diseases, educational level, and social activity were predictors associated with increasing depressive symptoms. CONCLUSIONS This study showed that many older adults living in the community have depressive symptoms. To prevent and treat depression and aid successful mental health aging among older adults, the development of interventions should be tailored to target specific needs for each symptom trajectory. It is necessary to develop community-based interventions and strategies to identify and prevent depressive symptom trajectories among older adults.
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Affiliation(s)
- Jinhee Shin
- grid.15444.300000 0004 0470 5454Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 606 Nursing Education Building, 50-1 Yonsei-ro, Seodaemoon-Gu, Seoul, 03722 Republic of Korea
| | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 606 Nursing Education Building, 50-1 Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, Republic of Korea.
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Ryu K, Baek H, Skare S, Cho E, Nam I, Kim T, Sprenger T. Clinical Feasibility of Ultrafast Contrast-Enhanced T1-Weighted 3D-EPI for Evaluating Intracranial Enhancing Lesions in Oncology Patients: Comparison with Standard 3D MPRAGE Sequence. AJNR Am J Neuroradiol 2022; 43:195-201. [PMID: 35027347 PMCID: PMC8985684 DOI: 10.3174/ajnr.a7391] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/29/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE Contrast-enhanced 3D T1WI is a preferred sequence for brain tumor imaging despite the long scan time. This study investigated the clinical feasibility of ultrafast contrast-enhanced T1WI by 3D echo-planar imaging compared with a standard contrast-enhanced 3D MPRAGE sequence for evaluating intracranial enhancing lesions in oncology patients. MATERIALS AND METHODS Sixty-one patients in oncology underwent brain MR imaging including both contrast-enhanced T1WI, 3D-EPI and 3D MPRAGE, in a single examination session for evaluating intracranial tumors. Two neuroradiologists evaluated image quality, lesion conspicuity, diagnostic confidence, number and size of the lesions, and contrast-to-noise ratio measurements from the 2 different sequences. RESULTS Ultrafast 3D-EPI T1WI did not reveal significant differences in diagnostic confidence, contrast-to-noise ratiolesion/parenchyma, and the number of enhancing lesions compared with MPRAGE (P > .05). However, ultrafast 3D-EPI T1WI revealed inferior image quality, inferior anatomic delineation and greater susceptibility artifacts with fewer motion artifacts than images obtained with MPRAGE. The mean contrast-to-noise ratioWM/GM and visual conspicuity of the lesion on ultrafast 3D-EPI T1WI were lower than those of MPRAGE (P < .001). CONCLUSIONS Ultrafast 3D-EPI T1WI showed comparable diagnostic performance with sufficient image quality and a 7-fold reduction in scan time for evaluating intracranial enhancing lesions compared with standard MPRAGE, even though it was limited by an inferior image quality and frequent susceptibility artifacts. Therefore, we believe that ultrafast 3D-EPI T1WI may be a viable option in oncology patients prone to movement during imaging studies.
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Affiliation(s)
- K.H. Ryu
- From the Departments of Radiology (K.H.R., H.J.B., E.C., I.C.N.)
| | - H.J. Baek
- From the Departments of Radiology (K.H.R., H.J.B., E.C., I.C.N.),Department of Radiology (H.J.B.), Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - S. Skare
- Department of Neuroradiology (S.S.),Clinical Neuroscience (S.S., T.S.), Karolinska Institute, Stockholm, Sweden
| | - E. Cho
- From the Departments of Radiology (K.H.R., H.J.B., E.C., I.C.N.)
| | - I.C. Nam
- From the Departments of Radiology (K.H.R., H.J.B., E.C., I.C.N.)
| | - T.H. Kim
- Internal Medicine (T.H.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - T. Sprenger
- Clinical Neuroscience (S.S., T.S.), Karolinska Institute, Stockholm, Sweden,MR Applied Science Laboratory Europe (T.S.), GE Healthcare, Stockholm, Sweden
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June Choe Y, Yi S, Hwang I, Kim J, Park YJ, Cho E, Jo M, Lee H, Hwa Choi E. Safety and effectiveness of BNT162b2 mRNA Covid-19 vaccine in adolescents. Vaccine 2022; 40:691-694. [PMID: 35012777 PMCID: PMC8702409 DOI: 10.1016/j.vaccine.2021.12.044] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/16/2021] [Accepted: 12/18/2021] [Indexed: 01/25/2023]
Abstract
In South Korea, all 12th grade students (highs school seniors) were offered BNT162b2 vaccine starting July 19, 2021; while 10th-11th grade students were not eligible. We conducted a nationwide retrospective cohort study by to determine the safety and effectiveness of BNT162b2 mRNA Covid-19 vaccine in adolescents against SARS-CoV-2 infection. Among 444,313 persons who received the first dose of vaccine, reporting rate for myocarditis and/or pericarditis was 1.8 per 100,000 (95% C.I. 0.8-3.5) among first-dose recipients and 4.3 per 100,000 (95% C.I. 2.6-6.7) in second-dose recipients. Vaccine effectiveness against symptomatic/asymptomatic SARS-CoV-2 infection 14 days post-first dose vaccination was 91.1% (95% C.I. 89.6-92.5), and 14 days post-second dose was 99.1% (95% C.I. 98.5-99.5). In this retrospective cohort study, BNT162b2 vaccination was safe and was associated with a significantly lower risk of SARS-CoV-2 infection, suggesting that vaccination in adolescent may reduce the burden of Covid-19.
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Affiliation(s)
| | - Seonju Yi
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Insob Hwang
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Jia Kim
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Young-Joon Park
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Eunhee Cho
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | | | - Hyunju Lee
- Seoul National University College of Medicine, Seoul, Korea
| | - Eun Hwa Choi
- Seoul National University College of Medicine, Seoul, Korea,Corresponding author at: Professor of Pediatrics, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-769, Korea
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Cho E, Kim S, Heo SJ, Shin J, Ye BS, Lee JH, Kang B. Machine Learning-Based Predictive Models of Behavioral and Psychological Symptoms of Dementia. Innov Aging 2021. [PMCID: PMC8681298 DOI: 10.1093/geroni/igab046.2446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Models predicting the occurrence of specific types of behavioral and psychological symptoms of dementia (BPSD) can be highly beneficial for its early intervention and individualized care planning. Using a machine learning approach, this study developed and validated predictive models of the occurrence of BPSD, categorized into seven subsyndromes, among community-dwelling older adults with dementia in South Korea. BPSD dairy was used to measure BPSD and the state of unmet needs daily. We measured sleep and activity levels using actigraphy, and stress and fatigue using a portable heart rate variability analyzer. We developed predictive models and conducted cross-validation using training data that consisted of the first two wave dataset, and then validated the models using wave 3 test data. To deal with imbalanced datasets, we used Synthetic Minority Oversampling Technique (SMOTE), an over-sampling method. Categorical variables were pre-processed using target encoding. We then compared the machine-learning models with logistic regression. The area under the receiver operating characteristic curve (AUC) scores of the support vector machine (SVM) models for the wave 3 test data showed a similar or greater value than logistic regression models across all BPSD subsyndromes. The SVM model (AUC = 0.899) had an AUC value greater than that of the logistic regression model (AUC = 0.717), particularly for hyperactivity symptoms. Machine learning algorithms, especially SVM models, can be used to develop BPSD prediction models to help identify at-risk individuals and implement symptom-targeted individualized interventions.
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Affiliation(s)
- Eunhee Cho
- Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Sujin Kim
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Seok-Jae Heo
- Yonsei University Graduate School, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Jinhee Shin
- Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Byoung Seok Ye
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Jun Hong Lee
- National health insurance service Ilsan hospital, Goyang, Kyonggi-do, Republic of Korea
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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Lee JY, Yang YS, Cho E. Effectiveness of Transitional Care from Hospital to Home in Frail Older Adults: A Systematic Review. Innov Aging 2021. [PMCID: PMC8681478 DOI: 10.1093/geroni/igab046.2995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Frail older adults are at high risk of negative consequences from hospitalization and are discharged without completely returning to their pre-existing health status. Transitional care is needed to maintain care continuity from hospital to home. This systematic review aimed to examine transitional care for frail older adults and its effectiveness. The Cochrane guidelines were followed, and search terms were determined by PICO: (P) frail older adults, not disease-specified; (I) transitional care initiated before discharge; (C) usual care; and (O) all health outcomes. Four databases were searched for English-written randomized controlled trials (inception to 2020), and eight trials were ultimately included. Frail older adults in eight trials (1996–2019) totaled 2,785, with a mean sample size of 310. The intervention components varied from hospital care (e.g., geriatric assessment, discharge planning, rehabilitation) to follow-up care after discharge (e.g., home visit, phone follow-up, community service). Most measured outcomes were readmission (n = 7), function (n = 4), quality of life (n = 4), self-rated health (n = 3), and mortality (n = 3). Statistical significance was reported in the following number of trials: readmission (n = 2), function (n = 2), quality of life (n = 1), self-rated health (n = 3), and mortality (n = 0). The effectiveness of the intervention on each outcome was inconsistent across the trials. Varied transitional care between hospital and home was implemented to improve health status; however, its effectiveness was controversial. A novel, yet evidence-based approach is needed to develop transitional care interventions for these vulnerable populations.
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Affiliation(s)
- Ji Yeon Lee
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Yong Sook Yang
- Yonsei University, Kwangju, Kwangju-jikhalsi, Republic of Korea
| | - Eunhee Cho
- Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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Kang B, Cho E, Oh S. Social Disengagement and Cognitive Function: Does the Association Vary by Gender? Innov Aging 2021. [PMCID: PMC8969823 DOI: 10.1093/geroni/igab046.2614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Although social disengagement is considered to be a predictor of cognitive decline, and increase risk of Alzheimer’s and related dementias, little is known regarding the gender-specific association between social disengagement and cognition among Korean middle-aged and older adults. Korea’s Confucianism-based gender roles provide unique contexts to examine gender differences in the influence of social disengagement on cognition. This study investigated the association between social disengagement and cognitive function in a nationally representative sample of Koreans aged 45 years or older (N = 5,196 women and 2,707 men), using data from the Korean Longitudinal Study of Aging (2008-2018). Results from the generalized estimating equation model showed that compared to consistent social engagement, consistent non-engagement was significantly associated with lower cognitive function among both genders. Transitioning from social engagement to non-engagement was significant for males only. Of various types of social activities (religious, senior center, sport, reunion, voluntary, political), consistent non-engagement in a senior center was most associated with lower cognitive function among both genders, while consistent non-engagement in religious activities was significant for females only. While household arrangements were not associated with cognition in men, widowed women had increased risk of cognitive decline than married women, as did women living in households of three or more people. Depression was a predictor of cognitive decline among males only. In this gender-specific study, we found that consistent participation in social activities, especially via membership in a senior community center, is beneficial in preventing cognitive decline among both genders.
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Affiliation(s)
- Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Eunhee Cho
- Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Sarah Oh
- Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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Shin J, Cho E, Kim GS, Kim H, Ye BS, Pack CG. Development and Evaluation of Treatment Adherence Interventions for Older Adults With MCI Using IoT Devices. Innov Aging 2021. [PMCID: PMC8681551 DOI: 10.1093/geroni/igab046.2600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
For older adults with mild cognitive impairment (MCI), treatment adherence is essential to prevent and delay dementia. Older adults with MCI should maintain treatment for chronic diseases, exercise regularly, and adhere to treatment to maintain health status. There is a lack of comprehensive interventions to promote treatment adherence (medication adherence and physical activity) for older adults with MCI. The purpose of this study was to develop an internet of things (IoT)-based real-time treatment adherence for old adults with MCI and examine the effectiveness of the program. This study was a randomized controlled trial. The patients were enrolled from the neurology outpatient department clinic at a hospital in Korea. The subjects were 18 in the experimental group and 20 in the control group. This study intervention was IoT-based medication adherence device and real-time monitoring sever plus wrist wearable device. The study consists of a 10-week intervention period. The intervention program was provided for only the experimental group and the control group with a wearable device and usual care. Assessments were conducted at baseline, 6 weeks, and 10-weeks. A mixed-effects model was used in the analysis to evaluate the program. The IoT-based treatment adherence intervention was effective in improving medication adherence over time (β =11.465, p<.001), physical activity (K-PASE) (β =27.376, p<.001) and average the number of steps per week (β=3202.53, p<.001). Health care providers can use this program to improve treatment adherence for chronic disease management and dementia prevention of older adults with cognitive impairment.
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Affiliation(s)
- Jinhee Shin
- Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Eunhee Cho
- Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Gwang Suk Kim
- Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Heejung Kim
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Byoung Seok Ye
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Chang-Gi Pack
- University of Illinois at Chicago, Seoul, Illinois, United States
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Shin J, Cho E, Kang B, Kim S, Hwang S, Kwon E, Heo SJ. Risk Factors of Sleep Disturbance in Older Adults With Dementia: An Actigraphy-Based Validation Study. Innov Aging 2021. [PMCID: PMC8681196 DOI: 10.1093/geroni/igab046.2467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Sleep disturbance is a common and significant symptom experienced by older adults with dementia. Early detection and timely treatment of sleep disturbance are critical to prevent adverse consequences including decreased quality of life for persons with dementia and increased caregiver burden. While direct observations and sleep diaries are often unreliable, actigraphy is a cost-effective method in measuring sleep problems in older adults with dementia and provides reliable and rich sleep data. Therefore, this study aimed to examine sleep disturbance objectively measured by actigraphy and its risk factors in community-dwelling older adults with dementia in Korea. This is a prospective study consisting of a two-wave dataset. The model was fitted using Wave 1 data (n=151) and then validated using Wave 2 data (n=59). Independent variables were demographics, cognitive and physical function, depressive symptoms, physical activity level, and neuropsychiatric symptoms measured by Neuropsychiatric Inventory(NPI), and clinical factors including dementia type, sedative use, and comorbidities. Sleep disturbance was defined as less than six nighttime sleep hours and sleep efficacy less than 75%. Using the Youden’s Index, the sample was dichotomized into sleep disturbance group (n=83) and sound sleep group (n=68). The results of the generalized linear mixed model showed that the risk factors for sleep disturbance included vascular dementia, age, step count, and having three neuropsychiatric symptoms (i.e., delusions, depression, and disinhibition). Individuals with dementia at risk for sleep disturbance should be identified to prioritize early prevention strategies and individualized interventions. Particularly, management of delusion, depression, disinhibition is critical in preventing disturbed sleep.
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Affiliation(s)
- Jinhee Shin
- Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Eunhee Cho
- Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Sujin Kim
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Sinwoo Hwang
- Korea Armed Forces Nursing Academy, Daejeon, Taejon-jikhalsi, Republic of Korea
| | - Eunji Kwon
- Korea Armed Forces Nursing Academy, Daejeon, Taejon-jikhalsi, Republic of Korea
| | - Seok-Jae Heo
- Yonsei University Graduate School, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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Kang B, Cho E, Kim S, Hwang S, Kwon E, Heo SJ, Lee JH, Ye BS. Predictors of Behavioral and Psychological Symptoms in Community-Dwelling Older Adults With Dementia. Innov Aging 2021. [PMCID: PMC8681596 DOI: 10.1093/geroni/igab046.2449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Although disclosing the predictors of different behavioral and psychological symptoms of dementia (BPSD) is the first step in developing person-centered interventions, the current understanding is limited as it considers BPSD as a homogenous construct, not accounting for its heterogeneity. Therefore, this study explored the predictors of BPSD subsyndromes, and built prediction models for these subsyndromes in community-dwelling older adults with dementia in Korea. This prospective study consisted of a two-wave dataset. We fit the generalized linear mixed models using Wave 1 data (N = 145) and then validated them using Wave 2 data (N = 59). BPSD and their proximal factors were assessed on a daily basis using diaries written by family caregivers. Sleep and activity levels were objectively measured using actigraphy. The amount of nighttime sleep hours was significantly associated with next-day sleep and nighttime behaviors (OR = 0.87; p = 0.005), with the amounts of energy expenditure showing significant association with euphoria/elation (OR = 0.02; p = 0.019). All subsyndromes except euphoria/elation were found to be significantly associated with either hunger, thirst, urination, or bowl movement; with all BPSD showing a significant association with environmental changes. We also found several background factors, including premorbid personality and taking sedatives as predictors for specific subsyndromes. The area under the receiver operating characteristic curve scores for the data were greater than 0.9 and 0.8 in Waves 1 and 2, respectively, across all subsyndromes. Prediction models for BPSD will help in the development of symptom-targeted, individualized interventions.
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Affiliation(s)
- Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Eunhee Cho
- Yonsei University College of Nursing, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Sujin Kim
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Sinwoo Hwang
- Korea Armed Forces Nursing Academy, Daejeon, Taejon-jikhalsi, Republic of Korea
| | - Eunji Kwon
- Korea Armed Forces Nursing Academy, Daejeon, Taejon-jikhalsi, Republic of Korea
| | - Seok-Jae Heo
- Yonsei University Graduate School, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Jun Hong Lee
- National health insurance service Ilsan hospital, Goyang, Kyonggi-do, Republic of Korea
| | - Byoung Seok Ye
- Yonsei University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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Seok JW, Shin J, Kang B, Lee H, Cho E, Lee KH. Non-pharmacological interventions using information and communication technology for behavioral and psychological symptoms of dementia: A systematic review and meta-analysis protocol. J Adv Nurs 2021; 78:282-293. [PMID: 34812533 DOI: 10.1111/jan.15109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 11/27/2022]
Abstract
AIM To review and examine the effectiveness of non-pharmacological interventions on behavioural and psychological symptoms of dementia using information and communication technology. DESIGN This is a systematic review and meta-analysis. METHODS The databases including PubMed, CINAHL with Full Text (EBSCOhost), PsycINFO, Embase, and the Cochrane Library will be searched for all published studies. Studies will be screened and selected with criteria described in PICOS format. Risk of bias will be assessed by the National Institute for Health and Clinical Excellence checklist. Data will be extracted from eligible studies and used to perform a meta-analysis examining the overall effects and effects on individual outcomes. Additionally, we will conduct meta-regression to examine the association between explanatory variables and behavioural and psychological symptoms. This study has been funded since June 2020. DISCUSSION This study will be the first to reveal the effects of non-pharmacological interventions using information and communication technology on behavioural and psychological symptoms of dementia. Furthermore, this study will provide updated and valid evidence of interventions using this for managing behavioural and psychological symptoms of dementia. IMPACT Although non-pharmacological interventions using information and communication technology for older adults living with dementia are continuously developing, their direct effect remains unclear. This study will evaluate the effectiveness of these interventions on behavioural and psychological symptoms of dementia and provide the evidence to implement these interventions among older adults living with dementia. Thus, caregivers and nursing staff can manage behavioural and psychological symptoms of dementia more effectively by incorporating information and communication technology.
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Affiliation(s)
- Jo Woon Seok
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Jinhee Shin
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Bada Kang
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Hyangkyu Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Eunhee Cho
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Kyung Hee Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
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Lee JY, Yang YS, Cho E. Transitional care from hospital to home for frail older adults: A systematic review and meta-analysis. Geriatr Nurs 2021; 43:64-76. [PMID: 34823079 DOI: 10.1016/j.gerinurse.2021.11.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 11/04/2022]
Abstract
Frail older adults are vulnerable to hospitalization and transitional care is needed to maintain care continuity; however, there exists no review regarding transitional care focusing on frailty. This study aimed to investigate transitional care for frail older adults and its effectiveness. Search terms were (P) frail older adults; (I) transitional care initiated before discharge; (C) usual care; (O) all health outcomes. Fourteen trials were identified. The most measured outcome was readmission (n = 13), followed by mortality (n = 9), function (n = 7), quality of life (n = 5), and self-rated health (n = 5). Statistical significance effects were reported in the followings: n = 6, readmission; n = 0, mortality; n = 3, function; n = 2, quality of life; and n = 4, self-rated health. The meta-analysis demonstrated that transitional care reduced readmission at six months but not other time points nor mortality or quality of life. The intervention effectiveness was inconclusive; therefore, an evidence-based yet novel approach is necessary to establish an adequate transitional care intervention for frail older adults.
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Affiliation(s)
- Ji Yeon Lee
- Yonsei University College of Nursing, Seoul, 03722, South Korea
| | - Yong Sook Yang
- Yonsei University College of Nursing, Seoul, 03722, South Korea
| | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, 03722, South Korea.
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Choi S, Cho E, Kim E, Lee K, Chang SJ. Effects of registered nurse staffing levels, work environment, and education levels on adverse events in nursing homes. Sci Rep 2021; 11:21458. [PMID: 34728676 PMCID: PMC8563772 DOI: 10.1038/s41598-021-00946-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
This study examined the effects of nurse staffing levels, work environment, and education levels on adverse events in nursing homes. A cross-sectional study was conducted involving 216 nurses working in 62 nursing homes in South Korea, using self-reported questionnaires and data from the National Health Insurance Service of South Korea. A logistic regression model was used to investigate the effects of nurse staffing levels, work environment, and nursing education levels on the adverse events experienced by residents. An increase of one resident per nurse was significantly associated with a higher incidence of medication error, pressure ulcers and urinary tract infections. A poor work environment increased the incidence of adverse events. Compared to nurses with a bachelor’s degree or higher, those with diplomas reported increased incidence rates of pressure ulcers. Improving the health outcomes of residents in nursing homes requires efforts that strengthen the nursing workforce in terms of numbers and educational level, and which improve their work environment at institutional and policy levels.
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Affiliation(s)
- Seonhwa Choi
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, South Korea
| | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1, Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, South Korea
| | - Eunkyo Kim
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, South Korea
| | - Kyongeun Lee
- Department of Nursing, Tongmyong University, 428, Sinseon-ro, Nam-gu, Busan, 48520, South Korea
| | - Soo Jung Chang
- Department of Nursing, Gangneung-Wonju National University, 150, Namwon-ro, Heungeop-myeon, Wonju, 26403, South Korea.
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Cho E, Kim S, Hwang S, Kwon E, Heo SJ, Lee JH, Ye BS, Kang B. Factors Associated With Behavioral and Psychological Symptoms of Dementia: Prospective Observational Study Using Actigraphy. J Med Internet Res 2021; 23:e29001. [PMID: 34714244 PMCID: PMC8590188 DOI: 10.2196/29001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/07/2021] [Accepted: 09/27/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Although disclosing the predictors of different behavioral and psychological symptoms of dementia (BPSD) is the first step in developing person-centered interventions, current understanding is limited, as it considers BPSD as a homogenous construct. This fails to account for their heterogeneity and hinders development of interventions that address the underlying causes of the target BPSD subsyndromes. Moreover, understanding the influence of proximal factors-circadian rhythm-related factors (ie, sleep and activity levels) and physical and psychosocial unmet needs states-on BPSD subsyndromes is limited, due to the challenges of obtaining objective and/or continuous time-varying measures. OBJECTIVE The aim of this study was to explore factors associated with BPSD subsyndromes among community-dwelling older adults with dementia, considering sets of background and proximal factors (ie, actigraphy-measured sleep and physical activity levels and diary-based caregiver-perceived symptom triggers), guided by the need-driven dementia-compromised behavior model. METHODS A prospective observational study design was employed. Study participants included 145 older adults with dementia living at home. The mean age at baseline was 81.2 (SD 6.01) years and the sample consisted of 86 (59.3%) women. BPSD were measured with a BPSD diary kept by caregivers and were categorized into seven subsyndromes. Independent variables consisted of background characteristics and proximal factors (ie, sleep and physical activity levels measured using actigraphy and caregiver-reported contributing factors assessed using a BPSD diary). Generalized linear mixed models (GLMMs) were used to examine the factors that predicted the occurrence of BPSD subsyndromes. We compared the models based on the Akaike information criterion, the Bayesian information criterion, and likelihood ratio testing. RESULTS Compared to the GLMMs with only background factors, the addition of actigraphy and diary-based data improved model fit for every BPSD subsyndrome. The number of hours of nighttime sleep was a predictor of the next day's sleep and nighttime behaviors (odds ratio [OR] 0.9, 95% CI 0.8-1.0; P=.005), and the amount of energy expenditure was a predictor for euphoria or elation (OR 0.02, 95% CI 0.0-0.5; P=.02). All subsyndromes, except for euphoria or elation, were significantly associated with hunger or thirst and urination or bowel movements, and all BPSD subsyndromes showed an association with environmental change. Age, marital status, premorbid personality, and taking sedatives were predictors of specific BPSD subsyndromes. CONCLUSIONS BPSD are clinically heterogeneous, and their occurrence can be predicted by different contributing factors. Our results for various BPSD suggest a critical window for timely intervention and care planning. Findings from this study will help devise symptom-targeted and individualized interventions to prevent and manage BPSD and facilitate personalized dementia care.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Sujin Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Sinwoo Hwang
- Korea Armed Forces Nursing Academy, Daejeon, Republic of Korea
| | - Eunji Kwon
- Korea Armed Forces Nursing Academy, Daejeon, Republic of Korea
| | - Seok-Jae Heo
- Department of Biostatistics and Computing, Yonsei University Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Jun Hong Lee
- National Health Insurance Service, Ilsan Hospital, Goyang, Republic of Korea
| | - Byoung Seok Ye
- College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
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Oh SS, Cho E, Kang B. Social engagement and cognitive function among middle-aged and older adults: gender-specific findings from the Korean longitudinal study of aging (2008-2018). Sci Rep 2021; 11:15876. [PMID: 34354162 PMCID: PMC8342413 DOI: 10.1038/s41598-021-95438-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022] Open
Abstract
Recent findings suggest that social disengagement in later life may result in cognitive decline and increase risk of Alzheimer’s and related dementias. However, little is known regarding the gender-specific longitudinal association between social engagement and cognition among middle-aged and older adults. Using data from a nationally representative sample of 2707 men and 5196 women from the Korean longitudinal study of aging, we examined the gender-specific association between social activity and cognitive function. Results from the generalized estimating equation model showed that compared to individuals with consistent social engagement (religious, senior center, sport, reunion, voluntary, political), individuals with inconsistent engagement had lower cognitive function. Transitioning from engagement to non-engagement was associated with lower cognitive function among men only. Not being part of a senior center was associated with decreased cognitive function among both genders, while not being part of a religious group was significant for women only. While marital status was a significant predictor of cognitive ability for women, depression was a significant predictor for men. These findings have implications for policy-makers as interventions targeting improved cognitive function among middle-aged and older adults may be more effective when gender-specific predictors are taken into consideration.
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Affiliation(s)
- Sarah Soyeon Oh
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Kim B, Lee KH, Cho E, Kim H. Behaviors of care providers and resistiveness to oral care of persons living with dementia. Geriatr Nurs 2021; 42:915-918. [PMID: 34098445 DOI: 10.1016/j.gerinurse.2021.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
Since care providers' behavior could be related to resistiveness to care (RTC) among persons living with dementia, developing care providers' behavioral strategies to reduce or prevent RTC is required. This study examined whether care providers' person-centered or task-centered behaviors were related to RTC. A secondary data analysis was conducted using 70 videos of 23 persons living with dementia who received routine oral care in long-term care settings. Data were analyzed using linear mixed models. Among task-centered behaviors, "physically controlling" significantly increased RTC. For person-centered behaviors, "cooperatively negotiating" increased RTC, while "assessing comfort" decreased RTC. Care providers need to consider the comfort or needs of persons living with dementia rather than physically controlling them in oral care situations. These findings may offer insight into the context of RTC occurrences to provide more comfortable oral care for persons living with dementia.
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Affiliation(s)
- Bora Kim
- Yonsei University College of Nursing, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea; Brain Korea 21 FOUR Project, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea
| | - Kyung Hee Lee
- Yonsei University College of Nursing, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea; Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea.
| | - Eunhee Cho
- Yonsei University College of Nursing, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea; Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea
| | - Heejung Kim
- Yonsei University College of Nursing, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea; Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea
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Cho E, Jeong DY, Kim JG, Lee S. The Acute Effects of Swimming Exercise on PGC-1α-FNDC5/Irisin-UCP1 Expression in Male C57BL/6J Mice. Metabolites 2021; 11:metabo11020111. [PMID: 33669194 PMCID: PMC7919784 DOI: 10.3390/metabo11020111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/04/2021] [Accepted: 02/14/2021] [Indexed: 01/02/2023] Open
Abstract
Irisin is a myokine primarily secreted by skeletal muscles and is known as an exercise-induced hormone. The purpose of this study was to determine whether the PGC-1α -FNDC5 /Irisin-UCP1 expression which is an irisin-related signaling pathway, is activated by an acute swimming exercise. Fourteen to sixteen weeks old male C57BL/6J mice (n = 20) were divided into control (CON, n = 10) and swimming exercise groups (SEG, n = 10). The SEG mice performed 90 min of acute swimming exercise, while control (non-exercised) mice were exposed to shallow water (2 cm of depth) for 90 min. The mRNA and protein expression of PGC-1α, FNDC5 and browning markers including UCP1 were evaluated by quantitative real-time PCR and western blotting. Serum irisin concentration was measured by enzyme-linked immunosorbent assay. An acute swimming exercise did not lead to alterations in the mRNA and protein expression of PGC-1α in both soleus and gastrocnemius muscles, the mRNA and protein expression of UCP1 in brown adipose tissue, mRNA browning markers in visceral adipose tissue and circulating irisin when compared with the control group. On the other hand, an acute swimming exercise led to increases in the mRNA and protein expressions of FNDC5 in the soleus muscle, the protein expression of FNDC5 in the gastrocnemius muscles and the protein expression of UCP1 in subcutaneous adipose tissue.
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Affiliation(s)
- Eunhee Cho
- Department of Human Movement Science, Graduate School, Incheon National University, Incheon 22012, Korea;
| | - Da Yeon Jeong
- Division of Life Sciences, College of Life Sciences and Bioengineering, Incheon National University, Incheon 22012, Korea; (D.Y.J.); (J.G.K.)
| | - Jae Geun Kim
- Division of Life Sciences, College of Life Sciences and Bioengineering, Incheon National University, Incheon 22012, Korea; (D.Y.J.); (J.G.K.)
- Institute for New Drug Development, Division of Life Sciences, Incheon National University, Incheon 22012, Korea
| | - Sewon Lee
- Division of Sport Science, College of Arts & Physical Education, Incheon National University, Incheon 22012, Korea
- Sport Science Institute, College of Arts & Physical Education, Incheon National University, Incheon 22012, Korea
- Health Promotion Center, College of Arts & Physical Education, Incheon National University, Incheon 22012, Korea
- Correspondence: ; Tel.:+82-32-835-8572
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Kim S, Lee TW, Kim GS, Cho E, Jang Y, Choi M, Baek S, Lindsay D, Chan S, Lee RLT, Guo A, Wong FKY, Yu D, Chair SY, Shimpuku Y, Mashino S, Lim G, Bonito S, Rumsey M, Neill A, Hazarika I. Nurses in advanced roles as a strategy for equitable access to healthcare in the WHO Western Pacific region: a mixed methods study. Hum Resour Health 2021; 19:19. [PMID: 33588873 PMCID: PMC7885366 DOI: 10.1186/s12960-021-00555-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The Western Pacific region constitutes one-quarter of the world's population and has diverse health needs. While dialogue on and promotion of advanced practice nurses are ongoing, this study investigated the current responsibilities of nurses in advanced roles, future healthcare needs, and the implications of these components for nurses' professional development within the Western Pacific region. METHODS This study employed three phases, a descriptive survey on the current status of nurses in advanced roles in the Western Pacific region, followed by a Delphi survey, and exploratory interviews. A total of 55 national experts with clinical, academic, and/or government-related backgrounds from 18 countries participated from December 2017 - December 2018. The descriptive survey via email to identify the status of nurses in advanced roles and a working definition was developed. This formed the basis for the Delphi survey, which identified key barriers and challenges for enhancing the development of nurses in advanced roles within the country (round 1) and for the region (rounds 2 and 3). Lastly, semi-structured individual interviews were conducted to identify strategies for establishing nurses in advanced roles to improve equitable access to healthcare. RESULTS Thirty-seven roles and characteristics were identified and categorized for nurses performing advanced roles. Emergency care, critical care, elderly health, child health, and rural/remote communities were identified as fields with particular need for nurses in advanced roles in the Western Pacific region. Providing effective services, influencing government leadership, and advocating for health system sustainability were deemed necessary to improve equitable healthcare access. We found that nurses in advanced roles are not limited to clinical tasks within the hospital but are poised for active participation in primary healthcare, education/teaching, professional leadership, quality management, and research. CONCLUSIONS Demand for nurses in advanced roles is high in the Western Pacific region and 15 items were identified across five core strategic areas to enhance development of nurses in advanced roles. Governmental-level recommendations include establishing legislative protection, improving systems for remuneration, strengthening supportive channels, and conducting national needs assessments.
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Affiliation(s)
- Sue Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Tae Wha Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Gwang Suk Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Eunhee Cho
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Yeonsoo Jang
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Mona Choi
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Seoyoung Baek
- Korea Armed Forces Nursing Academy, Jaun-ro 90, Yuseong-gu, Daejeon, 34059 Republic of Korea
| | - David Lindsay
- James Cook University, 1 James Cook Drive, Douglas, Townsville, QLD 4811 Australia
| | - Sally Chan
- Tung Wah College, 31 Wylie Road, Kowloon, Hong Kong SAR China
| | - Regina L. T. Lee
- The University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Aimin Guo
- School of Nursing, Peking Union Medical College, No.9 Dong Dan San Tiao, Dongcheng, District, Beijing, 100730 China
| | | | - Doris Yu
- The School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 21, Sassoon Road, Pokfulam, Hong Kong SAR China
| | - Sek Ying Chair
- The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR China
| | - Yoko Shimpuku
- Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima 734-8551 Japan
| | - Sonoe Mashino
- Research Institute of Nursing Care for People and Community, University of Hyogo, 13-71 Kitaohji-cho, Akashi, Hyogo 673-8588 Japan
| | - Gigi Lim
- The University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Sheila Bonito
- College of Nursing, University of the Philippines Manila, Pedro Gil St, Ermita, 1000 Manila, Metro Manila, Philippines
| | - Michele Rumsey
- University of Technology Sydney, 15 Broadway, Ultimo, NSW 2007 Australia
| | - Amanda Neill
- University of Technology Sydney, 15 Broadway, Ultimo, NSW 2007 Australia
| | - Indrajit Hazarika
- WHO Ethiopia Country Office, Menelik Avenue, PO Box 3069, Addis-Ababa, Ethiopia
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50
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Choi S, Cho E, Kim E, Lee K, Chang SJ. Effects of Nurse Staffing, Work Environment, Education on Adverse Events in Nursing Homes. Innov Aging 2020. [PMCID: PMC7740494 DOI: 10.1093/geroni/igaa057.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This study examined the effect of registered nurse (RN) staffing level, work environment, and education on adverse events experienced by residents in nursing homes. A cross-sectional study was conducted with 216 RNs working in nursing homes who were selected using random stratified sampling by location and bed size. Self-reported questionnaires regarding staffing level, work environment, education level, adverse events, and nurse characteristics were administered. Data from the National Health Insurance Service were used to describe nursing home characteristics. Both multiple and multinomial logistic regressions were used to control for the characteristics of nurses and nursing homes, and investigate the effects of nursing staffing level (number of older adults assigned to a nurse), work environment (Practice Environment Scale of the Nursing Working Index), and level of nursing education on the adverse events experienced by residents. An increase of one resident per RN was significantly associated with a higher incidence of pressure ulcers (OR= 1.019, 95% CI=1.004-1.035). Poor work environment increased the incidence of adverse events such as pressure ulcers (OR= 3.732, 95% CI=1.155-12.056) and sepsis (OR=3.871, 95%CI=1.086-13.800). Compared to RNs with a baccalaureate or higher, RNs with diplomas reported increased incidence rates of pressure ulcers (OR=2.772, 95%CI= 1.173-6.549). RN staffing, work environment, and education level affect the incidence of pressure ulcers, and the work environment affects the incidence of sepsis among residents in nursing homes. Policy-wise, improving the level of nurse staffing, nursing work environment, and nursing education will improve health outcomes of residents.
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Affiliation(s)
| | - Eunhee Cho
- Yonsei University, Seoul, Republic of Korea
| | - Eunkyo Kim
- Yonsei University, Seoul, Republic of Korea
| | | | - Soo Jung Chang
- Gangneung-Wonju National University, Wonju, Republic of Korea
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