Journal of Korean Gerontological Nursing最新文献

Purpose: The purpose of this study was to explore the perceptions of a good death, person-centered care, and empathy competency among nursing staff in long-term care facilities, examining their influence on end-of-life (EOL) care.

Methods: A descriptive survey was conducted with 154 nursing staff, including nurses, nursing assistants, and care workers, from three long-term care facilities. Data were collected through structured questionnaires assessing perceptions of a good death, person-centered care, empathy competency, and EOL care. Regression and mediation analysis were performed to identify influential factors and mediation effects using the SPSS 27 program and PROCESS Macro.

Results: The key factors influencing EOL care were person-centered care (β=.44, p<.001), empathy competency (β=.16, p=.028), age (β=.16, p=.013), and job type (β=-.14, p=.034). The overall explanatory power for EOL care was 41.5% (adjusted R²=.415). The mediating effect of empathy competency was statistically significant between perceptions of a good death and EOL care (β=.24, p=.002, 95% confidence interval 0.09~0.33) and between person-centered care and EOL care (β=.51, p<.001, 95% confidence interval 0.03~0.24).

Conclusion: Enhancing EOL care in long-term care facilities requires improving empathy competency and person-centered care. Tailored education and interventions to strengthen empathy and professional attitudes among nursing staff are essential. Organizational support and systemic approaches are also needed to improve the quality of EOL care.

Purpose: This study was designed to construct and test a structural model of successful aging in older adults with osteoarthritis using the selection, optimization, and compensation (SOC) strategy, and to identify the direct and indirect effects of various influencing factors.

Methods: Physical factors, depression, healthcare provider, and family support were set as exogenous variables. Endogenous outcomes were the SOC strategy and successful aging. The 220 study participants were older adults (aged ≥65 years) and had degenerative osteoarthritis. Data were collected with a structured questionnaire administered between December 2019 and February 2020. Subsequently, the data were analyzed, and a hypothetical model was tested. The data were analyzed using SPSS ver. 25.0 and AMOS ver. 20.

Results: Nine paths of the hypothetical model were changed to six modified routes, and a simple modified model was defined as this study's final modified model, including increasing the goodness-of-fit. Variables influencing successful aging were depression (β=-.70, p=.002), healthcare provider support (β=.20, p=.002), family support (β=.14, p=.041), and the SOC strategy (β=.21, p=.020). For depression, the direct effect (β=-.70, p=.002), the indirect effect (β=-.07, p=.001), and the total effect (β=-.77, p=.006) on successful aging were statistically significant. For healthcare provider support, it was noted that the direct effect (β=.20, p=.002), the indirect effect (β=.02, p=.044), and the total effect (β=.23, p=.022) on successful aging were statistically significant.

Conclusion: It is important to reduce depression and promote healthcare provider support for successful aging in older adults with osteoarthritis using the SOC strategy.

Purpose: This study aimed to assess the job competency and performance of nurses with gerontological nurse practitioner (GNP) certification, and identify barriers and improvement plans for performing gerontological nursing duties.

Methods: A total of 100 nurses holding GNP certification participated in the study, with data collected via online self-report questionnaires from June 15 to November 8, 2024. The survey explored general characteristics, job competency, job performance, barriers to gerontological nursing practice, and suggestions for improvement. Data were analyzed using descriptive statistics, independent t-test, and one-way ANOVA.

Results: The duty with the highest job competency was 'Evaluation' (4.00±0.73), whereas the lowest was 'Managing & using resources' (3.54±0.78). The most frequently performed duty was 'Plan & implementation' (73.6%) and the least was 'Research' (36.1%). The most cited barrier was 'Lack of job performance opportunities' (24.0%~51.0%) and 'Job assignment based on certification' (25.0%~47.0%) was the most suggested improvement plan.

Conclusion: This study found that GNPs had difficulty performing their duties due to an unsuitable work environment, lack of legal function, and lack of education. These findings suggest that it is essential to provide appropriate job placements, establish legal foundations to support their roles, and develop educational programs, such as simulation-based training.

Purpose: This study aimed to identify factors influencing long-term care hospital nurses' moral distress and job satisfaction on turnover intention.

Methods: Participants were 158 nurses working in one of 13 long-term care hospitals. Data were collected from July 22 to September 10, 2024, and analysed using two-stage multiple regression analysis with SPSS.

Results: Turnover intention was a statistically significant positive correlation with moral distress. In the sub factors, there was correlation with futile care, nursing practice, institutional and situational factors, and physician practice. Turnover intention was a statistically significant negative correlation with job satisfaction and all sub factors. Factors influencing the turnover intention of long-term care hospital nurses were under the age of 40, male nurses, moral distress, futile care sub factors of moral distress, job satisfaction, and administration and professionalism sub factors of job satisfaction, showing 30.0% explanatory power.

Conclusion: The significance of moral distress and job satisfaction was confirmed as a factor influencing the turnover intention of long-term care hospital nurses. Therefore, the organization must make active efforts to find and solve factors and problems that reduce job satisfaction and intensify moral distress of long-term care hospital nurses. In addition, at the organizational level, a management strategy will be needed to lower nurses' intention to turnover by preparing and applying ethical standards and guidelines to systematically solve the moral distress of nurses in the organization.

Purpose: The purpose of this study was to identify predisposing, precipitating, and environmental factors related to the severity of delirium among older adults in a neurologic intensive care unit (ICU) based on the clinical practice guideline.

Methods: A retrospective study was conducted using electronic medical record data from 945 older adults admitted to the neurological ICU at a tertiary hospital in Seoul, South Korea from January 2020 to July 2023. Delirium and subsyndromal delirium were evaluated using the Intensive Care Delirium Screening Checklist. Statistical analyses were performed using one-way ANOVA, χ ² tests, and multinomial logistic regression using the SPSS/WIN 26.0 program.

Results: Compared with the normal group, a multinominal analysis revealed factors significantly associated with both delirium and subsyndromal delirium, including physical function, the length of ICU stay, dexmedetomidine use, anticonvulsants use, and physical restraints. However, compared to the normal group, ICU stay emerged as the most strongly related factor to delirium, whereas physical function was identified as the most significant factor related to subsyndromal delirium. These findings suggest that factors associated with delirium vary by its severity.

Conclusion: Understanding the factors associated with delirium and subsyndromal delirium is crucial for clinicians. Pre-classification of high-risk groups based on the delirium severity among critically ill older adults is essential for providing high-quality delirium prevention.

Purpose: This study employed Q-methodology to explore frames of reference of nursing home practitioners in managing discomfort of residents with dementia.

Methods: In-depth interviews were conducted with eight nursing home practitioners, all of whom had experience caring for residents with dementia. Additionally, a literature review on discomfort, its assessment, and interventions was conducted. Thirty-four practitioners as a P-sample, including nurses, care workers, social workers, and physical therapists, classified 34 Q-samples through Q-sorting. Data analysis was performed using the PQ-method 2.35 program. Results were interpreted based on factor arrays, post-interview data, and distribution of the P-sample.

Results: Four Q-factors were identified as practitioners' frames of references for discomfort management of nursing home residents: exploring possible management based on a synthesis of related clues, an individual assessment-based approach using possible assumptions, linking subtle changes to management direction based on a trusting relationship, and configuration-centered management direction using objective data.

Conclusion: Utilizing nursing home practitioners' frames of reference for managing demented residents' discomfort can be used for developing strategies that can be used in practitioners' education and promoting practice that can reduce discomfort of nursing home residents.

Purpose: This study aimed to determine high-risk groups and develop a predictive model of hearing loss among adults in South Korea.

Methods: We analyzed 1,873 participants aged 40 years and older using the Korean National Health and Nutrition Examination Survey (KNHANES). Complex sample analysis and decision tree analysis were conducted.

Results: Among the participants, 764 (36.0%) had hearing loss, with 54.5% aged 65 or older. The decision tree analysis identified age as the most significant predictor, revealing six high-risk groups: five in older adults and one in middle-aged adults. The characteristics of high-risk groups varied by age group. In high-risk groups among older adults, sarcopenia, self-reported health status, and economic activity were key predictors, whereas in middle-aged groups, education level and lifestyle factors such as self-reported oral health played a major role. The highest-risk group was older adults with sarcopenia, with 81.3% experiencing hearing loss.

Conclusion: It is essential to implement age-specific strategies to effectively prevent and manage hearing loss. For older adults, strengthening support systems to address sarcopenia, enhance perceived health status, and reduce social isolation is crucial. For middle-aged adults, prevention should focus on health management, lifestyle modifications, and improved accessibility to healthcare.

Purpose: To examine the effects of a spousal participation health promotion program (health promotion program, HPP) based on Cox's Interaction Model of supporting husbands' health behavior compliance following a percutaneous coronary intervention (PCI).

Methods: This study was a nonequivalent control group pretest-posttest design. A total of 52 participants (26 in each group) completed the study. The researchers conducted pretest and posttest at 12-week intervals on 26 control groups. Those in the 26 experimental groups attended in the entire 12-week program with pretest and posttest. Also, 10 control groups who wished to receive the intervention were given the opportunity to participate in the HPP for 3 weeks and were provided with the materials used from weeks 4 through 12 after completion of the study. Descriptive statistics, independent t-test, paired t-test, Mann-Whitney U-test, and a Wilcoxon signed rank test were conducted.

Results: Spousal participation HPP was effective in promoting participants' marital compatibility and health behavior compliance.

Conclusion: Spousal participation HPP was an effective intervention for reducing body mass index, total cholesterol, triglyceride, and low-density lipoprotein, enhancing marital harmony, and promoting health behavior compliance among middle-aged and older men who underwent PCI. Therefore, it is recommended to actively utilize the spousal participation HPP as an effective intervention strategy for health management of this population.