Nursing Intervention Strategies Research Articles

Effects of Foot-Reflexology Massage on Body Weight, Lower Extremity Edema and Serum Lipids in Postpartum Women

【Purpose: This study examined the effects of foot-reflexology massage on body weight, lower extremity edema, and serum lipids in postpartum women. Method: This study was a nonequivalent control-group pretest-posttest design. Postpartum women were assigned to the experimental group (n=16) or a control group (n=15). Foot reflexology massage was applied 5 times a week, for a total of 2 weeks to the experimental group. The tool for measuring lower extremity edema was the girth of the thigh, and the calf. The measuring tool for serum lipids was total cholesterol and TG in blood serum by clinical process. Data was analyzed by $x^2$ -test, t-test, and paired t-test, ANOVA using SPSS/Win PC 14.0. Results: There was a statistically significant decrease in levels of TG in blood serum in the experimental group compared to the control group. Conclusion: Foot reflexology massage is a useful nursing intervention that decreases serum lipids level in postpartum women. Therefore foot reflexology massage is recommended as a nursing intervention strategy for serum lipids reduction in postpartum women.】

Process of Seeking Positive Life of Patients with Parkinson's Disease

The purpose of this study was to help understand the life and illness-experiences of focusing on a positive lifestyle, patients with Parkinson's disease, The present study adopted a ethno graphic methodology. The participants for this study were 4 men and 3 women, who were treated for Parkinson's disease. Data was collected by an interview and participant observations from August 2003 to September 2004. Tape-recorded interviews were transcribed after the interview and classified and described to realistic tale. Patients with Parkinson's disease experienced the stage of retake-off pursuing positive life by overcoming the acceptance process of illness including the stage of recognition of change, the stage of disruption and the stage of acceptance. The factors of positive life of Patients with Parkinson's disease were their strong will and social support. This study may be used in future studies as an important resource to develop nursing intervention strategies and programs for patients with Parkinson's disease that can help the patients to achieve strong willingness and positive life in Korea.

Development of E-Mail Education for Hyperlipidemia Health Check-up and Application Effects

This study was to monitor the effects of forming desirable eating and exercise habits and change the blood lipid levels by developing and applying E-Mail educational programs for a hyperlipidemia health check-up. The research design used a nonequivalent control group pre-post test. Ninety-nine subjects (Exp.=50, Cont.=49) were selected randomly and the male subjects agreed to a hyperlipidemia health check-up at a comprehensive medical screening center. This study verified validity and reliability through factor analysis on a life habit measurement tool. The data was analyzed with SPSS win 12.0 using an chi- square-test,t-test, ANOVA and ANCOVA. Eatingand exercise habit scores of the experimental group which were educated through E-Mails changed considerably more than that of the control group which was not educated. Total-cholesterol and LDL-cholesterol in the experimental group was considerably lower than that in the control group, but HDL-cholesterol increased considerably. Triglycerides, however, didn't show change. An E-Mail educational program may be applied as a hyperlipidemia health check-up nursing intervention strategy.

Factors Related to Neonatal Suckling in the Initiation of Breastfeeding in Primiparous Mothers

【Purpose: This study was conducted to discover the related factors of neonatal suckling in the initiation of breastfeeding in primiparous mothers and to provide basic data for promoting nursing intervention strategies to improve the practice of breastfeeding. Method: The subjects of this study were 71 primiparous mothers who had normal vaginal deliveries at one obstetric hospital in P metropolitan city and one delivery center in J city. The collected data was analyzed using the SPSS program. Result: The average IBFAT(Infant Breastfeeding Assessment Tool) score was 9.6 $\pm$ 2.3. The general characteristics studied that had a significant influence on neonatal suckling in the initiation of breastfeeding were the place of delivery (ex: Hospital, Postnatal Unit), whether oxytocin was used, no usage of analgesic medication, amount of satisfaction after the first breastfeeding weight of the newborns and the Apgar score at one minute. Conclusions: A higher IBFAT score was related to primiparous mothers who had a hospital delivery, received oxytocin, received maternal labour analgesics, neonatal weight, Apgar score at one minute, and satisfaction after the first breastfeeding.】

Effects of a Drug Misuse and Abuse Prevention Program on Knowledge, Attitude, and Preventive Behaviors Related to Drug Misuse and Abuse, and Depression in Low-income Elderly Women

This study was conducted to determine the effects of a drug misuse and abuse prevention program on knowledge, attitude, and preventive behaviors related to drug misuse and abuse, and depression in low-income elderly women in the urban area. The design of this study was a nonequivalent control group pretest-posttest design. The subjects consisted of 26 in the experimental group and 23 in the control group. The program was performed for about 1 hour, once a week for 5 weeks. Data was analyzed by the SAS(ver.8.02) computer program, and it included descriptive statistics, Fisher's exact test, Mann-Whitney U test, Wilcoxon signed ranks test, and ANCOVA. There were statistically significant differences in knowledge, attitude, and preventive behaviors related to drug misuse and abuse, and depression between the experimental group and the control group. This study showed that this prevention program of drug misuse and abuse is appropriate for low-income elderly women, Therefore this program is recommended as a nursing intervention strategy for the elderly.

Decision tree model of the treatment-seeking behaviors among Korean cancer patients.

The purpose of this study was to develop and test a decision tree model of the treatment-seeking behaviors among Korean cancer patients. The study used methodological triangulation, applying the cognitive ethnographic decision tree modeling approach. The model was developed based on qualitative data collected from in-depth interviews with 29 cancer patients. The model was tested using qualitative and quantitative data collected from interviews and a structured questionnaire involving 165 cancer patients. The predictability of the decision tree model was quantified as the proportion of participants who followed the pathway predicted by the model. Two models were developed, the first for decision making about when to visit a doctor after detecting symptoms, and the second for decision making about treatment type following the diagnosis. Decision outcomes for the first model were categorized into immediate visit and delayed visit. The first model was influenced by the perceived seriousness of symptoms, the experiences of visiting a doctor previously with similar symptoms, social-group influences on visiting a doctor, and barriers to visiting a doctor. Decision outcomes for the second model were hospital treatment only, and a mixture of hospital treatment and alternative therapies. The second model was influenced by curability, social-group influences on alternative therapies, and confidence in alternative therapies. The predictabilities of the 2 models were 90.3% and 94.5%, respectively. This study result can help nurses understand the treatment-seeking behaviors of cancer patients, and hence develop nursing intervention strategies.

A study on depression, stress, and social support in adult women

This study was conducted to examine the relationship among Depression, Stress, and Social support in Korean Adult Women. The subjects of this study consisted of 2,503 Korean Adult Women from 20 to 64 years. The data was collected through personal interviews from March to May of 2001 using questionnaires. The data was analyzed by the SPSS(ver.10.0) computer program, and it included descriptive statistics, t-test, one way ANOVA, the pearson correlation coefficient, and Stepwise multiple regression. The level of depression, stress, and social support were 16.22 for depression, 27.43 for stress, and 87.48 for social support. There was a significant difference in social support according to residence area, age, level of education, marital status, type of family, religion, income, and job. There was a significant positive correlation between stress and depression, a significant negative correlation between stress and social support, and social support and depression. Stress and social support were significant predictors (29.6%) of depression. This study showed that thorough nursing assessment of variables related to social support is needed for development of nursing intervention strategies. Further studies need to be conducted for group comparisons according to the life cycle of Korean women.

A Study on the Effects of Father Class upon Father's Level of Knowledge and Confidence about Postpartal Woman and Newborn Care

【The purpose of this study is to find out how Father Class, which is being practiced at a hospital located in Seoul, influences on fathers' level of knowledge and confidence of postpartal mother and newborn care. Research design was quasi-experimental study using non equivalent experiment and control group. The data, questionaires, were collected from Sep. 13, 2001 to Oct. 31, 2001 through e-mail, telephone and mail, after discharge from S hospital located in Seoul, where experimental group was educated at Father Class and control group take part in class. The objects were fathers who have first baby through normal delivery or C-sec delivery including experimental group 48 persons and control group 52 persons. Four instruments were revised ones of Lee Mi Kyoung's(1990) and Kwak Yon Hee's tool based on resources of direct interviews of fathers and one expert, professor. The reliability of four instruments were Cronbach's $\alpha$ scores .85 -93. Data were analyzed by SPSS 10.0 program using $x^2$ -test, and t-test and, One- way ANOVA, and Pearson correlation, etc. The results of this study are as follows; 1.The two groups were confirmed as a homogeneous group by showing no significant difference statistically at level of 5%. 2.The results of proving hypothesis are followings: 1)The first hypothesis, the fathers who participated in Father Class will have higher level of knowledge about postpartal mother care than fathers who didn't was accepted by significant difference statistically (p=0.000). 2)The second hypothesis, the fathers who took part in class will have higher confidence in postpartal mother care than fathers who didn't, was supported by significant difference statistically (p=0.000). 3) The third hypothesis, the fathers who attended class will have better knowledge about taking care of newborn than was accepted by significant difference statistically (p=0.000). 4)The fourth hypothesis, the fathers who participated in class will have higher confidence in newborn care than others, was supported by significant difference statistically (p=0.000). 3.The further analysis showed whether they participated in Prenatal Birth Preparing Class influenced on father's level of knowledge and confidence in postpartal mother and newborn care. In conclusion, Father Class is effective nursing intervention strategy that can help new fathers attain father and husband roles by enhancing level of confidence in and knowledge of postpartal mother and newborn care.】

A Study on Recognition and Practice of Teakyo by Pregnant Women

This study is a descriptive study to offer an actual basic data as Nursing intervention strategy of nurses before delivery in order that pregnant women in Korea may effectively practice Taekyo by examining the relation after apprehending level of recognition and practice of our pregnant women about Taekyo. This study collected questionnaires from 801 pregnant women who visited general hospitals in 10 areas(Seoul, Daejon, chunan, Daegu, Kummi Kyongju, Pohang, Busan, Jonju, and Yonkwang) for prenatal care through an outpatient obstetrics and gynecology from July 15 to August 30, 1999. This study used the tool of lee, Ki Young(1993) revised an complemented by investigator to measure recognition of Taekyo and the tool of Jang, Shun Buk and Park, Young Ju(1996) revised and complemented by investigator to measure practice of Taekyo. The Cronbach's alpha value of each tool was .88 in recognitionof Taekyo, while the value was .90 in practice of Taekyo. For data analysis, this study used the descriptive and statistical analysis, Pearson correlation, t-test, ANOVA, Tukey's post hoc contrast, and Stepwise multiple regression in accordance with the purpose of this study with using SPSS Win 7.5 program. The results were as follows ; 1. The practice of Taekyo was low in comparison with recognition of Teakyo by showing average 4.28 points and standard deviation 0.48 at level of recognition of pregnant women about Taekyo on the basis of 5 points and showing to show average 2.81 points and standard deviation 0.36 at practice level on the basis of 4 points.2. They showed the higher level of recognition on Taekyo at high educational background of pregnant woman(F=3.735, p=.005), Roman catholicism (F=4.570, p=.002), satisfied married life(F=5.448, p=.004), high monthly income(F=6.096, p=.000) and cases of hoping pregnancy(F=2.525, p=.012).3. They showed the higher level of practice on Taekyo at high educational background of pregnant woman(F=2.883, P=.022), Roman catholicism(F=3.616, p=.032), satisfied married life(F=19.924, p=.000), good health condition(F=2.386, p=.017), cases of hoping pregnancy(F=0.677, p=.000), cases of planning pregnancy with husband(F=3.024, p=.001), cases of regular prenatal care before delivery(F=0.241, p=.005), cases of maternal breast feeding (F=9.132, p=.000), and the number of less children(F=2.763, p=.041).4. In result of examining correlation between recognition and practice of Taekyo, they showed high level of practice on Taekyo under high level of recognition of pregnant women on Taekyo by showing the statistically significant correlation.5. In result of examining the related factors that affect recognition and practice of Taekyo y the object, practice of Taekyo had 16.8 percents of explanatory range, purpose of practicing Taekyo 8.5 percents of explanatory range, and monthly income 1.9 percent of explanatory range as variables of affecting recognition of Taekyo. The total explanatory range was 27.2 percents, Recognition of Taekyo had 16.1 percents of explanatory ragne, time of starting Taekyo 3.2 percents, health condition 2.2 percents of explanatory range, condition of hoping pregnancy 1.1 percent of explanatry range, satisfaction of married life 0.8 percent of explanatory range, and religion 0.6 percent of explanatory range as variables of affecting practice of Taekyo. The total explanatory range was 24.0 percents.

The Effect of a Childcare Education for First-time Mothers on Newborn Care Behavior and Confidence in Maternal Role

The postpartum is a period of transition to motherhood where a childless woman transforms into a woman with children. Parents, especially mothers must perform an essential role of implementing instrumental and emotional care behaviors on part of the helpless, dependent, and immature infant. First-time mothers, however, suddenly face the responsibility of round the clock duty without neither parenting training during pregnancy, nor a time to gradually adapt to growing responsibilities after birth, with confusion and frustration as a result. Thus, after providing first-time mothers with childcare education as maternal role preparation, this study will try to examine its effects on childcare behaviors and confidence in maternal role during the early postpartum period. This quasi-experimental study using a nonequivalent control group non-synchronized design, was carried out from March 1995 to May 1996 to verify the effects of a childcare education program with first-time mothers who had vaginal delivery in Ewha University Hospital, Seoul, Korea, and collected data from 60 subjects who consented to the study. The education was given in the early postpartum period(48-72 hours after delivery) and to measure its effects, a posttest was done 4 weeks later with the results analyzed by SPSS shown in the following : 1. The childcare behavior score of the experimental group that had received the newborn care education was higher than the control group(t=3.5, P=.001).2. The control group and the experimental group which had received the education showed no difference in degree of confidence in maternal role.3. The higher the childcare behavior score, the higher the degree of confidence in maternal role was among the subjects(r=.56, P=.001). The preceding results are significant in that childcare practices can be promoted by providing child-care education to first-time mothers in the early postpartum period. Thus, this education can be used as a nursing intervention strategy in the early postpartum period.

Factors influencing related Health Promoting Life-Style in Middle-aged Women

The purpose of this study is to provide a basis for nursing intervention strategies to enhance health promoting practice that are constructive to a healthy lifestyle. Data were collected through self-reported questionnaires from 281 middle-aged women living in Seoul, Kyeung ki, Taegu, Kyeung pook, and Kyeung nam from July to September 1997. The following instruments were used in the study after some adaption : scale of perceived health status, self-esteem, perceived benefits, family hardiness index, purpose in life, Walker and other health promoting lifestyle profiles. The data were analyzed, by t-test, ANOVA Scheffe's Pearson's correlation & stepwise multiple regression, by using the SAS program. The results are as follows: 1) The average score for the health promoting lifestyle was 2.65. In the sub-categories, the highest degree of practice was self-actualization(2.91), and in the lower degree was health responsibility(2.13).2) In the relationship between social demographic and health promoting lifestyle there were significant differences in education, occupation, economic status, and type of family.3) There is a significant correlation between perceived health status, self-esteem, perceived benefits, family hardiness index, existential vacuum and total & subcategory health promoting lifestyles.4) Existential vacuum was the highest factor predicting a health promoting lifestyle for middle-aged women(38.0%).5) Existential vacuum, commitment and self-esteem accounted for 45.9% of the total variance.

Nursing standard of practice protocol: depression in elderly patients. NICHE faculty.

Depression is a highly prevalent but underrecognized and undertreated mental health problem in community-dwelling, medically ill, and institutionalized older adults. Untreated depression is associated with serious negative consequences for the elderly patient. Nurses in various practice settings can reduce the negative effects of depression through early recognition, intervention, and referral of patients with depression. This article presents an overview of depression in late life with emphasis on age-related assessment considerations, clinical decision-making, and nursing intervention strategies for elders with depression. A standard of practice protocol for use by nurses in a variety of practice settings is also presented.

Current approaches and interventions for schizophrenia.

This article provides an overview of assessment and intervention strategies for nurses who have contact with people with schizophrenia. The article examines nurse/client relationships and looks at how clients may be empowered.

Myocardial protection for cardiac surgery: the nursing perspective.

The advancement of myocardial protection techniques is considered to be the most instrumental in achieving successful cardiac surgical outcomes. Although many issues complicate the efficacy of myocardial protection, warm cardioplegia is instituted more often as a better myocardial protection method for patients undergoing cardiac surgery. Understanding differences in patient response between warm and cold cardioplegia is essential for development of appropriate nursing intervention strategies and prevention of postoperative complications. Advanced practice nurses in cardiac surgical settings must continue to evaluate metabolic, functional, and hemodynamic variations of patients with different cardioplegia for positive patient outcomes.

1330 Fatigue in patients undergoing chemotherapy: A nursing intervention approach

A patient (pt) with cancer experiences many potential causes of fatigue. Pts who are undergoing chemotherapy (CT) have identified fatigue as a frequent and significant treatment side effect There is a lack of empirical knowledge based on systematical approach to understand this phenomenon. The objectives of this study were: To design a questionnaire for fatigue assessment, to determine the extent of problems associated with fatigue and to develop a nursing intervention strategy to modify fatigue. Data will be collected from about thirty ambulatory pts who are undergoing CT for hematological malignancies. Initial results show a difference in pts’ report about periods of fatigue occurrence and the reasons for their fatigue. The pts’ experience will be the basis to identify specific effective interventions in order to improve quality of life for pts undergoing CT.

Clinical nursing management of sickle cell disease and trait during pregnancy.

Sickle cell-related hemoglobinopathies present challenges for clinical management during pregnancy, labor, delivery, and the postpartum course because perinatal morbidity remains a significant practice concern. Nursing strategies that strive for synthesis of knowledge pertaining to pathophysiology, genetic counseling, life events that have affected the patient's health history, treatment modalities, and psychosocial needs may improve obstetric and neonatal outcomes. Clinical management strategies for the prenatal, intrapartum, and postpartum courses are provided. Nursing intervention strategies such as follow-up teaching, involvement of the partner and support network in aspects of care, and patient advocates, in conjunction with independent nursing practice activities involving emotional support and measures to alleviate symptoms associated with disease manifestations, are cornerstones in the contribution of nursing to the multidisciplinary care of the pregnant woman with sickle cell disease and trait.

Battered women in the critical care setting: strategies for critical care nurses.

Nursing intervention with battered women can be a frustrating and discouraging experience, as battered women are trapped in a cycle of violence that is difficult to break. Research reveals an Open Window Phase within the cycle of violence. During this brief period, battered women are most receptive to interventions. The responsibility of the critical care nurse to intervene during this short period of time is particularly urgent. This article provides intervention strategies for nurses in critical care to use during the Open Window Phase.

Patients With Disordered Water Balance: Innovative Psychiatric Nursing Intervention Strategies

1. Patients with disordered water balance (DWB) have difficulty with fluid intake/output and osmoregulation. These difficulties are characterized by polydipsia, polyuria, significant variation in pattern of excretion, abnormal diurnal weight gain, and behavioral changes. 2. Therapeutic milieu-management strategies for patients experiencing acute and chronic phases of DWB are the cornerstone of long-term management of these patients. 3. Implementation of the intervention and milieu-management strategies described in this article resulted in a reduction of patients requiring acute medical treatment subsequent to an acute phase of DWB.

Cultural themes in family stress and violence among Cambodian refugee women in the inner city

Cambodian refugee women frequently face the cumulative trauma of war experiences and cultural adaptation to the American inner-city environment. This qualitative study investigated cultural beliefs, coping strategies, and management of family stress among Cambodian refugee women living in the inner-city environment. Focused and open-ended interviews were conducted in the informants' homes using the Cambodian language. Stressful and violent events were managed by nonconfrontation and withdrawal. These two themes are hypothesized as the culturally identified means by which inner-city Cambodian refugee women control and harmonize situations of stress. Further study is needed to develop the theoretical base for developing culturally sensitive nursing intervention strategies with this high risk population.

Cambodian refugee adolescents: cultural factors and mental health nursing.

Cambodian adolescents in America are a high-risk group for physical, psychosomatic, and drug-related problems. Communication with the Cambodian community is a challenge to mental health nurses due to fundamental differences in American and Cambodian perceptions about parental roles and causation and treatment of illness. The authors focus on the Cambodian cultural theme of equilibrium in treatment of illness, management of stress, and patterns of parenting. Conflicts faced by Cambodian adolescents and nursing intervention strategies are identified.