Purpose: The purpose of this study was to examine the effects of an anger management program on anger, job stress, psychological well-being, and heart rate variability in clinical nurses. Methods: A quasi-experimental study was conducted using a nonequivalent control group, pretesteposttest design Q5 with repeated measures. The participants included 43 nurses assigned to the experimental and control groups. Anger, job stress, psychological well-being, and heart rate variability were evaluated before the intervention, immediately after the completion of the intervention, and four weeks after the end of the intervention. Chi-square test, t-test, Fisher's exact test, and GEE (Generalized Estimating Equations) were used to analyze the data. Results: There were significant differences in the level of anger, state anger, job stress, and psychological well-being between the two groups. The rate of change in the total power (TP) and the high-frequency band (HF) of the experimental group increased immediately after the intervention completion, but that of the control group decreased at the same time. Conclusion:The above results demonstrate that an anger management program for nurses effectively attenuated anger and job stress, improved psychological well-being, and regulated heart rate variability.
ObjectivesTo provide useful information for clinicians and policy makers to prepare guidelines for adequate use of medical resources during end-of-life period by analysing the intensive care use and related costs at the end of life in South Korea.DesignCross-sectional, retrospective, observational study.SettingTertiary hospitals in South Korea.ParticipantsWe analysed claim data and patient information from the Health Insurance Review and Assessment Service national dataset. This dataset included 19 119 older adults aged 65 years or above who received high-intensity care at least once and died in the intensive care unit in South Korea between 2016 and 2019. High-intensity care was defined as one of the following treatments or procedures: cardiopulmonary resuscitation, mechanical ventilation, extra-corporeal membrane oxygenation, haemodialysis, transfusion, chemotherapy and vasopressors.Primary and secondary outcome measuresUsage and cost of high-intensity care.ResultsThe most commonly used high-intensity care was transfusion (68.9%), mechanical ventilation (50.6%) and haemodialysis (35.7%) during the study period. The annual cost of high-intensity care at the end of life increased steadily from 2016 to 2019. There existed differences by age, gender, length of hospital stays and primary cause of death in use of high-intensity care and associated costs.ConclusionFindings indicate that invasive and device-dependent high-intensity care is frequently provided at the end of life among older adults, which could potentially place an economic burden on patients and their families. In Korea’s ageing society, increased rates of chronic illness are expected to significantly burden those who lack the financial resources to provide end-of-life care. Therefore, guidelines for the use of high-intensity care are required to ensure affordable end-of-life care.
Purpose: This descriptive research study aimed to identify the factors that influence depression according to household type (older adults who live with a spouse, adult children, or alone).Methods: A total of 9,790 older adults were selected and analyzed using the 2020 National Older Koreans data. A Rao-Scott x2 test was conducted to evaluate the differences in the individual, health-behavior, and mental-health factors according to family structure. A complex samples logistic regression was used to analyze the factors that influence depression according to family structure.Results: Depression according to family structure was in the order of older adults who live alone, with adult children, or a spouse (p<.001). Total income, number of chronic diseases, hospitalization, exercise, and suicide ideation were identified as depressive factors for older adults who live with adult children. Employment, subjective health status, number of chronic diseases, hospital visitation, hospitalization, drinking, suicide ideation, economic status satisfaction, and cultural life satisfaction were depressive factors for older adults who live with a spouse. Employment, subjective health status, hospitalization, drinking, suicide ideation, and cultural life satisfaction were depressive factors (p<.05) for older adults who live alone.Conclusion: It is necessary to detect depression early and operate a mental health program considering the family structure of older adults.
With the enforcement of the Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End-of-Life Act in 2018, interest in the quality of death in South Korea is increasing. However, few studies have provided an updated perspective on a good death. This integrative review describes the attributes of a good death from the perspective of South Korean older adults. Among the 32 studies included in this review, 16 main themes representing good death were identified. Themes of maintaining dignity, not burdening others, living a meaningful life, being pain-free, and being prepared to die were commonly reported attributes of a good death in other cultures; themes further reflected in Korean culture were filial piety and parenting. In contrast, older adult characteristics such as low income and education level, bereavement experience, disease uncertainty, and depressive symptoms were associated with high levels of fear of death or negative attitudes, such as trying to avoid suffering through death. This review provides insights into the health care provider's approach to older people at the end of their life in South Korea. Consequently, this can help determine potential unmet needs that can be improved.
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