Aims The purpose of this study was to identify the role of psychological insulin resistance in the relationship between diabetes self‐efficacy and diabetes self‐care management in people with diabetes over 65 years of age. Design A descriptive, cross‐sectional design was used. Methods Participants included 326 patients with type 2 diabetes who were over 65 years of age. Structural equation modelling was performed to estimate the direct and indirect effects of diabetes self‐efficacy on diabetes self‐care management when psychological insulin resistance was entered as a mediator. Data were collected from May 2015 to January 2017. Results Diabetes self‐efficacy (r = .53, p < .001) and psychological insulin resistance (r = .33, p < .001) were significantly associated with diabetes self‐care management, whereas a negative association was found between diabetes self‐efficacy and psychological insulin resistance (r = −.16, p < .001). When psychological insulin resistance was entered as a mediator, the association between diabetes self‐efficacy and diabetes self‐care management was attenuated. Therefore, psychological insulin resistance served as a mediator of diabetes self‐care management.
The purpose of this study was to evaluate the psychometric properties of the Korean version of the European Organization for Research and Treatment of Cancer Quality of Life-QLQ-BRECON23 in women diagnosed and treated for breast cancer undergoing all types of breast reconstruction. Methods: A total of 148 Korean women who underwent breast reconstruction were recruited from the breast cancer center to participate in the study. After performing forward and backward translation of the original English version of the questionnaire into Korean, its validity (construct, known-group validity, concurrent) and reliability were assessed. A structural equation model (SEM) was used to assess construct validity. Results: The mean age of the patients was 52 years, and 89.8% underwent implant-based reconstruction. Construct validity using confirmatory factor analysis showed a good fit, and the effect size was small-to-medium regarding known-group validity. Concurrent validity was confirmed by the significant correlation between the QLQ-BRECON23 and the QLQ-BR23. The reliability of the QLQ-BRECON23 symptom and function scales ranged from 0.61 to 0.87. Conclusion: The Korean QLQ-BRECON23 can be applied to assess quality of life and its related factors, and also to internationally compare the level of quality of life in breast cancer patients undergoing breast reconstruction.
Purpose: This scoping review focused on the application of simulation education for nursing college students and analyzed studies measuring problem-solving ability to present an overview of research trends and future directions. Methods: The scoping review followed the review guideline. The study was conducted independently by two reviewers, who searched the literature through electronic databases (DBpia, KISS, Science on, RISS, and Google Scholar). Results: In total, 32 studies were included in the final analysis, and each study was analyzed according to the following domains: general characteristics, simulation-related characteristics, and instrument-related characteristics. Simulation-based learning was primarily conducted for third- and fourth-year nursing students using various scenarios and high-fidelity simulators. However, the effect of simulation education on problem-solving ability was somewhat inconsistent, and some studies reported different names of tools and numbers of items by sub-area from the original instruments. Conclusion: It is necessary to critically reflect upon whether “Process Behavior Survey” tool can be used for simulation education. Therefore, conceptual analysis or instrument development research is needed in the future to accurately measure the problem-solving process or problem-solving ability.
Despite the well documented effectiveness of insulin on glycemic control, many patients with type 2 diabetes are reluctant to receive insulin therapy, called Psychological Insulin Resistance (PIR). Motivational Interviewing (MI) is a client-centered counseling method that may improve PIR and insulin acceptance behavior. The purpose of the study was to examine the effect of MI on insulin acceptance in insulin naïve patients with type 2 diabetes. Participants were recruited from outpatient clinics in two academic affiliated hospitals in South Korea. A matched subjects design was used to allocate the intervention (n=55) and control (n=55) groups based on age, gender, and the stage of intention to receive insulin therapy. The stages of intention to receive insulin therapy were pre-contemplation, contemplation, and action stages. Sociodemographic and clinical factors (years of diabetes diagnosis, medications, HbA1c, comorbidity) were collected by chart reviews. Six MI sessions (2 face-to-face [60 min/session] + 4 telephone sessions [20 min/session]) were provided to the intervention group by 6 trained nurses for 3 months. The effect of MI was measured by attitudes toward diabetes, PIR, and intention to receive insulin therapy at baseline and at 3 months using validated measures. Data were analyzed with paired t-test, t-test, and χ²-test. There was no significant difference in clinical factors, attitudes toward diabetes, PIR, and intention to receive insulin therapy between intervention and control groups at baseline. After the 6 MI sessions, the intervention group improved the intention to receive insulin therapy (χ²=10.44, p=.01) and attitudes toward diabetes (t=2.60, p<.01), and <significantly decreased PIR (t=-2.71, p<.01). MI combined with face-to-face and telephone sessions may be an effective strategy to improve attitudes toward diabetes, PIR, and intention to receive insulin therapy in insulin naïve Korean patients with type 2 diabetes. Disclosure Y. Song: None. J. Cho: None. H. Lee: None. K. Park: None. Y. Lee: None. B. Kim: None. K. Seo: None. A. Lim: None. Y. Jun: None. S. Nam: None.
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