The purpose of this study was to explore the factors influencing low birth rate among married women using the National Survey data in Korea. We compared the different influences on women’s first and subsequent childbirths. This study was a secondary analysis using the “National Survey on Fertility and Family Health and Welfare”, which was a nationally representative survey conducted by the Korea Institute for Health and Social Affairs. We analyzed the data of 3,482 married women (aged between 19 and 39 years) using SPSS 20.0 program for descriptive statistics, t-test, one-way ANOVA, and binary and ordinal logistic regression models. The factors influencing women’s first childbirth included perceptions about the value of marriage and children and their education level. The factors influencing their subsequent childbirths included multifaceted variables of maternal age during the first childbirth, residential area, religion, monthly household income, perceptions about the value of marriage and children, and social media. It is necessary to improve women’s awareness and positive perceptions about marriage and children in order to increase the birth rate in Korea. Moreover, consistently providing financial and political support for maternal and childcare concerns and using social media to foster more positive attitudes toward having children may enhance birth rates in the future.

Background: It is an important strategy for healthcare providers to support heart failure patients with comprehensive aspects of self-management. A practical alternative to a comprehensive and user-friendly self-management program for heart failure patients is needed. This study aimed to develop a mobile self-management app program for patients with heart failure and to identify the impact of the program. Methods: We developed a mobile app, called Heart Failure-Smart Life. The app was to provide educational materials using a daily health check-up diary, Q & A, and 1:1 chat, considering individual users’ convenience. An experimental study was employed using a randomized controlled trial to evaluate the effects of the program in patients with heart failure from July 2018 to June 2019. The experimental group (n = 36) participated in using the mobile app that provided feedback on their self-management and allowed monitoring of their daily health status by cardiac nurses for 3 months, and the control group (n = 38) continued to undergo their usual care. The differences in the physical, psychosocial, and behavioral factors between the two groups over time were analyzed using the analysis of covariance. Results: After 3 months of intervention, significant differences between experimental and control groups were shown in the New York Heart Association functional class (p = 0.003) and cardiac diastolic function (p = 0.024). The improvements over time in the experimental group tended to be higher than those in the control group in considered variables. However, no changes in psychosocial and behavioral variables were observed between the groups over time. Conclusions: This study provides evidence that the mobile app program may provide benefits to its users, specifically improvements of symptom and cardiac diastolic function in patients with heart failure. Healthcare providers can effectively and practically guide and support patients with heart failure using comprehensive and convenient self-management tools such as smartphone apps.

Yoo JS, et al. J Korean Acad Nurs. 2009 Aug;39(4):594-601. http://dx.doi.org/10.4040/jkan.2009.39.4.594

Heart failure is a chronic disease requiring lifetime self-management at home by patients, who often require additional support. However, the long-term nature of this self-management presents great challenges for both heart failure patients and their family caregivers. The role of family caregivers is critical, but little is known about the relationship between the burden, stress, depressive symptoms, and quality of life in the family caregivers of heart failure patients. We aimed to explore caregiver burden, stress, depressive symptoms, and quality of life in both patients with heart failure and their family caregivers and identify the factors associated with family caregivers’ quality of life. The sample included 120 participants (60 heart failure patients and 60 corresponding family caregivers) from cardiovascular outpatient clinics at 2 university-affiliated hospitals in South Korea from September 2018 to July 2019. The mean ages of the heart failure patients and their caregivers were 72.72 (SD = 12.73) and 57.03 (SD = 13.42) years, respectively. Caregiver burden (r = −0.601, P < .001) and caregiver depressive symptoms (r = -0.535, P < .001) were negatively correlated with the caregivers’ quality of life. The result of the hierarchical multiple regression analysis identified 3 significant factors related to the family caregivers’ quality of life: caregiver’s age (β = −0.257, P = .012), caregiver burden (β = −0.408, P = .002) and caregiver depressive symptoms (β = −0.298, P = .018), with overall explanatory power of 47.5%. It is necessary to develop practical strategies to improve family caregivers’ quality of life by alleviating their burden and depressive symptoms. Healthcare providers should be engaged with not only heart failure patients but also their family caregivers during the disease management process to improve patients’ outcomes.

Mothers of children with complex congenital heart disease face unique challenges and emotional burdens, while their children go through physical and psychological difficulties during disease progression. In this study, we aimed to explore the in-depth experiences and feelings of mothers facing the prognosis of their children with complex congenital heart disease that was surgically corrected. This is a descriptive qualitative study. We conducted semi-structured, face-to-face interviews with 12 mothers of children with complex congenital heart disease at a tertiary hospital in Seoul, Korea. The interview data were analyzed by content analysis. Participants were mothers aged between 40–58 years whose children were diagnosed with complex congenital heart disease which was surgically corrected. Based on the content analysis, the mothers’ experiences and feelings were categorized as immense suffering and adapting to a new life. Under the main categories, the concepts included feeling of abandonment, anxiety with potentially losing their children, having hope, seeking reassurance, being encouraged, and trying to embrace the situation. Mothers who cared for their children with complex congenital heart disease expressed emotions that changed sequentially alongside physical and psychosocial changes in the children. The results of this study are valuable for understanding the experiences and emotions of mothers facing the prognosis of their children with complex congenital heart disease in order to aid in the development of programs that support these mothers.

Song JE, et al. Korean J Women Health Nurs. 2013 Sep;19(3):129-141. http://dx.doi.org/10.4069/kjwhn.2013.19.3.129