Miyeon Jung

Concordia University–Ann Arbor, Ann Arbor, Michigan, United States

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Publications (3)6.2 Total impact

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    ABSTRACT: Almost one-fourth of older adults hospitalized with heart failure (HF) are discharged to skilled nursing facilities (SNFs). The purpose of this review was to evaluate knowledge about HF patients discharged to SNFs to provide a foundation for future studies. A search was conducted of Medline, CINAHL, PubMed, and Google Scholar. Key words were heart failure, congestive heart failure, skilled care, skilled nursing care, skilled nursing facilities, nursing home, postacute care, postacute services, and subacute care. Publications (n = 37) were reviewed and categorized into case studies, editorials, clinical care, evaluation projects, and data-based publications. Of 29 data-based publications, 6 were focused on factors associated with hospital readmission from postacute settings, 3 on trends in hospitalizations, 12 on hospital discharge to postacute services, 5 on rehabilitation services in postacute settings, 1 on cost, and 2 on interventions. Patients discharged to SNFs were at high risk for mortality and multiple hospitalizations. No HF-specific care or guidelines were found at SNFs. Only 1 study evaluated quality of life at SNFs. Prospective studies are needed to evaluate the clinical condition of HF patients discharged to SNFs and the interventions they receive.
    Journal of cardiac failure 11/2012; 18(11):854-71. · 3.25 Impact Factor
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    ABSTRACT: BACKGROUND:: The family caregivers of patients with heart failure (HF) report burden and poor quality of life, but little is known about changes in their perceptions over time. OBJECTIVES:: The aims of this study were (1) to evaluate changes in caregiver burden (perceived time spent and difficulty with caregiving tasks), perceived control, depressive symptoms, anxiety, perceived life changes, and physical and emotional health-related quality of life; (2) to determine differences in perceptions between caregivers of patients with low HF symptoms (New York Heart Association class I and II) and caregivers of patients with high HF symptoms (New York Heart Association class III and IV); and (3) to the estimate time spent performing caregiving tasks. METHODS:: Sixty-three HF patients and 63 family caregivers were enrolled; 53 caregivers completed the longitudinal study. Data were collected from medical records and interviews conducted by advanced practice nurses at baseline and 4 and 8 months later. RESULTS:: Caregivers who completed the study had significant improvements in perceived time spent on and difficulty of caregiving tasks from baseline to 4 and 8 months, and depressive symptoms decreased from baseline to 8 months. Perceived life changes resulting from caregiving became more positive from baseline to 4 and 8 months. Perceived control, anxiety, and health-related quality of life did not change. Compared with caregivers of patients with low symptoms, caregivers of patients with high symptoms perceived that they spent more time on tasks and that tasks were more difficult, had higher anxiety, and had poorer physical health-related quality of life. Estimated time in hours spent providing care was high. CONCLUSIONS:: In this sample, perceptions of the caregiving experience improved over 8 months. Health-related quality of life was moderately poor over the 8 months. Caregivers of patients with more severe HF symptoms may be particularly in need of interventions to reduce time and difficulty of caregiving tasks and improve physical health-related quality of life.
    The Journal of cardiovascular nursing 06/2012; · 1.47 Impact Factor
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    ABSTRACT: BACKGROUND:: The self-care regimen necessary in heart failure (HF) is notably complex. A complication to integrating new knowledge and behaviors is that impaired cognition has been frequently reported in patients with HF, which significantly impacts patients' health, admission and mortality rates, and instrumental activities of daily living. OBJECTIVE:: The identification of reliable cognitive screening tools to assess potential difficulties in performing self-care for cardiac populations is essential. As such, the current purposes were to evaluate the validity and stability of the International Shopping List (ISL) auditory learning subtest from the computerized CogState battery as a screening tool in HF populations, determine the ISL's ability to predict functional declines, and evaluate the task's sensitivity in myocardial infarction. METHODS:: Forty patients with chronic HF were enrolled in a longitudinal study evaluating the impact of a cognitive training intervention. Baseline neuropsychological and behavioral measurements before treatment were used in the current study, including measures of auditory memory, orientation, verbal fluency, processing speed, and activities of daily living, and a subset of patients (n = 17) received repeat testing at 8 weeks on some tasks. Analyses also were performed with patients organized based on myocardial infarction status. RESULTS:: The current study indicated that the ISL performed comparably with an established measure of auditory memory (Hopkins Verbal Learning Test-Revised; r = 0.70, P < .001), displayed adequate coefficients of stability (r = 0.53-0.68), and successfully predicted declines over time in daily functioning (β = .47, P < .001) in our HF sample. CONCLUSIONS:: The computerized CogState auditory memory subtest, the ISL, seems to be a beneficial tool in evaluating cognitive change in HF patients. Particularly given its cross-cultural sensitivity and ease of administration and scoring, this task may provide assistance to quickly and reliably monitor memory functioning in these vulnerable patients and gauge their potential for self-care behaviors.
    The Journal of cardiovascular nursing 06/2012; · 1.47 Impact Factor