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16 "Aging"
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Research Paper
Assessment of Risk Factors for Postoperative Delirium in Older Adults Who Underwent Spinal Surgery and Identifying Associated Biomarkers Using Exosomal Protein
Baek, Wonhee , Lee, JuHee , Jang, Yeonsoo , Kim, Jeongmin , Shin, Dong Ah , Park, Hyunki , Koo, Bon-Nyeo , Lee, Hyangkyu
J Korean Acad Nurs 2023;53(4):371-384.   Published online August 31, 2023
DOI: https://doi.org/10.4040/jkan.22146
AbstractAbstract PDF
Purpose
With an increase in the aging population, the number of patients with degenerative spinal diseases undergoing surgery has risen, as has the incidence of postoperative delirium. This study aimed to investigate the risk factors affecting postoperative delirium in older adults who had undergone spine surgery and to identify the associated biomarkers.
Methods
This study is a prospective study. Data of 100 patients aged ≥ 70 years who underwent spinal surgery were analyzed. Demographic data, medical history, clinical characteristics, cognitive function, depression symptoms, functional status, frailty, and nutritional status were investigated to identify the risk factors for delirium. The Confusion Assessment Method, Delirium Rating Scale-R-98, and Nursing Delirium Scale were also used for diagnosing deliri-um. To discover the biomarkers, urine extracellular vesicles (EVs) were analyzed for tau, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), neurofilament light, and glial fibrillary acidic protein using digital immunoassay technology.
Results
Nine patients were excluded, and data obtained from the remaining 91 were analyzed. Among them, 18 (19.8%) developed delirium. Differences were observed between partici-pants with and without delirium in the contexts of a history of mental disorder and use of benzodiazepines (p = .005 and p = .026, respectively). Tau and UCH-L1—concentrations of urine EVs—were comparatively higher in participants with severe delirium than that in partici-pants without delirium (p = .002 and p = .001, respectively).
Conclusion
These findings can assist clinicians in accurately identifying the risk factors before surgery, classifying high-risk patients, and predicting and detecting delirium in older patients. Moreover, urine EV analysis revealed that postoperative delirium following spinal surgery is most likely associated with brain damage.
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Original Articles
Development of an Aging Anxiety Scale for Middle-Aged Women
Haejin Lee, Mi-Ae You
J Korean Acad Nurs 2019;49(1):14-25.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.14
AbstractAbstract PDF
Abstract Purpose

This was a methodological study that aimed to develop a measurement scale for aging anxiety among middle-aged women.

Methods

In this study, construct factors were extracted, and a conceptual framework was established through an extensive literature review and in-depth interviews with middle-aged women. Under the conceptual framework, 44 preliminary items were constructed, and a preliminary scale of 25 items was completed after two rounds of expert validation and item review. For this study, data were collected from 201 women aged 40∼59 years, and the construct validity and reliability of the preliminary scale were verified.

Results

To verify the construct validity, exploratory factor analysis was conducted. Four factors containing 19 items were extracted. Concurrent validity of the developed scale was verified with Pearson's correlation analysis. The final scale comprised 4 factors (“Social valueless”, “Physical weakness”, “Concern about changes in appearance”, and “Expectations of old age”) and 19 items. The Cronbach's α value was .91.

Conclusion

The scale for measuring aging anxiety in middle-aged women developed in this study validly reflected the peculiarities of aging anxiety in middle-aged women, who experience many physical, emotional, and social changes. The scale can be said to reflect the cultural background, as it reflected real experiences gained through in-depth interviews with middle-aged women.

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Structural Equation Modeling on Successful Aging in Elders with Chronic Obstructive Pulmonary Disease Based on Selection-Optimization-Compensation Strategy
Young Mi Jang, Rhayun Song
J Korean Acad Nurs 2017;47(4):488-498.   Published online August 31, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.4.488
AbstractAbstract PDF
Purpose

The focus of the study was on the selection-optimization-compensation (SOC) strategy to predict successful aging mediated by dyspnea symptoms in older adults with chronic obstructive pulmonary disease. The model was constructed based on the hypotheses that coping strategy and social support of the elders predict successful aging through the SOC strategies.

Methods

Participants were 218 outpatients with chronic obstructive pulmonary disease recruited for the study. Data collection was done from March 25 to September 11, 2015, and analyzed using SPSSWIN 22.0 and AMOS 21.0.

Results

The hypothetical model appeared to be fit to the data. Seven of eight hypotheses selected for hypothetical model were statistically significant. The SOC strategy has only significant indirect effects through dyspnea symptoms on successful aging. Coping strategy, social support, SOC strategies and dyspnea symptoms explained 62% of variance in successful aging.

Conclusion

The SOC strategies with social support and dyspnea symptoms significantly explained successful aging among patients with chronic obstructive pulmonary disease. Nursing strategies should be focused on social support and coping strategies to optimize SOC strategies so that older adults with chronic obstructive pulmonary disease are able to manage dyspnea symptoms and eventually achieve successful aging.

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Lived Experience with Aging in Middle-Aged Woman
K R Shin, E S Kong, G B Kim, N C Kim, C H Kim, C K Kim, H K Kim, Y J Ro, M S Song, S Y Ahn, K J Lee, Y W Lee, S O Chang, S J Chon, N O Cho, M O Cho, K S Choi
Journal of Korean Academy of Nursing 2002;32(6):878-887.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.6.878
AbstractAbstract PDF

PURPOSE: This study was to explore lived experience of middle-aged women with aging. The ultimate purpose of this inquiry was to discover the essence of middle-aged women's experience of aging and to promote understanding. METHOD: This inquiry was performed by using Van Manen's hermeneutical phenomenological approach to make more plausible interpretation of experience. First-handed experiences were explored through multi-stage in-depth interview with 6 women aged between 40 and 64. Second- handed experiences were explored with text such as essay, novel, and photographs. RESULT: As the process of reflecting and analysing the data of experience were performed, essential themes were emerged: striking onset of event, discomfort and tired body and mind, everything in ones mind, age of harvest gaining much more than loss. CONCLUSION: This inquiry would be a cornerstone for humanistic nursing care for the mid-aged women.

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The Association Between Expectations Regarding Aging and Health-Promoting Behaviors Among Korean Older Adults
Su Hyun Kim
Journal of Korean Academy of Nursing 2007;37(6):932-940.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.6.932
AbstractAbstract PDF

PURPOSE: This study was performed to measure expectations regarding aging among community-residing older adults, identify sociodemographic characteristics associated with the level of expectations regarding aging, and examine whether expectations regarding aging were associated with health-promoting behaviors. METHODS: Data was collected by using questionnaires of a short version of the Expectations Regarding Aging Survey (ERA-18) and Health Promoting Lifestyle Profile II (HPLP II) from 99 older adults who resided in the community of Kyunggi, Daegu, and Kyungpook province. RESULTS: More than 75% of the participants reported that it was an expected part of aging to have more aches and pains, to become depressed, and to become more forgetful. The mean score of expectations regarding aging was 23.15+/-17.80 (possible range 0-100). The old-old, women, those with less education, less monthly allowance and poor health status had lower expectations regarding aging than other elderly. After controlling for sociodemographic characteristics and perceived health, expectations regarding aging were independently associated with health-promoting behaviors in older adults. CONCLUSION: The findings demonstrate that older Korean adults have low expectations regarding aging, and expectations regarding aging influence health-promoting behaviors.

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Types of Nurse's Attitudes Toward the Aging Process: A Q-Methodological Approach
Kae Hwa Jo, Gyeong Ju An
Journal of Korean Academy of Nursing 2007;37(6):823-834.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.6.823
AbstractAbstract PDF

PURPOSE: The purpose of this study was to analyze types of nurse's attitudes toward the aging process. METHODS: A Q-methodology which provides a method of analyzing the subjectivity of each item was used. Thirty-four selected Q-statements from each of 38 subjects were classified into a shape of normal distribution using a 9 point scale. The collected data was analyzed using a QUANL PC program. RESULTS: Five types of attitudes towards the aging process from research subjects in Korean nurses were identified. Type I is a positive acceptance type, Type II is a negative acceptance type, Type III is a passive coping type, Type IV is an active coping type, and Type V is an ambiguous acceptance type. CONCLUSION: The results of the study indicate that different approaches of educational programs for elderly care are recommended based on the five types of nurse's attitude toward the aging process.

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Development and Evaluation of Online Aging and Health Management Education for Undergraduate Students
Myonghwa Park
Journal of Korean Academy of Nursing 2007;37(4):540-548.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.4.540
AbstractAbstract PDF
Purpose

The purpose of this study was to develop online aging and health management education for undergraduate students and to evaluate its effects analyzing the differences in knowledge and attitude toward aging and the elderly.

Method

An Online aging and health management education program was established through analysis, planning, content framing and production, program application, and evaluation stages. The study sample consisted of 98 undergraduate students in one university in D city. The instruments used were FAQ I for knowledge of aging and a 20 item semantic differential scale for attitude toward aging and the elderly.

Results

The results of this study were as follows. First, undergraduate students' knowledge level was low and attitudes were negative at the baseline. Second, after the class, knowledge scores improved significantly from 14.44 to 20.12. In addition, the attitudes toward elderly and aging changed from negative to a more positive way showing a 23.57 point difference.

Conclusion

This study shows that the online aging and health management education program was an effective educational method to improve knowledge and attitude of aging for the young generation such as college students.

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Experience of Frailty in Korean Elderly: A Phenomenological Study Utilizing the Colaizzi Method
Jin Kyoung Park
J Korean Acad Nurs 2017;47(4):562-574.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.4.562
AbstractAbstract PDF
Abstract Purpose

This study attempts to explore the subjective experience of frailty among elderly individuals in Korea.

Methods

From June to August in 2014, 11 elderly persons who had experienced frailty in a community were interviewed. For data analysis, the method suggested by Colaizzi was applied as a phenomenological method.

Results

According to the analysis, the study participants’ frailty process was structured in seven categories: ⒜ ‘natural phenomenon with ageing,’ ⒝ ‘life force comes to an end,’ ⒞ ‘the light in my heart turns off,’ ⒟ ‘unavoidable situation,’ ⒠ ‘continuous and connected vicious cycle,’ ⒡ ‘the limit of recovery energy already passes,’ and ⒢ ‘life is supported by someone's help.’

Conclusion

The frailty experience in the participants is a natural process of aging, which cause vicious cycle acting with each other among physical, psychological, and social health. It is said that the cycle of frailty was started from weight loss and insufficient sleep, and boostered by pain. The participants from repetition of the vicious cycle become exhausted and pass the threshold of their recovery energy at some points. If they meet with sudden accidents such as falling, traffic accident and so on, they become to live a dependent life supported by someone's help in a moment. To prevent frailty and worsening conditions in Korean elderly individuals, it is recommended to provide a interventional programs using this study's results.

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The Influence of Subjective Health Status, Post-Traumatic Growth, and Social Support on Successful Aging in Middle-Aged Women
Seung Hee Lee, Hyung Suk Jang, Young Hee Yang
J Korean Acad Nurs 2016;46(5):744-752.   Published online October 31, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.5.744
AbstractAbstract PDF
Purpose

This study was done to investigate factors influencing successful aging in middle-aged women.

Methods

A convenience sample of 103 middle-aged women was selected from the community. Data were collected using a structured questionnaire and analyzed using descriptive statistics, two-sample t-test, one-way ANOVA, Kruskal Wallis test, Pearson correlations, Spearman correlations and multiple regression analysis with the SPSS/WIN 22.0 program.

Results

Results of regression analysis showed that significant factors influencing successful aging were post-traumatic growth and social support. This regression model explained 48% of the variance in successful aging.

Conclusion

Findings show that the concept 'post-traumatic growth' is an important factor influencing successful aging in middle-aged women. In addition, social support from friends/co-workers had greater influence on successful aging than social support from family. Thus, we need to consider the positive impact of post-traumatic growth and increase the chances of social participation in a successful aging program for middle-aged women.

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Successful Aging of Korean Older Adults based on Rowe and Kahn's Model: A Comparative Study According to the Use of Community Senior Facilities
Soo Jin Lee, Misoon Song
J Korean Acad Nurs 2015;45(2):231-239.   Published online April 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.2.231
AbstractAbstract PDF
Purpose

This study was conducted to examine the prevalence of successful aging and factors influencing successful aging.

Methods

This was a secondary analysis study. Data were analyzed from 10,462 elderly people who participated in the 2011 National Elderly Survey. According to the use of community senior facilities, participants were divided into 4 groups: those who used senior centers (group A, n=580), village senior clubs (group B, n=3,240), both of the 2 facilities (group C, n=339), and neither of the 2 facilities (group D, n=6,303). Cross-tabulation and logistic regression were performed.

Results

The prevalence of successful aging was highest in group C (20.94%) and lowest in group D (10.41%). The physical & mental function and active engagement domains were highest in group C, while they were lowest in group D. The disease & risk factors domain were highest in group A, while lowest in group B. An educational level of middleschool or higher and income level in the third or higher quintile were significant factors for predicting successful aging in all groups.

Conclusion

These results provide a basis for designing prevention and management programs as interventions to increase the prevalence of successful aging in Korean older adults.

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Relationship between Expectations Regarding Aging and Physical Activity among Middle Aged Adults in Urban Areas: Based on the Pender's Health Promotion Model
Sung-Hye Cho, MoonKi Choi, JuHee Lee, Hyewon Cho
J Korean Acad Nurs 2015;45(1):14-24.   Published online February 27, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.1.14
AbstractAbstract PDF
Purpose

The purpose of this study was to measure the level of expectations regarding aging (ERA) and identify relationship between ERA and physical activity of middle aged adults.

Methods

Participants were middle aged adults who resided in the community in three cities in Korea. Data were collected using questionnaires that contained items on individual characteristic, International Physical Activity Questionnaires (IPAQ), and behavior-specific cognitive factors including ERA-12. Hierarchical multiple regression was conducted to examine whether ERA would predict physical activity by controlling other factors.

Results

The mean age of the participants was 51.1±6.9 years. The mean score for ERA (possible range=0 to 100) was 40.04±14.31. More than half of the participants (62.6%) were not engaged in health promoting physical activity. Gender, employment status and exercise confidence were associated with level of physical activity (F=7.14, p<.001, R2=.36). After controlling for individual factors and behavior-specific cognitive factors, ERA was independently related to physical activity (F=7.19, p<.001, R2=.38).

Conclusion

The results demonstrate that individuals' belief about aging has effects on physical activity in Korean middle aged adults. Thus, nursing interventions which focused on ERA could help enhance physical activity in middle aged adults.

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Accessing Factor Structure and Construct Validity of the Successful Aging Inventory
Eun Joo Kim
J Korean Acad Nurs 2013;43(4):568-578.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.568
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the reliability and validity of the Korean version of the Successful Aging Inventory (SAI-K) to determine its suitability for use with older Korean adults.

Methods

Exploratory and confirmatory factor analyses were utilized to assess the factor structure and the construct validity of the SAI-K. First- and second-order Confirmatory Factor Analysis (CFA) were conducted to identify the most adequate model. Cronbach's alpha was used to test the reliability.

Results

Using a second-order CFA, a four-factor structure was validated (χ2=122.82, p<.001, GFI=.92, AGFI=.88, SRMR=.06 RMSEA=.07, 90% CI=.05-.09, CFI=.93). The four-factor SAI-K showed reliable internal consistency with a Cronbach's alpha for the total scale of .86.

Conclusion

The four-factor, 13-item SAI-K showed satisfactory reliability and validity and, thus, has the potential to be an appropriate instrument for measuring successful aging in older Korean adults.

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Effects of a Smoking Cessation Program including Telephone Counseling and Text Messaging using Stages of Change for Outpatients after a Myocardial Infarction
Jung-Hyeon Kong, Yeongmi Ha
J Korean Acad Nurs 2013;43(4):557-567.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.557
AbstractAbstract PDF
Purpose

This study was done to identify effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients who have had a myocardial infarction (MI).

Methods

This research was a quasi-experimental design with a nonequivalent control group pretest-posttest. The participants were 48 outpatients (experimental group=24, control group=24) recruited from one university hospital. They were randomly assigned to one of two groups: (a) an experimental group with telephone counseling (once a week) and text messaging (five times a week) using stages of change, and (b) a control group with traditional telephone counseling (once a month). Efficacy of the intervention was measured by comparing the two groups on smoking-related variables at 3 weeks and 12 weeks.

Results

At the 3-week and 12-week measurements, there were significant differences between the experimental and control groups on smoking cessation self-efficacy (p<.001), nicotine dependence (p<.001), CO levels (p<.001), and smoking cessation rates (p<.001).

Conclusion

The results indicate that the smoking cessation program including telephone counseling and text messaging using stages of change is effective for outpatients after a MI. Further attention should be paid to the intensity of the smoking cessation program and periods for long-term follow-up.

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Effects of Perceived Health Status, Self-esteem and Family Function on Expectations Regarding Aging among Middle-aged Women
Yoo Rim Kweon, Hae Ok Jeon
J Korean Acad Nurs 2013;43(2):176-184.   Published online April 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.2.176
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate expectations regarding aging by middle-aged women in the community, and identify factors contributing to their expectations about aging.

Methods

Participants in the survey for this study were 303 middle-aged women from community health centers and religious facilities in Seoul, Gyeonggi Province, and Chungcheongbuk Province. Data were collected from March 2 to April 17, 2012 using self-report structured questionnaires. The instruments were the Health Perceptions, Rosenberg Self-esteem Scale (RSES), Family APGAR, Expectations Regarding Aging (ERA-12). The data were analyzed using t-test, one-way ANOVA, Scheffe test, Pearson correlation coefficients and hierarchical multiple regression with IBM SPSS/WIN 20.0 program.

Results

Perceived health status (β=0.16, p=.009) and self-esteem (β=0.20, p=.001) of middle-aged women were identified as significant predictors of expectations regarding aging, after adjusting for age, education, occupation, monthly income and menstrual status.

Conclusion

These results suggest that nurses should make an effort to improve expectations about aging among middle-aged women. Ultimately, community health programs for middle aged women need to be developed to achieve successful aging.

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Structural Equation Modeling on Successful Aging in Elders - Focused on Selection · Optimization · Compensation Strategy -
Doo Nam Oh
J Korean Acad Nurs 2012;42(3):311-321.   Published online June 29, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.3.311
AbstractAbstract PDF
Purpose

This study was designed to construct and test a structural equation modeling on specific domain health status and the Selection · Optimization · Compensation (SOC) strategy affecting successful aging in elderly people.

Methods

The model construction was based on the SOC model by Baltes and Baltes. Interviews were done with 201 elderly people aged 65 or older. Interview contents included demographics, functional health status, emotional health status, social health status, SOC strategies, and successful aging. Data were analyzed using SPSS 15.0 and AMOS 7.0.

Results

Model fit indices for the modified model were GFI=.93, CFI=.94, and RMSEA=.07. Three out of 7 paths were found to have a significant effect on successful aging in this final model. Functional health status had a direct and positive effect on successful aging. Emotional health status influenced successful aging through SOC strategies.

Conclusion

This study suggests that interventions for improving functional health status and for strengthening SOC strategies are critical for successful aging. Continuous development of a variety of successful aging programs using SOC strategy is suggested.

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Development of a Web-based Senescence Preparation Education Program for Successful Aging for Middle-aged Adults
Young-Mi Jung
J Korean Acad Nurs 2008;38(6):831-842.   Published online December 31, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.6.831
AbstractAbstract PDF
Purpose

The purpose of this study was to develop a web-based senescence preparation education program to promote successful aging.

Methods

This program was developed based on Network-Based Instructional System Design (NBISD) model, using the following 5 processes: analysis, design, development, implementation, and evaluation. The program was operated for 10 weeks from March 17 to May 25, 2008.

Results

There were 4 menu bars, introduction, related data, lecture room, and communication on the main page. In the operation of this program, HTML, ASP, JAVA Script, Namo web editor, Edit Plus, Front Page and multimedia technology were applied. The program content consisted of understanding elderly people, physical health, activity & exercise, nutrition, medication use, psychological health, intellectual health, understanding death, welfare system and leisure activity.

Conclusion

This program could be a useful means to provide senescence preparation information to middle-aged adults. Also, it is expected to offer individualized learning opportunities to many learners in various settings. Nurses should further develop and facilitate various learning strategies including web- based programs for elder care.

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