This study aimed to evaluate the effectiveness of a customized health promotion program (CHPP) on depression, cognitive functioning, and physical health of elderly women living alone in the community.
A randomized comparison of pre-and post-test design was used with 62 participants assigned to either an intervention (n=32 in seven clusters) or a control group (n=30 in seven clusters) in 14 areas of a town. The final sample included 30 intervention participants who completed the CHPP for 10 weeks, and 26 control participants. The intervention group participated in the CHPP weekly; they were provided with instructions about coping with their chronic illnesses, lifestyle modification, risk management, providing emotional support to each other, and floor-seated exercise, which they were encouraged to do three times a week in their homes.
Significant group differences were found in depression (U=48.50,
The findings indicate that CHPP was overall effective at improving depression, cognitive functioning, and physical functioning of elderly women living alone, and could therefore be considered a positive program for community-dwelling elderly women living alone.
The purpose of the study was to identify the effects of 12-week low-intensity exercise program on muscle strength, flexibility, balance, and cognitive characteristics related to the performance of activity of daily living(ADL). A total of 16 patients who were admitted to the medical unit of a general hospital in ChoongChung province were recruited eight for the exercise group and eight for the comparison group. Four levels of low-intensity exercise from 'ROM on bed' to 'exercise while walking' were then applied to the exercise group according to their physical condition. During hospitalization, patients in the exercise group performed each level of the prescribed exercise with the researchers until they felt. comfortable doing it independently. The researchers also visited the patients' homes after discharge to make sure they could perform the exercise with Theraband in their living environment. The exercise group was contacted by phone once a week to assess the frequency and intensity in which they performed the exercise as well as their physical condition. The subjects in the comparison group participated in measurements for the study without performing the exercise and were contacted by phone after discharge, in a matched time frame with the exercise group, to assess physical condition. Muscle strength, flexibility, balance, cognitive characteristics, and performance of ADL for the two groups were compared at the pretest and the posttest after the low-intensity exercise program by utilizing SPSSWIN and the results are as follows : 1) At the posttest, measurments of muscle strengths showed that the strength of the dorsal flexor in the exercise group was significantly higher than in the comparison group. 2) Objective balance for the exercise group was significantly better than for the comparison group as measured by 'standing on one foot' and Tinetti gait and balance control. 3) The exercise group showed significantly higher task self-efficacy than the comparison group. 4) Perceived exertion for ADL for the exercise group was significantly lower than for the comparison group. 5) Improvement of performance of ADL without assistance was significantly for the exercise group than the comparison group. The findings suggest that a low-intensity exercise program would be useful for the elderly who show decline in their physical functioning due to hospitalization by partly improving physical strength, task self-efficacy, and performance of ADL. Directions for further research on issues of motivating people to exercise as well as of standardizing various types of exercise were discussed.
This study was done to describe health promoting lifestyle and determine affecting factors in elderly based on the Heath Promotion Model by Pender. Cognitive-perceptual factors that were included in this study were self-efficacy and hardiness. Modifying factors were demographic characteristics(sex, age, partner, previous illness, education level, income and religion). The specific purpose of this study was to examine the relationships of self-efficacy, hardiness and the demographic chasteristics to health promoting lifestyle and to determine causal factors affecting the elderly. The subjects were a volunteer sample of 98 elderly in one city in? The instruments for this study were Health Promoting Lifestyle Profile(47items, 4scale), Health Related Hardiness Scale(22items, 6scale), general Self-Efficacy Scale((13items, 5scale). Frequency, percentage, t-test, ANOVA, Pearson's correlation coefficient and Stepwise Multiple regression technique with SAS program were used to analyze the data. The Results of the study are follows ; 1) The average item score for the health promoting lifestyle was 2.63, the highest score on the subscales was interpersonal support(M=3.3), followed by self-actualization(M=2.9), nutrition (M=2.8), stress management(M=2.7), health responsibility(m=2.1) with the lowest being exercise(M=2.0). 2) A significant difference between education level, income, religion and health promoting lifestyle were found. 3) All of the subscales on health promoting lifestyle were positively related to total hardiness(r=0.330, p<0.001). The hardiness subscale of control was positively related to self-actualization(r=0.276, p<0.01), and commitment was positively related to self-actualization(r=0.315, p<0.001), exercise/nutrition(r=0.245, p<0.01), interpersonal support(r=0.278, p<0.01), stress management(r=0.250, p<0.01). Challenge was positively related to self-actualization(r=0.315, p<0.001), exercise/nutrition((r=0.245, p<0.01). There was no significant correlation between self-efficacy and all of the subscales of health promoting lifestyle. Self-efficacy showed a significant correlation only with control(r=0.469, p<0.001), committment(r=0.507, p<0.001), Challenge(r=0.489, p<0.001). 4) Committment, self-efficacy and income explained 25.01% of the variance for the total health promoting lifestyle. The results of this study show that commitment, self efficacy and income predicted the health promoting lifestyle of the elderly. So health promoting programs that increase committment and self-efficacy should be developed to promote a healthy lifestyle of the elderly, especially those who have low income.
The main purpose of this study was getting related to the pain charactristic data of elderly. It contains past and present health status, daily living activity level, pain frequency, causes, pain area, pain intensity, pain worse causes, and pain releave causes, pain management methods. The subject were 79 elderly whose age were over 65 years old. They were lived in their home environment. Half of them were resident of middle range city at province and the others were Seoul city. The data was collected from Dec. 1st. 1995 to Jan. 30th. 1996. Interviews were held with semi-structured questionaire after pilot study by researchers. Pain measurement tool were used graphic rating scale and Abstract of Korean Pain Language Scale. To analize the subject's general characteristics, past and present health status, daily living activity level, characteristics about pain, pain management methods statistical SPSS for win frequency were employed. The findings were as follows; 1. There were 33(41.8%) male and 46(58.2%) female Below 69 year old were 20(25.3%), 70-79 year old were 42 (53.2%), over 80 year old were 17(21.5%), mean age was 74(from 65 to 89). 2. Buddhist were 24(30.4%), Christian were 29(36. 7%), the other religious status or nun religians were 26(32.9%). 3. Past good health status were 63(79.7%), not so good status were 6(7.6%). Present good health status were 19 (24.1%), moderated health status were 6(7.6%), not so good status were 14(17.7%). 4. Daily living activity limitation were 39(49.4%), nonlimitation of activity were 5(6.3%). 5. Walking limitation were 3(3.8%), nonlimitation walking were 52(65.8%). 6. Insomnia was 23(29.1%), no difficult were 38(48. 1%). 7. Chronic pain complaints were 64(81%), diseases causes of pain were 25(31.6%), bad health behavior causes of pain were 27(34.2%). 8. Most pain area were back 30(29.4%), leg 17(16. 7%), knee 16(15.7%), arm 13(12.7%), teeth, chest and head were each 5(4.9%), loin, trunk were each 4(3.9%), the other areas were 3(3%). 9. Pain intensity was 3.49(mean) by Korean Language Scale, 6.59(mean) by graphic rating scale. Sensitive pain was 3.5(47.9%), affective pain was 3(20.8%) It was high pain level and sensitive pain. 10. Most pain worse causes moving was 35(44.3%), pain relieving causes rest was 29(36.7%). 11. Pain management method were medication 40 (42.1%), physiotherapy 23(24.2%), hospital 12 (12.6%), the others 7(7.4%), none 13(13.7%). The conclusion; Present health status of eldery was not so good. Almost half of them have some diseases. Most common diseases of eldery were arthristis, respitatory and heart problems. Fourty nine percent of elderly had limitation of daily living activities. Eighty one percent of eldely had chronic pain. Most of them was back pain (30%). Pain intensity was high (score over 3.5). The worsening pain causes was moving and releiving causes was rest. Pain management method were pain medication, physiotherapy. Therefore, Nursing care plan for the elderly have to focus on pain because majority of elderly have chronic high level of pain related to the arthritis.
Regular long term dance movement could be one of ways to induce improvement of psychophysiological variables, resulting in improvement of quality of life. However, there have been few studies to evaluate the effect of dance movement training on both physiological and psychological variables in the elderly. This study was focused to determine the effect of Korean traditional dance movement training on psychophysiological variables-body weight, body fat, lean body mass, muscle strength, muscle endurance, flexibility, agility, resting heart rate and blood pressure, depression and life satisfaction-in Korean elderly women. Thirty four subjects, aged between 65 and 75years who have normal cognition, sensory function, cerebellum function, cardiovascular function, participated in this study. Seventeen experimental group subjects were selected from E-elderly university in Kyung Gi province, and Seventeen control group subjects were selected from N -welfare facility in Seoul City. Seventeen experimental group subjects participated for 12weeks dance movement program. Korean traditional dance movement program was developed on the basis of Korean traditional dance and music by the author. The program consisted of approximately 50minutes of dance, 3times a week for 12weeks. During 50minutes workout, there were 15minutes of warm-up dancing, 25minutes of conditioning dance and 10minutes of cool-down dancing. The intensity for the conditioning phase was at between 60% and 65% of age-adjusted maximum heart rates. The body weight, body fat, lean body mass, muscle strength(grip strength, leg strength), muscle endurance, flexibility, agility, resting heart rate and blood pressure, depression and life satisfaction were measured prior to and following the experimental treatment. The participants in dance movement were interviewed focusing on subjective feeling following 12 week's regular dance movement. Data were analyzed with mean, standard deviation, percentage of change, X2-test, t-test, and ANCOVA test using SPSS PC+ program. Subjec tive feeling was categorized into cognitopsy-chological and physiological responses. Results were obtained as follows: 1) The body weight(F=15.52, p=.000), body fat (F=18.33, p=.000) and lean body mass(F=7.28, p=.011) of the experimental group were significantly lower than those Of the control group following the dance movement training. 2) The leg strength (F=30.96, p=.000), muscle endurance (F=9.06, p=.005), agility(F=44.92, 000), flexibility(F=6.84, p=.014) of the experimental group were significantly higher than those of the control group following the dance movement training. There was no significant difference of grip strength (F=. 43, p=.515) between experimental and control groups. 3) The heart rate(F=26.96, p=.000), systolic (F=10.40, p=.000) and diastolic(F=3.99, p= .005) blood pressure at rest of the experimental group were significantly lower than those of the control group following the dance movement training. 4) No significant difference of score of depression (F=3.49, p=.071) was observed between experimental and control groups. 5) Score of life satisfaction of experimental group was remarkably higher than that of control group following 12weeks of dance movement training (p<0.05). 6) Thematic responses about the dance movement following the training were positive. "I feel good" was the most frequent among cognitopsychol-ogical responses and "I feel lightness of body" was the most frequent among physiological responses. The results suggest that Korean traditional dance movement training can improve psychophysiological variables of Korean elderly.
The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive understanding of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included: the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows: 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions(CDRL), bizarre behaviors and the families's burden by living arrangement and/or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus, it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.
It is important to evaluate nutritional status of elderly patients receiving dialysis, since wasting and malnutrition are their common problems. This study aims at assessing their nutritional status by the type and duration of dialysis. The nutritional status such as somatic fat and protein storage was evaluated with anthropometric measure including weight/height ratio, triceps skinfold thickness and midarm muscle circumference. It was also measured with albumin, transferrin, C3 and IGF-1 and calroie and protein intakes. The general clinical condition of patients was evaluated with the severity of uremia and metabolic acidosis, which were measured through the levels of serum urea, creatinine and bicarbonateion. The data were analyzed by using t-test, ANOVA, Wilcoxon -rank sums test, Scheffe test, Kruskal -Wallis test and Pearson correlation coefficients. The results are following; 1. There was no significant difference in the calorie and proten intakes by the type and duration of dialysis received. 2. As for the anthropometric measures, no significant difference was found by the type of dialysis in body mass index, triceps skinfold thickness and midarm muscle circumference. Yet these anthropometric measures differed significantly by the duration of dialysis in those elderly patients receiving hemodialysis(HD group), but this finding was not found in those receiving continuous ambulatory peritoneal dialysis(CAPD). 3. Regarding the indicators of uremia and metabolic acidosis, blood urea mtrogen(BUN) and creatinine were lower in the CAPD group than in the HD group, whereas bicarbonate ion was higher in the CAPD group than in the HD group, with no statistical significance. In the HD group, creatinine incresed significantly with the increase of the duration of dialysis. 4. Serum trasferrin and C3 were significantly higher in the CAPD group than in the HD group. However, each of biochmical indices did not show statistical significance by the duration of dialysis in both HD and CAPD groups. 5. Anthropometric measures were significantly associated with dietary intake. Significant correlations were observed between biocarbonate ion, BUN and creatinine. In addition, the correlations between serum protein and albumin and between transferrin and C3 were statistically significant. Yet, IGF-1 revealed no significant correlation with other nutritional indices. The above findings indicate that there were no difference in nutritional status mearsured with protein and calroie intakes between the type and duration of dialysis, but CAPD seems to benefit correcting uremia and metabolic acidosis than HD. Studies of dietary management for dialysis patients need to be pursued in order to improved the quality of aged patients receiving dialysis.
Sleep disturbance is a typical health problem of the elderly. The purpose of this study was to explore the extent of sleep disturbance of Korean elderly, and to identify the influencing and predicting factors. A total of 15216 subjects were interviewed. To measure the quality of sleep, "The Korean Sleep" Scale was used, and as influencing factors on sleep, physical health, emotional and social activity variables were included. In this study, the percentage of a change of sleep pattern was 59.2%, and it was higher in elderly women and in above 80 yrs. But only 10.4% of subjects regarded a change of sleep pattern as a problem, and it was higher in elderly women. Total sleeping time was shorter in female and it was shortest in 65-69yrs. The higher age, the presence of Ds, the longer sickdays, the lower level of ADL and IADL, the more depressive, the more tedious during the daytime, and the less frequent engagement in exercise, the lower quality of sleep measured by KSS. Predicting variables of quality of sleep included depression, boredness during the daytime, sex, the presence of Ds, IADL, the frequency of exercise during a week, and age. These seven variables explained 13% of total quality of sleep. The extent of change of sleep pattern in the elderly is very high. Continuous efforts to increase quality of sleep of the elderly by intervening in factors influencing quality of sleep are needed.
PURPOSE: It was identified that how many homebound bedridden elderlies and their primary caregivers were depressed, and which factors affected the bedridden elderly's depression. METHOD: The subjects were 191 homebound bedridden elderlies and their primary caregivers. The affecting factors were classified into two categories: bedridden elderly and their primary caregiver related factors. Then bedridden elderly's factors were classified demographic and disease-related factors again. The stepwise regression was used to identify significant factors. RESULT: The prevalence of bedridden elderly's and caregiver's depression was 77.8% and 67.0%, respectively. And the model explained 33.3% of variance of bedridden elderly's depression. Cognitively-impaired female elderlies who had depressed caregivers were found to be more depressed. And caregivers who perceived burden were identified to be more depressed. CONCLUSION: It is recommended that the health professionals need to identify bedridden elderlies and caregivers at risk of depression. Especially elderlies who is in poor cognition, those who are female, and those whose caregivers were depressed might be considered carefully in all counseling or follow-up. Also the primary caregivers must be helped to access already available formal and informal support.
PURPOSE: The purpose of this study was to evaluate the effect of a Yoga program on decreasing blood pressure in elderly patients with essential hypertension and to suggest a yoga program effective as a nursing intervention tool to reduced blood pressure with increasing life satisfaction. METHOD: The subjects of this study were 24 elderly's essential hypertension, who practiced yoga by three times a week for 8 weeks. In order to evaluate the effect of the yoga program, blood pressure, physiological parameters (Total cholesterol, HDL, LDL, triglycerides) and level of life satisfaction were measured before and after the training. Collected date were analyzed by SPSSWIN program. RESULT: 1) There were significant reduction in systolic and diastolic blood pressure. 2) There were significant reductions in total cholesterol, LDL, triglycerides but no significant increased in HDL. 3) Blood pressure changes were time specific: Both of systolic and diastolic blood pressures were significantly reduced after 2weeks. 4) There was a significant increase in life satisfaction. CONCLUSION: The results proved that a yoga program was an effective nursing intervention to reduce blood pressure and to increased life satisfaction for elderly patients with essential hypertension.
PURPOSE: The purpose of this study was to investigate the relationships among variables of transtheoretical model for exercise in the elderly. METHOD: A hypothetical model explaining the stage of change was constructed based on a transtheoretical model. Empirical data for testing the hypothetical model was collected from 246 old adults over 65 years old in a community settings in Seoul, Korea in June and July, 2000. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling(LISREL) 8.0 program was used to find the best fit model which explain causal relationship of variables. RESULT: The fitness of modified model to the data was X2= 96.75(df=49, p=.00005), GFI= .98, NFI=.99, AGFI=.95, NNFI=.99. The the predictable variables of stage of change explained 64% of stage of change for exercise. CONCLUSION: Results are consistent with the studies of application of the transtheoretical model, which has been used to understand how people change health behaviors. The findings of this study give useful informations to construct exercise intervention program for the elderly about relationships among variables influencing to the stage of change of exercise.
PURPOSE: This study was conducted to evaluate the process & outcome of a Health promotion program(Growing Younger & More Active) for the community resident older adults from March to December, 2001. METHOD: A quasi experimental research(one group pretest-posttest design) was used in this study. The subjects were 82 older adults(but 40 older adults 4 weeks after the program). Program had 5 sessions(10 hours) once a week. Data were collected before the program, immediately after & 4 weeks after the program and were analyzed with paired t-test. RESULT: The levels of Satisfaction, Interest & Understanding of the Program were high. Significant differences were found in health knowledge, health promoting behaviors, perceived health status and life satisfaction between before program and immediately after program as well as between before program and 4 weeks after program, but no significant differences in Health attitude. Self efficacy has significant difference only between before program and immediately after program , but no significant differences between before program and 4 weeks after the program. CONCLUSION: This results suggest that a Health promotion program for the community resident older adults developed this study is effective. So this program can be recommended as an effective nursing intervention for the health promotion of the older adults living in community.
PURPOSE: The purpose of this study was to measure the prevalence of urinary incontinence (UI), urologic symptoms, chronic health problems they have, and to explore whether the differences in incidence of UI ware by age, sex, voiding pattern, and chronic health problems.
METHOD
298 subject were selected, age range from 60 to 94 years residing in one city, in republic of Korea. Data was collected presence of UI, urologic symptoms, chronic health problems, knowledge, and the discomfort with incontinent. Collected data was analyzed with frequency, percentage, t-test, and x2-test.
RESULT
The results of this study are as follows: 1. Mean age was 71.4 years. Prevalent rate of UI was 17.0%, woman showed more than man. 2. UI incidence was significant in age (t=7.84, p=.000), sex (x2 =9.47, p=.002), and voiding frequency (x2=18.34, p=.000). Also, UI incidence was significant relationship with chronic health problem of heart disease (x2 =10.65, p=0.001), hypertension (x2=4.04, p= 0.046) and respiratory problem (x2=9.67, p=0.002). 3. The UI was grouped into urgent incontinence (45%), stress incontinence (33%), and combined (22%). UI occurred during the daytime 48% and 17% at night. 4. Only 9.8 % of the UI seek advice and/or treatment for their symptoms, almost 90 % remained untreated due to lack of knowledge or improper information. 5. The discomforts due to their UI was no significant difference in their condition, the urgent use of the rest room, leaking urine, and nocturia.
CONCLUSION
This study suggests that 1 year and 3 year follow-up study is needed to compare health status of UI. Also suggests intervention study for urologic discomfort of incontinent and behavioral education for the elderly are needed.
The purpose of this study is to seek the nursing intervention for the elderly people's positive lives by investigating the causes for their loss and its meanings. The method of this research derives from a phenomenological tool as a qualitative research design. The data collection had been performed from February, 2001 until August, 2001 through systematic interviews and participatory observations of six elderly people (4 elderly women and 2 elderly men) residing in downtown Seoul. It took one and a half hour for each interview arranged five times. The analysis of this research is based upon Giorgi method and the research results on the causes for elderly people's sense of loss and its meaning are as follows. 1) bitter disappointment of family members : unfaithful children, husband's infidelity, conflict with daughter-inlaw, economic hardships. 2) bereavement : loss of spouse or children, a sense of one's own mortality. 3) regret for the past : sorrowful things, unfair treatment, a sense of resentment, a sense of futility, a feeling of helplessness, despair, resignation. 4) unpleasant memories of others : hurt of self-esteem, hostile feelings aroused by betrayal or distrust. 5) grief of lost youth : loss of health, hard married life, unlucky fate. 6) sense of another superable life : regret, awareness, maturity through suffering. As a person ages, the number of deaths of close friends and family members usually increases. The occurrence of such multiple losses can cause the elderly to become overwhelmed by the events. Care givers need to be sensitive to these losses and need to be aware that the elderly can experience an overload of grief. Counselling can often be useful in helping them to come to terms with such multiple losses.
The purpose of this study is to provide the directions for the further development of the home care services in Korea, through comparison of the home care system and visiting nursing activities for the elderly in Japan and with those of Korea. The results of this study were summarised as follows: The major difference between the two countries was that Japan emphasised the development of home services by visiting nurse service stations (VNSS), especially in the community. In contrast, Korea has emphasised providing hospital based home care services and assuring the quality of services through the preparation of home care nurses before beginning services. And many elderly in Korea have used a public health center when they have health problems. According to the result, the establishment of a VNSS system and activation of a public health center in the community must be considered as the direction to advance home care systems for the elderly.
PURPOSE: This study sought to find a nursing intervention tool for enhancing elderly women's lives by investigating the causes and the meaning of their grief.
METHOD
This research was derived from a phenomenological tool such as qualitative research design. The data collection took place from December of 2000 until April of 2001 Through systematic interviews and participatory observations of five elderly women attending C welfare center located in downtown Seoul the data was collected. Each interview lasted an hour and a half and was arranged five times. The analysis of this research was conducted using the Giorgi method.
RESULTS
(1) There was obvious physical and physiological decline caused by aging old; as well as there being spouse health problems, additional physical suffering, signs of senility, adn insomnia, (2) Further grief was imposed by unpleasant memories of the spouse; infidelity, incapability, and even disregard of her own well-being, (3) Then there was pity for children; unfaithful children, uncertain futures of the children, and early death of a child, (4) Also, regrettable fate, painful daily acttrities, unreliable factors, bad circumstances, and feelings emptiness were reported, (5) Finally, anxiety for the future; ac sense of despair, loneliness, economic hardship, and the fear of imminent death increased grief levels.
CONCLUSION
A variety of programs and social meetings for the elderly to overcome their physiological or psychological crisis should be substantially developed and supported by the government. In order to implement the social welfare for the elderly women, special consideration whether on the governmental level or the personal level, should be devoted to the elderly who live without any financial support or social concern.
PURPOSE: This study aims at confirming exercise effects on obesity, mobility, self-efficacy, process of change, and decisional component by stage based exercise motivational intervention program for the elderly. The stage based exercise intervention program was constructed based on Transtheoretical Model.
METHODS
The design of this study is nonequivalent control group with repeated measuring by quasi-experimental study. The subjects of this study, composing of experimental group of 32 and control group of 28 were selected at one institution for the aged in Seoul.
RESULTS
1) The body fat (weight, BMI and circumference of waist), of the intervention group was significantly decreased than the control group. 2) The mobility of the intervention group was not significantly increased than control group. 3) The self-efficacy, Pros, Process of Change for exercise of the intervention group was not significantly increased than the control group. 4) The Cons for exercise of intervention group was not significantly decreased than the control group.
CONCLUSION
The above result have informed us that a stage-based exercise motivational intervention program for the elderly has the effect of decreasing old persons' body fat and has value as an effective means of nursing for the elderly.
PURPOSE: The purpose of the study was to analyze the functional status of low income elderly living at home according to their socio-economic factors, sensory function, health status, medical service utilization, commodity and types of chronic disease.
METHOD
Functional status was defined by the level of mobility, ADL and IADL categorized as independently functional, mildly impaired, moderately disabled, and severely disabled. The data was collected by home-visit interviews with 567 community dwelling adults who were 65 years of age or more with low a income status subsidized by government in ChonAn.
RESULTS
9.9% of community dwelling older adults were severely disabled, and 44.4% were moderately disabled in their functional status. There were significant differences in the functional status by age, education, religion, and types of family structure. The older adults with hearing impairment or dental problems had a significantly higher rate of severe disability. Self-rated health status and medical service utilization were also significant factors to the differences in functional status. The functional status of older adults was also significantly related to the presence of chronic health problems such as chronic back pain, stroke, and Alzheimer-dementia.
CONCLUSION
The results confirmed that community dwelling older adults with low income status were more functionally disabled in comparison to general older adults at national level, while the relating factors to their functional status seemed similar to other studies on older adults. Further studies were suggested to look into functional status longitudinally and focus on the changes of functional status by managing modifiable influencing factors.
PURPOSE: This study aims to identify the ADL and IADL of bed-ridden elderly. Also it is used to show fuctional status, and to investigate the content and the level of nursing services provided. METHOD: The subjects were 191 elderly who received visiting nurse service through public health centers in the Seoul Metopolitan and Chungnam Province. Data collection was conducted by public health center nurses during four months in 2000. Result: As for daily living activities, 100% of subjects had at least one difficulty in ADL and IADL. Among them, only 0.5% had moderate disabilities and 99.5% had severe disabilities by HFS, 27.9% were in a semi bed-ridden state and 72.1% were completely bed-ridden by JABC. The major service provided was a visiting nurse service which was preferable to the social welfare service. In the visiting nurse service, there was no significant difference according to the elderlys' functional status. In addition there was no standadization about the qualification of the visiting nurse, and single entry point for the nursing service. CONCLUSION: The researchers urgently suggest that a community based comprehensive service model has to be developed to respond to the needs of the elderly in Korea.
PURPOSE: To identify age, gender, medication, seasons and place of fall, and areas of
the fractures from the fall among the hospitalized elderly patients in order to provide the
basic data for future fall prevention program for the elderly.
METHODS
This study was conducted for 106 elderly patients admitted into a university
hospital by fractures from the fall during the period from January 1, 1999 to December
31, 1999. Data on the age, gender, medication, season and place of the fall, areas of the
fracture were collected based on their medical records.
RESULT
The age range of the subjects were from 60 to 96 years old. The subjects
were aged between 60-69 years old 49(46.2%), between 70-79 years old 31(29.2%),
between 80-89 years old 24(22.6%), and over 90 years
old 2(1.9%). Male patients comprised was 34(28.3%), while female patients comprised
76(71.7%). The fall occurred in Winter most frequently 34(32%). The place of the fall
included room 81(76.4%), streets 13(12.3%), bathroom 6(5.7%), stair 4(3.8%), and mountain
2(1.9%). Twenty-two subjects (20.8%) had medication regularly, while 84 subjects
(79.2%) had no medication. The areas of the fracture from the fall included upper
extremities 20(18.9%) and lower extremities 86(81.1%). Radius fracture (7.5%) was the area
where the fracture occurred most frequently in upper extremities and femur fracture (52.8%)
was the area where the fracture occurred most frequently in lower extremities. A
significant difference was found in the fracture area by age, season and place of the fall
(p<.05). No significant difference was found in the fracture area by gender and
medication. In all age groups, seasons and places of the fall, occurrence of fracture in
lower extremity was significantly higher than that in upper extremity.
The purpose of this study was to determine the meaning of the pain and experiences of
elderly women with osteoarthritis, by adopting Colaizzi's phenomenological method.
The participants were 7 elderly women over the age of 65. They were selected using a
theoretical sampling technique. The Data was collected by in-depth and open-ended
interviews from Dec. 1. 1999. to Feb, 28. 2000. The length of the interviews varied from
120 minutes to 180 minutes. Data was recorded and analyzed by a constant comparative
method
. From the data, significant statements were extracted and then organized into 48
themes, which resulted in 15 clusters of themes and 6 categories. The final descriptions
turned out to be valid through the interviewee' validation process.
Essential themes of the pain experiences emerged : "physical discomfortness(disturbances)",
"negative state of mind", "influence of the death", "positive change in life", "Cause of
pain perceived", and "change of their personal relationships". From these results, it was
found that elderly women need nursing care based on a deep understanding of pain, and
a reflection on their past is imperative to overcome their given situations.
In conclusion, it is suggested that the care givers provide more support to solve the
problems experienced by the elderly. Thus the researchers expect to provide
understanding of older people and give basic data of holistic care for them.
The purpose of this study was to verify the use of Seo's Elderly Stress Scale (SESS), which was developed in 1996. Through the modified tool, it is possible to examine the stress of Korean elders and to contribute to the welfare of them. The subjects were 350 elders over 65 years old who live in Seoul, Kwang-Ju, Yang-Ju Gun Kyung-ki Do, Ui-Jong Bu, and Young-Am Kun, Jeun-Ra Nam Do. the data of 331 elders (94%) were analyzed. Data were collected between January and March in 1996 and analyzed using the SPSS Win 8.0. The result are as follows: 1. Items with low correlation with the total items were removed. So 27 items were removed and 37 items remained. This 37 items were death in the family and/or close friends, family member's behavior not meeting expectations, marriage of daughter, marriage of son, friction with daughter- in-law, argument among children, children refuse to live with parent, children leaving home, sex injury or accident, in frequest visits from children and grandchildren, providing care for your daughter or daughter-in-law post-partum, decrease in decision making and authority in home, Lunar new year and the harvest featival, house sitting, working in the house, performing a sacrificial rite, missed birthday, not living with the eldest son, decreased eyesight, decreased strength, decreased memory, sleep pattern changes, thoughts about death, loneliness, decreased hearing, change of dental condition, change in your diet or eating style, difficulty in self care, moving because of disease or aging, argument with friend or neighbour, travel, dealing with the procedure of heritage, loss of money or property, not enough pocket money, hearing on elderly neglect in television or radio, hope of going home and ignorant from others. 2. Overlapped items were discussed by colleagues and were modified. 'marriage of daughter' and 'marriage of son' were modified in 'marriage of children'. 'self injury or accidents' and 'family accidents' were modified in to self or family accidents. 3. Factor analysis was done in order to identify validity and three factors were obtained from the result. The first factor familial relation area, included 17 items. The second factor, physical area, included 9 items. The third factor, psycho-socio-economic area, included 9 items. Cronbach coefficient alpha for the 35 items was .923. 4. Pearson's correlation was .704 between SESS and SOS (Symptoms of Stress) in order to confirm construct validity. Based on the result, the following is suggested; 1. The modified SESS needs to be reverified with elder. 2. Korean elder's health promotion can be made by development of stress intervention which was accurately measured with SESS.
This research was performed to compare life satisfaction of the elderly in institutions and homes. The scores of life satisfaction were collected from 74 elders in 5 institutions and 71 elders at their homes in Daegu and Gyungbuk province during October 1st to December 1st, 1999. The results were summarized as follows: 1. The elders in institutions revealed lower scores in life satisfaction than the elders at homes, but not statistically significant. 2. In institutions, the general characteristics which affected life satisfaction was health status and monthly income. For elderly at home, the general characteristics which affected life satisfaction scores were educational level and health status. According to the result of this research, the health-care and economic support must be considered as main factors in the nursing strategy for the elders. The results should be considered carefully when applied to the entire older population because it was conducted on a segment of the elderly population in Korea. And various social activities and nursing programs for the aged are required.
Due to great concern about quality of care in nursing home, legislative in the US mandated development of LTC MDS. MDS, a standardized assessment database for nursing home residents, provides comprehensive, holistic assessment data for nurses and make it possible to identify nursing needs of residents. The purpose of this study is to assess the health status of nursing home residents in Missouri, America, and to stimulate international comparative research assessing the health status of the elderly. This study presented the age-specific prevalence of diseases, sex differences, and the relative prevalence of chronic diseases among nursing home residents using the Minimum Data Set in Missouri. In addition, the possibility of racial and regional differences in chronic diseases and its relationship to demographic factors were analyzed. The prevalence of diseases was, in general, higher in female elderly then males and increased with age in both sexes. The average number of diseases in the elderly, among 31 chronic diseases, was 3.43 in women and 3.25 in men. The most prevalent 5 diseases were hypertension (29.1%), congestive heart failure (26.1%), dementia (23.6%), arthritis (20.6%), and diabetes mellitus (17.7%). Sixty-eight percent of nursing home residents had at least one of the heart/circulation related diseases and 58. 4% had neurology related diseases. In conclusion, the usefulness and implication of LTC MDS to nursing can't be overemphasized. Korean nurses should prepare themselves for using it for nursing research and to answer nursing questions.
The purpose of this study was to determine the effect of walk training on leg strength, flexibility, postural stability, balance and gait in home bound elderly women. Eighteen elderly women of the experimental group aged between 70 and 90 years image who have normal vision, hearing and Romberg test. They participated in the 12 week walk training. The subjects of the experimental group practiced walk training 3 times a week for during 12 weeks. During the 40 minute workout, the subjects practiced 5 minutes of warming-up exercises, 30 minutes of conditioning exercises and 10 minutes of a cool-down exercise. The intensity for the conditioning phase was determined by subject' heart rates, which ranged from 60% to 70% of age-adjusted maximum heart rates. The body composition, leg strength, flexibility, postural stability, balance and gait were measured prior to and after the experimental treatment. The body fat, lean body mass, leg strength (ankle dorsiflexor, plantarflexor, inversor and eversir, knee flexor, extensior), flexibility (range of motion of ankle dorsiflexion, plantarflexion, inversion and eversion), and postural stability of the experimental group were significantly greater than those of the control group. Duration of standing on the right foot and that of standing on the left foot of the experimental group was greater than that of the control group. Total balance scores of the experimental group were significantly higher than those of the control group. Among 13 items for balance, the scores of experimental group in balance with eyes closes, turning balance, sternal nudge, neck turning, one leg standing balance and back extension were higher than those of the control group. Total scores of gait of the experimental group were significantly higher than those of the control group following the walking training. Scores of experimental group in step height, step length and walk stance while walking among 9 items for gait were significantly higher than those of the control group. The results suggest that walk training can improve physical fitness for prevention in home bound elderly women.
The purpose of this study was to suggest directions for developing a Health Promotion Program for the elderly in Korea for the future. For this, twenty previously developed & implemented health promotion programs were reviewed and analyzed in terms of target population of the program, components of the program, measurement variables for effects of program, the effects of the program. The results were as follows. 1. Most of the target populations were older adults living independently in the community. 2. Components of the program were health education, health assessment and counseling and exercise program. - Health education was done in most of programs. The topics of health education that were often included in the programs were life style changes, medical knowledge, independent living, the concept of health promotion and changes related to aging. - In health assessment and counseling, health professionals discovered their health problems through health assessment or health risk appraisal. Then they developed health recommendations on each health problem and encouraged the elderly to implement the recommendations. 3. Variables measuring the direct effects of the program were health behavior, knowledge, attitude, skill, use of medical/health reference book. Variables measuring the indirect effects, biometric outcome, health status, functional status, medical service utilization, medical cost and wellbeing. 4. The analysis showed that health education was effective for changing health behaviors, improving knowledge, skill and attitude in the elderly. Those results were suggested to be used as guidelines for developing a health promotion program for the elderly in Korea for the future.
The purpose of this study was to investigate the factors influencing health perception in the elderly, to provide the basic data for health behavior program and nursing intervention. The subjects of this study were 240 elderly person over the age 60, living in Seoul and Kangnung. They were conveniently sampled for this study and the data was collected from June 1999 to September 1999. The instruments for this study were the Health Perception Questionaire developed by Ware(1979), the OARS Functional Assessment Questionaire (Duke University 1978), and Multidimensional Health Locus of Control by Wallston, Wallston, and De Vills(1978). The data were analyzed by using SPSS Win computer Program. The results are as follows; 1. The total mean score of the health perception was 52.02(S.D=+/-7.07) in a range of 33 to 69, and the mean score of the functional status was 27.02 (SD=+/-2.75) in a range of zero to 28 and the mean score of the health locus of control was 65.66(S.D=+/-8.68) in a range of 43 to 90. And The mean scores on the HLOC subscales were HLOC-I: 23.73+/-4.56 (range: 6-30), HLOC-P: 23.07+/-4.74 (range: 6-30), HLOC-C: 18.55+/-4.03 (range: 11-30). 2. There was a significant positive correlation between health perception and functional status(r=.216, p=.001), and health perception and the health locus of control(HLOC) were not correlated at the level of statistical significance. However, the HLOC-I and health perception were correlated positively(r=.328, p=.000), and the HLOC-P were correlated negatively (r=-.129, p=.046). 3. There was a significant difference statistically in the degree of health perception according to the age(F=3.351, p=.002), spouse(t=2.232, p=.021), education level(F=7.373, p=.001), disease(t=3.639, p=.000), group activity (t=2.458, p=.015). drink(t=2.327, p=.021). 4. Stepwise multiple regression analysis revealed that the most powerful predictor of health perception was internal health locus of control. A combination of HOLC-I, functional status, HLOC-P, group activity explained 17.9% of the variance for health perception in the elderly. In conclusion, the results of this study show that internal health locus of control factor is very important in explaining the health perception for the elderly. Therefore, it will be considered internal health locus of control factor in nursing intervention and program in order to enforce the health behavior for elderly people.
Every year the number of the elderly increases in Korea thanks to the improvement of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups: 33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.