Breast cancer is one of the most feared health problems in women ; Recent studies revealed that it had come up to be the second most in this country and high prevalent disease in the western countries among breast disease in women. However, early detection of the cancer mass is known to be easier than in many other malignancies. This study was performed to investigate the various characteristics of patients of brea st cancer; by the structural variables, menstrual, marital, and child bearing, and also their understandigs and attitude towards the disease. A hundred and in- and out- patients of St. Mary's Hospital and National Atomic Institute, Seoul were sampled. Data were gathered through direct interview by the researcher from February 1976 to January 1977 and the clinical records were used as references . Results are as follows ; 1. Breast cancer revealed to be most prevalent in the forties; average age of 45.2 years. 2. The average age of menarche revealed to be 15.4 years ; the largest group were the 16-20 years (N = 75, 68.2%). In 55 cases (50%.) menstruation were normal, 38 (34. 5%) postmenopause and only in 17(15.5%), menstruation revealed irregularity. 3. The average marital age revealed to be 22.3 years; the largest group were 21-25 group (N=43, 39.1%). The average duration of marital life revealed to be 24.7 years; 11-20 years group were the largest (M= 34, 30.9%). 4. Most of the patients revealed to have pregnancy experiences (N= 100, 90.9%) ; the average rate of experience were 5.3 times the largest group were 3.4 times group(N=32, 29.1%). 54 patients (49. 1%) revealed to have had abortion experience; the average were 3.4 times. 5. The largest group (N= 77, 70%) had been breast feeding, followed by mixed feeding (N = 12, 10.9%) and artificial feeding(N = 10, 9.1%). 6. Personal health history revealed that in 20 patients (18.2%) revealed to have the past history of purulent mastitis, 5 ps.tients (4. 5%) of breast cancer and 3 patients (2. 7%) of uterine cancer family history. 7. In the one half(N = 56, 50.9%), they had had some information about breast cancer ;27 (24.5%) by mass media, 12(10.9%) through personal contacts and 17(15.5%) were not able to classify the source of information. 8. In 55 cases (50%) the cancer mass were discovered incidentally, in 39 cases (35.5%) by manual detection by self, in 10 eases (9%) by others and in 6 cases (5. 5%) by observing subjective symptoms. 9. The average duration lapsed between the discovery of cancer mass and the visit to the hospital revealed to be 9.4 month. Chief reason for the delay revealed to be the non-chalancy due to the absence of pain(N = 50, 45.5%) followed by the administration of herb and commercial medication (N = 19, 17.3%). 10. The left side breast was more affected than the right side breast, represent by 60 cases in the left and 39 cases in the right. The most frequent site of the breast cancer was the upper-outer quadrant in 53 cases(47.'/%), and followed by the center in 20 cases(18 %), and the uppe inner quadrant, in 19 cases(17.1 %). There was / cases of bilateral carcinoma. The most prominent symptom was painless mass.
This study was performed from July to December 1974 to investigate the rates of contamination of distilled water for injection and local anesthetics. 222 vials were sampled from 7 different places of St. Mary' s Hospital The samples were cultured for isolation of microorganisms. The resultswere as follows; 1. Of 222 vials, 11 were Contaminated by 6 types; Staphylococcus epidermis, Bacillus subtilis, Mima polymorpha, Alcaligenes faecalis, Herellea vaginicala and pepto-streptococcus. 2. 5(9.1%) of 55 vials from surgical wards, 2(4.2%) of 48 vials from surgical OPD, and 4(12.1%) of 33 vials from pediotric wards were contaminated. 3. Between rates of contamination of distilled water for injection and local anesthetics and the number of punctures, there was no significant relationship. (CR=1.42 P> 0.1) 4. There was no significant relationship (CR=1.02 P> 0.1) between the rates of contamination of vials and the duration of the first and the last punctures. 5. The ratios of contamination between 75% alcohol and 2% phenol used for disinfection of rubber lids of vials did not show significant difference.
This descriptive study was under taken to explore relationships among the quality of life, health locus of control and perceived state of health persons with cancer to contribute theoretical understanding about these phenomenon of interest to the quality of nursing care. The subjects of this were 200 persons with cancer(100-in patients and 100-out patients), both male and female, between 30 and 59 years of age. Data were obtained using a convenience sample technique from two university in seoul from August, 1989, to June, 1990. The instruments used for this study were the Quality of life scale developed by Ro, You-Ja and the Health Locus of Control scale developed by Wallston & Wallston. Data were analyzed using a SAS program for ANOVA, t-test, Schefffe test, Pearson Correlation Coefficients and Stepwise multiple regression. The results were as follows : 1. The scores on the quality of life scale ranged from 95 to 191 with as mean of 147.85(range 47 to 235). The Mean scores(range 1-5) on the different dimensions were family relationships 3.50, relationships with neighbours 3.48m self-esteem 3.17, physical state and function 2.99, economic life 2.93 and emotional life 2.91. 2. Significantly higher scores on the quality of life and demographic characteristics were as follows : the quality of life for women(t=2.80, p=.006), for those without complications(t=2.54, p=.013), and for those who perceived their illness as mild(F=4.85, p=.009). Higher scores on quality of life were correlated with the following : 1) emotional state and the age group 50-59(F=3.43, p=.34). 2) economic life and higher income(F=6.72, p=.002), those without complications(t=2.68, p=.00), and those who perceived their illness as mild(F=3.11, p=.05). 3) self-esteem and marriage(F=3.64, p=.028), those without complications(t=2.18, p=.03), and those who perceived their illness as mild(F=7.72, p=.000). 4) physical state and function and the age group 30-39(F=4.65, p=.010), those without complications(t=2.00, p=.05), and those who perceived their illness as mild(F=3.38, p=.04). 5) family relationship and those who live with their spouse(t=2.82, p=.005). 3. There was a significant positive correlation between the subjects perceptions of their current state of health and the quality of life score(r=.4364, p=.0001). 4. There was no relationship between Locus of control and quality of life in this sample. 5. Stepwise multiple regression analysis showed that : 1) the perception of current health status was the main predictor and accounted for 20.11% of the total variance. 2) sex and educational level accounted for an additional 21.71% of the total variance. 6. The quality of life and the perception of their current health status of these patients with cancer were generally lower than those of healthy adults as noted in previous studies. In conclusion, the quality of life for these cancer patients was generally low especially in regard to their emotional state. The current perceived state of health, sex, complications and perceived degree of illness were important variables relating to quality of life.
The purpose of this study is to assess if ENG biofeedback training with progressive muscle relaxation training is effective in reducing the EMG level in patients with tension headaches. This study which lasted from 23 October to 30 December 1989, was conducted on 10 females who were diagnosed as patients with tension headaches and selected from among volunteers at C. University in Seoul. The process of the study was as follows : First, before the treatment, the baseline was measured for two weeks and the level of EMG was measured five times in five minutes. And then EMG biofeedback training was used to six weeks, 12 sessions in all, and progressive muscle relaxation was done at home by audio tape over eight weeks. Each session was composed of a 5-minutes baseline, two 5-minutes EMG biofeedback training periods and a 5-minutes self-control stage. Each stage was followed by a five minutes rest period. So each session took a total of 40 minutes. The EMG level was measured by EMG biofeedback(Autogenic-Cyborg: M 130 EMG module). The results were as follows: 1. The average age of the subjects was 44.1 years and the average history of headache was 10.6 years(range : 6 months-20 years). 2.The level of EMG was lowest between the third and the fourth week of the raining except in Cases I and IV. 3. The patients began to show a nonconciliatory attitude at the first session of the fifth week of the training.
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The purpose of this study was to assess and compare discrepancy in the scores of uncertainty perceived by patients and nurses' interperson perception. For this study, 124 hospitalized patients and the same numbered nurses assigned for direct care of each 124 patients were selected from general ward of C. University Hospital in Seoul during the time period from September to November 1987. Degree of uncertainty was measured by 27 items modified from Mishel Uncertainty in Illness Scale (M-UIS), and was utilized by a Likert type scale The data were analysed by Menemar-test, Unpaired t-test, ANOVA. Scheffe-test and Stepwise multiple regression. The results are summarized as follows: 1. The discrepancy in the scores of uncertainty perceived by patients and nurses' interperson perception showed significant differences in 23 of 27 items : 11 of 23 items showed that the scores of patients' perception of uncertainty were higher than that of nurses' interperson perception of uncertainty but 12 of 23 items were revealed reversely. 2. With regard to nurse's demographic variables, the discrepancy scores were the higest in the group under 22 years of age (F=3.20, p=.026) and in the group less than 1 year of nursing experience among 4 groups (F=4.41, p=.006). 3. The discrepancy scores had a tendency to be lowered in the higher age group(r= - .27, p=.0026) and in the longer experienced group (r=-.25, p=.0052). 4. The most important variable affecting the discrepancy scores was identified to be the nurses' age which acounted for 7.2% fo the total variances in the stepwise multiple regression analysis. This was followed by patient hospital days which accounted for an additional 4.5% of the total variances. To conclude, the discrepancy in the scores of uncertainty perceived by patients and nurses' interperson perception showed significant differences in 23 of 27 items. The discrepancy scores of uncertainty had a tendancy to be lowered in the higher age group and in the longer experienced group.
The main purpose of this study was to examine the validity of the vital sign as an instrument of stress reaction measurement. From July to August 1986, stress reaction was evaluated by the difference of endoscopic vital sign on 93 G-I troubled out-patients who underwent end-oscopy for the first time and did not have any evidence of cardiovascular disease. The data were analysed by .x(2)-test, Paired. t-test, ANCOVA and Multiple Comparison Test. The result of study were as follows; 1. The frequency of gastric disease was differed by the family type, and the mobility of gastritis and gastric cancer were more increased in nuclear family than in large family (p=0.019). 2. In a comparison of before with after 5 minutes endoscopic vital sign, and a pulse rate (p=0. 0001), respiration rate (p=0. 0001), systolic blood pressure (p=0. 0002) and diastolic blood pressure (p=0.006) were significantly increased after 5minutes by end-oscony in contrast with before 5minutes. 3. The control of before 5 minutes of endoscopic vital sign, after 5 minutes of endoscopic systolic (p=0. 024) and diastolic bluud pressure (p=0. 0146) were more elevated in biopsyed group than in non-biopsyed group. And after 5minutes of endoscopic respiration rate was more increased in gastric cancer than in gastritis (p=0.0406) or gastric ulcer (p= 0. 0073). And after 5 minutes of endoscopic systolic blood pressure was elevated over 50years old men (p=0. 0238). fa short, the increase of a pulse rate af ter 5 minutes of endoscopy was not influenced by general characteristics of samples in this experiment. And systolic blood pressure over 50years old men must be considered of physiological hypertension.
This study was done to investigate levels of physical fitness, self efficacy(SE), instrumental activities of daily living (IADL), and quality of life(QL), and their relationships among the elderly. Data were collected from 47 noninstitutionalized elderly dwelling in their own homes and 43 institutionalized elderly living in homes for older people. The ages of the subjects were 65 years and over. The data were collected from January 20th to February 20th, 1995. Physical fitness was measured with T.K.K dynamometer, grip dynamometer, stop watch, and Purdue pegboard. Structured questionnaires developed by Kim, by Lawton and Brody, and by Ro were adopted to measure SE, IADL, and QL, respectively. The data were analyzed using t-test, ANOVA, and Pearson correlation coefficients. The results were as follows: 1. The noninstitutionalized elderly had higher scores in such measures of physical fitness as body weight, skinfold thickness, flexibility and coordination as compared to the institutionalized elderly. 2. On the following measures of physical fitness, men showed higher levels than women; in height when standing, height when sitting, body weight, and muscle strength. Women had more trunk flexibility than men. 3. Muscle strength was positively correlated with height when standing, height when sitting, and body weight. The following measures of physical fitness, muscle strength, flexibility and coordination, were negatively correlated with "up and go". 4. The noninstitutionalized elderly had higher scores in SE(t=2.28, p<0.05), IADL(t=2.24, p<0.05), and QL (t=2.41, p<0.05) as compared to the institutionalized elderly. 5. SE was positively correlated with both IADL (r=0.41, p<0.001) and QL(r=0.54, p<0.001), and the latter two variables were a positively correlated(r=0.30, p<0.001). 6. SE was positively correlated with the physical fitness measures of height when standing, body weight, strength of leg muscles, strength of back muscles, grip strength, and level of touching the floor, but negatively correlated with "up and go." 7. Positive correlations were revealed between IADL and the physical fitness measures of height, strength of leg muscles, level of trunk muscle extension, level of touching the floor, and coordination. The IADL was negatively correlated with "up and go". 8. QL was positively correlated with body weight (r=0.28, p<0.01) and skinfold thickness(r=0. 26, p<0.05). 9. Age was negatively correlated with the physical fitness measures of height when standing, height when silting, "up and go", strength of leg muscles, strength of back muscles, grip strength, level of trunk muscle extension, and coordination. 10. Age was also negatively correlated with SE (r=-0.24, p<0.05) and IADL(r=-0.22, p<0. 05). The above results suggest that caring elderly in their own homes were more effective and that nursing interventions to enhance physical fitness, SE, IADL, and QL especially for the institutionalized elderly are stressed.
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PURPOSE: The purpose of the study was to compare home care nursing intervention activities analyzed by the Nursing Intervention Classification (NIC) system for hospice and general patients.
METHOD
For the descriptive survey study, data was collected by reviewing charts of 151 hospice patients and 421 general patients who registered in the department of home health care nursing at K Hospital.
RESULTS
According to the NIC system application, there were 2380 total nursing interventions used for the hospice patients and 8725 for the general home care patients. For both sets of patients (hospice vs. general), the most frequently used nursing intervention in level 1 was the Physiological: Complex domain (40.13 vs. 31.06 percent), followed by the Safety domain; in level 2, the Risk Management class (28.4 vs. 27.70 percent), followed by Tissue Perfusion Management; and in level 3, Vital Sign Monitoring (6.18 vs. 4.84 percent), followed by Health Screening.
CONCLUSION
The study showed that there was a lack of specialized hospice nursing interventions such as emotional, family and spiritual support, and care for dying hospice patients.
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This study was to compare changes in health behaviors, motivational factors, cardiovascular risk factors, and functional status (SIP) after implementing the 6-month motivation-enhancing program to institutionalized elderly women.
METHODS
Sixty-four elderly women participated. Face to face interviews with blood sampling and anthropometric assessment were conducted at the pretest, 10 weeks and 6 months during the program.
RESULTS
1. The program participants showed significantly better health behaviors over 6 months. The mean motivational level was also significantly improved, especially for perceived benefits, perceived barriers, and emotional salience. 2. The mean of cardiovascular risk factors for the participants was 21.8 at the level of low to moderate risk. After completing the program, total risk score was significantly decreased to 18.7 at 10 weeks, and further to 17.7 at 6 months. A significant reduction was also found in HDL and LDL-cholesterol levels, blood pressure, obesity, inactivity, and stress. 3. The functional status (SIP) was 11% at the baseline and significantly changed in positive direction at 10 weeks (M=9.3) and at 6 month (M=6.3). The significant improvement was also found in physical and psychosocial dimensions and sleep/rest dimension.
CONCLUSION
The motivation enhancing program was effective to reduce cardiovascular risks and to improve the functional status of institutionalized elderly women by motivating them to perform better health behaviors.
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The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients residing in hospice units. The convenient sample of this study consisted of 41 terminally ill cancer patients at three hospice units in university affiliated hospitals. Patients were interviewed with structured questionnaires three times at predetermined intervals: admission to the hospice unit (Time 1), one week later (Time 2), and two weeks later (Time 3). The data was collected from January 1998 to January 1999 and was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. The results of this study were as follows: 1. The mean age of the participants was approximately 55 years old. In terms of diagnosis, lung cancer showed the highest frequency (19.5%), followed by stomach cancer and rectal cancer (17.1%). The motive of seeking hospice unit admission was control (72. 2%), followed by spiritual care (50%), and symptom relief (38.9%). 2. Regarding the type of pain felt, the highest pain frequency the participants experienced was deep pain (55%), followed by multiple pain (25%), intestinal pain (10%), then superficial (5%) and neurogenic pain (5%). For the level of pain measured by VAS, there was no significant difference among the three time points; Time 1 (5.04 +/-2.21), Time 2 (4.82+/-2.58) and Time 3(4.73+/-2.51). 3. There was significant change seen in spirituality and physical care in each time interval. Namely, the longer the length of admission at the hospice unit, the higher the importance of spirituality (p=0.0001) and the more the physical care the participants received (p=0.01). The opioid use at the three time points showed the following frequencies : Time 1 (75.6%), Time 2 (85.4%) and Time 3 (75.6%). 4. Regarding factors influencing pain, the pain level was significantly affected by the depression level (p <0.01) and the opioid use (p <0.1). These results were the most significant at the two time points (Time 1 and Time 2). At Time 3 (two weeks later), the pain level was significantly affected by the depression level (p <0.05) and the amount of physical care the participants received (p <0.1). In conclusion, the terminally ill cancer patients had moderate pain, were generally depressed, and were treated with opioid analgesics. As approaching death, the patients received more physical care due to increased physical symptoms experienced and they had a higher perception of the importance of spirituality. Thus, health care professionals need to provide continuous care for each of them to die comfortably physically, psycho- logically, and spiritually.
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This study was conducted to draw out prevalence and the risk factors of diabetes mellitus and impaired fasting glucose for adults,(age 30-69). The subjects were 2096 adults, who had regular health examinations between January and December of 1999 at K Hospital in Seoul. The data was analyzed using chi-square test, unpaired t-test and logistic regression. Diabetes Mellitus and impaired fasting glucose were diagnosed by ADA (American Diabetes Association, 1997) criteria. The results were as follows: 1. Mens' prevalence of Diabetes Mellitus was 7.9% and womens' prevalence of Diabetes Mellitus was 3.8%. Mens' prevalence of impaired fasting glucose was 10.4% and womens' prevalence of impaired fasting glucose was 6.5%. Prevalences of Diabetes Mellitus and impaired fasting glucose increased with age. 2. Prevalence of Diabetes Mellitus and impaired fasting glucose of obese subjects (relative body weight>=162) was higher than that of overweight subjects (110<=relative body weight<=119) in men and women. 3. The diagnoses of Diabetes Mellitus and impaired fasting glucose increased with systolic blood pressure and triglyceride. 4. Significant factors associated with diabetes in the logistic regression best gut model were age, relative body weight, systolic blood pressure, triglyceride in men, and systolic blood pressure in women. In conclusion, as age, weight, systolic blood pressure and triglyceride get higher, Diabetes Mellitus and impaired fasting glucose prevalence also increases, porportionally.
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The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. For the organizational structure, the center is represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.
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This study was conducted to develop an education program of hospice care for the professional in order to care for nurses for terminally ill patients facing death and their families. The Modified Tyler-Type Ends-Means model was used to guide the curriculum development of the study. The curriculum include a philosophical conception of hospice education, fundamental concepts, purpose, objective and the educational contents. The content was developed based upon a 70% or more demand in educational demand analysis. The education program has a total of 360 hours consisting of 172 hours of theoretical study and 188 hours of practice including fundamental nursing care for hospice.
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This study aims at providing more qualitative care in family nursing practice. It is designed to analyze the degree of quality of life(QL) among families of the patients. The subjects consisted of 79 families of hospital hospice patients and 74 families of home-based hospice patients. The ages of the subjects were 17-74 years, at five university hospitals in Seoul, Inchon, and Kyung Gi Province, and one clinic in Chunchon. The data were collected from September, 1996 to August, 1997. The instrument used for the study was the Quality of Life Scale(QLS), which was composed of six factors, developed by Ro. You Ja, The analysis was done using t-test, ANOVA, Scheffe test, and Stepwise multiple regression. The results were as follows : 1. There were no statistically significant differences between the families of hospital hospice patients and the families of home-based hospice patients ; however, the mean score of the families of hospital hospice patients was higher than that of the families of home-based hospice patients. The scores on QLS ranged from 75 to 224 with a mean score of 140.58 in the families of hospital hospice patients. In the families of home-based hospice patients, the scores ranged from 79 to 214, showing a mean score of 135.25. Among six factors of QLS, family relationships showed the highest score in the families of hospital patients. Self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of home-based hospice patients(t= 2.69, P= 0.008 ; t= 2.04, p= 0.043). 2. In the families of hospital hospice patients, QL had significant relationship with family member's age (F= 2.52, P=0.029), marital status (F= 3.57, P = 0.018), economic state(F= 6.07, P= 0.004), and education level(F =3.77, P=0.014), In the families of home based hospice patients, QL had significant relationship with marital status(F=2.53, P=0.049), education level(F= 4.35, P=0.007), occupation(F=3.93, P=0.002), and patient's age(F=2.73, P=0.020). 3. Economic status accounted for 17% of QL, and diagnosis accounted for an additional 7% of QL in the families of hospital hospice patients by means of stepwise multiple regression analysis, In the families of home-based hospice patients, relationships with patient accounted for 12% of QL. The findings showed that self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of homed-based hospice patients and family relationships showed the highest value in QL. These finding should be considered in nursing practice.
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Issues related to the elderly have been recognized in Korea and nursing scholars have tried to study there issues. It is hard to say which the direction we, are going or have to go, since there has been little systemic effort to establish gerontological nursing field yet. Therefore, it is necessary to find out the trend and the guidelines of gerontolotical nursing studies for the future. Dissertation and published articles related to the elderly in the nursing field from 1991 to the February of 1997 were are reviewed. Total 127 studies were analysed in terms of concept, design/methodology, and results, and the nature and issues of the geronotologic nursing studies in Korea were explored. The results are as follows: 1. There was no clear chronological definition of the elderly. 2. The most popular research design was an exploratory/descriptive study. 3. The major concepts studies were physical and mental health. 4. Among those studies using instrument which were developed and modified and /or translated by researchers, the reliability and validity were rarely reported. 5. Theory based studies were rare. We suggest the following issues for future studies : 1. The chronological and other criteria related to the definition of elderly is needed. 2. Physiopsychosocial characteristics of Korean elderly and their managements in terms of intervention studies need to be conducted more synthetically. 3. Social issues from the change of types and function of family such as single elderly family need to be studied. 4. Participation in and collaborate with other disciplines are needed. 5 Development and test of instruments to measure phenomena or concepts is needed. 6. Macroscopic approach such as policy also needed. 7. Theory based studies are needed.
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