Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

The Effects of Health Conservation Program in Community-dwelling Vulnerable Diabetic Elderly

취약계층 당뇨병 노인을 위한 건강보존프로그램의 효과

  • 성기월 (대구가톨릭대학교 간호대학) ;
  • 박미경 (영남이공대학교 간호대학) ;
  • 강혜승 (구미대학교 간호학과) ;
  • 박지현 (가톨릭상지대학교 간호학과) ;
  • 남지란 (구미대학교 간호학과)
  • Received : 2017.10.13
  • Accepted : 2018.01.05
  • Published : 2018.01.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study was conducted to develop and apply the health conversation program to determine its effectiveness. The study employed a pretest-posttest nonequivalent control group design. There were 25 subjects in one intervention group and 22 subjects in the control group. The program included a 4-week, 12-session education program in health conversation for professionally retired elderly mentors and an 8-week, 24-session program for vulnerable elderly diabetics provided by mentors who were older persons trained in diabetes management. Data were collected from December 2015 to May 2016 and subsequently analyzed by an independent t-test using SPSS 20.0. Biochemical variables and physical variables were assessed by blood test and Inbody 230 (Biospace). Psychosocial variables were assessed by questionnaires. The health conservation program led to significantly decreased FBS (p<0.01), TC (p<0.01), TG (p=0.04), SBP (p=0.03), waist (p<0.01) and symptoms of depression (p=0.01), and significantly increased social support (p=0.02). These results indicated that the health conservation program is effective at increasing social support and decreasing FBS, TC, TG, SBP, waist, and symptoms of depression in community-dwelling vulnerable diabetic elderly; accordingly, health conservation programs should be applied to improve quality of life of vulnerable diabetic elderly.

본 연구의 목적은 지역사회 취약계층 당뇨병노인을 위한 건강보존프로그램을 개발하고 프로그램을 적용하여 그 효과를 검증하는 것이다. 건강보존프로그램은 전문직 은퇴노인이 멘토로서 취약계층 당뇨병노인 멘티에게 건강보존을 위한 프로그램을 제공하는 것이다. 본 연구는 유사실험연구로서 비동등성 대조군 전후 설계이며 대상자는 실험군 25명, 대조군 22명이다. 본 프로그램은 전문직 은퇴노인을 대상으로 4주, 12회기 건강보존에 관한 멘토 교육 프로그램과 8주, 24회기의 취약계층 당뇨병노인을 위한 멘토링 프로그램을 포함한다. 혈액학적 변수와 신체적 변수는 혈액검사와 Inbody 230(Biospace)를 활용하여 측정하였고 정신사회적 변수는 설문지를 통하여 측정하였다. 자료수집기간은 2015년 12월부터 2016년 5월까지이며 자료분석은 SPSS 20.0.를 사용하여 독립 t-test로 하였다. 건강보존프로그램을 통해 실험군이 대조군보다 공복시 혈당(p<0.01), 총콜레스테롤(p<0.01), 중성지방(p=0.04), 수축기 혈압(p=0.03), 허리둘레(p<0.01)와 우울증상이 유의하게 감소되었고 사회적 지지는 유의하게 증가되었다. 본 연구의 결과는 건강보존프로그램이 취약계층 당뇨병노인의 사회적 지지를 효과적으로 증가시키며 공복시 혈당, 총콜레스테롤, 중성지방, 수축기 혈압, 허리둘레와 우울증상을 효과적으로 감소시키는 것을 알 수 있다. 그러므로 취약계층 당뇨병노인의 삶의 질 향상을 위해 건강보존프로그램을 활용할 것을 제언한다.

Keywords

References

  1. Ministry of Health and Welfare. The national basic livehood security recipients status, Ministry of Health and Welfare, Seoul, 2016.
  2. Korean Diabetes Association. Diabetes fact sheet in Korea. 2016. Available from : http://www.diabetes.or.kr/pro/news/admin.php?code=admin&number=1331&mode=view (updated Oct, 14, 2016).
  3. H. S. Jang, "The Effect of Case Management for Clients with Hypertension in Home Visiting Health Services", Journal of Korean Public Health Nursing, vol. 28, no. 2 pp. 258-269, 2014. DOI: https://doi.org/10.5932/JKPHN.2014.28.2.258
  4. H. Y. Kim, W. J. Yun, M. H. Shin, S. S. Kweon, H. R. Ahn, S. W. Choi, Y. H. Lee, D. H. Cho, J. A. Rhee, "Management of Diabetic Mellitus in Low-income Rural Patients", Journal of Preventive Medicine and Public Health, vol. 42, no. 5 pp. 315-322, 2009. DOI: https://doi.org/10.3961/jpmph.2009.42.5.315
  5. K. W. Sung, M. K. Park, J. J. Nam, J. H. Park, H. S. Kang, "Experience as a Vulnerarable Elderly Individual with Diabetes", Journal of Korean Public Health Nursing, vol. 31, no. 1 pp. 149-161, 2017. DOI: https://doi.org/10.5932/JKPHN.2017.31.1.149
  6. G. A. Choi, S. M. Jang, H. W. Nam, "Current Status of Self-management and Barriers in Elderly Diabetic Patient", Korean Diabetes Journal, vol. 32, no. 3 pp. 280-289, 2008. DOI: https://doi.org/10.4093/kdj.2008.32.3.280
  7. J. Nagelkerk, K. Reick, L. Meengs, "Perceived Barriers and Effective Strategies to Diabetes Self-management", Journal of Advanced Nursing, vol. 54, no. 2 pp. 151-158, 2006. DOI: https://doi.org/10.1111/j.1365-2648.2006.03799.x
  8. K. W. Sung, "Relationship of Daily Activity and Biochemical Variables in the Elderly with Diabetes Mellitus", Journal of Korean Academy of Nursing, vol. 41, no. 2 pp. 182-190, 2011. DOI: https://doi.org/10.4040/jkan.2011.41.2.182
  9. K. W. Sung, J. R. Nam, M. J. Yu, "Factors Affecting Highly Educated Elders' Diabetic Health Leader Attitude", Journal of Korean Academy of Community Health Nursing, vol. 25, no. 2 pp. 119-127, 2014. DOI: https://doi.org/10.12799/jkachn.2014.25.2.119
  10. A. Dunphy, B. Gavin, S. Frank, A. Grant, Guide to Effective Practice in Youth Mentorring New Zealand, Youth Mentorring Network, 2008.
  11. H. G. Kim, K. J. Lee, "A Survey on Elders' Experience in and Preference for a Mentoring Program", Journal of Korean Academy of Community Health Nursing, vol. 19, no. 4 pp. 554-563, 2008.
  12. S. B. Park, "The Analysis of Needs for Successful Aging in Professional Retiress : Focused on Their Competencies, Learning and Social Activities", Doctoral dissectation, Kyungsung university, Busan, 2010.
  13. N. S. Kim, "Designing Youth Mentoring for Disadvantaged Family", Korean journal of youth studies, vol. 18, no. 3 pp. 355-380, 2011.
  14. S. J. Kang, B. H. Ryu, "Effects of Combined Exercise on HBA1c, Cardiovascular Disease Risk Factors, and Physical Fitness in Elderly Women with Type 2 Diabetes Mellius", The Official Journal of the Korean Academy of Kinesiology, vol. 16, no. 2 pp. 21-30, 2014. https://doi.org/10.15758/jkak.2014.16.2.21
  15. F. Faul, E. Erdfelder, A. Buchner, AG. Lang, "Statistical Power Analyses using G*Power 3.1: Tests for Correlation and Regression Analyses", Behavior Research Methods, vol. 41, no. 4 pp. 1149-1160, 2009. DOI: https://doi.org/10.3758/BRM.41.4.1149
  16. World Health Organization. "Assessment diagnosis steering committee, The Asia pacific perspective: Redefining obesity and its treatment", Health Communications Australia Pty Limited Publication, pp. 15-21, 2000.
  17. B. S. Kee, "A Preliminary Study for the Standardization of Geriatric Depression Scale Short Form-Korea Version", Journal of the Korean Neuropsychiatric Association. vol. 35, no. 2 pp. 298-307, 1996.
  18. M. K. Lim, M. H. Kim, Y. J. Shin, W. S. Yoo, B. M. Yang, "Social Support and Self-rated Health Status in a Low Income Neighborhood of Seoul, Korea", Korean journal of preventive medicine, vol. 36, no. 1 pp. 54-62, 2003.
  19. Cathy Donald Sherbourne, Anita L. Stewart, "The MOS Social Support Survey", Social Science & Medicine, vol. 32, no. 6 pp. 705-714, 1991. DOI: https://doi.org/10.1016/0277-9536(91)90150-B
  20. H. J. Yu, "Elderly Diabetes Mellitus. In G. B., Hu (Chair), Diabetes mellitus in geriatric population", Symposium conducted at the 3rd Annual Congress of Korean Diabetes Association, Seoul, 2006.
  21. The ADVANCE Collaborative Group, "Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes", New England Journal of Medicine, vol. 358, no. 24 pp. 2560-2572, 2008. DOI: https://doi.org/10.1056/NEJMoa0802987
  22. M. K. Kim, J. H. Park, "Metabolic Syndrome", Journal of the Korean Medical Association, vol. 55, no. 10 pp. 1005-1013, 2012. DOI: https://doi.org/10.5124/jkma.2012.55.10.1005
  23. Y. J. Lee, M. K. Kwon, H. J. Baek, S. S. Lee, "Comparative Analysis of Food Intake According to the Family Type of Elderly Women in Seoul Area", Journal of Nutrition and Health, vol. 48, no. 3 pp. 277-288, 2015. DOI: https://doi.org/10.4163/jnh.2015.48.3.277
  24. US Department of Health and Human Service. Healthy People 2010/Diabetes. Washington : US Department of Health and Human Service; 2010, [cited 2009 May 13], Available From http://www.healthypeople.gov/Document/HTML/ Volume1/05Diabetes.htm
  25. N. H. Kim, Y. R. Yang, M. H. Lee, "Effects of Health Literacy and Knowledge on Diabetic Self-care in the Elderly with DM Living Alone", Journal of Korean Academic Community Health Nursing, vol. 27, no. 4 pp. 370-379, 2016. DOI: https://doi.org/10.12799/jkachn.2016.27.4.370
  26. M. S. Kirkman, V. J. Briscoe, N. Clark, H. Florez, L. B. Haas, J. B. Halter, E. S. Huang, M. T. Korytkowski, M. N. Munshi, P. S. Odegard, R. E. Pratley, C. S. Swift, "Diabetes in Older Adults: A Consensus Report", Journal of the American Geriatrics Society, vol. 60, no. 12 pp. 2342-2356, 2012. DOI: https://doi.org/10.1111/jgs.12035
  27. S. H. Lee, "The Analysis of Self-care Knowledge, Competence, Behavior, and Quality of Life in Community Diabetes Elderly", Journal of the Korea Academia-Industrial cooperation Society, vol. 18, no. 9 pp. 157-166, 2017. DOI: https://doi.org/10.5762/KAIS.2017.18.9.157
  28. S. Y. Jeon, "A Conceptual Model for the Transformative Learning of Adult Cancer Patients : Focused on the Patients' Participation in the Learning Community", Unpublished master's thesis, Sangmyung University, Seoul, 2013.
  29. T. W. Lee, I. S. Ko, K. J. Lee, K. H. Kang, "Health Status, Health Perception, and Health Promotion Behaviors of Low-income Community Dwelling Elderly", Journal of Korean Academy of Nursing, vol. 35, no. 2 pp. 252-261, 2005. DOI: https://doi.org/10.4040/jkan.2005.35.2.252
  30. J. S. Won, K. H. Kim, "Evaluation of Cognitive Functions, Depression, Life Satisfaction among the Elderly Receiving Visiting Nursing Services", Journal of Korean Academic of Nursing, vol. 38, no. 1 pp. 1-10, 2008. DOI: https://doi.org/10.4040/jkan.2008.38.1.1
  31. I. G. Oh, Y. S. Oh, M. I. Kim, "Effect of Social Networks on the Depression of Elderly Females in Korea: Analysis of the Intermediating Effect of Health Promoting Behavior", Korean Journal of Family Welfare, vol. 14, no. 1 pp. 113-136, 2009.
  32. H. R. Kim, "Prevalence and Risk Factors of Depression in Low Income Women Elders in Urban Community", Korean Review of Crisis & Emergency Management, vol. 10, no. 1 pp. 163-177, 2014.
  33. K. S. Jeon, H. K. Lee, B. K. Hong, S. R. Jang, "Community Health Promotion Program for Vulnerable Women", Journal of Korean Society for Health and Promotion, vol. 24, pp. 99-118, 2007.
  34. A. Bowling, D. Banister, S. Sutton, O. Evans, J. Windsor, "A Multidimensional Model of the Quality of life Older Age", Aging & Mental Health, vol. 6, pp. 335-371, 2002. DOI: https://doi.org/10.1080/1360786021000006983
  35. J. H. Choi, "A Study on Self-efficacy, Family Support and Health Promoting Behavior of the Aged in a Community", Journal of the Korean Academy of Community Health Nursing, vol. 14, pp. 1-10, 2003.
  36. Y. K. Chu, J. H. Shon, "Effect of Combined Exercise Program for 16 weeks on Health-related Physical Fitness and Depression in Elderly Women", Journal on Coaching Development, vol. 14, no. 3 pp. 105-114, 2012.
  37. K. W. Sung, J. H. Lee, "The Effects of Regular Walking Exercise on Metabolic Syndrome, Cardiovascular Risk Factors, and Depressive Symptoms in the Elderly with Diabetic Mellitus", Journal of Korean Academic Community Health Nursing, vol. 21, no. 4 pp. 409-418, 2010. DOI: https://doi.org/10.12799/jkachn.2010.21.4.409