• 한국노년학
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• v.31 no.2
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• pp.195-209
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• 2011

This study examined the prevalence of and factors associated with unmet care need among community-dwelling middle-aged and older people in Korea. Data were from the 2006 Korean Longitudinal Study on Ageing (KLoSA), a national survey of 10,254 non-institutionalized adults aged 45 or older. Having unmet care needs was defined as needing personal assistance with activities of daily living (ADL) or instrumental activities of daily living (IADL) but having no available helper. Weighted logistic regressions were fitted to examine factors associated with unmet care needs. Overall, 7.3%, 14.5%, and 41.8% of subjects among the middle-aged, younger old, and older old, respectively, reported care needs of these, 34%, 33%,and 24% had unmet needs. Factors associated with unmet needs differed among the three groups: Education and income level were negatively associated with unmet needs among the middle-aged, but living alone was the only factor positively associated with unmet needs in both the younger and older old. The prevalence of and factors associated with unmet care needs differ by life-stage. Needed are home- and community-based care and services to meet the need for personal assistance among the elderly living alone in a community.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.597-615
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• 1994

This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.77-94
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• 2002

This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.

• Journal of East-West Nursing Research
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• v.5 no.1
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• pp.36-49
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• 2000

This study aims to provide the fundamental data for substantial nursing intervention in the elderly through a comparative appreciation on family support, self-esteem, and health status between the institutionalized elderly people and the home-staying ones. The subjects of this study are the institutionalized 108 elderly people of E and C Public Homes and the home-staying 109 elderly ones of O-Nho In Jeong(a kind of public recreational facilities for the aged) over the age of 65. The instruments for this research are based upon the tool(11 items, 5 points for each) for measuring family support developed by Choi, Young Hee(1984), a self-esteem scale done by Rosenberg (1965), the tools(20 items) for checking the health status of the elderly done by Lee, Young-Ja(1989). The sampling for this study has been carried on from July, 2000 until November, 2000. Questionnaire data were drawn up by personal interviews. The analyses of collected data are based on general characteristics calculated at the rate of 100 percentage to the average, t-test, ANOVA(some difference on a level with p<.05 being subsequently confirmed by DMR) for family support, self-esteem and health status, and Pearson Correlation to verify the hypothetical correlation among the subjects' family support, self-esteem and health status. The results of this study are as follows: 1. The difference between two groups in the light of family support, self-esteem and health status. (1) Family support - The rate of the family support that the institutionalized elderly people perceive turned out to be 22.13, that of the home-staying ones 30.99. (2) Self-esteem - The rate of the self-esteem that the former perceives proved to be 25.59, that of the latter 32.28. (3) Health Status - The rate of the health status that the former perceives turned out to be 39.67, that of the latter 51.60. 2. Family support, self-esteem, health status in terms of demographic characteristic (1) Family support - The group of institutionalized elderly people shows a tendency to be chiefly influenced by the death or life of the spouse and the number of the children; the group of the home staying ones to be chiefly influenced by the educational level (2) Self-esteem - The group of institutionalized elderly people shows a tendency to be chiefly influenced by educational level; the group of the home staying ones to be chiefly influenced by the amount of pocket money, the pocket money provider and the family main supporter. (3) Health Status - The group of institutionalized elderly people shows a tendency to be chiefly influenced by educational level; the group of the home staying ones to be chiefly influenced by age, the death or life of spouse, religion, and the educational level. 3. Correlation among family support, self-esteem, and health status The rate of correlation between family support and health status proved to be the highest (r=.549). After came the rate of correlation between health status and self-esteem, which turned out to be(r=.506). The last came the rate of correlation between family support and self-esteem, which proved to be(r=.406). According to this study, there is a conspicuously close correlation among family support, self-esteem, and health status for the elderly. Thus, it would be indispensable to seek out a variety of nursing intervention ways how the elderly could promote family support, self-esteem, and health status.