• Title/Summary/Keyword: Community Dwelling Patients

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The Effects of a Brief Intervention for Insomnia on Community Dwelling Older Adults (지역 사회 노인을 대상으로 한 불면증 단기 치료 프로그램의 효과)

  • Oh, Eui Sun;Park, Kyung Mee;An, Suk Kyoon;Namkoong, Kee;Shim, Da-hye;Lee, Eun
    • Sleep Medicine and Psychophysiology
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    • v.25 no.2
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    • pp.74-81
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    • 2018
  • Objectives: Insomnia is one of the major concerns in the elderly population. Cognitive behavioral treatment for insomnia is the first line treatment option, but there are some limitations including time and cost burdens and the requirement for sufficient cognitive resources to obtain a proper treatment effect. The Brief intervention for insomnia (BII) is a treatment that focuses on behavioral aspects of insomnia in primary care practices. The purpose of this study was to evaluate the effects of BII in community-dwelling older adults. Methods: A total of 47 older adults with insomnia were enrolled from community centers between May 2016 and January 2018. They participated in the BII program for three weeks. We gathered sleep-related participant information with using the Pittsburgh sleep quality index (PSQI), the Sleep hygiene index, and a sleep diary. Clinical efficacy was evaluated by comparing total sleep time (TST), sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) before and after the treatment. Results: There was significant improvement in sleep-related features after BII. Global score and sleep quality from the PSQI, freshness, and WASO from the sleep diary showed statistically significant improvement. Conclusion: We found BII showed positive clinical efficacy in community dwelling older adults, especially from the perspective of subjective sleep quality and WASO. This finding implies that BII can be effectively applied for the managment of elderly insomnia patients in a community setting.

Medication Status and Adherence of the Elderly under Home Care Nursing (가정간호 노인대상자의 처방약물복용 실태 및 복용 이행도 영향요인)

  • Kim, Young-Hee;Lee, Mi-Kyoung;Lee, Sung-Ja;Cho, Myung-Sook;Hwang, Moon-Sook
    • Research in Community and Public Health Nursing
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    • v.22 no.3
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    • pp.290-301
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    • 2011
  • Purpose: This study is a descriptive research intended to clarify the medication status of community-dwelling elders and to identify factors affecting their medication adherence. Methods: Data were collected using questionnaires and interviews from 101 subjects who had taken prescribed drugs for at least 7 days sampled among elderly people using home care nursing at a general hospital in Seoul. Results: According to the results of this study, medication adherence measured by pill counting was 88.3% and that measured by self-reporting was 94.6%. There were statistically significant differences in medication adherence according to major disease (p=.006), the number of admissions (p=.032), the number of drugs (p=.051), the frequency of medication (p=.026), and depression (r=-.205). In addition, depression was found to be a significant variable explaining the medication adherence with explanatory power 3.8% (p=.035). Conclusion: The presence of depression affected the elderly subjects' the medication adherence. Therefore, more concern and educational approaches are required to encourage elderly people to comply correctly with medication regimens particularly for elderly patients who have a malignant or long-lasting disease or who have to take multiple drugs or maintain a daily dosing frequency.

Illness Experiences and Palliative Care Needs in Community Dwelling Persons with Cardiometabolic Diseases (심혈관대사질환이 있는 지역사회 거주 환자의 질환경험 및 완화의료 요구)

  • Cha, EunSeok;Lee, JaeHwan;Lee, KangWook;Hwang, Yujin
    • Journal of Hospice and Palliative Care
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    • v.22 no.1
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    • pp.8-18
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    • 2019
  • Purpose: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. Methods: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. Results: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. Conclusion: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.

The Effects of Laughter Therapy on Depression and Laughter Index in a Community-dwelling Aged (웃음치료 프로그램이 지역사회 노인의 우울과 웃음지수에 미치는 효과)

  • Kim, Jinju;Kang, Gyun Young;Ju, Sejin
    • Journal of East-West Nursing Research
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    • v.20 no.2
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    • pp.160-166
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    • 2014
  • Purse: The purpose of this study was to examine the effect of a laughter therapy on mental health promoting like depression, laughing index of elderly. Methods: The study was conducted based on the non-equivalent control group pretest-posttest design. The participations included 12 older adults in the control group and 11 in the experiment group. Data was collected from October 1 to November 22, 2013. Experimental group participated in laughter therapy six times, once a week for 60 minutes of each session. Questionnaires were used to measure pretest and posttest levels of depression and laughing index. Results: At the end of six-week intervention, depression score (z=-2.95 p=.003) and laughter index score (z=-2.81 p=.005) was significantly decreased in the experimental group compared to the control group. Futhermore, there was a significant difference in the depression scores of the experiment group at the posttest, but no signigicant difference was found between the two groups. Conclusion: The study results suggest that the laughter therapy is an effective intervention to reduce the depression but helpful to enhance the laughing index. Therefore, it is expected that laughter therapy will serve as an emotional nursing intervention for elderly patients with depression.

The Effect of Thoracic Cage Mobilization and Breathing Exercise of Respiratory Function, Spinal Curve and Spinal Mobility in Elderly with Restrictive Lung Disease

  • Wang, Joong San
    • Journal of International Academy of Physical Therapy Research
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    • v.9 no.1
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    • pp.1393-1397
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    • 2018
  • The purpose of this study was to examine the effects of combined respiratory physical therapy on respiratory function, spinal curve and spinal mobility for community-dwelling elderlies with restrictive lung diseases. In total, 10 patients participated in an 8-week intervention program of thoracic cage mobilization and breathing exercise in combination. The results of the study are as follows: for respiratory function, the forced expiratory volume in 1 second (FEV1), forced vital capacity(FVC), and FEV1/FVC were significantly improved to $.30{\pm}0.31{\ell}$, $.46{\pm}.42{\ell}$, and $18.10{\pm}11.39%$, respectively (p<.05). For spinal curve, the thoracic curve and the lumbar curve were improved significantly to $-2.20{\pm}1.40^{\circ}$ and $-1.20{\pm}1.14^{\circ}$, respectively (p<.01). For spinal mobility, the thoracic flexion ($3.40{\pm}2.99^{\circ}$), thoracic extension ($3.50{\pm}1.43^{\circ}$), lumbar flexion ($4.50{\pm}4.74^{\circ}$), and lumbar extension($-1.50{\pm}1.84^{\circ}$) were all significantly improved (p<.05). These findings indicate that thoracic cage mobilization and breathing exercise in combination improve the respiratory function, spinal alignment, and spinal mobility in elderly people with restrictive lung diseases.

Economic Evaluation of Visitng Nurse Services for the Low.;.income Elderly with Long-term Care Needs (도시 저소득층 만성질환노인을 위한 보건소 방문간호서비스의 경제성 분석)

  • 이태화
    • Journal of Korean Academy of Nursing
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    • v.34 no.1
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    • pp.191-201
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    • 2004
  • Purpose: This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs. Method: The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care. Result: The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home. Conclusion: Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.

Mental Exercises for Cognitive Function: Clinical Evidence

  • Kawashima, Ryuta
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.sup1
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    • pp.22-27
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    • 2013
  • The purpose of this study was to examine the beneficial effects of a new cognitive intervention program designed for the care and prevention of dementia, namely Learning Therapy. The training program used systematized basic problems in arithmetic and Japanese language as training tasks. In study 1, 16 individuals in the experimental group and 16 in the control group were recruited from a nursing home. In both groups, all individuals were clinically diagnosed with senile dementia of the Alzheimer type. In study 2, we performed a single-blind, randomized controlled trial in our cognitive intervention program of 124 community-dwelling seniors. In both studies, the daily training program using reading and arithmetic tasks was carried out approximately 5 days a week, for 15 to 20 minutes a day in the intervention groups. Neuropsychological measures were determined simultaneously in the groups both prior to and after six months of the intervention. The results of our investigations indicate that our cognitive intervention using reading and arithmetic problems demonstrated a transfer effect and they provide convincing evidence that cognitive training maintains and improves the cognitive functions of dementia patients and healthy seniors.

Analysis of Psychosocial Factors Affecting Health Behavior Adherence among Community-dwelling Older Adults undergoing Percutaneous Coronary Intervention (관상동맥중재술을 받은 지역사회 거주 노인의 건강행위 이행에 영향 미치는 심리사회적 요인 분석)

  • Jeon, Hye-Won;Chang, Hee-Kyung
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.4
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    • pp.231-244
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    • 2020
  • This study is a descriptive research to analyze psychosocial factors affecting health behavior adherence among community-dwelling older adults undergoing Percutaneous Coronary Intervention. Data were collected with structured questionnaires from 126 patients discharged after hospitalization from a university hospital in J city, Gyeongnam, from July 15 to October 2 in 2018, and analyzed using SPSS/WIN 21.0. The result shows that the general characteristics, such as existence of spouse, education level, subjective health status, and subjective life satisfaction, have a significant influence on health behavior adherence. The research also identifies that medical support and resilience are positively correlated with health behavior adherence. In contrast, perceived stress, 3 sub-categories from perceived stress such as, family relations, anxiety and withdrawal, poverty and finance, and depression are negatively correlated. In the multiple regression analysis, resilience, perceived stress from poverty and finance, education level, and subjective life satisfaction explained 27.9% of health behavior adherence among older adults undergoing Percutaneous Coronary Intervention. Based on the results of this study, it is necessary to develop and apply a nursing intervention program to improve the health behavior adherence of local older adults who had Percutaneous Coronary Intervention.

Effects of Group Task-Oriented Circuit Training on Motor Function, ADLs and Quality of Life in Individuals with Chronic Stroke: A Case Study (과제지향적순환훈련이 만성 뇌졸중 환자의 운동기능, 일상생활동작 및 삶의 질에 미치는 영향 : 사례연구)

  • Ko, Myung-Sook;Jeon, Hye-Seon;Hwang, Sujin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.1894-1903
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    • 2015
  • The purpose of this study was to examine the effects of group task-oriented circuit training (TOCT) based on motor learning applied in conjunction with physical and occupational therapy on functional activity, activities of daily living (ADLs), and quality of life in individuals with chronic stroke. Six chronic stroke patients participated for a duration of 31 weeks. Treatment outcomes were assessed via Chedoke-McMaster Stroke Assessment, the Berg Balance Scale, the Assessment of Motor and Process Skill (AMPS), and the Stroke Impact Scale pre- and post-intervention. The participants exhibited significant improvements in impairment, static and dynamic balance, and mood and emotion after group TOCT. The results of AMPS indicated an improvement in the motor area in 3 of the subjects. In the process area, 4 of the subjects exhibited improvement. The results of this study suggest that TOCT is beneficial to physical functions for chronic hemiparetic stroke patients in community-dwelling.

Survey on the Care Burden and Quality of Life in Family Caregivers of Patients Using Home Mechanical Ventilator in Yeongnam Region, Korea (영남권역에서 가정용 인공호흡기를 사용하는 환자 가족간병인의 간병 부담과 삶의 질)

  • Son, Ju-Hyun;Moon, Myung-Hoon;Cho, Mi-Kyung;Yun, Ra-Yu;Huh, Sung-Chul;Min, Ji-Hong;Moon, Jung-In;Kim, Soo-Yeon
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.1
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    • pp.39-49
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    • 2020
  • Objective : The aim of this study was to investigate the care burden and life quality in family caregivers of community-dwelling patients using home mechanical ventilator(HMV) in Yeognam region. Methods : Survey performed to family caregivers of the patients using HMV in Yeognam region, Korea. The questionnaire is composed with patient care and the burden on caring. Korean version of Short Form Zarit Burden Interview(K-ZBI-12) and 3-Level version of EuroQol-5 Dimension applying Korean weight(KEQ-5D-3L) were also investigated. Statistical significance was accepted for p<.05. Results : A total 98 out of 150 questionnaires were analyzed. The K-ZBI-12(33.08±10.34) had a correlation with KEQ-5D-3L(0.71±0.25) negatively(p=.038). Patients' age, duration of HMV, financial burden and professional caregivers' care time had correlations with K-ZBI-12 positively(p<.05). KEQ-5D-3L correlated duration of HMV negatively(p=.017). Invasive ventilator group had lower KEQ-5D-3L than the non-invasive ventilator group(p=.008). K-ZBI-12 was lower in more than one caregiver care of patients than in one(p=.001). Conclusion : This study revealed high care burden and low quality of life in family caregivers of the patients with HMV in Yeongnam region, Korea. Efforts are needed to continually identify the needs of patients and their families, and the socioeconomic support and medical services associated with HMV.