Purpose: This study was to identify health needs of the elderly at nursing homes by long-term care grade. Methods: The health needs of 116 elders at two nursing homes in Seoul were measured with resident assessment protocols (RAPs), activities of daily living (ADL), and cognitive performance scale (CPS), and pain and depression were measured by resident assessment instrument (RAI). Results: With regard to RAPs, 11 out of 18 items had different distribution in the 3 groups significantly. The 1st-grade elders had a higher percentage of 9 items than the 2nd- and 3rd-grade ones but the 3rd-grade ones had the highest health needs related with activity. The 2nd-grade elders had similar health needs to the 1st-grade ones. In terms of functional level, the 1st-grade elders had the highest percentage of CPS and ADL but the 3rd-grade ones had the highest score of pain and depression out of the 3 groups. The standardized assessment instrument to identify specific health needs by the 3 groups should be developed. Therefore, care plans to meet health needs of the 3 groups will be made. Conclusion: It is suggested that nursing care is required to the elderly of the 1st- and 2nd-grade and safe activity and environment to the 3rd-graded ones.
The purpose of this study was to determine the effects of self-help management program which strengthens self-efficacy for post stroke elders who attend day care center in Chongju. One group pretest-posttest design was used, and the subjects were 7 post stroke elders with hemiparesis. The self-help management program consisted of 5 sessions and each session included group education on stroke, ROM exercise, recreation and self-care strategies. Those strategies for encouraging and reinforcing self-efficacy provided verbal persuasion, performance accomplishment and vicarious experience. All subjects were questioned before and after the program about ADLs, IADLs, self-efficacy, self-care behavior and depression. The analysis of data revealed that the program was effective to increase the IADLs, self-efficacy and self-care behavior. However, there was no significant difference between pre and post ADLs and depression. The results indicated that this program may be adopted to improve the physical and psychological function of post stroke elderly patients in community settings.
According to the aging acceleration phenomenon of the population, Korean society is progressing toward the insecurity society on the 'blessing' or 'disaster'. The purpose of this paper is to establish direction of planning about the dwelling form of collective housing for the senior citizen who lives alone in rural and fishing villages. This focus of study is closely related to the health of the elderly and dwelling form preference. The results of research are as follows. First, the dwelling type of collective housing should be developed for elderly living alone, that must be secured by community life and private life at the same time. Second, it should be supported by such a level of application with Universal Design and Barrier Free Design. Third, collective housing served to the design that the elderly care, as one of the domiciliary care is value in having fact to psychological, physical intention. Fourth, it should be developed visit care or call care for welfare system service and community service manpower on the various types.
Objectives: This study was performed to investigate the effect of active nutrition care on feeding and nutritional status of elderly patients receiving long-term enteral tube feeding. Methods: Subjects included 77 elderly patients who had received enteral nutrition more than one week before admission. Nutrition care was provided to patients supplied less calories than required. Feeding intolerance was examined and managed every day and formula was adjusted to meet nutritional requirement during the first 3 months after admission. Patients were classified into under or over 80% of percent ideal body weight (PIBW) and medical records were used to compare changes in weight,, biochemical indices, and nutritional status during the study. Results: Weight, BMI, triglyceride and total cholesterol in blood, hemoglobin, and hematocrit levels were significantly lower in patients under 80% of the PIBW than in those over 80% of the PIBW at admission. The percentage of supply to required calories was also lower in patients under 80% of the PIBW. After 1 month of nutritional care, supplied volume of formula was significantly increased in patients under 80% of the PIBW. Weight, BMI, and PIBW were increased and there were no differences between groups after 6 months. In addition, the concentrations of triglyceride and total cholesterol in blood, hemoglobin, and hematocrit tended to increase in patients under 80% of the PIBW, leading to no difference between groups after 3 months. Conclusions: Personalized active nutrition care is effective to increase weight and improve feeding and nutritional status in underweight elderly patients receiving long-term enteral nutrition.
Purpose: This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes. Methods: A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0. Results: Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups. Conclusion: These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population.
The purpose of this study was to develop a home health care model in the public health system and to test the effectiveness of the model. Seven com-munity health practitioners in Yon- Cheon county. Kyunggi province, carried out home health care service for this research. The subjects of the home health care were a total of 111 community residents with chronic health problems and risk-prone infants and children; 29 persons with hypertension, 18 persons with diabetes, 12 persons with neurologic problems, 12 elderly, and 40 infants and children. During the period of study, from December, 1993 to March, 1995, a demonstrative home health care model was developed in the Yon-Cheon County community health centers with the cooperation of the Yon-Cheon Medical Center and Yon-Cheon Public Health Center for the first six months. A home care practice manual and recording system for home visits were also co-developed by the researchers and community health practitioners. Four workshops and monthly conferences were held for this purpose. Actual home care practice took place for two months, and on-going evaluation and replanning accompanied this process. The result of the evaluation of home care service were as follows. 1) For persons with hypertension, diabetes, neurologic problems, there was significant improvement in knowledge of disease and care, but no significant difference was seen in health behavior or symptoms after home care service. 2) No significant difference was seen in level of self esteem or depression after reminiscence therapy among 12 elderly subjects. 3) There were significant differences in satis-faction toward child rearing and parental sup-port, but no significant difference In education needs for parental role after home care service among parents of infants and children. 4) There was significant improvement in the quality of life among the subjects after the home care service. 5) Subjects responded that they were highly satisfied with the home care service given by the community health practitioners. Although, the actual implementation period was very short, and not all of the evaluation outcomes showed significant improvement, the home health care model of community health practitioners was, in general, positively evaluated. Through this re-search, the possibility of community health practitioners working as active home care personnel in the public health care system is supported. Further research with an expanded area and subjects for a longer period is recommended. Cost effectiveness research is also needed.
Purpose: The purposes of this study were to identify variables related to self-care behavior and to find factors related to the control of hypertension. A cross-sectional study was carried out to provide basic data for effective and continuous hypertension control in the low-income elderly. Methods: This study was performed with a total of 189 subjects who were hypertensive and were receiving pharmacological treatment of hypertension from a community health center in D Metropolitan City. Data were collected through a face to face survey, and systolic and diastolic blood pressure (the mean value of the two measures) were measured during May 2004. Obtained data were analyzed by $x^2$ test, t-test, multiple logistic regression and Pearson's correlation coefficient (using SPSS Version 10.1). Results: 1. According to demographical characteristics, the score of self-care behavior was significantly higher in elders living along ($47.63{\pm}7.276$) than in those living with the family ($45.19{\pm}5.501$) (p<.05), and in those with religion ($47.11{\pm}6.722$) than in those without religion ($45.01{\pm}6.110$) (p<.05) 2. As to blood pressure control, the percentage of blood pressure control within the normal range (systolic 140mmHg, diastolic below 90mmHg) was 37.03%. According to demographical characteristics, the percentage of blood pressure control was significantly lower in those without religion (p<.05). In practicing hypertension self-care behavior, those who do not control salk intake showed a significantly lower percentage of hypertension control (p<.05). The score of hypertension self-care was $48.28{\pm}4.443$ in the controlled group, and $45.42{\pm}7.399$ in the uncontrolled group, showing a significant difference (p<.01). 3. Hypertension self-care behavior was in a positive correlation with blood pressure control (r=.210, p<.05). Conclusion: Attention should be paid to self-care behavior to increase the control of hypertension in the low-income elderly. These results can be used guidances for improving self-care behavior and the control of hypertension in the low-income elderly.
This study has been performed to explore verbal and behavioral expression of sexual desires among male elderly residents who have been living in long tenn care facilities. There are three topics covered in this study; first, in what situations and how seriously do care workers encounter expression of sexual desires of the elderly residents? Second, what kind of negative consequences do they believe those sexual behaviors will lead to? Third, how can we implement defensive measures against the sexual behaviors? In this study, twenty three care workers working full time in five retirement and care facilities were asked about their experience and perception of the above study agendas, and answers of the qualitative interview were drawn as follow; first, the elderly residents apparently show a variety of sexual harassment and provoking behaviors such as sticking to specific women, physically touching and attacking, and induce obscenely activities against female residents, care workers, and volunteer visitors. Second, their sexual behaviors are often influenced by their isolated and abandoned emotionality as well as living situation in rural areas. Third, their sexual behaviors often critically affect care work plan and facility managements by severely discouraging female care givers and community supporters. Therefore in this study, suggestions and defensive measures were made as follows: first, education and counselling programs toward female workers and volunteers need to be developed, and the programs should cover psychological and behavioral mechanism of sexuality in later life. Second, self control plans need to be empowered toward the elderly residents; in the plans, the elderly residents shall be encouraged to evaluate primary cause and proper solutions of sexual behaviors of their peering residents. Third, combination of healthy housing and care facilities for frail elderly need to be integrated in a neighboring location, so that when residents and workers encounter extreme episodes of sexuality of healthy residents in a housing facility, the problematic sexual residents are partially transferred into a neighboring care facility and thereafter other residents and cafe givers are relieved from stressful contacts with the extremely sexual residents.
The proportion of the elderly in rural area(21.7%) is four times more than that of the urban area (5.4%) in Korea. With this rapid aging of the population in rural Korea there has been growing concern about the quality of life of rural elderly. Compare to urban elderly, rural elderly experience many disadvantages, especially in terms of limited offering of social/educational programs. Their social/educational needs are rarely assessed and there are few programs geared to the needs of rural elderly. In this regard, this study aims (1) to identify education and activity program needs of the rural elderly related to three dimensions: Family life, Farming life, and Community activities and (2) to develop education and activity programs for the rural elderly based on the needs assessment. For this purpose, data are gathered from 413 rural elderly and 110 community welfare specialists, using a structured questionaire. The statistical methods used for data analysis are descriptive statistics, cross tables with SPSS wins 10.0 program. The major findings of this study are as follows: Majority(94.1%) of the rural elderly wants to participate in diverse social/educational programs. They want to have programs dealing with 'relationship enhancement with children', 'nutrition', 'health and care', 'farming skill', 'gardening', 'volunteering', etc. Based on these results, we develop eight types of education program and four types of activity program, according to the priority of their needs in each dimension. There are four sessions of Family life program, and four sessions of Community activities program. The effect of these programs will be evaluated by taking pretest and protest in local basis.
Purpose: The purpose of this study was to understand the role of community health nurse through a nurse practitioner of primary health care post. Methods: An assay, 'Even if we were allowed to look at', written by a nurse practitioner of primary health care post was analyzed with the contents analysis method. Results: In the assay, we checked the following roles: client-oriented, delivery-oriented, and population-oriented roles described and classified by Clark. In particular, direct care such as in-patient care, home visiting nursing care, and drug prescription was frequently performed. Moreover, community health nurse has been listening, counselling, expressing sympathy, and advocating vulnerable elderly people economically and psychologically. Conclusion: The assay gave us a better understanding of the role of community health nurse, and we need more assays delineating the role of community health nurse in others setting as well primary health care post.
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