The objectives of this study were to characterize the health status, the requirement of home nursing care, and dependency of daily life of the elderly so that the result could be used to provide basic data necessary for establishing home nursing care practices. The study subjects were 249 elders over 65 years old who resided at home in low income areas of three districts in Pusan. The field survey was conducted from December 27, 1993 through January 27, 1994, with a structured questionnaire. Statistical analysis was done by X²-test and Student's T-test using SPSS/PC/sup +/ program. The result were as follows; 1. Alcohol drinking rate was 50.0% for men and 27.7% for women, and cigarette smoking rate was 77.8% for men and 27.1% for women. 92.9% of elders aged 65-75 exercised regularly as compared to 81.9% of elders aged 75 and over(p<0.05). 2. 63.9% of male and 85.9% of female elders had chronic diseases showing singnificant differences(p<0.01), and both sexes had 1.7 kinds of chronic diseases in average; musculoskeletal diseases were the most common in 25.7%, while 6.8% of the elderly had cardiovascular diseases. 3. Partially movable elderly was 6.9% for men and 6.8% for woman, showing 47.1% of causes being cerebrovascular accidents. 4. The home nursing requirement was the highest for medication(66.3%), intramuscular injection(53.8%), and measurement of blood pressure·body·temperature·pulse rate(47.0%). 5. Among Physical Activities of Daily Life, bathing(10.4%) and movement(4.0%) showed high dependency rates, and among Instrumental Activities of Daily Life, phone calling(25.3%), shopping(24.5%), going out by bus(22.5%) showed high dependency rates. 6. For five categories of home nursing showing high requirements such as physical health examination, blood pressure·temperature·pulas rate measurements, medication, and intravascular injection, the requirements were different by age groups, education, and marital status(p<0.05).
Purpose: Increasing numbers of Koreans have immigrated to the United States since the late 1960s. The first generation of Korean immigrants or their parents become old and institutionalized in American nursing home setting. Although the Korean elders would experience many cultural differences in the nursing home, no study to date has investigated their everyday lives on how they live through their later lives within a different cultural environment from their own. Methods: Using ethnographic methodology, the purpose of this paper was to illustrate Korean residents' experiences and daily lives in a nursing home located in an east coastal city in the U.S. Participant observation, filed notes, semi-structured interviews were utilized by means of data collection. Eighteen Korean residents were observed, and five of them and two nurses participated in informal qualitative interviews. Results: The overriding theme from the findings is "thrown in a different world." Three sub-themes include "constant struggles in making themselves understood", "dealing with culturally inappropriate nursing care," and "maintaining their own ways of life". Conclusions: The discovered themes reflect culturally isolated lives of the participants and open a venue for designing a culturally congruent nursing care for Korean elders living in the U.S. nursing homes.
Purpose: This study was done to evaluate effectiveness of home healthcare services (HHCS) specialized for elders who received spinal surgeries. Methods: A non-equivalent control group pre-post test quasi-experimental study was performed. HHCS was developed based on the Rice model of dynamic self-determination for self-care. For data collection, a control group (n=23) and an experimental group (n=23) were selected by matching age, BMI, pain, general characteristics and type of spine surgery. Measurement tools to evaluate uncertainty and knowledge were developed by the authors. The Numeric Rating Scale (NRS) and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were used to evaluate pain levels. Muscular strength in the legs was measured using a digital muscle tester and tape ruler. Questionnaires were used to evaluate disability in performing ADL and psychological distress levels. Results: The experimental group showed significant decrease in uncertainty (p=.028), increased knowledge (p=.038), and partially decreased pain (p=.003-.331). Partial muscle strength increased significantly (p=.021-.644). Disability in performing ADL and psychological distress in the experimental group decreased significantly compared to control group (p=.002, p=.004). Conclusion: Results indicate HHCS is an efficient home care nursing program for these elders. Further experimental studies with larger samples are required to confirm effects of HHCS.
This study investigates differences by type of caregiving using data on three groups of caregivers, 177 from home stay situations, 189 from day care centers, and 138 from nursing homes. First, the result shows that characteristics of both caregivers and elders differ by type of caregiving. Second, caregivers in the home stay situation have the highest caregiving burden of the three groups. Third, from examination of the related variables, the caregiving burden of home stay caregivers is affected by family income, caregivers' health, type of job, and whether or not the elder has symptoms of dementia. Also, the study reveals that emotional services for elders reduce the aggravation of family relations and economic burden, but that instrumental services highly increase economic burden. It reveals that caregivers of elders in day care centers, especially those who are in bad health, are more likely to experience feelings of constriction, aggravation of family relations and economic burden. On the other hand, caregivers who receive more emotional services have better experiences in family relations, including relations with the elder. In case of the elders of nursing homes, if the main caregiver is a daughter-in-law, aggravation of family relations is higher than if the main caregiver is a spouse. Finally, the caregiver's burden is affected by their own health and income, and by whether the elder has symptoms of dementia or stroke.
The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.
Purpose: The purpose of this study was to determine the effects of low intensity exercise program with telephone coaching on the physical fitness of elderly people who are receiving home visiting nursing care. Method: This study was conducted using a non-equivalent control group pretest-posttest design. The participants were 61 elders. Elders (34) in the experimental group performed low intensity exercise and of these 16 received telephone coaching. The low intensity exercise program consisted of stretching, muscle strengthening with an elastic band, massage, and ball exercise, five days a week, for sixteen weeks. Data were collected from July 2007 to December 2007. $x^2$-test, ANCOVA with SPSS WIN 11.0 program were used to analyse the data. Results: There were statistical differences in the right grasping power in the right hand (p=0.021), Raising behind of right arm (p=0.006), Raising behind of left arm (p=0.007). Conclusion: These results indicate, that a low intensity exercise program with telephone coaching can help improve physical fitness in elders receiving served home visiting nursing care.
Purpose: The purpose of this study was to investigate the current state and trends of factors influencing the quality of life in low- income elders living at home. Methods: To carry out this study we established the patient, intervention, comparison, outcomes (PICO) strategy, reviewed 241 published documents from both national and international electronic databases, and finally selected 9 references based on inclusion and exclusion criteria alone. The quality of selected references was assessed using 15 questions. Two reviewers independently examined titles and abstracts and assessed whether each met the predefined inclusion and exclusion criteria. Results: The following factors were significantly associated with quality of life in low- income elders: (1) demographic factors such as number of children, income, and age; (2) health - related factors such as joint exercise capacity, activities of daily living/instrumental activities of daily living, health perception, health promotion behavior, and depression; and (3) socio environmental factors such as family support, community-based service program, leisure activity, and the number of neighborhoods involved. Conclusion: The results of our study provide a definite basis for the development of a policy strategy to improve the quality of life in elders with low income and we hence strongly recommend that any strategy to improve the quality of life in low-income elders be based on the results of our study.
Propose: This study was to identify the factors affecting the oral health status in vulnerable elders receiving home visiting health care service. Methods: A total of 444 elderly people over the age of 65 at 33 public health centers in Daegu and Gyungbuk areas were included in this survey. The data were collected by personal interview with nurses using oral health knowledge, behavior, and status questionnaires from the $10^{th}$ to $22^{nd}$ of July, 2012. The data were analyzed with t-test, one-way ANOVA, $Scheff{\acute{e}}$ test, and stepwise multiple regression, using SPSS program. Results: Factors affecting the oral health status were chewing satisfaction with denture 14.5% (${\beta}=.391$, p<.001), denture care (wash with water) 3.2% (${\beta}=-.187$, p<.01), and types of health insurance (medical aid type1, 2) 1% (${\beta}=-.111$, p<.05). The factors explained 18.7% of variance in the oral health status of vulnerable elderly subjects. Conclusion: The results of this study indicate that in order to improve the oral health status of vulnerable elders, it is necessary to provide oral health education that includes the proper usage of denture to elders who receive home-visiting care.
Purpose: This study investigated various factors relatied to wandering behavior of Korean elders with dementia (KED). Methods: A sample of 160 ambulatory residents with dementia from 14 long term care facilities was used to examine demographic, individual, cognitive, physical health, and environmental characteristics by comparing wanderers (N=108) to nonwanders (N=52). Subjects were evaluated by Korean versions of the Mini-mental State Exam (K-MMSE), the Physical and Instrumental Activities of Daily Living (K-PIADL), and the Revised Algase Wandering Scale Nursing Home version (KRAWS-NH) along its six dimensions. Demographic and environmental data were also obtained. Independent sample t-tests, Chi-square test, Fisher's Exact tests, and ANCOVAs were used to examine differences between wanderers and nonwanders. Results: Wanderers were significantly (p<.05) older and had more limitations in K-PADL and K-IADL. The degree of overall wandering and certain features of wandering were significantly different (p<.05) by total number of residents in the facility, type of bedroom (i.e., "Ondol"), and color of bedroom and living-room walls (i.e., sky blue). Conclusions: Findings of this study may be useful in understanding wandering behavior of KEDs and thus developing more culturally specific management strategies.
Purpose: This study was done to explore factors related to amount of service use for elders with long-term care needs. Methods: A descriptive-correlation design was used. The sample included 259 elders and their primary caregivers who had cared for the elders for at least 6 months. Data on long-term care need assessment, service use and interviews with primary caregivers were analyzed. Results: There was no significant relationship between the sociodemographic characteristics and the amount of services use. Amount of service use differed significantly by Long-term care classification. The mean scores for class 1, 2 and 3 were 22.68, 21.47 and 17.87 days respectively. Primary caregiver relationship with the elders and the number of family-friend helpers were also significant. Multivariate regression analysis showed that gender, marital status, activities of daily living, cognitive impairment, and secondary caregiver support explained 17% of the total variance of service use among these elders (F=3.50, p<.001). Conclusion: The results of this study indicate that critical factors including secondary caregiver support and individual background, and other functional dependencies except for physical function should be considered in accurately predicting the amount of service use for community dwelling elders with long-term care needs.
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