• Title/Summary/Keyword: Elders in Nursing home

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Effects of Case Management using Resident Assessment Instrument-Home Care(RAI-HC) in Home Health Services for Older People (재가노인 기능상태 평가도구를 이용한 재가노인 사례관리 프로그램의 효과 평가)

  • June, Kyung-Ja;Lee, Ji-Yun;Yoon, Jong-Lull
    • Journal of Korean Academy of Nursing
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    • v.39 no.3
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    • pp.366-375
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    • 2009
  • Purpose: To evaluate the effects of case management using Resident Assessment Instrument-Home Care(RAI-HC) in home health service for older people. Methods: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living(ADL), Instrumental Activities of Daily Living(IADL), Cognitive Performance Scale(CPS), Depression Rating Scale(DRS), Pain and the number of Clinical Assessment Protocols(CAP). Results: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression(odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL(OR: 4.423, CI: 1.151-16.999) and the number of CAP(OR: 11.443, CI: 3.805-34.410). Conclusion: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

The Effects of Home Visit Healthcare Using a Complex Program on Community-dwelling Frail Elders' Strength, Frailty, and Depression (복합 프로그램을 적용한 방문건강관리가 재가허약노인의 체력, 허약, 및 우울 개선에 미치는 영향)

  • Kim, Hee Gerl
    • Research in Community and Public Health Nursing
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    • v.26 no.4
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    • pp.405-414
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    • 2015
  • Purpose: The purposes of this study were to examine the effects of home visit healthcare using a complex program on community-dwelling frail elders' physical strength, frailty, and depression and to compare the effects among three regions. Methods: This study was conducted as a quasi-experimental study using one-group pretest-posttest design. A total of 86 subjects were sampled from three regions (metropolis, small city, and rural area). The program was applied for 14 weeks. This program consisted of disease management by a visiting nurse, exercise with a visiting nurse, self exercise, telephone monitoring, health education, counseling, providing handbook, and incentive. Physical strength was measured by balance, upper-limb, and lower-limb muscle strength. Frailty was measured by the Korean Frail Scale and depression was measured by the Geriatric Depression Scale. Paired t-test and ANCOVA were used to analyze the effects. Results: Physical strength, frailty, and depression were significantly improved after applying the complex program. There were not differences among the regions. Conclusion: Home visit healthcare using a complex program was effective in improving frail elders' physical strength, frailty, and depression. There were not differences among the regions. Therefore, home visit healthcare using a complex program needs to be expanded to other regions.

Health Welfare Service Needs Analysis Using a Functional Status Assessment Instrument (기능상태 평가도구를 이용한 일 농촌지역 노인의 보건복지 서비스 요구분석)

  • Choi, Jeong-Ae
    • Journal of Korean Academy of Rural Health Nursing
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    • v.2 no.1
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    • pp.60-69
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    • 2007
  • Objectives: This study was done to identify health and functional status of rural elders, to identify the use of health and medical treatment and welfare services in order to present directions for improving use of health and welfare services by rural elders. Methods: The participants in the study were 170 elders over 65 years of age who live in the one of the 6 villages served by the Young Am Community Health Post. The elders were visited at home and interviewed the elders using the RAI tool. Descriptive statistics including frequency and range were used to analyze the data. Results: Limitations in physical function, finances and medical treatment service were identified. Conclusions: The findings of this study indicate a need to develop good quality service which is affordable and convenient.

Factors Influencing Self-care in Elders with Hypertension Living at Home (고혈압 재가노인의 자가간호 영향요인)

  • Jeong, Hye Min;Lee, Myung Ha;Kim, Hye Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.1
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    • pp.72-83
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    • 2017
  • Purpose: The purpose of the study was to identify the level of resilience, autonomous motivation, depression and self-care and their correlates in elders with hypertension. Methods: The participants were 200 elders with hypertension living in J, I, and K city. Data were collected through face-to-face interviews using the Resilience Scale, Treatment Self Regulation Questionnaire, Short Form Geriatric Depression Scale, and Hypertension Self-care Scale. Results: Total scores for resilience, autonomous motivation, depression, and self-care were $109.65{\pm}20.78$, $38.18{\pm}5.99$, $8.33{\pm}2.61$, and $52.06{\pm}6.94$, respectively. Autonomous motivation, income, acceptance of self and life, resilience, experience of hypertension education, and gender were verified as factors influencing self-care. These factors accounted for 51.6% of self-care. Conclusion: Understanding these factors is essential for developing effective interventions to improve self-care in elders with hypertension.

Health Needs of the Elderly in Long-term Care Facilities: Using RAI-MDS-FC (노인요양시설 입소자의 요양등급별 건강 요구: RAI-MDS-FC를 적용하여)

  • Bang, Eun-Joo;Yun, Soon-Young
    • Research in Community and Public Health Nursing
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    • v.21 no.2
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    • pp.263-272
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    • 2010
  • 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.

Comparisons of personal characteristics in noninstitutionalized elders with activity limitations (기능장애 노인의 도우미 유무에 따른 특성 비교)

  • Kim Jung-Hee
    • Journal of Korean Public Health Nursing
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    • v.13 no.1
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    • pp.25-40
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    • 1999
  • This study was to identify various personal characteristics between those having a helper and those not having a helper for ADL and IADL performance in noninstitutionalized elders. Secondary analysis was done with the data collected in 1994 national survey of aged householders. Of the elders with ADL limitations $47.8\%$ had no helper. while $26.2\%$ of those with IADL limitations had no helper. Those elders with a helper experienced more limitations in ADL and in IADL than those with no helper. Most of the helpers were family members. whereas very few had a formal helper. Age period and subjective economic status were significantly different between the groups with a helper and with no helper for both ADL and IADL. Compared to the elders with a helper. those elders with no helper had fewer children living together. whereas they had more grandchildren. They also had more contacts with friends or neighbors. Health status. in general. was worse in those elders with a helper than those with no helper. Logistic regression analysis revealed that ADL and IADL limitations had largest influence on having an ADL helper. The odds ratios for low levels of subjective economic status were very high. As for having an IADL helper. IADL score was the most important predictor. In particular. ADL limitations had a negative effect on having an IADL helper. This finding may indicate the urgency of ADL needs. which leads to the lack of an IADL helper when both ADL and IADL limitations are present. Considering the nature of ADL. those disabled elders with low economic status need public support for their daily activities and for home visiting nursing services. There should be studies of examining the adequacy of help in satisfying basic needs for performing ADL and IADL in elders.

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Factors associated with Health-related Quality of Life among Family Caregivers of Elders Receiving Home Care Services (재가 장기요양노인 가족수발자의 건강 관련 삶의 질 영향요인)

  • Kim, Eun-Young;Yeo, Jung Hee
    • Research in Community and Public Health Nursing
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    • v.23 no.2
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    • pp.117-126
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    • 2012
  • Purpose: The purpose of this study was to identify the factors associated with the health-related quality of life of family caregivers. Methods: A cross-sectional study was conducted. This study included 191 primary family caregivers of elders who used home care services (home-visit nursing, home-visit care, daycare) covered by the public long-term care insurance. Data were collected using self-report questionnaires from December 2010 to June 2011. These data were analyzed by using hierarchical multiple regression. Results: The majority of the family caregivers were female (79.6%) and daughters-in-law (28.8%). The mean depression score was $6.33{\pm}6.49$ and the mean health-related quality of life score was $0.69{\pm}0.39$. It was found that the factors affecting the health-related quality of life of family caregivers included depression (${\beta}$=-.406, p<.001), home-visit nursing use (${\beta}$=.296, p<.001), and daycare use (${\beta}$=.178, p=.015), which accounted for 36.6% of their health-related quality of life. Conclusion: Using home-visit nursing and daycare services has a positive effect on the health-related quality of life of family caregivers. To improve health-related quality of life of family caregivers, South Korea needs to fully activate the home-visit nursing and daycare services, and to strengthen family support programs.

Elderly Koreans' Perception of Nursing Homes (노인요양시설에 대한 한국노인의 인식)

  • Kim, Se Young
    • Research in Community and Public Health Nursing
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    • v.27 no.3
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    • pp.242-253
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    • 2016
  • Purpose: This research aims to understand the perceptions of nursing homes from the perspective of the elderly, explores the themes of such perception and provides supporting evidence for developing nursing intervention that focuses on the subjects of care within nursing homes. Methods: This research is based on qualitative research in a phenomenological methodology. The research participants included elders aged 67~83 living at home in Jeonnam, Jeonbuk Provinces and G City. Data collection methodologies included in-depth interviews and observation of participants. The data were analyzed in the phenomenological methodology by Colaizzi. Results: As a result of the research, it was found that all significant statements about the Korean elders' perception of nursing homes fell within 3 categories with 9 major themes and 23 minor themes. The three observed categories for the Korean elders' perception on nursing homes were: 'places they do not like to be in', 'places they have to be in' and 'places that makes them feel fortunate as they have a place to go'. Conclusion: This research provides foundational tools that will provide a steer for changes in nursing environment, physiological support, programs and education so that the needs of the elderly can be met more sufficiently.

Influencing Factors on Care Burden among Family Caregivers for Elders with Dementia: Focusing on Family Caregivers using a Support Center for Dementia (치매노인을 돌보는 가족부양자 부양부담의 영향 요인: 치매지원센터 이용자를 중심으로)

  • Lim, Kyung Choon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.25 no.1
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    • pp.136-147
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    • 2019
  • Purpose: This study aimed to explore influencing factors on care burden among family caregivers for elders with dementia living at home. Methods: Participants in this study were 211 family caregivers who were taking care of elders registered at a support center for dementia located in S-gu, Seoul. Data were collected using a structured questionnaire. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression in SPSS WIN 23.0. Results: The care burden of family caregivers was mild to moderate ($40.31{\pm}21.50$) in this study. The factors influencing care burden among family caregivers for elders with dementia were the age, behavioral problems, and dependency in instrumental activities of daily living of demented elderly, in addition to the perceived health status and resting hours of family caregivers. Overall, these factors explained 46.5% of the total variability in care burden in this sample (F=13.01, p<.001). Conclusion: Findings from this study suggest that the characteristics of demented elderly and family caregivers can influence care burden differently. Individually tailored strategies based on the various caregiving contexts need to be developed to reduce the level of care burden among family caregivers for elders with dementia.

Development and Analysis of the Effects of Caregiver Training Program on Aggressive Behavior m Elders with Cognitive Impairment

  • Oh Heeyaung;Hur Myung-Haeng;Eom Miran
    • Journal of Korean Academy of Nursing
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    • v.35 no.4
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    • pp.745-753
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    • 2005
  • Purpose. The purposes of this study were to 1) describe the type and frequency of aggressive behavior of cognitively impaired nursing home resident, 2) develop a caregiver training program on prevention and management of aggressive behavior, 3) examine the effects of caregiver training program on the incidence of aggressive behavior of cognitively impaired nursing home resident, and 4) examine the effects of caregiver training program on nursing staff's aggressive behavior management skills. Methods. One-group, time series, quasi-experimental design with a pre-test and two post- tests was used. Data were collected from cognitively impaired home residents (N = 32) and nursing staff (N = 36) in a proprietary nursing home using Ryden Aggression Scale I, II, and Aggressive Behavior Management Scale. Data were entered and analyzed by descriptive statistics and repeated measures ANOVA. Results. Incidence of aggressive behavior was high with a mean score of 3.09 (SD = 3.11) at baseline. Caregiver training program was developed based on Progressively Lowered Stress Threshold (PLST) model and gerontological and psychiatric literature. The mean scores of aggressive behavior at baseline, Post I, and II did not differ significantly although the difference approached to the significant level (F = 2.925, p = .066). Nursing staff's aggressive behavior management skills increased at Post I, and at Post II when compared to baseline, and the difference was significant (F=12.736, p=<.00l). Conclusion. Caregiver training program showed potential impact on reduction of aggressive behavior in elders with cognitive impairment and was effective in increasing nursing staff's aggressive behavior management skills.