• Journal of Family Resource Management and Policy Review
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• v.20 no.3
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• pp.1-23
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• 2016

This study analyzes the effects of caring for grandchildren on Korean grandparents' health, using the Korean Longitudinal Study of Aging from 2006 to 2012. We investigate how caregiving is provided and analyze the effects of caregiving on grandparents' physical health, mental health, and health-related behaviors. As elderly people's health is generally frail, it is unclear whether the provision of childcare affects their health negatively. We control for the endogeneity of caregiving by an individual fixed effect (FE) model and instrumental variable-fixed effect (FE-IV) models. Using these models, we determine the endogeneity of caregiving and show that the significant effects of caregiving on health disappear as we control for endogeneity in the FE and FE-IV models. Even after controlling for endogeneity, we find that caregiving increases the probability of feeling pain as well as the number of different types of pain. Furthermore, caregiving increases the probability of restrictions on daily activities because of pain. On the other hand, caregiving reduces the symptoms of depression. In relation to health-related behaviors, caregiving reduces the probability of physical exercise and regular meals. Our results imply that although caregiving has a positive effect on mental health, the increase in physical pain and in non-healthy behaviors may lead to a deterioration of the caregiver's long-term health, which in turn may increase the medical costs of the elderly. Potential policy alternatives are discussed in the paper.

• Journal of The Korea Institute of Healthcare Architecture
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• v.10 no.2
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• pp.99-106
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• 2004

This study attempts to provide the fundamental materials for space program in terms of planning a senior welfare center by means of examining and analyzing the present conditions of spatial arrangement of each section in senior welfare center for the aged. The results of the study are as in the following. 1) The demand for new service programs corresponding to the improved quality of the elderly and various social desires is relatively on the increase. Each program in senior welfare center for the elderly should be connected in an organic manner and the organization of space should be provided. 2) The section of counseling, the first step when using a welfare center, should be located in the entrance of the building and it has to be closely connected with other section. 3) The section of medical rehabilitation is a place mostly for the elderly in their frail physical condition; therefore, it is effective to use horizontal line. 4) It is important for the room for volunteers in the section for domiciliary welfare to be arranged flexibly with the office or the room for social education, and it is necessary to consider how easy daytime or short-term care is accessible. 5) The space where dynamic programs are progressed in the section of social education should be distinguished from the section of medical rehabilitation or the room for daytime care and the room for short-term care of the section of domiciliary welfare.

• 한국노년학
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• v.28 no.4
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• pp.1249-1264
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• 2008

Guilt feelings are dysfunctional feelings that the primary caregiver of the frail elder are apt to have and those feelings increase a burden of caring, while there is lack of empirical study on the effect of guilt feelings on caring behaviors. In light of this, this study lays its purpose on examining the effect of the primary caregivers' guilt feelings on their burden of caring and request behaviors for help with caring, paying attention to their guilt feelings in our society where Confucian values toward supporting the elderly have remained. The questionnaire survey was conducted for 220 primary caregivers caring frail elders over 60 years of age by visiting. As a tool for measuring guilt feelings, a self-designed measure for caregivers was used (${\alpha}=.949$), and factors of guilt feelings were classified into four namely, the factors of lack of self-control, lack of resources, burnout, and the normative factor As a result, the following findings were derived. First, it was revealed that the guilt feelings of caregivers as family members have a positive correlation with a feeling of burden of caring and the feeling of burden have even effects on the four factors of guilt feelings. Second, when primary caregivers request help with caring, they feel guilty toward cohabiting family members and neighbors, and also they show no guilt feelings when using day-care services for the elderly. Especially, guilt feeling factors affecting primary caregivers were found to be the normative factor to cohabiting family members, the factor of lack of resources to neighbors, and the factor of burnout to using day-care services for the elderly. This result tells that the dysfunctional feelings of primary caregivers namely guilt feelings arising when asking help with caring not only increase their burden of caring but also can cause difficulties in sharing the role of the caregiver. Accordingly for the mental health of caregivers, we should develop programs with which we could understand and cope with their guilt feelings.

• Journal of agricultural medicine and community health
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• v.46 no.1
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• pp.23-31
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• 2021

Objectives: Frailty and sarcopenia are recent important concepts in elder health care. Sarcopenia is the most important factor influencing frailty, and exercise and nutritional status are known to affect sarcopenia. The purpose of this study was to identify the relationship between nutritional status, sarcopenia, and frailty. Methods: This study was a cross-sectional design. The subjects of this study were 411 elderly people aged 65 or older from 10 villages in Gyeongnam. The survey tools were the K-FRAIL for frailty, the GDS-SF for depression, the SARC-F questionnaire for sarcopenia, and the DETERMINE for nutritional status. Frequency analysis, the chi-square test, and multiple logistic regression analysis were performed using the SPSS 25.0 program. Results: As a result of the chi-square test, there was a significant difference in the nutritional status and the frailty proportion (p<0.001), and there was a significant difference between frailty and suspected sarcopenia (p<0.001). After adjustment, nutritional status was significantly associated with sarcopenia (OR=2.946, p<0.001). In addition, nutritional status was significantly associated with frailty (OR=2.958, p<0.001), and sarcopenia also had a significant effect on frailty (OR=5.898, p<0.001). Finally, even after including sarcopenia, nutritional status had a significant effect on frailty (OR=2.246, p=0.002). Conclusions: Nutritional status can have both a direct effect on frailty and an indirect effect through sarcopenia, and it was found that sarcopenia also affects frailty. Therefore, it is necessary to evaluate sarcopenia and nutritional status and to evaluate their levels in the elderly and to take appropriate interventions.

• 한국노년학
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• v.29 no.1
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• pp.37-50
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• 2009

The purpose of the present study was to develop a community-based intensive health care program for the community dwelling elderly to strength their functional status and to verify the effect on their geriatric syndrome. A one-group pretest-posttest design was used for the study. A total of 69 frail elderly, who lived in the area within 20 minutes by car, were committed themselves to the day care center(Sangikjae), and had the ability of verbal communication were selected from G city in Kyunggi province. The participants completed a set of questionnaires to measure the sub-score of frailty, fall, urinary incontinence, malnutrition, and mild cognitive disorder domain, using the Otasha-Kensin through the physical examinations and interviews. After 4 weeks of intervention, the outcome was measured to evaluate the effects of the program, and the data obtained were analyzed using descriptive statistics, paired t-test and McNemar test. The results showed that the sub-score of frailty, fall, urinary incontinence, and malnutrition domain were statistically significantly decreased after intervention except those of urinary incontinence and mild cognitive disorder domain, implying that the risk of frailty, fall, and malnutrition was decreased. These findings indicated that community-based the intensive health care program is effective for relieving geriatric syndrome of the community dwelling elderly.

• 한국노년학
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• v.31 no.2
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• pp.259-276
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• 2011

If frail elderly could use home care services adequately, quality of their life might improve and their costs of service would be decreased. The purpose of this study is to examine the factors on institutionalization of elderly using home care services in Korean long-term care insurance system. This study used the data of '2009 satisfaction survey of Korean long-term care system'. The survey proceeded using sampling data by region, level of long-term care need, and insurance type among beneficiaries from August 2009 to September 2010. The onset dates of institutionalization of 1,230 participants were ascertained from long-term care insurance claim data. This study calculated hazard ratio through Cox Proportional Hazard Model. The results showed that if elderly using home care services suffer a fracture, the hazard ratio of institutionalization is higher significantly. Although not significant, if older persons have more items of damaged cognitive functions, the hazard ratio of institutionalization is higher. The results have policy implications to supplement of home care service system and postpone institutionalization of elderly.

• Journal of the Korean housing association
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• v.22 no.5
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• pp.13-20
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• 2011

The purpose of this study was to describe the overall physical environment's features of nursing homes for Korean American elders in the United States. This investigation was conducted in Korean American nursing homes on the East Coast and in the Midwest with multiple qualitative data collection methods, such as interviews, observations, document review, and field notes. The findings of this study are as follows: 1) Although almost all respondents were unable to speak and understand English at all, most written materials in nursing homes were in only English; 2) The nursing homes were placed near or within the Korean communities; thus, it contributed to close ties with religious Korean American groups and other groups in the ethnic communities; 3) Whether the facility's physical features looked like those of a hospital or a home, many residents did not consider a nursing homes as a real home; 4) A fenced garden in the nursing home in the Midwest was the residents' favorite public space; 5) Due to being forced to room with residents who had dementia and were bedridden, they were more likely to have conflicts with their roommates and feel uncomfortable living in their room; and 6) The facilities seemed to be designed without consideration to protect residents' privacy.

• Korean Journal of Adult Nursing
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• v.18 no.3
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• pp.488-499
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• 2006

Purpose: Behavioral symptoms in dementia (BSD) are one of the most disturbing behaviors to caregivers and a major reason for nursing home placement. Behavioral symptoms are often treated with psychotropic drugs (PD), however, the effect of such drugs for the frail elderly dementia patient is not certain because of their critical adverse effects. Theoretical model applicable to nursing practice for BSD in nursing homes, which is essential in guiding and evaluating such interventions, is absent. This article presents the process of developing a theoretical model of BSD in nursing homes. Method: Using Walker and Avants' theory synthesis method, three behavior models and two system models were incorporated into the proposed model to provide the theoretical and analytical explanation of the relationships between PD usage, its determinants, and BSD. Results: Resident variables and nursing home variables related to the two focal concepts (i.e., PD usage and BSD) were identified. Resident variables include demographical characteristics such as age and gender, and dementia-compromised functions such as cognitive and functional impairment. Nursing home variables include facility characteristics such as ownership type and size, and physical and psychosocial environment. Conclusion: The proposed model suggests that fulfillment of resident unmet needs through improvement of physical and psychosocial environment may produce better health outcomes of nursing home residents with BSD. Assessment and intervening environmental triggers of such behaviors are also suggested to be prior to the PD usage.

• Korean Journal of Adult Nursing
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• v.24 no.6
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• pp.580-587
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• 2012

Purpose: To develop and test the validity and reliability of the Korean version of outcome expectations-2 for exercise. Methods: The Korean version of outcome expectations for exercise-2 was developed through forward-backward translation techniques. Content, criterion, and construct validity using confirmatory factor analysis and an internal consistency reliability were conducted. Survey data were collected from 200 older adults living in a community. Results: The Korean version of outcome expectations for exercise-2 had factor loadings of the 13 items ranged from .20 to .76, and was validated by confirmatory factor analysis (CFI=.829, NFI=.754, RMSEA=.086). Also there was a reliable internal consistency with a Cronbach's ${\alpha}$ for the positive domain of outcome expectations for exercise scale-2 of .73. Negative domain, however, reported slightly low Cronbach's ${\alpha}$ of .63. Conclusion: The findings of this study demonstrated that the Korean version of outcome expectations for exercise-2 had satisfactory validity to measure expectations regarding exercise among older adults in Korea. Negative domain, however, should be retested to verify reliability for the further study.

• Research in Community and Public Health Nursing
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• v.29 no.4
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• pp.429-439
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• 2018

Purpose: The aim of this study is to identify core keyword of frailty research in the past 35 years to understand the structure of knowledge of frailty. Methods: 10,367 frailty articles published between 1981 and April 2016 were retrieved from Web of Science. Keywords from these articles were extracted using Bibexcel and social network analysis was conducted with the occurrence network using NetMiner program. Results: The top five keywords with a high frequency of occurrence include 'disability', 'nursing home', 'sarcopenia', 'exercise', and 'dementia'. Keywords were classified by subheadings of MeSH and the majority of them were included under the healthcare and physical dimensions. The degree centralities of the keywords were arranged in the order of 'long term care' (0.55), 'gait' (0.42), 'physical activity' (0.42), 'quality of life' (0.42), and 'physical performance' (0.38). The betweenness centralities of the keywords were listed in the order of depression' (0.32), 'quality of life' (0.28), 'home care' (0.28), 'geriatric assessment' (0.28), and 'fall' (0.27). The cluster analysis shows that the frailty research field is divided into seven clusters: aging, sarcopenia, inflammation, mortality, frailty index, older people, and physical activity. Conclusion: After reviewing previous research in the 35 years, it has been found that only physical frailty and frailty related to medicine have been emphasized. Further research in psychological, cognitive, social, and environmental frailty is needed to understand frailty in a multifaceted and integrative manner.