• Korean Journal of Adult Nursing
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• v.29 no.2
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• pp.119-130
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• 2017

Purpose: The purpose of this study was to understand the nurses' experiences of end of life care of older adults with dementia living in long-term care hospitals and geriatric care facilities. Methods: The participants were nine nurses. Open in-depth interviews were used to collect data from June, 2016 to November, 2016. Colaizzi's phenomenological approach was used to analyze the data. Results: Three categories were identified. The nurses' reported experiences of end of life care of older adults with dementia were 'warm care with living together', 'care for family', and the 'self-reflection and responsibility as a nurse'. There were ten clusters of themes and 24 themes. The participants stated that the end of life care of older adults with dementia were individualized holistic care with dignity, being in older adults with dementia and family, and responsibility as a professional. Nurses reported the need for dementia hospice care. Conclusion: These results could be considered in planning nursing intervention for hospice care. The findings support the need for educational strategies and programs to improve end of life care among older adults with dementia.

• Journal of muscle and joint health
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• v.25 no.3
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• pp.167-175
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• 2018

Purpose: The aim of this study was to test the effects of passive exercise on upper extremities muscle spasticity, finger edema, and depression for chronic stroke patients. Methods: A non-equivalent pretest-posttest design was employed for this study. The subjects were 30 elderly patients who were hospitalized to treat chronic stroke. 15 patients were assigned to the experimental and control groups respectively. Passive exercise for 20 minutes per day, five days a week for 8 weeks (total 40 times) was provided for the experimental group. Outcome measurements included manual spasticity test to measure upper extremities' muscle spasticity, the ring measurement method for finger edema and the Korean version of Short-form Geriatric Depression Scale (SGDS-K) for depression. Results: The upper extremities' muscle spasticity (Z=-2.52 p=.012) and the degree of depression (F=5.56, p=.006) in the experimental group were significantly reduced compared to those of the control group. But the degree of finger edema did not significantly differ between the two groups (F=1.46, p=.240). Conclusion: Passive exercise for upper extremities should be encouraged for elderly patients with chronic stroke to enhance the upper extremities' functional capacity as well as depression.

• Journal of the Korean Dietetic Association
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• v.17 no.2
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• pp.176-189
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• 2011

The purpose of this study was to investigate the status of clinical nutrition services at various medical centers in Seoul, Korea. A questionnaire was distributed to the departments of nutrition at 44 hospitals in Seoul on July 2009. Nutritional screening carried out at a rate of 59.1% at the medical centers, and a significant difference was found according to the type of center, from 100% in tertiary hospitals to 18.8% in normal hospitals. On annual average, the numbers of inpatients, inpatients for malnutritional screening, inpatients with malnutrition, and inpatients for malnutrition management were 15,169.5, 10,870.9, 2,224.8, and 1,546.2, respectively. On average the group nutrition education was done 36.1 times/year for diabetes, 8.2 times/year for cancer, and 1.9 times/year for renal disease, and the numbers of participants 423.1, 95.1, and 31.5, respectively. On average the individual nutrition education of inpatients with diabetes was done 135.4 times/year for ordered-type, and 119.3 times/year for unordered-type, 106.2 times/year for paid-type, and 148.5 times/year for unpaid-type. The mean fee for education and counseling was the highest for peritoneal dialysis (73,090.9 won) but the lowest for heart disease (23,609.1 won). On average the individual nutrition education of outpatients with diabetes was done 234.6 times/year for ordered-type, and 2.5 times/year for unordered-type, 204.4 times/year for paid-type, and 32.7 times/year for unpaid-type. The mean fee for education and counseling was also the highest for peritoneal dialysis (63,500.0 won) but the lowest for heart disease (21,336.4 won). To implement more effective clinical nutrition service, a national medical insurance imbursement policy should be urgently instituted such that diseases left as unpaid are covered by health insurance, including all nutrition-related disease.

• Journal of Korean Academy of Nursing
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• v.38 no.2
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• pp.298-309
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• 2008

Purpose: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. Methods: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. Results: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. Conclusion: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

• Physical Therapy Korea
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• v.24 no.3
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• pp.47-56
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• 2017

Background: Given the potential benefits of wellness programs promoting physical activity of the community-dwelling frail elderly, it is recommended that comprehensive wellness programs combined with the component of physical activity. This may improve overall health and potentially lower the health care cost of the frail elderly. In general, the frail elderly residing in community or those after being discharged from hospitals are often committed to enhancing the status of participation in physical activity. Objects: The purposes of this study were to identify specific shortcomings of current wellness programs as part of continuum of community rehabilitation services and to propose alternatives for the care of the community-dwelling frail elderly. Through this study, geriatric health care professionals may be able to implement assessments and programs to successfully promote an effective continuum of care for the frail elderly. Methods: Article reviews were summarized and evaluated. Results: A model elaborating the relationship between components of successful wellness program and participation in physical activities for the community-dwelling frail elderly are recommended. First, periodic monitoring the levels of physical activity by the use of online measurement system should be considered. Second, individualized adaptive technologies for selecting optimal physical activities for the elderly may be better fit to individuals' current status of physical activity. Conclusion: The current status of physical activity in community-dwelling frail elderly can be monitored by online assessment systems. Through the innovative measurement system, elderly may assess his/her physical activity status overtime, select optimal physical activities matching the status, and create the elderly's own adaptive wellness programs that match to the status while residing in his/her community.

• Journal of Korean Academy of Nursing
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• v.24 no.3
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• pp.448-460
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• 1994

This study was conducted to investigate risk factors for senile dementia as well as care givers' stresses and thier needs for nursing care. It was done using a retrospective survey. A convenience sample or In senile dementia patients and l20 nor-mal elders in a rural area was used. The tools used in the study were the MMSE-K(Mini-Mental State Examination-Korea) for dementia screening test and a questionaire developed by the research team. Data were collected through home visits by Com-munity Health Practitioners. Data were analyzed using descriptive statistics, T-test, and Chi-square test. The findings are as follows : 1. There were significant differences in age, marital status, and religions between the two groups. 2. There was a significant difference in smoling behavior between the two groups. 3. There was a significant difference in past his-tory of cancer between groups. 4. There was a significant difference in past and present elderftmily relationship between the two groups. 5. There were significant differences in intellectual activities, assuming major role in family and seeking other's help in daily life troubles between the two groups. 6. There were significant differences in stress factors such as child problem, family conflict, health problem and illegal behavior between the two groups. 7. The major problems out by families in caring for dementia patient were catastrophic reactions, dirtiness, mood change, devouring and tremor. The most serious problems faced by families was dirtiness. with catastrophic reactions, sleep distrubance, changeableness, and a suspcio-usness following. The care givers expressed chronic fatigue, anxiety, tension, depression, disorder in daily life, shamefulness, blame from neighbours and guiltiness. 8. There is need for geriatric hospitals, nursing homes, burden sharing, and counselling or education for family care givers. A replicate study in the urban area is recommended to validate the findings of this study. To explore the impact of stress in life and ‘han’ on senile dementia, a qualitative study is recommended.

• The Journal of Korean Academic Society of Nursing Education
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• v.14 no.1
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• pp.127-137
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• 2008

Purpose: This study aimed to explore the level of importance perceived by caregivers of elderly on the education of long term care nursing assistants (LTCNAs) taking care of elders with dementia or stroke. Method: Data was collected from 296 participants (112 families, 98 NAs, and 86 RNs) from October 2006 to February 2007. A structured questionnaire was used for data collection. Result: The item of 'attitude while caring for the aged' was identified as most important. The family group reported that 'position change' and 'understanding of geriatric diseases' were the most important for education, while LTCNAs, highly identified, 'bathing', and 'bed sheet change'. The RNs group regarded 'position change', and 'bathing' as most important. Institutions demanding LTCNAs' activities were special facilities for elderly care and special hospitals for the aged, and the need was also high in families with an elder incapacitated by illness. Conclusion: Nurses need to take an interest in education for enhancing the quality of LTCNAs and thus advance the quality of nursing care as well as the quality of life for the aged.

• Journal of muscle and joint health
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• v.22 no.1
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• pp.1-12
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• 2015

Purpose: The purpose of this study was to explore the relationships among pain, depression, health behaviors, and activities of daily living (ADL) in older adults after femur fracture surgery. Methods: This was a descriptive correlational study. Ninety seven outpatients aged 65 or older were selected, who agreed to participate and visited the four hospitals located in G providence. Numeric Rating Scale (NRS) for pain, a Short form Geriatric Depression Scale (SGDS) for depression, health behavior scale and Korean version of Bathel Index for ADL were used. Data were analyzed using t-test and ANOVA, Pearson's correlation and the hierarchical regression analysis in SPSS 18. Results: Pain and depression were positively correlated (r=.35, p<.001). Pain and health behaviors (r=-.30, p=.010), pain and ADL (r=-.21, p=.044), depression and health behaviors (r=-.51, p<.001), depression and ADL (r=-.29, p=.004) were negatively correlated. The variables affecting the ADL was intake of a painkiller or not (${\beta}$=-.32), age (${\beta}$=-.25), transitional period after discharge (${\beta}$=.23) and depression (${\beta}$=-.23). ADL was accounted for 33.4% in total by these four variables. Conclusion: Interventions for alleviating pain, and managing depression would be effective in enhancing ADL in older adults after femur fracture surgery.

• Korean Journal of Occupational Health Nursing
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• v.25 no.2
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• pp.118-129
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• 2016

Purpose: This study aims to examine the levels of the perception and work performance of patient safety based on the healthcare accreditation criteria among long-term care hospital nurses. Methods: A cross-sectional study was performed using questionnaires. Out of 205 criteria, 39 items relevant to patient safety were selectively adapted for this study. Data were analyzed with descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. Results: The mean scores of perception and work performance were 4.36 and 4.24 out of 5, respectively, and the difference between them was significantly different (t=5.78, p<.001). The two variables were both significantly higher among those nurses who were older, married, head nurses, had many nursing experiences, and aware of Healthcare Accreditation than the other nurses. Positive correlations were observed between perception and work performance in all three sub-systems. The relations between these two in the patient care system was the most highly correlated (r=.894, p<.001). The lowest scores of perception and work performances were fire-related criteria (i.e., reporting). Conclusion: Overall, subject's perception proves to be higher than their work performance. It is necessary to develop some viable environment and training programs to enhance their work performance up to the level of their perception of patient safety.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.1115-1119
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• 2013

Background: Febrile neutropenia (FN) is a serious complication following chemotherapy and is associated with significant mortality and financial expenditure. The aim of this study was to evaluate risk factors for longer length of stay (LOS) and mortality and cost of treatment among hospitalized adults with cancer who developed febrile neutropenia in Thailand. Materials and Methods: Information on illness of inpatients and casualties came from hospitals nationwide and from hospital withdrawals from the 3 health insurance schemes in fiscal 2010. The data covered 96% of the population and were analyzed by age groups, hospital level, and insurance year schemes in patients with febrile neutropenia. Results: A total of 5,809 patients were identified in the study. The mortality rate was 14%. The median LOS was 8.67 days and 69% of patients stayed for longer than 5 days. On bivariate analysis, age, cancer type, and infectious complications (bacteremia/sepsis, hypotension, fungal infections, and pneumonia) were significantly associated with longer LOS and death. On multivariate analysis, acute leukemia and infectious complications were linked with longer LOS and death significantly. The median cost of hospitalized FN was THB 33,686 (USD 1,122) with the highest cost observed in acute leukemia patients. Conclusions: FN in adult patients results in significant mortality in hospitalized Thai patients. Factors associated with increased mortality include older age (>70), acute leukemia, comorbidity, and infectious complications.