Purpose: The purpose of this study was to investigate factors associated with drug misuse behaviors among polypharmacy elderly. Methods: This was a cross-sectional survey. Participants consisted of 116 polypharmacy elderly who were taking 5 or more medications each day. Data were collected via face to face interviews. Data were analyzed using the PASW 18.0 program. Data concerning predisposing factor (knowledge, benefit), enabling factor (communication with health care provider), and need factor (perceived health status, number of disease) were collected. Results: The total mean score of drug misuse behaviors among polypharmacy elderly was 3.04 out of 10 points. Communication with health care provider, perceived health status, and knowledge were found to be significantly correlated with drug misuse behaviors. In stepwise multiple regression analysis, a total of 42% of the variance in drug misuse behaviors was accounted for communication with health care provider, perceived health status, and knowledge. Conclusion: Therefore, education program for improving communication with health care provider, and knowledge should be designed and provided for polypharmacy elderly.
Purpose: The purpose of this study was to investigate the effect of denture care skills education program on denture self-care, denture satisfaction and subjective oral status among the elderly. Methods: The research design for this study was a non-equivalent control group quasi-experimental design. Total 61 elderly who visited a seniors center, Seoul, Korea, participated in this study. Participants were 31 elderly for the experimental group and 30 elderly for the control group. The experimental group received a lesson in denture care skills education program which was developed by the researchers. Using a structural questionnaire, the elderly's perception about denture self-care, denture satisfaction and subjective oral status were measured before and after the intervention. Descriptive statistics, independent t-test, chi-square test, and ANCOVA test were performed using SPSS WIN 21.0. Results: The experimental group showed significantly higher scores in denture satisfaction(p<.001), QOL of oral health(<.001), concern for oral health(p=.005), subjective oral health status(p<.001), bad breath(p=.010), oral dryness(p<.001) and number of denture clearing(p<.001). Conclusion: The results suggest that the denture care skills education program for elderly at a senior center was effective. Further work is required to develop more effective denture care skills education programs and an oral health promotion program to improve the health status of the elderly.
The Journal of Korean Society for School & Community Health Education
/
v.19
no.2
/
pp.53-63
/
2018
Objectives: This study was intended to provide resources for the development and operation of the elderly's oral health education programs by comparing the difference of oral health behavior, oral health care self-efficacy and oral health levels according to their oral health education experiences and by researching the correlation of oral Health Behavior, self-efficacy, subjective oral health level and oral health education experience. Methods: An interview survey using structured questionaries was done on 180 senior citizens older than 65 years old residing in some areas of Gyeonggi-do from April 19 to May 25, 2018. The data was analyzed with Chi-square, t-test, spearman correlation coefficient with the use of SPSS 20.0. Results: 1. Those who are older than 75 years old and have higher levels of education and finance have more experiences of oral health education. 2. Those who have experiences of oral health education brush their teeth more than three times a day, use more oral health care items and get more regular preventive treatments such as oral examination and scaling. 3. As they has experiences of oral health education, their oral health behaviors, oral health care self-efficacy(tooth care, dietary control, regular checkup) and subjective oral health levels are high. Conclusion: It is necessary to try to improve the elderly's oral health levels by motivating the importance of oral health care and changing their oral health behaviors positively with the implement of oral health education on the elderly. Especially, oral health education programs that are operated on the elderly should be planned with practical programs that can cause the change of their oral health behaviors and should be processed to reinforce oral health care self-efficacy. Furthermore, preventive treatments for the elderly such as oral health education, oral examination and scaling should be implemented systematically and continuously by policy.
Background: The elderly in long-term care facilities tend to have a diminished oral health status, with a high prevalence of dental caries and periodontal disease, as reduced cognitive function, joint mobility, and gait ability hinder the performance of oral hygiene. To improve the oral health of the elderly at long-term care facilities, it is necessary to have precise guidelines for oral health care and assessment; however, such guidelines are not readily available. Therefore, the present study aimed to develop an oral care assessment tool with verified reliability and validity. Methods: The participants in this study were 100 elderly patients at a care facilities and 10 clinical dental hygienists. Collected data were analyzed using the descriptive statistics, content validity index, and inter-rater reliability, as well as the analyses of intra-class correlation coefficient. Results: After a review of relevant literature, a preliminary questionnaire comprised of seven questions related to the evaluation of oral health was formed. After revising and supplementing the questions through a content validity test, a total of nine questions were selected. Conclusion: The novel assessment tool developed for the present study is anticipated to allow analyses of the level of problems related to oral health care before routine and professional care. Moreover, regular oral health status check-ups will enable the early diagnosis and treatment of diseases.
Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.
Purpose: The purpose of this study was to examine the effect of health literacy and self-care performance on health care utilization of medicaid elderly. Methods: A total of 203 medicaid elderly over 65 and living in B-metropolitan city were interviewed. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and Hierarchical Multiple regression. Results: The average score of the health literacy was 7.88±2.84 out of 12. The average score of self-care was 3.26±0.77 points on the 5 point scale. The frequency of health care utilization by the subjects was 6.65±5.25 a month. The health literacy and self-care performance showed a statistically significant positive correlation. The health literacy and self-care performance showed a statistically significant negative correlation with health care utilization. The factors affecting health care utilization of the subjects were self-care performance, health literacy, and religion, and the explanatory power was 25%. Conclusion: The results indicate that the self-care performance, health literacy, religion are significant factors of health care utilization in medicaid elderly. Therefore, it is necessary to develop strategies to improve their self-care performance and health literacy for reasonable health care utilization. Also, it is necessary to provide the elderly with correct information about medical use from accessible religious institutions, senior community center, and welfare centers.
Journal of Korean Academy of Nursing Administration
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v.4
no.2
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pp.351-361
/
1998
The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.
Objectives: This study confirms the current status of visiting oral health-care services for the elderly to draw policy implications for revitalization of the visiting oral health care services in the future. Methods: First, a survey was conducted on health centers about the current status of the elderly visiting oral health-care service and how to revitalize it. Next, the number of oral hygiene services provided to the elderly was checked in the long-term care insurance system. Results: Oral health education (100%) was the most common practice in visiting oral health-care service for the elderly, and the most difficult thing in providing services was the lack of dental hygienists (38.9%). The status of oral health-care services in the long-term care insurance system for elderly revealed that the total number of service claims has been confirmed to be zero since the introduction of the system. Conclusions: Despite the existence of a system that provides elderly visiting oral healthcare services, to revitalize it, the law must be amended to secure a dental hygienist as the main agent of the activity and to further take responsibility for autonomous authority and performance.
The purpose of this study was to explore the relationship between self-rated health and Activity of Daily Living (ADL) and self-care behavior of rural elderly in Korea, focused on the difference among three distinctive living arrangements; living alone, living only with his/her spouse, and living with their married children. For this purpose, data were gathered from a nationwide survey, a total of 586 elderly aged 65 or older and living in rural area, using the structured questionnaire. Also, self-care behavior were categorized into 4 groups; life-style practice, medical self-care, adaption to functional limitation, and emotional management. The major findings are as follows; 1) Rural elderly perceived their health little and more 'bad' but their ADL capacity were 'not difficult', especially among elderly living with spouse. 2) The level of 20 items in self-care behavior ($1{\sim}5$score) was ranged from 2.51 to 3.81 score. The behavior level of regular exercise, setting up additional phone, taking a nutrient, and testing BP or pulse regularly were low but that of taking a medicine according to prescription, close contact with other people, and regular eating were proportionally high. 3) The majority of self-care behavior were correlated with subjective health positively but medical self-care behavior were correlated with subjective health or ADL negatively. Based on these results, policy implications are discussed.
This study was objectively performed to identify dietitians' job in the elderly health-care facilities, to assess facilities and dietitian's demographic characteristics, and to determine performance and importance of dietitian's job including the demand of therapeutic diet development. Survey was conducted by mail and samples were the dietitians working in 376 facilities which capacity is over 50 members from nationwide 583 the elderly health-care facilities. Returned questionnaire was 102 and used for statistic analysis. The distributions of the elderly health-care facilities showed 39 the elderly nursing facilities(38.2%), 32 skilled nursing facilities (32.4%), 13 geriatrics hospital facilities(12.7%) and 9 the elderly cost nursing facilities(8.8%). 60.0 percent of the samples showed its menu price as 1,000 to 1,500 won. A cycle-menu program was in-use at the 79.0% facilities, but only 7.1% facilities have been introduced a selected menu system. 92.9% facilities employed only one dietitian. In the demographic characteristics of dietitian only 14.7% dietitian had a clinical dietitian license and 51.5% of respondents answered at least 1 to 3 months internship program is needed. Job activities of the dietitian in the elderly health-care foodservice were identified as 45 activities with 9 dimensions. Job performance score evaluated dietitian oneself was 4.71 of 7 points. The average importance score that the dietitian evaluated their own job was 5.66 points of 7. The job activities shown higher importance but lower performance were therapeutic diet development for in-patients, menu development suitable for taste of the elderly, and leadership. Job performance score by characteristics of dietitian and their elderly health-care facilities was significantly associated with experience of dietitian in elderly health-care (F=4.480, p<0.05), education of dietitian(F=2.659, p<0.01), number of dietitian(F=2.245, p<0.05), and number of employee in foodservice(F=2.607, p<0.05). Most common diseases of the aged was proved as hypertension(81.7%), diabetes mellitus(71.4%), and dementia(65.0%). The therapeutic diets frequently provided were diabetes mellitus diet, dysphagia diet, low sodium diet, high fiber diet, and high protein diet, in order. For those reasons, dietitian in the elderly health care emphasized that the information about therapeutic diet development such as diabetes mellitus diet, dysphagia diet, low sodium diet and hypertension diet must be continuously developed and provided. The result from this study can be applicable to enlarge and enrich job activities of dietitian in elderly health-care foodservice.
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