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Model Development of Affecting Factors on Health Behavior and Juvenile Delinquency of Adolescents (청소년의 건강행위와 비행의 영향 요인에 관한 모형 구축)

  • Kim, Hyeon Suk;Kim, Hwa Jung
    • Journal of the Korean Society of School Health
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    • v.11 no.2
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    • pp.171-187
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    • 1998
  • In recent years, adolescent issues including smoking, drinking, drug abuse, juvenile delinquency, deviant sexual behavior, mental health problems, high suicide rate, juvenile delinquency and absence without due notice, etc are emerging as serious social problems and the debate on these controversial issues is heating up. The previous studies on adolescent health behavior and social juvenile delinquency such as run-away from home and absence without due notice have been conducted mostly by cause analysis utilizing social demographic factors or biological factors. In other words, the main factors analyzed were demographic and economic factors or parent's educational level, etc, which were the fixed environmental ones that were unable to cause the change in the health behavior. Accordingly, the purpose of this study is to analyze factors which are changeable and fixable among the factors influencing the adolescent's health behavior and misconducts and, eventually influencing factors which can be used as the basis to establish health policies and health promotion program to reduce the health risk behavior and misconducts of adolescents. The study subjects were selected by dividing senior high school student in Seoul by region and through random sampling. The 890 subjects were selected from 10 schools including the preparatory school, vocational schools and institutional schools. The duration of the study was for July 1-5, 1997 for the first survey and the second one, for August 25-September 10. Regarding the analysis method, the SAS program was used. The adoptablity of theoretical model was tested through covariance structural analysis utilizing PC-LISREL 8.12 Program. The major findings of the study are as follows: As a result of establishing the model of factors influencing health behavior and juvenile delinquency, in case of male students as the health behavior self-efficacy, education level of fathers, economic level, self-control and the health interest of parent were higher, students were more likely to practice the health promoting behavior. Juvenile delinquency and health risk behavior were prevalent among those with the less shyness, the lower health behavior self-efficacy, lower self-control, lower self-assertiveness, lower economic level. The self-control was the most powerful factor. In case of female students, those with higher health behavior self-efficacy were more likely to practice the health promoting behavior whereas those with lower health behavior self-efficacy, lower self-control, lower self- assertiveness, less shyness were more likely to practice health risk behavior and juvenile delinquency. In case of prep schools, those with higher health behavior self-efficacy and better perceived health status were more likely to practice the health promoting behavior while those with less shyness, lower health behavior self-efficacy and lower academic achievement were more likely to engage in health risk behavior and juvenile delinquency. In case of vocational schools, as health behavior self-efficacy and economic level were higher, the practice rate of health promoting behavior was higher. As the self-control, shyness, self-assertiveness, health behavior self-efficacy were lower, the rate of health risk behavior and juvenile delinquency were higher. In case of social institutional schools, as, the health behavior self-efficacy, social support and economic level, health interest of parents were higher, the rate of health promoting behavior were higher. As the self-control, shyness, self-assertiveness, health behavior self-efficacy and social support were lower, the rate of health risk behavior and juvenile delinquency were higher. So the health promoting behavior was positively related to the health behavior self-efficacy, health interest of parents, social support, education level of fathers, level of perceived health status, economic level. The health risk behavior and juvenile delinquency were higher with the lower health behavior self-efficacy, self-control and self-assertiveness, lower health locus control, less shyness and loneliness, lower economic level and academic achievement. In conclusion, the health risk behavior and juvenile delinquency can be reduced by enhancing self-control, self-assertiveness, health behavior self-efficacy and social support. According to the final model drawn by connecting health behavior and juvenile delinquency, the reduction of health risk behavior can greatly contribute to decreasing social juvenile delinquency as the process of juvenile delinquency was extended from common behaviors to problem behaviors and further into juvenile delinquency.

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A Study on the Factors Affecting Subjective Health Index of the Aged in Daejon Area (일부지역 노인들의 주관적 건강수준에 영향을 미치는 요인에 관한 연구)

  • 민경진;김근조;차춘근
    • Korean Journal of Health Education and Promotion
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    • v.18 no.2
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    • pp.1-26
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    • 2001
  • This research is aimed to define how the depression, performing ability of IADL and muscular-skeletal pain of the Aged, according to their residential circumstance, sex and age, can affect the subjective health index and how all these are related and associated with. For the period of June 1 to July 31, 2000, in order to study and define how the depression, performing ability of IADL and muscular-skeletal pain are related to the subjective health index of the Aged, we have conducted an enquete through a direct interview with 693 persons over age sixty-five (65) in Daejon and in other adjacent areas, divided into three different residential types “The Aged living at home”, “The Aged living at welfare facilities” and “The Aged living alone”. We have studied all the data and information obtained through this enquete and have analyzed χ²-test, t-test, ANOVA, analysis of simple correlation, analysis of factor. by SPSS10.0/PC+. The results were as follows: Generally, the four (4) factors depression, IADL performing ability, muscular-skeletal pain and the subjective health index of the Aged, are a lot influenced by and related to their residential circumstance, their sex and their age. With regard to the depression of the Aged by their sex, it was analyzed that, on an average, the female-Aged gains 48.3 point which reflects comparatively the higher points and the female-Aged is more depressed. In analyzing depression of the Aged by their age, it appears that the Aged between eighty (80) to eight-four (84) years of age, gains 49.2 point which is the highest points and simultaneously we could realize that depression follows age, - the more the age gets, the more the depression is increased. In analyzing depression of the Aged by their residential type, it shows that “the Aged living alone” gains 50.9 point and is most depressed. With regard to the IADL performance of the Aged by their sex, it was analyzed that, on an average, the female-Aged gains 23.8 point, which shows the performance of the female-Aged is less independent. In addition, it was also found that the IADL performing ability is becoming less and less independent following their age increasing. In analyzing IADL performance by their residential type, it appears that “the Aged living at welfare facilities” gains the lowest 21.5 point and is least independent. We conclude that some assistances from others are required for the Aged living at welfare facilities in their performing IADL. With regard to the muscular-skeletal pain of the Aged by their sex, it was analyzed that, on an average, the female-Aged gains 3.0 point and the female-Aged suffers from this pain more severely. In analyzing this pain by their residential type, it was found that, on an average, the 3.0 point goes for “the Aged living alone”, which explains the Aged living alone is having the most serious pain. With regard to the subjective heath index of the all Aged participated in this research, the analysis indicates 8.8 point and this is considered as a general standard (7-10 point). In analyzing this index by their sex, the female-Aged gains 8.6 point only and it explains a lot of female-Aged consider they are not really healthy. In analyzing this index by their residential type, “the Aged living at welfare facilities” and “the Aged living alone” gain the comparatively lower point, -respectively 8.4 point for the Aged living at welfare facilities and 8.8 point for the Aged living alone. The Aged of these two residential types express they are obviously in a bad condition of health, which makes us think a lot. With regard to the factors affecting the subjective health index of the Aged, it was analyzed that this index can significantly be influenced by their depression, their pain, their age and by how much they are satisfied with their current living conditions, and also analyzed that the correlative relation certainly exists between the depression and pain, and the subjective health index, - that is, the more the depression and pain are serious, the lower the subjective health index indicates. As for the IADL, it appears that the IADL's relation with this index is not that significant and even not important.

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A Study on the Functional Status in Life and Life Satisfaction for Elderly Residing at Home - Comparing Urban and Rural Elderly - (재택노인의 생활기능상태와 생활만족도에 관한 연구)

  • 이재면
    • Korean Journal of Health Education and Promotion
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    • v.12 no.2
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    • pp.109-119
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    • 1995
  • As the population of elderly in Korea is increasing rapidly since the 1990's and will more rapidly in the 21st Century, the demand of their health care would be a great burden to health care expenditure. Then it would be necessary to contemplate the functional status and life satisfaction for elderly to make them live more independently. The objectives of this study were find out the functional status in life and life satisfaction for the elderly aged 65 or over who had resided in urban area of two Gus in Pusan and rural area of two Myuns in Haman Gun in Kyeognam Province, and to provide basic data for planning systematic health care programme. The study period was two weeks from February 6 to February 18, 1995 and the subjects were 274 elderly of which 143 were urban residents, 131 were rural residents, and the study method was by structured questionnaire. The data were analyzed with SAS/PC/sup +/ programme using Chi-square test, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analysis. The results were as follows; 1. To see the pattern of living together, those living with partners were the most common, 39.1% ; 37.8% of urban elderly lived with married sons, 32.2% of them lived with partners, but 46.6% of rural elderly lived with partners, 16.8% of them lived with married sons, which showed difference between residence(p<0.005). 2. Elderly who had jobs were 64.1% in rural residents, and 7.7% in urban residents, which showed significant difference(p<0.05). 3. The score of cognitive function of total subjects was 24.7, that of urban elderly was 23.8, and that of rural elderly was 25.7, then it was higher in rural ones and low for old-elders and those who had no jobs. 4. The score of PADL was 26.8 for urban elderly, 30.1 for rural elderly, and that of IADL was 22.2 for urban elderly, 25.6 for rural elderly, which showed higher activities of daily living for rural elderly than urban elderly(p<0.001). 5. The score of domestic performance was 21.9 for urban elderly, and 30.5 for rural elderly, which showed higher score for rural elderly(p<0.001). 6. The score of life satisfaction was 20.7 for urban elderly, 29.8 for rural elderly, then it was higher for rural elderly(p<0.01). 7. As a result of ANOVA for functional status in living by general characteristics; the score of cognitive function differed by age, job; that of PADL differed by age, job, education, and the pattern of living together, that of IADL differed by age, job, and the pattern of living together. The score of domestic role performance differed by age, job, marital status, and the pattern of living together. 8. ANOVA for life satisfaction showed that the score of life satisfaction differed by job(p<0.001) and the pattern of living together(p<0.01). 9. The correlations between functional status in living and life satisfaction showed that the higher the score of cognitive function was(r=0.39), the higher the score of activities of daily living was(r=0.50), and the higher the score of domestic role performance was(r=0.41), the higher the score of life satisfaction. 10. Stepwise multiple regression analysis for life satisfaction pointed out that residence was responsible for 39.9% of the variance. cognitive function was for 5.3%, and domestic role performance was for 1.2%.

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A Study on the Actual Conditions of Smoking in Middle and High School Students in One Region (일 지역 중·고등학생의 흡연실태)

  • Kim, Hyeon-Ok
    • Journal of the Korean Society of School Health
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    • v.12 no.1
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    • pp.149-167
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    • 1999
  • To investigate the actual conditions of smoking in middle and high school students in Chinan County, I used a sturctured questionnaire for 1,579 students attending twelve middle-high schools from December 1, 1998 to December 20, 1998. I collected and data correlated the using an $SPSS-PC^+$ 1. The smoking rate of middle-high schoo1 students in Chinan County was 17.9%, relatively high. This smoking rate was different according to the gender, grade, religion, and economic situation. In mals, high school students, non-religious, students low income family students, the smoking rate was higher. The smoking rate of high school students was almost the same as the smoking rate of adults, generally higher than that of foreign teenagers. Because the smoking rat of studinets in the third grade of middle school and in the first grade of high School was six times higher, increased education should be conducted during this time in an attempt to curb the sudden increase of the smoking rate. The smoking rate of girl students was 5.0%; this has increased mor than three times from ten years ago. Consequently, counter measures should be taken against the smoking of female students as well as juvenile smoking in general. In addition, the smoking rate of middle-high school students showed interesting differences when correnated with enviornmental factors. Students with low grades, who are not satisfied with school life, who don't have both parents, who have uncaring parents who nare too strict or too arbitary, who have smoking parents, or who have experienced smoking commonly smoked. Therefore, to lower the smoking rate we should improve the school environment, improve a student's interest in school life. And parents or siblings should lead by example and quit smoking at home. Schools should educate students more effectively concerning the harmful effects of smoking and create an accurate understanding of its dancers. From the beginning, we should teach students never ever to touch cigaretts. 2. The surve discovered that most students started out of curiosity, or solicitantion from friends or elders at middle school, and had been smoking one to five cigarettes for more than a year. They obtained cigarettes at stores and most of them have friends who smoke. As a result anti-smoking education should be conducted at elementary schools prior to middle school. More than 95% of the teenagers who smoke had friends who smote and smoked out of curiosity or the recommendation of elders. Thus, we must focus on teenagers who smoke in group, rather than individually. Fuyrthermore, the strict application of the regulation of tobacco sales as well as tobacco cooperation from retailers are needed. While students did not show any mood or academic achievement difference after beginning smoking, 58.1% of the students a health situdation that was worse. Juvenile smoking is more harmful to the juvenile than adult smoking is to the adult. This should be focused on in an anti-smoking campaign. 3. Students who smoke hada more positive attitude toward smoking than students who don't smoke. Students who smoke had a tendency to have a nuetral position and are not concerned about smoking compared to non-smoking students. The survey showed that the great number of students had a nuetral position. Because this nuetrality may increase Juvenile smoking, education that provides an exact understanding of smoking should be performed to build the correct attidude toward smoking. 4. Middle school students smoke when angry, gloomy, anxious, a lone and when they have some problems to solve, on when they feel inconveniened in other wores, they smoke to reliver stress. They also smok due to addiction. Because smoking is not a praetical method to relieve stress, a program which helps to acquire positive relief stress should be provided to help reduce smoking. 5. About 65% of students who smoke want to quit smoking because of health problem, 78% of them have tried mor than once to quit but failed due to weak will power and peer pressure from friends who smoke. Juvenile smoking is group, oriented. Thus, the program that advances less smoking will be the one that focuseds on groups. 6. As for advice to students who want to quit smoking, "persuasion" was used most commonly, followed by a "presentation on how to quit smoking". Another method were severe punishment. About 70% of the students wanted the anti-smoking guide at school. 7. Most students (73.5%) had a position that more anti-smoking education at school is needed. Obriously, then, anti-smoking education at middle-high schools should be reinfoced. Although the education which explains the harmful influence of tobacco is known as an efficient way prevent smoking; it does not influence students who already smoke. Therefore, for students who smoke, multi-dimensional approaches must be attempted that include physical training, phychokogical approache, consultation and discussion, medical chek-ups, audio-visual education technigues, and professonal instructors, in addition, because smoking students have more negative on lukewarm attitude to anti-smoking education anti-smoking education should be conducted through a communicative style by dedicated teachers who care about students. In order to increase the effectiveness of this program.

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A Study on Smoking Behavior and The Influencing Factors Among High School Male Students in Korea (고등학교(高等學校) 남학생(男學生)의 흡연행위(吸煙行爲)와 관련요인(關聯要因) 분석(分析))

  • Chang, Young Mee
    • Journal of the Korean Society of School Health
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    • v.4 no.2
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    • pp.193-215
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    • 1991
  • This study is aimed at providing basic information applicable to setting up the education programs and strategies to prevent smoking among high school students by analysing smoking behavior and influencing factors. The samples consisted of 814 students, 557 parents and 362 teachers selected randomly from 8 high schools, one from each school district in Seoul. Date Analyses were made through Chi-Square test, Factor Analysis, One Way ANOVA, Multiple Regression, Correlation. SPSS/$PC^+$program was utilized. Smoking behavior (continuous smoking, re-smoking, ex-smoking, never smoking, daily smoking, occasional smoking) were used as dependent variables. Influencing factors (male students, habits, attitudes and knowledge toward smoking, home life, school life, juvenile delinquency, friendship, demographic parent's and teacher's recognition toward male students smoking) were used as in dependent variables. The major findings of the study are as follows : 1. The total smoking rate occupies 41.1% whereas the continuous smoking rate stands at 19.2%, re-smoking rate 9.5%, ex-smoking rate 12.4% and never smoking rate 58.9%. 2. The total smoking rate among high school students is significantly correlated with their monthly expenditures and type of school (p<0.001). The continuous smoking rate also shows the same tendency. As the length of butt get shorter, the current smoking rate increase. The duration of smoking is in proportion to its continuity. The major motive of smoking is curiousity whereas that re-smoking is to follow friend's behavior. The study shows that peer pressure is the most powerful factor influencing smoking behavior of students. Friends and fellow students encourage to pick up smoking and resume smoking even alter one stops smoking. 3. The correlationship between favorable attitudes toward smoking and the current smoking rate and its continuity is statistically significant(p<0.05, p<0.01, p<0.001). 4. The stability and harmony of family life and the current smoking rate show negative correlationship. The daily smoking amount of father is in proportion to the continuity of students' smoking. When parents are in favor of smoking, it is more likely that the experimental smoking rate increase the smoking rate increases, and vice versa. The more acceptable attitudes toward smoking among siblings is also one of the factors to increase the smoking rate and continuity (p<0.001). The more lenient the attitudes of parents toward their children's association with smoking friends, the higher the smoking rate. When students have difficulties in adjusting to school life, it is more likely that the current smoking rate and continuity increase. 5. The continuity of smoking and friendship are significantly correlated (p<0.05, p<0.01, p<0.001). 6. The continuity of smoking and juvenile delinquency are significantly correlated (p<0.001). 7. The difference in attitudes and smoking reasons of parents and students is significantly correlated to different smoking behavior (p<0.01, p<0.001). While smoking knowledge does not significantly influence their smoking behavior, it is noted that in the case of teachers, smoking reason (p<0.05), attitudes (p<0.001) and knowledge (p<0.05) strongly influence their smoking behavior. 8. There is a significantly correlation among the smoking reasons, attitudes and knowledge between students and parents(p<0.001). As for the correlationship between regularity and smoking amount and other influencing factors, the daily smoking amount is in proportion to depth of inhalation and duration of smoking, negative attitudes of parents unstability of family, dissatisfaction of family members, juvenile delinquency, strong smoking reasons and positive attitudes towards smoking. 9. In the case of daily smokers depth of inhalation is significantly correlated to the duration of smoking, juvenile delinquency, acceptability of parents, dissatisfaction of family members and smoking reasons. The duration of smoking motives is significantly correlated to juvenile delinquency, high acceptability of parents, strong smoking motive and positive attitudes toward smoking. 10. It is noted that 40% of parents and 30% of teachers do not recognize the significant correlationship between and the relative influencing factors mentioned above.

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A Diagnostic Study on High School Students' Health and Quality of Life - Based on the PRECEDE model - (고등학생의 건강 및 삶의 질에 대한 진단적 연구 - PRECEDE 모형을 근간으로 -)

  • Yoo Jae-Soon;Hong Yeo-Shin
    • The Journal of Korean Academic Society of Nursing Education
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    • v.3
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    • pp.78-98
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    • 1997
  • Health education, as the most fundamental concept for national health promotion, alms for developing the self-care ability of the general public. High school days are regarded as the period when most important physical, mental and social developments occur, and most health-related behaviors are formed. School health education is one of the major learning resources influencing health potential in the home and community as well as for the individual student. High school health education in Korea has a fundamental systemic flaw in that health-related subjects are divided and taught under various subjects areas at school. In order to achieve the goal of school health education, it is essential to make a systematic assessment of the learner's concerns connected with his health and life, and the factors affecting them. So far, most of the research projects that had been carried out for improving high school health education were limited in their concerns to a particular aspect of health. Even though some had been done in view of comprehensive school health education, they failed to Include a health assessment of the learner. Therefore, in this study the high school students' concerns related to health and life were investigated in the first place on the basis of the PRECEDE model, developed by Green and others for the purpose of a comprehensive diagnostic research on high school health education. This study was done in two steps : one was the basic study for developing research instrument and the other was the main one. The former was conducted at five high schools in Seoul and Cheongju for 2 months-beginning in March, 1996. The students were asked to respond to questions related to their health and lives in unstructured open-ended question forms. On the basis of analysis of the basic study, the diagnostic instruments for the quality of life, health problems, health behavior and educational factors were constructed to be used for the collection of data for main study. An expert panel and the pilot study were used to improve content validity and reliability of the instruments. The reliability of the instruments was measured at between .7697 and .9611 by the Cronbach $\alpha$. The data for this study were collected from the sample consisted of the junior and senior classes of twenty general and vocational high schools in Seoul and Cheongju for two months period beginning in July, 1996. In analyzing the data, both t-test and $X^2$-test were done by using SAS-$PC^+$ Program to compare data between the sexes of the high school students and the types of high school. A canonical correlation analysis was carried out to determine the relationships among the diagnostic variables, and a multivariate multiple regression analysis was conducted by using LISREL 8.03 to ascertain the influences of variables on the high school students' health and quality of life. The results were as follows : 1) The findings of the hypothesis tests (1) The canonical correlation between the educational diagnosis variables and behavioral, epidemiological, social diagnosis variables was .7221, which was significant at the level of p<.001. (2) The canonical correlation between the educational diagnosis variables and the behavior variables was .6851, which also was significant (p<.001). (3) The canonical correlation between the behavioral diagnosis variables and the epidemiological variables was 4295, which was significant (p<.001). (4) The canonical correlation between the epidemiological diagnosis variables and the social variables was .6005, which was also significant (p<.001). Therefore, the relationship between each diagnosis variable suggested by the PRECEDE model had been experimentally proven to be valid, supporting the conceptual framework of the study as appropriate for assessing the multi-dimensional factors affecting high school students' health and quality of life. Health behavior self-efficacy, the level of parents' interest and knowledge of health, and the level of the perception of school health education, all of which are the educational diagnostic variables, are the most influential variables in students' health and quality of life. In particular, health behavior self-efficacy, a causative factor, was one of the main influential variables in their health and quality of life. Other diagnostic variables suggested in the steps of the PRECEDE model were found to have reciprocal relations rather than a unidirectional causative relationship. The significance of this research is that it has diagnosed the needs of high school health education by the learner-centered assessment of variety of factors related to the health and the life of the students. This research findings suggest an integrated system of school health education to be contrived to enhance the effectiveness of the education by strengthening the influential factors such as self-efficacy to improve the health and quality of the lives of high school students.

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Mobile Contents Transformation System Research for Personalization Service (개인화 서비스를 위한 모바일 콘텐츠 변환 시스템 연구)

  • Bae, Jong-Hwan;Cho, Young-Hee;Lee, Jung-Jae;Kim, Nam-Jin
    • Journal of Intelligence and Information Systems
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    • v.17 no.2
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    • pp.119-128
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    • 2011
  • The Sensor technology and portable device capability able to collect recent user information and the information about the surrounding environment haven been highly developed. A user can be made use of various contents and the option is also extending with this technology development. In particular, the initial portable device had simply a call function, but now that has evolved into 'the 4th screen' which including movie, television, PC ability. also, in the past, a portable device to provided only the services of a SMS, in recent years, it provided to interactive video service, and it include technology which providing various contents. Also, it is rising as media which leading the consumption of contents, because it can be used anytime, anywhere. However, the contents available for the nature of user's handheld devices are limited. because it is very difficult for making the contents separately according to various device specification. To find a solution to this problem, the study on one contents from several device has been progressing. The contents conversion technology making use of the profile of device out of this study comes to the force and profile study has been progressing for this. Furthermore, Demand for a user is also increased and the study on the technology collecting, analyzing demands has been making active progress. And what is more, Grasping user's demands by making use of this technology and the study on the technology analyzing, providing contents has been making active progress as well. First of all, there is a method making good use of ZigBee, Bluetooth technology about the sensor for gathering user's information. ZigBee uses low-power digital radio for wireless headphone, wireless communication network, and being utilized for smart energy, automatic home system, wireless communication application and wireless sensor application. Bluetooth, as industry standards of PAN(Personal Area Networks), is being made of use of low power wireless device for the technology supporting data transmission such as drawing file, video file among Bluetooth device. With analyzing the collected information making use of this technology, it utilizes personalized service based on network knowledge developed by ETRI to service contents tailor-made for a user. Now that personalized service builds up network knowledge about user's various environments, the technology provides context friendly service constructed dynamically on the basis of this. The contents to service dynamically like this offer the contents that it converses with utilizing device profile to working well. Therefore, this paper suggests the system as follow. It collects the information, for example of user's sensitivity, context and location by using sensor technology, and generates the profile as a means of collected information as sensor. It collects the user's propensity to the information by user's input and event and generates profile in the same way besides the gathered information by sensor. Device transmits a generated profile and the profile about a device specification to proxy server. And proxy server transmits a profile to each profile management server. It analyzes profile in proxy server so that it selects the contents user demand and requests in contents server. Contents server receives a profile of user portable device from device profile server and converses the contents by using this. Original source code of contents convert into XML code using the device profile and XML code convert into source code available in user portable device. Thus, contents conversion process is terminated and user friendly system is completed as the user transmits optimal contents for user portable device.

An Application Effect of Rhythmic Movement Program for the Health Promotion in the Elderly (노인의 건강증진을 위한 율동적 운동프로그램의 적용효과)

  • 이숙자
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.776-790
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    • 2000
  • Every year the number of the elderly increases in Korea thanks to the improvemen of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups:33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.

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A Study on the IADL Affecting Subjective Health Index of the Aged in Some Area (일부지역(一部地域) 노인(老人)들의 주체적(主體的) 건강수준(健康水準)에 영향을 미치는 IADL에 관한 연구(硏究))

  • Kim, Keun-Jo;Park, Heung-Ki;Koon, Hyeok-Su;Bae, Soo-Chan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.1
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    • pp.29-50
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    • 2001
  • This research have been made to define how the IADL (Instrumental Activity of Daily Living) performance and the subjective health index of the Aged are affected by their residential circumstance, gender and age, and how deeply these two factors are related and interact. For the period of June 1 to July 31, 2000, we had conducted a questionnaire and direct interview with 693 persons over age sixty-five (65) in Daejon and in other adjacent area, grouping into three different residential types The Aged living at home, The Aged living at welfare facilities and The Aged living alone, and studied on how the IADL performance and the subjective health index of the Aged are influenced and interact as per their characteristics, daily activity and mentality. We had analyzed all the data obtained through this research by the method of : - analysis of frequency as per specific factors by SPSS 1O.0/PC+, - $x^2$ test, - t-test, - ANOVA, - multiple regression analysis by factors. The research concludes followings : a. It appears that the three (3) factors such as gender, age and residential circumstance of the Aged deeply affect the IADL performance and subjective health index of the Aged. (p<0.01) b. With regard to IADL performance of the Aged by the gender, it was analyzed that the female-Aged gains 23.8 point on average, which shows the performance of the female-Aged is less independent. (p<0.01). In addition, it was also found that the IADL performance is becoming less and less independent following their age increasing. In analyzing IADL performance by the residential type, it appears that the Aged living at welfare facilities gains the lowest 21.5 points and is least independent. It was also found that the Aged living at welfare facilities need some assistances from others for their performing IADL. (20-24 point) (p<0.001) c. With regard to the subjective health index of the all-Aged participated in this research, the analysis indicates 8.8 point and this is considered as a point of general standard (7-10 point). In analyzing this index by the gender, the female-Aged gains only 8.6 point which explains a lot of female-Aged consider they are not really healthy. (p<0.001) In analyzing this index by the residential type, the Aged living at welfare facilities and the Aged living alone gain the comparatively lower point, - respectively 8.4 point for the Aged living at welfare facilities and 8.8 point for the Aged living alone. The Aged living at these two residential types express they are obviously in a bad situation of health. (p<0.001) d. With regard to the factors affecting the IADL performance and the subjective health index of the Aged, it was analyzed that the IADL performance can largely be affected by the factors such as depression, frequency of going-out and age rising, and that the subject health index can also deeply be affected by depression, pain and by how much they are satisfied with their current living conditions. e. It was analyzed that the interacting between the IADL performance and the subjective health index is not that strong but even weak. As a result, we were able to conclude that the IADL performance is less independent in case of the female-Aged, the Aged living at welfare facilities, and following the age rising. As for the subjective health state the Aged themselves are aware of, we concluded that the female-Aged, the Aged living at welfare facilities and the Aged living alone, are more critical about their health. From this research, we were able to realize that, when the OMT (Orthopedic Manual Therapy) needed, the physical therapists are really required to have a correct and cautious understanding of the situation in which the aged persons are, and take care of them with more concerns and more improved treatment.

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A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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