• 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.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.25 no.3
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• pp.173-181
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• 2018

Purpose: This study examined the effects of physical fitness and aging anxiety on life satisfaction among the elderly. Methods: The participants were 119 elderly. Data collection was conducted from July 1 to 10, 2018. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficients, and multiple linear regression analysis with SPSS software. Results: The mean life satisfaction score was 4.10. Life satisfaction differed significantly according to several general characteristics: education level (p=.014), income (p<.001), living with partner (p=.041), perceived health status (p<.001), and number of chronic diseases (p<.001). Statistically significant positive relationships were observed between life satisfaction with muscle strength (r=.20) and, flexibility (r=.21), and a negative relationship was observed with aging anxiety (r=-.66). A total of 60.0% of life satisfaction was explained by income, perceived health status, muscle strength, flexibility, and aging anxiety. Conclusion: These results can be used to develop life sports programs to improve physical, social, and emotional health promotion with consideration for support to alleviate economic burden. Effect of life sports are evident as a way for healthy and energetic elderly. It should not be a simple exercise program but an integrated plan for improving physical, mental, and social health of the elderly.

• Research in Community and Public Health Nursing
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• v.15 no.2
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• pp.218-227
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• 2004

Purpose: The purpose of this study was to determine the effects of 5 weeks self-help management program developed by Kim et al. (2000-b) and reinforced with music therapy for post stroke patients. Method: This was pre-experimental study and the subjects were 14 post stroke hemiplegic patients at home who were registered at the Gunsan Health Center. The program was applied for five weeks and two hours for each session composed of the preparation step, the main step and the finishing step. The contents of the program were ROM exercise, daily activity training, risk factors and aftereffects, nutrition management and stress management. To collect data, all subjects were questioned before and after the application of the program. Collected data were analyzed through frequencies, percentages, Wilcoxen signed rank test and Cronbach's alpha using SPSS-WIN program. Result: After the application of the self-help management program, a statistically significant increase was observed in the subjects' ability to perform activities of daily living (p=.039), ability to perform instrumental activities of daily living (p=.005), self-efficacy (p=.001), self-care behavior (p=.001) and quality of life (p=.001), and a statistically significant decrease was observed in depression (p=.012). Conclusion: The present self-help management program was found to be helpful in improving the subjects' physical and psychological functions after they were attacked by stroke, so to be an effective nursing intervention strategy for post stoke patients. Future researches need to reinforce and materialize music therapy and to develop and apply a self-help management program that includes not only post stroke patients but also their families. In addition, it is necessary to expand the scope of subjects and apply follow-up management in order to continue self-help meetings.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.10 no.2
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• pp.181-186
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• 2003

Purpose: The purpose of this study was to investigate the adherence to diabetes control recommendations (blood glucose testing, medication, diet, exercise) in patients with type 2 diabetes at home and to analyse the correlation between adherence and blood glucose level. Method: Participants, numbering 214, were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. The data were collected by a self report adherence questionnaire. Glycosylated haemoglobin (HbA1c) was determined by the high-performance liquid chromatography technique and fasting blood glucose was analyzed by the glucose oxidase method. Result: Medication adherence was higher than diet or exercise adherence. The frequency of blood glucose testing was lower for middle school graduates than college graduates. Diet adherence was significantly lower for participants who were obese, who did not have a spouse, and who had hyperglycemia. Medication and diet adherence were negatively correlated with HbA1c. Conclusion: A diet education program should be developed for patients with type 2 diabetes who are obese, who do not have a spouse, and who have hyperglycemia.

• Journal of muscle and joint health
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• v.5 no.1
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• pp.39-56
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• 1998

This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

• Korean Institute of Interior Design Journal
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• v.24 no.2
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• pp.206-216
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• 2015

Majority of the seniors living in nursing homes suffer from persistent chronic pain, which may cause depression and compromised quality of life if untreated. The environment should support them to lift their focus from current pain and worries to the positive feelings and the delight of life. The purpose of this research is to classify the healing environment elements for positive distraction, and analyze 6 international cases to see the current situation. The elements were categorized as follows, based on literature review from both healing spaces and elderly care field: spatial elements(view, natural elements, artificial elements, exercise space, garden), psychological elements(grooming area, space for privacy, meal/drink area, elements for recollection, religious space), social elements(common living area, activity/hoppy room, family/visitor area, information area, local community program space). Analysis on 6 facilities showed that each elements were reflected to designed relatively well. New inventions from workers who think distraction is important were also introduced. Healing environment for positive distraction requires delicate touch, derived from understanding characteristics and situation of the residing elderly individuals. Technology update is also significant, from audio books to virtual reality devices, since cultural life of nursing home is far behind from what the others enjoy now.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.7 no.1
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

• The Korean Journal of Pain
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• v.30 no.4
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• pp.265-271
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• 2017

Background: Health care services effort to provide alternative cardiac rehabilitation (CR) models to serve patients according to their preferences and needs. So, the present study aimed to assess and compare the effects of hospital-based and hybrid CR programs on chest pain intensity and discomfort in cardiac surgery patients. Methods: In this prospective study, 110 cardiac surgery patients were invited to the CR department of a hospital in the western part of Iran between March and July 2016. Patients were divided into two groups: hospital-based and hybrid CR. The hospital-based program included 26 sessions, and the hybrid program included 10 training sessions and exercise. The Brief Pain Inventory and Pain Discomfort Scale were used as research instrument, and data were analyzed using the paired t-test and ANCOVA. Results: The results indicated that both hospital-based and hybrid CR are effective in reducing the chest pain intensity and discomfort of cardiac surgery patients (P < 0.05). In addition, the comparison of scores before and after treatment using ANCOVA shows that no significant differences were observed between the two programs (P > 0.05). Conclusions: Traditional hospital-based CR delivery is still the first choice for treatment in developing countries. However, hybrid CR is as effective as a hospital-based program in reducing pain components and it includes only 38% of the total cost in comparison to hospital-based delivery. So, we recommend using hybrid CR according with the recommendations of American Heart Association about using CR for the management of angina symptoms.

• Journal of Industrial Convergence
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• v.17 no.4
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• pp.77-86
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• 2019

The purpose of this study was to identify the effect of Home Health Nursing based Respiratory Management Program (HHNbRMP) on unmet healthcare need and healthcare resource utilizations of patients applying the home mechanical ventilator in the home with amyotrophic lateral sclerosis. The subjects of this study were 40 patients placed in an experimental group(n=19) and a control group(n=21), respectively. This HHNbRMP based on Cox's interaction model was consisted of cognitive assent (education, specialized medical care, case management), internal motivation (airway clearance, thoracic and air accumulated exercise) and psychological response (meditation & active listening). The intervention was applied to experimental group during 12 weeks. As variables was measured at baseline, twelve, twenty-four weeks and healthcare unmet need, resource utilizations (admission, out patient department, emergency room) was measured at 24 weeks. The data were analyzed by t-test, ANOVA and Repeated Measures ANCOVA. This intervention was not effective the unmet healthcare need. But the admission in to the hospital among the healthcare resource utilizations variables showed a significant difference at twenty-four weeks(t=4.17, p=.049). This results suggest that applying this program tailored to patients condition, utility of medical resource would be decreased, specially admission.

• The Journal of Korean society of community based occupational therapy
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• v.8 no.3
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• pp.1-12
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• 2018

Objective : This study conducted a preliminary study to develop a occupational therapy model focused on improving living functions within the community care system. Methods : From June to July, 2018, the literature on community care was researched, focusing on cases of Japan's Management Tool for Daily Life Performance (MTDLP), Sweden, United Kingdom, Germany and domestic S Elderly Care Centers and I Health Centers. Based on this information, a group of experts developed a occupational therapy model within the community care system. Results : Assessment tools such as occupation-based health promotional table, interest checklist, occupational goals for improving living functions, sheet for evaluation of living functions, survey of daily life time (weekday and weekend), and sheet for transition of living functions were developed to conduct evaluation for occupational therapy. The improving living functions program, analysis of activities based on ICF model, lifestyle redesign program, cognitive exercise therapy, the Lee Silverman Voice Treatment (LSVT), hospice, and home modification were also organized interventions already in place by occupational therapists. Conclusion : This study showed specific measures and models for the implementation of occupational therapy within community care systems. Occupational therapy is positioned as a specialized area that is essential to the client, and we look forward to the use of this model.