• Perspectives in Nursing Science
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• v.15 no.2
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• pp.81-91
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• 2018

Purpose: This study aimed to suggest strategies for advancing local-government-based accreditation systems and surveyor training in long-term care facilities in Korea. Methods: A comprehensive review of the literature including research papers and official reports issued by governments from the United States, Australia, and Japan was conducted to explore domestic and international policies related to long-term care facility certification and accreditation systems. Results: The USA has two types of care quality assurance systems including mandatory certification (5-star rating system) by the Centers for Medicare and Medicaid Services and voluntary accreditation by the Joint Commission on Accreditation of Healthcare Organizations. Australia operates a government-based mandatory accreditation system for all long-term care facilities through the Australian Aged Care Quality Agency. Japan, particularly the Tokyo district, operates a third-party evaluation system that involves the voluntary participation of long-term care facilities. Conclusion: This study provides several strategies to enhance accreditation processes and surveyors'expertise. For instance, motivating facilities to voluntarily participate in accreditation is necessary by 1) providing sufficient and continuous consultations and feedback about how to improve care quality, 2) differentiating accreditation domains and indicators from the national health insurance certification system, and 3) actively utilizing accreditation results and providing incentives.

• Journal of Animal Science and Technology
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• v.61 no.6
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• pp.371-378
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• 2019

The purpose of this study was to investigate the effects of group combined intervention that combined animal-assisted therapy and integrated elderly play therapy on the depression, self-esteem, and emotional expression of geriatric patients residing in nursing homes. This was achieved by providing cognitive, physical, and emotional activities and social interaction at the same time. The group combined intervention method was applied to twelve elderly patients (six in the control group, six in the experimental group) aged 65 or older who live in a nursing home for the elderly in C province, from May 3, 2019 to June 21, 2019, for a total of 8 times (once a week, 50 minutes at a time). The quantitative evaluation was analyzed through SPSS 21.0 for comparison before and after the program was implemented, using the Korean version of the depression and the self-esteem scale. The qualitative evaluation compared emotional expression pre-test and post-test. The major results of the study were as follows: First, the group combined intervention was effective in reducing depression levels of the experimental group among the elderly patients. Second, it was effective in improving the self-esteem of the experimental group among the elderly patients. Third, it showed a significant difference in the emotional expression of the experimental group among the elderly patients. Therefore, it was found that group combined intervention reduces depression and improves self-esteem and emotional expression of the elderly. Based on these results, it is hoped that this study will be a cornerstone in the development of concrete programs for the benefit of elderly patients living in facilities.

• Nutrition Research and Practice
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• v.9 no.6
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• pp.637-643
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• 2015

BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged $73.5{\pm}5.2years$) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.

• Korean Journal of Community Nutrition
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• v.2 no.4
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• pp.547-555
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• 1997

This study was conducted to assess the nutritional status of the elderly from low income areas and its relationship with the indices of immunity. Ninety nine(male : 28, female : 71) healthy, subjects aged over 65 years staying in homes in Seoul were assessed with regard to their dietary intake and biochemical measurements. Their mean daily energy intakes were 1256kcal and 109kcal for males and females respectively. Mean serum IgG were 2356mg/dl in men and 2161mg/dl for women, higher than the normal range. Mean serum $C_3$ were 120.9mg/dl and 130.6mg/dl for males and females respectively and mean $C_4$ were 30.6mg/dl and 31.9mg/dl. The mean $C_3$ and $C_4$ were within the normal range and the proportion of subjects whose $C_3$ and $C_4$ were at a higher level than the upper limit were 15.4$\%$ and 16.3$\%$ respectively. Complement $C_3$ showed significant correlation with serum albumin(p〈0.01), serum cholesterol(p〈0.00l, serum TG(p〈0.05), LDL-C(p$\ll$$\ll$$\ll$$\ll$$\ll$$\ll$$\ll$$\ll$$\ll$$\ll$$\ll$$\ll$$\ll$q0.001), VLDL-C(p$\ll$0.05), serum copper(p$\ll$0.05) and serum Ca(p$\ll$0.01). (Korean J Community Nutrition 2(4) : 547-555, 1997)

• Research in Community and Public Health Nursing
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• v.29 no.2
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• pp.170-183
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• 2018

Purpose: Although innovative interventions using technologies have been introduced in long-term care settings, available evidence is still anecdotal. The purpose of this study is to investigate and synthesize the outcomes of interventions using technologies delivered to nursing home residents. Methods: Published clinical trials were identified through PubMed, CINHAL, Cochrane and PsycINFO databases and manually hand-searching. Eligible studies were articles published between 1997-2016 in English or Korean with a randomized controlled trial or quasi-experimental design in which interventions using technologies were delivered to nursing home residents. Results: A total of 20 studies were selected for this review. Types of interventions using technologies were classified into the electronic documentation technology (n=1), the clinical decision support system (n=1), the safety technology (n=1), the health and wellness technology (n=10), and the social connectedness technology (n=7). Overall resident outcomes indicated that interventions using technologies improved behavioral symptoms and psycho-social outcomes, but mixed results were shown in the aspects of physical function, cognitive function, social relationship and quality of service. Conclusion: This review demonstrates that incorporating technologies into nursing home care have positive effects on residents' psycho-social outcomes and behavioral symptoms. To disseminate the effectiveness of interventions using technologies, further research is needed to determine what mechanisms underlying such relationships exist.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.26 no.3
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• pp.197-209
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• 2019

Purpose: This study was done to examine good death awareness, attitudes toward advance directives (ADs), and preference for care near the end-of-life (PCEOL) of hospitalized elders in long-term care hospitals. Relevant characteristics were investigated as well as correlation of the variables. Methods: This descriptive research study involved 161 hospitalized elderly patients in long-term care hospitals. A self-report questionnaire was used to measure Good Death Scale, ADs Survey, PCEOL Scale, and general characteristics. Collected data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation with SPSS/WIN 23.0. Results: In terms of good death awareness, a significant difference was observed; in according to age (F=3.35, p=.037), payer of treatment costs (F=3.98, p=.021), mobility (F=3.97, p=.021), heard discussion about ADs (t=-3.89, p<.001), and willing to complete ADs (t=2.12, p=.036). As far as attitudes toward ADs, the participants presented significant difference depending on religion (t=2.38, p=.018), average monthly income (F=3.91, p=.022), duration of hospital admission (F=5.33, p=.006), person to discuss ADs (t=-2.76, p=.006). On PCEOL, there was a significant difference, depending on religion (t=-3.59, p<.001) and perceived health status (F=3.93, p=.022). Finally, as for how the variables were related to each other, good death awareness and attitudes toward ADs had a weak positive correlation with PCEOL. Conclusion: To help seniors staying in nursing homes face a good death and enjoy autonomy, there should be educational and support systems that reflect each individual's sociodemographic characteristics so that the seniors can choose what kind of care they want to receive near the end-of-life.

• Journal of the Korean Society of Food Culture
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• v.12 no.3
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• pp.331-339
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• 1997

With increases in senior citizens and changes in family structure, the need for long-term care system for elderly is increasing, however, the capacity and environment of Korean facilities are very limited. Health and nutritional status of long-term care residents are worse than free-living elderly. In this study, general food service management and health care practices in long-term care systems were investigated. Questionnaire were sent to the directors of all 162 long-term care facilities in Korea and 81 returned the complete answers. The results showed 1) There are slow but steady increase in long-term care systems in Korea, however, the capacity is far from adequate. Less than 10,000 elderly were resided in the facilities. Most of the systems were free-nursing homes and supported by the goverment. Staffing structure revealed that most of the facilities had a director, a secretary, nurses, but only 21% of the systerm hired a dietitian. It showed the shortage of nurses, physical therapists, and dietitians. Therefore, food purchasing, menu planning, food delivery, and the other food service management processes are handled by non-professionals, such as director, secretary, or cooks. Modified fool frequency questionnaire were used to get the frequencies of each food items used in menu and a menu-analysis was made on the one-day menu provided by the facilities. The results showed relatively satisfactory in nutrients content and food frequencies., however, this was about what was used in menu, not what was eaten by the residents. Therefore this results did not tell that the food intake status of individuals. In most facilities general health checkup was done on a regular basis, and had residents with various chronic degenerative diseases, such as hypertension, neuralgia, stroke, arthritis, diabetes. But the items checked on health checkup included weight, height, blood and urine tests, X-ray test, which suggested that the checkup lists should be revised to accomodate the health problem of the aged today.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.2
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• pp.111-119
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• 2024

Purpose : This study aimed to demonstrate the effects of visiting cognitive activities using brain training on cognition, subjective memory complaints and depression among elderly participants residing in community living in Gwangmyeong city. Methods : Over a 14-month period (October 2022 to December 2023), four brain training instructors visited the homes of older adults and conducted the intervention using a brain training kit. The participants included 32 elderly individuals aged 65 years and older, who were living in Gwangmyeong city. The assessments were conducted by an occupational therapist, a nurse and a social worker at the Gwangmyeong dementia relief center. These assessments included the following the subjective memory complaints questionnaire (SMCQ), short geriatric depression scale-Korean (SGDS-K), a cognitive impairment screening test (CIST), the consortium to establish a registry for Alzheimer's disease-Korean (CERAD-K). The participants were divided into three groups (A: 20-30 points, B: 10-19 points, C: 1-9 points) based on the CIST score. For data analysis, descriptive statistics and wilcoxon signed-rank test were performed using SPSS 24.0, and the statistical level was at a=.05. Results : The results of the intervention showed that the SMCQ score of group A improved significantly (p<.05), the CIST score of group B also improved significantly (p<.05). However, the SGDS-K score of group C improved, but did not demonstrate statistical significance (p=.080). Conclusion : The visiting cognitive activities using brain training produced significant effects on cognition, depression, and subjective memory disorders, depending on the cognitive level of the elderly participants. In the future, it will be necessary to demonstrate the effects according to cognitive level in various aspects with more elderly people.

• Human Ecology Research
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• v.61 no.4
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• pp.565-583
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• 2023

This study sought to examine the effects of current single-parent family policies on the psychological adaptation of family members in single-parent homes, while also confirming that visitation and child support are indeed in the best interests of children in such cases. An online survey was conducted in 2021 for divorced single mothers and their children (aged 11 to 19) living in metropolitan regions (Seoul, Kyunggi, and Incheon). A total of 171 dyads, comprised of single mothers and their adolescent children, participated in this study. Using the collected data, descriptive statistical analysis and structural equation modeling were performed. The major results of this study are as follows. First, visitation with fathers was not significantly associated with self-esteem, aggression, or life satisfaction among the participating adolescent children. On the other hand, when child support was paid, aggression among adolescents was lower than when child support was not paid. Second, neither visitation nor child support was significantly associated with single mothers' levels of depression and life satisfaction. The enforcement of child support guarantees the welfare of children and conforms to the principle of promoting the best interests of minor children. Therefore, child support should be continuously encouraged and supported by agencies in accordance with current law. In order for the implementation of visitation to be in the best interest of the child, the amount and quality of visitation should be secured so that the child can still recognize their non-custodial parents as "caregivers."

• Korean Journal of Community Nutrition
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• v.5 no.2
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• pp.201-207
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• 2000

This study was performed to assess the nutritional status of nursing home residents and to assess the effect of nutrition intervention. The subjects were 123 people aged over 60 years from 5 different nursing homes. The nutrition intervention study was carried out by supplementing their diet with multivitamin-minerals for 2 months. The mean intakes of most nutrients did not meet the RDA, Though the nutrient content of the menus provided by the facilities were satisfactory. Nutrients of which intakes fell below 75% of the RDA were protein, Ca, Fe, vitamin A vitamin B$_1$, and vitamin B$_2$. The BMIs of male and female subjects were 22.0kg/$m^2$ and 24.6kg/$m^2$ and the WHRs were 0.92 and 0.90, respectively. The percentage of subjects with hypertention (BP$\geq$140/90mmHg) and with anemia(Hb$\leq$13mg/100$m\ell$ in men, Hb$\leq$12mg/100$m\ell$ in women) were 34.6% and 41.9%, respectively. The serum cncentrations of albumin, total protein, triglyceride, total cholesterol, HDL-cholesterol, and total lipid fell within normal ranges. However, 27.5% of the subjects showed a high serum cholesterol level of over 250mg/100$m\ell$. The concentration of C3 was 81.2mg/100$m\ell$, IgG, 1343mg/100$m\ell$, and IL-2, 0.766mg/$m\ell$. after 2 months of vitamin-mineral supplementation, the levels of blood glucose and total cholesterol were significantly decreased and triglyceride was significantly increased. The vitamin-mineral supplementation had no effect on the mean levels of vitamin A and E, IgG, IL2, and C3. However, the intervention resulted int he improvement of serum vitamin A and E levels when the subject\`s serum levels were low before the supplementation.