• Title/Summary/Keyword: Nursing Home for the Elderly

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Policy Measures for Improving Health Care Services in Rural Areas (농촌보건의료서비스 향상을 위한 제도 개선방안)

  • Moon, O.R.;Lee, L.S.;Park, J.Y.;Ko, D.H.;Lee, K.H.
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.97-119
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    • 1991
  • Korea has made a rapid economic development since the last three decades. This has helped Korea narrow the gap in health service differences in resource availability and in quality of care. However urban and rural differentials are still remarkable. This study has maintained that health status of rural residents is inferior to that of urban dwellers. Therefore, this study was carried out to develop policy measures for improving health services in rural areas. In order to achieve the objective of this study the authors collaborated closely and made field visits, interviews and conducted an extensive literature review regarding rural health services. The following policy options are recommended as a summary ; First, the quality of rural health personnel is a single most important factor influencing the level of rural health services. An innovative program for public health doctors to the internship and/or residency training program such as specialty board program of family medicine. Second, dissatisfaction regarding employment of public health doctors is problematic. More rational employment and deployment programs are needed to meet their personal desire. One way to do this is to make it wide open and competitive. Third this study shows how to increase physician productivity in the rural public health sector. Incentive system needs to be elaborated for the career development of rural health workers. University linked job opportunity as clinical professor is an example. Fourth, without straightening the function of health centers and subcenters, the future of rural health services is doomed to failure. Straightening primary health care is one way to enrich the program of public health facilities and reactivating the operation of health center/hospital is another. A close linkage of public facilities with private hospitals is a minimum requirement for the operation of health delivery system within a health district. Fifth, some measures are urgently required to enhance hospital services in medically underserved areas. Financial subsidy, tax exemption, long-term public loans and higher priority of health manpower deployment are some of them. Sixth, new health programs should be in tiated to meet changing needs of peoples in rural areas. Home health care program, hospice program, nursing home, residential program for the elderly are recommended.

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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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Effect of Depression, Sleep and Self-esteem on Quality of Life of Elders Living at Home (일개 시 재가노인의 우울, 수면, 자아존중감이 삶의 질에 미치는 영향)

  • Chang, Koung-Oh
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.401-412
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    • 2017
  • This study was conducted to examine the effects of depression, sleep and self-esteem on quality of life of elders living at home. A descriptive survey study was conducted based on a survey of 285 older people in person at five senior welfare centers in J city from May 20, 2016 to 9. The data were analyzed by at-test, ANOVA, Pearson's correlation coefficients and multiple regression using SPSS WIN 21.0. The mean scores were depression $7.27{\pm}3.80$, sleep $30.75{\pm}9.35$, self-esteem $36.40{\pm}5.30$ and quality of life $8.05{\pm}2.53$. Depression(r=0.491, p<0.001) and sleep(r=0.590 p<0.001) were positively correlated with quality of life and negatively correlated with self-esteem (r=-0.234, p<0.001). The results of the regression indicated that depression, sleep, and self-esteem explained 39.9% of the variance in quality of life. Overall, these results suggest that depression, sleep and self-esteem were associated with quality of life. Therefore it is necessary to develop strategies to reduce depression and sleep disorders for community dwelling elders to improve quality of life.

Unmet Care Needs Among Community-dwelling Middle-aged and Older People in Korea (지역사회 거주 중고령자의 미충족 돌봄요구와 관련요인)

  • Kim, Soojung;Park, Yeon-Hwan;Kim, Hongsoo
    • 한국노년학
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    • v.31 no.2
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    • pp.195-209
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    • 2011
  • This study examined the prevalence of and factors associated with unmet care need among community-dwelling middle-aged and older people in Korea. Data were from the 2006 Korean Longitudinal Study on Ageing (KLoSA), a national survey of 10,254 non-institutionalized adults aged 45 or older. Having unmet care needs was defined as needing personal assistance with activities of daily living (ADL) or instrumental activities of daily living (IADL) but having no available helper. Weighted logistic regressions were fitted to examine factors associated with unmet care needs. Overall, 7.3%, 14.5%, and 41.8% of subjects among the middle-aged, younger old, and older old, respectively, reported care needs of these, 34%, 33%,and 24% had unmet needs. Factors associated with unmet needs differed among the three groups: Education and income level were negatively associated with unmet needs among the middle-aged, but living alone was the only factor positively associated with unmet needs in both the younger and older old. The prevalence of and factors associated with unmet care needs differ by life-stage. Needed are home- and community-based care and services to meet the need for personal assistance among the elderly living alone in a community.

Effect of Perceived Health Status, Self-Esteem and Quality of Life on Life Satisfaction of Elders Living at Home (재가노인의 지각된 건강상태, 자아존중감, 삶의 질이 생활만족도에 미치는 영향)

  • Chang, Koung Oh;Kim, Min Ja;Kim, Ick-Jee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.7
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    • pp.4723-4733
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    • 2015
  • This study was to examine the effect of perceived health status, self-esteem and quality of life on life satisfaction of community dwelling elders school participants. A cross-sectional descriptive study was conducted with a survey of 269 older people in person 3 senior center welfare at G City. The data were analyzed with t-test, ANOVA, Pearson's correlation coefficients and multiple regression using SPSS WIN 21.0 program. The mean score of the was life satisfaction $27.05{\pm}6.63$. Life satisfaction was had a positive correlation with self-esteem (r=.676 p<.001) and a negative correlation with perceived health status(r=-.6.02, p<.001) and quality of life(r=-.536, p<.001). The result of the regression indicated that perceived health status, self-esteem, quality of life explained 59.3% of variance in life satisfaction. The result suggest that it is necessary to develop strategies to promote life satisfaction for community dwelling elders to improve life satisfaction.

A study on the Physical, Mental and Social Factors Influencing the Health Status of Aged Women in Korea (여성노인의 건강상태와 신체적.심리적.사회적 요소들과의 관계연구)

  • Ro, Seung-Ok
    • Women's Health Nursing
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    • v.2 no.1
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    • pp.53-67
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    • 1996
  • A total health state evaluation of Korean female elderlies was made by using the questionary scheme measuring the physical, mental and social functions of the elderlies, in order to investigate the critical factors for the health maintenance of female elderlies and to develop their preventive nursing program. A total of 280 subjects over 65 years old living in Seoul and the suburban area were selected and interviewed during the period of September and October in 1995. The materials collected were analyzed statistically by using SAS data processing program, and the results and recommendations are summarized as follows. 1. The physical health state of Korean elderly women was evaluated to be satisfactory by showing an average score of 3.722 in 5.0 full-score scale. But this score was lower than those evaluated for the elderlies combined both sexes(4.054). The mental health state of the subjects was also evaluated as high scoring 3.484, possibly due to the fact that 78% of the subjects lived together with their children's family. On the other hand, the social health state of the subjects was relatively low scoring 2.585, mainly due to that 80% of them was widows which was resulted by the 6-7 years longer life-expectancy of Korean women. 2. A significant differences in the physical health state scores between different age groups was observed, indicating the rapid ageing process occurring in this age group. The family structure was appeared to be an important factor influencing the physical health state of the female elderlies ; the physical health score of the women with her husband only was higher than that of those living with children's families, and the lowest score was obtained from those living alone. 3. The age was the most important factor determining the mental health state of the subjects, while the religion, educational status, marriage state and family structure did not significantly influenced the mental health state of the aged women. 4. The social health state of the subject was deeply influenced by the marriage state and family structure, showing significantly lower scores with widowers compared to the married couples. Those living with their married spouse only obtained the highest social health score, while those living along showed the lowest score. The parent and grandparentship of those living with their children and the religion, especially Catholic and Protestant, had positive influence on the social health state of the aged women. 5. The mental health state of aged women showed significant correlation with the factors determining the physical health, except for digestive system related ability and sexual ability and the highest extra home ability. 6. The mental health state of aged women showed significant correlation with the factors determining social health, especially with the parent and grandparentship and the family relative's role. From these results, the following recommendations are made. 1. Since the physical, mental and social health states of aged people are deeply influenced by the sex and the average values of the both sex can create misleading figures, the health evaluation of the elderlies should be made separately by sex. 2. Since the health state of aged women is highly influenced by their family structure, the spouse's role and living with married couple only should be emphasized in respect of preventive health care. 3. The social activity programs and grandparentship teaching programs should be prepared in the nursing care program for aged people.

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Needs of Patients and their Families in Hospice Care Unit (일 호스피스 병동 입원 환자와 가족의 요구도)

  • Kim, Hyung-Chul;Kim, Eun-Sook;Park, Kwang-He
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.137-144
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    • 2007
  • Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

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Research Trend of the Healthcare and Medical Care for Elders in the Journal of the Korea Gerontological Society (한국노년학의 보건·의료·건강영역 연구동향)

  • Kim, Hyun Sook;Park, Yeon-Hwan;Kim, Young Sun
    • 한국노년학
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    • v.38 no.3
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    • pp.705-723
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    • 2018
  • In this study we review the selected articles on elderly health and medical care published in the Journal of the Korea Gerontological Society (JKGS) in the last 40 years, and make suggestions for future research directions for gerontological health and medical care issues. Of all the 40 year publications from volume 1 (1980) to 38 (2017), we first examined the 30th anniversary review on the subject of gerontological nursing care and healthcare policies published in JKGS from 1980 (vol. 1, No. 1) to 2008 (vol. 28, No. 2), and reviewed recent 237 researches of this decade (out of all 655 articles from 2008, vol. 28, No. 3 to 2017, vol. 38, No. 4). We could find the following trends. Firstly, the analysis of the primary authors in the past 10 years revealed that those in public health, nursing and other health-related including physical education areas have dealt the subjects focusing on physical health while those in social welfare mostly on mental health. That is, physical health has been the prime subject of researches in the health and medical care area. Secondly, in the same period quantitative researches were accounted for 89.9%, which is similar to the trend of the first 30 years 81.5 %. On the other hand, qualitative studies were only 11 cases and the focus group interview were the most frequently used method comprising 33.3% among them. Thirdly, the non-experimental researches in the past 10 years comprise 65.4%, which was 82.7% in 1980 2008 period, indicating the increasing trend in experimental researches to deal with the issues in medical and healthcare fields. Lastly, the subjects of the researches were mostly the elders who are healthy, residents of city areas, or home dwellers, and 60% of them were over 65 years old in the past 10 years while the proportion was 42.7% in the previous review period. 81.6 % of the researches in the past 10 years was dealing both genders, slightly decreased trend compared to 88.5% of the previous review period. This study reveals that the researches in non-experimental physical health remains the main stream of JKGS despite the efforts by some researchers to diversify the methods and subjects. Systematic and in-depth researches employing multidisciplinary, qualitative, longitudinal and meta-analytical approaches are called for to guide the gerontolgical health issues with preventive and proactive perspectives.

The study of food habit and degree of depression in nursing home and privite home living elderly (시설노인과 재가노인의 식습관과 정신건강 상태에 관한 실태조사)

  • Han, Myung-Joo;Koo, Sung-Ja;Lee, Young-Soon
    • Journal of the Korean Society of Food Culture
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    • v.13 no.5
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    • pp.475-486
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    • 1998
  • The dietary habit, health condition and the cognition concerning the health food have been surveyed with the help of the 151 old people living in In-Cheon and Seoul. In this study, the old are classified as an institution for the aged and the old in their own home. The preference and mental health condition influenced on dietary habits have been surveyed as wall. Their dietary habits such s three meals a day and a regular meal time have show) that they have generally good eating habits. Psychologically, the old in an institution for the aged think their health condition is not so good in comparison with the old in their own home. The old in their own home have good condition in that they can go up the stairs, exercise often and walk relatively well. Moreover, men's health condition is better than women. The old generally like meats(especially beef) and prefer sesame oil, perilla oil, soy been oil to Western oil. They like sweat flavor the most and hot, salty taste in order. Thier favorite cooking method is a pot stew, soup and season. The difference between dietary habit and mental health based on an academic career, an allowance and a residential condition shows that the old who live alon have relatively terrible eating habit and the more learned, the better. The more pocket money they have, the better dietary habits they have. The old feel glommy in general and the old in an institution are more depressed and it is statistically significant.

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Health Concern, Health Practice and ADL of The Elderly Who Stay at Home in a Rural Community (농촌(農村) 재택노인(財宅老人)들의 건강관심도(健康關心度), 건강실천행위(健康實踐行爲)와 일상생활동작능력(日常生活動作能力))

  • Eom, Young-Hee;Kam, Sin;Han, Chang-Hyun;Cha, Byung-Jun;Kim, Sang-Soon
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.269-289
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    • 1999
  • This study was conducted to examine the relationship among health concern, health practice and ADL of elderly staying at home in a rural community and their affecting factors. Data were collected through direct interviews made with 480 old people aged more than sixty-five from November 15, 1998 to December 20, 1998. Out of 189 male and 291 female, the high-level group that showed high health concern accounted for 44.4%, the medium-level group for 13.1%, and the low-level group for 42.5%, in the health practice, the high-level group accounted for 3.8%, the medium-level group for 18.8%, and the low-level group for 77.5%. In the self-rated health status, the high-level group accounted for 29.0%, the medium-level group for 31.0%, and the low-level group for 40.0%, and in the ADL, the high ADL group accounted for 91.5%, and the low-level ADL group for 8.5%. The result of the chi-square test showed that for male, there was a significant relation between the health concern and the health practice index score. In the relation between the health practice index score and the self-rated health status, there was significant positive relationship between health practice index and self-rated health status, and in the relation between the health practice Index score and the ADL, old people with higher health practices showed good ADL(but not significant). Old people with good ADL also showed good self-rated health status. In the multiple regression analysis where the health practice was used as a dependent variable, the health concern was added to the sociodemographic variables as an independent variables, a formula was formed for male old people only and ones with high concern in health showed good health practice. In the multiple logistic regression analysis where the sociodemographic variables to which the health practices was added were used as an independent variable and the ADL as a dependent variable, the ADL appeared to be not good if for male old people the living costs were born by their sons and daughters and as for female old people their ages increased, but it was good if old people had sources of health information such as hospitals or health centers. The self-rated health status was worse, for male old people, if they had short living costs or diseases and for female old people, if they had spouses, living costs born by their sons and daughters or diseases, but it was better, for male old people, if they had periodical gatherings or carried out health practices a lot, and for female old people, if they had sources of health information such as hospitals or health centers or carried out health practices a lot. In view of the results stated above, the higher the old people had health concern, the more they carried out health practices, and the more they carried out health practices, the better they had ADL and self-rated health status that served as the level of health. Further, the better ADL, the better self-rated health status.

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