• Journal of Korean Gerontological Nursing
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• v.21 no.2
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• pp.125-134
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• 2019

Purpose: The purpose of this study was to investigate factors related to use of restraints for older adults with dementia in long-term care settings. Methods: This study analyzed secondary data from the Nationwide Survey on Dementia Care in Korea (NaSDeCK). Demographic characteristics, disease characteristics, and functional characteristics were analyzed. Data were analyzed with χ² test, t-test, ANOVA, and logistic regression analysis. Results: Among participants, 8.2% experienced use of restraints. 'Strap' (78.3%) was the most commonly used restraint and 'Behavioral problem' (51.3%) was a major reason for the restraint. Persons who have low levels of daily activity and cognition deficits, higher levels of dependence, histories of falls within the past 3 months, and living in long-term hospitals have greater probability of restraint experience. Conclusion: Developing interventions for older adults who have a high risk of being restrained is essential to minimize unnecessary restraint use among older adults with dementia in long-term care settings. Further study exploring the interacting roles of organizational and staff factors related to use of physical restraints would provide more comprehensive perspectives in understanding this phenomenon.

• Journal of Korean Academy of Nursing
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• v.47 no.3
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• pp.431-444
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• 2017

Purpose: This study was conducted to verify the effects of a memory and visual-motor integration program for older adults based on self-efficacy theory. Methods: A non-equivalent control group pretest-posttest design was implemented in this quasi-experimental study. The participants were 62 older adults from senior centers and older adult welfare facilities in D and G city (Experimental group=30, Control group=32). The experimental group took part in a 12-session memory and visual-motor integration program over 6 weeks. Data regarding memory self-efficacy, memory, visual-motor integration, and depression were collected from July to October of 2014 and analyzed with independent t-test and Mann-Whitney U test using PASW Statistics (SPSS) 18.0 to determine the effects of the interventions. Results: Memory self-efficacy (t=2.20, p=.031), memory (Z=-2.92, p=.004), and visual-motor integration (Z=-2.49, p=.013) increased significantly in the experimental group as compared to the control group. However, depression (Z=-0.90, p=.367) did not decrease significantly. Conclusion: This program is effective for increasing memory, visual-motor integration, and memory self-efficacy in older adults. Therefore, it can be used to improve cognition and prevent dementia in older adults.

• Health Policy and Management
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• v.27 no.2
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• pp.167-176
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• 2017

Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

• Journal of Hospice and Palliative Care
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• v.16 no.3
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• pp.145-154
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• 2013

This study was performed to evaluate the existing pain assessment methods including the tools developed for use with nonverbal older adults with dementia, and to suggest recommendations to clinicians based on the evaluations. Computerized literature searches published after year 2000 using databases - Google scholar, RISS, KoreaMed, Medline, ScienceDirect, CINAHL - were done. Searching keywords were 'pain', 'pain assessment', and 'cognitive impairment/dementia'. The pain assessments for non-communicative dementia patients who are unable to self-report their pains are often made using the assessment tools relying on the observation of behavioral indicators or alternatively the strategy of surrogate reporting. While several tools in English version and only one in Korean are suggested for the pain assessments based on the observation of behavioral indicators, none are commonly used. In this review, we selectively evaluated those tools known to show relatively higher degree of validity and reliability for nonverbal older adults with dementia, namely, CNPI, DOLOPLUS 2, PACSLAC, PAINAD, and DS-DAT. It is hoped that the present review of selected tools for assessing pain in those vulnerable population and the general recommendations given be useful for clinicians in their palliative care practice. And future studies should focus on enriching the validation of the useful tools used to observe the nonverbal patient's behavioral indicators for pain in Korean.

• Journal of Korean Academy of Nursing
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• v.29 no.3
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• pp.585-595
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• 1999

The purpose of this study was to examine the predictors of burnout among informal caregivers of older adults. One hundred thirty seven caregivers who had provided care to older adults over 60 years of age for more than one month were included in the study. Most of the caregivers were white (91%) and female (78%). Mean ages of the caregivers were 64 years and 78% of them were married. Seventy percent of the older adults suffered from Alzheimer and related disease. In this study, caregivers reported that they experienced burnout once a month. The scores of emotional exhaustion and reduced personal accomplishment of the caregivers were in the moderate burnout range. To examine the predictors of burnout, discriminant analysis was used. Caregivers were divided by two groups based on the sum of scores (cutpoint＝6) on three dimensions of burnout after each dimension was categorized into high(3), moderate(2), and low(1). Nine predictors were included in the analysis : Caregiver's age, employment status, Instrumental Activities of Daily Living (IADL) of the older adult, presence of dementia of the older adult, caregiver's empathy toward the older adult (emotional and cognitive), and 3 coping strategies (negative, problem-focused, cognitive reconstructioning). Caregivers who reported high burnout showed higher cognitive empathy toward the older adults than those who showed low burnout. Caregivers who experienced high burnout used negative coping more often, and cognitive reconstructioning coping and problem focused coping less often than their counterparts. Wilks' Lambda was .78 indicating that differences between the two groups were significant. Cognitive empathy and cognitive reconstructioning coping showed high standardized canonical discriminat function coefficients over .40. Discriminant function with 9 predictors correctly classified 71% of the sample. In conclusion, informal caregivers also experienced certain level of burnout. Cognitive empathy and coping strategies predicted burnout experience of the caregivers. Based on this study, nursing intervention to the informal caregivers to improve their cognitive empathy toward the older adults and to modify their coping strategies in a way to reduce burnout experience can be applied. Further research to develop effective nursing interventions for the purpose of reducing burnout experience by modifying predictors was suggested.

• The Journal of the Convergence on Culture Technology
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• v.6 no.2
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• pp.161-168
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• 2020

The purpose of this study was to identify the factors that influence the dementia and recognition of dementia policy of nursing students. The participants were 184, 1~2 grad of nursing students of K university in G city. The data were collected from May 1 to May 31, 2017, and analyzed using the SPSS/WIN 21.0 program with one-way ANOVA, t-test, Pearson correlation coefficients and multiple stepwise regression. The general characteristics, such as dementia attention and dementia ward intent to work had a significant influence on dementia attitudes. The level of dementia attitudes, recognition of dementia policy, dementia knowledge and attitudes toward older adults were more than moderate. The correlations among recognition of dementia policy, dementia knowledge, attitudes toward older adults and dementia attitudes were significant. These variables showed an explanation rate 23.4% and recognition of dementia policy(β=.22, p=.004), dementia attention(no)(β=-.20, p=.006), dementia ward intent to work(no)(β=-.16, p=.021), dementia knowledge(β=.15, p=.027) were statistically significant among the variables that influenced dementia attitudes. It is necessary to develop a systematic dementia education program that can raise dementia knowledge, positive attitude, and recognition of dementia policy of nursing college students.

• Journal of Convergence for Information Technology
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• v.11 no.11
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• pp.204-209
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• 2021

This study is a data analysis study to identify the factors influencing the prevalence and risk factors for falls of older adults with dementia in Korea. Using the data of the 7th Aging Research Panel in 2018, 119 people were enrolled. We used response data on the dementia-related factors that is the duration of dementia and whether or not activity of daily living was restricted due to dementia. For comorbid diseases, data on hypertension, diabetes, and obesity were used. For statistical analysis of the collected data, logistic regression analysis was performed using SPSS statistics 22.0. Dementia-related factors and comorbidities of the analyzed subjects had a significant effect on the falling index. In particular, it was found that the influence was greatest in the order of obesity, diabetes, hypertension, daily life restrictions due to dementia, and the duration of dementia. This study is meant to identify factors that should be prioritized in the composition of a fall prevention program for the elderly with dementia. Based on the findings of this study, strategies for preventing falls due to the duration of dementia and limiting daily life, intensive management of high-risk groups for falls due to comorbid diseases, and training in the use of safety aids such as walking aids will be required in the care of the elderly with dementia,

• Korean Journal of Clinical Pharmacy
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• v.34 no.2
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• pp.118-125
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• 2024

Background: Numerous studies have consistently demonstrated that depression can be associated with cognitive function decline, primarily focusing on older adults due to the neurodegenerative characteristics of dementia. With persistent depression frequently reported in patients with early-onset or young-onset dementia, this study aimed to assess the impact of depression, specifically the changes in depressive symptoms over time, on the risk of cognitive function decline in middle-aged adults in Korea. Methods: This retrospective study utilized data from the first four waves (2006-2012) of the Korean Longitudinal Study of Aging (KLoSA), focusing on middle-aged adults with normal cognitive function at baseline. Changes in depressive symptoms were categorized into four groups based on the CES-D score, and their association with cognitive function decline was evaluated using a multivariate logistic regression model. Results: Of the initial 10,254 participants, 3,400 were included in the analysis. Depressive status, particularly newly onset (adjusted odds ratio [aOR] 1.96; 95% confidence interval [CI] 1.32-2.93) and persistent depression groups (aOR 5.59; 95% CI 2.90-10.78), were significantly associated with cognitive function decline. In contrast, recovery from depressive symptoms was not significantly associated with cognitive function decline (p=0.809). Conclusions: Our study showed a significant association between changes in depressive symptoms and cognitive function decline in middle-aged Korean adults. This suggests that management of depressive symptoms could be crucial for the prevention of cognitive function decline in this population.

• Journal of Korean Academy of Nursing
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• v.39 no.2
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• pp.177-185
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• 2009

Purpose: The purposes of this study were to examine the relationships among activities of daily living, self-efficiency, nursing home care quality and nursing home adaptation, and to identify the influencing factors of nursing home adaptation in nursing home residents. Methods: The study employed a descriptive correlational design. The data were collected from 148 older adults without dementia by interview from six nursing homes in three cities from February 1, 2008 to February 28, 2008. Results: Levels of nursing home adaptation in older adult residents were different by type of decision maker of nursing home admission, reason of nursing home admission, type of payment and length of nursing home stay. The nursing home adaptation was significantly correlated with self-efficiency and nursing home care quality. The strongest predictor of nursing home adaptation was type of decision maker of nursing home admission followed by the self-efficiency. Conclusion: The study suggested that during the decision making period of nursing home admission, older adults should have enough time and careful considerations of their families to decide by themselves in positive ways. Nursing home staff should be able to identify reasons of nursing home admission and demands or expectations of older adults and their families.

• Journal of Korean Physical Therapy Science
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• v.16 no.1
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• pp.21-29
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• 2009

Background: The purpose of this study was to find out the effects of the hand movement exercise program on the cognitive function of the older with dementia. Methods: A total of twenty-four subjects were divided into two research groups and one control group, respectively. Each exercise was conducted in twelve weeks: three times a week, twice a day for fifteen minutes. Enhancement of cognitive function in each exercise program was evaluated four times using MMSE-KC, the Korean version of the Mini-Mental State. Results: As for enhancement of cognitive function, the hand movement exercise program represented an increase of $1.63{\pm}.92$ over those before study, showing significant differences (p<.05); the large muscle exercise program, $.75{\pm}.89$; and the activities of daily living program, $.00{\pm}2.14$, showing no significant differences. Conclusion: Hand Movement Exercise Program can be inferred from the results that consistent exercise program is more effective than any other ways for enhancement of cognitive function of the older with dementia.