• Journal of Korean Academy of Nursing
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• v.31 no.6
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• pp.1077-1087
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• 2001

The purpose of this study was to analyze the effects of respite care. The analysis was conducted by reviewing published intervention studies on the effects of formal respite care for caregivers of dementia patients, patients with dementia, and the prevented or delayed rate of institutionalization of the patients. Method: Two computerized databases (MEDLINE, CINAHL) were searched to find respite care-related articles published from the year of 1981 to 2000. A total of 49 published articles were identified. Of them, nine studies, which met for the inclusion criteria of this study, were included. Results: Results revealed that there was little evidence of the effect of respite care on, not only caregivers' burden, stress, depression and well-being, but also the rate of institutionalization of the patients. It was noteworthy that dementia patients reported fewer problems in behavior, although cognitive functioning and activity of daily living abilities continued to decline. However, these findings should be carefully interpreted because of methodological problems, such as non-random sampling, non random group assignment, a small sample size, uncontrolled confounding variables, limited period of services, and no specific types of services. Conclusion: It is recommended to conduct intervention studies of respite care being conducted in Korea with the corrections of methodological problems suggested from this study.

• Korea Journal of Hospital Management
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• v.25 no.1
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• pp.21-31
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• 2020

Purposes: Family living with dementia patients have the burden for caring and suffer from health problems. Therefore, proper supports for their health disorders are required. The purpose of this study with regard to this is to subdivide unmet healthcare needs of family living with dementia patients into affordability, accommodation, and accessibility and figure out the relevant factors. Methodology: The 2017 Community Health Survey was used, and 2,331 families living with dementia patients was included. To figure out the factors with regard to the types of unmet healthcare needs, multinominal logistic regression analysis was conducted. Findings: According to the analysis result, sex, age, monthly household income, economic activity, self-rated health, self-rated stress and perception of depressive symptoms turned out to be the factors related to unmet healthcare needs. Regarding affordability, unmet healthcare needs were low when the object was female, over 65, highly educated, and monthly household income were high. On the other hand, unmet healthcare needs was high when self-rated health was bad, self-rated stress was high, and had depression. With regard to accommodation, unmet healthcare needs were low when the object was over 65. Unmet healthcare needs were high when the object was female, economically active and had depression, and self-rated health was high. Regarding accessibility, unmet healthcare needs were low when the object was high school graduate, but it was high when self-rated health was bad. Practical Implication: This study confirmed that the family with dementia patients had a high proportion of unmet healthcare needs due to affordability and accommodation. The existing main discussion was that the experience of unmet healthcare needs normally occurred due to economic reasons, but a consideration on various cases and factors is required to ultimately achieve the policy goal to reduce the unmet healthcare needs of the family living with dementia.

• Journal of Acupuncture Research
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• v.34 no.3
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• pp.49-58
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• 2017

Objectives : The purpose of this study is to provide data to guide dementia health-care policy in Korea and to establish the position of Korean medical specialists in long-term care hospitals by analyzing the data of dementia inpatients. We analyzed the actual condition of dementia patients in care hospital and the effect of Western-Korean cooperative medicine on the progress of dementia. Methods : From January 1, 2016 to December 31, 2016, inpatients who were diagnosed with dementia at Mungyeong municipal long-term care hospital and admitted for more than 3 months were enrolled. Their medical records and simple tests were analyzed retrospectively. Results : We examined the detailed diagnosis, including both main and sub diagnosis, and Alzheimer disease dementia, at 97%, was the most common. At the time of admission, Korean Version of the Mini-Mental State Exam (K-MMSE) analysis showed that severe dementia affected 52%, and most were rated as Geriatric Depression Scale (GDS) 6. Based on the admission date, the results of a simplified test applied to the dementia patients every 6 months showed an maintain in the K-MMSE and GDS scores in 83%. Conclusion : The results of this study show that the rate of progression of dementia is somewhat lower in inpatients with moderate to severe Alzheimer's who have received Western-Korean cooperative treatment. However, due to institutional limitations, long-term inpatients such as those with dementia do not receive active traditional Korean medical treatment; hence, it is necessary to improve the national institution of traditional Korean medicine in long-term care hospitals.

• Journal of Korean Academy of Nursing
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• v.48 no.5
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• pp.601-621
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• 2018

Purpose: This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method. Methods: By searching through nine Korean and English databases, we compared 37 qualitative studies on caring experiences of family members of patients with dementia. The selected studies were synthesized through meta-synthesis, proposed by Sandelowski and Barroso (2007). Results: The meta-synthesis elicited four themes: tough life due to care for patients, changes in relationships, adaptation to caregiver's roles, and new perspectives of life through personal growth. Caregivers were shocked when a sudden diagnosis of dementia was made prior to any preparation on their part. They were tied to their patients all the time and their mind and body got exhausted. Their relationship with patients began to change and they looked at them differently. They experienced conflicts with the other non-caring family members and were alienated from them. They were also socially isolated. However, by building their own care strategies and utilizing social resources, they gradually adapted to their caregiver roles. Finally, they experienced personal growth and acquired a new perspective toward life by accepting their roles and finding meaning in their lives. Shifting the caregiver's centricity from themselves to the patient was the process of becoming human beings who actively constructed their realities while giving meaning to their painful lives and interacting with the environment. Conclusion: The results of the study can be useful for nurses in understanding the experiences of caregivers of the patients with dementia and in providing them with practical interventions.

• Dementia and Neurocognitive Disorders
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• v.22 no.4
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• pp.130-138
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• 2023

Background and Purpose: Growing evidence has shown that cognitive interventions can mitigate cognitive decline in patients with mild cognitive impairment (MCI). However, most previous cognitive interventions have been group-based programs. Due to their intrinsic limitations, group-based programs are not widely used in clinical practice. Therefore, we have developed a tablet-based cognitive intervention program. This preliminary study investigated the feasibility and effects of a 12-week structured tablet-based program on cognitive function in patients with MCI. Methods: We performed a single-arm study on 24 patients with MCI. The participants underwent a tablet-based cognitive intervention program 5 times a week over a 12-week period. The primary outcome was changes in cognitive function, measured using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). Outcomes were evaluated at baseline, within two weeks of the last program (post-intervention), and at the six-month follow-up session. Results: The completion rate of the tablet-based program was 83.3% in patients with MCI. The program improved cognitive function based on the CERAD-K total score (p=0.026), which was maintained for at least three months (p=0.004). There was also an improvement in the depression scale score (p=0.002), which persisted for three months (p=0.027). Conclusions: Our 12-week structured tablet-based program is feasible for patients with MCI. Furthermore, although further studies with a double-arm design are required, the program appears to be an effective strategy to prevent cognitive decline in patients with MCI.

• Journal of muscle and joint health
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• v.27 no.2
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• pp.81-93
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• 2020

Purpose: We developed and tested the effects of a care program for dementia patients among community- dwelling older adult men. Methods: This study used a non-equivalent control group pre-and post-test design. To verify the effectiveness of the care program for dementia patients, 26 community dwelling older adult men participated in this study. We used multiple intervention strategies including improving understanding of dementia through education, activities for dementia prevention, and promoting psychological change. In particular, based on the current understanding of the care of the men older adults, we used strategies to promote motivation and reinforce strengths. Results: After completing the 6-week intervention program, when compared with the control group, older adult men in the care program intervention group showed significant differences in scores for the following: cognitive functions (p=.035), attitude toward dementia (p=.026), preventive behavior (p=.007), geriatric depression (p=.013), caring confidence (p=.018), and self-esteem (p=.013). Conclusion: These results indicate that the care program for dementia patients has positive effects on increasing their cognitive function, attitude toward dementia, preventive behavior, caring confidence, self-efficacy, and on decreasing depression rates in this population. Based on this, we can recommend this program to men caregivers for the improved care of dementia in community centers.

• Journal of Oriental Neuropsychiatry
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• v.29 no.2
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• pp.111-119
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• 2018

Objectives: To investigate the characteristics of patients diagnosed with dementia or mild cognitive impairment who are treated by means of a blend between Western and Korean medicine. Methods: We searched for outpatients with dementia or mild cognitive impairment by means of a collaboration between Western and Korean medicine from August 1, 2015, to July 31, 2017, through electronic medical records in Wonkwang Hospital. The records were retrospectively analyzed according to the patients' demographic and clinical characteristics, pathway of medical care, diagnostic tests, treatment, and medical expenses. Results: Thirteen patients were included in the analysis. Among them, six patients were diagnosed with mild cognitive impairment, five with dementia, Alzheimer's type, one patient with frontotemporal dementia, and one patient with unspecified dementia. Twelve of the thirteen patients were over 60 years of age. The number of pathways from the Dept. of Neurology to the Dept. of Neuropsychiatry of Korean Medicine was almost the same as the opposite pathway. The most used diagnostic test in Korean medicine was a neuropsychological test such as SNSB, MMSE and GDS. In Western medicine, hematology and neuroimaging were frequently used for patients. Acupuncture in Korean medicine and medication in Western medicine were the most frequently used. In Korean medicine, uncovered service costs were much higher than covered service costs,. whereas, in Western medicine, covered service costs were higher than uncovered service costs. Conclusions: This study describes the basic characteristics of dementia and mild cognitive impairment patients treated by a collaboration between Western and Korean medicine. Based on these results, a clinical pathway of the collaborative practice system between Western and Korean medicine for dementia patients needs to be developed.

• Korean Journal of Adult Nursing
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• v.28 no.4
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• pp.388-398
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• 2016

Purpose: The purposes of this study were to identify nurses' empathy, attitude and pain management for patients with dementia and the factors associated with their performance of pain management. Methods: The study design was a cross-sectional survey. The participants in the study were 114 nurses working at 12 geriatric hospitals. This study utilized the Interpersonal Reactivity Index (IRI), which measures four empathy factors. Nurses' attitudes toward pain and performance of pain management, and general and pain related characteristics were measured by self-administered questionnaires. Results: Barriers to pain management for patients with dementia were absence of guidelines, prejudice of pain in dementia, and lack of time and knowledge deficit. There was a significant positive correlation between empathic concern and attitudes, perspective-taking of empathy and pain management. There was also a correlation between empathy and pain management. Stepwise linear regression analysis indicated that the significant factors affecting the performance of pain management included perspective-taking of empathy, use of pain management in dementia guideline and attitudes toward pain. These factors explained 24.0% of variance. Conclusion: The findings from this study suggest that empathy and positive attitude are the important provider attributes which needs to be enhanced by educational programs. It is also necessary to develop and disseminate guidelines for a dementia specific pain management.

• Korean Journal of Adult Nursing
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• v.28 no.2
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• pp.213-225
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• 2016

Purpose: The purpose of this study was to provide basic data about agitation in patients with dementia by surveying the literature. Method: Key words used for search through hand-search and electronic database (CINHAL, Pubmed, Google scholar, Riss, Kiss, DBpia) included 'dementia', 'Alzheimer disease', 'agitation', 'aggression or aggressive behavior', 'problem or disruptive behavior', and 'abnormal behavior.' Seventeen studies met the inclusion criteria for the Meta-analysis and 'R' version 3.2.2 was used to analyze the correlated effect size. Results: Study results showed that variables related to agitation were identified as the demographic (age, gender), dementia-related (cognition, medication uses), physical (Activity of Daily Living [ADL], pain), psychological (depression, psychotic symptom, caregiver burden) and environmental (psychosocial environment) factors. The effect size between the correlated variables and agitation were low to moderate (caregiver burden .36; ADL -.24; psychotic symptom and depression .21; pain .19; cognition -.15; medication uses .12; and psychosocial environment -.12). Conclusion: Based on the findings of this study, strategies to improve patients' depressive and psychotic symptoms and ADL and to reduce caregivers' burden are needed for prevention and management of agitation in patients with dementia.

• Journal of Korean Academy of Nursing
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• v.36 no.7
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• pp.1253-1264
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• 2006

Purpose: The purpose of this study was to understand conversations and to identify typical conversational problems between nurses and patients with dementia. Method: A conversation analysis method was used. The data was collected in a geriatric institutional setting, using a videotape recorder, and transcribed. The transcribed data was analyzed in terms of expressions, contents, and relationships to identify communicative problems and their resolutions, Results: Among a total of 532 episodes, 440(82.7%) we're identified as nurse-involved episodes. In addition, 66 of the 440 episodes were selected based on the significance of the conversation. The communicative problems between nurses and patients in terms of expressions were identified as 'directive and authoritative expressions', 'emotional and competitive expressions', 'evasive and on-looking expressions', and 'excessive use of title only', such as calling them granny or grandpa without proper names. In terms of content and relationships, 'lack of themes in psychosocial areas' and 'nurse-led relations' were identified respectively as communicative problems. Conclusion: The results of this study will provide substantial guidelines for nurses in caring for elderly patients with dementia by deeply understanding linguistic structures and problems of everyday conversations between nurses and patients with dementia.