• Journal of agricultural medicine and community health
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• v.41 no.3
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• pp.129-139
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• 2016

Objective: The purpose of this study was to identify the predictors and frailty level in the frail elderly receiving home visiting health care services. Methods: The subjects were 177 frail elders aged over 65 registered in the home visiting health care services of three public health centers in Daegu. The data collection was performed from June 9 to June 24, 2015. This study used descriptive statistics, t-test, ANOVA, scheffe test and stepwise multiple regression by SPSS Win 18.0 program. Results: The mean of the frailty score was 10.05 (${\pm}4.52$). Age and life satisfaction were the significant factors related to the frailty score in frail elderly. Health promotion behavior, empowerment, social participation and perceived health status had a negative correlation with the frailty score. Thirty seven point four percent of the variance in the frailty score can be explained by perceived health status (${\beta}=-0.398$, p<0.001), health promotion behavior (${\beta}=-0.251$, p<0.001) and age (${\beta}=0.232$, p<0.001)(Cum $R^2=0.374$, F=25.744, p<0.001). Perceived health status was the most important factor related to the frailty score in our study. Conclusions: An integrative care program which includes these significant variables of subjects is essential to prevent the deterioration of frailty in frail elderly.

• 한국체육학회지인문사회과학편
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• v.57 no.6
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• pp.263-272
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• 2018

This study examined the association of gait variability and physical fitness with frailty status in older women. In a cross-sectional design, 168 elderly women, aged 65 years and older (75.07±5.40 years), measured body composition, gait parameters gait variability, physical fitness variables, MMSE-DS and CES-D. Subjects were classified as robust, pre-frail, and frailty based on the Fried et al.(2001) criteria for frailty weight loss, exhaustion, low hand-grip strength, low gait speed, and physical inactivity. Logistic regression analyses were used to determine the odds ratio (ORs) and 95% confidence interval (CI) of frailty status for having gait variability and physical fitness levels. Compared to the robust group (OR=1), the frailty group had significantly higher ORs of having terminal double limb stance (OR=1.48, 95% CI=0.10-2.21, p=.049), step cadence (OR=2.06, 95%CI=1.20-3.43, p=.009) variability, and significantly lower ORs of having upper-strength (OR=0.49, 95%CI=0.31-0.77, p=.002) even after adjusting for age, education, comorbidity, K-IADL, MMSE-KC and CES-D score. The finding of this study suggested that terminal double limb stance, step cadence and upper body muscular strength were independent predictors of frailty.

• Annals of Geriatric Medicine and Research
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• v.22 no.4
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• pp.208-208
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• 2018

• The Korean Journal of Applied Statistics
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• v.28 no.5
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• pp.965-976
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• 2015

Determining relevant variables for a regression model is important in regression analysis. Recently, a variable selection methods using a penalized likelihood with various penalty functions (e.g. LASSO and SCAD) have been widely studied in simple statistical models such as linear models and generalized linear models. The advantage of these methods is that they select important variables and estimate regression coefficients, simultaneously; therefore, they delete insignificant variables by estimating their coefficients as zero. We study how to select proper variables based on penalized hierarchical likelihood (HL) in semi-parametric frailty models that allow three penalty functions, LASSO, SCAD and HL. For the variable selection we develop a new function in the "frailtyHL" R package. Our methods are illustrated with breast cancer survival data from the Medical Center at Chonnam National University in Korea. We compare the results from three variable-selection methods and discuss advantages and disadvantages.

• Korean Journal of Adult Nursing
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• v.27 no.4
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• pp.428-437
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• 2015

Purpose: The aim of this study was to describe health status and to identify the factors related to health behavior in older adults in South Korea. Methods: A cross-sectional survey was conducted with a convenience sample of 186 older people (mean age =68.2yrs, 65.1% Female) registered at one senior center. Data were collected by self-report questionnaires or through face to face interview. The instruments were the Modified Health Behavior Assessment Scale, Stanford Research Instruments for Chronic Disease, Self-Efficacy, SOF Frailty Index and Quality of life questionnaire. The data were analyzed using t-test, ANOVA, Pearson's correlation, and stepwise multiple regression. Results: 58.6% older adults perceived their health status positively. Education level and economic status were significantly related to health behaviors of older adults. Self-rated health, sleep, stress, quality of life, health distress, depression, and frailty were significantly correlated with the health behaviors of older adults. Frailty, education level, and sleep disturbance were the significant factors predicting the health behaviors. Conclusion: The findings from this study suggest that nurses should take into consideration education level of older adults to promote their health behaviors and health promotion program which focuses on maintaining the quality of sleep and preventing frailty.

• Korean Journal of Adult Nursing
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• v.27 no.1
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• pp.52-62
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• 2015

Purpose: The purpose of this study was to examine the relationships between frailty, nutritional status, positive thinking, family function, and health conservation and to identify the factors influencing health conservation of the elderly at home. Methods: The research design was a descriptive survey using a convenience sampling. Data were collected from 142 elders using self-reported questionnaires. Data were analyzed using the SPSS/WIN 20.0 program for descriptive statistics, Pearson's correlation coefficients, and multiple linear regression. Results: The average health conservation score was 98.85. There were significant correlations between frailty, nutritional status, positive thinking, family function and health conservation. As a result of the multiple linear regression analysis, positive thinking, perceived health status, spouse and frailty accounted for 69% of the variance in health conservation of the elderly at home. Conclusion: These influencing factors on health conservation can be taken into account in the development of nursing intervention programs for improving health conservation of the elderly at home.

• Journal of the Korean Data and Information Science Society
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• v.9 no.2
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• pp.311-322
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• 1998

In this paper the problem of modeling count data where the observation period is determined by the survival time of the individual under study is considered. We assume marginal frailty model in the counts. We assume that the death times follow a Weibull distribution with a rate that depends on some covariates. For the counts, given a frailty, a Poisson process is assumed with the intensity depending on time and the covariates. A gamma model is assumed for the frailty. Maximum likelihood estimators of the model parameters are obtained. The model is applied to data set of patients with breast cancer who received a bone marrow transplant. A model for the time to death and the number of supportive transfusions a patient received is constructed and consequences of the model are examined.

• The Korean Journal of Applied Statistics
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• v.23 no.4
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• pp.715-724
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• 2010

Recurrent event data occurs when a subject experience the event of interest several times and has been found in biomedical studies, sociology and engineering. Several diverse approaches have been applied to analyze the recurrent events (Cook and Lawless, 2007). In this study, we analyzed the YTOP(Young Traffic Offenders Program) dataset which consists of 192 drivers with conviction dates by speeding violation and traffic rule violation. We consider a subject-specific effect, frailty, to reflect the individual's driving behavior and extend to time-varying frailty effect. Another feature of this study is about the redefinition of risk set. During the study, subject may be under suspension and this period is regarded as non-risk period. Thus the risk variables are reformatted according to suspension and termination time.

• Research in Community and Public Health Nursing
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• v.27 no.4
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• pp.380-387
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• 2016

Purpose: The purpose of this study was to examine the mediating and moderating effects of fall-related efficacy and social support on the relationship between frailty and health-related quality of life among rural community-dwelling elderly. Methods: A cross-sectional survey was conducted with a convenient sampling method, and data of 438 elderly residents living in a rural community was used. The structured questionnaire included items from the Euro Quality of life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/ depression), fall-related efficacy and social support. Results: Analysis of the mediating effect of fall-related efficacy and social support showed that there was significant mediating influence of fall-related efficacy on the relationship between frailty and health-related quality of life. There were no moderating effects of fall-related efficacy and social support. Conclusion: The findings suggest that fall-related efficacy may play a role in reducing the effect of frailty on health-related quality of life and underscore the need to consider ways of enhancing fall-related efficacy in interventions for rural community-dwelling frail elderly.

• Research in Community and Public Health Nursing
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• v.30 no.4
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• pp.528-538
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• 2019

Purpose: The purpose of this study was to follow-up the frailty of the old who received home health care by Registered Nurse in Public Health Center over 8 years. Methods: We used the second wave data which was a comprehensive longitudinal data set, Public Health Information System of a public health center located in Seoul from 2010 to 2018. For statistical analysis, a mixed model of repeated measures by R program was used. Results: Frailty (range: 0~31) was getting worse significantly from 5.38 on registration to 6.54 on 4th year, 7.40 on 7th year, 7.69 on 8th year with adjustment for age, sex, economic status, the number of family, and the number diseases. The coefficient of parameters with frailty change was serviced year (β=0.29, p<.001), age (70~79 to 60~69; β=0.98, p=.018) and sex (female to male; β=2.55, p<.001). Conclusion: This study showed that the home visiting health service needs to take attention to aged 70s and over, female. The home health care of public health center need to be extended more practical and effective services in terms of 'community care'and 'ageing in place'.