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An Ethnography of the Concept of Illness by the Elderly (노인의 질병 관념에 관한 문화기술적 연구)

  • Cho, Myoung Ok
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.690-705
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    • 2000
  • This ethnography was based on Kleinman's explanatory model of a health care system. It is conducted to make thick discription of illness conception of the elderly in a sociocultural context. The basic assumptions were as follows. 1) A health care system is a cultural system, and as with any other cultural system, it is a system of symbolic meanings anchored in a particular arrangement of social institutions and patterns of interpersonal relationships; 2) In all societies health care activities are more or less interrelated. Therefore, they need to be in a holistic manner as socially organized responses to disease that constitute a special cultural system; health care system; 3) Health and illness experiences are the natural process of disease. Individuals who recognized a for state of health, their family, neighbors, and communities define the state, search for causes of the health problems, and response to it. According by, they proceed to search for healing stratagies. So, understanding of the illness experience is the starting point for health care. The study participants were 12 elders aged 60 or more. The fieldwork was conducted in an agricultural clan village of Namwon city. The data collection and analysis were cyclic, from descriptive observation, domain analysis, focused observation, taxanomic analysis, selected observation, componential analysis, and finally cultural themes were all analysed. Proxemic and text analysis techniques were used according to the characteristics of the data. The data of sociocultural context and descriptive data were collected from 1990 to 1992. Informations on illness concepts were collected during 1994 using focused observation. Data confirming and contrast observations were conducted from 1997 and 1999. Illness concepts of the elderly were taxonomized supernatural cause, non-supernatural cause, immediate cause, and ultimate cause. The supernatural ones were ancestors, god of home, god of village, and ghost such as 'sal(evil force of dead man)' and 'gagqui(ghost of begger)'. The non-supernatural ones were Ki, natural phenomenones, natural objects, foods, human and human behaviors. Immediate ones were insufficiency and overflows, discretion and consolidation, disorder and out of order, cloudness and contamination, and fluctuation and stagnation of supernatural cause and non-supernatural ones. Ultimate causes were intrusion and loss of supernatural and nonsupernatural ones. The cultural themes of illness concepts of the elderly are: 1) illness concepts are not based on causality principle, but on reciprocal principle; 2) illness concepts are affected by social level and charicteristics of the patients; 3) the causes of disease are recognized as imposed both positive and negative effects on health based on interpretation of the indiviuals; 4) illness concepts reflects on principles of everyday life of the society members such as hierachial structure and group cohesiveness; 5) illness concepts are ruled on principle of reciprocity and spread; 6) illness concepts are interrelated with physical environment of the participants. It can be concluded that the illness concepts of the elderly in a traditional clan village are a component of health care system as a cultural system based on these results. The these results can be a useful basis for gerontological nursing practice and education.

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Factors influencing metabolic syndrome perception and exercising behaviors in Korean adults: Data mining approach (대사증후군의 인지와 신체활동 실천에 영향을 미치는 요인: 데이터 마이닝 접근)

  • Lee, Soo-Kyoung;Moon, Mikyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.581-588
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    • 2017
  • This study was conducted to determine which factors would predict metabolic syndrome (MetS) perception and exercise by applying a machine learning classifier, or Extreme Gradient Boosting algorithm (XGBoost) from July 2014 to December 2015. Data were obtained from the Korean Community Health Survey (KCHS), representing different community-dwelling Korean adults 19 years and older, from 2009 to 2013. The dataset includes 370,430 adults. Outcomes were categorized as follows based on the perception of MetS and physical activity (PA): Stage 1 (no perception, no PA), Stage 2 (perception, no PA), and Stage 3 (perception, PA). Features common to all questionnaires for the last 5 years were selected for modeling. Overall, there were 161 features, categorical except for age and the visual analogue scale (EQ-VAS). We used the Extreme Boosting algorithm in R programming for a model to predict factors and achieved prediction accuracy in 0.735 submissions. The top 10 predictive factors in Stage 3 were: age, education level, attempt to control weight, EQ mobility, nutrition label checks, private health insurance, EQ-5D usual activities, anti-smoking advertising, EQ-VAS, education in health centers for diabetes, and dental care. In conclusion, the results showed that XGBoost can be used to identify factors influencing disease prevention and management using healthcare bigdata.

A meta-analysis of intervention studies on the effects of self-management in knee osteoarthritis (무릎 골관절염 대상자에게 적용한 자가관리 중재의 효과 메타분석)

  • Kim, Young-Il;Park, Jeong Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.1946-1956
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    • 2015
  • The purpose of the this study was to provide objective evidence through a systematic review and meta-analysis regarding the effects of self-management in knee osteoarthritis. Articles published between 1999 and 2013 from periodicals indexed Ovid Medline, CINAHL, PubMed, RISS, KISS and other databases were selected, using the following key words: Osteoarthriti* OR OA, self-(management OR care OR help). A selection of 11 studies(7 randomized controlled trials and 4 quasi-experimental interventions that were used were exercise, education, massage and self-help group. As a result of mera-analysis, self-management significantly effected pain, physical function, activities of daily living, and self-efficacy. In particular, self-management showed great effect on ADL, and moderate effect on pain and physical function. Based upon these result, it is necessary to develop a standardized self-management program for knee osteoarthritis patients.

Influencing Factors on Low Body Weight in Korean Adolescents (한국 청소년의 저체중 영향요인)

  • Lee, Jaeyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.7
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    • pp.562-570
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    • 2019
  • This study examined the factors affecting the underweight of Korean adolescents using data from Korea youth risk behavior web-based survey, which are national health statistics. This is a second data analysis study using the 13th Korea youth risk behavior web-based survey. The subjects were 48,242 adolescents who range from the first-year middle school students to the third-year high school students. The measurement variables were classified into demographic, physical activity, dietary, and mental health characteristics. The collected data were analyzed by logistic regression analysis. The factors affecting the underweight of Korean adolescents were sex, school type, academic performance, economic level, physical activities, weight control efforts, ramen intake, confectionary intake, stress, and subjective sleep fulfillment rate. Based on the results of this study, we need to search for the measures to help underweight adolescents recover their proper weight.

Study of Patient Teaching in The Clinical Area (간호원의 환자교육 활동에 관한 연구)

  • 강규숙
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.3-33
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    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

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A Study on a Coping Method of the Family Caregivers of Demented Patients (치매노인 가족부양자의 대처방법에 관한 연구)

  • You, Kwang-Soo
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.648-667
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    • 2002
  • This was a descriptive study designed to identify the level of coping method and its influencing factors on the family caregivers of demented patients, and resolve the family caregivers' level of stress. The data were collected from September 10 to October 10, 2001. Subjects for this study were recruited from four clinics, which were chosen from 15 clinics located in Chunbuk-Do as the study sites because of their cooperation for the study. They were similar in terms of size, the characteristics of the local community. and the population and registration status of the demented patients. The instruments used for the study were as follows: 1. Problematic behaviors of demented patients are measured by the Memory and Behavior Problem Checklist (Zarit, 1980), and the Linguistic Communication Symptoms Questionnaire (Bayles and Tomoeda, 1991) 2. The ability to carry out daily activities was measured using the Barthel Index (1965) and Katz Index (1963), which as well-known ADL assessment methods. 3. Burden was measured using Cost of Care Index by the Kosberg and Cairl (1986). 4. Coping strategy was measured Bell's 18 methods (1977). The data were analyzed using SPSS/PC. The study results were as follows: 1. The total stress score was 2.90 out of a maximum score of 5. The highest score reported was 3.09 on the dimension of restriction of individual and social activities, and the lowest region reported was 2.58 on the dimension of mental and physical health. 2. The total score of the coping method was 2.65 out of a maximum score of 5. The highest score reported was 4.01 on the dimension of thinking that includes an ideation such that it is better than any possible worst case, and the lowest score reported was 1.45 on the dimension of the self-image as a scapegoat. 3. There were significant differences in coping method among the subjects by age (F=2.752 p=0.04), caregiver (F=4.33 p=0.003), care-giving period (F=2.68 p=0.049), and dementia stage (F=2.87 p=0.034). 4. There were highly negative correlations ($\gamma$=-0.301 p=0.000) between problematic behaviors of demented patients and the coping method of their family caregivers. The highest correlation coefficient ($\gamma$=-0.339 p=0.000) was found between aggressive behaviors of the demented patients and the coping method of their family caregivers. 5. There was a low negative correlation ($\gamma$=-0.201 p=0.019) between the ADL of the demented patients and the coping method of their family caregivers. 6. There were highly negative correlations ($\gamma$=-0.213 p=0.005) between stress and the coping method of the family caregivers. The highest correlation was found between financial burden ($\gamma$=-.327 P=.000) and the coping method of the family caregivers. There was no significant correlation among unpleasant aspects of the demented patients, willingness to the demented patients, and the coping method of the family caregivers.

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A Study on Mental Health of Single Aged Persons in Home Perceived by Daughter-in-law (재가 독신노인을 부양하는 주부가 인지하는 노인의 정신건강에 관한 연구)

  • Yun Suk-Rye
    • Journal of Korean Public Health Nursing
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    • v.7 no.1
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    • pp.31-48
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    • 1993
  • Nowaday, there have a lot of changes in the demands of the aged persons. Their problems also came to the fore with diverse forms under the influences of industrialization, urbanization and nuclear family. To make the matter worse, the aged population is mounting rapidly. Also, such structure as nuclear family is widely disseminating uncomfortable to the aged. People is mainly being guided by self interest above everything else. Indeed, they had, all together, bad effects on our traditional value system regarding 'respect for the aged and devotion to patients'. It seems unfortunately obvious that the family responsibility is gradually weakening to support the old who is a dependent family. The result is that the aged must have suffered all sorts of hardships in lightenning psychological, physical and economical difficulties. First, to grasp the situations and conditions supporting for single aged persons from each view of psychological, emotional, family-relational, healthy, social and economical standpoints, and second, to analyze their own recognition levels thinking of their health conditions and the relationships between the supporting environments of old family dependants and their psychological healths and then finally, to propose suggestions being able to be helpful for living comfortably in an old age and thereby, building up good family relation. The statistical techniques used to analyze 115 respondents living in Puchun city are frequency, $x^2$ test, t-Jest, ANOVA, Pearson's Correlation Coefficiency and Regression analysis (SPSS package), pertnent to prove the hypothesis suggested in this paper. Of course, it is needless to say that more data are needed on this point. However, several main research findings can be summarized as follows: First, the better single aged persons may be in the habit of eating a meal and the higher they may think of their physical health conditions and movement, the more they want to participate in economic activities to be free from economical dependence upon their children and to overcome lonliness. Second, single aged women appear to have had higher ability to take care their health for themself than single aged men do. It is why signle aged women do not, in general, have big problems to manage their health. But, as shown in this paper, single aged person"s were more liable to the diseases of the aged and, thereby, requiring special medical treatment badly to be healthy. Third. single aged persons revealed potential desires to free themself from socio economic dependence upon their children even in simple labor Job which can draw a monthly salary of about W200, 000. Fourth, they are generally satisfied with their children's filial piety toward them. Nonethless, most of them appear to be reluctantly dependent upon their children and live lonly lives very much. Fifth, they seem to have some hesitation in expressing their candid opinions as that then are some others along with family environmental factors for psychological and emotiona stability. Accordingly, it is safe to conclude by saying that much attention should' be paid no only to socio-economic supports and better medical services for the aged but also to political supports of the society and towards their children for the aged's emotiona support, for improving the quality of their lives in old age and promoting efficiency in suporting for old family dependants.

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Death Orientation of the Korean Adult - Data was focused on residents who were living in urban area - (대도시에 거주하는 한국인 성인의 죽음정위)

  • Kim Soon-Ja;Kil Suk-Yong;Park Chang-Seung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.5 no.2
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    • pp.237-256
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    • 1998
  • Death and dying of human being is a comprehensive system, and death orientation, the subjective meaning related to every component of the death system is developed throughout life. This study was designed and carried out to identify, describe and classify the orientations of Korean adult towards the death system. In an attempt to measure the subjective meaning of death and dying, unstructured Q-methodology was used. The 65 Q-statements developed by Kim(1994), used by Kim(1994) and Park(1996) were adopted as Q-population and 39 Q-statements were selected by the three researchers for Q-items for this study. Thirty-three P-samples were sampled from P-population of literate Korean men and women, 35 and 55 years of age, lived in urban Korea for the last 10 years. Sortings of the 39 Q-items according to the level of personal agreement, and a forced normal distribution into the 9 levels were carried out by the P-samples. The Z-scores of the Q-sort data were computed, and the principal components factor analysis by PC-QUANL Program were carried out. The demographic, socio-cultural and health-related attributes of the P-samples were descriptively analysed. Eight types of death orientation were identified ; Type I ; 'naturalist'. Six P-samples. Death is a natural phenomena, to be accepted as it is and to follow its natural course. Prefer to be informed of all facts and possibilities concernig the course of dying and death to occur to self. Type II ; 'life-after-life negator'. Three P-samples. Time and process of death is the destiny of each person. Death means 'darkness' and 'end to every thing, the absolute end'. Yet, wish physical integrity at the dying and after death. Type III ; 'life-after-life believer'. Six P-samples. Men are travellers passing by this life bound to the life-after-life. Priority concerns are on the activities to prepare self for the eternal life ahead. Disregard premature and sudden death. Type IV ; 'here-now believer' Five P-samples. Positive regard to the cremation of the body and donation of the organs on death. Regard religious and customary post-motem rituals meaningless. Negate life-after life. Type V; 'believer of rituals'. Five P-samples. Death being accepted as a part of, a natural end to, and destiny of human life. Concerned to ensure a dignified end to personal life and dignified post-mortem rituals. Type VI ; 'Realist'(derived from Type I). Two P-samples. Life and death as universal reality. The abrupt death at golden age at the peak of happiness is favored to avoid inevitable physical and mental distress of self and the family. Agreed to the cremation of the body. Disregard rituals. Type VII : 'Fatalist' (derived from Type II). Five P-samples. Not favored, yet, all man are destined to death, the inevitable end of all living beings. To ensure dignified end by personal consummation, information on one's dying and imminent death are to be shared. Type VIII ; 'reality avoider'(derived from Type III). One P-sample. Negative to longevity, artificial prolongation of, meaningless and distressful life. Highly positive to postmortem organ donation.

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Effects of Laughter Therapy on Joint Pain, Functional Status of Knee Joint and Depression in Elderly with Degenerative Knee Arthritis (웃음요법이 퇴행성 슬관절염 노인의 관절통증, 관절기능상태, 우울에 미치는 효과)

  • Lee, Yim Sun;Park, Hyo Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.9
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    • pp.440-449
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    • 2020
  • This study examined the effects of laughter therapy in the elderly with degenerative arthritis who had joint pain, joint dysfunction, and depression. Through a single-blind, randomized assignment, an experimental group of 26 subjects and a control group of 26 subjects were recruited among the elderly with degenerative knee arthritis, who were over 65 years of age. From January 8 to March 11 of 2019, a total of 16 laughter therapies were administered two times a week, 60 minutes per session, in eight weeks. The pain threshold (p=.012) and joint function status (p<.001), which represents the pain, joint stiffness, and physical function, and depression (p<.001), in the experimental group improved after the eight weeks laughter therapy compared to the control group. Laughter therapy is a therapeutic intervention that can be delivered through physical or intellectual activities. This therapy is a non-invasive procedure and has the advantage that nurses can practice easily with a little training. It can be used as an intervention within community and clinical settings to relieve pain and improve depression in the elderly with arthritis.

Depression and Health Status in the Elderly (노인의 우울과 건강수준과의 관련성)

  • Kim, Jimee;Lee, Jung-Ae
    • 한국노년학
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    • v.30 no.4
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    • pp.1311-1327
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    • 2010
  • This study was conducted to identify the relationship between depression and subjective/objective health status, and to examine predicting factors on depression in the elderly in Korea. This study was a secondary analysis using the data of Korea National Health and Nutrition Examination Survey(VI-1) 2007. A total of 939 data from the subjects ≥60 years who completed health-related survey were used for analysis. Data were analyzed using SAS (version 9.1) PC program. Depression was identified in the 20.3% of the older subjects. Multiple logistic regression analysis showed that women (OR=2.04), senior high school graduation (OR=0.27) and lowermiddle household income (OR=2.83) were significant associating factors(p<0.05). After adjustment for socio-demographic factors, hypertension (OR=1.93) and asthma (OR=3.32) as objective health status, and stress (OR=7.27), limited activity in daily living due to fracture or joint injury (OR=6.59) and poor self-rate health (OR=1.64) as subjective health status were found as factors predicting depression in the elderly(p<0.05). According to the type of health status, the subjects who had chronic disease or perceived poor physical health were 5.94 times more likely to have disposition to depression than the subjects who had no chronic disease or perceived good physical health (p=0.001). These findings suggest that preventive education and intervention focus on preventing and managing chronic diseases such as hypertension, asthma, fracture and joint injury should be needed to decrease depression in the elderly.