I. Background The problem of discharging patients from hospital have been well documented in the literature over the last 20 years. They included poor communication between hospital and community, inadequate notice of discharge, over-reliance on informal support and lack of statutory support, inattention to patients needs before leaving hospital, and wasted or duplicated visits by community nurses. Most patients discharged from hospital are able to return home with little or no support, while others will require a 'package of care' to support them back to good health. Patient with complex care needs, including the frail elderly and those with mental health problems, may require continuing care in special housing, residential, or nursing homes. With this population,effective discharge arrangement is needed and the study on this problem is urgent in Korea because the Medical Reform Project is on suspension of success. II. Results of the Study: 1. Discharge service needs assessed on 360 elderly patients who were hospitalized during the survey period at four university hospitals. Patients want to know the information on disease management after discharge. Follow-up telephone service is the most frequently checked service. 2. Multidisciplinary Discharge Planning is recommended at the hospital level to reduce the readmission and decrease the length of stay. 3. Further research is needed to validate and test the assumption of the solution which is developed in this research.
Background: It is getting important to improve the oral health status of the elderly because oral health status may affect their health status of the whole body. In this respect, we aimed to explore the association of oral health status and behavior factors with self-rated health status by sex. Methods: Using the data from the 7th Korea National Health and Nutrition Examination Survey for health surveys and oral examinations (2016-2018), we analyzed a total of 3,070 people aged 65 or older (men: 1,329; women: 1,741). Our dependent variable, self-rated health status, was divided into two groups: not good (bad and very bad) and good (very good, good, and fair), whereas our independent variables of interest were oral health status and behavior factors. In addition to descriptive analysis and the Rao-Scott chi-square test, reflecting survey characteristics, we conducted hierarchical multivariable logistic regression analyses adjusted for socio-demographics and health status and behavior factors. All analyses were stratified by sex. Results: The proportion of people having 'not good' self-rated health was 36.5% in women but 24.5% in men. In a model adjusted for all covariates, the self-rated health status showed significant association with the self-rated oral health status. For example, in men, the risk of having 'not good' self-rated health was high in people having 'poor' (odds ratio [OR], 5.31; 95% confidence interval [CI], 2.34-12.03) self-rated oral health status and in those having 'fair' (OR, 4.03; 95% CI, 1.68-9.70) in comparison with those having 'good' self-rated oral health status. Dental status regarding speaking difficulty seemed to be very important in influencing self-rated health status. For instance, in women, compared to people having 'no discomfort' speaking difficulty, the risk of having 'not good' self-rated health was high in people having 'not bad' (OR, 1.60; 95% CI, 1.14-2.24) and 'discomfort' (OR, 1.79; 95% CI, 1.30-2.47) speaking difficulty. The covariates significantly associated with the risk of having 'not good' self-rated health were: physical activity, chronic disease, stress, and body mass index in both sexes; health insurance type and drinking only in men; and economic activity only in women. Conclusion: Oral health status and behavioral factors were associated with self-rated health status among the elderly, differently by sex. This suggests that public health policies toward better health in the elderly should take their oral health status and oral health behaviors into account in a sex-specific way.
People have experienced physical problems including vision problems with aging; some are normal and some are abnormal. When they have abnormal and impaired vision, they have a lower level of life satisfaction than their sighted peers. For the elderly with sight loss, well-designed housing could be an important indicator for their quality of life. Housing adjustment and modification could help the elderly cope with sight loss, do daily activities more independently, and lead to better quality of life. The purpose of this study is to investigate housing conditions for the elderly with vision impaired, state of housing adjustment or modifications, and the effects of housing conditions on the wellness of the elderly in Korea. For this study, 18 housing cases were investigated and a total number of 65 visually impaired people aged over 55 participated. Housing condition of those participated was poor. Most observed home hazards are level differences in living areas, obstacles in the hallway, confined space that is not allowed structural modification, swing doors from wardrobe or cabinets, color contrast, poor lightings, and etc. Majority of households participated in this study did not make modification or refurbishments, rather many of them tend to adapt themselves to their residential environments. Older adults living in better housing condition and under less difficult environments are likely to have higher life satisfaction. The effects of housing condition on wellness could be more influential when individual capabilities (e.g. health condition) are weaker. The findings underline that with intervention of individual characteristics, the effects of housing and physical environment on negative outcomes of vision loss would get ameliorated or reduced.
Living conditions of the rural elderly were assessed in terms of clothing behavior, health and nutritional status, housing and envioronmental condition, and psychological adjustment. The subjects were eighty individuals over sixty residing in the rural community of Iksan-kun, Chollabukdo. The interview method using questionnaires, direct measurement, and observation was used for this study. Data were compared with those obtained from a previous study of the elderly residing in an urban area. Clothing behavior showed that the elderly residing in the rural community were more concerned about plain and conservative design of clothes than their urban counterparts. Special protective clothes for cropdusting with agricultural chemicals had not been prepared. The following urgent needs were pointed out: development and supply of agricultural chemical protective clothing and development and education of appropriate washing and clothing care methods. The health status of the elderly was generally good, but poor eating habits were found more frequently in the rural elderly than among the urban dwellers. Several dietary nutrient intakes were insufficient. Contrasting the urban elderly with the rural group, it was found that the urban group lacked sufficient vitamin A and vitamin C and the urban women had insufficient calorie whereas the rural group was deficient in protein, vitamin A, calorie, and fat. A significant relationship was found between dietary nutrient intake and health index, food habit points, self recognized health status, meal satisfaction, and economic status. Urgent needs of the development of a nutrition education program for the elderly were pointed out. Most of elderly residing in the surveyed rural communities were living alone or with their spouse only, therefore only one room was used among the three or four available rooms. Most of the rural elderly were living either in a traditional Korean house built with differing floor levels or in a modified Korean style house. Minimal modernization had been made for kitchen facilities such as sink and gas range or for heating facilities with the briquette boiler. However, sanitary space such as lavatory and bathroom had not been remodeled. A housing welfare program for rural communities should be implemented at the national level. The comparison of psychological characteristics of the rural elderly with their city counterparts revealed that the rural elderly have a more stable psychological status and optimistic attitude than those living in a city. However, it was found that most of the elderly did not have any future plan. Community programs for the elderly including hobbies or leisure activities or education programs to generate close interpersonal relationships with their children should be developed and provided.
Journal of the Korean Society of Food Science and Nutrition
/
v.44
no.3
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pp.370-378
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2015
Oral health is a critical factor for diagnosing overall health, as poor oral health has a negative impact on food intake and results in deterioration of nutritional status. The purpose of this study was to research the needs for food developments for the elderly based on their oral and overall health status. Oral status was significantly associated with self-reported health status, and dry mouth (lack of saliva) especially showed a significant relationship with negative self-perception of both oral and overall health. For both elderly men and women, fish and leafy vegetables were the most preferred side dishes. Bread, rice cake, and beverage-type foods were also preferred for snack development. Disease status of the elderly was significantly related with their preference for food development. For instance, those with diabetes were more likely to ask for anti-diabetic diets. The most important factor for the elderly in choosing food was nutritional balance, and less than 3,000 won was cited as an affordable price. The results could be utilized as basic data to develop foods for the elderly.
Community-based centres were surveyed to determine the frequency of and risk factors for falls among elderly Koreans. We examined fall-related risk factors, including physiological and physical health, psychosocial functions, self-reported physical capacity and activity, vision, and the use of medication, among 351 elderly people aged 65 years or older, with ambulatory. Forty-two per cent of elderly Korean subjects reported at least one episode of falling in the previous 12 months, $38\%$ of whom had consequences that required either the attention of a physician or hospitalization. Factors significantly associated with an increased risk of falling were a restricted activity during the previous five years (adjusted OR 1.3), use of alternative therapy (adjusted OR 2.7), low knee flexor and extensor-muscle strength (adjusted OR 1.21 and 1.20), and poor balance with closed eyes (adjusted OR 8.32). We conclude that falls among older persons living in the community are common in Korea and that indicator of bad health and frailty or variables directly related to neuromuscular impairment are significant predictors of the risk of falling.
The nutritional and health status of low-income alone-living elderly(ALE) was assessed in relation to the activity of daily living (ADL) and nutritional risk factors. One hundred and eighty five ALE over 65 years old, living in the Sungnam area, were interviewed in their homes through questionnaires. The results were as follows : 63.6% of the subjects considered themselves in poor the health and only 4.3% of them considered thermselves healthy. 89.7% of the subjects answered that they were suffering from illness and 29.7% were taking medication. The ADL was assessed through 10 checklist items and the average score of the ADL was $84.78{\pm}11.11$(maximum :100) The nutritional risk index(NRI) was evaluated by 12 risk factors and the average score of the NRI was $4.43{\pm}1.38$ (maximumː12) The scores of the ADL were positively correlated with the scored of the instrumental activities of daily living (IADL)(r=0.7523, p<0.001) and negatively correlated with NRI(r= -0.2694, p<0.001) When subjects were divided into nutritionally high risk group(HNARI: TEX>$NRI{\geq}5$) and nutritionally low risk group(LNRI : NRI<5) according to the USA screening basis, 48.9% of the subjects belonged to the HNRI, But 16.9% of the HNRI and 34.4% of the LNRI belonged to the fourth quartile($Q_{0.75}$) of the ADL, the distribution of which showed significant differences(p<0.05) We suggest that the application of the ADL as a screening tool for nutrition intervention programs for the elderly. Oncemore, further research is needed to develop appropriate checklist items for the ADL and NRI along with the screening basis for the NRI 새 diagnose the adverse nutritional status of the Korean elderly.
Journal of Agricultural Extension & Community Development
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v.17
no.2
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pp.233-259
/
2010
The purpose of this study is to find out about how are physical health, economical states and social relationships of women elderly living alone in an island. The measurement variables are subjective health status, satisfaction of life and a feeling of depression through Activities of Daily Life, social supports, social network and social relationship. First, the ADLs of the aged women living alone in the island are that can't do themselves 23.4%, and need to other's help on their walking 23.4%, bathing 6.5%, and going out 10.3%. Second, them answered that is very shortage or shortage with living expenses 46.8%. Average income in a month is under 200thousands won are account for 32% in a rural and 32.4% in an urban but the aged women living alone in an island are account for 35.1%. comparing with that they are living under the absolute poor with a small income less than 300thousands won. Third, social relationships of the aged women living alone in the island are living with an offspring in a same region 50.6%, a neighboring village 11.7%, and living with a relation in same region. At this study differs from other studies are about studying to be compared aged people between rural and urban area. This study is researched comprehensively about more fragility people.
Purpose: This descriptive study aims to analyze the effects of the satisfaction level in the relationship between mother-in-law and daughter-in-law, conflicts between them, acculturative stress and stress coping strategies on elderly depression in multi-cultural families. Methods: The survey was conducted on 89 mothers-in-law, aged 65 or older, in multi-cultural families with a foreign daughter-in-law. Data were collected through structured questionnaires, and then were used to conduct t-test, ANOVA, correlation and multiple regression analyses using the statistical program SPSS 21.0. Results: This study found several factors contributing to depression of mothers-in-law in multi-cultural families. Those factors include living alone without a spouse, poor health, a high level of perceived discrimination and a passive reaction in terms of stress coping strategies. Conclusion: A sense of discrimination perceived by the mothers-in-law having a foreign daughter-in-law implies that the people around them and the community should make efforts to reject distorted perspectives and remove prejudice against foreign daughters-in-law. In addition, the mothers-in-law should receive education and training to use more active and positive stress coping strategies in a stressful situation with the foreign daughter-in-law.
Elder people in Korea was affecting the nutritional status by following factors : low energy intakes, low food diversity, and poor quality of nutrition. Management a nutrition education program was planned to change the elder's nutrition knowledge and improve their nutritional status. There are seven kinds of indicator - knowledge for health questionnaire (before and after education) - we have investigated elderly nutrition education group in Su-Jung ku, Sung-Nam city. The items of surveyed was general characteristics and anthropometric measurement of the elder people, their mini dietary assessment index score, nutritional risk, nutrition knowledge test, and it's valuation comparisons between the before and after every education we did. According to the results of mini dietary assessment index score, the mean was 22.7 at the maximum 30 points and $94.2\%$ of respondents got more than nomal group. The nutritional risk score was the highest in 'high risk' group. Also the results of nutrition knowlede test showed that the mean increase $35.1\%$ of respondents. Therefore, significant improvement results showed by nutrition education programs in elders. These results suggests that the educating nutrition programs fur elder's encouraging eating behavior themselves and changing their knowledge in nutrition.
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