Factors influencing subjective cognitive function among community-dwelling older adults.

BACKGROUND: Subjective cognitive decline (SCD) is one of the most common complaints in older adults and may increase risk factors for dementia. Therefore, it is important to identify and manage risk factors for subjective cognitive function (SCF). PURPOSE: This study aimed to investigate factors influencing SCF in community-dwelling older adults. METHODS: With a cross-sectional research design, 164 older adults responded to questionnaires. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé-test, Pearson's correlation coefficient, and multiple regression with SPSS 23.0. RESULTS: Participating in religious activities, sleeping well, a lower number of comorbidities, better perceived health status, lower depression, and higher self-esteem were associated with better SCF. Overall, approximately 24.9% of the variability in SCF was explained by perceived health status, religion, and depression. CONCLUSION: Multifaceted aspects must be considered when developing interventions to improve SCF in community-dwelling older adults who complain of experiencing SCD.

Effectiveness of a community-based integrated service model for older adults living alone: A nonrandomized prospective study.

OBJECTIVE: Older adults living alone face physical, emotional, and social health problems, and prefer to age in place (AIP) in their homes. A community-based integrated model for AIP is needed and few studies have identified its impact on older adults living alone. METHODS: This was a non-randomized prospective study. Participants were 877 community-dwelling older adults living alone, aged above 65 years, in S* city in South Korea. The intervention group (n = 331) received a community-based integrated service (CBIS) model based on AIP for six months from October 2019 to April 2020. RESULTS: Scores on frailty (ß = -0.377, p < .001), loneliness (ß = -1.897, p = .018), and health-related quality of life (ß = 4.299, p = .021) significantly improved in the intervention group. Among the intervention group, loneliness scores significantly improved among participants aged under 80 years than those aged over 80 years. CONCLUSION: The CBIS model improved frailty, loneliness, and quality of life in community-dwelling older adults living alone.

Changes in the health status and health-related quality of life of community-dwelling older adults living alone: one-year follow-up from a cohort study.

Background: The percentage of older adults living alone is rapidly increasing, improving the health status and health-related quality of life (HRQoL) in this group is becoming a more significant public health issue. This study aimed to examine the changes in the HRQoL of older South Korean adults living alone and identify the factors that affect their HRQoL. Methods: A longitudinal study design was followed. Data were collected at baseline and 1-year follow-up. Participants consisting of 789 older adults living alone in S*City aged>65 years completed a cohort survey regarding health status and HRQoL from August 2018 to August 2019. Trained interviewers conducted face-to-face interviews with the participants using a validated questionnaire (physical health, mental health, social health, and HRQoL). Generalized estimating equations were used to assess the change in health status and the interaction effect of time and gender. Then, a stepwise multiple logistic regression analysis was performed to identify factors related to HRQoL. Results: Time differences were observed in the subjective evaluation of health status (SEH), IPAQ scores, frailty, nutritional status, and depression. Gender differences were observed in the SEH, IPAQ, frailty, loneliness, depression, and social support. The interaction between time and gender was observed in the IPAQ and HRQoL. At baseline, SEH, depressive symptoms, gender, frailty, and age were associated with HRQoL. After one year, HRQoL was associated with SEH, frailty, depressive symptoms, cost of living, suicidal thoughts, gender, social support, loneliness, and suicide attempts. Conclusion: Our results highlight that HRQoL is associated with physical health, mental health, and social support. Future detailed studies are needed to determine whether governments and communities can prevent depression, loneliness, and suicidal thoughts through psychological support and provide economic support to improve the quality of life of older adults living alone.

Development of a Community-Based Integrated Service Model of Health and Social Care for Older Adults Living Alone.

The number of elderly people living alone worldwide is increasing, and the responsibility of the state in this context is emerging. This study aimed to develop a community-based integrated service (CBIS) model of health and social care for older adults living alone. The model was designed based on a literature review of previous community care models and per older adults' health and daily life needs. Thereafter, feedback on the integrated model was taken from older adults living alone by conducting a survey (n = 1023) and focus group interviews, after which the opinions of the Public type Health Management Promotion Council were considered and content validity was confirmed. The model, comprising eight healthcare services and five social care services, was tested on 22 older adults for two weeks to assess its feasibility and preliminary efficiency. Each service included screening, assessment, providing service, evaluation, and quit. Participants rated their overall satisfaction with the services as 9 out of 10. Care navigators reported feeling comforted and discovered their own sense of being while providing the services. We believe that the CBIS model may foster independence among community-dwelling older adults living alone, thereby improving their quality of life through "aging in place".

Understanding Educational Barriers and Needs of North Korean Defector Nursing Students: A Qualitative Descriptive Study.

INTRODUCTION: A growing number of North Korean defector students enter nursing schools in South Korea. Many of them, however, quit nursing school and fail to obtain a nurse license. The purpose of this study was to describe the educational barriers and needs of North Korean defector nursing students. METHOD: A qualitative descriptive approach was employed. Convenience sampling was used, and 14 students participated. Qualitative content analysis was employed. RESULTS: Five themes emerged: lack of preparation for higher education, multiple language barriers, differences in education and culture, lack of support and resources, and lack of information and understanding. DISCUSSION: South Korean government needs to provide North Korean defector students with more practical supportive programs. South Korean nursing schools need to provide more transcultural education for South Korean students and supportive adaptation programs for North Korean defector students to produce culturally competent nurses who provide culturally congruent health care.

Gender differences in health status, quality of life, and community service needs of older adults living alone.

OBJECTIVES: The aim of this study was to identify gender differences in the health status, community service needs, and quality of life of older adults living alone in an urban city in South Korea. METHODS: A cross-sectional descriptive correlational design was used. The study sampled 1023 older adults (≥65 years) living alone in S* City, during the period from August to October in 2018. Trained interviewers conducted face-to-face interviews with the participants, using the UCLA Loneliness Scale, Short Form Geriatric Depression Scale - Korean version, ENRICHD Social Support Instrument (ESSI), the Mini-Mental State Examination Standard Version (MMSE-2SV), and Health-Related Quality of Life (EQ-5D). RESULTS: 77.8% were women and the mean age was 77.38 years (men = 74.65, women = 78.16). Women had lower socioeconomic and health status than men. Men felt more lonely, depressed, and had suicidal thoughts more frequently than women. Women had more needs regarding care, residential environment, movement, connection, and emergency services than men. In men, depressive symptoms, suicidal thoughts, loneliness, and right-hand grip strength were identified using the EQ-5D. The EQ-5D was also used to explain depressive symptoms, suicidal thoughts, cognitive function, and physical activity in women. CONCLUSION: Health status and community service needs were dependent on gender; therefore interventions should be tailored according to gender. Our research found that to decrease depression and suicidal thoughts, improve physical health, and enhance quality of life for older adults living alone, interventions need to be designed to decrease male loneliness and to enhance female cognitive function.

Conceptualizing physical activity behavior of older Korean-Americans: an integration of Korean culture and social cognitive theory.

People can live longer and healthier lives by engaging in physical activity (PA). The purpose of this article is to assess the social cognitive theory (SCT) in relation to its relevance to produce cultural-specific directions for gerontological nursing practice in order to guide the design of PA interventions for Korean-American elders. SCT is compared to the Korean cultural, social, and health belief system and is analyzed and evaluated based on 3 criteria: assumptions of the theory, completeness and consistency, and essence of nursing. Within the Korean culture, as presumed in the SCT and the nursing paradigm, health-promoting behavior, such as PA, is conceptualized as the desire for a higher level of health rather than a fear of disease as is proposed by other health behavior theories. SCT with the integration of Korean culture recognizes cultural, developmental, societal, and other external constraints that may help in formulating interventions and better understanding of the limits faced by older Korean-Americans (OKAs) in their pursuit of routine PA.

Literature Review for the Effects of Physical Activity on Musculoskeletal Outcomes in Community-dwelling Older Adults.

PURPOSE: The purpose of this study was to review the effects of physical activity on musculoskeletal outcomes in older Koreans. METHODS: Experimental studies were retrieved from the search engines (PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed). The selected studies for analysis were 27 articles of musculoskeletal outcomes (gait, muscle strength, flexibility, balance, grip strength, endurance, body fat, and weight) from 515 articles. RESULTS: The most common type of physical activity was a resistance exercise. There were significant improvements in gait (71.4%), muscle strength (86.7%), flexibility (63.6%), balance (72.2%), grip strength (71.4%), endurance (71.4%), body fat (57.1%), and weight (28.6%). The activity programs that apply over 150 minutes a week showed greater improvement of 69.5% than 65.0% from those did not meet the guidelines totally. CONCLUSION: Based on the review, we conclude that regular physical activity in the elderly may improve the musculoskeletal outcomes. To be more effective programs, it is necessary to meet the guidelines of 150 minutes a week or 30 minutes of moderate-intensity activities on 5 days per week for the elderly.

Relationship between Physical activity and Cardiovascular Outcomes in the Korean Elderly: Review of Experimental Studies.

PURPOSE: The purpose of this study was to review the relationship between physical activity and cardiovascular outcomes in the Korean elderly. METHODS: Experimental studies were located using PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed. The selected studies for analysis were 20 articles of cardiovascular outcomes (total cholesterol, triglyceride, high density lipoprotein (HDL), low density lipoprotein (LDL), blood pressure, and pulse rate) from 515 articles. RESULTS: One-group pretest-posttest design was the most common. The main physical activity was an aerobic exercise. Five of 14 studies reported a significant improvement of total cholesterol. Four of 14 studies found relationship between exercise and triglyceride. Eight of 12 studies reported a significant improvement of HDL, whereas 3 of 9 studies reported a significant improvement of LDL. In over 60% of selected studies, reported significant improvement of blood pressure. CONCLUSION: Based on the review, it suggests that regular physical activity of the elderly may improve cardiovascular outcomes.

CRP detection from serum for chip-based point-of-care testing system.

Most of point-of-care testing (POCT) to improve facilitates in diagnosis, treatment, and monitoring of patients. POCT technique has still remained a quantitatively and accurately detective effect. In this article, we demonstrated that real human C-reactive protein (CRP) in serum was detected for a chip-based point-of-care testing application based on a nanogap-embedded field effect transistor (FET), and the results were compared with those obtained via the enzyme-linked immunosorbent assay (ELISA) method. The limit of detection (LOD), determined from the standard curve, was 0.1 ng/ml, which is comparable to that of commercialized ELISAs. We evaluated that an improved detection range (0.1 ng/ml to 100 ng/ml) was achieved by comparing with commercialized ELISA. Control experiments to determine selectivity and to discern false-positive/false-negative rates were also performed. This report is the first description of the detection of CRP in human serum using a silicon-based biosensor.

Pressure ulcers among terminally ill nursing home residents.

The purpose of this prospective, anthropological study was to describe and analyze the experiences and care of terminally ill nursing home residents who were admitted with or acquired pressure ulcers (PUs) after admission. Data were collected in two proprietary nursing homes. Participant observation, in-depth interviews, event analysis, and chart review were used to obtain data. A total of 64 (54.7%) of the 117 terminally ill residents in the study had PUs; 52 (81.3%) of whom died with PUs. The findings disclosed that the absence of family advocacy, inability to speak English, and inadequate staffing and lack of supervision, along with other previously reported risk factors, contributed to the development of PUs. Specifically, inadequate staffing and lack of supervision led to inadequate assistance at mealtime, infrequent repositioning, and inadequate continence care, which in turn led to weight loss, unrelieved pressure on bony prominences, and moist, irritated skin. The outcome was a high rate of residents dying with PUs. Knowledge of and attention to these risk factors can guide nurses in the prevention and management of PUs.

Aging, health, and physical activity in Korean Americans.

Little is known about the health benefits and the factors that influence physical activity among older adults from ethnically different backgrounds. The aim of this article is to provide a sociocultural context for understanding aging, health, and physical activity among older Korean Americans. Studies that focused on physical activity and exercise among older adults, older Koreans, or older Korean Americans were reviewed. The results of the review were integrated to better understand physical activity in older Korean Americans. Results from varied population-based, cross-sectional, and longitudinal studies that assessed the relationships among aging, health, and physical activity were relatively consistent in their findings. Many correlational studies found a strong, positive relationship between physical activity and health benefits and a moderately positive but sometimes mixed association between physical activity and quality of life among older adults. Additional research is needed to clarify the gap between physical activity and actual and predictive quality of life among older Korean Americans. Also, we need more evidences to show the effects of late-life physical activity or exercise on reducing or minimizing disablement in older Korean Americans.