Daughters rewarding mothers' piteous lives: Eldest daughters caring for aging mothers.

This study is an analysis of the personal and social meanings of married women's experiences caring for their aging mothers as the eldest daughter in Korean society. Semi-structured interviews were conducted with seven participants for this study. The interviews were conducted in Korean, and the collected data were analyzed using descriptive phenomenological analysis in four categories: "being the eldest daughter and daughter-in-law in a patriarchal society with nothing but duties"; "the pain of taking care of my mother that invades my daily life"; "The compassion of an eldest daughter who can't turn a blind eye to her mother's miserable life."; and "Support from society to overcome the psychological difficulties of caregivers and help older adults in their daily lives". The study participants felt emotional pain in caring for their mothers, and it was difficult for them to simultaneously play the roles of daughter-in-law, wife, and mother. However, they felt compassion for their mothers' lives in a patriarchal society and believed they could compensate for their mothers' hardships by caring for them. The participants emphasized the need for specialized in-home services that address the specific health needs of the older adult, along with counseling services for their caregivers. In Korean society, when daughters care for their mothers, it strengthens the shared history and emotions between mothers and daughters, affirming female solidarity. Based on the above findings, policy and practical measures are recommended to ensure that daughters who provide care for their mothers can deliver stable care.

Developing and Validating the Senior Meaning in Life Evaluation (SMiLE) Scale.

The Senior Meaning in Life Evaluation scale encompasses not only older adults' personal motivation and growth but also the meaning for them in society and in their relationships: With this scale, we aimed to present their voices. A three-phase process was followed: The scale's items were developed empirically from interviews of older adults; exploratory factor analysis (EFA) was conducted to test convergent and concurrent validity; and finally, confirmatory factor analysis (CFA) was performed. EFA resulted in 18 items grouped into 4 factors (i.e., proactive on life, overcoming emptiness, acceptance in life, and social contribution), which was supported by the CFA.

Changes in the Equity of the Long-Term Care System in Korea Based on Coulter Index Differences for the Years 2000, 2008, and 2015.

In this study, we examined the adequacy of supply and demand under private expansion of the long-term care (LTC) infrastructure after the introduction of long-term care insurance (LTCI) for the older people in Korea. We used Coulter's coefficient of inequality (Coulter index) to analyze the equity of LTC services by region. In addition, we analyzed the trend of equity changes through equity analysis for three time points: 2000, 2008, and 2015. We found that the level of inequity in LTC service infrastructure in Korea is lower in 2015 compared with 2000, but the differences among regions are high. The adjustment factors in 2015 showed prominent shortages of facilities in urban areas and oversupply in suburban areas. Based on these results, we propose an LTC service infrastructure that meets the demand and improves service access according to regional characteristics.

Implementation of a Home-Based mHealth App Intervention Program With Human Mediation for Swallowing Tongue Pressure Strengthening Exercises in Older Adults: Longitudinal Observational Study.

BACKGROUND: Tongue pressure is an effective index of swallowing function, and it decreases with aging and disease progression. Previous research has shown beneficial effects of swallowing exercises combined with myofunctional tongue-strengthening therapy on tongue function. Tongue exercises delivered through mobile health (mHealth) technologies have the potential to advance health care in the digital age to be more efficient for people with limited resources, especially older adults. OBJECTIVE: The purpose of this study is to explore the immediate and long-term maintenance effects of an 8-week home-based mHealth app intervention with biweekly (ie, every 2 weeks) human mediation aimed at improving the swallowing tongue pressure in older adults. METHODS: We developed an mHealth app intervention that was used for 8 weeks (3 times/day, 5 days/week, for a total of 120 sessions) by 11 community-dwelling older adults (10 women; mean age 75.7 years) who complained of swallowing difficulties. The app included a swallowing monitoring and intervention protocol with 3 therapy maneuvers: effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation. The 8-week intervention was mediated by biweekly face-to-face meetings to monitor each participant's progress and ability to implement the training sessions according to the given protocol. Preintervention and postintervention isometric and swallowing tongue pressures were measured using the Iowa Oral Performance Instrument. We also investigated the maintenance effects of the intervention on swallowing tongue pressure at 12 weeks postintervention. RESULTS: Of the 11 participants, 8 adhered to the home-based 8-week app therapy program with the optimal intervention dosage. At the main trial end point (ie, 8 weeks) of the intervention program, the participants demonstrated a significant increase in swallowing tongue pressure (median 17.5 kPa before the intervention and 26.5 kPa after the intervention; P=.046). However, long-term maintenance effects of the training program on swallowing tongue pressure at 12 weeks postintervention were not observed. CONCLUSIONS: Swallowing tongue pressure is known to be closely related to dysphagia symptoms. This is the first study to demonstrate the effectiveness of the combined methods of effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation using mobile app training accompanied by biweekly human mediation in improving swallowing tongue pressure in older adults. The mHealth app is a promising platform that can be used to deliver effective and convenient therapeutic service to vulnerable older adults. To investigate the therapeutic efficacy with a larger sample size and observe the long-term effects of the intervention program, further studies are warranted. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/19585.

Development of an Ultrasonic Doppler Sensor-Based Swallowing Monitoring and Assessment System.

Existing swallowing evaluation methods using X-ray or endoscopy are qualitative. The present study develops a swallowing monitoring and assessment system (SMAS) that is nonintrusive and quantitative. The SMAS comprises an ultrasonic Doppler sensor array, a microphone, and an inertial measurement unit to measure ultrasound signals originating only from swallowing activities. Ultrasound measurements were collected for combinations of two viscosity conditions (water and yogurt) and two volume conditions (3 mL and 9 mL) from 24 healthy participants (14 males and 10 females; age = 30.5 ± 7.6 years) with no history of swallowing disorders and were quantified for 1st peak amplitude, 2nd peak amplitude, peak-to-peak (PP) time interval, duration, energy, and proportion of two or more peaks. The peak amplitudes and energy significantly decreased by viscosity and the PP time interval and duration increased by volume. The correlation between the time measures were higher (r = 0.78) than that of the amplitude measures (r = 0.30), and the energy highly correlated with the 1st peak amplitude (r = 0.86). The proportion of two or more peaks varied from 76.8% to 87.9% by viscosity and volume. Further research is needed to examine the concurrent validity and generalizability of the ultrasonic Doppler sensor-based SMAS.

Role changes of hospital social workers in South Korea.

The roles of social workers in hospitals have changed in accordance with the environmental changes in the healthcare system. Since 1958, hospital social workers have performed important roles in providing care services in South Korea. Providing psychosocial services was considered to be the most important for more than 30 years from the 1970s to the 1990s. The healthcare system has since undergone major environmental changes, yet there has been little study on the role of hospital social workers in South Korea. In order to address this research gap, this study aims to explore how the roles of hospital social workers have changed since the 2000s. We recruited 198 hospital social workers who were active members of the Korean Association of Medical Social Workers as study participants. The average age of participants was 35.36 years old (SD = 8.27), and they had an average of 8.24 years in hospital social work experience (SD = 6.35). The results indicated that the roles of financial support and community resource linkage, which were regarded to be relatively less important until the 1990s, were recognized as the most important. Given the role changes of hospital social workers in South Korea, implications are discussed.

Later-Life Preparation Patterns on Depression Among Korean Baby Boom Generations.

The aim of this study was to examine the later-life preparation pattern of Korean baby boomers and its effect on depression. Using the fourth wave of Korean Retirement and Income Study, later-life preparation was measured by economic, physical, and psychological preparation, and leisure, and family relationship satisfaction. The data analysis included latent class analysis, correlations, multiple logistic regression, and analysis of variance. Later-life patterns of Korean baby boomers were classified as high-level (35.7%), low-level (31.1%), and health and family relationship (33.2%) preparation patterns. For depression, the low-level pattern was associated with significantly higher level of depression; however, no differences were found in other two patterns. Researchers recommended a postretirement program to reflect the unique characteristics of Korean baby boomers. Moreover, findings regarding the importance of health and family relationships can be applied to other countries that have historical and cultural backgrounds similar to Korea.

The effect of advocacy for overcoming stigma on posttraumatic growth: Focusing on childhood cancer survivors.

The aim of this study was to investigate both strategies for coping with stigma and the effects of participating in advocacy. The participants were childhood cancer survivors who had been diagnosed before the age of 18 years who had completed treatment. An embedded-design mixed-methods approach was used with 30 interview scripts, and 145 survey results were collected. Coping strategies for the stigma of cancer were "secrecy, avoid stereotypes, and discrimination" and "disclosure of medical history." Participation in advocacy confirmed self-worth, helped in achievement, and promoted social skills. Quantitative analysis showed that greater advocacy participation was associated with higher levels of posttraumatic growth. This study could provide support for advocacy among childhood cancer survivors by demonstrating its positive effects.

Prevalence and Trends in Domestic Violence in South Korea: Findings From National Surveys.

To examine trends in the prevalence of domestic violence since 1997, 1 year prior to the introduction of legislative countermeasures and accompanying services in South Korea, and to analyze what socio-demographic characteristics of perpetrators contribute to spousal violence and whether there were any changes in risk factors over time. This study used two sets of nationally representative household samples: married or cohabiting couples of 1,540 from the 1999 national survey and 3,269 from the 2010 National Survey of Domestic Violence. Frequency analysis was used to measure the prevalence of intimate partner violence (IPV), and cross-tabulation, correlation, and logistic regression analyses were used to look for socio-demographic risk factors of spousal physical violence and patterns of change over time. The frequency analysis showed that the IPV prevalence dropped by approximately 50%, from 34.1% in 1999 to 16.5% in 2010, though it was still higher than many other countries. The cross-tabulation and logistic regression analyses suggested that men with low socio-demographic characteristics were generally more violent, though this tendency did not apply to women. Instead, younger women seemed to be more violent than older women. Last, different levels of household income were associated with different levels of IPV in 2010, but no linear trend was detected. In this study, IPV prevalence trends and risk factors of two different time periods were discussed to provide implications for tackling the IPV problem. Future countermeasures must build on understanding about men with low socio-demographic status and younger women, who were more violent in marital relationships.