The Activities of Dementia Partners and the Quality of Life of the Elderly with Dementia in Rural Area / 農村醫學 地域保健

Objectives@#The purpose of this study was to identify the level of quality of life and related factors in the elderly with dementia living in their houses of rural area who are receiving dementia partners’ supporting activities. @*Methods@#The study participants were 55 elderly people with dementia living in their houses who were participating in the dementia partner pilot project among those registered in the public health center in one area and 55 dementia partners. Data were analyzed by independent t-test, ANOVA, Pearson correlation analysis and multiple regression analysis. @*Results@#The factors that had a significant effect on quality of life included depression to predict the quality of life in the elderly with dementia. And its explanatory power was 46.8%. @*Conclusions@#Based on these results, it is crucial not only to maintain physical functions but also to decrease depression by emotional support activities so as to enhance their quality of life, therefore, it is required to develop and apply the integrative supporting programs in rural area. From the result that dementia partner’s self-compassion would lower the depression in the elderly with dementia significantly, it is considered to develop the programs to enhance dementia partners’ self-compassion.

Effects of Tai Chi Exercise Program on Cognitive Function among Older Adults at Risk for Dementia Living in Rural Areas / 재활간호학회지

Purpose@#This study aimed to examine the effects of the Tai Chi exercise program on cognitive function among older adults at risk of dementia living in rural areas. @*Methods@#A non-equivalent control group with a pretest-posttest design was used. Forty-four subjects at risk of dementia aged over 75 were recruited from the dementia care center in O county. The experimental group participated in the Tai Chi exercise program twice a week for one-hour session for 12 weeks, while the control group received the routine management from the dementia care center. Data were analyzed using the SPSS version 24.0 program with descriptive statistics, x2 test, and Mann-Whitney test, t-test and ANCOVA. @*Results@#The significant improvement was found in cognitive function (F=4.72, p=.036) and attention (F=4.44, p=.041) for the Tai Chi exercise group compared to the control group. No adverse events have been notified during the intervention. @*Conclusion@#The study findings suggest that Tai Chi exercise program is safely and effectively applied to older adults at risk of dementia, revealing the potential benefits to improve cognitive function in this population. Further studies are warranted to explore the relationship between physical exercise and cognitive function in older adults with various types of cognitive impairment.

Psychosocial Well-Being of Clinical Nurses Performing Emotional Labor: A Path Analytic Model Approach

PURPOSE@#This study was conducted to investigate the influence of emotional expressivity, emotional intelligence, affectivity, job autonomy, social support, and emotional labor on clinical nurses' individual well-being and to provide guidelines for interventions and strategies for its improvement.@*METHODS@#The sample consisted of 207 nurses recruited from a general hospital in Korea. The participants completed a structured self-report questionnaire comprising measures of emotional expressivity, emotional intelligence, positive affectivity, negative affectivity, job autonomy, supervisor support, coworker support, deep acting, surface acting, emotional exhaustion, and job satisfaction. Data were analyzed using SPSS statistics 22.0 and AMOS 22.0.@*RESULTS@#The final model was a good fit for the data based on the model fit indices. In the path analysis, surface acting, negative affectivity, supervisor support, and coworker support had statistically significant effects on emotional exhaustion, explaining 29.0% of the variance. Deep acting, emotional exhaustion, positive affectivity, and emotional intelligence had statistically significant effects on job satisfaction, explaining 43.0% of the variance.@*CONCLUSION@#Effective strategies to improve clinical nurses' individual well-being should focus on surface acting, deep acting, affectivity, social support, and emotional intelligence. The results of this study can be utilized as base data to manage emotional labor and improve clinical nurses' individual well-being.

Psychosocial Well-Being of Clinical Nurses Performing Emotional Labor: A Path Analytic Model Approach

PURPOSE: This study was conducted to investigate the influence of emotional expressivity, emotional intelligence, affectivity, job autonomy, social support, and emotional labor on clinical nurses' individual well-being and to provide guidelines for interventions and strategies for its improvement. METHODS: The sample consisted of 207 nurses recruited from a general hospital in Korea. The participants completed a structured self-report questionnaire comprising measures of emotional expressivity, emotional intelligence, positive affectivity, negative affectivity, job autonomy, supervisor support, coworker support, deep acting, surface acting, emotional exhaustion, and job satisfaction. Data were analyzed using SPSS statistics 22.0 and AMOS 22.0. RESULTS: The final model was a good fit for the data based on the model fit indices. In the path analysis, surface acting, negative affectivity, supervisor support, and coworker support had statistically significant effects on emotional exhaustion, explaining 29.0% of the variance. Deep acting, emotional exhaustion, positive affectivity, and emotional intelligence had statistically significant effects on job satisfaction, explaining 43.0% of the variance. CONCLUSION: Effective strategies to improve clinical nurses' individual well-being should focus on surface acting, deep acting, affectivity, social support, and emotional intelligence. The results of this study can be utilized as base data to manage emotional labor and improve clinical nurses' individual well-being.

Factors Affecting on the Quality of Life of the Elderly with Mild Dementia Living in Some Rural Community in Korea / 農村醫學 地域保健

OBJECTIVES: The purpose of this study is to investigate the influencing factor of the quality of life of the elderly with mild dementia in rural community. METHODS: A total of 123 elderly who were managed by public health center participated. They were diagnosed as mild dementia by MMSE-DS and CDR. Data were collected during the period from May to September in 2017 by a structured questionnaire that included general characteristics, depression, dependence, comorbidity, sleep scale. Data were analyzed by t-test, ANOVA, Pearson's correlation analysis, and multiple regression analysis. RESULTS: The quality of life was correlated significantly with depression. Depression was the factor affecting the quality of life of the elderly with mild dementia in rural community. Depression accounted for 54.0% as a variable of quality of life. CONCLUSION: This study was meaningful in that it directly measured the quality of life of the elderly with mild dementia is known to be difficult to measure and found meaningful results. it is necessary to identify the cause of depression and establish a linkage system between public health centers and health related organizations in the community. We suggest the need for individualized preventive intervention program and integrated psychological health service considering depression.

Comparision of Health Behaviors, Diabetes Mellitus(DM) Management and Health-related Quality of Life(HRQoL) between DM Groups with and without Diabetic Education Experience / 農村醫學 地域保健

PURPOSE: This study was to compare health behaviors, DM management and HRQoL among Diabetic patients according to education experience. METHODS: Data were obtained from Community health Survey(CHS) of 2015. The participants were 22,937 diabetic patients who had education experience or not. Data were analyzed on complex sample anaysis using SPSS 24 program. RESULTS: The education experience group showed higher percentages of health behaviors and DM Management and higher HRQoL. The significant negative factors influencing HRQoL were Bed ridden experience, higher subjective stress, depression expereince, age, low education and positive factors were good subjective health status, walking, mod-exercise, drinking, employment, spouse, good subjective happiness. CONCLUSION: These results show that education experience is a way to help diabetic patients' health behavior, DM management, HRQoL.

Structural Equation Modeling on Self-Care Behavior and Quality of Life in Older Adults with Diabetes Using Citizen Health Promotion Centers

PURPOSE: The purpose of this study was to construct and test a structural equation model for Diabetes self-management (DSM) behavior and Quality of life (QoL) in older adults with diabetes who use Citizen Health Promotion Centers. The theory used this study was a combination of the Information-Motivation-Behavioral Model (IMB) and Self-Determination Theory (SDT) to reflect autonomous characteristics of participants. METHODS: Data were collected from April 20 to August 31, 2015 using a self-report questionnaire. The sample was 205 patients with type 2 Diabetes who regularly visited a Citizen Health Promotion Center. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factor affecting the participants' DSM behavior and QoL. RESULTS: The supported hypotheses were as follows; 1) The variable that had a direct effect on QoL was health behavior adherence (γ=.55, p=.007). 2) The variables that had a direct effect on DSM behavior were DSM information (γ=.15, p=.023), DSM confidence (γ=.25, p<.001), and autonomous motivation (γ=.13, p=.048). 3) The variable that had a direct effect on DSM confidence was autonomy support (γ=.33, p<.001). CONCLUSION: The major findings of this study are that supporting patient's autonomous motivation is an influential predictor for adherence to DSM behavior, and integrative intervention strategies which include knowledge, experience and psychosocial support are essential for older adults with diabetes to continue DSM behavior and improve QoL.

Different Effects of Cognitive and Non-exercise Physical Leisure Activities on Cognitive Function by Age in Elderly Korean Individuals

OBJECTIVES: We aimed to examine the effects of various leisure activities on cognitive impairment in young-old (aged 65–74 years) and old-old (aged ≥ 75 years) adults. METHODS: In total, 10,279 elderly Korean individuals from the 2014 Korean National Survey on Older Adults’ cohort were enrolled in our study. Cognitive impairment was assessed using the standardized score of the Mini-Mental State Examination for Dementia Screening, whereas leisure activities were recorded via self-reporting of the extent and type of leisure activity the subjects involved in over the past year. Multivariate logistic regression was used to assess the effect of leisure activities on cognitive impairment, while controlling for potential covariates. RESULTS: The subjects were more likely to participate in cognitive activities than in non-exercise physical activities. After controlling for selected covariates, involvement in cognitive activities was found to be a significant predictor of cognitive impairment in both the groups, whereas involvement in non-exercise physical activities was not a predictor of cognitive impairment in individuals aged ≥ 75 years. Moreover, depressive symptoms, rural residence, and hearing difficulties were common predictors of cognitive impairment among elderly-Korean-individuals. CONCLUSION: Leisure activity involvement may help delay cognitive impairment, which is often concomitant with aging. Hence, an early intervention service may significantly benefit both young-old and old-old individuals.

Effects of Bullying Experience on Psychological Well-Being Mediated by Conflict Management Styles and Psychological Empowerment among Nursing Students in Clinical Placement: A Structural Equation Modeling Approach

PURPOSE: This study aimed to test a proposed structural equation model in which bullying experience, conflict management styles and psychological empowerment predict psychological well-being among Chinese nursing students in clinical placement. METHODS: Three hundred and sixty-six nursing students recruited from five hospitals in J city and Y city were assessed with self-report questionnaires on bullying experience, conflict management styles, psychological empowerment and psychological well-being including depression, self-esteem, and academic major satisfaction. Data were analyzed using SPSS version 20.0 and AMOS version 22.0. RESULTS: The evaluation parameters included the comparative fit index at .90, the goodness of fit index at .93, the root mean square error of approximation at .07, and χ²/df ratio at 2.66, indicating that the proposed structural equation model provided a good fit to the data. Experience of being bullied during clinical placement, conflict management styles and psychological empowerment explained 93.0% of the variance and had significant effects on psychological well-being, with conflict management styles and psychological empowerment mediating the association between bullying and psychological well-being. CONCLUSION: The findings indicated that mediation by conflict management styles and psychological empowerment alleviated the negative influence of bullying on psychological well-being. To limit bullying and its negative effects, development of effective guidelines to deal with bullying will be a critical tool for both Chinese nursing students and their instructors. Further research should incorporate conflict management styles and psychological empowerment into the specific intervention strategies for handling bullying behaviors among nursing students and staff nurses and promoting nursing students' psychological well-being.

Development and Application of Motivation-enhancing Self-management Program for Rural Aged with Hypertension / 農村醫學 地域保健

OBJECTIVE: The purpose of this study was to develop a motivation-enhancing self-management program and apply to rural aged with hypertension to evaluate the applicability of the Program. METHODS: The motivation-enhancing self-management program was on the evidence of Orem's self-care theory and Ford's Motivational system theory which consists of group education and tele-coaching conducted 12-week. The program evaluation was done by structured questionnaires of motivation (self-efficacy, perceived benefit, perceived barrier and emotional salience), self-care and blood pressure. There were totally 31 aged with hypertension in 2 rural areas enrolled in the program. RESULTS: There was only perceived benefit statistically significant between the intervention and control group (t=2.05, p=.04) and self-care level was no difference between the two groups (t=0.21, p=.84) after program. But there are statistically significant differences of systolic blood pressure between the intervention and control group(t=-2.62, p=.01). CONCLUSION: The motivation-enhancing self-management program is necessary for the rural aged with hypertension, but it's needed modify and revise in the future study.

The Association between Bullying Experience related to Clinical Placement and Psychological Well-being in Nursing Students

PURPOSE: This study aimed to explore the prevalence of bullying and to examine the effect of bullying on psychological well-being including depression, self-esteem, and academic major satisfaction among nursing students during clinical training. METHODS: Three hundreds one nursing students who were recruited from three universities in D City were assessed with self-report questionnaires of bullying experience and psychological well-being. Data analyses were performed using the SPSS 21.0 program, which included one-way ANOVA, independent t-test, Pearson's correlation, and multiple linear regression analyses. RESULTS: More than three quarters of the participants experienced bullying during their clinical training, and their experience of being bullied was a significant predictor of psychological well-being even after controlling for perceived academic performance, relationship between nurses and students, teachers' or nurses' help to deal with bullying, and religion. CONCLUSION: Bullying was an issue among nursing students during clinical placement. Bullying experience yielded negative psychological outcomes associated with high depression, low self-esteem, and low academic major satisfaction. Practical guidelines are required in nursing education to protect students from the possible harm of bullying in clinical settings during training.

A Study on Occupational Satisfaction and Stress of Visiting Nurses at District Health Centers in Chungnam Province / 산업간호학회지

PURPOSE: The purpose of this study is to identify visiting nurses' occupational satisfaction and their stress who are working at district health centers in Chungnam province. METHODS: The subjects of the study were 109 visiting nurses of 16 district health centers in Chungnam province. The data were collected by self report questionnaires from March 1 to 31, 2010. The data were analyzed by Cronbach's alpha, t-test, ANOVA (Sheffe's test), and correlation coefficient using the SPSS program. RESULTS: The results of this study were as follows. The occupational stress level of the subjects was 46.7 and the level of subjects' occupational satisfaction was 2.46. There was a significant negative correlation between occupational satisfaction and occupational stress (r=-.627). CONCLUSION: The occupational stress level of the subjects, and stress levels of 'work environment,' 'job insecurity' and 'organizational structure' were higher than those of the Korean women workers' standard. The level of subjects' occupational satisfaction was lower than that of the nurse practitioners. There was a significant correlation among occupational stress and 'burden of workload' and 'visiting nurse career'. The study showed that occupational stress was correlated with occupational satisfaction. The results suggest that further follow-up study on visiting nurse is necessary to relieve their occupational stress and increase occupational satisfaction.

Prediction Model of Quality of Life in Elderly Based on ICF Model

PURPOSE: The purpose of this study was to identify from the International Classification of Functioning model, factors influencing quality of life in elderly persons and to describe the concrete pathway of influence and the power of each variable. METHODS: The sample included 334 elders who lived in 5 districts of D Metropolitan City. A structured questionnaire was used and the collected data were analyzed for fitness, using the AMOS 18.0 program. RESULTS: This model was concise and extensive in predicting the quality of life of elders. The research verified the factors influencing quality of life for elders as direct factors such as activity of daily living (ADL) (beta=.13, t=2.47), leisure activity (beta=.55, t=5.04), social disengagement (beta=-.25, t=-2.25), and depression (beta=-.62, t=-10.86). Indirect factors including economic status (gamma=.17, p=.009), type of residence (gamma=.19, p=.004), ADL (gamma=.12, p=.027) were important factors in predicting quality of life for elders. These variables explained 75.6% of variance in the prediction model. CONCLUSION: The findings indicate a need for the nursing scientific community to develop intervention programs considering these variables to improve the quality of life for elders.

The Association among Activity of Daily Living, Instrumental Activities of Daily Living, Depression and Isolation in Disabled People / 재활간호학회지

PURPOSE: The purpose of this study was to evaluate the association among of Activity of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), depression and isolation in disabled people. METHOD: The subjects consisted of 761 disabled people in Korea. Data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson's correlational statistics. RESULTS: There were significant differences in age, cause of disability, type of disability, degree of disability, education, job, perceived health condition, and economic status between disabled people with high and low levels of ADL and IADL. Depression showed significant differences in type of disability, degree of disability, education, job, perceived health condition, and economic state; isolation showed significant differences in age, cause of disability, type of disability, education, job, residence, perceived health condition, and economic status. A significant association was identified between depression and isolation (r=.69, p<.001). CONCLUSION: There was a high incidence of depression in disabled men with high levels of isolation and ADL and IADL dependence. An effort to increase disabled people's ADL, IADL, and independence levels is needed, and nursing interventions should be designed and tested to increase their community involvement and decrease the sense of isolation and depression.

Relationships among Obesity, Bone Mineral Density, and Cardiovascular Risks in Post-menopausal Women / 여성건강간호학회지

PURPOSE: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. METHODS: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. RESULTS: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. CONCLUSION: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.

Relationships among Obesity, Bone Mineral Density, and Cardiovascular Risks in Post-menopausal Women / 여성건강간호학회지

PURPOSE: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. METHODS: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. RESULTS: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. CONCLUSION: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.

Effects of Tai Chi Exercise on Physical Fitness, Bone Mineral Density, and Fracture Risk in Institutionalized Elderly / 기본간호학회지

PURPOSE: The purpose of this study was to examine the effects of Tai Chi exercise on flexibility, balance, walking ability, muscle strength, bone mineral density, and fracture risk in institutionalized elders. METHOD: A quasi-experimental pretest-posttest design with a nonequivalent comparison group was utilized, and 53 older adults living in one institution were recruited and assigned to one of two groups, experimental group (18) or comparison (20). Both groups completed posttest measures at 6 months. There was a 31% rate of dropouts. Tai Chi exercise was provided twice a week for 24 weeks. Outcome measurements were conducted by a physiotherapist at a university hospital health promotion center who did not know the group assignment. RESULTS: At 6 months, the experimental group had significantly greater grip strength(t=2.12, p=.04), back muscle strength (t=2.42, p=.02), balance (t=5.31, p<.001), and flexibility (t=3.57, p<.001). They also showed significantly greater bone mineral density of lumbar spine and femur, and reduced fracture risk. CONCLUSION: Tai Chi exercise was safely and effectively used with institutionalized elders for 6 months and significantly improved physical fitness, bone mineral density along with a reduction in fracture risk. Whether Tai Chi exercise would lead to prevention of fall episodes and fall related fractures in this population will require further study.

A Study about Elder Abuse Experiences of Elderly People / 재활간호학회지

PURPOSE: This study was to explore elderly people's elder abuse experiences, and the relations between the abuse experiences (direct and indirect) and their level of activities of daily living, family relations and self-integrity. METHOD: A descriptive survey was conducted, and the participants were 108 elderly people. Data were analyzed using SPSS by descriptive statistics and t-test. RESULT: It was that indirect abuse experiences of the elder was higher than direct abuse experiences. In this research, the most common kind of direct elder abuse was 'psychological abuse and negligence', and the severity was low. The largest portion of indirect abuse experiences belonged to 'physical abuse and negligence', and the severity was high. The older people who had direct abuse experiences showed lowered self-integrity and serious family problems and stress. CONCLUSION: The experiences of elder abuse showed differences in family relations and self integrity. Hence, there should be a nursing intervention improving psycho-social factors such as self integrity and family relations, and systematic and easily available supporting organizations for victims of elder abuse.

The Effect of Health Care Program for Newly Married Couple in a Community Health Care Center

PURPOSE: The research purpose was analysis of the effect of a health education program for newly-married executed from 2003 to 2005 as a part of health care service from community health center and providing the fundamental source for health education needed during newly-married. METHOD: The data collection with structured questionnaires was conducted during October to December in 2006. From the health center 106 brides who participate the program and 130 brides who didn't participate. Health care program for newly married couple were composed health examinations and health educations. Health examinations were CBC, LFT and Ag & Ab prevallence rates of hepatitis B, rubella. Health educations were done two times, the first individual health education was done at enrolled in health center for establishment of desirable couple relationship, family planning, contraception method and management of pre-pregnancy. The second individual health education was done for explanation of blood examination results, prevention of the congenital deformity and the vertical transmission of hepatitis B, management for pregnancy, breast feeding method, introduction to safety delivery method and encouraging self-study using by materials made by health center after two weeks at revisiting health center. SPSS/PC(ver. 12.0) and chi2-test, t-test was used to analyze the collected and tabulated data. Socio-demographic characteristics and regional characteristics of residence area of two groups shows no significant difference. RESULT: As a variables of experimental effect, The natural childbirth rates of participants group was significantly higher than Non-participants group(p=.012). Breast feeding rates for participants group was also statistically significant higher than Non-participants group. Contraception rates showed no significant difference. The rubella vaccination rates (p=.001) and The hepatitis B vaccination rates (p=.012) shows statistical differences. CONCLUSION: Therefore health care program for newly married couple in a community health care center was effective generally. We supposed that explore participation ways for non-participants, expand the program to community health care center in whole country.

Cognitive and Physical Function by the Social Disengagement in Institution and Community Living Elderly / 재활간호학회지

PURPOSE: This study was conducted to compare the level of cognitive and physical function by the level of social disengagement in institutions and community dwelling elderly. METHOD: The study subjects were 209 people whose age ranged from 65 to 94. The data were surveyed with social disengagement index, MMSE-K, and ADL, and analysed by SPSS 11.0 using frequency, t-test, ANCOVA and ANOVA. RESULTS: 1) The level of social disengagement was 1.67 in institution and 3.25 in community elderly, and showed statistically significant difference (F=41.07, p<.001). 2) There were statistically significant difference in MMSE-K (F=15.51, p<.000), and activity of daily living (F=9.65, p=.002) between two residence after control the age, gender, religion, allowance and number of children. 3) There were statistically significant difference in MMSE-K (F=6.55, p=.002) by social disengagement in community dwelling elderly. CONCLUSIONS: Programs for successful aging to reduce social disengagement should be developed that stimulate social activities and then improve cognitive function for the elderly. For these, establishing social policies in nation and local government is needed. Especially, these policies should be conducted among the elderly with low-income living in institutions.