Career decision profiles and characteristics of nursing students / 한국간호교육학회지

Purpose@#This study aimed to identify the career decision profiles for nursing students and analyze their career barriers, preparation behaviors, decision-making self efficacy, and adaptability according to the career decision profiles. @*Methods@#This cross-sectional study used content analysis. A total of 219 nursing students enrolled in two private Korean universities participated in this study. The data were collected in person and via email between December 8 and 31, 2020. @*Results@#The decidedness and comfort results were statistically significant. Four clusters were identified: undecided-uncomfortable, decided-uncomfortable, decided-comfortable, and undecided-comfortable. Most participants were found to be decided-uncomfortable, followed by decided-comfortable, undecided-uncomfortable, and undecided-comfortable. The self efficacy scores were higher for the decision-comfortable profile than for the undecided-uncomfortable and decided-uncomfortable profiles. The mean adaptability scores were higher for the decision-comfortable profile than for the undecided-comfortable profile. Career barriers were negatively correlated with preparation behavior, decision-making self efficacy, and adaptability, while preparative behaviors were positively correlated with decision-making self efficacy and adaptability. Decision-making self efficacy was positively correlated with adaptability. The mean career barriers, preparation behaviors, decision-making self efficacy, and adaptability scores differed significantly across profiles. The mean career barrier score was higher for the undecided-uncomfortable than for the decided-comfortable profile; preparation behaviors exhibited no significant differences. @*Conclusion@#Tailored career coaching and counseling programs based on personal characteristics and areas of interest are needed for freshmen and senior nursing students to reduce career barriers and to improve preparation behaviors, decision-making self efficacy, and adaptability.

The Risk of Hypertension and Diabetes Mellitus According to Offspring’s Birthweight in Women With Normal Body Mass Index: A Nationwide Population-Based Study

Background@#Maladaptation to vascular, metabolic, and physiological changes during pregnancy can lead to fetal growth disorders. Moreover, adverse outcomes during pregnancy can further increase the risk of cardiovascular and metabolic diseases in mothers. Delivering a large-for-gestational-age (LGA) baby may indicate a pre-existing metabolic dysfunction, whereas delivering a small-for-gestational-age (SGA) baby may indicate a pre-existing vascular dysfunction. This study aims to assess the risk of hypertension (HTN) and diabetes mellitus (DM) in women with normal body mass index (BMI) scores who did not experience gestational DM or hypertensive disorders during pregnancy based on the offspring’s birthweight. @*Methods@#This retrospective nationwide study included women with normal BMI scores who delivered a singleton baby after 37 weeks. Women with a history of DM or HTN before pregnancy and those with gestational DM or hypertensive disorders, were excluded from the study. We compared the risk of future maternal outcomes (HTN and DM) according to the offspring’s birthweight. Multivariate analyses were performed to estimate the hazard ratio (HR) for the future risk of HTN or DM. @*Results@#A total of 64,037 women were included in the analysis. Of these, women who delivered very LGA babies (birthweight > 97th percentile) were at a higher risk of developing DM than those who delivered appropriate-for-gestational-age (AGA) babies (adjusted HR = 1.358 [1.068–1.727]), and women who delivered very SGA babies (birthweight < 3rd percentile) were at a higher risk of developing HTN than those who delivered AGA babies (adjusted HR = 1.431 [1.181–1.734]), even after adjusting for age, parity, gestational age at delivery, fetal sex, maternal BMI score, and a history of smoking. @*Conclusion@#These findings provide a novel support for the use of the offspring’s birthweight as a predictor of future maternal diseases such as HTN and DM.

Chromosomal Microarray Analysis in Fetuses With Ultrasonographic Soft Markers: A Meta-Analysis of the Current Evidence

Background@#Ultrasonographic soft markers are normal variants, rather than fetal abnormalities, and guidelines recommend a detailed survey of fetal anatomy to determine the necessity of antenatal karyotyping. Anecdotal reports have described cases with ultrasonographic soft markers in which chromosomal microarray analysis (CMA) revealed pathogenic copy number variants (CNVs) despite normal results on conventional karyotyping, but CMA for ultrasonographic soft markers remains a matter of debate. In this systematic review, we evaluated the clinical significance of CMA for pregnancies with isolated ultrasonographic soft markers and a normal fetal karyotype. @*Methods@#An electronic search was conducted by an experienced librarian through the MEDLINE, Embase, and Cochrane CENTRAL databases. We reviewed 3,338 articles (3,325 identified by database searching and 13 by a hand search) about isolated ultrasonographic soft markers, and seven ultrasonographic markers (choroid plexus cysts, echogenic bowel, echogenic intracardiac focus, hypoplastic nasal bone, short femur [SF], single umbilical artery, and urinary tract dilatation) were included for this study. @*Results@#Seven eligible articles were included in the final review. Pathogenic or likely pathogenic CNVs were found in fetuses with isolated ultrasonographic soft markers and a normal karyotype. The overall prevalence of pathogenic or likely pathogenic CNVs was 2.0% (41 of 2,048). The diagnostic yield of CMA was highest in fetuses with isolated SF (9 of 225, 3.9%). @*Conclusion@#CMA could aid in risk assessment and pregnancy counseling in pregnancies where the fetus has isolated ultrasonographic soft markers along with a normal karyotype.

Changes in the visual display terminal syndrome of college students in online classes during the COVID-19 pandemic / 한국간호교육학회지

Purpose@#The purpose of this study was to identify changes in the experience rate and level of symptoms of visual display terminal syndrome in college students attending online classes during the COVID-19 pandemic. @*Methods@#Data were collected from February 22 to June 8, 2021 at three measurement points. A total of 117 college students were administered a visual display terminal syndrome survey just before online classes (T1), one month after the start of online classes (T2), and three months after the start of online classes (T3). The collected data were analyzed by frequency and percentage, paired t-test, McNemar test, and repeated measures analysis of variance using the IBM SPSS 25.0 program. @*Results@#The intensity of college students’ visual display terminal syndrome during online classes increased at T2 and T3 compared to T1. The rate of experiencing back discomfort or pain increased abruptly at T2 compared to T1. The intensity of college students’ eye related symptoms and skin related symptoms increased at T2 and T3 compared to T1, while the intensity of college students’ psychological symptoms, general body discomfort, and musculoskeletal symptoms increased at T3 compared to T1. @*Conclusion@#The results of this study suggest that self-care programs are needed to prevent visual display terminal syndrome in college students who are in long-term online classes.

Validity and Reliability of the Korean Version of the Menopause-Specific Quality of Life

Purpose@#This study aimed to evaluate the validity and reliability of the Korean version of Menopause-Specific Quality of Life (MENQOL). @*Methods@#The MENQOL was translated into Korean according to algorithm of linguistic validation process. A total of 308 menopausal womenwere recruited and assessed using the Korean version of MENQOL (MENQOL-K), the World Health Organization Quality of Life BriefVersion (WHOQOL-BREF), and Center for Epidemiological Studies Depression Scale (CES-D-K). In estimating reliability, internal consistencyreliability coefficients were calculated. Validity was evaluated through criterion validity and construct validity with confirmatory factor analysesusing SPSS 23.0 and AMOS 25.0 software. @*Results@#In item analyses, the “increased facial hair” symptom was excluded because of thelow contribution of MENQOL-K. The confirmatory factor analysis supported good fit and reliable scores for MENQOL-K model, and thefour-factor structure was validated (x2=553.28, p <.001, NC=1.84, RMSEA=.05, AGIF=.85, AIC=765.28). The MENQOL-K consists of 28 itemsin 4 domains, including vasomotor (3 items), psychosocial (7 items), physical (15 items), and sexual subscales (3 items). There was an acceptablecriterion validity with moderately significant correlation between MENQOL-K and WHOQOL-BREF. The Cronbach’s a for the 4subsacles ranged from .80 to .93. @*Conclusion@#The MENQOL-K is a valid and reliable scale to measure condition-specific quality of life forperimenopausal and postmenopausal women. It can be used to assess the impact of menopausal symptoms on the quality of life of Koreanwomen in clinical trials.

Prevalence and Factors related to Irritable Bowel Syndrome in University Students / 기본간호학회지

PURPOSE: The purpose of this study was to identify the prevalence of irritable bowel syndrome and factors related to irritable bowel syndrome (IBS) in university students. METHODS: A cross-sectional, descriptive study was conducted using a self-report structured questionnaire with 420 university students. Data collection was done during May and June, 2017. The data were analyzed using descriptive statistics, a t-test, χ² test, and binary logistic regression analysis with IBM SPSS/WIN 22.0 program. RESULTS: The prevalence for IBS was 24% among Korean university students. Family history of IBS (OR=2.98, 95% CI=1.32~6.70), history of stomach and intestinal disease (OR=2.24, 95% CI=1.36~3.77), sleep quality (OR=2.01, 95% CI=1.16~3.48), mild anxiety (OR=2.75, 95% CI= 1.19~6.33) and more than moderate anxiety (OR=2.02, 95% CI=1.02~4.00) were found to be factors related to IBS. CONCLUSION: The prevalence of IBS was high among university students, and sleep quality and anxiety significantly influenced prevalence of IBS in these students. Therefore, interventions to decrease symptom of IBS must focus on management of sleep quality and anxiety.

Psychoeducational Approach to Distress Management of Newly Diagnosed Patients with Breast Cancer

PURPOSE: The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer. METHODS: A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast. RESULTS: Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group. CONCLUSION: These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.

Risk of Emergency Operations, Adverse Maternal and Neonatal Outcomes according to the Planned Gestational Age for Cesarean Delivery

BACKGROUND: The objective of this study was to assess the risk of emergency cesarean deliveries (CDs) and adverse neonatal/maternal outcomes according to the planned gestational age at delivery (GAD) for elective CD. METHODS: The study population consisted of term singleton pregnant women who were booked for elective CD and were subsequently delivered at term by CD, after excluding cases with a trial of labor. The relationship between the planned GAD, risk of emergency CD prior to planned date, and adverse neonatal/maternal outcomes were determined. RESULTS: The frequency of emergency CD, adverse neonatal and maternal outcomes were 9.5%, 4.5%, and 5.9%, respectively. The risk of emergency CD prior to the planned delivery date increased significantly according to the planned GAD (5.8% at 37 weeks, 8.2% at 38 weeks, 13.6% at 39 weeks, and 26.7% at 40 weeks or more of planned GAD, P = 0.005). Emergency CD was associated with an increased risk of adverse maternal outcomes, whereas the risk of adverse neonatal outcomes did not differ. In the total study population including both cases with elective and emergency CD, the risk of adverse maternal outcomes did not increase according to the planned GAD, and the risk of adverse neonatal outcomes decreased significantly according to the planned GAD. CONCLUSION: The risk of emergency CD increased as the planned GAD increased, but the risk of adverse maternal outcomes did not increase and the risk of adverse neonatal outcomes decreased significantly according to the planned GAD in the total study population including elective/emergency CD.

Effects of Medication Reconciliation and Cost Avoidance Analysis by Clinical Pharmacists in a Neurocritical Care Unit

BACKGROUND: The role of clinical pharmacists in medication therapy to improve clinical and economic outcomes has been reported in the literature. This study was conducted to analyze the changes in details of medication interventions before and after the introduction of clinical pharmacists into the care of neurocritical care unit (NCU) patients, and to evaluate the economic effects of clinical pharmacists by calculating the avoidance cost. METHODS: A retrospective study was conducted reviewing the electronic medical records from June 2013 to May 2014 (before), and from June 2016 to May 2017 (after). We calculated the number and rates of intervention, the acceptance rates of it, and also reviewed the list of interventions. We calculated avoidance cost if there was no intervention. RESULTS: The monthly mean number of interventions increased from 8.0 (±5.7) to 31.7 (±12.8) (P < 0.001) and the frequency of intervention also increased from 0.8% to 1.6% (P=0.003). The most frequently provided pharmacist intervention was nutritional support before introduction of clinical pharmacists and discussions on the medication plan after. The number of classified interventions was 14 before introduction of clinical pharmacist services and 33 after. The calculated cost avoidance associated with a clinical pharmacists' integration was 77,990,615 won per year. CONCLUSION: Introduction of clinicals pharmacist into the NCU was associated with increased intervention rates and expanded types of clinical interventions. The cost avoidance achieved by the pharmacists' interventions can be further explored to evaluate if similar expansions of pharmacists' services achieve similar results in other settings.

Development and Validation of the Cancer-Specific Posttraumatic Growth Inventory

PURPOSE: The purpose of this study was to develop a scale to evaluate posttraumatic growth in patients with cancer and to examine the validity and reliability of the scale. METHODS: A literature review, semi-structured patient interviews and an expert panel consultation produced a 27 preliminary item questionnaire. Participants were 150 cancer patients recruited to test the reliability and validity of the preliminary scale. Data were analyzed using item analysis, exploratory factor analysis, convergent validity and internal consistency. RESULTS: Item reduction and exploratory factor analysis led to 23 items, grouped into five subscales which were labelled new possibilities (6 items), coping skills (5 items), preciousness of life (5 items), relating to others (4 items), and personal strength (3 items). Convergent validity was evaluated by total correlation with the Functional Assessment of Cancer Therapy-General (r=.45, p<.001). The final scale demonstrated satisfactory internal consistency (Cronbach's α =.94). CONCLUSION: Findings from this study indicate that the Cancer-Specific Posttraumatic Growth Inventory has validity and reliability and is considered to be appropriate for assessing posttraumatic growth in patients with cancer.

Pretreatment serum human chorionic gonadotropin cutoff value for medical treatment success with single-dose and multi-dose regimen of methotrexate in tubal ectopic pregnancy

OBJECTIVE: To investigate individual pretreatment serum human chorionic gonadotropin (hCG) cutoff value for medical treatment success with single-dose and multi-dose regimen of methotrexate in tubal ectopic pregnancy. METHODS: Eighty-five women who received methotrexate for the treatment of tubal ectopic pregnancy during 2003 to 2015 were selected. Fifty-three women received a single-dose regimen and 32 women received a multi-dose regimen. Medical treatment failure was defined as necessity of surgical treatment. The medical treatment success rate was estimated in both regimens and the pretreatment serum hCG titer to predict the success was assessed by receiver operating characteristics curve analysis. RESULTS: Pretreatment clinical and laboratory parameters were similar between group of single-dose regimen and multi-dose regimen. Treatment success rate was 64.2% in the single-dose regimen group and 71.9% in the multi-dose regimen group (P>0.05). Pretreatment serum hCG titer was an independent prognostic factor for treatment success in each regimen. Serum hCG cutoff value to predict the treatment success was 3,026 IU/L in single-dose regimen group and 3,711 IU/L in multi-dose regimen group. CONCLUSION: We recommend use of single-dose regimen when pretreatment serum hCG <3,026 IU/L but multi-dose regimen may be favored when initial serum hCG level between 3,026 and 3,711 IU/L.

Changes of Supportive Care Needs and Quality of Life in Patients with Breast Cancer

PURPOSE: The purpose of this study was to identify changes of supportive care needs and relationship to quality of life (QOL) in patients with breast cancer. METHODS: 117 patients with breast cancer were administered the Supportive Care Needs Survey-Short form 34 and the Functional Assessment of Cancer Therapy-Breast before adjuvant therapy after mastectomy (T1), at the end of completing adjuvant therapy (T2), as well as 6 months after the completion of adjuvant therapy (T3). Data were analyzed using SPSS/Win 21.0. RESULTS: The highest unmet supportive care needs were observed in the health system and information domain and the psychological domain at each time point. The health system and information (F=22.49, p<.001) and physical and daily living needs (F=5.72, p=.004) were higher at T1 and T2 than T3. The psychological (F=7.43, p=.001) and patient care and support needs were higher at T1 than T2 and T3. Multiple regression analysis showed that breast cancer patients with greater physical and daily living and psychological needs were significantly associated with poorer QOL at all times. CONCLUSION: Supportive care should be timely provided to breast cancer patients to improve their ability to cope with physical and psychological problem and QOL. Breast cancer patients who had more unmet needs in psychological and physical domains were more likely to have a poor QOL.

Changes of Symptom Distress and Quality of Life in Breast Cancer Patients Receiving Adjuvant Therapy

PURPOSE: The purpose of this study was to identify changes of symptom distress and quality of life (QOL) in breast cancer patients receiving adjuvant therapy. METHODS: 113 patients with breast cancer were administered the Memorial Symptom Assessment Scale-Short Form and the Functional Assessment of Cancer Therapy-Breast before adjuvant therapy, both a week and 6 months after completing adjuvant therapy. 71 patients (CTx group) were treated with adjuvant chemotherapy and radiotherapy. 42 patients (RTx group) received only adjuvant radiotherapy. Data were analysed using the SPSS/Win 21.0 program. RESULTS: Compared with the RTx group, patients in the CTx group reported higher overall symptom distress and physical symptom distress. The CTx group reported lower scores in overall QOL, physical well-being and the breast cancer specific domain than the RTx group. CONCLUSION: Findings from this study support that chemotherapy results in higher risk for more severe symptoms and leads to impaired QOL for breast cancer patients. Comprehensive symptom management should be implemented for breast cancer patients receiving chemotherapy.

Prevalence and Characteristics of Chemotherapy-related Cognitive Impairment in Patients with Breast Cancer

PURPOSE: Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy. METHODS: Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses. RESULTS: At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function. CONCLUSION: These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.

Factors Influencing Elevated Distress Scores at the End of Primary Treatment of Breast Cancer

PURPOSE: The purpose of this study was to determine the prevalence of distress and to investigate the related problems in breast cancer patients at the end of primary treatment. METHODS: A sample of 118 participants was recruited among outpatients who had successfully completed primary treatment of breast cancer. Data were collected between July, 2013 and October, 2014 using the Distress Thermometer (DT) scale and problem lists. Descriptive statistics and logistic regression analysis were used to analyze data. RESULTS: Among the 118 patients that participated in this study, 34 patients (28.8%) suffered from elevated distress using the previously validated cut point > or =4 for the DT. Problems most frequently encountered were fatigue (68.8%), worry (59.3%), appearance (51.7%) and memory/concentration (48.3%). Multivariate logistic regression analysis revealed that depression (OR=9.55), worry (OR=8.34), fatigue (OR=8.19) and age (OR=1.14) were independent predictors for elevated distress scores. CONCLUSION: Utilizing the DT, onethird of breast cancer patients screened met criteria for distress at the end of the primary treatment. Breast cancer patients with depression, worry, fatigue and older age should be targeted for distress screening and management.

Impacts of Social Support and Acculturative Stress on Depression among Korean Registered Nurses in the United States / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify the impacts of social support and acculturative stress on depression among Korean registered nurses in the United States. METHOD: In total, 137 nurses were recruited through direct interviews and online surveys. The data were collected through a structured questionnaire from June 1, to September 16, 2012, and analyzed using descriptive statistics, t-test, ANOVA, Scheffe's test, Pearson correlation coefficient, and stepwise multiple regression with SPSS WIN 14.0. RESULTS: Social support significantly differed by the length of one's nursing career in US, monthly income and perceived health status. Acculturative stress significantly differed by the length of one's nursing career in US and types of employment setting. Depression significantly differed by the total length of one's nursing career, type of employment setting, and perceived health status. Moreover, Depression was negatively correlated with social support; positively correlated with acculturative stress; social support was negatively correlated with acculturative stress. Factors influencing depression were acculturative stress, perceived health status, and social support, which explained about 23% of the total variance. CONCLUSION: These results suggest that an adaptation program that decreases acculturative stress and improves social support should be developed and implemented for Korean nurses to help them successfully integrate into the healthcare system of new country.

Factors Influencing Middle-Aged Men's Attitude towards Death / 한국호스피스완화의료학회지

PURPOSE: This study aims to identify factors that influence middle-aged men's attitude towards death. METHODS: The study enrolled 204 middle-aged (range=40~59 years) male residents of Daegu in Korea. Using a structured questionnaire, data were collected in October 4~30, 2010. For data analysis, we used descriptive statistics, t-test, one-way ANOVA, Scheffe's test, Pearson correlation coefficient, and stepwise multiple regression with SPSS WIN 14.0. RESULTS: Participants' attitude towards death significantly differed according to educational level, religion, volunteer activities, and perceived health status. Moreover, their attitude towards death was negatively correlated with life stress and depression and positively correlated with self-esteem, life satisfaction, and coping behavior. The factors influencing the attitude towards death were life satisfaction, daily stress, religion, and depression, which explained approximately 25.7% of the total variance. CONCLUSION: Middle-aged men perform a crucial role in our society, and their attitude toward death affects how they cope with a situational crisis such as a terminal cancer or withdrawal of life sustaining treatment. Therefore, it is necessary to develop and implement a support program for middle-aged men, which offers them with various strategies to better manage their daily stress and improve their life satisfaction and coping skills.

Chronic Obstructive Pulmonary Disease in Korea: Prevalence, Risk Factors, and Quality of Life

PURPOSE: This study seeks to examine prevalence, risk factors, and quality of life of Korean adults with Chronic Obstructive Pulmonary Disease (COPD). METHODS: From the database of the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV-1, 2008), the researchers selected 1,458 adults over the age of 45. The original study was a population-based epidemiological survey of health and nutrition with a stratified multistage clustered probability design. Prevalence of COPD was computed on the basis of the sampling weight. Data were analyzed using descriptive statistics, chi2 test, t-test and multiple logistic regression with the SPSS WIN 18.0 and SAS Ver. 9.1 program. RESULTS: The prevalence of COPD was 18.0% among people older than 45 yr. The prevalence of current smokers was 19.7% in this population and 26.3% in individuals with COPD. Age, gender, education, and smoking levels were found to be risk factors for COPD. Significant difference in quality of life was founded between adults with COPD and the healthy controls. CONCLUSION: The results of this study indicate that COPD is a highly prevalent disease in Korea. To reduce the prevalence of COPD and improve health-related quality of life in patients with COPD, nursing interventions must focus on prevention of risk factors.

The Comparison of Functional Status and the Level of Health Care Needs in Elderly Koreans in Health Care Institutions

PURPOSE: The purpose of this study was to compare functional status and the level of health care needs in elderly Koreans in health care institutions. METHODS: Data were collected from 2,521 elderly patients admitted in 50 health care institutions (hospitals, oriental hospitals, geriatric hospitals, and health care facilities) selected through proportional stratified sampling in 2008. We used a long-term care (LTC) assessment tool developed by the government, which consists of 52 items with 5 subscales. RESULTS: Statistically significant differences were detected in functional status and the level of health care needs among the subjects in different health care institutions. Of the sample population in geriatric hospitals, 48.9% were eligible for LTC Category 1, 20.9% for Category 2, and 17.2% for Category 3, and 13.1% of the subjects were not eligible for any of the categories. Of the sample population in health care facilities, 29.9% were eligible for LTC Category 1, 20.5% for Category 2, and 21.8% for Category 3, and 27.0% of the subjects were not eligible for any of the categories. CONCLUSION: The findings of this study indicate the necessity of the development of an evaluation system that helps determine whether a subject is eligible for LTC.

Cognitive Impairment, Behavioral Problems, and Mental Health in Institutionalized Korean Elders: An Eligibility Issue for Care Settings

PURPOSE: The purpose of this study was to identify the prevalence of cognitive impairment, behavioral problems, and the state of mental health for elderly Korean people who have been institutionalized. METHODS: A cross-sectional, nation-wide survey was performed using an anonymous questionnaire. The participants in this study were 2,521 institutionalized elderly Korean people. A proportional stratified random sampling method was employed. RESULTS: 1) Elders admitted to subacute hospitals and long term care (LTC) facilities showed a higher level of cognitive impairment compared to elders admitted to acute care hospitals. 2) Elders confined in LTC facilities showed a higher level of behavioral problems compared to elders in acute or subacute hospitals. 3) Elders admitted to subacute hospitals and LTC facilities showed more serious mental health problems, such as depression or suicidal ideation, compared to elders in acute care hospitals. CONCLUSION: The results of this study indicate that the severity of cognitive-behavioral or mental health problems do not match well with type of care setting. Therefore, health personnel working with elderly people should be provided guidance on detection and management of cognitive-behavioral and mental health problems. The necessity of a decision support system for eligibility and placement in long-term care is also discussed.