Factors Associated with Social Isolation in Older Adults using Senior Welfare Centers

Purpose: The purpose of this study was to investigate the factors associated with social isolation in older adults using a senior welfare center. Methods: This study was a cross-sectional survey. Data was collected from June to August 2006 using a questionnaire. A total of 248 older adults responded. Results: About one third (34.9%) of participants responded they felt socially isolated. There were statistically significant differences in living, religion, family and belongingness social support, loneliness, depression, family function, perceived health status, and number of chronic illnesses between socially isolated and non isolated groups. However, factors influencing social isolation were family function (OR=0.954, CI=0.926-0.982), loneliness (OR=1.042, CI=1.002-1.083), depression (OR=1.041, CI=1.002-1.081), and number of chronic illness (OR=1.657, CI=1.153-2.382). Conclusion: We found that some older adults were feeling socially isolated even though the senior welfare center was a good place to meet people. The findings of this study indicated that older adults suffering from social isolation need special attention and may benefit from interventions which promote health and social interactions. Further studies are needed to develop and evaluate an intervention program for this population

Physical Activity and Sleep Patterns in Elderly Who Visited a Community Senior Center

Physical Activity and Sleep Patterns in Elderly Who Visited a Community Senior Center Park, Yeon Hwan1) 1) Assistant Professor, College of Nursing, Seoul National University Purpose: The purpose of this study was to identify the relationship between physical activity and sleep patterns of the elderly. Methods: The subjects of this study were 154 elderly who visited a community senior center in Korea. Data was collected by an interview and a self reported questionnaire, during the period from June to October, 2006. Physical activity was measured by IPAQ Korean version (2006), and sleep pattern by Korean Sleep Scale A developed by Oh et al. (1998). Results: The prevalence of chronic illness in the subjects was 73.4 %. The mean time of vigorous activity was 6.62±31.27 minutes/day during the past week. Moderate activity time was 28.85±50.31 minutes/day and walking time was 28.85±50.3 minutes/day. The total sleep time was 397.63±111.53 minutes/day. Physical activity of the elderly significantly correlated with sex, chronic illness, job, and sleep patterns of the elderly. Stepwise multiple regression analysis revealed that the most powerful predictor of sleep pattern was the satisfaction of sleep. A combination of the number of chronic illnesses, moderate physical activities (MET), and total time of sleep accounted for 44.4% of the sleep pattern. Conclusions: Moderate physical activity is more effective than vigorous physical activity for improving the sleep quality of the elderly.N

Nursing Care of Patients with Dysphagia

Dysphagia becomes an increasingly common problem ad people age; its prevalence and the increased risk of related complications have brought the attention of nurses. Especially with a growing number of older people in nursing homes suffering from dysphagia, need for evidence-bases dysphagia assessment and nursing management increasing worldwide. Older adults with dysphagia can be identified through systematic interviews, observations, and test swallows. The diverse range of causes may manifest in a number of different ways, but should always act as a warning sign, which requires further investigation. Management is multidisciplinary, depending on the underlying cause, extent of dysphagia, likely prognosis, and setting. Nurses have successfully used standardized swallowing assessments to provide early detection and management of dysphagia. Nurses benefit from application of systematic guideline. Early detection and management of dysphagia by nurses using a standardized guideline is essential for evidence- based nursing practice in nursing homes as well as acute care settings.N

Family Caregivers' Stress of the Old Adults

인구의 고령화, 핵가족화, 여성의 사회 진출 증가로 노인을 부양하는 가족이 경험하는 스트레스에 대한 관심이 증가하고 있다. 가족의 스트레스는 가족 체계내의 변화를 야기하는 가족 단위의 생활사건 또는 충격으로 stress coping theory, social stress model, ABCX model, stress process model 등의 이론에서 다루어지고 있다. 가족 스트레스에 영향을 미치는 요인은 스트레스 유발요인과 가족이 처한 상황적 요인으로 구분된다. 스트레스 유발요인에는 노인의 신체기능상태, 기능장애로 인한 증상 등이 포함되며, 상황적 요인에는 부양에 일차적 책임을 지고 있는 가족구성원의 성, 노인과의 관계 유형, 노인과 가족구성원간의 관계의 질, 가족의 경제상태, 부양 기간 등이 포함된다. 노인을 부양하는 가족들은 스트레스 상황에서 신체적, 정신적, 사회적, 재정적 부담감을 경험하게 되는데 부담감이 커지면 가족기능 악화, 가족구성원의 삶의 질 저하, 노인의 장기요양시설 입소 등 부정적인 결과를 초래할 수 있다. 노인 가족의 스트레스를 경감시키기 위해서는 사회적 지지를 증가시키고, 가족구성원에게 사교생활의 기회를 제공하며, 노인과 가족구성원 간의 관계의 질 향상을 도모하고, 스트레스 대처 기술을 증진시키는 것 등이 있다. 특히, 가족 관계 향상 및 케어 연속성에 대한 신뢰를 바탕으로 노인을 시설에 입소시키지 않으면서도 노인 가족들에게 휴식 및 사적인 활동을 위한 시간을 제공할 수 있는 주간보호시설은 노인 가족의 스트레스 경감과 삶의 질 향상을 도모할 수 있는 최선책이 될 수 있다. (Korean J Str Res 2007;15:331∼337)N

The Current Status of Adult Day Care in Korea - Operation, Staffing, and Service -

The Current Status of Adult Day Care in Korea* - Operation, Staffing, and Service - Park, Yeon-Hwan1) 1) College of Nursing, Seoul National University Purpose: The purpose of this study was to describe the operation, staffing, and services provided at adult day care centers in Korea. Methods: The study was a cross-sectional descriptive survey. The subjects were 209 centers among 280 centers registered in Korea (response rate 74.6%). The data was collected from August to December in 2006. Results: 48.8% of centers were located in a city area. The centers were based on the Social Model 65.5% of the centers were open Monday to Friday, an average of 7～8 hours per day. Dementia, stroke or frail elderly could use the center, and 57.4% of centers were used for dementia and stroke elderly together. The enrollment of elderly was 13.5. The number of total staff was 8.27, the number of RNs and social workers was 0.67, and 2.54 respectively. The social services(Meal preparation 98.6%, Special event 98.1%, Transportation, 97.1%) were provided more than the health services(Physical therapy 98.1%, ADL training 95.2%, Counseling 84.7%, Vaccination 82.8%, Health monitoring 78.9%, Health education 78.5%, Bathing 66.1%, and Speech therapy 28.2%). Conclusion: These results suggest we have to develop a health-focused adult day health care model based on the needs of elderly and their families. Nurses will have an important role in adult day health care.N

Concept Analysis of Triage Competency in Emergency Nursing

Purpose : This concept analysis identified attributes and defined triage competency among emergency nurses. Method : Walker and Avant's approach was used to guide the concept analysis. A literature review was completed including 26 studies, 5 reports of related associations, and 5 books. Results : The concept of triage competency in emergency nurses was identified as five attributes: clinical judgment, expert assessment, management of medical resources, timely decision, and communication. Antecedents of the concept were triage education and emergency room experience. The consequences of the concept were efficiency of care, patient rating, and safety. Triage competency in emergency nurses was defined as the comprehensive ability to prioritize patients urgency and allocate limited medical resources. Conclusion : This study is meaningful since it clarified triage competency among emergency nurses. The attributes and empirical indicators of this study will likely lay the foundation for development of triage competency metrics.N

The Effects of the Day Care Service Program for the Elderly and Family with the Stroke Compared with the Elderly and Family in Home

Purpose: The purpose of this study was to identify the effects of the day care service for the elderly and family with the stroke. Method: Data were collected from September 2002 to March 2003 by self report questionnaires and interview. 50 elderlies and families(Gr I) who used day care center were compared with 51 elderlies and families (Gr II) who didn't used. The data were analyzed using independent sample t test and chi square test. Result: The general characteristics, stressors, and situational variables related to outcome variables were homogeneous between two groups. The caregiver burden(t=-2.287, p=.024) score in the Gr I was significantly lower than in the Gr II. However there was no evidence of an effect day care center attendance on the depression of the elderly, the relationship between elderly and caregiver, and the family functioning. Conclusion: Findings indicate that day care service was effective in reducing the caregiver burden of the elderly, however more day care service programs(elderly health management, rehabilitation...)will be added.N

The Effects of support group intervention for spouses of stroke patients on caregiver burden and well-being

학위논문(박사)--서울대학교 대학원 :간호학과 간호학전공,1999.Docto

Influencing Factors on Family Functioning of Caregivers in Families with Stroke Patients

-Influencing Factors on Family Functioning of Caregivers in Families with Stroke PatientsN

The Effect of an Exercise-based Swallowing Training Program for Nursing Home Residents with Stroke

Purpose: The purpose of this study was to develop a training program for swallowing and to test its effect on swallowing capacity and nutritional status among nursing home residents with stroke. Methods: A swallowing training program was developed by literature review, expert validation and a pilot test. A pretest and posttest quasi-experimental study design with nonequivalent control group was used to evaluate the effectiveness of the program. Swallowing training was conducted for thirty minutes, three times a week for 8 weeks. Swallowing capacity including dysphagia screening score, swallowing symptom questionnaire and tongue pressure, and nutritional status including body mass index and mid arm muscle circumference weremeasured at the baseline and at 8 weeks. Results: The exercised-based swallowing training program consisted of oromotor exercise, expiratory muscle strength exercise and effortful swallow. The participants were 77.2 years old on average. At thecompletion of 8-week program, the experimental group showed better scores in dysphagia screening (p=.039) and swallowing symptom questionnaire (p=.004) and a significant increase in tongue pressure (p=.003). Conclusion: The exercised-basedswallowing training program was safely applied to nursing home residents with stroke and showed a significant improvement of swallowing capacity. Further studies are needed to identify its effect on the nutritional status.N