• Journal of Korean Academy of Nursing
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• v.23 no.4
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• pp.678-693
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• 1993

The purposes of this study were to describe the level of vision and hearing impairments, depression and functional capacity, among Korean institutionalized elderly and to examine the relation-ship between sensory impairments, depression, and functional capacity in these people. The final pupose was to test the cognitive function path model using sensory competencies as predictors. A convenience sample of thirty nine male and 90 female subjects with a mean age of 80.5 were the subjects of this study. The subjects were tested for cognitive function, and vision and hearing impairments. Physical function and social function were measured by observation of designated task performance by the subjects. Their level of de-pression was measured using a Geriatric Depression Scale administered through an interview. Individual subjective ratings of hearing and vision were marked by the subjects, on a ladder scale. The results of the study showed that 48.8% of the subjects had a hearing impairment, 63.5% had a vision impairement, and 36.4% had both a vision and hearing impairement. The four sensory groups (no sensory impairement, hearing impairement, vision impairement, hearing and vision impairement) were tested for differences in depression, physical function, social behavior and cognitive function. The only significant difference that was found was in cognitive function, between the no sensory impairement group and the hearing and vision impairement group(F=3.25, P<.05), Subjective ratings of hearing showed a significant correlation with cognitive function(r=.34, p<.001) and with social behavior(r=.31, p<.001). There was no correlation between subjective vision ratings and cognitive function or social behavior. However there was a significant correlation between vision and hearing(r=.49, p<.001). There was also a significant negative correlation between age and vision(r=-.21, p<.01) and between age and hear-ing(r=-.34, p<.001). There was a significant correlation between depression and physical function (r=-.32, p<.001) but there was no correlation between depression and cognitive function or social behavior. Based on the literature review and the result, this study, a path model of sensory competence-> cognitive function- >social behavior was developed and tested : Perceived vision and perceived hearing were the exogenous variahles and cognitive function and social behavior were the endogeneous variables in the model. The path analysis result demonstrated an accept-able fit (GFI=.997, AGFI=.972, X$^2$=.72 (p=.396), RMSR=.019) between the data and the model. There was a significant direct effect($\beta$=.38) of perceived hearing on cognitive function. There was a significant direct effect ($\beta$=.32) of cognitive function on social behavior. The total effect of hearing on social behavior was $\beta$=.32 including the indirect effect ($\beta$=.12) . However perceived vsion had little effect ($\beta$=-.08) on cognitive function. The result of path analysis confirms that hearing levels influence cognitive function, and both hearing and cognitive function levels influence social behavior. However, vision has little effect on cognitive function or on social behavior. For the next study, a combined model of the pre viously developed environment - >depression- > physical and social function model, and the present cognitive function model, should be tested to further refine the functional capacity model. There also a need for longitudinal study of functional capacity and sencory competence in order to better understand how declining sensory competence influences functional capacity and how it effects in-creasing dependency and nursing needs in the elderly.

• Journal of Korean Academy of Nursing
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• v.27 no.3
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• pp.541-549
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• 1997

This study was done to describe health promoting lifestyle and determine affecting factors in elderly based on the Heath Promotion Model by Pender. Cognitive-perceptual factors that were included in this study were self-efficacy and hardiness. Modifying factors were demographic characteristics (sex, age, partner, previous illness, education level. income and religion). The specific purpose of this study was to examine the relationships of self-efficacy, hardiness and the demographic chasteristics to health promoting lifestyle and to determine causal factors affecting the elderly. The subjects were a volunteer sample of 98 elderly in one city in? The instruments for this study were Health Promoting Lifestyle Profile(47items, 4scale), Health Related Hardiness Scale(22i1ems, 6scale), general Self-Efficacy Scale(13i1ems, 5scale). Frequency, percentage, t-test, ANOVA, Pearson's correlation coefficient and Stepwise Multiple regression technique with SAS program were used to analyse the data. The Results of the study are as follows : 1) The average item score for the health promoting lifestyle was 2.63, the highest score on the subscales was interpersonal support (M=3.3), followed by self-actulization(M=2.9), nutrition(M=2.8), stress management(M=2.7), health responsibility(M=2.1) with the lowest bring exercise(M=2.0) 2) A significant difference between education level, income, religion and health promoting lifestyle were found. 3) All of the subscales on health promoting lifestyle were positively related to total hardiness (r=0.330, p<0.001). The hardiness subscale of control was positively related to self-actulization(r=0.276, p<0.01), and commitment was positively related to self-actualization(r=0.315, p<0.001), exercise /nutrition(r=0.245, p<0.01), interpersonal support(r=0.278, p<0.01), stress management(r=0.250, p<0.01). Challenge was positively related to self-actualization(r=0.315, p<0.001), exercise /nutrition(r=0.245, p<0.01). There was no significant correlation between self-efficacy and all of the subscales of health promoting lifestyle. Self-efficacy showed a significant correlation only with control(r=0.469, p<0.001), comittment(r=0.507, p<0.001), challenge (r=0.489, p< 0.001). 4) Comittment, self-efficacy and income explained 25.01% of the variance for the total health promoting lifestyle. The results of this study show that commitment, self efficacy and income predicted the health promoting lifestyle of the elderly. So health promoting programs that increase commitement and self-efficacy should be developed to promote a healthy lifestyle of the elderly, especially those who have low income.

• Journal of Korean Academy of Nursing
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• v.20 no.3
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• pp.307-323
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• 1990

This Study was done to design and test an instrument to measure the health status of the elderly including physical, psychologyical and social dimensions. Data collection was done from July 18 to August 17, 1990. Subjects were 412 older persons in Korea. A convenience sample was used but the place of residence was stratified into large, medium and small city and rural areas. Participants located in Sudaemun-Gu, Mapo-Gu, and Kangnam-Gu, Seoul were interviewed by brained nursing students, and those in Chungju, Jonju, Chuncheon, and Jinju by professors of nursing colleges. Rural residents were interviewed by community health practioners working in Kungsang-Buk-Do, Kyngsang- Nam - Bo, Jonla Buk -Do, and Kyung Ki- Do. The tool developed for this study was a structured questionnaire based on previous literature and then tested for reliability and validity. This tool contained 20 physical health status items, 17 mental-emotional health status items and 38 social health status items. Physical health status items clustered in to six factors such as personal hygiene, activity, home management, digestive, sexual, sensory, and climination functions. Mental-emotional health status items clustered into two factors, mental health and emotional health. Social health status items clustered into seven factors, grandparent, parent, spouse, friend, kinships, group member and religious role functions. Data analysis included percentage, average, S.D., t-test and ANOVA. The results of the analysis were as follows : 1. The tool measuring the health status of the elderly and developed for this research had a relatively high reliavility indicated by a cronbach＝0.97793. 2. Average score of the subjects physical health status was 4, 054 in a 5 point likert scale, mentalemotional health status was 3.803, social health status was 2.939 and the total average was 3.521. The social status of the subjects was the lowest and the next was mental-emotional health status ; physical health status was the highest. 3. Educational background, perceived health status, the amount of pocket money were related to physical and mental-emotional health status and family structure was related mental-emotional physical and social health status. Occupation was related to physical and mental-emotional status. Area of residence was related to metal-emotional and social status. Source of living in the expeneses was related to physical and mental-emotional health status marital status to mental-emotional and social health status, and the number living in the home physical health status and religion to social health status. The following conciusions were derived from the above results ; 1. The health status of Korean elderly was relatively sound but social health status was the most vulnerable. The Social activity for Korean elderly is needed to improve social health. 2. Educational background, perceived health status and the amount of pocket money must be considered in the health assessment criteria of the elderly, Family structure, marial status, occupation, residence variables and sources of living expense must also be considered as significant. 3. A health education program based on the educational background of the elderly, and provision of an occupational socioeconomic welfare policy will be useful in order to increase social health status of Korean elderly.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.4 no.2
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• pp.283-300
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• 1997

This study was undertaken to grasp health-promoting behavior of the elderly and to identify variables related to them in order to facilitate nursing intervention for health promotion of this population. The subjects for this study were 291 old persons obtained by cluster sampling from twenty general social welfare centers located in Tague. Data were collected by self-reported questionnaires from August 13 to September 13, 1996. Questionnaires were developed based on Sherer and others' Self-Efficacy scale, Rosenberg's Self-Esteem scale, Wallston and other's Multidimensional Health Locus of Control scale, Northern illinois University's Helath Self Rating Scale, Walker and others' Health Promotion Lifestyles Profile. Analysis of the data was done by use of descriptive statistics, stepwise multiple regression, Pearson Correlation Coefficient, MANOVA, t-test, and ANOVA. The results were summarized as follows : 1. For the practice of health-promoting behavior, the mean score was 2.89 and range was 3.59 to 2.09. The factor of the highest mean score was regular diet(M=3.42) and factor of the lowest mean score as stress management(M=2.27). 2. The combination of self-efficacy, internal health locus of control, family number, and average monthly pocket money explained 30.0% of the variance of health-promoting behavior. 3. With regard to the relationship between health-promoting behavior and cognitive perceptual factor, self-efficacy correlated positively with health-promoting behavior(r=.4951, P=.0001), self-esteem correlated positively(r=.3263, P=.0001), internal health locus of control correlated positively(r=.3244, P=.0001), perceived health status correlated positively(r=.1355, P=.0274). 4. According to age(F=2.50, P=.0431), sex(t=2.14, P=.0332), marital status(F=7.85, P=.0005), education(F=5.44, P=.0003), family number(F=11.18, P=.0001), people living together(F=7.21, P=.0009), previous occupation(F=5.83, P=.0001), average monthly pocket money(F=7.27, P=.0001), there were differences of health-promoting behavior. The above findings show that health-promoting behavior are related to demographic characteristics, four cognitive perceptual factors(self-efficacy, self-esteem, internal health locus of control, perceived health status). On the basis of the above findings the following recommendations are made ; 1. Nursing interventions enhancing exercise or activity, accountability for health, stress management of the elderly must be provided. 2. Nursing strategies enhancing self-efficacy which is most significant effect on health-promoting behavior must be developed.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.332-344
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• 2000

The subjects of this study were 100 elderly people who were over 60 years of age and had chronic pain. The study examined the matter of quality of life and self-efficacy of elderly patients with chronic pain including the influence of related factors on these variables. Also, by examining their relation, it provides basic data for the development of efficient nursing interventions for the elderly patients with chronic pain. The tools were the general self-efficacy scale by Sherer & Maddux(1982) and a specific self-efficacy Scale(Lorig et al, 1989) modified to better suit the subjects of this study. The quality of life scale by You-Ja Ro(1988) modified to better suit the subjects of this study was used. The data were collected from August to October 1999. Four researchers and two research assistants developed a data collection protocol subjected to a pilot study for confirmation of validity. In this study, the research assistants read the questionaire to the subjects and recorded the responses themselves. The interviews lasted 40-50 minutes on an average. The data thus collected were analyzed in terms of t-test, ANOVA, Pearson's correlation coefficient, using the SAS PC program. The major findings are as follows: 1) For self-efficacy it was found that males had higher self-efficacy than females for specific self-efficacy. But for general efficacy, males and females showed similar results. The the quality of life was found to be higher for males than females. 2) A positive correlation was identified between the specific self-efficacy, general self-efficacy and quality of life. 3) The general characteristics affecting the self-efficacy of elderly patients with chronic pain were employment, age, level of education, spouse, economic status and income. Self-efficacy was higher among those who were employed, aged between 66-70, well-educated, married and rich or having their own income. 4) The general characteristics affecting the quality of life of elderly patients with chronic pain were lodging with children, religion, level of education and economic status. The quality of life was higher among those who lived with their children and were Buddhists, were well-educated and rich.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.271-286
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• 2000

This study is designed to investigate what elders think about the meaning of aging. We have used Q-methods to identify meaning of aging from elders, and developed self-referenced surveys to analyze characteristics In this study, we used a non-structured method to select Q sampling. From 183 Q populations, we selected 36 Q sampling. A total of 32 persons sixty-years or older were randomly selected for P samples, When the Q-sorting was complete, we interviewed the participants at both end of the extremes(agree or disagree), and documented their responses. We used PC QUANL to process the data and used principal component analysis for Q factor analysis. There were five subjective types for the meaning of aging by elders. Of the 32 P-samples of elders, 11 were identified as Type 1, 7 as Type 2, 2 as Type 3, 8 as Type 4, and 4 as Type 5. Type 1 : 'Matured elders' Elders wished the well being of their children, thought older persons should maintain good health, worried about becoming senile, and dependent God believing in life after death. Type 2 : 'Assertive-Rights' Elders categorized as Assertive-Rights insisted on their rights to life as a person. Type 2 elders characterized themselves as people who should keep themselves healthy, become weak and lack sexual desires, act selfish like a child, need to be protected, and be financially independent. Type 3 : 'Passive-Dependents' Elders characterize themselves as those who pray for their children's well being, worry about the children even after their death. and becoming senile. Type 4 : 'Hopeless' The 'Hopeless' type of elders characterized aging as a time to pray for their children, insignificant beings, thoughts were selfish and child-like, poor, worried about going senile, regret their life overall, and preferred to die than to live as an old person. Type 5 : 'Attached-Present' The 'Attached-Present' type of elders thought elderly characterized themselves as acting selfish and child-like, wiser, anxious, regret their life, stand aloof of greed and worldly things, being a model for the society, and deserving to be treated with filial respect. Thus far, Korean elders seemed to have a positive and negative meaning of aging due to the current changes in the society, value system, and family structures. The above five subjective meanings of aging confirm that we need to approach and nurse the elderly differently. Years of aging are a part of and a natural process of life with various physical, psychological, and sociological changes. Nurses need to assist elderly to find the positive meaning of their life by providing appropriate physical, psychological, and social support at an earlier stage in nursing. Based on this study, we could derive the following two implication from the perspectives of science of nursing to care for elders. 1) Based on the studies investigating the type of meaning of aging, we could develop tools to assist in nursing intervention programs for elderly. 2) Based on research on the meaning of aging for different developmental stages of life, we could develop a model for roles for different family members in nursing and caring for the elders.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.690-705
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• 2000

This ethnography was based on Kleinman's explanatory model of a health care system. It is conducted to make thick discription of illness conception of the elderly in a sociocultural context. The basic assumptions were as follows. 1) A health care system is a cultural system, and as with any other cultural system, it is a system of symbolic meanings anchored in a particular arrangement of social institutions and patterns of interpersonal relationships; 2) In all societies health care activities are more or less interrelated. Therefore, they need to be in a holistic manner as socially organized responses to disease that constitute a special cultural system; health care system; 3) Health and illness experiences are the natural process of disease. Individuals who recognized a for state of health, their family, neighbors, and communities define the state, search for causes of the health problems, and response to it. According by, they proceed to search for healing stratagies. So, understanding of the illness experience is the starting point for health care. The study participants were 12 elders aged 60 or more. The fieldwork was conducted in an agricultural clan village of Namwon city. The data collection and analysis were cyclic, from descriptive observation, domain analysis, focused observation, taxanomic analysis, selected observation, componential analysis, and finally cultural themes were all analysed. Proxemic and text analysis techniques were used according to the characteristics of the data. The data of sociocultural context and descriptive data were collected from 1990 to 1992. Informations on illness concepts were collected during 1994 using focused observation. Data confirming and contrast observations were conducted from 1997 and 1999. Illness concepts of the elderly were taxonomized supernatural cause, non-supernatural cause, immediate cause, and ultimate cause. The supernatural ones were ancestors, god of home, god of village, and ghost such as 'sal(evil force of dead man)' and 'gagqui(ghost of begger)'. The non-supernatural ones were Ki, natural phenomenones, natural objects, foods, human and human behaviors. Immediate ones were insufficiency and overflows, discretion and consolidation, disorder and out of order, cloudness and contamination, and fluctuation and stagnation of supernatural cause and non-supernatural ones. Ultimate causes were intrusion and loss of supernatural and nonsupernatural ones. The cultural themes of illness concepts of the elderly are: 1) illness concepts are not based on causality principle, but on reciprocal principle; 2) illness concepts are affected by social level and charicteristics of the patients; 3) the causes of disease are recognized as imposed both positive and negative effects on health based on interpretation of the indiviuals; 4) illness concepts reflects on principles of everyday life of the society members such as hierachial structure and group cohesiveness; 5) illness concepts are ruled on principle of reciprocity and spread; 6) illness concepts are interrelated with physical environment of the participants. It can be concluded that the illness concepts of the elderly in a traditional clan village are a component of health care system as a cultural system based on these results. The these results can be a useful basis for gerontological nursing practice and education.

• Journal of Korean Academy of Nursing
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• v.29 no.4
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• pp.766-779
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• 1999

The purpose of this study was to investigate the relationship between the burden on families who live with an elderly person suffering from senile dementia, and the degree of their depression. There were 400 participants in this study, staying in the Seoul and Kyonggi areas from August 1, 1997 to February 28, 1998. Among the group, 100 participants took care of their patient at home, and another 300 participants left 100 patient at a day-care center, 100 sanatorium for senile dementia(asylum for helpless elderly people), 100 an infirmary for elderly people. Eventually 242 subjects out of the 400 were selected for the data analysis. The Zarit (1980) tool was employed to measure the degree of burden and Zung's(1965) “Self-Rating Depression Scale” was employed for the data analysis. The data was analyzed, and the percentage, t-test, ANOVA and Person's Correlation Coefficient were calculated. The results are as follows : 1. The average degree of burden that care-giving families felt was 49.13, which is somewhat high. 2. The average degree of depression that care -giving families felt was 51.95, which is relatively high. 3. The degree of burden was directly affected by the relation with the patient(F＝2.48, P＜.05), and the socio-economic status of the family(F＝5.17, P＜.05). Its also affected by the patient's educational status(F＝2.17, P＜.05). 4. The degree of depression of the family was significantly dependent on sex(t＝-2.05, P＜.05), age (F＝2.99, P＜.05), the relationship with the patient(F＝3.65, P＜.01), socio-economic status (F＝7.74, P＜.001), occupation(t＝2.82, P＜.01), health status(F＝4.42, P＜.01), and the place of residence(F＝4.30, P＜.01), The patient characteristics was significantly dependent on his/her educational status(F＝3.85, P＜.01), the period of suffering from senile dementia(F＝2.47, P＜.05), and smoking habit(F＝6.17, P＜.001). 5. The relationship between the degree of burden and that of depression reads r＝0.43, which is statistically positive correlation in the high significant level. Upon analyzing the entire summation, most care-givers for elderly patients suffering from senile dementia lack time in caring for themselves. They also experience chronic fatigue and mental discomfort caused by the isolation from society, curtailment of certain activities, a sense of responsibility for their patients, and limits of their endurance in taking care of their patients over time. In conclusion, this study emphasizes the necessity for the following propositions : 1. In order to measure the degree of burden that Korean care-giving families undergo, a new tool must be developed on the basis of Korean culture. 2. An educational program based on the demands that care-giving families undergo must be developed, and its clinical effect also has to be examined.

• Journal of Korean Academy of Nursing
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• v.30 no.2
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• pp.354-365
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• 2000

Purpose: This study was performed to identify the factors that change exercise behave. This study will also classify and identify the characteristics of excercise stages to which the elderly belong Also, to identify the processes of change which influence on the changes in exercise performed by the elderly. Methods: Convenient samples of 198 subjects over the age 60 in Seoul Korea(mean age=70) were selected from elderly communities and were all mentally conpetant older adults. The data were collected from April 1,1999 to May 30, 1999. The research instruments were measured the change in exercise (Marcus et al., 1992b), such as Stage of Change measure(Marcus et al,1992a). The data were analyzed by SAS Program. Results: 1. According to the measure of change without missing data, 191 subjects were distributed each stage of change for exercise: 50 subjects (26.1%), 7 subjects (3.6%), 52 subjects (27.2%), 4 subjects (2%), and 78 (40.8%) belonged to the precontemplation stage, the contemplation stage, the preparation stage, the action stage and the maintenace stage. 2. According to the factor analysis, 6 factors of change were identified as appropriate processes of change and were named by the researchers. The names were; 'Supportive helping relationship', 'Self cognitive determination', 'Environmental reinforcement', Consciousness raising', Reinforcement of negative condition and 'Conversion of negative condition'. 3. According to the stage of change, there were significant mean differences in the 'Supportive helping relationship(F=22.04, p=.0001)', 'Self cognitive determination (F=50.87, p=.0001)', 'Reinforcement of negative condition(F=7.84,p=.0006)'. 4. Through the discriminant analysis, it was found that Self cognitive determination is the most influential variable as one of the processes of change which can discrimiate the three stages of change (precontemplation, preparation, and maintenance). Also the next significant variable was Reinforcement of negative condition. Conclusion: The process of the dey change is one of concepts of The transtheoretical model known as strategies and the techniques people use as they go through the different stages of change. Even though this study is cross- sectional not longitudinal study, the finding of this study gives useful information for exercise intervention, by using this strategy of exercise for elderly in different stages of change in exercise.

• Journal of Home Health Care Nursing
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• v.2
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• pp.19-34
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• 1995

The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).