• Physical Therapy Korea
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• v.24 no.3
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• pp.47-56
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• 2017

Background: Given the potential benefits of wellness programs promoting physical activity of the community-dwelling frail elderly, it is recommended that comprehensive wellness programs combined with the component of physical activity. This may improve overall health and potentially lower the health care cost of the frail elderly. In general, the frail elderly residing in community or those after being discharged from hospitals are often committed to enhancing the status of participation in physical activity. Objects: The purposes of this study were to identify specific shortcomings of current wellness programs as part of continuum of community rehabilitation services and to propose alternatives for the care of the community-dwelling frail elderly. Through this study, geriatric health care professionals may be able to implement assessments and programs to successfully promote an effective continuum of care for the frail elderly. Methods: Article reviews were summarized and evaluated. Results: A model elaborating the relationship between components of successful wellness program and participation in physical activities for the community-dwelling frail elderly are recommended. First, periodic monitoring the levels of physical activity by the use of online measurement system should be considered. Second, individualized adaptive technologies for selecting optimal physical activities for the elderly may be better fit to individuals' current status of physical activity. Conclusion: The current status of physical activity in community-dwelling frail elderly can be monitored by online assessment systems. Through the innovative measurement system, elderly may assess his/her physical activity status overtime, select optimal physical activities matching the status, and create the elderly's own adaptive wellness programs that match to the status while residing in his/her community.

• Journal of Community Nutrition
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• v.2 no.1
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• pp.12-26
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• 2000

In Japan, a new nursing insurance system was enforced in April 2000, where premiums were paid according to the level of necessary care. Our project, Nutrition Care and Management(NCM) for the elderly was started in 1995, funded by the Ministry of Health and Welfare of Japan. The NCM project was to provide appropriate nutrition care for the elderly and to see that it effectively functions as part of the health care services. There were 4 stages to the project : the first stage was to find out the PEM status among the elderly patients in hospital and home-care settings in Japan. The 2nd stage was to develop and evaluate nutritional assessment methods, anthropometry, resting energy expenditure measuring methods using of portable indirect calorimeter, and the convenient protein energy intake assessment methods, etc. for the elderly patients with PEM risk. The 3rd stage was to examine the effectiveness of the nutrition care plan induced of protein energy supplement and team care in improving nutrition among the elderly patients. The last stage was to develop the NCM set for the elderly patient based on the past three years of scientific evidence. it is expected that the NCM system for the elderly will provide adequate nutritional care management, improve the elderly care environment and create effective resource management.

• Korean Journal of Community Nutrition
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• v.23 no.4
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• pp.277-288
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• 2018

Objectives: This study was performed to verify the validity and judgment criteria setting of a health status assessment tool based on dietary patterns for middle-aged women. Methods: A total of 474 middle-aged women who visited the Comprehensive Medical Examination Center at Hanmaeum Hospital in Changwon were enrolled (IRB 2013-0005). The validity was verified using clinical indicators for the diagnosis of metabolic syndrome (MS), and it was used to set the criteria for the tool. A logistic regression analysis was performed for validation. The area under-receiver operation (AUC), sensitivity, specificity, and Youden Index were calculated through ROC curve analysis. Statistical analysis was performed by SPSS 21, and p value <0.05 was considered to be statistically significant. Results: The mean score of the group with no MS (73.3 points) was significantly higher compared to the group with MS (65.7 points) (p<0.001). An analysis of the association between the tool scores and risk of MS showed a 0.15-fold reduction in the risk of MS every time the tool's score increased by one point. As the result of the ROC curve analysis, the assessment reference point was set to 71 points, indicating 77.0% sensitivity and 61.0% specificity. Risk of MS was significantly higher in the group with a score of less than 71.0 than a group with more than 71 points (OR=5.28, p<0.001). Conclusions: This study was the first attempt to develop a health status assessment tool based on the dietary patterns for middle-aged women, and this tool has proven its usefulness as an MS assessment tool through the application of middle-aged women in the field of health screening.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.4
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• pp.421-431
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• 2008

Purpose: Using comprehensive and valid instrument, MDS-HC 2.0, this study aimed to analyze the functional status and to evaluate the care needs of the community-dwelling disabled with cerebral impairment. Method: With a convenient sample of 88 disabled with cerebral impairment, the data were collected at a community health center located in rural area in Choongchung providence in August 2005. Subject's functional status and care needs were evaluated using Minimum Data Set-Home Care version 2.0. Result: Significant proportion of subjects were totally dependent for locomotion-outdoor (26.1%), personal hygiene (24.1%), bathing (24.1%). For IADLs, over 40% of subjects were totally dependent for ordinary house work, managing finances, or shopping. Top five ranked care needs were preventive health care measures (100%), communication disorders (71.6%), visual function (55.7%), health promotion (52.3%), and pressure ulcers (48.9%). The proportion of triggered clinical assessment protocols were significantly higher in disability level I group for the risk of institutionalization (p=<.001), communication disorders (p=.004), cognitive problems (p=.001), pressure ulcers (p=<.001), skin and foot conditions (p=.010), and urinary incontinence and indwelling catheters (p=<.001). Conclusions: It is necessary to provide community based rehabilitation services that are individualized for their service needs thus enhance optimal level of functioning.

• Research in Community and Public Health Nursing
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• v.20 no.1
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• pp.105-111
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• 2009

Purpose: The purpose of this study was to identify minimum datasets for ulcer assessment and to map the minimum datasets to paper-based nursing records for pressure ulcer care in homecare setting. Methods: To identify minimum datasets for pressure ulcer assessment, the authors reviewed four guidelines for pressure ulcer care. The content validity of the minimum datasets was assessed by three homecare nurse specialists. To map the minimum datasets to nursing records, the authors examined 107 pressure ulcer events derived from 45 pressure ulcer patients who received home nursing from two hospitals in Gyeonggi Province. Results: The minimum datasets for initial assessment were anatomical location, stage, size, tissue, exudate, condition of periwound skin, undermining, odor, and pain. 'Location' was recorded best, accounting for a complete recording rate of 98.1%. 'Exudate' and 'pain' showed the poorest record, accounting for 2.8% and 0%, respectively. The minimum datasets for progress assessment were wound size, tissue, and exudate, each accounted for 31.8%, 2.8%, and 4.7%, respectively. Conclusion: This study concluded that data on pressure ulcer assessment was not sufficient homecare and it can be improved by adopting minimum datasets as identified in this study.

• 대한예방의학회:학술대회논문집
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• 1994.02a
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• pp.405-411
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• 1994

Hazardous wastes released into the general environment are of concern to the public and to public health authorities. In response to this concern, the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (commonly called Superfund), was enacted in 1980 to provide a framework for environmental, public health, and legal actions concerning uncontrolled releases of hazardous substances. The Agency for Toxic Substances and Disease Registry (ATSDR) was created by Superfund to address the public health issues of hazardous wastes in the community environment. Two key Agency programs, Public Health Assessments and Toxicological Profiles, are designed to assess the risk to human health of exposures to hazardous substances that migrate from waste sites or through emergency releases (e.g., chemical spills). The Agency's public health assessment is a structured process that permits ATSDR to identify which waste sites or other point sources require traditional public health actions (e.g.. human exposure studies, health studies, registries, health surveillance, health advisories). The ATSDR qualitative public health assessment complements the U.S. Environmental Protection Agency's quantitative risk assessment. For Superfund purposes, both assessments are sitespecific. ATSDR's toxicological profiles are prepared for priority hazardous substances found most frequently at Superfund sites. Each profile presents the current toxicologic and human health effects information about the substance being profiled. Each profile also contains Minimal Risk Levels (MRLs), a type of risk assessment value. This paper covers ATSDR's experience in conducting public health assessments and developing MRLs, and it relates this experience to recommendations on how to improve chemical risk assessments.

• Research in Community and Public Health Nursing
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• v.26 no.4
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• pp.330-341
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• 2015

Purpose: This study developed a self-report measure for easy assessing of the health literacy of Asian immigrant women in South Korea. Methods: After a literature review, focus group interviews, and content validity evaluation, 14 preliminary items were generated. These were translated into Chinese, Vietnamese, and English. Data were collected from 229 Asian immigrant women. Validity and reliability tests were conducted. Results: Factor analysis yielded final 10 items in three factors: primary functional and interactive health literacy, secondary functional and interactive health literacy, and critical health literacy, which explained 61.90% of the total variance of health literacy. In known-group comparisons, health literacy was significantly lower in recent immigrants, those with a low education level, and those with low Korean language proficiency. For convergent validity, health literacy was positively associated with health specific self-efficacy and maternal health knowledge. For criterion-related validity, health literacy was positively associated with the REALM-SF. The overall reliability coefficient (Cronbach's ${\alpha}$) of the instrument was .773. Conclusion: The Health Literacy Assessment Scale for Asian Immigrant Women (HLAS) represents a multidimensional construct which encompasses functional, interactive, and critical health literacy. This self-report HLAS can be a useful and convenient method for appraising the health literacy of Asian immigrant women.

• Research in Community and Public Health Nursing
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• v.26 no.1
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• pp.18-30
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• 2015

Purpose: The purpose of this study was to investigate the research methods, types and effects of community health center exercise programs for the elderly. Methods: We established the PICOTS-SD (Participants, Interventions, Comparisons, Outcomes, Timing of outcome measurement, Setting, Study Design), reviewed 583 studies from electronic database of DBpia, KoreaMed, KISS, RISS, NDSL and Pubmed, and finally selected 20 studies based on the inclusion and exclusion criteria. Methodological quality was assessed with the Risk-of-Bias Assessment tool for non-randomized studies. Results: With regard to research methods, the majority of studies on community health center exercise programs for the elderly were performed after 2010 and using non-equivalent control group pretest-posttest research design. As for the types and effects of exercise programs, the exercise period ranged from 6 to 28 weeks, and the most common exercise frequency was three times a week for 60 minutes. In addition, mixed-type and group exercise programs were performed most commonly. Conclusion: The results of this study provide a basis for the development of exercise programs to improve elders' health.

• Research in Community and Public Health Nursing
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• v.12 no.2
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• pp.329-337
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• 2001

Purpose: This study was to develop a critical pathway for COPD clients in home health care. Method: Review of literature. Analysis of 10 cases of home health records of COPD clients without other major chronic illness, and Contents validity test Results 1. Vertical axis(l4 activities) physical and mental assessment, family assessment. environment assessment, rights and duties of client, oxygen use and safety, education of disease process and symptom, medication, nutrition and elimination, tests, activities, respiratory exercise, sleeping pattern. consultations and discharge planning. 2. Horizontal axis was set by the number of visits(average number of visits is 6.4) and vertical axis was set with 14 activities and the contents which should have occurred, according to the time frames of the horizontal axis. 3. According to the contents validity test, among the total of 234 items, 176 items showed over 83% agreement and 58 items showed less than 83% agreement. Those items with less than 83% agreements were either deleted or revised. Conclusion this critical pathway is applicable to the home health care of COPD clients to provide quality home nursing care services at lower cost.

• Korean Journal of Community Nutrition
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• v.10 no.1
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• pp.122-131
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• 2005

The purpose of this study was to assess the needs for nutrition programs in the public health centers by general characteristics and body mass index (BMI) of community residents. Information of general characteristics of study participants including age, education, income, marital status, residence, and job, and resident's interest in nutrition programs, the preferred educational methods and the willingness to participate in nutrition programs were collected by an interview. Weight and height were measured and were used to calculate the BMI. The program that resident's were most interested in was 'diet therapy for chronic disease and counseling' ($28.5\%$), followed by 'nutritional management for the elderly' ($21.1\%$), and 'obesity and weight control' ($17.1\%$). 'Education and counseling by nutrition professionals' was the most preferred educational method. Among the programs that the subjects would participate in, if they were offered in public health centers, $65.8\%$ subjects would participate in 'diet therapy for chronic disease and counseling' programs, $64.9\%$ would participate in 'nutritional management for the elderly' programs and $52.2\%$ would participate in 'obesity and weight control' programs. The contents of programs that the subjects were interested in, the preferred methods and their willingness to participate nutrition programs differed significantly by age, income, education, marital status, and body mass index. The results imply that the planning of nutrition interventions in the public health centers must be tailored and targeted group specific by taking the participants general characteristics and body mass index into consideration. This would surely increase the nutrition program's effectiveness