• Title/Summary/Keyword: Community-Dwelling

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Medication Use Review Tools for Community Dwelling Older Patients: A Systematic Review (지역사회 거주 노인을 위한 약물사용검토 도구에 대한 체계적 문헌고찰)

  • Park, Ji-Young;Jun, Kwanghee;Baek, Yang-Seo;Park, So-Young;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.1
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    • pp.61-78
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    • 2021
  • Background and Objective: The use of potentially inappropriate medications (PIMs) increases the risk of negative health outcomes, including drug-related admissions. Tools for structured medication review have been developed to ensure optimal medication use and safety. Here, we aimed to evaluate medication use review (MUR) tools for community-dwelling older patients. Methods: We performed a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). We searched PubMed, Embase, and the Cochrane Library from 1991 to 2020, excluding tools that are specifically applied to hospitalized patients or nursing home residents. We identified the most common inappropriate medications, drug-disease interactions, drug-drug interactions and prescribing omissions presented among tools. Results: From among 9,788 identified reports screened, 60 met our inclusion criteria; finally, 27 were eligible for data analysis considering originality and up-to-dateness. Most tools presented explicit criteria (93%), and only one was specific to community-dwelling elderly. The most common PIM was tricyclic antidepressants. Use of diltiazem and verapamil in patients with heart failure and the combination of nonsteroidal anti-inflammatory analgesics and warfarin were the most frequent disease-specific PIM and drug-interaction, respectively. Conclusions: Although several medication review tools have been developed for older adults, specific guidelines for community-dwelling populations remain limited. Furthermore, the list of PIMs differed among available tools. In future, specific but integrating MUR tools need to be developed for clinical practice considering this population.

Perceived Benefits and Barriers of Exercise in Community-Dwelling Adults at a Local City in Korea (성인들이 지각하는 운동유익성 및 운동장애성에 관한 연구)

  • Hyoung, Hee-Kyoung
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.699-709
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    • 2002
  • Purpose: This descriptive study was aimed to assess the perceived benefits/barriers of exercise in community-dwelling adults in K city in Korea, and to provide a basic data for developing an exercise program for them as a nursing intervention. Method: The study subjects were 520 adults who lived in the K city. The data were collected from February 2 to March 5, 2002. The perceived benefits/barriers of exercise were measured by the Exercise Benefits/Barriers Scale (EBBS). The EBBS was developed by Sechrist. Walker, & Pender (1987) and revised by Jang & Shin (1999). Results: The adults reported that the exercise benefits were moderately high and the exercise barriers were moderately low. A significant relationship was found between the reported level of exercise and the perceived benefits/barriers of exercise. Age, gender, marital status, education, residence type were significantly correlated with perceived exercise benefits/barriers (p<.05). Conclusion: Community health nurses should plan exercise programs that minimize the perceived barriers to exercise and enhance the perceived benefits of exercise. In addition, those exercise programs should be implemented in the consideration of several demographic characteristics of the clinents.

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Depression and Cognitive Function of the Community-dwelling Elderly (지역사회노인의 우울과 인지기능)

  • Seo, Seong Ok;So, Ae Young
    • Research in Community and Public Health Nursing
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    • v.27 no.1
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    • pp.1-8
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    • 2016
  • Purpose: The purpose of this study was to examine the depression and cognitive function of community-dwelling older adults. Methods: 243 aged over 65 in Won-Ju in South Korea participated in this study. Data were collected from April to June 2013 through interviews. This study utilized the Geriatric Depression Scale Short Form, the Korean version of MMSE-DS (MMSE for Dementia Screening), and infirmity testing for basic health status. Descriptive statistics, ${\chi}^2$, t-test, ANOVA, $Scheff{\acute{e}}^{\prime}s$ test, and Pearson's correlation coefficient were used. Results: 75.3% of the participants belonged to the depression group, and the prevalence of cognitive impairment was 17.3%. There were significant differences in depression and cognitive function according to gender, educational level, type of insurance, subjective health, frailty, and whether to be a client of home care service. The level of depression was significantly higher and the level of cognitive functions was significantly lower in older adults in home care services than in community-dwelling older adults. Conclusion: This study is meaningful in that it included older adults in home care services to provide information to develop effective prevention programs for improving cognitive functions. The results of this study can be used to develop future community prevention and intervention.

Effects of Frailty on Health-related Quality of Life of Rural Community-dwelling Elderly: Mediating and Moderating Effects of Fall-Related Efficacy and Social Support (농촌노인의 허약상태가 건강 관련 삶의 질에 미치는 영향: 낙상예방 효능감과 사회적 지지에 의한 매개효과와 조절효과 분석)

  • Choi, Kyung Won;Jeon, Gyeong-Suk
    • Research in Community and Public Health Nursing
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    • v.27 no.4
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    • pp.380-387
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    • 2016
  • Purpose: The purpose of this study was to examine the mediating and moderating effects of fall-related efficacy and social support on the relationship between frailty and health-related quality of life among rural community-dwelling elderly. Methods: A cross-sectional survey was conducted with a convenient sampling method, and data of 438 elderly residents living in a rural community was used. The structured questionnaire included items from the Euro Quality of life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/ depression), fall-related efficacy and social support. Results: Analysis of the mediating effect of fall-related efficacy and social support showed that there was significant mediating influence of fall-related efficacy on the relationship between frailty and health-related quality of life. There were no moderating effects of fall-related efficacy and social support. Conclusion: The findings suggest that fall-related efficacy may play a role in reducing the effect of frailty on health-related quality of life and underscore the need to consider ways of enhancing fall-related efficacy in interventions for rural community-dwelling frail elderly.

Management Strategy by Evaluation on Comprehensive Health Problem in the Community-dwelling Elderly of Korea (재가노인의 포괄적 건강문제 평가와 관리방안)

  • Lee, Jae-Chang;Kim, Eun-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.3
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    • pp.464-472
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    • 2006
  • Purpose: The aim of this study was to define the health problem in the community-dwelling elderly of Korea and to compare differences of CAPs(Client Assessment Protocols) by characteristics. Method: Data was collected by visiting nurse from 556 elderly over 65 years in selected metropolitan areas. To evaluate the functional state of elderly in the community, I used "RAI-MDS HC; Residental Assessment Instrument Minimum Data Set-Home Care(2.0 version)" and established information exchange system among resources, by developing the data into a computer program. Results: The health problem of 'preventive health measures' was the largest(99.6%), and then 'health promotion(85.3%)', 'visual function(75.5%)', 'psychologic drug(68.9%)', 'pain(68.5%)', ‘social function(59.2%)', 'communication disorders(56.2%)', 'environmental assessment(53.2%)', 'depression & anxiety(46.9%)', 'oral health(43.4%)' followed. The number of health problems was average 10.16 in the community-dwelling elderly. Conclusion: The results suggest the need to emphasize the importance of assessment of the health problem of the elderly. We can apply it in the distribution of community resources and the development of service providing programs by figure out the health problem and resource in need for the elderly in the community.

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Comparison of Functional Independence among Community-dwelling Older Adults in Rural Areas in South Korea and the United States

  • Lee, Jia
    • Korean Journal of Adult Nursing
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    • v.24 no.5
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    • pp.540-545
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    • 2012
  • Purpose: The purpose of the study was to compare level of functional independence and its correlates among community-dwelling older adults in rural areas between South Korea and the United Sates. Methods: The study employed a comparative and correlational design. Data were collected from 198 community-dwelling older adults in rural areas (South Korea=100, & US = 98). Functional independence, cognitive function, obesity and general characteristics were measured. Results: From both countries, approximately fifteen percent of older adults living independently had cognitive problems without any treatments. Among Korean older adults functional independence was associated with a number of chronic diseases and aging while in the United States the participants had a negative correlation with obesity and aging. Conclusion: For Korean older adults in rural areas, nurses should focus on monitoring older adults' abilities to manage chronic illness and designing self-management programs while in the United States the focus should be on healthy lifestyle programs about exercise and diet to increase functional independence.

Balance Training Program for Community-Dwelling Elders with Risk of Falls: A Multi-center Randomized Controlled Trial

  • Yang Rae Kim
    • Physical Therapy Rehabilitation Science
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    • v.12 no.2
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    • pp.192-200
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    • 2023
  • Objective: This study aimed to assess the effectiveness of a balance training program in improving balance and functional independence to reduce fall risks among community-dwelling elders. Design: A multi-center randomized controlled trial Methods: A total of 66participants were randomly assigned to a balance training group or a control group. The balance training program, conducted three times a week for 32 weeks, included warm-up exercises, main balance training exercises, and cooldown stretch exercises. Outcome measures included the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), and Modified Barthel Index (MBI). Results: The balance training group demonstrated significant improvements in all outcome measures, indicating enhanced balance, improved functional mobility, and increased independence in activities of daily living. In contrast, the control group showed only slight improvements in BBS, TUGT and MBI scores. Conclusions: These findings provide evidence supporting the effectiveness of balance training programs in reducing fall risk and promoting health and wellbeing among community-dwelling elders. Future research should aim to refine the design of these programs and assess the sustainability of the observed improvements.

Effects of Oral Health Impact Profile (OHIP) on Depression and Quality of Life among Community-dwelling Korean Elderly Persons (노인의 구강건강 영향지수가 우울과 삶의 질에 미치는 영향)

  • Lee, Hung Sa;Kim, Chunmi
    • Research in Community and Public Health Nursing
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    • v.23 no.3
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    • pp.338-346
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    • 2012
  • Purpose: The purpose of this study was to examine the association between oral health impact profile, depression and quality of life among community-dwelling elderly persons in South Korea. Methods: The design of this research was cross-sectional descriptive study. The participants were 266 community-dwelling individuals aged 65 and older. Data were collected from November 20 to December 20, 2011. The measurements for assessing the subjects' oral health, depression, quality of life were OHIP-14, GDS-SF and QOL. Data were collected using self-administered or interviewer-administered questionnaires. Collected data were analyzed using descriptive statistics, Pearson's correlation coefficient and stepwise multiple regression. Results: The participants' mean age was 77.68, and 86.5% were female, 42.9% were living-alone elders. Pearson's correlation coefficient analysis found that oral health impact profile was significantly associated with depression (r=-.622, p<.001), QOL (r=-.400, p<.001), number of disease (r=.298, p<.001), age (r=.198, p=.002), education (r=-.149, p=.015), eating habit (r=.185, p=.003). The QOL was explained 54.7% by depression (${\beta}$=-.619), oral health impact profile (${\beta}$=-.127), number of benefited welfare service (${\beta}$=.235), perceived health (${\beta}$=-.327), eating habit (${\beta}$=-.094) using stepwise multiple regression analysis. Conclusion: These results indicate that the intervention program of oral health promotion for community-dwelling elders is needed from now on.

Predictors of Chewing Discomfort among Community-dwelling Elderly (지역사회 노인에서의 저작불편감 예측요인)

  • Moon, Seol Hwa;Hong, Gwi-Ryung Son
    • Research in Community and Public Health Nursing
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    • v.28 no.3
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    • pp.302-312
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    • 2017
  • Purpose: The purpose of this study was to identify associated factors of chewing discomfort among community-dwelling elderly. Methods: The study was cross-sectional design and secondary data analysis using the 6th Korea National Health and Nutrition Examination Survey. Among the total of 7,550 participants, data was analyzed with 1,126 adults aged 65 years and over. Chewing discomfort was assessed by the perceived chewing discomfort. Multivariate logistic regression analysis was used to find the associated factors of chewing discomfort. Results: Along with 61.7% of the participants reported having chewing discomfort, 85.2% reported to perceive poor oral health and 35.0% had oral pain. In multivariate logistic regression, perceived oral health (OR 3.22, 95% CI 2.24~4.63), oral pain (OR 2.46, 95% CI 1.76~3.43), activity limitation (OR 1.71, 95% CI 1.05~2.80), teeth requiring treatment (OR 1.61, 95% CI 1.14~2.26), number of remaining teeth (OR 1.60, 95% CI 1.22~2.10) and educational level (OR 1.56, 95% CI 1.15~2.12) were the significant predictors of chewing discomfort. Conclusion: The prevalence in chewing discomfort was high in elderly Koreans and various factors were associated with chewing discomfort. To improve chewing ability, it is suggested that the national level of policies offer strategical oral health programs in this population.

The Development and Effect of a Dementia Care Support Program among Community Dwelling Older Adult Men (지역사회 거주 남성노인을 위한 치매 돌봄 프로그램 효과)

  • Ko, Hana;Park, Yeon-Hwan
    • Journal of muscle and joint health
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    • v.27 no.2
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    • pp.81-93
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    • 2020
  • Purpose: We developed and tested the effects of a care program for dementia patients among community- dwelling older adult men. Methods: This study used a non-equivalent control group pre-and post-test design. To verify the effectiveness of the care program for dementia patients, 26 community dwelling older adult men participated in this study. We used multiple intervention strategies including improving understanding of dementia through education, activities for dementia prevention, and promoting psychological change. In particular, based on the current understanding of the care of the men older adults, we used strategies to promote motivation and reinforce strengths. Results: After completing the 6-week intervention program, when compared with the control group, older adult men in the care program intervention group showed significant differences in scores for the following: cognitive functions (p=.035), attitude toward dementia (p=.026), preventive behavior (p=.007), geriatric depression (p=.013), caring confidence (p=.018), and self-esteem (p=.013). Conclusion: These results indicate that the care program for dementia patients has positive effects on increasing their cognitive function, attitude toward dementia, preventive behavior, caring confidence, self-efficacy, and on decreasing depression rates in this population. Based on this, we can recommend this program to men caregivers for the improved care of dementia in community centers.