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Fear of Falling and Related Factors in Elderly Living Alone Based on Fall Experience (독거여성노인의 낙상경험에 따른 낙상두려움과 관련요인)

  • Lee, Myungsuk;Lee, Yunbok
    • Journal of agricultural medicine and community health
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    • v.38 no.4
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    • pp.243-256
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    • 2013
  • Objectives: This study was to investigate fear of falling and related factors in elderly living alone based on fall experience. Methods: Participants were 404 elderly women(faller=148, non-faller=256) over 65 years who were homebound living alone in Jeollanam-do Province. Face-to-face interviews were conducted using questionnaires from April $23^{th}$ to June $9^{th}$ 2013. The questionnaires consisted of demographic variables, fall experience, Fear of falling questionnaire(FOFQ), Falls Efficacy Scale(FES) and Center for Epidemiologic Studies Depression(CES-D). The collected data were analyzed using the SPSS version 14.0. Results: The fear of falling and the influential factors were different according to fall experience. Regression model for fear of falling in fallers significantly accounted for 46.1%(F=6.71, p<0.001); difficulty of performing activity, depression, fall-efficacy, static balance and assistive devices. Regression model for fear of falling in non-fallers significantly accounted for 55.2%(F=15.16, p<0.001); fall-efficacy, environmental hazards, difficulty of performing activity, risk of nutrition, housing type, dizziness and assistive devices. Conclusion: Results demonstrate that fall is an important health problem for elderly women living alone, and show fall experience for factors influencing fear of falling. These results could be used in the developing fall prevention programs.

Factors for the Prediction of Pain in Terminally Ill Cancer Patients in Hospice Units (호스피스 병동에 입원한 말기 암환자의 통증 예측요인)

  • Yong, Jin-Sun;Han, Sung-Suk;Ro, You-Ja;Hong, Hyun-Ja
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.125-135
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    • 2002
  • Purpose : The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients in the hospice units. Method : The convenient sample of this study consisted of 58 terminally ill cancer patients at three hospice units in university-affiliated hospitals. Patients were interviewed with structured questionnaires. The data was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. Result : The results of this study were as follows : 1) The mean age of the participants was approximately 57 years. Regarding diagnosis, stomach cancer showed the highest frequency (24.1%), followed by lung cancer (17.2%) and rectal cancer (13.8%). Regarding motivation for admission to the hospice unit, the majority of the participants indicated pain control (67.2%), followed by spiritual care (39.7%), and symptom relief (27.6%). 2) The mean pain level measured by VAS was 5.13 (${\pm}2.61$). Regarding pain type, the highest pain frequency the participants experienced was deep pain (53.4%), followed by multiple pain (20.7%), intestinal pain (17.3%), and neurogenic (5.2%) and superficial pain (3.4%). 3) Regarding the factors influencing pain, the pain level was significantly affected by the depression level (P<0.01) and the opioid use (P<0.01). Conclusion, In summary, the higher the level of pain the terminally ill cancer patents had the higher the depression level as well as the opioid use. Thus, health care professionals need to continuously provide holistic care for them to die comfortably.

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A Study for Investigating of Predictors of Compliance for Preventive Health Behavior. -centered on early detection of cervical cancer- (예방적 건강행위 이행의 예측인자 발견을 위한 연구-자궁암 조기발견을 중심으로-)

  • 이종경
    • Journal of Korean Academy of Nursing
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    • v.12 no.1
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    • pp.25-38
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    • 1982
  • As technological civilization and medical science has developed, standards of living have imp-roved and human life expectancy has been extended. But the incidence and mortality rate of cancer have been gradually increasing due to the pollution of the environment. Even though cancer is still a great threat to human beings, the etiology and appropriate cure forcancerhavenotyetbeendiscovered. The early detection and treatment of cancer is urgently needed. This study concentrates on the health behavior of woman regarding the papanicolau smear for early detection of cervical cancer. It was done in order to provide a direction for scientific health education materials by investigating predictors of preventive health behavior. The subjects for this study were made up of 54 woman, who comply with preventive health practices(compliant) who attended the Cervical Cancer Center of Y University Hospital in order to have tests for early detection of cervical cancer and 54 woman who did not comply with preventive health practices (noncompliant) selected from 100 housewives of I apartment, Kang Nam Ku, Seoul. The study method used, was a questionnaire for the compliance group and an interview for the noncompliance group. The period for data collection was from October 13th to October 24th. 1981. Analysis of the data was done using percentages, T-test, Pearson Correlation and Stepwise Multiple Regression. The results of study were as follows: 1. The hypotheses tested were based on the health belief model; 1) The first hypothesis,“The compliant may have more knowledge of the cervical cancer than the noncompliant”was rejected(T=-1.86, p>.05) 2) The second hypothesis,“The compliant may have a higher severity of cervical cancer than the noncompliant”was accepted (T=5.41, p<.001) 3) The third hypothesis, “The compliant may have a higher susceptability to cervical cancer than the noncompliant”was accepted(T=3.51, p<.01). 4) The fourth hypothesis,“The compliant may have more beneHt than cost'from the cervical cancer tests than the noncompliant" was accepted(T=7.46, p<.001). 5) The fifth hypothesis,“The compliant may have more health concern than the noncompliant”. was accepted(T=3.39, p<.01). These results show that severity, susceptability, benefit(over cost) and health concern influence the preventive health behavior in this Study. 2. In the correlation among variables, it was found that the knowledge of cervical cancer and the benefit(over cost) of preventive health behavior were negatively correlated(r=-2.75, p<.01), Severity of cervical cancer and benefit (over cost) of preventive health behavior were positively correlated(r=.280, p<.01), severity and susceptability of cervical cancer were positively correlated(r= .238, p<.01), benefit(over cost) and health concern were positively correlated(r= .299, p<.01). The benefit(over cost) may be raised by increasing the severity and health concern. Therefore the compliance rate of woman may be raised through health education by increasing the benefit(over cost) of the individual. 3. The Stepwise Multiple Regression between health behavior and predictors. 1) The factor“Benefit(over cost)”could account for preventive health behavior in 34.4% of the sample(F=55.6204 P<.01). 2) When the factor“Severity”is added to this, it accounts for 44.3% of preventive health behavior(F=41.679, p<.01). 3) When the factor“Susceptability”is also included, it accounts for 46.7% of preventive health behavior(F=30.373, p<.01). 4) When the factor “Health concern”is included, it accounts for 48.1% of preventive health behavior(F=23859, p<.05). This means that other factors appear to influence preventive health behavior, since the combination of variables explains only 48.1% of the Preventive health behavior. Therefore further study to investigate the predictors of preventive health behavior is necessary.

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Preference and Performance Fidelity of Modified Korean Physician Order for Life-Sustaining Treatment (MK-POLST) Items in Hospice Patients with Cancer (수정된 한글 연명의료계획서(Modified Korean Physician Order for Life-Sustaining Treatment, MK-POLST) 분석을 통한 호스피스 병동 환자의 의료 중재 항목별 선호도 및 충실도 조사)

  • Han, Ji Hee;Chun, Hye Sook;Kim, Tae Hee;Kim, Rock Bum;Kim, Jung Hoon;Kang, Jung Hun
    • Journal of Hospice and Palliative Care
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    • v.22 no.4
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    • pp.198-206
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    • 2019
  • Purpose: The Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for Patients at the End of Life was enacted in 2016 and has taken effect since 2018 February. The content of this act was based on Physician Orders for Life-Sustaining Treatment (POLST) in the United States and we modified it for terminal cancer patients registering hospice. The object of this study is to investigate preference and implementation rate for modified Korean POLST (MMK-POLST) items in hospice ward. Methods: From February 1, 2017 to April 30, 2019, medical records regarding MMK-POLST were retrospectively analyzed for all patients hospitalized in the hospice ward of Gyeongsang National University Hospital. Results: Of the eligible 387 total cohorts, 295 patients filled out MK-POLST. MK-POLST has been completed in 133 cases (44.1%) by the patient themselves, 84 cases (28.5%) by the spouse, and 75 cases (25.4%) by their children, respectively. While only 13 (4.4%) out of 295 MK-POLST completed patients refused the parenteral nutrition and 5 patients (1.7%) for palliative sedation, the absolute majority of 288 (97.6%) patients did not want cardiopulmonary resuscitation (CPR) and ventilators and 226 people (76.9%) for pressor medications. Kappa values for the matched strength of MK-POLST implementation were poor for all items except CPR, ventilators and palliative sedation. Conclusion: Hospice patients refused to conduct cardiopulmonary resuscitation, ventilators and pressor agents. In contrast, antibiotics, parenteral nutrition and palliative sedation were favored in the majority of patients.

Performance of Occupational Health Services by Type of Service : Cost Benefit Analysis (사업장 보건관리 사업의 형태별 수행성과 분석 -비용편익 분석을 중심으로-)

  • Cho, Tong Ran;Kim, Hwa Joong
    • Korean Journal of Occupational Health Nursing
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    • v.4
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    • pp.5-29
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    • 1995
  • Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

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A Study on Knowledge and Disease Management of Tuberculosis by Themselves of Tuberculosis Patients Among the Middle and High School Students in Seoul. (서울시내 중고등학교 결핵이환학생에 대한 결핵관리실태 및 지식에 관한 조사연구)

  • Do Sung-Sook
    • Journal of Korean Public Health Nursing
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    • v.1 no.1
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    • pp.32-44
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    • 1987
  • The purpose of this survey was to find out the knowledge and the disease management of the Tuberculosis patients by themselves among the first grade middle and high school students in Seoul city during the period of June 15-July 19, 1986. Questionaires were used to collect the data and were analysed from answers of 188 students at the 113 schools. The results were as follows: 1. The ages of the students were distributed as follows: in middle school, 13 years old was $70.0\%$. 14 years old, $20.0\%$, and 15 years old, $6.7\%$. In high school, 16 years old was $66.5\%$, 17 years old, $18.4\%$, and 15 years old, $10.1\%$. 2. In X-ray mass examination by school, the rate of execution was $50.4\%$ in middle school and $96.7\%$ in high school, and in X-ray mass examination by student, it was $50.1\%$ in middle school and $97.3\%$ in high school. 3. The prevalence of Tuberculosis among the middle school students was $00.3\%$and high school students, $0.15\%$. 4. Of the total, $77.1\%$ of the respondents did not realized Tuberculosis bdore X-ray mass examination 5. The perfect cure rate of the respondents was $52.7\%$. 6. General characteristics of the respondents: a. The educational background was varied as follows: of the total $47.9\%$ of the fathers had the level of high school education and $37.2\%$ of the mothers had the level of middle school education. The educational background of the parents had no statistical significant to the medical cure rate of Tuberculosis. (P>0.05). b. The average monthly income of the family was as follows : above five hundred thousand won was $21.8\%$, three or four hundred thousand won was $22.9\%$, and below two hundred thousand won was $10.6\%$. The most frequent family size was 5-6 persons. $(59.6)\%$. 7. The actual situation of Tuberculosis control and the variables related to the treatment: a. $69.1\%$ of the respondents wanted mental support from their surroundings. $48.7\%$ of the respondents answered that their parents or the other family helped treatment as mental supporter, b. As a medical service, $53.2\%$ of the respondents were treated at Health Center, $38.8\%$ were treated at a hospital. A medical service was statistically significant to the medical cure (P<0.01). c. Family members of $61.7\%$ of the respondents had checked chest X-ray. A X-ray examination of family was statistically significant to the medical cure (P<0.005). d. $73.9\%$ of the respondents had taken the Anti-Tuberculosis-drugs regularly. Regular taking of Anti-Tuberculosis drugs was statistically significant to the medical cure (P<0.005). e. $89.4\%$ of the respondents had received a regular examination during the treatment. A regular examination was statistically significant to the medical cure (P<0.05). f. The period of perfect cure was that $50.0\%$ of the respondents took from half a year to one year, $25.2\%$ took below half a year and $16.2\%$ took from one year to one year and a half. g. The rate of the respondents who abhored to let anyone know their disease was $93.1\%$. 8. Knowledge related with Tuberculosis: a .$63.3\%$ of the respondents answered that Tuberculosis is a communiable disease. b. $89.9\%$ of the respondents answered that there is a preventive method of Tuberculosis. Among them, $28.4\%$ answered that it is B.C.G. vacination. c. $96.8\%$ of the respondents belived they can be cured perfectly. d. $42.4\%$ of the perfect curer answered that they had have permanent immunity of Tuberculosis. According to the results of above study, it is desired to be practiced X-ray mass examination to the total middle school students. Nurse teachers and the responsible persons who participated to the helping of disease management to the Tuberculosis patients must make an offer knowledge of Tuberculosis to the Tuberculosis patients. And also, it will be very helpful to the cure of Tuberculosis patients if they do their best and to have a mental supporter.

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An Analysis of the Determinants of Employment and Wage of New College Graduates (신규대졸자의 취업 및 임금수준 결정요인 분석)

  • Chai, Goo-Mook
    • Korean Journal of Social Welfare
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    • v.59 no.4
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    • pp.35-61
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    • 2007
  • This study examines the determinants of employment and wage of new college graduates by using Youth Panel Data(2003-2005) of the Work Information Center, and seeks assignments for mitigating unemployment and wage disparities of new college graduates. Results are summarized as follows. First, an analysis of the determinants of employment shows that the Kyunggi Inchon district in school locations, higher school records, and qualification certificates positively affect the employment rate, while the private college group in the non-capital area negatively affects the employment rate. Second, an analysis of determinants of standard employment demonstrates that the Kyunggi Inchon district in school locations, higher school records, qualification certificates, and the major group of medical science, pharmacy, nursing science and health science, and the major group of education positively affect the employment rate, while the private college group in the non-capital area, the junior college groups in the capital and non-capital areas negatively affect the employment rate. Third, an analysis of determinants of nonstandard employment shows that the junior college graduation in scholarly attainments, the junior college groups in the capital and non-capital areas positively affect the employment rate, while the private college group in the non-capital area negatively affects the employment rate. Fourth, an analysis of the determinants of wages demonstrates that male in sex, the older in ages, the major group of medical science, pharmacy, nursing science and health science, and the major group of education positively affect the wages, while nonstandard employment, Kyunggi Inchon and Cholla districts in school locations negatively affect the wages. These results suggest several implications. First, college education should be reformed to cultivate professional manpower who are required by industries. Second, alternative measures to mitigate sex discrimination in labor markets should be prepared. Third, the process of attaining qualification certificates should be reformed in order that it is actually connected to the abilities of work performances and the improvement of productivity. Fourth, a locally balanced development must be realized through the decentralization of industries. Fifth a systematic and comprehensive program need to be prepared to promote the employment of new college graduates.

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Comparison of Raw versus Relative scores in the Assessment of Coping Patterns in Chronic Arthritis Patients (만성관절염 환자의 대응양상정도와 관련변수 분석 -원점수와 상대점수를 이용한 비교-)

  • Chun, Chung-Ja;Mun, Mi-Suk
    • Journal of muscle and joint health
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    • v.3 no.1
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    • pp.90-103
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    • 1996
  • The purpose of this paper is to compare two approach to assessment of coping patterns. The sampling method was a purposive sampling technique. The study participants were out patients 113 of rheumatoid arthritis center of one University hospitals in Seoul. Datas were collected from Nov. 13 to Nov. 24, 1995. The instruments used for this study were Graphic Rating Scales of pain, The Beck Depression Inventory and Coping Patterns tool. The collected data were analyzed for frequency, means, SD, factor analysis., Pearsons' correlations and ANOVA. The results were summerized as follows ; 1. When raw scores were used : there were not correlation in all three coping patterns. 2. When relative scores were used : there were significantly correlated in all three coping patterns. 1) Active coping and Positive-cognitive coping (r=-0.352, p< 0.0001) 2) Positive-cognitive coping and Negative-cognitive coping (r=-0.594, p< 0.0001) 3) Active coping and Negative-cognitive coping(r=-0.544, p< 0.0001) The results of this research with relative scales provided more insight into the correlation in all three coping patterns. 3. Pearsons' Correlations were computed for each coping pattern, age, pain level, duration of pain and BDI. 1) Using raw score : (1) Active coping was significantly related to pain level(sensory score ; r=0.268, p<0.05, affective score ; r=0.266, p< 0.05) (2) Positive-cognitive coping was significantly related to age (r=-0.252, p< 0.05), pain level (sensory score ; r= -0.244, p< 0.05) (3) Negative-cognitive coping was significantly related to depression level (r=0.312 p< 0.0001). 2) Using relative score (1) Active coping was significantly related to pain level(sensory score ; r=0.299, p<0.05, affective score ; r=0.246, p< 0.05) (2) Positive-cognitive coping was significantly related to age (r= -0.187, P< 0.05), pain level (sensory score ; r=-0.317, p<0.0001, affective score : r=-0.305, p<0.0001) and depression level(-0.339, p<0.0001)) (3) Negative-cognitive coping was significantly related to depression. level(r=0.313, p<0.0001). 4. When raw and realtive coping scores were compared to those of age groups, religious groups and BDI level(high, middle, low) ; 1) Using raw score : (1) Active coping : there were not significantly difference (2) Positive-cognitive coping ; 20-39 age group and 50-59age group had significantly higher scores than over 60age group. BDI-low level group had significantly higher scores than other groups. (3) Negative-cognitive coping : 20-39age group and over 60age group had significantly higher scores than 40-49age group. Non-religious group had significantly higher scores than christian group. BDI-high level group had significantly higher scores than other groups. 2) Using relative score : (1) Active coping : over 60 age group had significantly higher scores than 20-39 age group and 40-49age group had significantly higher scores than 20-39 age group (2) Positive-cognitive coping ; 40-49age group, 20-39age group and 50-59age group had significantly higher scores than over 60age group. Christian group had significantly higher scores than non-religious group. BDI-low level group had significantly higher scores than other groups. (3) Negative-cognitive coping ; Non-religious group had significantly higher scores than christian group and buddhistic group. BDI-high level group had significantly higher scores than other groups. The current data suggest that relative scores may yield a different perspective on coping patters than raw scores. The use of relative scores reveals the relation clearly, without its being blurred statistically by the effect of other coping strategies or being relegated to a partial correlation. The use of relative scores holds promise for delineating the relations between ways of coping and health-related behavior.

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The Effects of Treatment Dumbbell Exercise on Body Composition, Fitness, and Blood Lipid Profiles in Sarcopenic Elderly (미용덤벨 운동이 노인의 근감소증 예방을 위한 신체조성, 체력 및 혈중지질에 미치는 영향)

  • So, Wi-Young;Song, Mi-Soon;Cho, Be-Long;Park, Yeon-Hwan;Kim, Yeon-Soo;Lim, Jae-Young;Kim, Seon-Ho;Song, Wook
    • 한국노년학
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    • v.29 no.3
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    • pp.837-850
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    • 2009
  • Previous epidemiological studies reported that significant muscle loss is observed with advancing aging, called sarcopenia. This study is to investigate the effects of treatment dumbbell exercise on prevention of sarcopenia. The subjects were elderly between 60~70 years old who participated in J-Welfare senior center exercise program at J-gu in S-city and divided into control group(N=19) and exercise group(N=8). Treatment dumbbell exercise was performed 2 times per week for 12 weeks and body composition, fitness, and blood lipid profiles were measured before and after this program. There was no significance in body fat before and after 12 weeks of treatment dumbbell exercise, but there was significance in weight(F=4.312, p=0.048), BMI(F=4.532, p=0.043), and FFM(F=4.743, p=0.039). There was no significance in fitness such as arm curl(F=1.103, p=0.304), and back scratch(F=0.214, p=0.648), but there was significance in 2-minute step(F=33.638, p<0.001), chair stand(F=14.575, p=0.001), chair sit and reach(F=7.198, p=0.013), and 8-ft up and go(F=14.890, p=0.001). The variables of blood lipid profiles such as TC(F=0.030, p=0.864), TG(F=0.142, p=0.710), HDL(F=2.066, p=0.163), glucose (F=0.125, p=0.727), and HbA1c(F=0.945, p=0.340) has no significance. It was found that treatment dumbbell exercise has positive effects on body composition and fitness but has no positive effects on blood lipid profiles of the elderly.

A Study of the Development of a Korea Wind Chill Temperature Index(III) - Principal Experiment for Development of the Korea Wind Chill Temperature Index - (한국형 체감온도지수 개발연구(III) - 체감온도지수 개발을 위한 본실험 -)

  • Park, Jong-Kil;Jung, Woo-Sik;Kim, Byung-Soo;Yoon, Sook-Hee;Lee, Jong-Tae;Kim, Eun-Byul;Park, Gil-Un;Kim, Seok-Cheol;Jeong, Kyeong-Seok
    • Journal of Environmental Science International
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    • v.17 no.10
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    • pp.1093-1109
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    • 2008
  • This paper aims to provide a fundamental basis for the improvement and verification of existing wind chill temperature index through the observation of skin temperature change of human body with air temperature and wind speed. For this, we control air temperature $5^{\circ}C$ interval from $0^{\circ}C$ to $-20^{\circ}C$ and classify wind speed by 0, 2, 6 and 8 m $s^{-1}$ respectively. The results are as follows; At each combination of air temperature and wind speed, the reduction rate of the mean skin temperature are different. When our body is exposed to the atmosphere, the mean skin temperature decreases at an exponential rate. The duration of the steady state is more than one hour, while it decreases with strong wind speed. Among 4 sites on a face, the skin temperature of forehead is the highest, followed by one of chin, left cheek, right cheek in orders. Especially, since the skin temperature of right cheek is the lowest, we think that it is suitable to use the data set of the right cheek skin temperature for the development of a Korea wind chill temperature index as a worst case.