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A Prediction Model of Fear of Falling in Older Adults Living in a Continuing-Care Retirement Community(CCRC) in United States (미국 노인의 낙상에 대한 두려움 예측모형에 관한 연구)

  • Jung, Dukyoo
    • 한국노년학
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    • v.29 no.1
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    • pp.243-258
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    • 2009
  • Background: Falls are among the most common and serious health problems of older people. The psychological symptoms of falling have received relatively little attention compared to physical problems. Objective: The purpose of this study is to test a model to explain the factors that influence fear of falling among older adults living in a continuing care retirement community (CCRC) in Baltimore city, United States. Methods: A secondary analysis was conducted using data obtained from a Health Promotion Survey done on 149 older adults living in a CCRC. Data was originally obtained during face to face interviews with each participant. Descriptive statistics and bivariate correlations were used to describe the sample and evaluate simple correlations. A path analysis was done using the AMOS 4.0 statistical program. Results: Of the 49 hypothesized paths, 13 were statistically significant, and the model accounted for 22% of the variance in fear of falling among the elderly. There was support for the fit of the model to the data with a nonsignificant chi square at 0.478 (df=2, p=0.79), and the ratio of chi-square to degrees of freedom was 0.24, a CFI of 0.99 and RMSEA of 0.00. In particular, gender, a history of falling, and exercise were significant predictors of fear of falling. Conclusions/Implications: As anticipated, exercise is an important factor to prevent fear of falling. As a modifiable variable, self-efficacy and outcome expectation indirectly influence fear of falling through exercise.

Determinants of Long-Term Care Service Use by Elderly (노인장기요양서비스 이용형태 결정요인 연구)

  • Lee, Yun-kyung
    • 한국노년학
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    • v.29 no.3
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    • pp.917-933
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    • 2009
  • This study examined the factors affecting forms of long-term care service use by elderly and the forms of use are classified facility care service, home care service, and unused. It is used data from the 2nd pilot program for the Long Term Care Insurance scheme and it is analysed 5,497 cases. Multi-nominal regression is used. According to the results, women use formal service more than man do, and wowen use facility care than home care. Those who eligible for National Basic Livelihood Security System(NBLSS) are shown to have higher use of formal care(especially facility care) than the middle income class, and the low income class than the middle income class has lower use of formal care. In addition, higher the family care is available, lower the taking part in the service. The big cities and mid sized cities than rural are used the formal service and moreover mid sized cities are used facility care than home care. Furthermore, the level of care need is determinants of service use and function of ADL, IADL, and abnormal behavior is also determinants of formal service(especially facility care). But nursing need and rehabilitation need are not determinants of formal service use. Based on the results, the recommendations are developed and implemented for the improvement the elderly long-term care insurance.

Factors Influencing the Respiratory Infection Preventive Behavior among College Students (대학생의 호흡기감염 예방행위에 영향을 미치는 요인)

  • Sunhee Lee;Hana Yoo
    • Journal of Practical Engineering Education
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    • v.15 no.2
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    • pp.449-457
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    • 2023
  • The purpose of this descriptive research study was to investigate health beliefs and self-efficacy in respiratory infection management as factors that affect the respiratory infection prevention behavior of college students. The subjects were 178 students attending a university in K city of Gyeongsangbuk-do. Data were collected with a structured questionnaire from September 1st to October 16th of 2020. The results of this study are as follows; Health belief was significantly different from participant's gender (t=-2.86, p=.005), major classification (F=2.95, p=.034), and taking any medications (t=2.18, p=.030). Self-efficacy in respiratory infection management was significantly different from university students' gender (t=-3.56, p=<.001) and major classification (F=4.59, p=.004). Health belief (r=.276, p<.001) and self-efficacy in respiratory infection management (r=.660, p<.001) had a positive correlation with respiratory infection preventive behavior. Multiple regression analysis results show that self-efficacy in respiratory infection management (β=.66, p<.001) significantly affected respiratory infection preventive behavior. The model had an explanatory power of 43%. The findings demonstrate that the major factor influencing the respiratory infection preventive behavior of university students is self-efficacy in respiratory infection management. Therefore, in order to promote behavior to prevent respiratory infection in college students, a program that can strengthen self-efficacy in respiratory infection management should be developed.

The Effects of Learning Flow, Academic Stress and Resilience on Self-efficacy of University Students (대학생의 학습몰입, 학업스트레스, 회복탄력성이 자기효능감에 미치는 영향)

  • Suk Ja Yoon;Eun Kyung Byun
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.5
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    • pp.335-342
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    • 2023
  • This study was attempted to confirm the effects of learning flow, academic stress, and resilience on self-efficacy in college students. This study targeted 304 university students in B and G cities. Data analysis was analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis using the SPSS 22.0 program. The average self-efficacy of the subjects was 3.14±0.62 points, and the difference in self-efficacy according to general characteristics was significant in gender(t=-2.533, p=.012) and satisfaction with major(F=5.687, p=.004). Self-efficacy of the subjects was positive correlation with learning flow(r=.574, p<.001), resilience(r=.525, p<.001), and negative correlation with academic stress(r=-.262, p<.001). Resilience of the subjects showed positive correlation with learning flow(r=.325, p<.001) and negative correlation with academic stress(r=-.291, p<.001). Learning flow showed negative correlation with academic stress(r=-.211, p<.001). Factors influencing the self-efficacy of the subjects were identified as academic commitment (β=.442, p<.001) and resilience (β=.363, p<.001) and the explanatory power was 45.6%. Therefore, in order to improve college students' self-efficacy, it is necessary to develop and apply education and programs that can improve learning flow and resilience.

The Impact of Arthritis Self-management Education on Changes in Arthritis-related Knowledge Levels and Arthritis-specific Self-efficacy of the Aged at a Senior Center (관절염 자가관리 교육이 경로당 노인의 관절염 관련 지식수준과 관절염 특이형 자기효능감 변화에 미치는 영향)

  • Soon-Gyo Yeoum;Jong-Hwa Lee;Sunah Park
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.3
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    • pp.783-790
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    • 2024
  • This study aimed to investigate the impact of arthritis self-management education on changes in arthritis-related knowledge levels and arthritis-specific self-efficacy among elderly individuals at a senior center. This study was conducted with one group pre-test and post-test design. The participants included 48 elderly individuals who utilized four senior centers, and they received arthritis self-management education for three weeks. Data analysis used a paired t-test to compare the effects before and after education. The results of the study showed that arthritis self-management education significantly increased arthritis-related knowledge (t=9.17, p<0.001) and arthritis-specific self-efficacy (t=3.96, p<0.001). There were significant differences in knowledge and self-efficacy levels by age group, with the results varying among participants aged 85 and above. These findings suggest that a three-week education program is appropriate for improving arthritis-related knowledge and self-efficacy among the elderly, and that education should be tailored to different age groups.

A study on knowledge, self-efficacy and compliance in Reumatic arthritis Patients (류마티스 관절염 환자의 지식, 자기효능감 및 치료이행과의 관계연구)

  • Kim, Soon-Bong
    • Journal of muscle and joint health
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    • v.5 no.2
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    • pp.238-252
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    • 1998
  • Reumatic arthritis is a disease with joint pain being one of the key symptoms. The patient suffers from the pain, stiff sensation and edema due to the inflammation taking Place In one or more joints. Accompanying these problems are fatigue, unusual exhaustion, fever, tachycardia and weakness. Inaddition, joints are often deformed and muscles shrink along with the progress of edema, coupled with depression and psychological instability resulting from the loss of the mobile function and limitations on the daily life. Some patients become fed up with the long and hard flight with the disease and just give up, which aggravates the symptoms. Others come to the hospital only when the conditions have become serious. We need to prevent these and guide the patients in the right direction. Against this backdrop, this study aims to look into the relations between the knowledge on the part of the patients together with their feeling of self-efficacy and the compliance. The results are expected to help the patients improve their life, In addition to providing useful materials for setting up appropriate plan for nursing intervention. The study was conducted by distributing questionnaire to 88 patients selected from the out-patient department of a university hospital in Inchon, from April 6 to 27, 1998. The following tools were used the yardstick of self-efficacy, developed in 1997 by the Society for the Health of Rheumatism Patients, was used for measuring the levels of knowledge and the feeling of self-efficacy. The degree of compliance was measured by the data collected from documents in addition to the results of the analysis of the interviews with the patients. The reliability of the tools was confirmed. In the analysis, the general characteristics were expressed in figures and percentages. The levels of knowledge, feeling of self-efficacy, and compliance were expressed in the average values and standard deviations. The relations among the variables following the general characteristics were analysed by the t-test and one-way ANOVA. The Pearson correction coefficient was used for the analysis of factors. Multiple-loop analysis was used to identify the variables affecting the compliance. The following are the results of this study. 1. Among the 88 patients, 18 were men and the remaining 70 were women, with a ratio 1 : 3.87. Regarding the age groups, 23 were between 50 and 59 years old, with those between 50 and 69 accounting for 51.1% of the total. High school graduates or higher amounted to 58%. Religious patients was 67% or 59 persons. Fifty nine percent were unemployed, and 58.3% (49 persons) had two children or fewer. The period of suffering from rheumatism varied between 2 months and IS years, with 70% less than years. 2. The average figure In relation to the of knowledge was 17.63 points over 30 or 58. 76%, which means a medium level. 3. The average figure of the feeling of self-efficacy was 60.06 points. 4. The level of compliance was 3.26, which was above average. 5. The relation between the feeling of self-efficacy and compliance showed an "r" value of 0.37, which was significant. It means that the higher the feeling, the greater the compliance points. 6. The analysis of the knowledge level revealed that the difference is found only between the college graduates and junior-high graduates or lower. 7. The feeling of self-efficacy varied along with the age and education level. 8. The general characteristics of patients as discussed above did not show significant difference with the compliance. 9. Regarding the elements influencing the compliance, the number of children, period of suffering, income, age, feering of self-efficacy, knowledge, and compliance had 54% of significance. In conclusion, rheumatism victims can lead a better life if they are appropriately educated, based on efficient training program from the early days of the disease ; if they become able to manage themselves thanks to the training ; and if they are helped by a program focusing on the increase of the feeling of self-efficacy aimed at changing patient's behavior.

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Changes in Arterial Oxygen Tension($PaO_2$) and Cardiac Arrhvthmias after Endotracheal Suction (기관내 흡인 실시 후의 동맥혈 산소 분압 변화와 심부정맥 발현에 관한 연구)

  • Kim, Sun-Wha;Shin, Jung-Sook;Choi, Young-Hee
    • The Korean Nurse
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    • v.33 no.4
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    • pp.62-85
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    • 1994
  • The data were analyzed by using an S. P. S. S. computerized program for mean, standard deviation, percentage and paired t-test. The results of this study were as follows: 1. The increase in $PaO_2$ after hyperoxygenation and hyperinflation was highly statistically significant(p=0.041), and the increase in $PaO_2$ immediately after suctioning was not significant (p=0.752). The time of lowest $PaO_2$ was 30 seconds after the endotracheal suction. 2. The occurrance of cardiac arrhythmia after the endotracheal suction included sinus tachycardia, sinus arrhythmia, sinus bradycardia, premature atrial contraction (PAC), and premature ventricular contraction (PVC). The most frequent cardiac arrhythmia was sinus tachycardia (a subjects). Sinus arrhythmia was observed in 5 subjects and continued till 10 minutes after suctioning in two of these. Sinus bradycardia occurred in only 3 subjects and among them, 1 subjects shows sinus arrythmia till 10 minutes after suctioning along. PAC was observed in only one subject and continued till five minutes after suctining along with sinus arrhythmia. PVC was observed in three subjects: it lasted for only 30 seconds after suctioning in two subjects. but continued for 10 minutes after suctioning in the third. 6 subjects manifested two kinds of Cardiac arrhythmia Three of them showed sinus tachycardia with PVC, another 2 showed sinus bradycardia with sinus arrhythmia, and the other subject showed sinus arrhythmia with PAC. 3. The increases in heart rate during the endotracheal suction immediately after and at 30 seconds after suctioning were statistically significant (p=0.005). The increase in heart rate at one minute after suctioning was also significant (p=0.023). The increase in heart rate continued until 10 minutes after the endotracheal suction, but was not statistically significant In this study, endotracheal suctioning with hyperoxygenation and hyperinflation was effective in preventing a decrease in $PaO_2$ after suctioning, but not in preventing cardiac arrhythmias. Nurses should be aware of the complications of endotracheal suctioning and do effective hyperoxygenation and hyperinflation before and after suctioning. Further research is needed to develop a efficient endotracheal suction method which will minimize complications. This study needs to be replicated with different population of patients intubatted or having a tracheostomy, specifically, patients who cardiac or pulmonary desease. The data were analyzed by using an S. P. S. S. computerized program for mean, standard deviation, percentage and paired t-test. The results of this study were as follows: 1. The increase in $PaO_2$ after hyperoxygenation and hyperinflation was highly statistically significant(p=0.041), and the increase in $PaO_2$ immediately after suctioning was not significant (p=0.752). The time of lowest $PaO_2$ was 30 seconds after the endotracheal suction. 2. The occurrance of cardiac arrhythmia after the endotracheal suction included sinus tachycardia, sinus arrhythmia, sinus bradycardia, premature atrial contraction (PAC), and premature ventricular contraction (PVC). The most frequent cardiac arrhythmia was sinus tachycardia (a subjects). Sinus arrhythmia was observed in 5 subjects and continued till 10 minutes after suctioning in two of these. Sinus bradycardia occurred in only 3 subjects and among them, 1 subjects shows sinus arrythmia till 10 minutes after suctioning along. PAC was observed in only one subject and continued till five minutes after suctining along with sinus arrhythmia. PVC was observed in three subjects: it lasted for only 30 seconds after suctioning in two subjects. but continued for 10 minutes after suctioning in the third. 6 subjects manifested two kinds of Cardiac arrhythmia Three of them showed sinus tachycardia with PVC, another 2 showed sinus bradycardia with sinus arrhythmia, and the other subject showed sinus arrhythmia with PAC. 3. The increases in heart rate during the endotracheal suction immediately after and at 30 seconds after suctioning were statistically significant (p=0.005). The increase in heart rate at one minute after suctioning was also significant (p=0.023). The increase in heart rate continued until 10 minutes after the endotracheal suction, but was not statistically significant In this study, endotracheal suctioning with hyperoxygenation and hyperinflation was effective in preventing a decrease in $PaO_2$ after suctioning, but not in preventing cardiac arrhythmias. Nurses should be aware of the complications of endotracheal suctioning and do effective hyperoxygenation and hyperinflation before and after suctioning. Further research is needed to develop a efficient endotracheal suction method which will minimize complications. This study needs to be replicated with different population of patients intubatted or having a tracheostomy, specifically, patients who cardiac or pulmonary desease.

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A Study on the School Health Education Programs Performed by School Nurses in Seoul Area (서울 시내 일부 국민학교에서 양호교사가 실시하고 있는 보건교육의 실태조사. (교실 수업을 중심으로))

  • 방에스터
    • Korean Journal of Health Education and Promotion
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    • v.5 no.2
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    • pp.26-40
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    • 1988
  • This survey was conducted to find out the present status of health education program being provided in primary schools focusing its planning, operation, contents and attitude of school nurses in September, 1988. Total 413 school nurses who are presently working in Seoul city was surveyed by mail and 167 school nurses who responded to the questionnaire were finally ana lysed. The following results were obtained. 1. The general charcteristics of the school nurses′ surveyed. As for age distribution, 30-40 age group was 60.4% the highest and the mean age was 30. 13. As for educational attainment, junior nursing college was 71.9%. 68.3% of the surveyed was married and 43.1% of them has 5-10 years of working experiences. As for schools where school nurses are presently working, 31.7% has 2,000-3,000 students, 22.8% has 50-60 classes and 5 schools have more than 80 classes. 2. Planning of a school health education School health education was planned every semester in 55.7%, which was the highest. As for utilization status of the materials for planning of a school health education as a referance, 86.8% of the total respondants utilized the guidelines published by Seoul city School nurses′ Association, and the administrative guidelines for school health, textbooks, school health statistics and articles related to school health in order. It was tried whether the number of referances being utilized was related to the working experiences. It was found that the shorter the experiances, the more materials were utilized. It was answered that teaching plan for health education was prepared by school-nurses themselves (95.2%), and was differentiated as three levels as the first and second grades, the third and fourth grades, and the fifth and sixth grades 3. The contents of the school health education 16 subjects offered to 6 grades of students were surveyed as follows. As for fifth and sixth grades, contents on growth and development was most widely provided as 54.5%, and 68.9%, respectively. And the next to this subject, dental health education was also frequently offered to the second, third and fourth grades as 50.9%, 68.9%, and 47.3%, respctively. 4. The operation of school health education Health education provided by school nurses was conducted formallu in 36.6%, and formally of informally accordin to grades in 43.9%. It was answered that 50.3% of the surveyed school had started health education from 1987, when the plan for activation of school health was ordered from. Educational Committee. Teaching hours of school nurses was 6 in 32.9%, which was the highest. The lesson was provided for class unit in 77.2%, and sex education was sometimes offered to male and female students separately. As for support of health personnels out of school for health education, 79.0% did not receive any support. If there were any aids out of school, 62.9% received them from other related agencies and 74.3% anwered that it was once in a semester. As for expenses for health education, 57.3% did not input any expenses alloted to school health program as a whole. As audio-visual materials, slides were utulized most frequently and models, and charts in order. 5. Awareness of school nurses on the operation of school health education School nurses evaluated their educational quality as a health educator subjectively, 60-70% of them answered to be average in 4 domains such as knowledge, educational skill, ability to prepare teaching plan, and cooperation. As for the awareness on the support and cooperation of the higher institutions, 46.4% -61.8% answered that "so and so" toward Ministry of Education and Ministry of Affairs, and 13-37% "not supportive" Teachers of the corresponding schools were answered to be "so and so" in 55.9%-56.7%, and "very supportive" in 33.34%. There was a significant difference in formality of the lesson according to the support of the superintendent.

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Education Need of the Visit ing Health Service Workers in Gwangju and Jeollanam-do Public Health Facilities (일부 공공보건기관 방문보건요원의 교육요구도 조사)

  • Kim, Young-Lak;Kim, Shin-Woel;Chung, Eun-Kyung;Choi, Jin-Su
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.51-64
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    • 2002
  • This study was aimed to provide the basic data for the development of effective educational program by reflecting the opinions of the visiting health service workers. The subjects were 144 visiting health service workers in Gwangju and Jeollanam-do area who responded the mail questionnaire. The data were collected from June to July, 2001 using questionnaire composed of the education need, knowledge by subjective appraisal, and experience of education. The major findings of this study were as follows: 1. The number of respondents who received at least one education within recent three years were 43(29.9%) at the central level, 57(39.6%) at the provincial level and 53(36.8%) at the district level. The satisfaction with education was higher at the central level than at the provincial and district level. 2. Knowledges by subjective appraisal on the 'chronic degenerative diseases management' and 'health promotion' was relatively high. while that of 'rehabilitation' was low. 3. The knowledge by subjective appraisal of visiting health service was related with experience of education and license status. The knowledge was higher in registered nurses than in nurse aids. The curricula related to increased level of knowledge of visting health service workers were 'elderly health care', 'rehabilitation' and 'psychiatric-mental health nursing' educations at the central level 'continuing education for the community health practioners' and 'psychiatric-mental health education' at the provincial level and 'elderly health care', 'rehabilitation' 'psychiatric-mental health' and 'acute diseases control' educations at the district level. 4. The respondents preferred elderly health management as the contents of education, officer group education as the method of education, province(30.4%) as the main body of education, exercise and practice as the form of education, 2-3 times per year as the frequency of education, and 3-5days as the period of education. The findings of this study could suggest that future education program should be planned to increae the knowledge level of visiting health service workers by reflecting their educational need.

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Evaluation of a Community-Based Cancer Patient Management Program: Collaboration between a Hospice Center and Public Health Centers (병원 호스피스센터-보건소 연계를 통한 지역사회 재가암환자 관리 프로그램 평가)

  • Lee, Hae-Sook;Park, Sun-Hee;Chung, Young-Soon;Lee, Boo-Kyung;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • v.13 no.4
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    • pp.216-224
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    • 2010
  • Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.