• Journal of Korean Academy of Nursing
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• v.26 no.1
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• pp.223-247
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• 1996

This study was done to provide information which would lead to nursing care of the elderly being more holistically through an understanding of the phenomena of powerlessness based on the lived experience of powerlessness by the elderly, the meaning the elderly give to such phenomena, and what essence of powerlessness is. The methodology used in this study was Max Van Manen's phenomenological method based on the philosophy of Merleu-Ponty and a concerted approach was realized through the 11 steps suggested in the Van Manen's method. Data collection was done from March 2, 1995 to December 30, 1995. The subjects for this study were four elderly persons who lived with their families and who were over 60 years of age. Data were collected about the lived experience of the elderly, this researcher's experience of powerlessness, the linguistic meaning of powerlessness, idioms of the word or a feeling of powerlessness, and descriptions of powerlessness in the elderly as they appeared in the literature, are works, and phenomenological literature. All data were used to provide insights into the phenomena of powerlessness. Data about the experience of powerlessness by the elderly were collected through open interviews, participation, and observation. In the analysis of the theme of this study, the aspects of the theme, powerlessness in the elderly were clarified, thereby abstracting and finding meaningful statements by the elderly about their feeling of powerlessness, and then those significant statements were expressed as linguistic transformations. The summarized findings from the study are as follows : 1. Five meanings of powerlessness in the elderly were defined. 〈weakness〉, 〈dependence〉, 〈frustration〉, 〈worthlessness〉 and 〈giving up〉. 2. 〈Weakness〉 means that the elderly experience, not only their aging but also, their becoming weak and the loss of physical function frequently caused by diseases. 〈Dependence〉 means that the elderly experience dependence without any influence from the surroundings and that elderly patients who are hospitalized lose their autonomy, follow entirely their doctor's prescriptions, use aid equipment and directions, and depend only on those things. 〈Frustration〉 means that the elderly experience the loss of their roles from the past, there by feeling that there is no work for them to do anymore and therefore feel unable to do anything. 〈Worthlessness〉 means that the elderly experience the feeling of losing their social roles from the past, having no financial ability, thereby being a burden to their children or the people around them, and therefore regarding themselves useless. 〈Giving up〉 means that the elderly experience the feeling of closeness to death in the final stage of their lifetime, lose hope to be healed from their disease, and recognize the incontrollability of their own body. 3. From a general view of the meaning of the theme the powerlessness in the elderly-the most essential meaning of the theme is the 〈sense of loss〉. For the elderly are experiencing a sense of loss in the situation of being elderly and therefore being often hospitalized. Brief definitions of the five phenomena could be 〈weakness〉 meaning the loss of physical strength, 〈dependence〉 the loss of mentality caused by disease and hospitalization, 〈frustration〉 and 〈worthlessness〉 the loss of social performance caused by the loss of social functions from the past, and lastly 〈giving up〉 the loss of the controllability of such situations of aging and suffering disease. In light of the discussion above, it is understandable that the hospitalized elderly experience powerlessness not only as it related to their diseases but also to their normal aging, and this related to other characteristics of being elderly means that the 〈sense of loss〉 is the very essence of their powerlessness. 4. While most cases are of the normal elderly experiencing powerlessness in relation to their social network, cases of elderly who are hospitalized are of those experiencing powerlessness in relation to the loss of their physical desire. 5. The findings discussed above can serve as guidelines for nurses who take care of the ill elderly who are hospitalized and that can provide cues to appropriate nursing service, recognizing that the subjective experience of the objective age of the elderly is so important. Nurses can provide highly qualitative nursing service, based on their deep understanding of the suffering of the elderly due to feelings of powerlessness.

• Journal of Korean Public Health Nursing
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• v.16 no.2
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• pp.354-377
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• 2002

Aging population is a global trend and Korea is no exception. Due to the progress of the medical and scientific sectors, increase in the average lifetime incurred increase in the number of elderly people. Meanwhile, the family function of supporting the elderly has become a major issue in a society due to the changes in the society's structure and increased entry of the women into the workforce. As a means to substitute the protection of the elderly who are not protected at their respective homes and to replace the tending needs, weekly protection centers and short-stay centers for the elderly were established and operated in Seoul since 1992. However, structured and satisfactory services are not yet to be provided, thus this research intends to understand the current situation at the short-stay centers for the elderly, to identify users' characteristics and to conduct study on nursing need for the health reasons so that the results of the research can be utilized as basic data for the development of nursing care program. Towards this end, this research targeted 142 elderly people who were undergoing treatment at the 11 short-stay centers for the elderly out of total of 13 located in Seoul that were willing to cooperate. The research was conducted from April to May 2002, with the measurement tool developed by Rhee, Seon-ja (2001) to measure the level of nursing need. Then data was collected and analyzed using SPSS program. The results are as follows. The general characteristics of users of the short-stay centers for the elderly were: 123 females $(86.6\%)$, 19 males $(13.4\%)$ and 72 elderly were over the age of 80 $(50.7\%)$. Among these, 24$(16.9\%)$ were living by themselves. Among the illnesses that the subjects were inflicted with were: dementia $(54.2\%)$, stroke $(54.1\%)$ and high blood pressure $(50.7\%)$, in the respective order. Despite the fact that they were diagnosed with illnesses, $47.2\%$ responded that they do not undergo special treatment due to financial reasons. When the level of needs for nursing care among the elderly who use the short-stay centers is divided into informational. physical. and emotional need levels and scored between zero to two, the level of emotional need is the highest with 1.80, followed by physical (1.45) and informational (1.44) need levels. As for the realities of services at the centers and improvement areas, restriction on term was cited as the greatest inconvenience with $38.7\%$, followed by lack of budget (24 respondents, $16.9\%$). Wishful services were financial assistance $(46.5\%)$, medical and nursing services $(40.1\%)$, meal provision service $(8.5\%)$ and counseling service $(4.9\%)$, in the respective order. Based on the above mentioned results, the research identified the need to develop nursing program for the patients of dementia that can be applied onto the short-stay centers and the need to develop volunteer service, backed by societal support. Also, placement of specialized cadre of professionals is needed so that medical and nursing service functions can be provided in a complementary manner.

• Health Policy and Management
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• v.12 no.3
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• pp.1-22
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• 2002

Health is a fundamental human right and a sine qua non for happiness of people and for national development. Government has a responsibility for the provision of health services for their people. Recent changes of disease pattern, i.e. decrease of Infectious diseases and increase of chronic and degenerative diseases Including cancer and cardiovascular diseases, together with universal coverage of health insurance and improved living standard have prompted medical care utilization and skyrocketed the national health expenses. The goal of national health policy is improving the quality of life through the betterment of health level. To achieve this goal it is necessary to establish a healthcare system for lifetime, to improve the efficiency of healthcare delivery system, and to strengthen the public health services for disease prevention and health promotion. The current public health service programs are Inefficient due to an inconsistent policy for health service program, lack of health information system, irrational health program planning and evaluation, and Inadequate training of health workers. Local government has a legal responsibility for health service program planning and promoting the competence of health workers. Thus, municipal and provincial health departments should expand their roles and strengthen their function. The strategies for developing public health service programs at local level are ${\circled}1$ stipulating the goals of health policy, ${\circled}2$ promoting the ability for health program planning and evaluation, ${\circled}3$ establishing health information and surveillance system, ${\circled}4$ training of health workers, ${\circled}5$ establishing an institution for health information management and training of health workers, and ${\circled}61$ collaboration with local universities.