This study was to identify various personal characteristics between those having a helper and those not having a helper for ADL and IADL performance in noninstitutionalized elders. Secondary analysis was done with the data collected in 1994 national survey of aged householders. Of the elders with ADL limitations $47.8\%$ had no helper. while $26.2\%$ of those with IADL limitations had no helper. Those elders with a helper experienced more limitations in ADL and in IADL than those with no helper. Most of the helpers were family members. whereas very few had a formal helper. Age period and subjective economic status were significantly different between the groups with a helper and with no helper for both ADL and IADL. Compared to the elders with a helper. those elders with no helper had fewer children living together. whereas they had more grandchildren. They also had more contacts with friends or neighbors. Health status. in general. was worse in those elders with a helper than those with no helper. Logistic regression analysis revealed that ADL and IADL limitations had largest influence on having an ADL helper. The odds ratios for low levels of subjective economic status were very high. As for having an IADL helper. IADL score was the most important predictor. In particular. ADL limitations had a negative effect on having an IADL helper. This finding may indicate the urgency of ADL needs. which leads to the lack of an IADL helper when both ADL and IADL limitations are present. Considering the nature of ADL. those disabled elders with low economic status need public support for their daily activities and for home visiting nursing services. There should be studies of examining the adequacy of help in satisfying basic needs for performing ADL and IADL in elders.
The purpose of this study was to analyze characteristics related to the activity of Daily Living (ADL) and dementia among the elderly people who have Medicaid. The cross-sectional descriptive survey study was a nationwide randomization sampling among the population of elderly families who have Medicaid. The data were collected during the month of October, 1999 and total sample was 1,027 elderly people. There were major findings according to the studies. In the results of the ADL assessment most of elderly people were within the 24 to 45 point range. Also, 63.3% of elderly people who made 45 points do not need help when performing daily activities according to the 15 areas of activity components, and 4.9% of these people couldn't do their daily activities. The results of the Dementia assessment were 70.6% of elderly people were in the normal range, 21.7% have a mild case, and 2.8% have severe case of dementia. These were found by using instruments for mental states, which simplified to items of detection of early dementia. In the result of these tests, there was a significantly positive correlation between ADL and degree of dementia with the pearson correlation coefficients. As a result of these studies, the author recommend to strengthen function and organization of public health like a visiting nurse center for elderly people who are over 65 years old. In addition, the government should apply early detection and management system for dementia in the community continuously and cost-effectively, especially for elderly people who live alone and are vulnerable elderly as our priority.
There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.
The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.
Purpose: The purpose of the study was to compare levels of health-related quality of life (HRQOL) between fallers and non-fallers among community-dwelling elderly people. Methods: A cross-sectional comparative study was conducted with the secondary analysis of 2,067 elderly people registered in S-Gu Visiting Health Care Program in Seoul, South Korea. Participants were 206 fallers and 206 non-fallers who were age- and sex-matched with fallers. HRQOL was measured by SF-8 including physical component summary (physical HRQOL) and mental component summary (mental HRQOL). Results: There were more people in the faller group having more than or equal to three chronic diseases (p<.001), living in multiplex houses (p=.004), and being dependent by the activities of daily living (ADL) (p=.001) and instrumental ADL (IADL) levels (p<.001) than those in the non-faller group. Fallers had higher levels of depression than non-fallers (p<.001). Moreover, fallers had significantly lower levels of both physical HRQOL (p<.001) and mental HRQOL (p=.001), after adjusting for number of chronic diseases, ADL, IADL, depression, healthcare insurance, and living environment. Conclusion: Among the community-dwelling elderly people, falllers had lower levels of HRQOL than non-fallers, and such a difference remained even after the adjustment for covariates. Factors that underlie the different susceptibility to HRQOL need to be explored.
This study was done to investigate how importantly midwives thought of Lamaze Method of Childbirth, how satisfactorily they performed their Lamaze Method of Childbirth and what inhibited their activities from being performed if not done satisfactorily. The subjects of this study were 76midwives at midwifery in Pusan, Deagu, Kyungnam and Kyungbok. Data were collected by using questionaire from Sep. 1 to Sep.30, 1991. The measurement tools was maded by the researcher based on Kim's scale for prenatal nursing activities. The statistical analysis was done with based statistical values likes frequencies, means, standard deviations and advanced methods such as Pearson's correlation coefficient, 1-test, F-test, F-test by using SPSS package program. The results of this study can be summarized as follows ; 1. The results of Investigating perception according to importance degree and performance degree of Lamaze Method of Childbring showed that midwives were slightly below both perception according to importance(2.17) and performance(2.16) of Lamaze Method of Childbirth 2. Inhibiting factors of Lamaze Method of Childbirth were abscence of husband(3.08), lack of teaching room(2.71), and lack of books or literature of Lamaze Method (2.58). 3. There appears to be a positive relation between perception according to importance degree and performance degree of Lamaze Method of Childbirth (r=0.69, P<0.01). There appears to be a negative relation between perception according to importance degree and inhibit factors of performance (r=-0.38, P<0.01). There appears to be a negative relation between performance and inhibit factors of performance (r=-0.22. P<0.01). 4. The item of highest perception defree in prenatal education is 1st, Consultation about sexual life (2.53), End, illustration of the importance of a bath and perinal cleanliness and Avoidance of excessive respiration method and also its comfortable application during uterine contractility(2.45). The item of lowest perception degree is about pregnant symptom sign and predicted date of birth (E.D.C.). On the other hand, The item of highest performance degree is education about nurtrition during pregnacy. 2nd, Illustration of the Importance of a bath and perineal cleanness(2.45). The lowest one is leaching the pregnant woman and her family about the role of husband and her family and also teaching the couple to learn exercise and respiration method (1.84). Though importance perception degree and performance degree is low. Midwives who wert subject in this research shoves that they perform general items concerning prenatal education well. 5. In the relationship between perception according to importance degree of Lamaze Method of Childbirth and the general characteristics of subjects, the differences in mean number of visiting pregnacies for 1 month. 6. In the relationship between performance degree of Lamaze Method of Childbirth and the general characteristics of subjects, the differences in age, marriage, and mean number of visiting pregnancies for 1 month. With the above information we see the importance of midwife prenatal care education and high correlation between performance degree and perception degree. When Lamaze prenatal education is well performed the number of pregnant woman who have follow-up, check-ups increase. Therefore in this research we can validity that there is a relation between Lamaze prenatal education and patient follow-up. This research showes in a situation where if one does not maximally perform a prenatal education there is a possibility that the popular use of midwife activities may encounter obstacles so the education to save new knowledge and training for prenatal education is needed as a function of Lamaze prenatal education, when a special Lamaze education is well performed for the pregnant woman, who follows-up at amidwife clinic. With the above conclusion we can suggest : 1. Continued research which minimized obstacles to Lamaze prenatal education is needed. 2. The official method of midwives is necessary.
This study has been performed to explore process of forming low cost small site housing communities and residential lives of the young elderly around small cities along rural counties of America and Canada, and suggest future implications for Korea. In this study, five low cost small housing zones such as cottage and mobile home parks in non-metropolitan counties of California and Ontario State such as Weed, Paradise, Sun City,, Wellington on the Lake, and Trenton were visited and the elderly residents and service experts were interviewed. The senior concentrating housing clusters were formed primarily from influx of both metropolitan and rural residents for the purpose of seeking warmful localities, traffic connections, and business purposes in theme focused production areas. On the other hand, residential lives in the zones are occasionally negatively influenced by unbalanced concentrations of elderly facilities such as nursing stations and funeral homes. For the future of Korean rural elderly policies, suggestions are made as follows: first, integrated forms of urban and rural township need to be settled as attracting places for early retiring people who seek low cost pastoral oriented but culturally activated environment. Second, a model town of mobile housing structures needs to be initiated as a measure of evaluating adaptation process of those movers. Third, a cooperation system among governmental ministries needs to be formed in order to integrate a long term master plan of establishing traditional rural town of independent housing districts. fourth, productive and active lifestyles need to be maintained for government lead retirement rural villages by limiting expansion of nursing related facilities around the independent areas. Fifth, visiting welfare service programs and volunteer groups need to be further developed for the housing area especially in winter time, when social integration and emotional comforts are extremely limited.
The purpose of this study is to Identify the amount of ability of daily living, depression and quality of life and to examin the relationship among ability of daily living, depression and quality of life of the Indestrial Accident Disabled. Three hundred and forty five industrial accident disabled were randomly selected among who have stayed in Seoul, Incheon, and Gyeonggi area and who were confirmed as the disabled classified according to its severity from the first to fourteenth grade between January, 1998 to December, 2000. Data were collected for one month between August 1, 2001 to August 31, 2001. Each study team was consisted of two members of researcher among 20 members and interviewed the disabled individually by visiting their home. Collected data were analyzed from the frequency, percentages, Correlation, etc. The mean score of ability of daily living was 136.3 out of possible 147. The mean score of depression was 31.5 out of possible 64. The mean score of quality of life was 20.1 out of possible 32. The relationship between ability of daily living and depression was significantly correlated and between depression and quality of life was significantly correlated and between ability of daily living and quality of life was significantly correlated. The industrial accident disabled had been in bad health or faced by difficulties in daily activities even after the completion of therapy for the disability. Especially, they are depressed and perceive lowly their quality of life. So, the rehabilitation program for the disabled should be psychosocial oriented program and a comprehensive service.
This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of aerobic walking exercise program on the physical & psychological functions of home stayed stroke patients. The data were collected during the period of May 20th to August 15th, 2001. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b)suffering from stroke for 6 months to 5 years, (c)without recognition disorder with the MMSE-K score above 25, (d)below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease (f)able to walk beyond 15 minutes for themselves. The aerobic walking exercise program for the experimental group was aerobic exercise and education and supportive care. The aerobic exercise was 8 weeks' period, three times a week, 35 to 50 minutes a day. And the education and supportive care was consisted of one home visiting and 2 times telephoning a week. The data were analysed by $X^2$-test, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. There was insignificant difference in the gait length experimental and control group. There was significant difference in the gait speed between the two groups. 2. There was significant difference in the dynamic valance between the two groups. 3. There was significant difference in ADL score between the two groups. 4. There was no significant difference in the depression between the two groups. As shown above, the results of 8 weeks' the aerobic walking exercise program for home stayed stroke patients produced positive effects on gait speed, dynamic valance, ADL score. And this program was expected that it was more effective in different intervention period, verified program. Also it was needed follow study.
Purpose: This study was attempted to provide the basic data in order to develop a supportive system for the family by investigation of the general and disability-related features of the industrial accident disabled and their family function. Method: Three hundred and forty six industrial accident disabled were randomly selected among those who resided in the Seoul, Incheon, and Gyeonggi areas, and who were confirmed as disabled according to its severity from the first to fourteenth grade from January, 1998 to December, 2000. The data were collected for one month from August 1 to August 31, 2001. Each study team consisted of two members out of 20 researchers and they interviewed the disabled individually by visiting their homes. Collected data were analyzed using frequency, percentages, t-test, ANOVA, and Correlation, etc. Results: The average score for family function was 102.60. The adaptability represented the highest score among the concepts dependent on the family function. The concepts were cohesion, adaptability and communication, which scored as 33.59, 35.38, 33.34, respectively. The family function was significantly different in education, marital status and subjective health status. In particular, the family function was excellent from the industrial accident disabled who had graduated from middle school, was married, and felt healthy. Depression and quality of life were other factors, which were also correlated significantly with the family function. The lower the degree of depression and the better the quality of life, the better the family function. Conclusion: The industrial accident disabled who had been in poor health or faced with difficulties in daily activities even after the therapy for the disability was completed. In particular, their family always had a great burden to care for the disabled and to take financial responsibility. Therefore, the rehabilitation program for the disabled should be family oriented.
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