Purpose This study investigated the prevalence and risk factors of undernutrition among older adults living in nonsubsidized Residential Care Homes (RCHs).
Methods: Face-to-face interviews and assessments were conducted in a convenience sample of 298 older adults (aged 65 years or older) residing in nonsubsidized RCHs in Hong Kong in January 2015. Subjects who ate by mouth (with or without assistance) and who had no communication barriers were included. We employed a descriptive cross-sectional study design according to the STROBE reporting guidelines. Data were collected on participants' demographics, history of chronic illness, physical function (assessed by the 10-item Simplified Barthel Index with the self-care ability and mobility subscales), cognitive function (assessed by the 10-item Abbreviated Mental Test), and nutritional status (assessed by the 18-item Mini Nutritional Assessment). After identifying the variables associated with undernutrition, hierarchical multivariate logistic regression was used to identify salient predictors.
Results: In total, 40.9% of participants had undernutrition, which was associated with a longer length of stay in RCHs and poorer physical and cognitive functions compared to adequate nutrition or being at risk of undernutrition. Hierarchical multivariate logistic regression showed that residents with better cognitive function (adjusted Odds Ratio [OR]=0.88) and self-care ability (adjusted OR=0.75) were at a lower risk of undernutrition.
Conclusion: Undernutrition is prevalent among residents in RCHs in Hong Kong and poses a significant risk of cognitive impairment and poor self-care skills. To lessen the likelihood and the consequences of undernutrition, RCHs must give special consideration to residents with these risk factors.
Purpose This study investigated the effects of spiritual well-being on the cognitive function of elderly people, focusing on the mediating effects of health-promoting behaviors and depression. Methods Using convenience sampling, 136 elderly people were recruited from October 2018 through February 2019 for a cross-sectional survey. Data were collected through the Spiritual Well-Being Scale, Health-Promoting Lifestyle Profile, Geriatric Depression Scale, Everyday Cognition, and Montreal Cognitive Assessment and analyzed using descriptive statistics and correlation. Mediation analysis was also conducted using Hayes’ PROCESS macro (Model 4). Results The mean scores for spiritual well-being, health-promoting behaviors, depression, objective cognitive function, and subjective cognitive function were 60.96, 108.09, 18.58, 19.49, and 63.35. The mediation effects in step 1 indicated that spiritual well-being had a statistically significant positive effect on health-promoting behaviors (B=0.32, p<.001) (R2 =32.0%) and a significant negative effect on depression (B=-0.09, p=.001) (R2 =31.0%). In step 2, spiritual well-being had a significant negative effect on subjective cognitive function (B=-0.12, p=.007) (R2 =23.0%). In step 3, the direct effect of spiritual well-being on subjective cognitive function was not significant when the mediating variables (healthpromoting behaviors and depression) were introduced. Health-promoting behaviors (B=-0.18, p=.047) and depression (B=0.41, p=.008) had complete mediating effects on the relationship between spiritual well-being and subjective cognitive function. Conclusion These findings suggest that there is a need to develop and implement nursing strategies that can improve spiritual well-being, and to develop a holistic nursing intervention that considers depression and health-promoting behaviors, when applicable, to improve cognitive function in elderly people.
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PURPOSE Geriatric depression is often closely connected with physical symptoms among older adults. This study aimed to determine the factors related to depressive symptoms among older adults with multiple chronic diseases. METHODS We assessed 6,672 older adults using data extracted from the 2014 National Survey on the Elderly in Korea. The short form of the Geriatric Depression Scale and the Korean versions of the Mini-Mental State Examination for dementia screening and the DETERMINE Your Nutrition Health Checklist were used. Statistical analyses included independent t-test, χ2 test, and logistic regression analysis. RESULTS We found that 36.7% of the older adults exhibited depressive symptoms, and the average score on the short form of the Geriatric Depression Scale was 5.90±4.53. The factors significantly related to depressive symptoms were unemployment (Odds Ratio [OR]=1.85, 95% Confidence Interval [CI]=1.59~2.15), “high risk†nutritional management status (OR=1.19, 95% CI=1.16~1.22), slight visual dysfunction (OR=1.21, 95% CI=1.05~1.38), high visual dysfunction (OR=1.41, 95% CI=1.04~1.91), slight hearing dysfunction (OR=1.22, 95% CI=1.05~1.43), slight chewing dysfunction (OR=1.37, 95% CI=1.19~1.59), high chewing dysfunction (OR=1.59, 95% CI=1.30~1.95), low cellphone utilization (OR=1.60, 95% CI=1.04~2.46), older age (OR=0.99, 95% CI=0.98~1.00), and higher educational level (OR=0.96, 95% CI=0.95~0.98). CONCLUSION Preventive interventions for depressive symptoms should include nutritional education programs, functional assistive devices, and the use of information technology.
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PURPOSE The purpose of this study was to examine the relationship among cognitive function, depression, social support, and self-care in elderly with hypertension. METHODS The subjects were 132 elderly with hypertension living in Seoul, Korea. Data were collected through face-to-face interviews using the Korean version of Mini-Mental State Examination(MMSE-K), Short form geriatric depression scale, social support questionnaire 6, and hypertension self-care scale. RESULTS Thirty-four percent of the subjects had questionable dementia and forty-two percent of the subjects were depressed. Means for social support were 2.40 for network size and 4.07 for satisfaction. The mean score of hypertension self-care was 60.34, indicating that the subjects took care of themselves moderately well. Cognitive function was negatively related to depression. Social support network and satisfaction were negatively related to depression. Self-care was negatively related to social support network. CONCLUSION Programs are needed for elderly with hypertension to improve their cognitive function, depression, and social support. Also further studies are needed to confirm the factors related to self-care in the elderly with hypertension.
PURPOSE This study was conducted to develop a timeout protocol as the process of patients verification in the operating room, and to evaluate its effects. METHODS: The timeout protocol was developed based on the experience of practices and the universal protocol of JCAHO 2004. The subjects of this study were 192 surgical members working in the operating room at an university hospital in Daegu, Korea. RESULTS: The timeout protocol was developed in six steps; participants verification, encouragement of compliance, verification of right 3 PSP, agreement of surgical team members, verification of the parties to a patient, patient agreement. The data which have been resulted from the experimental group show significantly higher than those of control group as follows; cognition(t = -6.580, p = .000), contents of performance; progress of anesthesiologist as leader(chi-square = 29.029, p = .000), verification of right patient, right site and right procedure(chi-square = 40.663, p = .000), participation of surgical team(chi-square = 68.412, p = .000), and the number of cases of performance(chi-square = 242.900, p = .000). CONCLUSION: It suggests that medical accidents caused by failures in a preoperative verification process can be prevented if a timeout is conducted active involvement and effective communication among surgical team members for a final verification of the correct patient, procedure, and site.
PURPOSE This study was conducted to develop and evaluate a dementia prevention intervention program for the elderly with mild cognitive disorder. METHODS The study was nonequivalent control group pretest-posttest design. The subjects of the study were a total of 68 elderly who ranged from 21 to 24 of total scores of K-MMSE, aged over 65, in home. The program consisted of music therapy, humor therapy, art therapy, dancing therapy, recreation, and health education to enhance brain function. The program was applied to the experimental group twice a week, ninety minutes per session for eight weeks. The data were analysed by using chi-square test and t-test. RESULTS The variables measured in the experimental group and the control group before the intervention were not significantly different in the homogeneity test. The dementia prevention program improved the cognition(t=9.243, p<.001), self-esteem(t=.4.336, p<.001), quality of life(t=8.375, p<.001) and reduced depression(t=-3.913, p<.001). CONCLUSION These findings confirmed that the dementia prevention program made a contribution to improving cognitive function, self-esteem, and quality of life and also to reduce depression in the elderly with mild cognition disorder. Therefore, it is recommended that this program could be used in clinical practice as an effective nursing intervention for the elderly with mild cognitive disorder.
PURPOSE The purpose of this study was to determine the relationships of pain cognition, performance status, and hope with health-related quality of life. METHODS Patients(n=149) with various cancer diagnoses completed the SF-36 standard Korean Version and the Herth Hope Index. The Perceived Meanings of Cancer Pain Inventory was used to measure the cognition dimension of pain, whereas the Brief Pain Inventory Korean version was used to represent the sensory dimension of pain. RESULTS The patients in the pain group had significant differences in the three dimensions(loss, threat, spiritual awareness) of pain cognition. There were statistically significant negative correlations between the three dimensions(loss, threat, and spiritual awareness) of pain cognitions and SF-36 dimension, and the positive correlations between challenge dimension and SF-36 dimension. Hope had the positive correlation with SF-36 dimensions. CONCLUSION Pain has a negative impact on health-related quality of life, especially on physical health. However, patients who ascribed more positive meaning to their pain, tended to have a higher quality of life. Therefore, nursing intervention to reinforce the positive aspects of pain cognition is to empower patients to create a sense of control and assume an active role in pain management and quality of life.
PURPOSE The purpose of this study was to compare the degree of attitude toward elders, cognitive level, and mood state by living arrangements of the elderly. METHOD The subjects consisted of 238 elderly who divided by living arrangements(living alone, living with spouse, living with children). The data were collected by structured questionnaire that included general characteristics, attitude toward elders, MMSE-K and mood state scale, from March to December, 2005. The collected data were analyzed by Windows SPSS program including descriptive statistics, chi-square-test, Fisher's exact test, ANCOVA, Scheffe test and Pearson Correlation Coefficient. RESULTS In MMSE-K and mood state, there were statistically significant differences among the three groups. In depression and anxiety factor of mood state, the living alone group showed higher scores than the other two groups. There was a positive correlation between attitude toward elders and MMSE-K in the elderly living with a spouse group and a negative correlation between MMSE-K and mood state in all three groups. CONCLUSION It is necessary to develop a supportive program for decreasing the risk of health in the elderly and perform a differential approach according to their living arrangementa. Especially, more concern and intervention are needed to be performed for the elderly living in solitude.
PURPOSE As population of elderly people continues to grow, successful aging has risen to the top of the nursing science agenda. The successful aging includes maintenance of the cognitive and physical functions, as well as emotional well-beings. This study was carried out to evaluate effects of the environmental enrichments on cognition of institutionalized elderly. METHOD: The population was selected among the elderly aging over 65 residing at two of institutions. A quasi experimental design was used with non-equivalent control group. Study subjects were thirteen for each group. For the experimental group, physical, social and symbolic environmental enrichment program was provided for six weeks. The data were analyzed by repeated measure ANOVA and repeated measure ANCOVA using SPSS Win 11.0. RESULT: Compared to control group, the experimental group showed a significant difference on DSF(F=3.29, p=.046), and TMTA(F=4.76, p=.013) of cognitive function, and depression (F=5.56, p=.007) of emotional distress after 1 and 12 weeks of environmental enrichment program. CONCLUSION: Findings indicate that physical, social, and symbolic environmental enrichment was effective to partially prevent from cognitive decline, and to decrease emotional distress of elderly. As a nursing intervention, environmental enrichment program for elderly should be expanded for nursing practice to promote healthy aging and to offer support to the growing population of elderly. Further research should be conducted to evaluate the effect on the community elderly.
PURPOSE The purpose of this study was to examine the effect of use of a horticultural program on the cognitive function, activities of daily living, and hand grip strength of institutionalized dementia patients. METHOD: Twenty three study participants completed a five week protocol comprised of one week of baseline and four weeks of treatment. The study design was a one group repeated measurement study. For the first and fifth week of the study period, data was collected with 3 instruments: Korean Version of Hasegawa Dementia Scale (HDS-K), Katz's ADL index, hand grip strength. Data analysis was conducted by SPSS version 10.0. RESULTS: Total HDS-K score(p=.000), Activities of daily living(p=.013) and hand grip strength(p=.001) was significantly improved after treatment compared to the baseline. CONCLUSION: The horticultural program was effective for improving cognitive function, ADL and hand grip strength of the dementia patients. Repeated studies utilizing a control group are needed, using various durations, plants and processes, to confirm these results and to standardize the horticultural program protocol.
The purpose of this study was to determine the effects of the music therapy, one of the dementia treatment programs, on patients' cognition, behaviors and affection, and thereby, developing a nursing intervention to help them live a quality of life. The subjects of the study were 37 dementia senial people who admitted the mental hospital at K city in chungnam province. The study was designed as repeated measures design for a single test group. The subjects were received music therapy for 40 minutes 2 times a day during 6 weeks from February 16 to March 29, 2000. The tools of study were K-MMSE developed by Park, J. H. and Kuen, Y. C.(1989), Clinical Dementia Rating developed by Morris, J(1993) at Washington university, and A fourteen symptom behavior and mood rating scale developed by Wyatt and Kupfer(1968). For the tools of music therapy, elderly favorite songs (changs, folk songs, old popular songs and children's songs) were recorded. These tapes and other tools were edited according to experts' advices. The music therapy consisted of music listening, rhythmic instrument playing and following-up singing. The therapy was performed at the lounge of the center to which the sample people could get access conveniently. A nurse was asked to observe sample people's cognition, dementia behaviors and affection, evaluated them according to the checklist scale. The collected data were processed using the SPSS WIN 7.5 program for absolute values, percentiles, mean, SD, ANOVA, GLM-repeated measure method. The items of scale and its reliability analyzed were Cronbach's alpha. The results of this study were as follows: 1. As a result of analyzing dementia elderly cognition, behaviors and affection before the music therapy, it was found that the disorder of cognition, behavior and affection was most outstanding. 2. After the therapy, the average scores of subjects' overall cognition, behavior and affection were lowered significantly. It was conceived that the music therapy should continue for 3-4 weeks. 3. Difference of cognition in test groups was significant statistically between pre-test and 2 weeks, 4 weeks, 6 weeks after test (df=3, F=6.39, p=.000), pretest and 4, 6 weeks after test (p=.01, p=.001), which suggests that a continued music therapy would be desirable to treat dementia. Difference of behaviors and affection in test groups was significant statistically between pre-test and 1-6 weeks after test (F=52.01, p = .000), pretest and 3-6 weeks after test (p=.000), which suggests that a continued music therapy would be desirable to treat dementia. 5. It was found that the music therapy was more effective in treating moderate dementia (MMSE-K score 16-23) than severe one (MMSE-K score 15 or lower), and vascular type of dementia than Alzheimer's type of one. After all, it may well be concluded that the musical therapy is an effective nursing intervention to provide the dementia elderly with a quality service and thereby, increase cognition and reduce the problematic behaviors and affection of dementia senile people.
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