The Effect of Health Promotion Program for Frail Elderly Residents on Health Promoting Behavior and Health Status

Sang Min Kwon; Jeong Sook Park

doi:10.7475/kjan.2013.25.1.194

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The Effect of Health Promotion Program for Frail Elderly Residents on Health Promoting Behavior and Health Status

Sang Min Kwon¹, Jeong Sook Park²

Korean Journal of Adult Nursing 2013;25(2):194-206.
Published online: February 4, 2013

DOI: https://doi.org/10.7475/kjan.2013.25.1.194

¹Center for Continuing Eduction, Keimyung University, Daegu, Korea

²College of Nursing, Keimyung University, Daegu, Korea

Corresponding author: Park, Jeong Sook College of Nursing, Keimyung University, 1000 Shindang-dong, Dalsseo-gu, Daegu 704-701, Korea. Tel: +82-53-580-3907, Fax: +82-53-580-3907, E-mail: jsp544@kmu.ac.kr

• Received: November 25, 2012 • Revised: April 23, 2013 • Accepted: April 23, 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
The purpose of this study was to develop a health promotion program for frail elderly nursing home residents, and to analyze the effects of the program.
Methods
The research was a nonequivalent control group pre-test-posttest design. Data collection was performed from February 26, 2012, to April 26, 2012. The subjects were 28 residents for the experimental group, who were selected at A nursing home, D city, in Korea and 27 residents for the control group, who were selected at B nursing home. Data were analyzed using descriptive statistics, x²-test, independent t-test, ANCOVA and Cronbach's ⍺ with SPSS/Win 17.0 program.
Results
There was a significant improvement in health promoting behaviors (F=64.26, p<.001), Lt. Grip strength (F=39.76, p<.001), Rt. Grip strength (F=38.06, p<.001), Static balance (F=3.98, p =.050), TUG (F=18.60, p<.001), oral status (F=26.75, p<.001), depression (F=18.79, p<.001), and subjective health status (F=10.75, p<.002) in the treatment group compared to the comparison group.
Conclusion
The health promotion program improved the health promoting behavior, physical fitness, oral status, depression, and subjective health status of the frail elderly nursing home residents. Therefore, health promotion programs for frail elderly nursing home residents could be helpful.
Key Words: Frail elderly; Health promotion; Health status

Table 1.

Health Promotion Program for Frail Elderly Residents

Weeks	Time	Contents	HPLP area
1	120 minutes	Pretest	Health responsibility
		Informed consent
		Orientation
2	90 minutes	Senile diseases and drug management	Health responsibility
		Low-intensity exercise	Physical activity
3	90 minutes	Group art therapy for self-esteem	Self-actualization
		Low-intensity exercise	Physical activity
4	90 minutes	Nutrition education	Nutrition
		Oral hygiene	Physical activity
		Low-intensity exercise
5	90 minutes	A joyful old song contest: trot medley	Stress management
		Low-intensity exercise	Physical activity
6	90 minutes	Self-reflection	Self-actualization
		Low-intensity exercise	Physical activity
7	90 minutes	Interaction through team play therapy	Interpersonal relations
		Low-intensity exercise	Physical activity
8	120 minutes	Low-intensity exercise	Physical activity
		Posttest	Interpersonal relations
		Peer group activity

HPLP=health promoting lifestyle profile.

Table 3.

Comparison between Experimental and Control Group of Post HPLP

Variables	Groups	Pretest	Posttest	F^†	p
Variables	Groups	M±SD	M±SD	F^†	p
HPLP: Total	Exp. (n=28)	80.89±10.03	95.89±10.07	64.26	＜.001
	Cont. (n=27)	80.44±10.92	77.03±9.22
Health responsibility	Exp. (n=28)	26.67±4.60	30.78±4.21	16.92	＜.001
	Cont. (n=27)	28.59±4.68	27.62±4.35
Physical activity	Exp. (n=28)	4.25±1.62	5.25±1.17	20.57	＜.001
	Cont. (n=27)	3.77±1.57	3.51±1.50
Nutrition	Exp. (n=28)	16.25±2.61	18.89±1.96	45.34	＜.001
	Cont. (n=27)	15.55±2.60	14.85±2.42
Interpersonal relations	Exp. (n=28)	12.60±2.72	15.39±2.76	28.86	＜.001
	Cont. (n=27)	11.66±2.96	10.81±2.90
Self-actualization	Exp. (n=28)	11.21±2.16	13.25±1.85	23.41	＜.001
	Cont. (n=27)	11.70±2.21	10.81±2.46
Stress management	Exp. (n=28)	9.89±2.46	12.32±2.38	19.88	＜.001
	Cont. (n=27)	9.14±2.17	9.40±1.78

Exp.=experimental group; Cont.=control group; HPLP=health promoting lifestyle profile.

^†F-value of ANCOVA with pretest value as covariate.

Table 4.

Comparison between Experimental and Control Group of Post Physiological Variables

Variables	Groups	Pretest	Posttest	F^†	p
Variables	Groups	M±SD	M±SD	F^†	p
Left grip strength (kg)	Exp. (n=28)	9.21±3.46	12.76±4.61	39.76	＜.001
	Cont. (n=27)	8.13±3.81	7.07±2.88
Right grip strength (kg)	Exp. (n=28)	9.68±3.77	13.21±4.95	38.06	＜.001
	Cont. (n=27)	7.84±2.69	7.21±2.52
Static balance (sec)	Exp. (n=28)	2.69±2.70	3.98±4.16	3.98	.050
	Cont. (n=27)	2.72±3.18	2.16±2.53
Timed up and go (sec)	Exp. (n=28)	16.48±4.54	14.93±3.78	18.60	＜.001
	Cont. (n=27)	17.95±4.75	19.70±5.92
Oral status	Exp. (n=28)	7.42±1.10	9.14±1.11	26.75	＜.001
	Cont. (n=27)	7.00±1.30	7.25±1.37

Exp.=experimental group; Cont.=control group.

^†F-value of ANCOVA with pretest value as covariate.

Table 5.

Comparison of Post Depression and Perceived Health Status between Experimental and Control Group

Variables	Groups	Pretest	Posttest	F^†	p
Variables	Groups	M±SD	M±SD	F^†	p
Depression	Exp. (n=28)	5.96±3.58	4.03±3.42	18.79	＜.001
	Cont. (n=27)	6.92±3.19	8.33±3.22
Perceived health status	Exp. (n=28)	8.35±2.21	9.82±1.38	10.75	.002
	Cont. (n=27)	7.77±2.45	7.92±2.12

Exp.=Experimental group; Cont.=Control group.

^†F-value of ANCOVA with pretest value as covariate.

Table 2.

Homogeneity of General Characteristics and Dependent Variable between Experimental and Control Group

Characteristics	Categories	Total (n=55)	Exp. (n=28)	Cont. (n=27)	x² or t	p
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	x² or t	p
Gender	Male	7 (12.7)	4 (14.3)	3 (11.1)	0.12	.724
	Female	48 (87.3)	24 (85.7)	24 (88.9)
Age (year)	65∼69	2 (3.6)	2 (7.1)	0 (0.0)	2.95	.398
	70∼79	19 (34.5)	11 (39.3)	8 (29.6)
	80∼89	32 (58.2)	14 (50.0)	18 (66.7)
	≥90	2 (3.6)	1 (3.6)	1 (3.7)
Education	None	35 (63.6)	16 (57.1)	19 (70.4)	1.48	.475
	Elementary school	16 (29.1)	9 (32.1)	7 (25.9)
	≥ Middle school	4 (7.3)	3 (10.7)	1 (3.7)
Religion	Buddhism	19 (34.5)	7 (25.0)	12 (44.4)	3.97	.410
	Protestant	8 (14.5)	6 (21.4)	2 (7.4)
	Catholic	7 (12.7)	3 (10.7)	4 (14.8)
	None	17 (30.9)	10 (35.7)	7 (25.9)
	Other	4 (7.3)	2 (7.1)	2 (7.4)
Marital status	Single	6 (10.9)	3 (10.7)	3 (11.1)	4.42	.351
	Married	3 (5.5)	3 (10.7)	0 (0.0)
	Divorce	4 (7.3)	3 (10.7)	1 (3.7)
	Bereavement	37 (67.3)	17 (60.7)	20 (74.1)
	Other	5 (9.1)	2 (7.1)	3 (11.1)
Length of the stay of	49	25 (45.5)	17 (60.7)	8 (29.6)	7.70	.103
facility (month)	50∼69	10 (18.2)	4 (14.3)	6 (22.2)
	70∼99	10 (18.2)	2 (7.1)	8 (29.6)
	≥100	7 (12.7)	3 (10.7)	4 (14.8)
Entrance motive	Heath problem	30 (54.5)	13 (46.4)	17 (63.0)	2.43	.295
	No dependents	12 (21.8)	6 (21.4)	6 (22.2)
	Economic problem	13 (23.6)	9 (32.1)	4 (14.8)
The number of	Zero	2 (3.6)	1 (3.6)	1 (3.7)	1.19	.754
disease	One	21 (38.2)	10 (35.7)	11 (40.7)
	Two	24 (43.6)	14 (50.0)	10 (37.0)
	≥ Three	8 (14.5)	3 (10.7)	5 (18.5)
Satisfaction of	Bad	6 (10.9)	5 (17.9)	1 (3.7)	2.83	.242
facility	Not bad	19 (34.5)	9 (32.1)	10 (37.0)
	Good	30 (54.5)	14 (50.0)	16 (59.3)
HPLP	Total	80.67±10.38	80.89±10.03	80.44±10.92	0.15	.875
Grip strength	Left hand	8.68±3.64	9.21±3.46	8.13±3.81	1.09	.278
	Right hand	8.78±3.38	9.68±3.77	7.88±2.69	2.07	.043
Static balance		2.70±2.92	2.69±2.70	2.72±3.18	–0.03	.972
Timed up and go		17.20±4.66	16.48±4.54	17.95±4.75	–1.17	.244
Oral status		7.21±1.21	7.42±1.10	7.00±1.30	1.31	.193
Depression		6.43±3.40	5.96±3.58	6.92±3.19	–1.04	.299
Perceived health status		8.07±2.33	8.35±2.21	7.77±2.45	0.92	.362

Exp.=experimental group; Cont.=control group; HPLP=health promoting lifestyle profile.

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Byun Y. C., Kim S. H., Yoon S. Y., Kwon S. J., Cho H. S., Cho S. Y., et al. 2006. A study of the characteristics of the person with disabilities based on the life cycle perspectives. Seoul: Korea Institute for Health and Social Affairs.
Cho M. J., Bae J. N., Suh G. H., Hahm B. J., Kim J. K., Lee D. W., et al. 1999;Validation of geriatric depression scale, korean version (GDS) in the assessment of DSM-Ⅲ-R major depression. Journal of Korean Neuropsychiatry Association. 38:48-63.
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The Effect of Health Promotion Program for Frail Elderly Residents on Health Promoting Behavior and Health Status

Korean J Adult Nurs. 2013;25(2):194-206. Published online April 30, 2013

DOI: https://doi.org/10.7475/kjan.2013.25.1.194

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The Effect of Health Promotion Program for Frail Elderly Residents on Health Promoting Behavior and Health Status

Korean J Adult Nurs. 2013;25(2):194-206. Published online April 30, 2013

DOI: https://doi.org/10.7475/kjan.2013.25.1.194

The Effect of Health Promotion Program for Frail Elderly Residents on Health Promoting Behavior and Health Status

Table 1.

Health Promotion Program for Frail Elderly Residents

Weeks	Time	Contents	HPLP area
1	120 minutes	Pretest	Health responsibility
		Informed consent
		Orientation
2	90 minutes	Senile diseases and drug management	Health responsibility
		Low-intensity exercise	Physical activity
3	90 minutes	Group art therapy for self-esteem	Self-actualization
		Low-intensity exercise	Physical activity
4	90 minutes	Nutrition education	Nutrition
		Oral hygiene	Physical activity
		Low-intensity exercise
5	90 minutes	A joyful old song contest: trot medley	Stress management
		Low-intensity exercise	Physical activity
6	90 minutes	Self-reflection	Self-actualization
		Low-intensity exercise	Physical activity
7	90 minutes	Interaction through team play therapy	Interpersonal relations
		Low-intensity exercise	Physical activity
8	120 minutes	Low-intensity exercise	Physical activity
		Posttest	Interpersonal relations
		Peer group activity

HPLP=health promoting lifestyle profile.

Table 3.

Comparison between Experimental and Control Group of Post HPLP

Variables	Groups	Pretest	Posttest	F^†	p
Variables	Groups	M±SD	M±SD	F^†	p
HPLP: Total	Exp. (n=28)	80.89±10.03	95.89±10.07	64.26	＜.001
	Cont. (n=27)	80.44±10.92	77.03±9.22
Health responsibility	Exp. (n=28)	26.67±4.60	30.78±4.21	16.92	＜.001
	Cont. (n=27)	28.59±4.68	27.62±4.35
Physical activity	Exp. (n=28)	4.25±1.62	5.25±1.17	20.57	＜.001
	Cont. (n=27)	3.77±1.57	3.51±1.50
Nutrition	Exp. (n=28)	16.25±2.61	18.89±1.96	45.34	＜.001
	Cont. (n=27)	15.55±2.60	14.85±2.42
Interpersonal relations	Exp. (n=28)	12.60±2.72	15.39±2.76	28.86	＜.001
	Cont. (n=27)	11.66±2.96	10.81±2.90
Self-actualization	Exp. (n=28)	11.21±2.16	13.25±1.85	23.41	＜.001
	Cont. (n=27)	11.70±2.21	10.81±2.46
Stress management	Exp. (n=28)	9.89±2.46	12.32±2.38	19.88	＜.001
	Cont. (n=27)	9.14±2.17	9.40±1.78

Exp.=experimental group; Cont.=control group; HPLP=health promoting lifestyle profile.

^†F-value of ANCOVA with pretest value as covariate.

Table 4.

Comparison between Experimental and Control Group of Post Physiological Variables

Variables	Groups	Pretest	Posttest	F^†	p
Variables	Groups	M±SD	M±SD	F^†	p
Left grip strength (kg)	Exp. (n=28)	9.21±3.46	12.76±4.61	39.76	＜.001
	Cont. (n=27)	8.13±3.81	7.07±2.88
Right grip strength (kg)	Exp. (n=28)	9.68±3.77	13.21±4.95	38.06	＜.001
	Cont. (n=27)	7.84±2.69	7.21±2.52
Static balance (sec)	Exp. (n=28)	2.69±2.70	3.98±4.16	3.98	.050
	Cont. (n=27)	2.72±3.18	2.16±2.53
Timed up and go (sec)	Exp. (n=28)	16.48±4.54	14.93±3.78	18.60	＜.001
	Cont. (n=27)	17.95±4.75	19.70±5.92
Oral status	Exp. (n=28)	7.42±1.10	9.14±1.11	26.75	＜.001
	Cont. (n=27)	7.00±1.30	7.25±1.37

Exp.=experimental group; Cont.=control group.

^†F-value of ANCOVA with pretest value as covariate.

Table 5.

Comparison of Post Depression and Perceived Health Status between Experimental and Control Group

Variables	Groups	Pretest	Posttest	F^†	p
Variables	Groups	M±SD	M±SD	F^†	p
Depression	Exp. (n=28)	5.96±3.58	4.03±3.42	18.79	＜.001
	Cont. (n=27)	6.92±3.19	8.33±3.22
Perceived health status	Exp. (n=28)	8.35±2.21	9.82±1.38	10.75	.002
	Cont. (n=27)	7.77±2.45	7.92±2.12

Exp.=Experimental group; Cont.=Control group.

^†F-value of ANCOVA with pretest value as covariate.

Table 2.

Homogeneity of General Characteristics and Dependent Variable between Experimental and Control Group

Characteristics	Categories	Total (n=55)	Exp. (n=28)	Cont. (n=27)	x² or t	p
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	x² or t	p
Gender	Male	7 (12.7)	4 (14.3)	3 (11.1)	0.12	.724
	Female	48 (87.3)	24 (85.7)	24 (88.9)
Age (year)	65∼69	2 (3.6)	2 (7.1)	0 (0.0)	2.95	.398
	70∼79	19 (34.5)	11 (39.3)	8 (29.6)
	80∼89	32 (58.2)	14 (50.0)	18 (66.7)
	≥90	2 (3.6)	1 (3.6)	1 (3.7)
Education	None	35 (63.6)	16 (57.1)	19 (70.4)	1.48	.475
	Elementary school	16 (29.1)	9 (32.1)	7 (25.9)
	≥ Middle school	4 (7.3)	3 (10.7)	1 (3.7)
Religion	Buddhism	19 (34.5)	7 (25.0)	12 (44.4)	3.97	.410
	Protestant	8 (14.5)	6 (21.4)	2 (7.4)
	Catholic	7 (12.7)	3 (10.7)	4 (14.8)
	None	17 (30.9)	10 (35.7)	7 (25.9)
	Other	4 (7.3)	2 (7.1)	2 (7.4)
Marital status	Single	6 (10.9)	3 (10.7)	3 (11.1)	4.42	.351
	Married	3 (5.5)	3 (10.7)	0 (0.0)
	Divorce	4 (7.3)	3 (10.7)	1 (3.7)
	Bereavement	37 (67.3)	17 (60.7)	20 (74.1)
	Other	5 (9.1)	2 (7.1)	3 (11.1)
Length of the stay of	49	25 (45.5)	17 (60.7)	8 (29.6)	7.70	.103
facility (month)	50∼69	10 (18.2)	4 (14.3)	6 (22.2)
	70∼99	10 (18.2)	2 (7.1)	8 (29.6)
	≥100	7 (12.7)	3 (10.7)	4 (14.8)
Entrance motive	Heath problem	30 (54.5)	13 (46.4)	17 (63.0)	2.43	.295
	No dependents	12 (21.8)	6 (21.4)	6 (22.2)
	Economic problem	13 (23.6)	9 (32.1)	4 (14.8)
The number of	Zero	2 (3.6)	1 (3.6)	1 (3.7)	1.19	.754
disease	One	21 (38.2)	10 (35.7)	11 (40.7)
	Two	24 (43.6)	14 (50.0)	10 (37.0)
	≥ Three	8 (14.5)	3 (10.7)	5 (18.5)
Satisfaction of	Bad	6 (10.9)	5 (17.9)	1 (3.7)	2.83	.242
facility	Not bad	19 (34.5)	9 (32.1)	10 (37.0)
	Good	30 (54.5)	14 (50.0)	16 (59.3)
HPLP	Total	80.67±10.38	80.89±10.03	80.44±10.92	0.15	.875
Grip strength	Left hand	8.68±3.64	9.21±3.46	8.13±3.81	1.09	.278
	Right hand	8.78±3.38	9.68±3.77	7.88±2.69	2.07	.043
Static balance		2.70±2.92	2.69±2.70	2.72±3.18	–0.03	.972
Timed up and go		17.20±4.66	16.48±4.54	17.95±4.75	–1.17	.244
Oral status		7.21±1.21	7.42±1.10	7.00±1.30	1.31	.193
Depression		6.43±3.40	5.96±3.58	6.92±3.19	–1.04	.299
Perceived health status		8.07±2.33	8.35±2.21	7.77±2.45	0.92	.362

Exp.=experimental group; Cont.=control group; HPLP=health promoting lifestyle profile.

Table 1. Health Promotion Program for Frail Elderly Residents

HPLP=health promoting lifestyle profile.

Table 3. Comparison between Experimental and Control Group of Post HPLP

Exp.=experimental group; Cont.=control group; HPLP=health promoting lifestyle profile.

†

F-value of ANCOVA with pretest value as covariate.

Table 4. Comparison between Experimental and Control Group of Post Physiological Variables

Exp.=experimental group; Cont.=control group.

†

F-value of ANCOVA with pretest value as covariate.

Table 5. Comparison of Post Depression and Perceived Health Status between Experimental and Control Group

Exp.=Experimental group; Cont.=Control group.

†

F-value of ANCOVA with pretest value as covariate.

Table 2. Homogeneity of General Characteristics and Dependent Variable between Experimental and Control Group

Exp.=experimental group; Cont.=control group; HPLP=health promoting lifestyle profile.

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The Effect of Health Promotion Program for Frail Elderly Residents on Health Promoting Behavior and Health Status

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