Dukyoo Jung

Computer and Internet Interventions for Loneliness and Depression in Older Adults: A Meta-Analysis

Objectives This study conducted a meta-analysis to examine the effectiveness of computer and Internet training interventions intended to reduce loneliness and depression in older adults. Methods Searches were performed to retrieve studies that had been published in peer-reviewed journals from January 2001 to July 2012 and written in English or Korean from PubMed, CINAHL, Scopus, the Cochrane Library, PsycINFO, KoreaMed, KMbase, KISS, MEDLIS, and RISS. We used combinations of the keywords for population, intervention, and psychosocial problems. A meta-analysis was employed to summarize the findings of studies on computer and Internet interventions for older adults. An overall mean weighted effect size for each outcome was calculated, and Q statistics were used to test the heterogeneity of variance in the effect sizes of the selected studies. Results As the Q statistics revealed heterogeneity, random effects models were chosen for the meta-analysis. The overall mean weighted effect size for loneliness from five studies was statistically significant for decreased loneliness (Z = 2.085, p = 0.037). However, the overall mean weighted effect size for depression from five studies was not statistically significant (Z = 1.528, p = 0.126). Conclusions These results suggest that computer and Internet programs were effective in managing loneliness among older adults. Therefore, further computer-mediated social support should be considered to help manage loneliness in this population.

The prevalence, characteristics and correlates of falls in Korean community‐dwelling older adults

BACKGROUND The risk factors for falls that have been reported in Caucasian older adults may not be the same for Korean older adults. OBJECTIVE To examine the prevalence, characteristics and correlates of falls among community-dwelling older adults in Korea. METHODS A stratified random sampling method was conducted to recruit participants, and 335 were eligible to participate from September 2006 to March 2007. Socio-demographic data, history of disease and medications, activities of daily living (ADL), cognitive status, health behaviour and fall incidents were collected. Descriptive statistics were used to describe the sample. The prevalence of falls was obtained. Univariate analyses for risk factors of falls using chi-square and t-test statistics, and multivariate logistic regression analyses for correlates of falls were performed. RESULTS Of the 335 older adults, 48 (15%) elderly had experienced falls. There was a significant difference between older adults who fell and those who did not fall with regard to ADL and exercise behaviour. Non-fallers had higher ADL scores and showed higher levels of adherence to exercise than fallers. The independent risk factor for falls was ADL. CONCLUSIONS/IMPLICATIONS In this study, an individuals functional status and exercise engagement were significant factors that differentiated fallers and non-fallers. Therefore, an effective fall prevention programme should be focused on encouraging older adults to participate in regular exercise.

Effects of a Clown–Nurse Educational Intervention on the Reduction of Postoperative Anxiety and Pain Among Preschool Children and Their Accompanying Parents in South Korea

This study examined the effects of a clown-nurse educational intervention on children undergoing day surgery for strabismus. This was a quasi-experimental study, using a nonequivalent control group, non-synchronized design. Fifty preschool children and their parents were invited to participate. The children in the intervention group (n=23) received clown therapy and subsequently reported significantly lower states of physiological anxiety, which was evidenced by systolic blood pressure, standardized behavioral anxiety tests, and post-surgery pain, than the control group (n=27). In addition, the parents in the experimental group showed a low state of physiological anxiety, evidenced by systolic blood pressure, pulse rates, standardized behavioral anxiety tests, and state-trait anxiety. The use of preoperative clown intervention may alleviate postoperative problems, not only for children, but also for their parents.

Comparative study between depression in Korean elderly with mild cognitive impairment and normal cognitive function

This cross-sectional comparative study compares differences in depression in the elderly with mild cognitive impairment and those with normal cognitive function in a community. Study subjects were drawn from elderly people visiting one particular public health center in Seoul, South Korea and included 81 people with mild cognitive impairment and 81 with normal cognitive function who were matched based on age, sex, education, and daily living activities. Study variables, including cognitive function, activities of daily living, instrumental activities of daily living, and depression, were measured with standardized instruments. Collected data were statistically analyzed with Students paired t-test and χ(2) test. The results showed no significant differences between these groups in terms of depression. Therefore, in community practice settings, nurses should understand that depression is not a manifestation of cognitive impairment and should develop effective nursing strategies to assess depression while considering other factors including age, sex, education, and daily living activities.

Psychometric evaluation of the Korean Version of the Self-Efficacy for Exercise Scale for older adults

We evaluated the psychometric properties of the Korean version of the Self-Efficacy for Exercise Scale (SEE-K). The SEE-K consists of nine items and was translated into Korean using the forward-backward translation method. We administered it to 212 community-dwelling older adults along with measures of outcome expectation for exercise, quality of life, and physical activity. The validity was determined using confirmatory factor analysis and Rasch analysis with INFIT and OUTFIT statistics, which showed acceptable model fit. The concurrent validity was confirmed according to positive correlations between the SEE-K, outcome expectation for exercise, and quality of life. Furthermore, the high physical activity group had higher SEE-K scores. Finally, the reliability of the SEE-K was deemed acceptable based on Cronbachs alpha, coefficients of determination, and person and item separation indices with reliability. Thus, the SEE-K appears to have satisfactory validity and reliability among older adults in South Korea.

Prediction model of blood pressure control in community-dwelling hypertensive adults in Korea

The purpose of the present descriptive study was to test a hypothetical model explaining the factors that influence blood pressure control among hypertensive Korean adults > or = 20 years of age. Subjects were 1041 individuals with hypertension identified from 2005 Korean National Health and Nutrition Examination Survey data. Twelve of the 24 hypothesized paths in the structural model were significant. Gender (beta = 0.09, P < 0.00), medication (beta = -0.24, P < 0.00), regular physical activity (beta = 0.06, P = 0.02) and comorbidity (beta = 0.14, P < 0.00) were significantly associated with blood pressure control, representing 10% of the variance therein. The fit of the model to the data was supported. The study results indicate that health professionals should develop strategies to motivate compliance with antihypertensive medication and regular physical activity of hypertensive adults.

Development and Validation of a Scale for the End of Life Caregiving Appraisal

PURPOSE End-of-life caregiving experiences can be complex. Family members experience physical and mental suffering as they anticipate their impending loss. Healthcare providers should be able to provide good quality of end-of-life (EOL) care and support for primary EOL caregivers. Studies have highlighted the role of healthcare providers providing information in the EOL situation to caregivers of chronic disease patients. This has resulted in the development of the End-of-life Caregiving Experience Appraisal Scale (EOLCAS) presented in this paper. The purposes of this study were to develop a scale that can evaluate the experiences of EOL caregivers, and to test the reliability and validity of this scale. METHODS The scale domains were derived from systematic review of 35 relevant studies. We then examined its content validity with nurse scholars and clinicians using content validity index. To examine construct validity, a total of 175 caregivers from tertiary hospital setting in Korea participated in this study from December 2007 to May 2008. For the construct validity, factor analysis was utilized. RESULTS The scale was composed of 32 items with four subscales: two negative appraisals (physical suffering and burden), one positive appraisal (maturation), and one neutral appraisal (social support pursuit). In this sample, the Cronbachs alpha for the entire scale was .84 indicating adequate reliability. However, Cronbachs alpha of subscales was varied. CONCLUSION Nurses and other healthcare professionals could use the EOLCAS to assess the experiences of EOL caregivers to understand their experience in the EOL and enhance their quality of life although psychometrics of EOLCAS shows limited findings.

Factors associated with cognition recovery among elders with mild cognitive impairment in Korea

Background Of elders with mild cognitive impairment, around half recover their cognitive function at some point in time. However, very little is known about the factors that influence their cognitive change towards recovery. Aim This study evaluated the role of depression, instrumental activity of daily living and sleep quality as they affect cognition recovery among community-dwelling elders. Methods The study follows a longitudinal comparative research design using secondary data analysis. Community-dwelling elders with mild cognitive impairment were assessed twice with a 1-year interval to assess their levels of cognition. Adult participants were drawn from those who visited a community health centre, were aged 65 or over and who were assessed as having MCI. Results Those with mild cognitive impairment when compared with the normal cognition group were more likely to be younger, have more education, living with their spouses and had better cognitive function at baseline assessment than other participants. Predictors for cognitive recovery among elders with mild cognitive impairment were age, depression and cognitive function at baseline assessment. Limitations Participants included only those who visit a community health centre in an urban area of Korea, so the findings may not be applicable to other elders with less mobility or who live in rural areas. Implications for nursing and health policy With the understanding that cognitive function and depression predict the recovery of mild cognitive function, nurses might be able to identify and target those older adults who are likely to achieve recovery of cognitive function. Additionally, health policy options, as suggested by the study as having the potential to improve mild cognitive impairment recovery, could include public education strategies.BACKGROUND Of elders with mild cognitive impairment, around half recover their cognitive function at some point in time. However, very little is known about the factors that influence their cognitive change towards recovery. AIM This study evaluated the role of depression, instrumental activity of daily living and sleep quality as they affect cognition recovery among community-dwelling elders. METHODS The study follows a longitudinal comparative research design using secondary data analysis. Community-dwelling elders with mild cognitive impairment were assessed twice with a 1-year interval to assess their levels of cognition. Adult participants were drawn from those who visited a community health centre, were aged 65 or over and who were assessed as having MCI. RESULTS Those with mild cognitive impairment when compared with the normal cognition group were more likely to be younger, have more education, living with their spouses and had better cognitive function at baseline assessment than other participants. Predictors for cognitive recovery among elders with mild cognitive impairment were age, depression and cognitive function at baseline assessment. LIMITATIONS Participants included only those who visit a community health centre in an urban area of Korea, so the findings may not be applicable to other elders with less mobility or who live in rural areas. IMPLICATIONS FOR NURSING AND HEALTH POLICY With the understanding that cognitive function and depression predict the recovery of mild cognitive function, nurses might be able to identify and target those older adults who are likely to achieve recovery of cognitive function. Additionally, health policy options, as suggested by the study as having the potential to improve mild cognitive impairment recovery, could include public education strategies.

Traditional Yangsaeng oriental health promotion in patients with cardiovascular disease

Background A traditional Korean health behavior regimen, ‘Yangsaeng’ is an ancient Chinese concept that incorporates health promoting behaviours. Aim The purpose of this study was to test a hypothesized model that identified the effects of activity status, internal health locus of control, and resilience on Yangsaeng among patients with cardiovascular disease. Methods Secondary data were utilized in this study. Originally, 543 Korean patients with cardio-vascular disease were recruited from general hospitals, although only 532 were included in this study. Path analysis was performed using AMOS 17.0. Results Resilience was significantly associated with and accounted for 37% of the variance in Yangsaeng. Activity status and internal health locus of control were significantly associated with and accounted for 4% of the variance in resilience. Limitations Given the cross-sectional data used, the sequencing and/or direction of the relationships found remains uncertain. There may be complex interactions that were not considered. Conclusions These results suggest that enhancing resilience is essential to foster a health-promoting lifestyle that helps prevent the recurrence of cardio-vascular disease. Implications for nursing and health policy Nurse development of a Yangsaeng program for patients with cardiovascular disease may be a useful means of enhancing resilience in western as well as eastern cultures. This will help such patients to recognize the health benefits of improving their resilience through heightened activity levels and adopting an internal health locus of control.

Factors associated with cognition recovery among elders with mild cognitive impairment in Korea: Cognition Recovery

Background Of elders with mild cognitive impairment, around half recover their cognitive function at some point in time. However, very little is known about the factors that influence their cognitive change towards recovery. Aim This study evaluated the role of depression, instrumental activity of daily living and sleep quality as they affect cognition recovery among community-dwelling elders. Methods The study follows a longitudinal comparative research design using secondary data analysis. Community-dwelling elders with mild cognitive impairment were assessed twice with a 1-year interval to assess their levels of cognition. Adult participants were drawn from those who visited a community health centre, were aged 65 or over and who were assessed as having MCI. Results Those with mild cognitive impairment when compared with the normal cognition group were more likely to be younger, have more education, living with their spouses and had better cognitive function at baseline assessment than other participants. Predictors for cognitive recovery among elders with mild cognitive impairment were age, depression and cognitive function at baseline assessment. Limitations Participants included only those who visit a community health centre in an urban area of Korea, so the findings may not be applicable to other elders with less mobility or who live in rural areas. Implications for nursing and health policy With the understanding that cognitive function and depression predict the recovery of mild cognitive function, nurses might be able to identify and target those older adults who are likely to achieve recovery of cognitive function. Additionally, health policy options, as suggested by the study as having the potential to improve mild cognitive impairment recovery, could include public education strategies.BACKGROUND Of elders with mild cognitive impairment, around half recover their cognitive function at some point in time. However, very little is known about the factors that influence their cognitive change towards recovery. AIM This study evaluated the role of depression, instrumental activity of daily living and sleep quality as they affect cognition recovery among community-dwelling elders. METHODS The study follows a longitudinal comparative research design using secondary data analysis. Community-dwelling elders with mild cognitive impairment were assessed twice with a 1-year interval to assess their levels of cognition. Adult participants were drawn from those who visited a community health centre, were aged 65 or over and who were assessed as having MCI. RESULTS Those with mild cognitive impairment when compared with the normal cognition group were more likely to be younger, have more education, living with their spouses and had better cognitive function at baseline assessment than other participants. Predictors for cognitive recovery among elders with mild cognitive impairment were age, depression and cognitive function at baseline assessment. LIMITATIONS Participants included only those who visit a community health centre in an urban area of Korea, so the findings may not be applicable to other elders with less mobility or who live in rural areas. IMPLICATIONS FOR NURSING AND HEALTH POLICY With the understanding that cognitive function and depression predict the recovery of mild cognitive function, nurses might be able to identify and target those older adults who are likely to achieve recovery of cognitive function. Additionally, health policy options, as suggested by the study as having the potential to improve mild cognitive impairment recovery, could include public education strategies.