Young-Mi Jung

Cognitive Impairment, Behavioral Problems, and Mental Health in Institutionalized Korean Elders -An Eligibility Issue for Care Settings-

PURPOSE The purpose of this study was to identify the prevalence of cognitive impairment, behavioral problems, and the state of mental health for elderly Korean people who have been institutionalized. METHODS A cross-sectional, nation-wide survey was performed using an anonymous questionnaire. The participants in this study were 2,521 institutionalized elderly Korean people. A proportional stratified random sampling method was employed. RESULTS 1) Elders admitted to subacute hospitals and long term care (LTC) facilities showed a higher level of cognitive impairment compared to elders admitted to acute care hospitals. 2) Elders confined in LTC facilities showed a higher level of behavioral problems compared to elders in acute or subacute hospitals. 3) Elders admitted to subacute hospitals and LTC facilities showed more serious mental health problems, such as depression or suicidal ideation, compared to elders in acute care hospitals. CONCLUSION The results of this study indicate that the severity of cognitive-behavioral or mental health problems do not match well with type of care setting. Therefore, health personnel working with elderly people should be provided guidance on detection and management of cognitive-behavioral and mental health problems. The necessity of a decision support system for eligibility and placement in long-term care is also discussed.

Testing a theoretical model predicting uncertainty and depression in patients undergoing renal replacement therapy in Korea.

PURPOSE The purpose of this study was to test hypothesized relationships among experiences of uncertainty, depression, and social support in a sample of subjects undergoing renal replacement therapy in Korea. METHODS Path analysis was used in the sample to examine the relationships among depression and experiences of uncertainty, direct social support, indirect social support, and demographic variables. The size of the sample was 104 patients. Patients received either hemodialysis at one of three clinics or continuous ambulatory peritoneal dialysis. RESULTS One hundred and four subjects participated in the study. It was found that 6.2% of variance in uncertainty was predicted by direct social support (β =- .267), and 46.2% of variance in depression was predicted by three variables: direct social support (β =- .517), economic status (β = .299), and number of admissions (β = .275). Unlike the theoretical model, experiences of uncertainty could not predict depression. CONCLUSION The effectiveness of social support in relieving experiences of uncertainty and consequently depression was shown in this study. Moreover, depression in this population could be predicted by direct social support, economic status, and frequency of admission. The study was needed to investigate the relationship between depression and experiences of uncertainty with time covariates, as well as to find the factors that influence depression in patients with chronic renal failure.