Young Mi Lim

Factors Affecting Burden of Family Caregivers of Community-Dwelling Ambulatory Elders with Dementia in Korea

The purpose of the study was to test a staged causal model as a theoretical base to explain the burden of family caregivers of community-dwelling self-ambulatory persons with dementia (PWDs) in Korea. The model contained three stages including antecedents (Stage 1), behavior (Stage 2), and outcome (Stage 3). The antecedents were variables of the PWDs (e.g., cognitive impairment and activities of daily living [ADL] dependency of the PWDs) and caregiver variables (e.g., age, gender of caregiver, and the relationship of caregiver to PWD). Stage 2 focused on wandering behavior. In Stage 3, the outcome variable was caregiver burden. A total of 83 noninstitutionalized, community-dwelling elders with dementia and their family caregivers participated. The instruments used in this study were the Korean version of Mini Mental State Examination, K-PADL (Korean-Physical Activities of Daily Living), Korean-Revised Algase Wandering Scale-Community Version, and K-CWOB (Caregiver Worry, Overload, and Role Captivity Scale-Korean) Korean versions of standardized Western instruments. Results indicate that cognitive impairment and ADL dependency had an indirect influence on caregiver burden through wandering behavior. In addition, caregiver age had a direct impact on caregiver burden. The findings of this study suggest that further refinement of the underlying model is warranted.

Burden of family caregivers with schizophrenic patients in Korea

The purpose of the study was to test a staged causal model as the theoretical base to determine the relationships among knowledge, coping, and burden among Korean family caregivers with schizophrenic patients. The staged theoretical model contained three stages comprised of contextual variables (stage 1), interactional variables (stage 2), and perception variables (stage 3). The situational variables were caregiver knowledge, gender and age of family caregiver, duration of family caregiving, and the nature of the relationship between patient and family caregiver. The interactional variable was represented by two styles of copings (positive and negative). The perception variable was the perception of subjective burden. A total of 57 family caregivers with schizophrenic patients participated in this study. The instruments, Knowledge Scale, Coping Scale, and Burden Scale, were used. A path analysis was used in this model. The family caregivers knowledge had an indirect impact on the burden through negative coping, indicating that the less caregivers knowledge, the more caregivers use negative coping strategies, which results in caregiving perception of subjective burden. The results support that interactional outcome of coping mediates the relationships between caregivers knowledge and the impact of subjective outcome of caregiving burden.

Translation and validation of the Revised-Algase Wandering Scale (community version) among Korean elders with dementia

The purpose of this study was to examine the psychometric properties of a Korean translated version of the Revised Algase Wandering Scale, community version (K-RAWS-CV) among persons with dementia in Korea. A cross-sectional survey design was used. After established equivalence of the instrument using back-translation and a field test, 69 community dwelling family caregivers described the wandering behavior of their family members with dementia. The overall mean of the K-RAWS-CV was 1.73 (SD = 0.61, range = 1–3.87). Means of each subscale ranged from 1.44 (meal-time impulsivity, MI) to 2.04 (escape behavior, EB). The reliability alpha for the overall scale was 0.96 with reliabilities for subscales ranging from 0.82 (negative outcome, NO) to 0.93 (persistent walking, PW). The correlation between the overall K-RAWS-CV and each subscale ranged from 0.52 (overall and NO) to 0.82 (overall and PW) with a mean value of 0.66. Pearsons correlations between the level of cognitive impairment and each subscale of the K-RAWS-CV demonstrated significant, moderate relationships ranging from −0.24 (MI, RW, and MMSE) to −0.39 (PW, EB and MMSE). Mean differences between wanderers and non-wanderers were statistically significant for the K-RAWS-CV overall and all subscale except for MI. Results support the validity and reliability of the K-RAWS-CV overall and the six subscales.

Effect of 16-week Kouk-Sun-Do exercise on physical fitness, emotional state, and immunoglobulin A in community-dwelling elders in Korea

The purpose of this study was to determine the effects of 16-week Kouk-Sun-Do (KSD) exercise on physical fitness, emotional state, and immunoglobulin A (IgA) in community-dwelling elders in Korea. A total of 19 elders in the intervention group and 20 elders in the control group participated. The KSD exercise with low-intensity exercise was performed over a 45-minute session, three times a week for a 16-week period. The results show the effectiveness of KSD exercise on the physical fitness, emotional state, and IgA, and KSD can be identified as a feasible type of low-intensity exercise for elders. The findings suggest the need to determine clinical significance of KSD for patients in specific clinical settings; nurses with training in KSD can play a key role in implementing movement-based nursing interventions for specific health outcomes.

Home environmental and health-related factors among home fallers and recurrent fallers in community dwelling older Korean women

The purpose of the study was to determine home environmental and health-related factors among home fallers and recurrent fallers in community dwelling older Korean women. The study population included 438 older women aged 65 years and over. Measures included a checklist of home environments and health-related items. Risk indicators for accidental falls and recurrent falling were analysed using logistic regression. Logistic regression analysis revealed that chronic disease (odds ratio (OR) = 2.02, P = 0.007), poor night light (OR = 1.97, P = 0.032) and obstacle of door sill (OR = 1.76, P = 0.021) were predictors of accidental falls, and physical inactivity (OR = 2.34, P = 0.018) and slippery floor in the bathroom (OR = 0.41, P = 0.034) were predictors of recurrent falling. The findings have implications for strategies and suggest the need to modify home environmental context in systematic and consistent ways and the need to maintain physical activities to prevent falls and recurrent falling.

Wandering behaviour of persons with dementia in Korea: investigation of related factors.

Objectives: Despite being identified as a significant clinical phenomenon, wandering of persons with dementia (PWDs) has not been studied in Korea. As an initial trial, various factors chosen from the literature for their predictive relationships to wandering of Korean PWDs were evaluated in this study. Method: A total of 160 PWDs residing in 14 long-term care facilities participated in this study. The Mini-Mental State Exam (MMSE), Physical Activities of Daily Living (PADL) and Korean-translated Revised Algase Wandering Scale (Nursing Home version) (KRAWS-NH) were used to assess participants’ degree of cognitive impairment, functional ability and wandering behaviour on six dimensions: persistent walking (PW), specific patterns (SP), spatial disorientation (SD), escape behaviour (EB), attention shift (AS) and negative outcomes (NO). Demographic, personal and environmental data were also collected. Results: The MMSE score was a significant negative predictor for KRAWS-NH overall and subscales except for EB; while age, PADL and history of falls were positive predictors for SD and NO. Total number of residents in a room was a significant negative predictor for EB and AS. Conclusion: Different factors found in PWDs may contribute to different aspects of wandering behaviour. Further studies on factors influencing multiple facets of wandering in various cultural settings are warranted.

Multidimensional Caregiving Burden of Female Family Caregivers in Korea

The purpose of this study was to examine a staged theoretical model to explain cultural knowledge-based multidimensional burden of women family caregivers caring for community-dwelling older adults using a modified Poulshock and Deimling model. In the model, the antecedents included elders’ impairment in activities of daily living (ADL), elders’ cognitive impairment, caregivers’ self-efficacy, and caregivers’ familism. The perception contained the disruptive behavior burden and social functioning burden of caregivers. The consequence variable included social activity restriction and negative changes in family relationships. The total sample was 157 primary women caregivers caring for community-dwelling older adults aged 65 and older. Instruments were General Self-Efficacy Scale, Family Scale, and Burden Scale. Path analysis was done to analyze the model using multiple linear regression methods. This study showed that impairments of older adults (impairment in ADL, cognitive impairment) and caregiver beliefs (strong familism, low self-efficacy) had an indirect influence on negative changes in family relationship and social activity restriction through the perceived emotional distress.

Translation and Validation of the Korean Version of MUDI and MUSIQ with Urinary Incontinent Older Men

Purpose The purpose of this study was to evaluate the psychometric properties of the Korean version of the Male Urinary Distress Inventory (MUDI) and Male Urinary Symptom Impact Questionnaire (MUSIQ). Patients and Methods A convenient sample of community-dwelling older men with urinary incontinence participated. A cross-sectional survey design was used for this study. A panel of experts completed the initial translation into Korean and back-translated the MUDI and MUSIQ. Upon establishment of the content and translation equivalence between English and Korean versions of the MUDI and MUSIQ, psychometric properties were evaluated for reliability, concurrent, and construct validity with a sample of 143 older men. Results The internal consistencies of both instruments were found to be acceptable, and Cronbachs coefficients were 0.88 for the MUDI-K and 0.92 for the MUSIQ-K. A significant moderate correlation between MUDI-K and MUSIQ-K was found in this study, indicating modest concurrent validity between these 2 instruments (r = 0.56, p < 0.001). For construct validity, the mean scores of the MUDI-K were significantly different for age, marital status, prostate surgery, erectile dysfunction, and depression (p < 0.05). The means scores of MUSIQ-K were significantly different for depression (p < 0.05) only. For both the MUDI-K and MUSIQ-K, 7 factors were extracted, accounting for 68.1% and 72.1% of the variance. Conclusion Results of this study suggest that the MUDI-K and MUSIQ-K can be used as a reliable and valid measure of health-related quality of life in community-dwelling Korean older men with urinary incontinence.

Validation of the Korean Version of the Depression Coping Self-Efficacy Scale (DCSES-K)

Coping self-efficacy is regarded as an important indicator of the quality of life and well-being for community-dwelling patients with depression. The Depression Coping Self-Efficacy Scale (DCSES) was designed to measure self-efficacy beliefs related to the ability to perform tasks specific to coping with the symptoms of depression. The purpose of this study was to examine the psychometric properties of a Korean version of the Depression Coping Self-Efficacy Scale (DCSES-K) for community-dwelling patients with depression. A cross-sectional survey design was used. Content and semantic equivalence of the instrument using translation and back-translation of the DCSES was established. A convenience sample of 149 community-dwelling patients with depression was recruited from psychiatric outpatient clinics. The reliability alpha for the DCSES-K was .93, and the internal consistency was found to be acceptable. For convergent validity, DCSES-K score was positively correlated with the General Self-Efficacy Scale (GSES-K) score. For construct validity, significant differences in DCSES-K scores were found between a lower BDI group (mean=73.7, SD=16.54) and a higher BDI group (mean=53.74, SD=16.99) (t=7.19, p<.001). For the DCSES-K, 5 factors were extracted, accounting for 62.7% of the variance. Results of this study suggest that DCSES-K can be used as a reliable and valid measure for examining self-efficacy coping with depression for Korean community-dwelling patients with depression.