Journal of Korean Gerontological Nursing最新文献

Purpose: We investigated factors associated with malnutrition in nursing home residents and estimated pooled effect sizes of those associations.

Methods: We report this study according to the PRISMA checklist 2020. After registering the protocol, we conducted a systematic search using the keywords "malnutrition," "nursing home," and "factor" on PubMed, EMBASE, CINAHL, and Scopus and conducted a hand search of relevant sources in November 2023. We conducted the meta-analysis using R4.3.1 software.

Results: We included 46 studies and entered 35 studies into the meta-analysis. Meta-analysis results showed that (1) demographic factors included being female: pooled odds ratio (pOR) 1.38 (95% confidence interval [95% CI], 1.29~1.47) and higher body mass index: pOR 0.74 (95% CI, 0.66~0.83); (2) health functional factors including dependence with activities of daily living: pOR 3.70 (95% CI, 2.97~4.60) and being immobile: pOR 2.50 (95% CI, 1.39~4.47); (3) eating and oral intake factors including: eating <50% of offered food portions: pOR 3.56 (95% CI, 2.05~6.19) and loss of appetite: pOR 3.60 (95% CI, 1.36~9.57); (4) disease-related factors including dementia: pOR 1.98 (95% CI, 1.59~2.46), depression: pOR 1.84 (95% CI, 1.18~2.85), diabetes: pOR 0.76 (95% CI, 0.58~0.99), and pressure ulcers: pOR 2.14 (95% CI, 1.54~2.97); and (5) medication-related factors such as taking polypharmacy pOR 1.75 (95% CI, 1.24~2.47) were found to have a significant association with malnutrition in nursing homes.

Conclusion: These results contribute to updating knowledge about factors associated with malnutrition in nursing homes. Results supported that demographic status, health function, eating and oral intake, and disease, and medication factors significantly aligned with malnutrition. Study results contribute to improving nutritional care in nursing homes and long-term-care settings.

Purpose: This study aimed to investigate factors influencing the health-related quality of life (HRQOL) of older adults aged 65 years and older, living alone in rural areas in Korea.

Methods: We conducted a cross-sectional survey with 136 older adults living alone in rural areas from January 26 to February 15, 2024. We collected data through interviews conducted by trained surveyors with each older adult. Data were analyzed using t-tests, one-way ANOVA, Pearson's correlation, and hierarchical logistic-regression analysis with SPSS/WIN version 27.0.

Results: Factors influencing the HRQOL of older adults living alone in rural areas were depression (β=-.38, p＜.001), the number of diagnosed diseases (β=-.22, p=.001), and subjective health perception (β=.18, p=.014), with an explanatory power of 57.0%.

Conclusion: Managing depression, preventing and treating diseases, and improving subjective health perceptions could enhance the HRQOL of older adults living alone in rural areas.

Purpose: South Korea is rapidly aging, with older adult care costs soaring and lung diseases prevalent among the older adults. The correlation between hand grip strength (HGS) and lung function is contested, demanding further research to assess its viability as a predictor of lung health in this growing demographic. In this study, we explored the relationship between HGS and lung function.

Methods: In this cross-sectional study, of 32,379 participants, we selected 3,362 aged 65 years or older, after exclusions. We assessed lung function through forced vital capacity (FVC) and forced expiratory volume (FEV₁) measurements, and gauged HGS using a digital dynamometer. The analysis accounted for various covariates including medical history, lifestyle factors, and socioeconomic status, using complex sample analysis in SPSS.

Results: Analysis of 3,362 participants revealed that, after adjusting for relevant covariates, HGS retained a statistically significant correlation with FVC and FEV₁, with regression coefficients of 0.03 and 0.02, respectively. These findings indicate that HGS may serve as a reliable indicator of respiratory health in an aging population.

Conclusion: Findings showed HGS independently aligned with FVC and FEV₁, requiring a significant post-adjustment for confounders. Consistent with prior studies, results suggest HGS could indicate respiratory health in older adults. Despite divergent outcomes from earlier research, a persistent link between HGS and lung function underscores its value in geriatric screenings for early lung-decline detection.

Purpose: The purpose of this study was to identify depression in the baby boomer generation and identify risk factors for depression.

Methods: We selected and analyzed a total of 45,470 members of the baby boomer generation using the 2022 Korean Community Health Survey. We conducted the Rao-Scott χ ² test to evaluate differences according to depression and used logistic regression analysis to identify related factors.

Results: Of the baby boomer generation, 8.1% had depression. Sex (odds ratio [OR]=1.57, 95% confidence interval [CI]=1.39~1.78), working status (OR=0.76, 95% CI=0.69~0.85), marital status (OR=1.43, 95% CI=1.27~1.61), average monthly household income (OR=0.85, 95% CI=0.74~0.97), subjective health status (OR=1.91, 95% CI=1.64~2.22), eating breakfast (OR=0.83, 95% CI=0.72~0.96), sleep time (OR=1.17, 95% CI=1.05~1.30), unmet medical care (OR=1.68, 95% CI=1.42~2.00), stress (OR=2.69, 95% CI=2.42~3.00), life satisfaction (OR=2.30, 95% CI=1.90~2.79), and cognitive disability (OR=2.09, 95% CI=1.88~2.32) were significant risk factors for depression among members of the baby boomer generation.

Conclusion: It is necessary to develop programs to manage mental health issues such as stress, which is a major factor in the experience of depression among members of the baby boomer generation, to increase life satisfaction. In addition, active attention is needed continuously to assist in the mental health of members of the baby boomer generation.

Purpose: The purpose of this study was to develop and implement a customized integrated health-management program (CIHMP) for socially isolated older adults living alone and to evaluate its effectiveness.

Methods: We used a nonequivalent control group pretest-posttest design. Participants were 49 older adults living alone (experimental group: 24, control group: 25). The experimental group participated in a CIHMP 10-week program that included the following components: greeting phone calls, individual health counseling by phone, health education, laughter therapy, pottery activities, and physical exercise. The control group continued their usual isolated daily living. We analyzed data using the independent t-test and Mann-Whitney U test with SPSS/Win version 24.0.

Results: Significant differences emerged between groups in right-hand grip strength (t=-2.22, p=.031), Short Physical-Performance Battery (z=-5.57, p<.001), self-esteem (t=-3.54, p=.001), depression (z=-3.30, p=.001), and health-management self-efficacy (t=2.43, p=.019).

Conclusion: Findings indicated that the CIHMP was effective in improving physical function, self-esteem, depression, and health management self-efficacy among older adults living alone. Therefore, the CIHMP may be a useful community-based intervention for this population.

Purpose: In this study, we aimed to define the specific competencies required for nurses to effectively support healthy aging, thereby enhancing the professionalism of nurses, improving the quality of nursing services related to healthy aging, and ultimately contributing to the quality of life for older adults.

Methods: Through a literature review, we derived nursing competencies for healthy aging; based on the review, we verified content validity through a Delphi survey with 10 related experts. Expert Delphi survey participants judged that expert opinions were not in agreement when the content validity ratio was less than 0.62, the consensus was less than 0.75, and the convergence was in the range of 0 to 0.5.

Results: Nursing competency for healthy aging consists of 9 domains, 26 key competencies, and 132 enabling competencies. Areas include "Assessment of healthy aging," "Service coordination," "Prevention and management of intrinsic capacity decline," "Support for caregivers and care staff," "Collaboration," "Communication," "Leadership," "Professional ethics," and "Education and Research."

Conclusion: This study provides foundational data, enhancing the professionalism and expanding the roles of nurses by specifically presenting competencies required to support healthy aging in older adults. These competencies can serve as practical and systematic guidelines to advance nursing education and competency development, enabling nurses to effectively support healthy aging in older adults.

Purpose: In this study, we analyzed factors influencing depression among adults aged 65 and over.

Methods: In this descriptive cross-sectional study, we analyzed secondary data from the 9th wave (2022) of the Korean Longitudinal Study of Aging (KLoSA). A total of 4,431 participants were included. Multiple regression analysis was conducted to identify factors influencing depression in older adults.

Results: Significant factors influencing depression included occupation, region, instrumental activities of daily living, body mass index, number of chronic diseases, subjective health status, contact with children, meetings with friends, and the presence of a spouse.

Conclusion: Social connectedness, perceived health, and functional autonomy significantly influenced depression in older adults. Community-based nursing interventions should foster social ties, enhance chronic disease management, and support independence through tailored programs.

Purpose: This study aimed to identify factors influencing older patients' self-decision in withholding or withdrawing life-sustaining treatment (LST) during hospitalization.

Methods: For this retrospective case-control study (self-decision versus family-decision groups), we used electronic medical records. The sample included 624 older patients who died after completing the LST implementation form. 249 (39.9%) patients were in the self-decision group versus 375 (60.1%) patients in the family-decision group. We performed chi-square tests, t-tests, and binary logistic regression.

Results: Receiving treatment in an internal medicine department (odds ratio [OR]=12.60, 95% confidence interval [CI]=2.83~56.13), admission to a general ward (OR=2.83, 95% CI=1.33~6.02), experiencing pain (OR=2.64, 95% CI=1.68~4.13), being alert upon admission (OR=2.27, 95% CI=1.15~4.51), having a diagnosis of cancer (OR=2.01, 95% CI=1.16~3.49), and younger age (65~74 years) were significantly associated with an increased likelihood of self-decision. All factors increased the likelihood of self-decision. The self-decision group showed higher rates of withholding or withdrawing LST interventions (e.g., ventilators, dialysis, chemotherapy, extracorporeal membrane oxygenation, transfusions, and vasopressors) and received more hospice and palliative care with reduced Intensive Care Unit deaths.

Conclusion: The self-decision group (i.e., those in internal medicine, with cancer, admitted to general wards, and maintaining consciousness) chose reduced futile LSTs. These findings highlight the need to develop a standardized protocol for counseling and education to facilitate informed end-of-life decisions among older inpatients.

Purpose: In this study aimed to identify the impact of depression, social support, and uncertainty on self-management compliance in patients with chronic obstructive pulmonary disease (COPD).

Methods: Participants were 160 patients with COPD in a university hospital located in B metropolitan city. Data were collected from August to September 2023 using a questionnaire on depression, social support, uncertainty, and self-management compliance. We analyzed data using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple regression.

Results: The average age of the participants was 66.94±6.83 years; men accounted for 73.1%. Self-management compliance showed a significant statistical positive correlation with social support (r=.53, p<.001) and negative correlations with depression (r=-.64, p<.001) and uncertainty (r=-.65, p<.001). Total explanatory power was 62.0% of the total variance in self-management compliance (F=38.04, p<.001). Related factors of self-management compliance were depression (β=-.35, p<.001), uncertainty (β=-.32, p<.001), social support (β=.17, p=.006), current smoking status (β=.14, p=.007), and gender (β=.11, p=.038).

Conclusion: These results provide basic data for the development of patient-education protocols to promote the self-management compliance of patients with COPD.