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뇌졸중 노인과 가족을 위한 주간보호사업의 효과 재가 노인 및 가족과의 비교
박연환 한국간호과학회 2003 Journal of Korean Academy of Nursing Vol.33 No.8
Purpose: The purpose of this study was to identify the effects of the day care service for the elderly and family with the stroke. Method: Data were collected from September 2002 to March 2003 by self report questionnaires and interview. 50 elderlies and families(Gr I) who used day care center were compared with 51 elderlies and families (Gr II) who didn't used. The data were analyzed using independent sample t test and chi square test. Result: The general characteristics, stressors, and situational variables related to outcome variables were homogeneous between two groups. The caregiver burden(t=-2.287, p=.024) score in the Gr I was significantly lower than in the Gr II. However there was no evidence of an effect day care center attendance on the depression of the elderly, the relationship between elderly and caregiver, and the family functioning. Conclusion: Findings indicate that day care service was effective in reducing the caregiver burden of the elderly, however more day care service programs(elderly health management, rehabilitation...)will be added.
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박연환,김주현,김희자 성인간호학회 2002 성인간호학회지 Vol.14 No.3
Purpose: The purpose of this study was to identify the factors influencing regular exercise of the elderly in discriminating regular exercise and non - regular exercise groups. Method: The subjects of this study were 167 elderly over the age of 60, living in a rural city in Korea. The data was collected by interview and self report questionnaire in 1999. The Cronbach 's alpha of scales used this study were .66 ∼.97. Result: 1. There were significant differences in doing regular exercise between the perceived importance of the health(p=021), the perceived health status(p=.050), the perceived need of the exercise(p=000), the perceived importance of the exercise(p=.000), the intent of participation in the exercise program(p=.000), IADL score(p=.022), the perceived benefits of exercise (p=.000), the emotion of exercise(p=.000), HPLP(p=.000), the self efficacy(p=.001), the perceived benefits of health promoting behaviors(p= .011), the perceived barriers of the health promoting behaviors(p=.002), and the Internal locus of control (p=.021) of the elderly. 2. Variables which showed significance for discriminating regular exercise of the elderly in this study were the perceived need of the exercise(p=.000) and the perceived benefits of the exercise(p=.000). By using the combination of these variables, the possibility of proper prediction for predicting regular exercise group was 84.8%, non - regular exercise group was 93.9%, and total Hit ratio was 89.4%. Conclusion: To improve exercise behavior in older adults, health care providers should focus of developing interventions to strengthen the perceived benefits, the perceived needs of the exercise.
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박연환,송미순 서울대학교 간호대학 간호과학연구소 1995 간호학 논문집 Vol.9 No.1
This study was accomplished to attain basic data to establish Korean Home Care Model through the investigation of prevalence of chronic disease and frequency, contents of home care needs of the elderly who were aged over sixty five in a rural county of Kunggi province, Korea. The number of subjects was 513 elderly who were selected by stratified cluster sampling from a county population. The data were collected during the period from July 26, 1993 to August 6, 1993. The data were collected through interviews with questionnaire, checking blood pressure and observation by trained senior nursing students who visited each household. Six out of seven criteria, which were selected by Seoul National University Community Health System Demonstration Project to investigate home health care needs in the area, were adapted in this study, to screen home care needs of the elderly. It was regarded that home care need is present if there is severe impairment on any one item of the questionnaire composed of eighty eight three point rating scale. The items of questionnaire consisted of symptoms of chronic illness, source of social support, functional capacity and demographic data. The data were analyzed with descriptive statistics and x²test by means of p/c SAS program. The results were as followings; 1) The prevalence of chronic illness in the elderly was 49.9%, and the number of chronic illness for each older person was .65. Neurological and joint disease(22%), and hypertensive disease(19.0%) were the most prevalent chronic illness. 2) The elderly who have more than one home care need were 61.0% of all subjects. There were 34% of the subjects who met more than two home care need criteria. The rates of home care need among subjects according to each home Care need criteria were as follows. (1)The subjects who impaired to control or recover from the chronic were 19.3%, and the subjects who had educational need were 40.7%. It means that major proportion of home care activities should be planned with appropriate education and management of chronic illness, which enhances ompliance, minimize complications and potentiate rehabilitational abilities. (2) The rate of recently discharged patients and the subjects with special medical appliance was under 1%. However they should be cared by the hospital based home care nurses who are familial with high technique nursing. (3) The subjects with insufficient health management abilities among elderly were 33.1%. Therefore, home care service for the elderly should not be limited to the extension of hospital care, but comprehensive health promotion services should be included. (4) The subjects who have insufficient familial support were 18.9%, It is suggested that social service should be included in home care service. 3) Followings are the result of chi square tests, examing difference in prevalence of home care needs among different characteristics of the subjects. (1) There were significant differences in prevalence of need for control or recovery from the chronic illness between sexes (P<.001), chronically ill and non-chronically ill(P<.001). (2) There were significant differences in prevalence of need for health management between sexes (P<.001), young-old and old-old age(P<.001), educational levels(P<.001), chronically ill and non-chronically ill(P<.001), and good and poor transportational convenience(P<.05). (3) There were significant differences in familial support need between sexes (P<.05), educational levels (P<.05), the number of family members (P<.05), chronically ill and nonchronically ill (P<.001), and rural and non-rural and non-rural residental area (P<.05). (4) There were significant differences in educational need between chronically ill and non chronically ill (P<.001), rural and non-rural residental area (P<.001), and good and poor transportational convenience (P<.001). In conclusion, above characteristics of home care needs of community elderly should be considered in development of Korean Home Care Model.
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Dysphagia Screening Measures for Use in Nursing Homes: A Systematic Review
박연환,방활란,한혜라,장희경 한국간호과학회 2015 Journal of Korean Academy of Nursing Vol.45 No.1
Purpose: The purpose of this study was to evaluate the psychometric quality and feasibility of measurements for screening dysphagia inolder adults to identify the ‘right tool’ for nurses to use in nursing homes. Methods: A systematic review was done. Electronic databaseswere searched for studies related to dysphagia screening measurements. A checklist was used to evaluate the psychometric quality andapplicability. Tools were evaluated for feasible incorporation into routine care by nurses. Results: 29 tools from 31 studies were identified. Dysphagia screening tools with an acceptable validity and reliability had sensitivity between 68% and 100% and specificity between 52%and 100%. The Gugging Swallowing Screen (GUSS) and the Standardized Swallowing Assessment (SSA) were the tools with high psychometricquality, especially with high sensitivity, that nurses could perform feasibly to identify the risk and to grade the severity of dysphagiaand aspiration of nursing home residents. Conclusion: Results show that GUSS and SSA are reliable and sensitive tools forscreening dysphagia which nurses can use in nursing homes. Further research is needed to examine feasibility of screening with identifiedtools, and also, to establish effective and standardized protocols for these tools so they can be effectively incorporated into routine care.
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박연환 대한연하장애학회 2011 대한연하장애학회지 Vol.1 No.1
Dysphagia becomes an increasingly common problem ad people age; its prevalence and the increased risk of related complications have brought the attention of nurses. Especially with a growing number of older people in nursing homes suffering from dysphagia, need for evidence-bases dysphagia assessment and nursing management increasing worldwide. Older adults with dysphagia can be identified through systematic interviews, observations, and test swallows. The diverse range of causes may manifest in a number of different ways, but should always act as a warning sign, which requires further investigation. Management is multidisciplinary, depending on the underlying cause, extent of dysphagia, likely prognosis, and setting. Nurses have successfully used standardized swallowing assessments to provide early detection and management of dysphagia. Nurses benefit from application of systematic guideline. Early detection and management of dysphagia by nurses using a standardized guideline is essential for evidence- based nursing practice in nursing homes as well as acute care settings.
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