Predictive Model for Quality of Life of the Older Men Living Alone

Purpose@#This study aimed to construct and test a predictive model that explains and predicts the quality of life in older men living alone. @*Methods@#A self-report questionnaire was used to collect data from 334 older adult men living along aged 65 years or over living in Jeollanam-do provinces. The endogenous variables were depression, self-rated health, instrumental activity of daily life, health promotion behaviors, the number of social participation activities and quality of life. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs. @*Results@#The final model with 14 of the 8 analysed paths showed a good fit to the empirical data: χ2= 173.26(p < .001, df = 53),normed χ2= 3.27, GFI = .92, NFI = .90, CFI = .93, TLI = .89, RMSEA = .08 and SRMR = .06. Activities had direct effect on quality of life of older men living alone and social support had both direct and indirect effects. Meanwhile, function and socioeconomic status showed only indirect effects.The variables included in the eight significant paths explained 83.7% of variance in the prediction model. @*Conclusion@#Instrumental activities of daily living and social support effect directly on quality of life in the older men living alone. Findings suggest that health care providers including community nurses need to provide social support as well as empowerment programs of instrumental activities of daily living and health promotion for improving quality of life of the older men living alone.

Socioeconomic Inequalities in Depressive Symptoms among Korean Older Men and Women: Contribution of Social Support Resources

Purpose@#This study explored the contribution of social support resources to the explanation of socioeconomic inequalities in depressive symptoms of older Korean men and women. @*Methods@#Data were derived from Living Profiles of Older People Survey (LPOPS), which comprises a nationally representative sample of non-institutionalized Korean older adults living in the community. The data were analyzed by using multiple logistic regression. The sample consisted of 4,046 men and 6,036 women aged ≥65 years. The Korean version of the Geriatric Depression Scale-Short form (SGDS-K) was employed as an outcome variable. @*Results@#Compared to the older men and women who were in higher socioeconomic status, those in lower socioeconomic status had significantly higher risk of depressive symptoms after adjusting for other covariates. When social support resources were individually included in the base model, each factor contributed to inequalities in depressive symptoms. Social networks explained about 20% of the differential impact of education and 10% to 15% of the differential impact of household income for depressive symptoms in men. Among women, it mitigated 23.6% to 39.0% of education and household income inequalities for depressive symptoms. Social participation contributed to buffer depressive symptom inequalities of 24.0% to 46.3% among men and those of 11.7% to 45.3% among women. @*Conclusion@#Our findings suggest community care nurses acknowledge the value of social support resources to alleviate socioeconomic inequality in depressive symptoms among older men and women.

Predictive Model for Quality of Life of the Older Men Living Alone

Purpose@#This study aimed to construct and test a predictive model that explains and predicts the quality of life in older men living alone. @*Methods@#A self-report questionnaire was used to collect data from 334 older adult men living along aged 65 years or over living in Jeollanam-do provinces. The endogenous variables were depression, self-rated health, instrumental activity of daily life, health promotion behaviors, the number of social participation activities and quality of life. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs. @*Results@#The final model with 14 of the 8 analysed paths showed a good fit to the empirical data: χ2= 173.26(p < .001, df = 53),normed χ2= 3.27, GFI = .92, NFI = .90, CFI = .93, TLI = .89, RMSEA = .08 and SRMR = .06. Activities had direct effect on quality of life of older men living alone and social support had both direct and indirect effects. Meanwhile, function and socioeconomic status showed only indirect effects.The variables included in the eight significant paths explained 83.7% of variance in the prediction model. @*Conclusion@#Instrumental activities of daily living and social support effect directly on quality of life in the older men living alone. Findings suggest that health care providers including community nurses need to provide social support as well as empowerment programs of instrumental activities of daily living and health promotion for improving quality of life of the older men living alone.

Socioeconomic Inequalities in Depressive Symptoms among Korean Older Men and Women: Contribution of Social Support Resources

Purpose@#This study explored the contribution of social support resources to the explanation of socioeconomic inequalities in depressive symptoms of older Korean men and women. @*Methods@#Data were derived from Living Profiles of Older People Survey (LPOPS), which comprises a nationally representative sample of non-institutionalized Korean older adults living in the community. The data were analyzed by using multiple logistic regression. The sample consisted of 4,046 men and 6,036 women aged ≥65 years. The Korean version of the Geriatric Depression Scale-Short form (SGDS-K) was employed as an outcome variable. @*Results@#Compared to the older men and women who were in higher socioeconomic status, those in lower socioeconomic status had significantly higher risk of depressive symptoms after adjusting for other covariates. When social support resources were individually included in the base model, each factor contributed to inequalities in depressive symptoms. Social networks explained about 20% of the differential impact of education and 10% to 15% of the differential impact of household income for depressive symptoms in men. Among women, it mitigated 23.6% to 39.0% of education and household income inequalities for depressive symptoms. Social participation contributed to buffer depressive symptom inequalities of 24.0% to 46.3% among men and those of 11.7% to 45.3% among women. @*Conclusion@#Our findings suggest community care nurses acknowledge the value of social support resources to alleviate socioeconomic inequality in depressive symptoms among older men and women.

Correlates of Depressive Symptoms and Stress among Korean Women Care-workers for Older Adults Dwelling in Community / 한국직업건강간호학회지

PURPOSE: This study identified the prevalence of depressive symptoms and explored correlates of depressive symptoms among Korean women care-workers caring older adults living in community. METHODS: A total of 465 participants were recruited for the study. Depressive symptoms was measured by the CES-D10 and distress was assessed using a single question given 5 Likert scale. RESULTS: The prevalence of depressive symptoms and distress among care-workers were 32.5% and 32.0% respectively. Work environment safety, violence exposure experience, work-family conflict, weekly care work time, and poor health status were significantly associated with depressive symptoms. Only violence exposure experience and poor health status were associated with distress. CONCLUSION: Our findings suggest more attention on mental health of care-workers and their risky work condition such as violence.

The Impacts of Psychosocial Work Environments on Depressive Symptoms among Korean Registered Nurses / 한국직업건강간호학회지

PURPOSE: The aim of this study was to explore the association between psychosocial work environments and depressive symptoms among Korean registered nurses. METHODS: The study population of 331 registered nurses was derived from the 2014 Korean Working Condition Survey (KWCS). Depressive symptom was assessed using the WHO-5 wellbeing index. RESULTS: The thirty-five percentage of Korean registered nurses reported the risk for depressive symptom. Korean nurses with higher ‘work-family conflict’ were more likely at the risk of depression almost 1.83 (95% CI 1.04~3.20) times than their counterpart. Higher ‘possibilities for development’ were more likely decrease almost 60% of the risk of depressive symptom. CONCLUSION: Work-family conflict and possibility of development were associated with depressive symptom among Korean registered nurses. We suggest future researches identifying strategies for decreasing work-family conflict and its negative effects.

Influence of Stigma and Social Support on Depressive Symptoms in Hospitalized Patients with Pulmonary Tuberculosis / 정신간호학회지

PURPOSE: The aim of this study was to examine the relationships between depressive symptoms, stigma and social support in hospitalized PTB (pulmonary tuberculosis) patients. METHODS: Participants were 256 patients with PTB who were admitted in two national tuberculosis hospitals. RESULTS: Higher levels of stigma were significantly related to depressive symptoms in patients with PTB. Self-reports of social support by medical staff were negatively associated with depressive symptoms in patients with PTB. Stigma and social support by medical staff were found to be significant predictors of depressive symptoms after controlling for potential confounders. CONCLUSION: Findings suggest that intervention for depressive symptoms be incorporated into treatment for patients with PTB, and strategies to decrease TB-related stigma and increase social support by medical staff be provided to prevent depressive symptoms.

Correlates of Depression among Married Immigrant Women in Korea / 정신간호학회지

PURPOSE: This study was done to examine the prevalence and associated factors of depressive symptoms among married immigrant women in South Korea. METHODS: Data from the 2015 Living Profiles of Multiculture Family Survey were used in this study. The sample consisted of 1,579 married immigrant women aged 19 to 39 years. Sociodemographic, acculturation, and social support factors were analyzed. Logistic regression was used for the data analysis. RESULTS: Married immigrant women having a poor relationship with their husbands and a culture gap with husbands were more likely to report depressive symptoms. Low socioeconomic status, no satisfaction with mother role, and no satisfaction with father role, and high social support resources were associated with depressive symptoms among married immigrant women in Korea. Having a moderate level of social support resources was more likely to lower the risk of depressive symptoms than high social support resources. CONCLUSION: The findings in this study indicate that prevention of depressive symptoms in married immigrant women in Korea could be aided by acculturation programs that include participation of husbands and social supports for the parenting role.

Prediction Model for Health-Related Quality of Life in Hospitalized Patients with Pulmonary Tuberculosis

PURPOSE: This study was conducted to construct and test a structural equation model of health-related quality of life (HRQoL) among hospitalized patients with pulmonary tuberculosis (PTB). METHODS: Participants were 256 patients with PTB who were 20 years or older and admitted in two national tuberculosis hospitals. The patients participated in pulmonary function testing and responded to structured questionaries. RESULTS: The goodness-of-fit statistics of the final hypothetical model were as follows: χ2/df=2.19, RMSEA=.07, SRMR=.05, GFI=.95, NFI=.95, CFI=.96, TLI=.92, and PCFI=.52. Symptoms and general health perception had significant direct effects, and subjective economic status, social support and stigma had significant indirect effect on HRQoL of hospitalized patients with PTB. These variables explained 64% of variance in the prediction model. CONCLUSION: Findings suggest that strategies and intervention for physical symptoms and depressive symptoms are crucial to improve the quality of life in hospitalized patients with PTB. The development of various social support programs is also recommended.

Effects of Frailty on Health-related Quality of Life of Rural Community-dwelling Elderly: Mediating and Moderating Effects of Fall-Related Efficacy and Social Support

PURPOSE: The purpose of this study was to examine the mediating and moderating effects of fall-related efficacy and social support on the relationship between frailty and health-related quality of life among rural community-dwelling elderly. METHODS: A cross-sectional survey was conducted with a convenient sampling method, and data of 438 elderly residents living in a rural community was used. The structured questionnaire included items from the Euro Quality of life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/ depression), fall-related efficacy and social support. RESULTS: Analysis of the mediating effect of fall-related efficacy and social support showed that there was significant mediating influence of fall-related efficacy on the relationship between frailty and health-related quality of life. There were no moderating effects of fall-related efficacy and social support. CONCLUSION: The findings suggest that fall-related efficacy may play a role in reducing the effect of frailty on health-related quality of life and underscore the need to consider ways of enhancing fall-related efficacy in interventions for rural community-dwelling frail elderly.

The Prediction of Industrial Accident Rate in Korea: A Time Series Analysis / 한국직업건강간호학회지

PURPOSE: The purpose of this study is to predict industrial accident rate using time series analysis. METHODS: The rates of industrial accident and occupational injury death were analyzed using industrial accident statistics analysis system of the Korea Occupational Safety and Health Agency from 2001 to 2014. Time series analysis was done using the most recent data, such as raw materials of Economically Active Population Survey, Economic Statistics System of the Bank of Korea, and e-National indicators. The best-fit model with time series analysis to predict occupational injury was developed by identifying predictors when the value of Akaike Information Criteria was the lowest point. Variables into the model were selected through a series of expertises' consultations and literature review, which consisted of socioeconomic structure, labor force structure, working conditions, and occupational accidents. RESULTS: Indexes at the meso- and macro-levels predicting well occurrence of occupational accidents and occupational injury death were labor force participation rate for ages 45-49 and budget for small scaled work-place support. The rates of industrial accident and occupational injury death are expected to decline. CONCLUSION: For reducing industrial accident continuously, we call for safe employment policy of economically active middle aged adults and support for improving safety work environment of small sized workplace.

The Impacts of Psychosocial Work Conditions on Self-rated Health among Korean Workers / 한국직업건강간호학회지

PURPOSE: Few studies have considered the psychosocial work environment factors in relation to employee health. This study explored the relationship between psychosocial work characteristics and self-rated health among Korean employees. METHODS: The study population of 21,476 employees was derived from the 2014 Korean Work Environment Survey (KWES). Psychosocial work environment was measured by Copenhagen psychosocial questionnaire scales. RESULTS: Among employees at workplaces (n=21,476), 23.3% rated their health as poor. Among 12 indicators of psychosocial work environment characteristics, ‘higher emotional demand’, ‘demands for hiding emotions’, ‘work-family conflict’, and ‘social community at work’ were independently associated with risk of poor self-rated health of Korean employees after adjustment of all sociodemographics, work condition characteristics and physical work environment exposure. In addition, higher ‘possibilities for development’ and ‘social support from supervisor’ were more likely to decrease the risk of poor health. CONCLUSION: We suggest that psychosocial work environment is an important determinant of employees' health. The study results provide a good starting point for developing intervention and strategies for health improvement.

Prevalence and Social Correlates of Frailty Among Rural Community-Dwelling Older Adults

BACKGROUND: Frailty, a multidimensional geriatric syndrome, confers a high risk of falls, disability, hospitalization, and mortality. The prevalence and correlates of frailty in older people dwelling in rural communities are unknown. METHODS: We examined frailty, as defined by the Korean Geriatric Society, and social correlates among rural community-dwelling older adults (n=419) aged 65 or older. RESULTS: The prevalence of frailty and prefrailty was 11.5% and 38.7%, respectively. Among eight frailty criteria, the prevalence of multiple medications was highest (57.3%), while self-rated health as "unhealthy" was the second highest (45.1%). In contrast, the prevalence of exhaustion was the lowest (10%) among the eight frailty criteria. The prevalence of frailty was 12.6% among women and 6.3% among men (p=0.02). Uneducated older adults showed a significantly higher prevalence of frailty (13.1%) than any other educational groups (6.3-9.2%). In addition, older adults with high social support showed lower frailty than the other groups. After adjustment for other factors; however, a lack of social support (odds ratio for frailty, 1.98; 95% confidence interval, 1.14-3.44) was associated with increased odds of frailty. CONCLUSION: Frailty is not uncommon among rural community-dwelling old men and women in Korea. In the rural community, females with a lack of social support might be at a higher risk of frailty, as those were two of the strongest risk factors discovered in this study. This study calls for more interest and concern for the frail older adults with a lack of social support in rural communities.

Social Support, Social Network, and Frailty in Korean Elderly

BACKGROUND: The concept of frailty has been extended to include social factors such as poverty and social support networks. The frailty index developed for elderly Canadians was recently examined in terms of the current broader concept of frailty. The present study explored the relationship between social support networks and frailty in Korean elderly individuals aged 65 years or older. METHODS: A total of 1,874 people aged 65 years or older were recruited by judgment sampling of the population of Seocho-gu in Seoul and surveyed in 2011. The Korean Frailty Index, developed by the Korean Geriatric Society, was used as an outcome variable. A proportional odds model was used to evaluate the relationship between social support networks and depressive symptoms. RESULTS: The prevalence of frailty and pre-frailty were 7.7% and 25.5%, respectively. A total of 9.9% of older adults lacked a social network, and 13.6% were deficient in social support. Social support networks were associated with frailty. Adjusting for sociodemographic factors (age, sex, marital status, economic status, and education), lack of a social network and support were associated with increased odds of frailty (social network: odds ratio 2.15, 95% confidence interval 1.58-2.92; social support: odds ratio 2.01, 95% confidence interval 1.54-2.63). CONCLUSION: Consistent with the concept of frailty being broadened to include social factors, frailty among elderly individuals was found to be influenced by social support networks.

The Relationship between Frailty and Health-Related Quality of Life among Korean Elderly

BACKGROUND: Verifying the effect of frailty on health-related quality of life may help us better understand the impact of frailty. The present study explored the relationship between frailty and health-related quality of life in community-dwelling Korean elderly. METHODS: Older adults aged 65 years or older recruited by judgment sampling of the population of Seocho-gu in Seoul were surveyed in 2011. The Korean frailty index measure developed by the Korean Geriatric Society was used as the outcome variable. Proportional odds model was used to evaluate the relationship between health-related quality of life (HRQoL) and frailty. RESULTS: We found that, after adjusting for sociodemographic covariates, being prefrail or frail significantly increased the proportional odds for lowering health-related quality of life than being nonfrail. In addition, of the five components of health-related quality of life, the magnitude of the adverse effects of frailty on HRQoL was largest for pain/discomfort, with anxiety/depression being the second largest. CONCLUSION: Compared to persons who are not frail, older Korean individuals identified as frail and prefrail exhibit significantly lower HRQoL scores. This association between Korean frailty measures and the generic measure of the HRQoL may offer new information to better understand frailty within its broader context.

Association between Psychosocial Work Environments and Problem Drinking: Age Differences in Korean Male Workers / 산업간호학회지

PURPOSE: This study firstly examined the pattern and prevalence of drinking. Secondly, we investigated the association between various psychosocial work environment and problem drinking among Korean male workers in different age groups. METHODS: The study sample was a weighted population of 3,289 (3,289 survey samples) men aged 20 to 64 years who responded to the 2006 Korean Working Condition Survey. Social support from colleague and supervisor, work autonomy, psychological wellbeing at work, and intellectual and emotional work demand were assessed. RESULTS: After considering sociodemographic factors, smoking, occupational characteristics and other psychosocial work environment factors, problem drinking was associated with "intellectual work demand" for the 20~34 year old group. Social support from colleague and supervisor was significantly associated with problem drinking in the 35~49 year old group. For the 50~64 year old group, problem drinking was associated with 'work autonomy'. CONCLUSION: The present study clarified that certain psychosocial work environmental factors relate to problem drinking, and the association varies among different age groups.

The Impact of Socioeconomic Factors on the Gender Differences of Disability and Subjective Health Among Elderly Koreans / 예방의학회지

OBJECTIVES: Research on the gender differences of health among older Korean people has been limited compared with the research for other stages of life. This study first examined the patterns and magnitude of the gender differences of health in later life. Second, we examined the gender differences in the health of older men and women that were attributable to differing socioeconomic conditions. METHODS: Using the nationally representative 2005 Korean National Health and Nutrition Examination Survey, the gender differences in disability and subjective poor health were assessed by calculating the age adjusted and gender-specific prevalence. Logistic regression analyses were used to assess if the differences between the men and women for health could be explained by differential exposure to socioeconomic factors and/or the differential vulnerability of men and women to these socioeconomic factors. RESULTS: Our results indicated that older women were more likely than the men to report disability and poor subjective health. The health disadvantage of older women was diminished by differential experiences with socioeconomic factors, and especially education. The differences shrink as much as 43.7% in the case of disability and 35.4% in the case of poor subjective health by the differential exposure to educational attainment. Any differential vulnerability to socioeconomic factors was not found between the men and women, which means that socioeconomic factors may have similar effect on health in both genders. CONCLUSIONS: Differential socioeconomic experience and exposure between the men and women might cause gender difference in health in old age Koreans.