Factors Influencing the Intention of Admission into a Charged Nursing Home for the Elderly / 예방의학회지

OBJECTIVES: To gather information about the factors which influence the interest and intention of admission into charging nursing homes for the elderly(CNH), as these homes represent an important method for resolving the problems related to the rapid population aging occurring in Korea. METHODS: A face-to-face interview survey was carried out with 328(men 159, women 169) patients over 60 years old who were admitted at 2 university hospitals and 5 general hospitals in the Busan area between December 1998 and March 1999. Data were analyzed through t-test, ANOVA, correlation and multiple regression analysis. microgram/g RESULTS: The mean age and years of education of the study population was 67.8 and 7.7 years, and the types of chronic degenerative disease included musculoskeletal disorders(20.1%), cerebrovascular disease(17.1%), and diabetes(14.3%). The major forms of household living arrangement prior to admission were elderly alone(22.6%), and elderly couple(33.5%), while about half of them(55.5%) didn't want to live with their children in the future. Almost half were paying medication fees by themselves(46.6%). The level of actual intention of admission(3.07+/-1.39) into a CNH was lower than that of interest(3.22+/-1.33)(p<0.01). Multiple analysis revealed that the intention of admission increased with decreasing number of future supportive persons(beta=0.107), lower level of activity in daily life(beta=0.447), and longer years of education(beta=0.447) with 32.7% of R2. As for the factors which determined the admission into a CNH, the fee and facilities were considered to be most important, and professional nursing and physician's care were the most desired services. In nomenclature, they preferred "elderly hospital" or "elderly health center" to CNH. CONCLUSIONS: Interest in CNH is increasing recently, but existing studies about patient experiences in CHN are still limited. This study may form a basis for future examinations of the needs and uses for CNH. Active financial support and public information are considered by the authors to be important factors for the induction of welfare services for the elderly, through CNH.

A Model for the Factors Affecting Depression in the Elderly with Chronic Disease

BACKGROUND: In elderly, chronic diseases are common, and depression is frequently associated with the chronic physical conditions and their progress. This study was conducted to propose the basic data to assist the comprehensive care of chronically ill elderly through draw-up the trimmed model to explain the factors affecting depression. METHODS: The subjects were 402 elderly patients (114 men, 288 women) who had been taking medication more than one year at the community health centers in the city of Busan. During March 2000, the questionnaire survey was performed on their demographic characteristics, the state of chronic disease and depression, psychosocial resources(mastery, self esteem, social support), nutritional state, economic strain, stress and functional state(ADL and IADL). The state of depression was assessed with the Short Form of Geriatric Depression Scale(SGDS) The reliability test and path analysis were done by SPSS(ver7.5) and LISREL(ver 8.3) RESULTS: The reliability of the scales were fair in all items(Cronbach's alpha>0.5) In the state of present chronic diseases, hypertension(30.4%), musculoskeletal disorders(28.6%), and diabetes mellitus(12.8%) were common. The prevalence of depression(>6 scale in SGDS) was relatively high as 61.2%. In the result of path analysis, depression was aggravated with undermined self-esteem and mastery, chronic disease, economic strain, poor functional and nutritional state (p<0.01). Chronic disease affected depression directly(65.6%) as well as indirectly through psychosocial resources, untritional state, functional state and stress. CONCLUSION: The results show that chronic disease were closely associated with depression, though this study was questionnaire based and limited to the elderly who visited the health centers. concludingly, when take care elderly with chronic disease, physicians'considerations about the depression as well as physically ill conditions were important for the comprehensive care.