No abstract

Background In Korea, along with the rapid aging of the population, older adults’ living arrangements have changed in various ways. In particularly, the happiness of older adults living alone warrants attention because they are more vulnerable to unhappiness than those living with families are. This study reports on the level of happiness among older adults in Korean and examines the potential mediating roles of depressive symptoms, present health status, socio-physical environment, social support networks, and social activities, and happiness in three different living arrangements, older adults living alone, with their spouse, or with their family. Method Data for this study were extracted from the secondary data from the 2017 Korean Community Health Survey, a non-experimental, cross-sectional survey conducted among Korean individuals that were aged 65 and above (n = 14,687). The chi-square test, one-way ANOVA, and Logistic regression were used to explore the related factors of happiness among the three groups. Results Findings revealed a significant difference in the happiness index among older adults living alone (6.22 ± 2.11), older adults living with their spouse (6.76 ± 1.99), and older adults living with their family (6.46 ± 1.94) (F = 88.69, p < .001). As the result of logistic regression, older adults living alone (odds ratio (OR) = 0.75, 95% confidence interval (CI) = 0.57–0.99) and those living with their family (OR = 0.80, 95% CI = 0.65–0.99) demonstrated greater happiness as the frequency of contact with their family increased. Older adults living with their spouse indicated an increase in happiness when their contact with friends was higher (OR = 0.69, 95% CI = 0.56–0.84). Conclusion It was recognized that factors influencing happiness differed according to older adults’ living arrangements, thus suggesting that older adults’ happiness could be facilitated through interventions that consider their circumstances, including living arrangements.

Purpose: The study purposes were to construct and test structural equation modeling on the causal relationship of community residents' perceived quality of care, image, and role performance with satisfaction, intention to (re)visit and intention to recommend hospital. Methods: A cross-sectional survey was conducted with 3,900 community residents from 39 district public hospitals. The questionnaire was designed to collected information on personal characteristics and community awareness of public hospitals. Community awareness consisted of 6 factors and 18 items. The data were collected utilizing call-interview by a survey company. Research data were collected via questionnaires and analyzed using SPSS version 20.0 and AMOS version 20.0. Results: Model fit indices for the hypothetical model were suitable for the recommended level: χ 2 = 796.40 (df=79, p < .001), GFI=.93, AGFI=.90, RMSR=.08, NFI=.94. Quality of care, image, and role performance explained 68.1% of variance in community awareness. Total effect of quality of care process factors on satisfaction (path coefficients=3.67), intention to (re)visit (path coefficients=2.67) and intention to recommend hospital (coefficients=2.45) were higher than other factors. Conclusion: Findings show that public hospitals have to make an effort to improve community image through the provision of quality care, and excellent role performance. Support for these activities is available from both Central and Local Governments.

Chronic diseases are a major cause of death and have a negative impact on community health. This study explored the effects of a chronic-disease management program utilizing the physician–primary-healthcare nurse telemedicine model (P–NTM) on medication adherence and health-related quality of life (HRQoL) in 113 patients with chronic diseases in remote rural areas. We used a quasi-experimental, nonequivalent-control-group pretest–post-test design. This study used secondary data from the 2018 Pilot Telemedicine Project for Underserved Remote Rural Areas. In this study, 113 subjects participated, in which the patient’s first visit was assigned as a control group for the previous face-to-face hospital care; after three months of receiving the P–NTM program, the same subjects were assigned to be the experiment group for P–NTM. Data were analyzed by using descriptive statistics, a paired t-test, and logistic regression. With regard to the results, subjects showed a 1.76 times higher probability of improving medication adherence after participating in P–NTM compared to hospital care (odds ratio (OR) = 1.76, 95% confidence interval (CI) = 1.34–2.31). Our findings showed that patients with chronic diseases, especially those who reside in remote rural areas, should be provided with effective health services, utilizing various strategies to enhance a healthy life.

This study explored the effects of a comprehensive health-care program (CHCP) on blood pressure, blood glucose, body composition, and depression in older adults living alone. We used a quasi-experimental, two-group, pretest–posttest design. The CHCP consisted of open lectures, health counseling, exercise classes, nutrition counseling, and self-help group meetings at a local senior welfare center. Fifty-eight subjects participated in this study, with thirty subjects in the experimental group and twenty-eight subjects in the control group. Data were analyzed by using the descriptive statistics, χ2-test, and t-test. Comparisons of the pretest and posttest systolic blood pressure (t = −2.530, p < 0.016) and blood glucose (t = 3.089, p < 0.004) between the experimental and control groups showed significant differences. In both the experimental (t = 3.949, p < 0.001) and control groups (t = 3.816, p < 0.002), depression symptoms showed a significant decrease posttest, compared with pretest. Our findings infer that older adults require physical and psychosocial health care and that more efforts must be made to improve the general health and well-being of this population group.

Introduction: The present study aims to understand the experiences and characteristics of nurses caring for patients with mental disorders characterized by aggressive behavior. Aim: The study aimed to understand and interpret the physical and psychological experiences and positive and negative aspects associated with nursing practices of patients with anger and aggressive behavior. Method: The participants of this study were twelve nurses with over three years of experience working in a mental hospital. More specifically, all our participants had experience caring for psychiatric patients with anger and aggressive behavior. The collected data were analyzed using the phenomenological analysis method and the procedure proposed by Colaizzi (1978). Result: The nurses’ experience was described in five categories: “fear of violence”, “exposure to a poor working environment”, “difficulty of emotional control”, “career regrets”, and “finding a solution to violence.” Discussion: The hospital should encourage and provide training sessions to teach nurses how to use proper intervention technique regarding medication and seclusion. Implications: The results of the present study suggest the need for ongoing hospital support and program development, intervention studies, and improvement of the work environment to resolve the burden of mental and physical difficulties experienced by psychiatric nurses.

This study examined the effects of a smoking cessation coaching program based on the motivation stage applying the Transtheoretical Model to stop the smoking of patients in terms of the amount of smoking, nicotine dependence, CO level, and urine cotinine. The study design was a multi-repeat multiple repeat intermittent time series study with one-group, a pre-post design. The participants were 47 smoking patients (44 males and 3 females), who were treated at a public hospital in N city. The participants were 4 (8.51%) subjects in the action stage and 43 subjects (91.49%) in the preparation stage of the motivation stage. The coaching program intervention was conducted at the first day, second week, and 6th week. The smoking cessation maintenance of the subjects was checked at the 12th week. A chi-square test and t-test were used to analyze the data. The subjects in the action stage were kept under the condition of no smoking and nicotine dependence. After the program of subjects in the preparation stage, the amount of smoking, nicotine dependence, and CO level were significantly lower compared to the pre-test (p<.001). The findings suggest that the coaching program based on the motivation stage was effective in improving the smoking cessation for patients who smoke. On the other hand, the patients in the smoking cessation program may require much more financial assistance than those of healthy people. A greater workforce and budget will be needed for patients to stop smoking.

Background The happiness of older adults living alone warrants attention because they are more vulnerable to unhappiness than those living with families. The present study aimed to construct and test a structural equation model to elucidate the relationship among participation in social activities, satisfaction with the neighborhood environment, subjective health status, and happiness in older adults living alone in South Korea. Methods Secondary data of 2768 older adults (605 males and 2163 females) living on their own were extracted from the 2017 Korean Community Health Survey and used in this cross-sectional study. Data were collected via self-reported questionnaires and analyzed using SPSS version 20.0 and AMOS version 20.0. Results The hypothetical model exhibited a good fit: χ2 = 342.06 (df = 58, p < .001), goodness-of-fit index = .98, adjected goodness-of-fit index = .97, root mean square error of approximation = .04, and nonstandard fit index = .92. Participation in social activities had a significant effect on participants’ subjective health status (path coefficient = .45, p = .001) and happiness (path coefficient = .20, p = .003). Conclusions Interventions to improve the health and happiness of older adults living alone should aim to enhance their social and physical environmental dimensions based on the participants’ various social activities and their neighborhoods’ characteristics.