PURPOSE: The purpose of this study was to investigate the effects of dependency and abuse on depression according to gender in widowed elderly. METHOD: A convenient sample consisted of 246 widowed elderly who were more than 65 years old in four cities. Data was collected using a structured questionnaire from August to September, 2002. A dependency Scale developed by Ahn (1999) was used to measure the level of dependency. Emotional abuse and physical abuse were measured by 10 items for emotional abuse and 7 items for physical abuse selected out of the Conditions Scale of Elder Abuse. The level of depression was measured by the Geriatric Depression Scale (GDS).The SPSS WIN 11.0 version program was used for data analysis. RESULT: In male widowed elderly, dependency affected depression indirectly through emotional abuse. While in female widowed elderly, dependency affected depression directly and affected emotional abuse indirectly. CONCLUSION: The study showed that dependency was the most explainable variable on depression in widowed female elderly. Therefore, it dependency should be assessed first in nursing intervention to relieve depression of widowed elderly.
Widowhood/*psychology ; Male ; Humans ; Female ; Elder Abuse/*psychology ; Depression/*etiology ; *Dependency (Psychology) ; Aged, 80 and over ; Aged

OBJECTIVETo verify the clinical efficacy on mild cognitive impairment (MCI) treated with electroacupuncture (EA) intervention based on the principle as "promoting the circulation of the Governor Vessel and regulating the marrow" and plan to provide the A-grade evidence of the evidence-based medicine for the clinical treatment of this disease with acupuncture and moxibustion.

METHODSThe multi-center randomized controlled trial (RCT) was adopted. One hundred and ninety-two cases of MCI were randomized into an EA group and a nimodipine group, 96 cases in each one. In the EA group, EA was applied to Shenting (GV 24), Baihui (GV 20), Sishen cong (EX-HN 1) and Fengchi (GB 20), once every other day. In the nimodipine group, Nimodipine was pre scribed for oral administration. Four weeks constituted one course, the treatment of 8 weeks was required. The minimum mental state examination (MMSE) and the graphic recognition test (GRT) were applied before and in the 1st and 2nd session of treatment separately. The follow-up visit of MMSE scale was provided in the 1st, 3rd and 6th months after treatment separately.

RESULTSThe total effective rate was 50.0% (47/94) in the EA group, which was superior to 34.4% (32/93) in the nimodipine group (P < 0.05). At the end of the 1st session treatment, the differences in MMSE total score and the cognitive, memory and speech dimensional scores were not significant statistically between two groups (all P > 0.05). At the end of the 2nd session treatment, the MMSE total score and the cognitive, memory, visual-space skill dimensional scores were improved in comparison before treatment (all P < 0.05). The results in the EA group were superior to those in the nimodipine group (all P < 0.05). But the difference in the speech dimensional score was not significant statistically between the two groups (P > 0.05). In the EA group, the GRT score was improved significantly after 2 sessions of treatment as compared with that before treatment (P < 0.01) and was superior to that in the nimodipine group (P < 0.05). In the 1st, 3rd and 6th month after treatment, the MMSE scale total scores were different significantly in statistics between the two groups (all P < 0.01). The long-term efficacy in the EA group was superior to that in the nimodipine group.

CONCLUSIONBoth of the EA therapy based on the principle as "promoting the circulation of the Governor Vessel and regulating the marrow" and the nimodipine program improve significantly the cognitive function of MCI patients. Compared with the nimodipine program, the EA therapy improves the comprehensive cognitive and the short-term memory abilities much more significantly and is especially advantageous at improving cognitive, memory and visual-space skill dimensions for MCI patients. In the half a year follow-up visit after the end of treatment, the long-term efficacy of EA is better than that of Nimodipine.

Aged ; Aged, 80 and over ; Cognition ; Cognitive Dysfunction ; psychology ; therapy ; Electroacupuncture ; Female ; Humans ; Male ; Memory ; Middle Aged

PURPOSE: This study was to identify the relationship between perceived stress, anger expression, and level of depression in cancer patients. METHOD: A cross-sectional descriptive study design was used. Data was collected by questionnaires from 185 in- and out-patients who were diagnosed with cancer at 3 university hospitals and the National Cancer Center using Spielberger et al.'s Anger Expression Scale, Cohen, Kamarch & Mermelstein's Perceived Stress, and Derogatise's SCL-90. The data was analyzed using descriptive statistics, Pearson correlation coefficient, and stepwise multiple regression with SAS/PC. RESULT: The perceived stress in cancer patients indicated a significant positive correlation to anger-in(r=.288, p=.000), anger-out(r=.232, p=.001), and depression(r=.68, p=.000), but no significant correlation to anger-control. The anger-in of cancer patients showed a significant positive relationship to anger-out(r=.53, p=.000), and depression(r=.383, p=.000), but no significant correlation to anger-control. Anger-out showed a significantly negative correlation to anger-control(r=-.248, p=.001) and a positive correlation to depression(r=.240, p=.001). The most significant predictor which influenced depression in cancer patients was perceived stress, followed by anger-in and hobby, and these factors explained their depression with a variance of 54%. CONCLUSION: These results suggested that cancer patients with a high degree of perceived stress are likely to be high in anger-out and anger-in. Perceived stress and anger-in are major factors which affect depression in cancer patients.
*Stress, Psychological ; Neoplasms/*psychology ; Middle Aged ; Male ; Humans ; Female ; Depression/*etiology/psychology ; *Anger ; Aged, 80 and over ; Aged ; Adult

OBJECTIVEWe investigated the feasibility and efficacy of cognitive training for older adults in rural settings and with low education levels, who have mild cognitive impairment (MCI).

METHODSForty-five older adults (ages >65 years) with MCI were assigned to treatment or control groups, at a 2:1 ratio. Cognitive training occurred in the treatment group for 2 months. The cognitive abilities of the participants were assessed at pre-training, metaphase, and post-training time points, using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and Hamilton Depression Scale (HAM-D).

RESULTSFollowing training, cognitive abilities improved in the treatment group, based on the total scores of all 4 measures, as well as specifically on the MoCA and LOTCA. There were differences in the main effects of group and time point on some subscales, but these differences had little, if any, effect on the overall analyses.

CONCLUSIONThe present study demonstrated that cognitive training has beneficial effects on attention, language, orientation, visual perception, organization of visual movement, and logical questioning in patients with MCI. Furthermore, the observed effects are long-term changes.

Aged ; Aged, 80 and over ; China ; Cognition ; Cognitive Dysfunction ; prevention & control ; psychology ; Female ; Humans ; Male ; Neuropsychological Tests

PURPOSE: This study was to develop and evaluate a folk play program as a nursing intervention for the elderly with dementia. METHOD: First, a folk play program was developed through a careful study of literature review and field-work. Second, a nonequivalent control group pre-post test was designed. The subjects of the study were the elderly with dementia staying in nursing homes; 15 were in an experimental group adopting a folk play program developed through this study, 18 in the control group on a gymnastics and walking program which is generally used. The 40 min. intervention was conducted 5 times a week for 4 weeks. RESULT: The folk play program improved the cognition(t=6.12, p<.001) and ADL(t=2.92, p=.014) and diminished the frequency of problematic behaviors significantly(t=-6.39, p<.001). There was a significant difference of cognition, ADL, and problematic behaviors between the control and the experimental group before and after the experiment(t=3.38, p=.002; t=2.05, p=.046; t=-7.74, p<.001). CONCLUSION: Compared with the gymnastics and walking program, the folk play program proved to be much more effective in the elderly with dementia in improving their cognition and ADL, as well as in diminishing their problematic behaviors. Therefore, a folk play program should be appliedas an effective and practical Korean nursing intervention for the elderly with dementia.
*Play Therapy ; Male ; Humans ; Female ; Dementia/*psychology/therapy ; *Cognition ; Aged, 80 and over ; Aged ; *Activities of Daily Living

PURPOSE: The purposes of this study were to examine the amount of daily fluid intake among nursing home residents and to explore the caregiver's perceived barriers to elderly's fluid intake. METHOD: Data was collected from 111 nursing home residents and 64 caregiver's in 4 nursing homes. A random, non-consecutive three days of 24 hour fluid intake was measured and recorded. The caregiver's perceived barriers to elderly's fluid intake was assessed using a structured questionnaire. RESULTS: The average amount of daily fluid intake was 1,035(SD=359)ml with the range of 210ml to 2,050ml. About 52% (n=58) of the subjects had a less than adequate fluid intake. The amount of daily fluid intake was significantly associated with age, mental status, physical functioning, and the number of oral medications ordered. The most frequently mentioned caregiver's perceived barrier was elderly's concern about incontinence with increased fluid intake. CONCLUSION: Inadequate fluid intake among nursing home residents is prevalent. To enhance adequate hydration of nursing home residents, an institution wide nursing intervention is necessary.
Aged ; Aged, 80 and over ; Caregivers/*psychology ; *Drinking ; Female ; *Frail Elderly ; Humans ; Male ; *Nursing Homes ; Urinary Incontinence/psychology

PURPOSE: The purpose of this study was to examine the relationship among fear of falling, pain, anxiety and depression, and to identify influencing factors in elderly women patients with degenerative arthritis living in the community. METHOD: The subjects of this study were 297 elderly women patients with degenerative arthritis. Data was collected by personal interviews using questionnaires. Data was analyzed by the SPSS(version 12.0) computer program, and it included descriptive statistics, one-way ANOVA, Pearson correlation coefficient, and Stepwise multiple regression. RESULTS: There was a significant difference (p= .000) in fear of falling according to the level of pain, anxiety, and depression. There was a significant positive correlation among fear of falling, pain, anxiety and depression. Depression, pain, number of medication, age, and anxiety showed significant predictors (43.5%) for fear of falling. CONCLUSION: This study suggested that thoroughly assessing predictors making an impact on fear of falling in the initial nursing assessment is the most important for falls prevention of elderly women patients with degenerative arthritis in the community.
*Accidental Falls/prevention & control ; Aged ; Aged, 80 and over ; Anxiety/psychology ; Depression/psychology ; *Fear ; Female ; Frail Elderly/psychology ; Humans ; Interviews as Topic ; Osteoarthritis/*psychology

PURPOSE: The purpose of this study was to develop a scale of free nursing home adjustment for the elderly in Korea. METHOD: The developmental processes were construction of a conceptual framework, development of preliminary items, verification of content validity, twice data gathering, verification of construct validity, and reliability of final items. The first 53 preliminary items were obtained through review of literatures about nursing home adjustment and in depth interviews with 5 staffs of nursing home. These items were reviewed by five specialists for content validity and 39 items were chosen. The first data was collected from 107 elderly residing in 3 nursing homes and the second survey was from 147 residents who were living in five nursing homes. Finally this data was analyzed for construct validity and reliability. RESULT: There were 23 final items which were sorted into 5 factors. The factors were identified as 'Relocation distress symptom'(8items), 'Making friends'(4items), 'Acceptance of new residence' (6items), 'Difficulty in group life'(3items), and 'Having self-worth'(2items). The cumulative percent of variance was 53.466%. The reliability of the scale, Cronbach's alpha was .837. CONCLUSION: The result of this study could be used for measuring nursing home adjustment of the elderly. However, for further validity and reliability, repeated researches are needed.
Adaptation, Psychological ; Aged/*psychology ; Aged, 80 and over/*psychology ; Female ; *Homes for the Aged ; Humans ; Interviews as Topic ; Male ; Middle Aged/*psychology ; *Nursing Homes ; Questionnaires ; Reproducibility of Results ; Stress, Psychological

OBJECTIVETo explore the relationship between anemia and cognitive function among senior female aged 90 years old and above in longevity regions in China.

METHODS383 senior female in 5 longevity areas from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008 - 2009 were included in the study. The cognitive function was assessed by mini mental state examination (MMSE) scale. All subjects were administered the physical examinations and biochemical testing of blood, including the hemoglobin. The difference of cognitive function between those with and without anemia was analyzed. Logistic regression was used to analyze the relationship between anemia and cognitive function.

RESULTSThe 383 subjects were divided into two groups, 141 in anemia group and 242 in group without anemia. The total score of cognitive function was 9.65 ± 9.32 in anemia group, and 13.06 ± 10.25 in group without anemia (χ(2) = 5.59, P < 0.05). The percentage of cognition impairment was 84.4% (119/141) in anemia group, and 72.3% (175/242) in group without anemia (χ(2) = 8.08, P < 0.05). In the multivariable logistic regressions, after adjustment for age, education, marital status, smoking and alcohol drinking, the risk for cognition impairment in anemia group was about twice of that in group without anemia (OR = 2.016, 95%CI: 1.185 - 3.431, P = 0.010).

CONCLUSIONAnemia increases the risk of cognition impairment among senior female in Chinese longevity areas.

Age Factors ; Aged, 80 and over ; Anemia ; epidemiology ; psychology ; Causality ; China ; epidemiology ; Cognition ; Female ; Humans ; Longevity

PURPOSE: Despite the ready availability of pneumococcal vaccine, vaccination rates are quite low in South Korea. This study was designed to assess perceptions and awareness about pneumococcal vaccines among subjects at risk and find strategies to increases vaccine coverage rates. MATERIALS AND METHODS: A cross sectional, community-based survey was conducted to assess perceptions about the pneumococcal vaccine at a local public health center. In a tertiary hospital, an outpatient-based pneumococcal vaccine campaign was carried out for the elderly and individuals with chronic co-morbidities from May to July of 2007. RESULTS: Based on the survey, only 7.6% were ever informed about pneumococcal vaccination. The coverage rates of the pneumococcal vaccine before and after the hospital campaign showed an increased annual rate from 3.39% to 5.91%. The most common reason for vaccination was "doctor's advice" (53.3%). As for the reasons for not receiving vaccination, about 75% of high risk patients were not aware of the pneumococcal vaccine, which was the most important barrier to vaccination. Negative clinician's attitude was the second most common cause of non-vaccination. CONCLUSION: Annual outpatient-based campaigns early in the influenza season may improve pneumococcal vaccine coverage rates. Doctor's advice was the most important encouraging factor for vaccination.
Aged ; Aged, 80 and over ; *Ambulatory Care ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Immunization Programs ; Male ; Patients/*psychology ; Physicians/*psychology ; *Pneumococcal Vaccines ; Republic of Korea ; Vaccination/*psychology