Concurrent medical problem is common in dementia patients and critical to their care. Despite its importance, there was no bedside global rating scale for the seriousness of medical comorbidity. Lykestos et al. newly developed a reliable bedside scale, the General Medical Health Rating(GMHR). The objective of this study was to standardize the GMHR in form of Korean version(KGMHR). The study population consisted of 35 dementia patients in nursing home. Rating was performed by 1 physician and 2 nurses. Forty percent(14/35) of patients had one or more unstable medical illnesses. KGMHR ratings no more than 3 were 71.5%(25/35) of patients. The value of interrater reliability coefficient alpha was 0.9121. Correlations between KGMHR ratings and number of unstable medi-cal illnesses were high(r=-0.487, p<0.01). KGMHR ratings were also correlated with number of medications being taken for comorbid conditions(r=-0.542, p<0.01). In conclusion, KGMHR is a very reliable and simple rating scale for medical comorbidity in dementia patients. So the KGMHR could be a useful tool for evaluation of comorbidity in dementia patients. To verify the prognostic value of KGMHR, further large sized long-term study are needed.
Comorbidity ; Dementia* ; Humans ; Nursing Homes

PURPOSE: This study was to investigate effects of the dementia family education program on dementia recognition, burden, and depression in caregivers of elders with dementia. METHODS: Aquasi-experimental research with a nonequivalent control group non-synchronized pre and post design was used with 52 caregivers of elders with dementia living in D city. Data were collected from August 12 to December 12, 2013. The dementia family education program was provided to the experimental group once a week over 8 weeks, for 90 minutes per session. Data were analyzed using χ² test, Fisher exact probability test, t-test. RESULTS: Experimental group participants who took part in the dementia family education program had higher dementia recognition scores than the control group that did not participate (t=3.79, p<.001). Experimental group participants who took part in the dementia family education program had lower burden and depression scores than the control group that did not participate (t=-2.90, p=.006) (t=-2.22, p=.034). CONCLUSION: The findings indicate that the dementia family education program enhances dementia recognition by caregivers of elders with dementia and lowers burden and depression in these caregivers. Use of the dementia family education program is recommended as an effective nursing intervention for caregivers of elders with dementia.
Caregivers* ; Dementia* ; Depression* ; Education* ; Humans ; Nursing

PURPOSE: This study was done to identify the types of pain identification made by nurses caring for patients with dementia in nursing homes. METHOD: To collect the Q-population, 12 nurses working in nursing homes were interviewed. From the collected data, 69 statements were derived and eight patterns of pain identification were categorized. Thirty statements were derived as the Q-sample. Thirty nurses were sampled as the P-sample. The 30 Q-cards with Q-statements were Q-sorted by the P-sample. The results of the Q-sorting were coded and analyzed using the PC QUANL program. RESULTS: Five types of pain identification were identified by nurses for patients with dementia living in nursing homes; Type 1 was named "estimating based on verbal expressions". Type 2 was named "reasoning through physical symptoms". Type 3 was named "confirming pain based on nonverbal expressions being consistent with conditions of physical function". Type 4 was named "empathizing with vocal expressions". Type 5 was named "confirming by comparison with objective pain indicators one by one". CONCLUSIONS: The results of this study indicate that comprehensive understanding of pain identification by nurses could help improve the assessment of pain in patients with dementia.
Dementia ; Humans ; Nursing Homes ; Q-Sort

PURPOSE: The research aims to identify the roles of nurses at dementia clinics or geriatric hospitals to set their tasks. METHODS: This research has been conducted through literature review and focus group methodology. The field survey has been done for 195 nurses at 36 hospitals for the aged and dementia clinics from Oct. 9 to Oct. 28, 2006. RESULTS: The nurses were identified to play eight roles as clinical specialists, educators, researchers, counselors, consultants, collaborators, leaders, managers, and advocators. They were also known to implement 27 nursing tasks and 104 nursing activities. CONCLUSION: The findings of this research could provide a foundation for the nursing care work as well as become a practice guideline for the nurses, at these hospitals, to implement versatile roles and tasks.
Consultants ; Counseling ; Dementia* ; Focus Groups ; Humans ; Nursing ; Nursing Care ; Specialization

PURPOSE: The purpose of this study was to determine the relationship between assessed pain, functional status, and emotional status in elderly women with dementia. METHODS: The method was a descriptive correlational design. Subjects were sampled from 75 elderly women with dementia who were resident in nursing home. and their pain, functional status(physical function, cognitive function), emotional status(depression, agitation) were measured. The collected data were analyzed for correlations between pain and functional status and for emotional status using the SPSS 11.0 statistical program. RESULTS: The pain degree of the aged women in dementia were as follows; between 0 and 27 points, average 4.04 points, which was a possible point extent. Looking at the grades in detail items, the wry face expression was shown highest, an average of 0.84 points. The relation with cognitive function was(r=-.259, p<.025) a minus relation. And the relation with physical function was (r=.406, p<.001) a plus one. The relation with depression was (r=.462, p<.001), plus one. And (r=.592, p<.001) a plus relation was found with agitation. CONCLUSION: Pain is associated with impaired functional and emotional status. Major efforts are needed to improve nursing assessment and management of pain in this cognitive impaired population.
Aged* ; Dementia* ; Depression* ; Dihydroergotamine* ; Female ; Humans ; Nursing Assessment ; Nursing Homes

PURPOSE: The purpose of this study was to examine the effects of the motivational interviewing (MI) dementia preventive intervention on dementia preventive behaviors, depression and cognitive function among elderly over 75 years of age in nursing homes. METHODS: A nonequivalent control group pretest-posttest design was used. A total of 57 participants were divided into three groups; 18 in the MI dementia preventive intervention (Group A), 20 in the dementia preventive program (Group B) and 19 in the control group. Dementia preventive behaviors, depression, and cognitive function were assessed at pre, post, and 1 month after the intervention. Data were analyzed using descriptive statistics, t-test, ANOVA and repeated measure ANOVA. RESULTS: The results reported that there were significant differences in dementia preventive behaviors and depression among Group A, B, and C. Also, there were significant differences in dementia preventive behaviors and cognitive function during time periods. There was a significant interaction between groups and times in relation to depression. Results suggested that the effects of MI dementia preventive program was persistent after 1 month following the intervention. CONCLUSION: Further research needs to develop dementia preventive programs considering physical and mental traits of the elderly in late years staying at nursing homes.
Aged* ; Cognition ; Dementia* ; Depression ; Humans ; Motivational Interviewing* ; Nursing Homes* ; Nursing*

PURPOSE: The purpose of this study was to develop and evaluate e-EBPP(Evidence-based Practice Protocol) system for nursing care for patients with dementia to facilitate the best evidence-based decision in their dementia care settings. METHOD: The system was developed based on system development life cycle and software prototyping using the following 5 processes: Analysis, Planning, Developing, Program Operation, and Final Evaluation. RESULT: The system consisted of modules for evidence-based nursing and protocol, guide for developing protocol, tool for saving, revising, and deleting the protocol, interface tool among users, and tool for evaluating users' satisfaction of the system. On the main page, there were 7 menu bars that consisted of Introduction of site, EBN info, Dementia info, Evidence Based Practice Protocol, Protocol Bank, Community, and Site Link. In the operation of the system, HTML, JavaScript, and Flash were utilized and the content consisted of text content, interactive content, animation, and quiz. CONCLUSION: This system can support nurses' best and cost-effective clinical decision using sharable standardized protocols consisting of the best evidence in dementia care. In addition, it can be utilized as an e-learning program for nurses and nursing students to learn use of evidence based information.
Dementia* ; Evidence-Based Nursing ; Evidence-Based Practice ; Humans ; Life Cycle Stages ; Nursing Care ; Nursing* ; Students, Nursing

Providing care to the dementia elderly with behavioral problem is a major issue in nursing homes today. This study was aimed to explore the nursing staffs' response to aggressive dementia patients, and the effect that the aggressive behavior had on Nsgstaff. The interviews used a semi-structured questionnaire are were carried out from May to July, 1999. The subjects were 23 nursing personnel working in the nursing homes for dementia elderly. The result are as follows; 1. The types of aggressive behavior cited by the subjects was "physical", "linguistic", and "sexual". 2. The factors that caused the behavior were "symptoms of disease", "under- conditioning", "context of nursing care", "unsatisfied need", "relationship to other patients", "change of outer environment", and "invasion of one's own privacy". 3. The response of the subjects were "unhappiness", "stress", "anger", "exaggeration", "anxiety", and "fear". 4. The management strategies listed by nursing personnel used to alleviate aggressive behavior were "ignorance" "patience" "leaving the area" "soothing sounds" "verbal punishment" "restriction and isolation" and "various management skill appliance" "adaptation". 5. The effect that aggressive behavior and were "disturbance of relationship to elderly" "decline in the amount and quality of nursing care" "interruption of task performance" "job exhaustion" "desire to leave the job" "physical impact" "stress on the cognition of others" "anxiety about health and one own future" "interference to family life'. The findings of this study will be useful in understanding the difficulties of nursing personnel when confronting the aggressive behavior of dementia partients. It also is useful as basic data in preparing efficient intervention program for these difficulties.
Aged ; Cognition ; Dementia* ; Humans ; Nursing Homes ; Nursing Staff* ; Nursing* ; Surveys and Questionnaires

Providing care to the dementia elderly with behavioral problem is a major issue in nursing homes today. This study was aimed to explore the nursing staffs' response to aggressive dementia patients, and the effect that the aggressive behavior had on Nsgstaff. The interviews used a semi-structured questionnaire are were carried out from May to July, 1999. The subjects were 23 nursing personnel working in the nursing homes for dementia elderly. The result are as follows; 1. The types of aggressive behavior cited by the subjects was "physical", "linguistic", and "sexual". 2. The factors that caused the behavior were "symptoms of disease", "under- conditioning", "context of nursing care", "unsatisfied need", "relationship to other patients", "change of outer environment", and "invasion of one's own privacy". 3. The response of the subjects were "unhappiness", "stress", "anger", "exaggeration", "anxiety", and "fear". 4. The management strategies listed by nursing personnel used to alleviate aggressive behavior were "ignorance" "patience" "leaving the area" "soothing sounds" "verbal punishment" "restriction and isolation" and "various management skill appliance" "adaptation". 5. The effect that aggressive behavior and were "disturbance of relationship to elderly" "decline in the amount and quality of nursing care" "interruption of task performance" "job exhaustion" "desire to leave the job" "physical impact" "stress on the cognition of others" "anxiety about health and one own future" "interference to family life'. The findings of this study will be useful in understanding the difficulties of nursing personnel when confronting the aggressive behavior of dementia partients. It also is useful as basic data in preparing efficient intervention program for these difficulties.
Aged ; Cognition ; Dementia* ; Humans ; Nursing Homes ; Nursing Staff* ; Nursing* ; Surveys and Questionnaires

PURPOSE: The purpose of this study is to identify the effects of telephonic counseling on burnout, depression, life satisfaction, and perceived physical health among family caregivers of older adults with dementia. METHOD: Subjects were randomly assigned into telephonic counseling group (n=21) and the comparison group (n=32). A weekly telephone counseling was conducted by research assistants for 12 weeks. T-test were used to answer the research questions. RESULT: 1) There were no significant differences between the two groups on the level of burnout, depression, life satisfaction, and perceived physical health after telephone counseling. 2) Spouse caregivers under the telephone counseling tended to report higher perceived physical health than comparison group at the post-test (t=-1.88, p=.08). Spouse caregivers under the telephone counseling tended to report higher emotional exhaustion and lower feeling of self achievement. 3) Daughter-in-law caregivers under telephone counseling showed increased feeling of self achievement, improved physical health condition, and decreased depression. CONCLUSION: This study showed potential effects of the problem-solving telephone counseling to improve perceived physical health and to reduce the level of burnout and depression. The findings suggest the necessity of screening most vulnerable subgroups of caregivers to increase the effectiveness of nursing intervention such as telephone counseling.
Adult* ; Caregivers* ; Counseling* ; Dementia* ; Depression* ; Humans ; Mass Screening ; Nursing ; Telephone*