This study examined age-specific prevalence and associated factors of activities of daily living (ADL) disability. Methods: This cross-sectional analysis used first-year data from a longitudinal study. Participants were 564 older adults residing in nursing homes or long-term care hospitals. Data were analyzed using chi-square test and logistic regression. Results: The mean age of the participants was 83.58 years, and 65.4% had severe ADL disability. Severe ADL disability was significantly associated with being female in the young- old group (odds ratio [OR]=4.18, 95% confidence interval [95% CI]=1.04~16.83); incontinence (OR=3.22, 95% CI=1.58~6.55), dietary change (OR=4.74, 95% CI=1.47~15.26), low calf circumference (OR=3.09, 95% CI=1.10~8.66), suspected cognitive impairment (OR=3.27, 95% CI=1.35~7.96), and long-term care hospital residence (OR=2.41, 95% CI=1.09~5.36) in the mid-old group; and incontinence (OR=3.87, 95% CI=2.13~7.05), low calf circumference (OR=6.38, 95% CI=2.65~15.34), suspected cognitive impairment (OR=2.24, 95% CI=1.02~4.94), and long-term care hospital residence (OR=3.04, 95% CI=1.42~6.54) in the old-old age group. Conclusion: Findings highlight the need for age-specific management strategies: muscle strengthening and exercise programs for young-old female, integrated and simultaneous management for the mid-old, and strategies to maintain core physiological functions for the old-old. These findings support long-term care policies and contribute to developing care systems in an aged society.

Despite a rapid increase in male older adults living alone, relatively little is known about their life satisfaction and related factors. Based on Levine’s conservation model, this study aimed to explore predictors of life satisfaction among older men living alone in South Korea. Methods: Using logistic regression, a cross-sectional secondary data analysis was conducted among male older adults living alone (N=548) from the 2020 National Survey of Older Koreans. Results: The factors associated with a risk of lower life satisfaction in older men living alone were income lower than the standard median income, unemployment, living in rural areas, moderate-high nutritional risk, declined sensory function, depression, and social isolation. Conclusion: To enhance the life satisfaction of older men living alone, customized interventions are required, including comprehensive health assessment with a holistic perspective. Addressing economic stability alongside prevention and multidimensional interventions is needed to mitigate nutritional risks, sensory function decline, depression, and social isolation. Healthcare providers and policymakers in local communities should understand the sociocultural characteristics of older Korean men living alone and provide well-suited formal and informal support programs to address these needs.

The purpose of this study is to identify the prevalence and risk factors of delirium of older adults after cardiac surgery at the intensive care unit (ICU). Methods: A retrospective descriptive correlational study design was used. Among 675 older adults who admitted to ICU after cardiac surgery in a tertiary hospital from May 2021 to April 2022, 528 were selected for data analysis. Data were collected through electronic medical records. Delirium and pain intensity were evaluated using the Confusion Assessment Method-Intensive Care Unit and Critical Care Non-verbal Pain Scale, respectively. Results: The incidence rate of delirium was 41.3% (n=218). Multivariate logistic regression analysis of the variables identified that ICU length of stay (odds ratio [OR]=1.77, p<.001), anesthesia time (OR=1.21, p=.016), pain intensity (OR=1.14, p=.044), and age (OR=1.07, p=.002) were identified as risk factors of delirium after cardiac surgery. Conclusion: ICU length of stay, anesthesia time, pain score, and advanced age should be considered as the prevention and management of delirium at the intensive care unit of older adults after cardiac surgery.

The aims of this study were to examine the rate of the changes in cognitive function and the related-factors in progression from the community-dwelling older adults with mild cognitive impairment to dementia during 3 years. Methods: Data were selected from the Seoul Dementia Management Project with 1,375 community-dwelling older adults with mild cognitive impairment at baseline and monitored the changes in cognitive function after 3 years. The main variables were included demographic characteristics, body mass index, cognitive function, attended number of non-pharmacological programs, and activity of daily living (ADL)-related educational programs. Data were analyzed using chi-square test, independent t-test, and logistic regression. Results: Of all the participants, 83.0% remained with mild cognitive impairment, and 17.0% progressed to dementia after 3 years. Old age (odds ratio [OR]=1.06, 95% confidence Interval [CI]=1.04~1.09), no exercise (OR=1.42, 95% CI=1.04~1.93), attendance at non-pharmacological programs less than eight times (OR=4.17, 95% CI=2.05~8.49), and no attendance at ADL-related educational programs (OR=1.05, 95% CI=1.02~1.26) significantly affected dementia progression. Conclusion: Regardless of the types of non-pharmacological programs, regular and continuous non-pharmacological programs must be one of the important services of the dementia care centers in Korea. The result of this study serves the basis for developing further strategies to activate non-pharmacological programs and ADL-related educational programs at the community level for older adults with mild cognitive impairment to prevent in progressing to dementia.

Purpose: This study aimed to develop a nursing work environment scale for clinical nurses and to verify its validity and reliability. Methods: The initial items comprised individual interviews with eleven clinical nurses. The content validity of the initial items was evaluated twice by nine experts, while 37 preliminary items were reviewed through pilot tests with 20 nurses and cognitive interviews with five nurses. The survey data were collected from 353 clinical nurses working at general hospitals. Results: In the exploratory factor analysis, the number of factors was determined through parallel analysis, scree test, and cumulative variance ratio. Consequently, 23 items and three factors were thus composed, yielding a total cumulative variance ratio of 91.3%. The finalized 20 items of the final three factors were subjected to a confirmatory factor analysis, which led to the validation of the three subscales model. The three sub-factors were composed of nurse manager competency, nurse safety management system, and a nurse support system. Conclusion This scale is expected to be useful for evaluating the nursing work environment of clinical nurses by verifying its reliability and validity through various methods.

Purpose: The purpose of this study was to identify the influence of self-care on burnout experienced by primary family caregivers of persons with dementia. Methods: The subjects of the study were 156 primary family caregivers of persons with dementia at home in Korea. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression using IBM SPSS Statistics ver. 24.0 for Windows. Results: The mean scores for self-care and burnout were 42.35 and 61.60, respectively. Self-care, subjective health status, living with a person with dementia, and behavioral and psychological symptoms of dementia were significant factors affecting burnout in family caregivers. Self-care was identified as the strongest factor affecting burnout, explaining 13.9% of burnout with controlling factors in caregivers and care receivers. Conclusion To prevent burnout in primary family caregivers of persons with dementia, self-care of family caregivers should be emphasized. In nursing education, family caregivers should be recognized and approached as nursing clients who are responsible for taking care of their health. In nursing practice and research, digital self-care or self-care improvement intervention programs should be designed to help family caregivers, and further studies on self-care centered on health of family caregivers should be conducted.

Purpose: The purpose of this study was to identify the influence of self-care on burnout experienced by primary family caregivers of persons with dementia. Methods: The subjects of the study were 156 primary family caregivers of persons with dementia at home in Korea. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression using IBM SPSS Statistics ver. 24.0 for Windows. Results: The mean scores for self-care and burnout were 42.35 and 61.60, respectively. Self-care, subjective health status, living with a person with dementia, and behavioral and psychological symptoms of dementia were significant factors affecting burnout in family caregivers. Self-care was identified as the strongest factor affecting burnout, explaining 13.9% of burnout with controlling factors in caregivers and care receivers. Conclusion To prevent burnout in primary family caregivers of persons with dementia, self-care of family caregivers should be emphasized. In nursing education, family caregivers should be recognized and approached as nursing clients who are responsible for taking care of their health. In nursing practice and research, digital self-care or self-care improvement intervention programs should be designed to help family caregivers, and further studies on self-care centered on health of family caregivers should be conducted.

PURPOSE: This study was conducted to expand nurse's experience of harmful work environments. METHODS: Data were collected through in-depth dividual interviews and analyzed using Colaizzi phenomenological analysis methodology. RESULTS: Harmful work environments experienced by nurses were categorized as followed: ‘Neglect concerning infections’, ‘Being thrown into a violent working environment’, ‘The hard times of being alone’, ‘Struggling with the harmful work environments’. CONCLUSION: The results of this study provide a deep understanding of the harmful work environments. It is necessary to create safe work environments and it is important to improve awareness in the system of organizations as well as individuals. Also, it is necessary to develop tools to measure work environment including risk factors.
Risk Factors

PURPOSE: The purpose of this study was to identify factors predicting behavioral and psychological symptoms of dementia (BPSD) in persons with dementia. Factors including the patient, caregiver, and environment based on the multi-dimensional behavioral model were tested. METHODS: The subjects of the study were 139 pairs of persons with dementia and their caregivers selected from four geriatric long-term care facilities located in S city, G province, Korea. Data analysis included descriptive statistics, inverse normal transformations, Pearson correlation coefficients, Spearman's correlation coefficients and hierarchical multiple regression with the SPSS Statistics 22.0 for Windows program. RESULTS: Mean score for BPSD was 40.16. Depression (β=.42, p<.001), exposure to noise in the evening noise (β=−.20, p=.014), and gender (β=.17, p=.042) were factors predicting BPSD in long-term care facilities, which explained 25.2% of the variance in the model. CONCLUSION: To decrease BPSD in persons with dementia, integrated nursing interventions should consider factors of the patient, caregiver, and environment.
Behavioral Symptoms ; Caregivers ; Dementia* ; Depression ; Humans ; Korea ; Long-Term Care ; Noise ; Nursing ; Residential Facilities ; Statistics as Topic

PURPOSE: The purpose of this study was to develop and test the psychometric properties of the newly developed instrument, Meaning in Life, for elderly Korean people. METHODS: Ten older adults participated in the qualitative research used to develop the initial items. Participants for the psychometric testing were 371 community-dwelling older adults. Validity and reliability analyses included content, construct, and criterion-related validities, internal consistency, and test-retest reliability. RESULTS: The Meaning in Life Scale consisted of 12 items with three distinct factors; value of life, source of life, and will to live, which explained 86.7% of the total variance. A three-factor structure was validated by confirmatory factor analysis. Criterion-related validity was supported by comparison with the Purpose in Life Test (r=.74). Reliabilities were secured with test-retest reliability of Intra-class Correlation Coefficient (ICC) .85 and the Cronbach's alpha coefficient .90. CONCLUSION: The results of this study indicate that this instrument is useful to measure meaning in life in Korean elders.
Adult* ; Aged ; Factor Analysis, Statistical ; Humans ; Psychometrics ; Qualitative Research ; Reproducibility of Results ; Value of Life