Factors Associated with the Fear of Falling after Discharge in Older Adults Who had Surgery after Experiencing a Fall Fracture

Purpose: The purpose of this study was to identify the factors associated with the fear of falling after discharge in older adults who had surgery for fall fractures.Methods: The participants were 143 older adults aged 65 or older hospitalized at the General Hospital due to a fall fracture. Data were collected from July 2019 to June 2020 using questionnaires for activities of daily living, pain, depression, and fear of falling. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation, and multiple regression.Results: The average age of the subjects was 75.34±6.89 years, and 74.1% were women. The influencing factors on the fear of falling after discharge were activities of daily living (β=.31, p=.001), age (β=.20, p=.004), the need for walking aids or assistance in walking before the fall (β=.20, p=.005), and pain (β=.15, p=.027). Total explained variance was 55% (F=13.17, p<.001).Conclusion: Based on the results of this study, it is necessary to actively intervene the fear of falling once older adults are hospitalized, considering the factors associated with the fear of falling after discharge in older adults who had surgery after experiencing a fall fracture and to develop an educational program to reduce the fear of falling.

A Study of Knowledge, Attitudes, and Educational Needs for Gerontological Nursing in Cancer Hospital Nurses

Purpose: The purpose of this study was to investigate the knowledge, attitudes, and educational needs for gerontological nursing in cancer hospital nurses.Methods: Participants included 208 nurses who had been working in the general wards for more than 6 months. Data collection was conducted through self-reported questionnaires. The Knowledge Scale and Educational Needs for Gerontological Nursing Scale were used for data collection. Also, a Korean version of the Attitudes Toward Older Adults Scale developed by Lim was used. Data were analyzed using descriptive statistics, t-test, ANOVA and Duncan test for multiple comparisons.Results: The average score of the nurses’ knowledge on nursing care for older adults was 21.09 out of 30 points, and their attitudes toward older adults scored 4.29 out of 7 points, which was within a neutral range. The average score of the needs for gerontological nursing education was 4.10 out of 5. In the knowledge level assessment, the drug intervention area showed the lowest score. In terms of the educational needs, geriatric clinical symptoms such as a sore and delirium, and the drug intervention, including dose and toxicity, showed the highest score.Conclusion: Based on the above results, providing education is necessary for cancer hospital nurses so their knowledge on and positive attitudes toward older adults can improve.

Effects of Different Types of Perceived Social Support on Changes in Subjective Health among Older Adults: A Focus on Gender Differences

Purpose: This longitudinal study aimed to investigate which types of perceived social support are associated with changes in subjective health over time among Korean older adults. We further explored whether these associations vary by older adults' gender.Methods: The current study examined 3,650 older adults drawn from additional survey data of the 6th and 7th waves of the Korean Retirement and Income Study (KReIS). Data were analyzed using hierarchical linear regression analyses.Results: Higher perceived instrumental and emotional supports significantly associated with less decline in subjective health over 2 years. Gender only moderated the association between emotional support and changes in subjective health. That is, higher emotional support associated with less decline in subjective health among older women, but not among older men.Conclusion: These findings suggest that instrumental support is the strongest predictor of older adults' changes in health over time, indicating the need for public supports for those who lack instrumental support from their social ties. Health promotion programs for older women should aim to enhance their perceived emotional support to protect them from faster declines in subjective health over time.

Medications and Falls Experiences among Older People

Purpose: This study aimed to identify the status of drug use and analyze the effects of drug use on falls among older people.Methods: The data were collected from 285 community-dwelling older persons through interviewing with questionnaires and checking participants’ medication prescriptions and the drugs using the Korea Pharmaceutical Information Center’s (KPIC) website. The medications were classified into anatomical and therapeutic divisions based on the medications’ ingredients provided by the KPIC. x2 test, ANOVA, t-test, and logistic regressions were applied to analyze the data.Results: The finding showed that 81.4% of the older adults were taking medications. Older people taking antihyperlipidemic drugs were at 1.79 times higher risk for experiencing a fall (95% CI=1.01~3.16, p=.046), and hypnotic sedative and sleeping pills increased their fall risks 11.06 times (95% CI=1.27~96.07, p=.029) compared to those not taking the medications. Nonsteroidal antiinflammatory agents showed a 2.74 odds ratio (95% CI=1.23~5.73, p=.013) and narcotic analgesics increased the fall experience risk 8.56 times (95% CI=1.02~71.88, p=.048). Those with chronic diseases experienced falls 3.04 times more than those without chronic diseases.Conclusion: The study findings showed medications might be one of the important influencing factors on fall risks among older adults. Raising awareness of fall risks associated with medicines through health education and medication reviews by health professionals should be considered a strategy for preventing older adults' falls.

Influence of Marital Communication on Cancer Coping, Health Promoting Behavior, and Subjective Happiness in Elderly Cancer Patients

Purpose: This study examined the effect of marital communication on cancer coping, health promoting behavior, and subjective happiness in elderly cancer patients.Methods: The participants were 88 older patients with cancer living with a spouse for at least one year. Data collected through a questionnaire covering general characteristics, marital communications, cancer coping, health promoting behavior, and subjective happiness were analyzed using descriptive statistics, Pearson’s correlation, and a simple linear regression test using the SPSS 26.0.Results: Marital communications showed a positive correlation with cancer coping (r=.54, p<.001), health promoting behavior (r=.47, p<.001), and subjective happiness (r=.46, p<.001). Positive marital communications had the greatest influence on cancer coping (β=.54, p<.001).Conclusion: The findings suggest that developing nursing interventions that can enhance marital communications between older patients with cancer and their spouses could improve their quality of living.

The Effects of Hearing Handicaps and Instrumental Activities of Daily Living on Hearing-Handicap-Related Quality of Life in Community-Dwelling Older Adults

Purpose: The aim of this study was to investigate hearing handicaps, instrumental activities of daily living, and hearing-handicap-related quality of life among community-dwelling older adults and identify factors that influence hearing-handicap-related quality of life.Methods: A total of 129 older adults aged 65 and over participated in the study, and data collection was conducted from December 20th, 2020 to March 20th, 2021. Descriptive statistics, t-test, ANOVA, Pearson’s correlations, and multiple linear regression were used for data analysis.Results: Self-reported hearing handicaps positively associated with instrumental activities of daily living (r=.82, p<.001), and negatively associated with hearing-handicap-related quality of life (r=-.80, p<.001). Instrumental activities of daily living negatively associated with hearing-handicap-related quality of life (r=-.71, p<.001). Hearing handicaps influenced hearing-handicap-related quality of life (β=-.70, p<.001). A regression model explained 66% of the variance in hearing-handicap-related quality of life.Conclusion: Hearing handicaps affect hearing-handicap-related quality of life of older adults living in the community. Therefore, nursing interventions to prevent hearing handicaps are required to improve hearing-handicap-related quality of life of older adults.

Personhood Communication with Persons with Dementia: Concept Analysis

Purpose: This paper aimed to clarify the meaning of personhood communication with persons with dementia, by identifying its attributes.Methods: Walker and Avant’s concept analysis method was employed. A literature review was performed using salient medical and health databases such as PubMed, Embase, and CINAHL between 1988 to June 2020. The literature review employed keywords such as “personhood”, “communication”, and “dementia”.Results: Personhood communication with persons with dementia is defined as providing social interaction based on their residual capacities, with adjustments being made in light of their remaining communication abilities, attentiveness to their emotions and respect for their individuality being shown, and decision-making rights being maintained.Conclusion: At the core of personhood communication is respect for persons with dementia and the goal of enabling them to be valid members of society. Further research is needed on the development of educational programs that impart the attributes of personhood communication with persons with dementia.

Safety Accidents and Coping Experiences among Family Caregivers Caring for Community-Dwelling Persons Living with Dementia

Purpose: The purpose of this study was to understand experiences in safety accidents and coping among family caregivers of persons living with dementia.Methods: Data were collected through face-to-face interviews with 10 family caregivers who are the main caregivers of community-dwelling persons living with dementia. Inductive qualitative content analysis was conducted to reveal themes.Results: Three major themes emerged in this study: 1) various safety accident experiences, 2) coping with safety accidents, and 3) concern for the prevention of safety accidents. Family caregivers experienced various risks when caring for their care recipients with reduced cognitive function and trying to cope with a tailored method for persons living with dementia. However, family caregivers eventually recognized that none of the methods were perfect for preventing dangers and looked forward to the emergence of new methods to ensure a safe environment.Conclusion: Dementia care services and tailored information and communications technology (ICT) should be provided to promote the safety of persons living with dementia and their family caregivers in the community environment.

Environmental Factors Related to Non-compliant Health Behaviors in Urban-Dwelling Elderly

Purpose: The purpose of this study was to explore non-compliant health behaviors among urban-dwelling elderly and identify related environmental factors.Methods: This study analyzed integrated data from the 2017 Korean National Survey on the elderly and 2017 Annual Report of Air Quality in Korea (N=3,198). In this study, health behaviors included seven recommendations for promoting health. Social and physical environmental factors were selected based on Bronfenbrenner’s ecosystem theory, including air quality as an environmental factor. Hierarchical multiple regression analysis was used to analyze the data while controlling for general characteristics of the elderly.Results: The average score for non-compliant health behaviors was 3.05±1.03 among seven health behaviors. Hierarchical multiple regression showed the environmental factors related to non-compliant health behaviors were social activity participation (β=.15, p＜.001); interactions with friends, neighbors, and acquaintances (β=.06, p=.002); access to institutions and facilities (β=.06, p=.001); and particulate matter concentration (β=-.10, p＜.001).Conclusion: Our study findings emphasized that social activity participation, interactions with significant others, access to institutions and facilities, and particulate matter concentration should be considered when developing ecological interventions to improve health behaviors among the urban-dwelling elderly.

Decision-Making Experience of Older Patients with Cancer in Choosing Treatment: A Qualitative Meta-Synthesis Study

Purpose: This study was conducted to analyze and synthesize the findings of qualitative studies related to the decision-making experience of older patients with cancer in choosing treatment.Methods: We used the seven steps of Noblit and Hare’s meta-ethnography to analyze and synthesize selected qualitative studies. Seven databases were used to search the literature that explored the decision-making experiences of older patients with cancer in choosing treatment: PubMed, CINAHL, Embase, Web of Science, Research Informations Sharing Service (RISS), Koreastudies Information Service System (KISS), and National Assembly Library.Results: The final 11 studies were included in the analysis. Three themes emerged as result of synthesizing: “Checking the feasibility of treatment in one’s own life”, “The constant weighing up the gains and losses of treatment”, and “Having meanings to life”.Conclusion: This study provides an in-depth understanding of treatment decision-making experiences of older patients with cancer and highlights the complex factors that influence their treatment decision-making process. This may contribute to the development of interventions that help older patients with cancer choose treatment during the decision-making process.