[논문]Health Empowerment of Older Adults with High-risk of Cardio-cerebrovascular Diseases

Son, HyoJin; Kim, Gwang Suk

doi:10.12799/jkachn.2017.28.4.410

Health Empowerment of Older Adults with High-risk of Cardio-cerebrovascular Diseases 원문보기

지역사회간호학회지 = Journal of korean academy of community health nursing, v.28 no.4, 2017년, pp.410 - 420

Son, HyoJin (School of Nursing, University of Maryland) , Kim, Gwang Suk (College of Nursing.Mo-Im Kim Nursing Research Institute, Yonsei University)

Abstract ▼ AI-Helper

Purpose: This study was to identify factors explaining health empowerment of older adults with high-risk of cardio-cerebrovascular diseases. Methods: Using a structured questionnaire, data were collected from 148 older adults residing in two areas who have one or more of the following diseases; hypertension, diabetes mellitus, hyperlipidemia, and atherosclerosis. Data were analyzed using descriptive statistics, independent t-test, analysis of variance (ANOVA), Pearson correlation analysis, and hierarchical multiple regression. Results: Health empowerment had a positive correlation with health literacy and social support. Perceived health status and social activity participation showed significant contribution in explaining health empowerment. Conclusion: This study showed that enhancing perceived health status and social activity participation are vital in an effort to improve health empowerment of the population. Main findings of this study can contribute to developing health empowerment interventions to improve health behavior practices of the older adults.

주제어

AI 본문요약
AI-Helper

* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.

문제 정의

The purpose of this study was to investigate the level of health empowerment and factors explaining health empowerment of older adults with high-risk of cardio-cerebrovascular diseases who need to perform health-promoting behaviors continuously. Among personal characteristics, health empowerment was significantly different according to age, presence of spouse, type of household, education, subjective living standard, and perceived health status.
However, there have not been many studies on health empowerment of older adults with high-risk of cardio-cerebrovascular diseases. Therefore, this study aimed to assess the level of health empowerment of older adults with high-risk of cardio-cerebrovascular diseases and to identify factors that explain health empowerment.
This study is a descriptive, cross-sectional study to assess the level of health empowerment of older adults living at home and having high-risk diseases of cardio-cerebrovascular system and to identify factors explaining their health empowerment.

가설 설정

Accompanied with a research assistant, data were collected in the same manner as the preliminary survey. Older adults who agreed to participate in the survey were asked whether they had one or more diseases among hypertension, diabetes, hyperlipidemia, and atherosclerosis. To determine their disease state those who answered 'yes' were asked whether the disease was diagnosed by a doctor.

제안 방법

Second, in this study, it was difficult to identify the direct or indirect paths of factors that explain health empowerment. Further research is needed to identify the path leading to health empowerment using different research designs and analysis methods.
Third, this study measured health empowerment with the instrument modified and translated DES into Korean. During the data collection process, there were opinions that some items did not written intuitively and it took some time to understand them.
This study was conducted to assess the level of health empowerment of older adults aged 65 years or older living at home and had high-risk diseases of cardio-cerebrovascular system, and to identify factors explaining health empowerment.

대상 데이터

The ethical approval for the study was obtained from the Institutional Review Board (IRB) of the College of Nursing at Yonsei University (IRB 2016-0009-2). A preliminary survey was conducted on 5 older adults living in Seoul. Participants of the preliminary survey completed the questionnaire by themselves.
Considering a dropout rate of 20%, the target number of participants was 150. A total of 158 participants were recruited. After excluding 7 cases not meeting the selection criteria and 3 cases having missing values, data from 148 participants were used for the final analysis.
A total of 158 participants were recruited. After excluding 7 cases not meeting the selection criteria and 3 cases having missing values, data from 148 participants were used for the final analysis.
From 25 districts in Seoul city, 2 districts were selected by convenience sampling. The study recruited older adults aged 65 or over who were residing in the 2 districts.
The Rand and Medical Outcomes Study Team (MOS) developed MOS-SSS in 1991, and Lim translated it into Korean [22]. The instrument consists of 20 items: 1 item of structural support and 19 items of functional support. The structural support item asks the number of people who one feels comfortable together and communicates freely.
Approximately 30 minutes was spent for participants completing the questionnaire, and there was no such item that participants could not understand or felt awkward. The main survey was conducted at welfare centers, senior centers, and public health centers in 2 districts of Seoul from April to May 2016. Accompanied with a research assistant, data were collected in the same manner as the preliminary survey.
From 25 districts in Seoul city, 2 districts were selected by convenience sampling. The study recruited older adults aged 65 or over who were residing in the 2 districts. The sample was recruited from welfare centers, senior centers, and public health centers.

데이터처리

• The difference of health empowerment according to personal characteristics and social-contextual characteristics by independent t-test and analysis of variance (ANOVA).
Reliability was checked by the Spearman's correlation coefficient calculated after a test-retest and Cronbach's ⍺.

이론/모형

Health literacy was measured by the Short Korean Health Literacy Scale (SKHLS) developed by Lee and Kang [21].
In this study, health empowerment was measured by a modified and translated version of DES [20] that was originally developed to measure empowerment of diabetic patients. The mean score was 3.
Social support was measured by the Korean version of Medical Outcomes Social Support Survey (MOS-SSS).

성능/효과

58 years. Considering that the mean age of participants in this study was 75.60 years and the majority (85.1%) had hypertension, health empowerment in this study is considered to be similar to that of the previous study.
In this study, health literacy showed a significantly positive correlation with health empowerment. There has been a lack of research that explores both health literacy and health empowerment in older adults with high-risk of cardio-cerebrovascular diseases, and studies conducted with other populations have reported inconsistent results about the relationship between the two concepts.
In this study, social activity participation is defined as including economic activities in which profit is generated and non-profit activities such as community organizational activities and group activities. In this study, participants with an average or good level of social activity participation showed significantly higher health empowerment than those with a low level of social activity participation. In Lee [27], empowerment of older adults with a upper level of social activity participation was higher than those with a lower level of social activity participation.

후속연구

Based on the study results, there are suggestions for future research and nursing practice in order to improve health empowerment of older adults with high-risk of cardio-cerebrovascular diseases.
001). Further research is needed to clarify the relationship between these two variables.
Nevertheless, this study can be considered meaningful, given that there have not been many empirical studies of health empowerment of older adults with high-risk of cardio-cerebrovascular diseases. In addition, the study results can be used as important data when designing and conducting future intervention studies based on health empowerment.
Therefore, it is limited to compare previous studies and this study to discuss why the personal characteristics, which had significant differences in health empowerment, were not identified as significant factors from the hierarchical multiple regression analysis. In order to find out whether the personal characteristics are factors explaining health empowerment, further research should be conducted that use regression analysis and structural equation modeling methods.
As a result of hierarchical multiple regression analysis, the variables significantly explaining health empowerment were perceived health status and social activity participation. The main results of this study can be used for developing programs to improve health empowerment and promote health behavior practices of older adults with high-risk of cardio-cerebrovascular diseases.
Previous research reported that health literacy is significantly correlated with perceived health status, and furthermore, it was found to be a factor explaining perceived health status [28]. Thus, it is recommended to conduct further research to verify the direct and indirect pathways that explain health empowerment.

참고문헌 (29)

Ministry of Health and Welfare. 2011-2015 comprehensive countermeasures for cardio-cerebrovascular diseases [Internet]. Seoul: Ministry of Health and Welfare. 2011 [cited 2017 September 4]. Available from: http://www.mohw.go.kr/front_new/gm/sgm0601vw.jsp?PAR_MENU_ID13&MENU_ID1304020301&page4&CONT_SEQ293395
Statistics Korea. 2015 cause of death statistics [Internet]. Daejeon: Statistics Korea. 2016 [cited 2017 September 4]. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/6/2/index.board?bmoderead&bSeq&aSeq356345&pageNo1&rowNum10&navCount10&currPg&sTargettitle&sTxt
Hong SM, Byeon HW, Kim JS, Mun SH. Development of risk prediction model for cardiovascular disease among community-dwelling elderly. Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology. 2015;5(1):37-46. https://doi.org/10.14257/AJMAHS.2015.02.02
Kang HJ, Kwon SM. Regional disparity of cardiovascular mortality and its determinants. Health Policy and Management. 2016;26(1):12-23. https://doi.org/10.4332/KJHPA.2016.26.1.12

원문보기 상세보기
Korea Centers for Disease Control & Prevention. 2015 health behavior and chronic disease statistics [Internet]. Cheongju: Korea Centers for Disease Control & Prevention. 2016 [cited 2017 September 4]. Available from: http://cdc.go.kr/CDC/contents/CdcKrContentView.jsp?cid60949&menuIdsHOME001-MNU1130-MNU1639-MNU1749-MNU1761
Shearer NB. Health empowerment theory as a guide for practice. Geriatric Nursing. 2009;30(2):4-10. https://doi.org/10.1016/j.gerinurse.2009.02.003

상세보기
Feste C, Anderson RM. Empowerment: From philosophy to practice. Patient Education and Counseling. 1995;26(1-3):139-144. https://doi.org/10.1016/0738-3991(95)00730-N

상세보기
Institute of Medicine. Health literacy: A prescription to end confusion. Washington, DC: National Academics Press; 2004. 345 p.
Simoes E, Wallwiener D, Kusicka H, Brucker S. Health literacy requires empowerment - Results of an analysis of patient needs and the demand for qualification over a 10-year period. Geburtshilfe und Frauenheikunde. 2013;73(10):1023-1027. https://doi.org/10.1055/s-0033-1350982

상세보기
Cohen S, Hoberman HM. Positive events and social support as buffers life change stress. Journal of Applied Social Psychology. 1983;13(2):99-125.

상세보기
Lee HK, Cho SH, Kim JH, Kim YK, Choo HI. Influence of self efficacy, social support and sense of community on health-related quality of life for middle-aged and elderly residents living in a rural community. 2014;44(6);608-616. https://doi.org/10.4040/jkan.2014.44.6.608

원문보기 상세보기
Kang YH, Kim MY, Lee GJ, Jung DY, Ma RW. A study of social support, loneliness, sleep quality, and perceived health status among community-dwelling older adults. Journal of Korean Public Health Nursing. 2012;26(2):303-313. https://doi.org/10.5932/JKPHN.2012.26.2.303

원문보기 상세보기
Shearer N, Fleury J. Social support promoting health in older women. Journal of Women and Aging. 2006;18(4):3-17. https://doi.org/10.1300/J074v18n04_02

상세보기
Shearer NBC. Facilitators of health empowerment in women [dissertation]. [Tucson]: The University of Arizona; 2000. 144 p.
Ha JY, Yun OJ, Ahn YM. Relationship between empowerment and falls efficacy in community-dwelling older adults. Journal of Korean Gerontological Nursing. 2010;12(3):191-199.
Moon MJ. Correlational study of IADL, self-esteem, empowerment of elderly people living at home. Journal of the Korean Academy of Fundamentals of Nursing. 2005;12(3):382-388.
Moon MJ. A study on the empowerment, health behavior and life satisfaction in the elderly home residents according to living situations. Journal of Muscle and Joint Health. 2006;13(2):94-107.
Park CR, Park YH. Validity and reliability of Korean version of Health Empowerment Scale (K-HES) for older adults. Asian Nursing Research. 2013;7(3):142-148. https://doi.org/10.1016/j.anr.2013.07.004

상세보기
Park CR, Song MS, Cho BL, Lim JY, Song W, Chang HK, et al. Effects of a multi-disciplinary approached, empowerment theory based self-management intervention in older adults with chronic illness. Journal of Korean Academy of Nursing. 2015;45(2):192-201. https://doi.org/10.4040/jkan.2015.45.2.192

원문보기 상세보기
Anderson RM, Funnell MM, Fitzgerald JT, Marrero DG. The diabetes empowerment scale: A measure of psychosocial selfefficacy. Diabetes Care. 2000;23(6):739-743.

상세보기
Lee TW, Kang SJ. Development of the short form of the Korean health literacy scale for the elderly. Research in Nursing and Health. 2013;36(5):524-534. https://doi.org/10.1002/nur.21556

상세보기
Lim MK. Relationships between social support and health among low income groups in urban area [master's thesis]. [Seoul]: Seoul National University; 2002. 88 p.
Anderson RM, Fitzgerald JT, Gruppen LD, Funnell MM, Oh MS. The diabetes empowerment scale-short form (DES-SF). Diabetes Care. 2003;26(5):1641-1642.

상세보기
Chang AK, Fritschi C, Kim MJ. Nurse-led empowerment strategies for hypertensive patients with metabolic syndrome. Contemporary Nurse. 2012;42(1):118-128. https://doi.org/10.5172/conu.2012.42.1.118

상세보기
Rohrer JE, Wilshusen L, Adamson SC, Merry S. Patient-centeredness, self-rated health, and patient empowerment: Should providers spend more time communicating with their patients? Journal of Evaluation in Clinical Practice. 2008;14(4):548-551. https://doi.org/10.1111/j.1365-2753.2007.00914.x

상세보기
Lee SJ, Chung KH, Lee YK, Yoo SH. Social participation of Korean older persons: Policy implications [Internet]. Seoul: Korea Institute for Health and Social Affairs. 2007 [cited 2017 September 4]. Available from: http://repository.kihasa.re.kr:8080/bitstream/201002/504/1/%EC%97%B0%EA%B5%AC-07-19-8.pdf
Lee YH. A study on the effect of social participation of the elderly on their empowerment. Journal of Community Welfare. 2003;12:111-129.
Kim SH, Lee EJ. The influence of functional literacy on perceived health status in Korean older adults. Journal of Korean Academy of Nursing. 2008;38(2):195-203. https://doi.org/10.4040/jkan.2008.38.2.195

원문보기 상세보기
Hand C, Law M, McColl MA, Hanna S, Elliott S. An examination of social support influences on participation for older adults with chronic health conditions. Disability and Rehabilitation. 2014;36(17):1439-1444. https://doi.org/10.3109/09638288.2013.845258

상세보기

저자의 다른 논문 :

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증