Research in Community and Public Health Nursing

Original Articles

The Effect of Dual Sensory Impairment on Cognitive Function Decline in the Elderly: The Moderating Effect of Social Support: Soo Jee Yang, Ju Young Yoon; Res Community Public Health Nurs. 2023;34(3):217-227. Published online September 27, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00255

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Abstract PDF: Purpose
This study verified that the dual sensory impairment (DSI) in the elderly is associated with cognitive impairment (CI) and confirmed how change in cognitive function varies depending on the social support (SS).
Methods
For a study sample of Korean older people, data from the Korean Longitudinal Study of Ageing (KLoSA) from the 7th (2018) to the 8th (2020), were included in this cross-sectional descriptive study. Among people who responded in both 2018 and 2020, a total of 2,069 people of those who are 65 years of age or older, and have living children and normal cognitive function, were analyzed. X2 -test, t-test and logistic regression analyses were utilized.
Results
First, the number of elderly with visual impairment (VI), hearing impairment, and DSI increased on 8th data compared with 7th data. In addition, 22.9% of the 2,069 people showed a decrease in cognitive function. Second, compared to the elderly with normal sensory function, the cognitive function of the elderly with only VI was found to be more degraded, and the cognitive function of the elderly with DSI was found to be much more degraded. In addition, among SS, only participation in social gatherings was found to show significant change in cognitive function of the elderly with DSI. Third, the interaction effect of participating in social gatherings was not significant in the CI of the elderly with DSI.
Conclusion
VI and DSI effected cognitive function, but participation in social gatherings such as SS has not significant interaction effect on CI of the elderly with DSI.

The Relationships between Rural Elderly’s Suicide Literacy, Suicide Stigma and Coping Advice for Suicide Prevention: The Moderated Mediation Effect of Social Expectations for Experiencing Negative Emotions: Soon Tae An, Han Nah Lee, Jeong Hee Cho; J Korean Acad Community Health Nurs. 2022;33(2):164-174. Published online June 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.2.164

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Abstract PDF: Purpose
The purpose of this study is to examine the effects of the rural elderly suicide literacy level upon suicide stigma and coping advice with suicidal crises (recommending professional help for a suicidal person). In particular, this study investigates the role of cultural norms (perceived social expectations for the experience of negative emotions) on suicide stigma and coping ability. Methods A survey was conducted addressing elderly people (N=119) living in rural areas. Regression analysis using SPSS PROCESS macro was used to examine the relationships among the key variables. Results Participants with higher suicide literacy showed lower suicide stigma, and this perception had a significant effect on enhancing their coping advice with suicidal crises. Also, perceived social expectations significantly influenced the relationship between suicide stigma and coping advice. With lower levels of social expectations, the mediating effect of suicide stigma on the relationship between suicide literacy and recommending professional help did not exist whereas the indirect effect was significant when it pertained to high levels of social expectations. Conclusion This result signifies that suicide stigma serves as a barrier deterring Koreans from reaching out for professional help regarding their mental health. Moreover, these findings underscore the importance of cultural psychological factors such as perceived social expectations in terms of developing suicide prevention strategies.

Effects of a Stim up Mat Walking Exercise Program on Balance, Gait Function and Joint Motion Range of the Frail Elderly: Gyeong Ran Kim, Mi Sook Song; J Korean Acad Community Health Nurs. 2019;30(1):47-56. Published online March 31, 2019; DOI: https://doi.org/10.12799/jkachn.2019.30.1.47

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PURPOSE
This study was performed to evaluate effects of a stim-up matt walking exercise program on balance and gait of the frail elderly.
METHODS
A total of 37 elderly people recruited from S city were randomly assigned to the experimental group (n=22) and control group (n=15). The stim-up matt walking exercise program was offered twice a week for 8 weeks. Data were analyzed by SPSS 21.0.
RESULTS
The dynamic balance ability Timed Up and Go test of the experimental group was significantly faster than that of the control group (t=21.72, p<.001). The static balance ability open-eye standing test (t=44.15, p<.001) and close-eye standing test (t=9.01, p=.005) also showed increase in effects of the experimental group. In the walking ability, gait cycle (t=2.48, p=.018), cadence (t=âˆ’2.21, p=.034) and gait speed (t=âˆ’2.78, p=.009), positive effects were on. However, no statistically significant differences were found in stride length and double support. At the ankle joint range left ankle plantar flexion (t=3.92, p<.001) and left ankle dorsal flexion (t=4.51, p<.001) were higher in the experimental group than in the control group, and also right ankle plantar flexion (t=2.79, p=.008) and right ankle dorsal flexion (t=2.92, p=.006) increased in the experimental group.
CONCLUSION
The significance of this study is that the stim-up matt walking exercise program for the frail elderly proves to be useful for improving balance and walking.

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Differences in the Gait Pattern and Muscle Activity of the Lower Extremities during Forward and Backward Walking on Sand
Chae-Won Kwon, Seong Ho Yun, Jung-Won Kwon
The Journal of Korean Physical Therapy.2022; 34(1): 45. CrossRef

Co-occurrence Network Analysis of Keywords in Geriatric Frailty: Young Ji Kim, Soong Nang Jang, Jung Lim Lee; J Korean Acad Community Health Nurs. 2018;29(4):429-439. Published online December 31, 2018; DOI: https://doi.org/10.12799/jkachn.2018.29.4.429

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Abstract PDF

PURPOSE
The aim of this study is to identify core keyword of frailty research in the past 35 years to understand the structure of knowledge of frailty.
METHODS
10,367 frailty articles published between 1981 and April 2016 were retrieved from Web of Science. Keywords from these articles were extracted using Bibexcel and social network analysis was conducted with the occurrence network using NetMiner program.
RESULTS
The top five keywords with a high frequency of occurrence include â€˜disabilityâ€™, â€˜nursing homeâ€™, â€˜sarcopeniaâ€™, â€˜exerciseâ€™, and â€˜dementiaâ€™. Keywords were classified by subheadings of MeSH and the majority of them were included under the healthcare and physical dimensions. The degree centralities of the keywords were arranged in the order of â€˜long term careâ€™ (0.55), â€˜gaitâ€™ (0.42), â€˜physical activityâ€™ (0.42), â€˜quality of lifeâ€™ (0.42), and â€˜physical performanceâ€™ (0.38). The betweenness centralities of the keywords were listed in the order of depressionâ€™ (0.32), â€˜quality of lifeâ€™ (0.28), â€˜home careâ€™ (0.28), â€˜geriatric assessmentâ€™ (0.28), and â€˜fallâ€™ (0.27). The cluster analysis shows that the frailty research field is divided into seven clusters: aging, sarcopenia, inflammation, mortality, frailty index, older people, and physical activity.
CONCLUSION
After reviewing previous research in the 35 years, it has been found that only physical frailty and frailty related to medicine have been emphasized. Further research in psychological, cognitive, social, and environmental frailty is needed to understand frailty in a multifaceted and integrative manner.

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A content analysis of research on technology use for teaching mathematics to students with disabilities: word networks and topic modeling
Mikyung Shin, Min Wook Ok, Sam Choo, Gahangir Hossain, Diane P. Bryant, Eunyoung Kang
International Journal of STEM Education.2023;[Epub] CrossRef
Artificial intelligence in customer relationship management: literature review and future research directions
Cristina Ledro, Anna Nosella, Andrea Vinelli
Journal of Business & Industrial Marketing.2022; 37(13): 48. CrossRef
Mining the sociome for Health Informatics: Analysis of therapeutic lifestyle adherence of diabetic patients in Twitter
Gael Pérez-Rodríguez, Martín Pérez-Pérez, Florentino Fdez-Riverola, Anália Lourenço
Future Generation Computer Systems.2020; 110: 214. CrossRef

Effects of a Health Promotion Empowerment Program Using a Resident Volunteer as a Lay Health Leader on Frail Elders' Health and Empowerment: Jeong Sook Park, Yun Jung Oh; J Korean Acad Community Health Nurs. 2018;29(3):335-348. Published online September 30, 2018; DOI: https://doi.org/10.12799/jkachn.2018.29.3.335

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PURPOSE
This study has been conducted to develop and examine a health promotion empowerment program using a lay health leader for frail elderly.
METHODS
The research was organized in a nonequivalent control group pre-post test design. Data collection was performed from August 18 to October 8, 2015. The subjects included 76 frail elders aged over 65 registered in home visiting services (Experimental group=39, Control group=37). A health promotion empowerment program using a resident volunteer as a lay health leader was run for 8 weeks. Health factors (health promotion behavior, perceived health status and frailty) and empowerment factors (empowerment, social participation) were assessed. The data were analyzed by using the SPSS/WIN 18.0 program.
RESULTS
After the program, health promotion behavior, perceived health status and social participation increased in the experimental group more significantly than in the control group, but frailty decreased in the experimental group greater than in the control group.
CONCLUSION
The health promotion empowerment program using a resident volunteer as a lay health leader was effective. Therefore, the health promotion empowerment program needs to be expanded to other frail elders. Also, a health leader should be recommended as a public health resource and systematically managed.

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Development and evaluation of the information and communication technology-based Loneliness Alleviation Program for community-dwelling older adults: A pilot study and randomized controlled trial
Jung Ae-Ri, Lee Kowoon, Park Eun-A
Geriatric Nursing.2023; 53: 204. CrossRef

The Death Anxiety and Depressive Symptoms among Poor Older Women in Rural Areas: The Moderating Effect of Social Support: Seung Joo Lim, Young Ko, Chun Mi Kim, Hung Sa Lee; J Korean Acad Community Health Nurs. 2017;28(4):440-449. Published online December 31, 2017; DOI: https://doi.org/10.12799/jkachn.2017.28.4.440

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Abstract PDF

PURPOSE
This study was conducted to identify the moderate effect of social support on the relationship between death anxiety and depressive symptoms among poor older women in rural areas.
METHODS
This was a secondary analysis of the data from 209 women who were participated in the intervention study to evaluate the effectiveness of depression prevention program. Data were collected between April and September 2012. The data were analyzed using moderate multiple regressions.
RESULTS
Among these poor older women, depressive symptoms were associated with death anxiety and social support. Self-esteem support had a moderating effect on the relationship between death anxiety and depressive symptoms.
CONCLUSION
The results indicate that the self-esteem support was effective in decreasing depressive symptoms and death anxiety in poor older women. In order to reduce their depression and make positive changes in their lives, self-esteem improvement programs are needed.

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The influence of tai chi on the death anxiety of elderly people living alone: the chain mediating effect of social support and psychological capital
Jiali Zhou, Baoyuan Wu, Lining Su, Xiujie Ma
Frontiers in Psychology.2024;[Epub] CrossRef
Death anxiety, self‐esteem, and health‐related quality of life among geriatric caregivers during the COVID‐19 pandemic
Xia Zhao, Weihua Zhang, Yonggang Su, Yanping Song, Huaxin Si, Lifeng Zhu
Psychogeriatrics.2022; 22(2): 236. CrossRef
Death Depression Among Older Adults: A Concept Analysis Utilizing An Evolutionary Approach
Ameneh Yaghoobzadeh, Rebecca H. Lehto, Leila Mardanian Dehkordi, Mohammad Ali Cheraghi, Shahzad Pashaeipour
Research and Theory for Nursing Practice.2022; 36(3): 265. CrossRef
Cohort profile: Korean Urban Rural Elderly (KURE) study, a prospective cohort on ageing and health in Korea
Namki Hong, Kwang-Joon Kim, Su Jin Lee, Chang Oh Kim, Hyeon Chang Kim, Yumie Rhee, Yoosik Youm, Jin-Young Choi, Hyun-Young Park
BMJ Open.2019; 9(10): e031018. CrossRef

Health Empowerment of Older Adults with High-risk of Cardio-cerebrovascular Diseases: Hyo Jin Son, Gwang Suk Kim; J Korean Acad Community Health Nurs. 2017;28(4):410-420. Published online December 31, 2017; DOI: https://doi.org/10.12799/jkachn.2017.28.4.410

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Abstract PDF

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.

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Association between health-related empowerment and health-protective behaviors among community-dwelling older adults
Manal Mohammed Hawash, Abeer Abd El-Rahman Mohamed, Mona Metwally El-Sayed, Ayman Mohamed El-Ashry, Sarah Ali Hafez
Archives of Psychiatric Nursing.2024; 48: 59. CrossRef
The effects of health empowerment and social support on health promotion behavior in older adults: A cross-sectional study
Kyungmi Lee, Semi Lim
Journal of Korean Gerontological Nursing.2022; 24(4): 433. CrossRef

Predictors of Chewing Discomfort among Community-dwelling Elderly: Seol Hwa Moon, Gwi Ryung Son Hong; J Korean Acad Community Health Nurs. 2017;28(3):302-312. Published online September 30, 2017; DOI: https://doi.org/10.12799/jkachn.2017.28.3.302

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Abstract PDF

PURPOSE
The purpose of this study was to identify associated factors of chewing discomfort among community-dwelling elderly.
METHODS
The study was cross-sectional design and secondary data analysis using the 6th Korea National Health and Nutrition Examination Survey. Among the total of 7,550 participants, data was analyzed with 1,126 adults aged 65 years and over. Chewing discomfort was assessed by the perceived chewing discomfort. Multivariate logistic regression analysis was used to find the associated factors of chewing discomfort.
RESULTS
Along with 61.7% of the participants reported having chewing discomfort, 85.2% reported to perceive poor oral health and 35.0% had oral pain. In multivariate logistic regression, perceived oral health (OR 3.22, 95% CI 2.24~4.63), oral pain (OR 2.46, 95% CI 1.76~3.43), activity limitation (OR 1.71, 95% CI 1.05~2.80), teeth requiring treatment (OR 1.61, 95% CI 1.14~2.26), number of remaining teeth (OR 1.60, 95% CI 1.22~2.10) and educational level (OR 1.56, 95% CI 1.15~2.12) were the significant predictors of chewing discomfort.
CONCLUSION
The prevalence in chewing discomfort was high in elderly Koreans and various factors were associated with chewing discomfort. To improve chewing ability, it is suggested that the national level of policies offer strategical oral health programs in this population.

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Association of Denture Use and Chewing Ability with Cognitive Function Analysed Using Panel Data from Korea Longitudinal Study of Aging (2006–2018)
Nu-Ri Jun, Jae-Hyun Kim, Jong-Hwa Jang
Healthcare.2023; 11(18): 2505. CrossRef
Suggestions for the Work of Dental Hygienists and a Reflection of Health Insurance Charges according to Demographic Changes
Myung-Jin Lee, Sang-Hwan Oh
Journal of Dental Hygiene Science.2020; 20(1): 1. CrossRef
Estimating Lifetime Dental Care Expenditure in South Korea: An Abridged Life Table Approach
Minsung Sohn, Xianhua Che, Sungwon Lim, Hee-Jung Park
International Journal of Environmental Research and Public Health.2020; 17(9): 3308. CrossRef
Change over a period of 9 years in self-reported oral health of a middle-aged population using 4-6th KNHANES data
Song-Yi Kim, Nam-Hee Kim
Journal of Korean Academy of Oral Health.2019; 43(2): 50. CrossRef

The Effect of a Dementia Preventive Intervention based on Motivational Interviewing among the Elderly over 75 Years of Age in Nursing Homes: Hyun Mi Jo, Suk Sun Kim; J Korean Acad Community Health Nurs. 2017;28(3):260-270. Published online September 30, 2017; DOI: https://doi.org/10.12799/jkachn.2017.28.3.260

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Abstract PDF: 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.

The Evaluation of Feasibility and Predictive Validity of Comprehensive Korean Frailty Instrument: Using the 2008 and 2011 Living Profiles of Older People Survey in Korea: Eun Mi Oh, Gwi Ryung Son Hong; J Korean Acad Community Health Nurs. 2017;28(2):206-215. Published online June 30, 2017; DOI: https://doi.org/10.12799/jkachn.2017.28.2.206

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Abstract PDF

PURPOSE
This study aimed to verify the predictive validity of Comprehensive Korean Frailty Instrument (CKFI) among older adults.
METHODS
A secondary analysis of data from a prospective cohort study was conducted. Frailty was determined in older adults (N=9,188) according to the data in 2008 and the effects of frailty on adverse outcomes (such as institutionalization and death) were evaluated according to the data in 2011. The Cardiovascular Health Study (CHS) index was used to compare with the predictive validity of CKFI.
RESULTS
The prevalence of frailty was 26.3%. With the CKFI, the frail group had a higher risk of negative health outcomes compared to the robust and pre-frail groups after three years. The two of the highest risks identified using the CKFI and CHS index were institutionalization (5.522 times higher) and mortality (3.210 times higher). For both instruments, the survival analysis revealed that the risk of death increased as the degree of frailty increased.
CONCLUSION
The CKFI consisting of self-report items and multidimensional aspects of frailty can be used as a simple instrument for assessing the frailty of older adults residing in a local community in Korea.

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Frailty assessment using routine clinical data: An integrative review
Arum Lim, JiYeon Choi, Hyunju Ji, Hyangkyu Lee
Archives of Gerontology and Geriatrics.2022; 99: 104612. CrossRef
Impact of Frailty, Depression, and Loneliness on Ego-Integrity in Community-Dwelling Elderly
Seon Ju Song, Sung Hee Ko, Ji Young Kim, Hyun Kyung Kim
STRESS.2022; 30(3): 139. CrossRef
Factors associated with frailty among community-dwelling older adults by age group: A multi-dimensional approach
Lee Seyune, Kim Hongsoo, Jung Young-il, Hong Yun-chul
Korean Journal of Health Education and Promotion.2018; 35(2): 89. CrossRef

The Level of Pain, Gait Speed, and ROM in Community-dwelling Older Adults with Knee Joint Pain: Kye Ha Kim, Jin Min Lee; J Korean Acad Community Health Nurs. 2017;28(2):156-164. Published online June 30, 2017; DOI: https://doi.org/10.12799/jkachn.2017.28.2.156

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PURPOSE
The purpose of this study is to investigate the level of pain, gait speed, and ROM (Range of motion) in community-dwelling older adults with knee joint pain.
METHODS
A convenience sample of 160 participants living in G city were recruited. Elderly people who suffer from knee joint pain with a pain level â‰¥5 during the last one year on a visual analogue scale were included in the study. The data were collected from June to August 2016. All statistical analyses were performed using IBM SPSS ver. 22.0.
RESULTS
Participants' pain was 6.81 by VAS. The mean gait speed was 13.9 sec/10m. The ROM of left knee and right knee were 54.06Â° and 56.50Â°, respectively. The level of pain was different according to gender (t=-4.87, p<.001), economic status (t=3.51, p=.032), diseases (t=5.23, p<.001), diagnosis of arthritis (t=3.86, p<.001), region of knee joint pain (F=9.30, p<.001), duration of pain occurrence (F=13.82, p<.001), and limp (F=3.58, p<.001). The level of knee joint pain and gait speed had significant correlations.
CONCLUSION
The gait speed in older adults is an important variable that should be taken into account in the assessment of their level of knee joint pain.

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The impact of low back pain and disability on frailty levels in older women: longitudinal data from the BACE-Brazil cohort
Vitor Tigre Martins Rocha, Amanda Aparecida Oliveira Leopoldino, Bárbara Zille de Queiroz, Renata Antunes Lopes, Silvia Lanziotti Azevedo da Silva, Juliano Bergamaschine Mata Diz, Daniele Sirineu Pereira, Leani Souza Máximo Pereira
European Geriatric Medicine.2023; 14(1): 181. CrossRef

Effects of Frailty on Health-related Quality of Life of Rural Community-dwelling Elderly: Mediating and Moderating Effects of Fall-Related Efficacy and Social Support: Kyung Won Choi, Gyeong Suk Jeon; J Korean Acad Community Health Nurs. 2016;27(4):380-387. Published online December 31, 2016; DOI: https://doi.org/10.12799/jkachn.2016.27.4.380

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Abstract PDF

PURPOSE
The purpose of this study was to examine the mediating and moderating effects of fall-related efficacy and social support on the relationship between frailty and health-related quality of life among rural community-dwelling elderly.
METHODS
A cross-sectional survey was conducted with a convenient sampling method, and data of 438 elderly residents living in a rural community was used. The structured questionnaire included items from the Euro Quality of life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/ depression), fall-related efficacy and social support.
RESULTS
Analysis of the mediating effect of fall-related efficacy and social support showed that there was significant mediating influence of fall-related efficacy on the relationship between frailty and health-related quality of life. There were no moderating effects of fall-related efficacy and social support.
CONCLUSION
The findings suggest that fall-related efficacy may play a role in reducing the effect of frailty on health-related quality of life and underscore the need to consider ways of enhancing fall-related efficacy in interventions for rural community-dwelling frail elderly.

Citations

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Multilevel Analysis of Factors Affecting Health-Related Quality of Life of the Elderly
Hyunjung Moon, Sunkyung Cha
Journal of Korean Academy of psychiatric and Mental Health Nursing.2022; 31(3): 391. CrossRef
Frailty and Quality of Life among Older Adults in Communities: The Mediation Effects of Daily Physical Activity and Healthy Life Self-Efficacy
Chia-Hui Lin, Chieh-Yu Liu, Chun-Ching Huang, Jiin-Ru Rong
Geriatrics.2022; 7(6): 125. CrossRef
The Effects of COVID-19 Risk Perception in Women in Their 20s and 30s on Preventive Efficiency and Beauty Health Care Behaviors
Chae-Won Lim, Ju-Youn Kim
Journal of the Korean Society of Cosmetology.2021; 27(6): 1461. CrossRef
Effects of a Person-Centered Nursing Intervention for Frailty among Prefrail Community-Dwelling Older Adults
Jiyeon Ha, Yeon-Hwan Park
International Journal of Environmental Research and Public Health.2020; 17(18): 6660. CrossRef
Understanding and Prevention of Fall-related Injuries in Older Adults in South Korea: A Systematic Review
Ki-taek Lim, Ji-eun Lee, Ha-eun Park, Su-young Park, Woochol Joseph Choi
Physical Therapy Korea.2019; 26(2): 34. CrossRef
Effects of the Elderly's Health Statuses, Health Behavior, and Social Relations on Their Health-related Quality of Life: Focusing on Family Types
Young Bum Kim, Seung-Hee Lee
Journal of Korean Academy of Community Health Nursing.2018; 29(3): 310. CrossRef

Effects of Health Literacy and Knowledge on Diabetic Self-care in the Elderly with DM Living Alone: Nan Hui Kim, Young Ran Yang, Myung Ha Lee; J Korean Acad Community Health Nurs. 2016;27(4):370-379. Published online December 31, 2016; DOI: https://doi.org/10.12799/jkachn.2016.27.4.370

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PURPOSE
The aim of this study was to evaluate the level of self-care adherence in the elderly with diabetes mellitus (DM) who have lived alone, and to investigate the association between health literacy, diabetic knowledge and self-care adherence.
METHODS
Descriptive research using the cross-sectional approach was conducted. Data was collected by using a convenience sampling of 201 participants who aged sixty-five years old or more and have lived alone. Statistical analysis was conducted by using an independent t-test, one-way ANOVA, ScheffÃ© test, Pearson correlation coefficient and stepwise multiple regression analysis.
RESULTS
Mean scores of health literacy, diabetic knowledge and adherence of self-care were 4.41Â±3.54 points out of a possible 12, 6.22Â±2.55 points out of a possible 15, 58.56Â±17.28 points out of a possible 112, respectively. Adherence of self-care showed a statistical association with health literacy (r=.26, p<.001) and diabetic knowledge (r=.30, p<.001). Statistically significant factors in the regression model were monthly income, diabetic knowledge and exercise.
CONCLUSION
The level of self-care adherence in the elderly with diabetes living alone was relatively low. Diabetic knowledge was an important factor to improve the level of self-care adherence for the elderly with diabetes living alone.

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Relationships Among Health Literacy, Self-Efficacy, Self-Management, and HbA1c Levels in Older Adults with Diabetes in South Korea: A Cross-Sectional Study
Geun Young Jang, Soo Jung Chang, Jun Hee Noh
Journal of Multidisciplinary Healthcare.2024; Volume 17: 409. CrossRef
Influencing factors on self-care of older adults living alone in a community during COVID-19: A cross-sectional study
Heeyoung Woo, Minkyung Gu
Journal of Korean Gerontological Nursing.2023; 25(1): 1. CrossRef
The effects of diabetes knowledge, self-efficacy, and depression on self-management in older patients with diabetes in the community: A cross-sectional study
Hyeok Gyu Park, Myoung Jin Kwon
Journal of Korean Gerontological Nursing.2022; 24(4): 389. CrossRef
The Effects of Self-efficacy and Self-stigma on Self-care in People with Diabetes
Kawoun Seo
Journal of Korean Academy of Community Health Nursing.2021; 32(1): 86. CrossRef
The Effects of Snack Control Education and Telephone Coaching on Self-Management, Social Support, Self-Efficacy, and Blood Glucose in Diabetes Patients
Hye Eun Park
The Journal of Korean Diabetes.2021; 22(4): 274. CrossRef
Health Literacy, Knowledge and Self-care Behaviors in Patients with Pulmonary Tuberculosis Living in Community
Seo Hui Yang, Eun Young Jung, Yang Sook Yoo
Journal of Korean Academy of Fundamentals of Nursing.2020; 27(1): 1. CrossRef
Intervention study of a foot‐care programme enhancing knowledge and practice among nurses and care workers at in‐home service providers
Kashiko Fujii, Minna Stolt
Nursing Open.2020; 7(4): 1039. CrossRef
Readiness for utilizing digital intervention: Patterns of internet use among older adults with diabetes
Sunhee Park, Beomsoo Kim
Primary Care Diabetes.2020; 14(6): 692. CrossRef
The Effect of Health Literacy and Self-care Performance on Health Care Utilization of Medicaid Elderly
Yun Hee Hwang, Ga Eon Lee
Journal of Korean Academy of Community Health Nursing.2019; 30(4): 484. CrossRef
Effects of Diabetic Foot Care Education for the Aged with Low Health Literacy
Hyemin Kim, Ji Min Seo
Journal of Korean Academy of Community Health Nursing.2019; 30(4): 560. CrossRef
A new comprehensive diabetes health literacy scale: Development and psychometric evaluation
Eun-Hyun Lee, Young Whee Lee, Kwan-Woo Lee, Moonsuk Nam, So Hun Kim
International Journal of Nursing Studies.2018; 88: 1. CrossRef
Relationships of health literacy to self‐care behaviors in people with diabetes aged 60 and above: Empowerment as a mediator
Kyung Suk Shin, Eun‐Hyun Lee
Journal of Advanced Nursing.2018; 74(10): 2363. CrossRef

Factors Influencing Health-related Quality of Life of Young Adults and Elderly with Multimorbiditiy: A Secondary Analysis of the 2013 Korea Health Panel Data: Seun Young Joe, In Sook Lee, Bo Hyun Park; J Korean Acad Community Health Nurs. 2016;27(4):358-369. Published online December 31, 2016; DOI: https://doi.org/10.12799/jkachn.2016.27.4.358

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PURPOSE
This study was to identify health-related quality of life of Korean young adults and elderly with multimorbidity and to examine factors influencing their health-related quality of life.
METHODS
Health-related quality of life was measured by the Korean version of the EQ-5D. Using a descriptive study, the study incorporated a secondary analysis of the Korean version of the EQ-5D data from the 8th wave of the Korea Health Panel Survey in 2013. Selected demographic data and the Korean version of the EQ-5D were analyzed using Ï‡Â²-test, t-test, ANOVA and multiple regression analysis.
RESULTS
Education, drinking, type of health insurance, and number of chronic disease significantly affected the health-related quality of life in the young adults with multimorbidity. Educational level, occupational type, drinking, physical activity, number of chronic disease, unmet healthcare need and the type of multimorbidity significantly affected the health-related quality of life in the elderly with multimorbidity.
CONCLUSION
The factors influencing health-related quality of life were different for young adults versus elderly with multimorbidity. Therefore, there is a need for age-specific health care programs that may improve health-related quality of life of adults with multimorbidity.

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Health Promotion Behaviors of Rural Elderly Women Living Alone and Their Life Satisfaction: Ha Jeong Kim; J Korean Acad Community Health Nurs. 2016;27(3):254-261. Published online September 30, 2016; DOI: https://doi.org/10.12799/jkachn.2016.27.3.254

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PURPOSE
This study was conducted to investigate the correlation between degrees of health promotion behaviors and life satisfaction and effects of health promotion behaviors on life satisfaction in rural elderly women living alone.
METHODS
A descriptive correlation study was conducted with 189 rural elderly women living alone aged 65 or older in four senior counties in Jeollanam-do. Descriptive statistics, t-test, ANOVA, ScheffÃ© test, Pearson's correlation, and multiple regression.
RESULTS
The subjects' health promotion behaviors and life satisfaction were significantly positive. Among the factors influencing the subjects' life satisfaction, nutrition and diet showed the greatest positive effects, followed by exercise and activity, and drinking and smoking. Among them, drinking and smoking had significantly negative influence.
CONCLUSION
Among the health promotion behaviors that influenced life satisfaction, nutrition and diet, exercise and activity, and drinking and smoking were most significant factors. Therefore, this study provided basic data for improving the life satisfaction among rural elderly women living alone.

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