Skip Navigation
Skip to contents

RCPHN : Research in Community and Public Health Nursing

OPEN ACCESS
SEARCH
Search
Advanced Search
mobile menu button

Articles

Page Path
HOME > J Korean Acad Community Health Nurs > Volume 27(4); 2016 > Article
Original Article
Factors Associated with the Changes in Activities of Daily Living in Older Adults with Stroke: A Comparison of Home Care and Institutional Care
Woon-Sook Jung, Eun-Shil Yim
Journal of Korean Academy of Community Health Nursing 2016;27(4):388-398.
DOI: https://doi.org/10.12799/jkachn.2016.27.4.388
Published online: December 31, 2016

1Division of Occupational Therapy, Kyungdong University, Wonju, Korea.

2Division of Nursing, Daegu Health College, Daegu, Korea.

• Received: October 25, 2016   • Revised: December 11, 2016   • Accepted: December 11, 2016

© 2016 Korean Academy of Community Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

prev next
  • 1,614 Views
  • 3 Download
  • 2 Crossref
Full Article

Download PDF Download PDF

  • Purpose
    To compare the changes in activities of daily living (ADLs) in older adults with stroke in different modalities of long term care (LTC) services, which include home care and institutional care.
  • Methods
    This is a comparative study using secondary data from the Korean national LTC insurance. Home care (HC) services users (n=3,494) and institutional care (IC) users (n=1,428) were extracted and compared in terms of ADLs and changes in ADLs to investigate the effects of HC and IC services in LTC.
  • Results
    All of the ADLs and LTC services benefit levels for 2 years had improved in both HC and IC services. The ADLs of older adults with stroke who received HC improved, while those who received IC experienced deterioration. The LTC services benefit levels of the HC and IC groups were significantly different after 2 years.
  • Conclusion
    The study has found that HC services may lead ADLs better for older adults with stroke. We recommend LTC policy makers to further develop HC and IC service programs to deliver quality LTC services.
  • Key Words: Activities of daily living; Stroke; Long-term care
Table 1

Baseline Characteristics according to Service Type (N=4,922)

Characteristics Categories Home care Institutional care p
n (%) or M±SD n (%) or M±SD
Grade Grade-1 894 (25.6) 410 (28.7) .025
Grade-2 2,600 (74.4) 1,018 (71.3)
Gender Male 1,672 (47.9) 482 (33.8) <.001
Female 1,822 (52.1) 946 (66.2)
Age (year) 65~69 1,351 (38.7) 391 (27.4) <.001
70~74 755 (21.6) 239 (16.7)
75~79 641 (18.3) 326 (22.8)
80~84 449 (12.9) 279 (19.5)
≥85 298 (8.5) 193 (13.5)
71.41±10.01 74.37±9.78 <.001
Care-giver Yes 3,154 (90.3) 500 (35.0) <.001
No 340 (9.7) 928 (65.0)
Insurance type Medicaid 398 (11.4) 294 (20.6) <.001
NHI 3,096 (88.6) 1,134 (79.4)
Dementia No 2,633 (75.4) 893 (62.5) <.001
Yes 861 (24.6) 535 (37.5)
Disease number 1.68±1.21 1.63±1.17 .600
Care need 0 2,919 (83.5) 1,073 (75.1) <.001
1 465 (13.3) 240 (16.8)
≥2 110 (3.1) 115 (8.1)
0.21±0.58 0.37±0.78 <.001
Cognitive function 5.77±2.55 6.01±2.54 .255
Rehabilitation function 16.88±3.89 16.07±3.98 .703

NHI=national health insurance.

Table 2

Profiles of Activities of Daily Living according to Service Type (N=4,922)

Variables Service type 2009 2010 2011 Time Group Time×group
M±SD M±SD M±SD p p p
ADL Home care 30.90±3.75 28.17±4.95 28.02±5.69 <.001 <.001 <.001
Institutional care 31.69±4.11 29.89±5.16 30.00±5.74
Dressing Home care 2.77±0.42 2.65±0.49 2.62±0.49 <.001 <.001 <.001
Institutional care 2.75±0.43 2.65±0.49 2.67±0.48
Washing face Home care 2.32±0.48 2.13±0.45 2.10±0.46 <.001 <.001 <.001
Institutional care 2.27±0.46 2.12±0.40 2.12±0.42
Gargling Home care 2.35±0.48 2.17±0.45 2.15±0.45 <.001 <.001 <.001
Institutional care 2.32±0.48 2.17±0.42 2.18±0.44
Bathing Home care 2.91±0.28 2.78±0.41 2.73±0.44 <.001 <.001 <.001
Institutional care 2.90±0.29 2.81±0.39 2.77±0.42
Eating Home care 1.93±0.66 1.63±0.64 1.61±0.68 <.001 <.001 <.001
Institutional care 1.83±0.71 1.54±0.61 1.56±0.67
Transfer Home care 1.88±0.72 1.64±0.69 1.65±0.72 <.001 <.001 <.001
Institutional care 1.84±0.75 1.72±0.73 1.75±0.77
Sit up Home care 2.35±0.75 1.97±0.82 1.95±0.83 <.001 <.001 <.001
Institutional care 2.29±0.78 2.08±0.85 2.10±0.87
Sitting move Home care 2.39±0.77 2.09±0.85 2.09±0.87 <.001 <.001 <.001
Institutional care 2.50±0.74 2.36±0.81 2.38±0.83
Emerging out of the room Home care 2.76±0.52 2.53±0.66 2.50±0.68 <.001 <.001 <.001
Institutional care 2.77±0.54 2.61±0.68 2.62±0.67
Toileting Home care 2.74±0.44 2.55±0.55 2.53±0.55 <.001 <.001 <.001
Institutional care 2.83±0.37 2.73±0.47 2.71±0.50
Bowel control Home care 1.72±0.82 1.57±0.77 1.63±0.81 <.001 <.001 <.001
Institutional care 2.16±0.87 2.07±0.86 2.11±0.88
Bladder control Home care 1.86±0.80 1.65±0.76 1.73±0.80 <.001 <.001 <.001
Institutional care 2.29±0.78 2.21±0.79 2.24±0.81
Shampoo Home care 2.92±0.28 2.79±0.42 2.74±0.44 <.001 <.001 <.001
Institutional care 2.94±0.29 2.82±0.39 2.79±0.42

ADL=activities of daily living.

Table 3

Maintenance, Improvement and Worsening of Outcomes over Time according to Service Type (N=4,922)

Variables Outcome Home care Institutional care p
n (%) n (%)
ADL Maintenance & improved 2,553 (73.1) 926 (64.8) <.001
Worsened 941 (26.9) 502 (35.2)
Dressing Maintenance & improved 3,176 (90.9) 1,268 (88.8) .026
Worsened 318 (9.1) 160 (11.2)
Washing face Maintenance & improved 3,238 (92.7) 1,297 (90.8) .031
Worsened 256 (7.3) 131 (9.2)
Gargling Maintenance & improved 3,235 (92.6) 1,271 (89.0) <.001
Worsened 259 (7.4) 157 (11.0)
Bathing Maintenance & improved 3,349 (95.9) 1,357 (95.0) .220
Worsened 145 (4.1) 71 (5.0)
Eating Maintenance & improved 3,080 (88.2) 1,187 (83.1) <.001
Worsened 414 (11.8) 241 (16.9)
Transfer Maintenance & improved 3,003 (85.9) 1,160 (81.2) <.001
Worsened 491 (14.1) 268 (18.8)
Sit up Maintenance & improved 3,055 (87.4) 1,198 (83.9) .001
Worsened 439 (12.6) 230 (16.1)
Sitting move Maintenance & improved 3,049 (87.3) 1,217 (85.2) .058
Worsened 445 (12.7) 211 (14.8)
Emerging out of Maintenance & improved 3,251 (93.0) 1,330 (93.1) .951
Worsened 243 (7.0) 98 (6.9)
Toileting Maintenance & improved 3,218 (92.1) 1,325 (92.8) .444
Worsened 276 (7.9) 103 (7.2)
Bowel control Maintenance & improved 2,864 (82.0) 1,118 (78.3) .003
Worsened 630 (18.0) 310 (21.7)
Bladder control Maintenance & improved 2,882 (82.5) 1,109 (77.7) <.001
Worsened 612 (17.5) 319 (22.3)
Shampoo Maintenance & improved 3,368 (96.4) 1,377 (96.4) .514
Worsened 126 (3.6) 51 (3.6)

ADL=activities of daily living.

Table 4

Multiple Logistic Regression to Predict Change of Activities of Daily Living by 2009~2010 (N=4,922)

Variables Comparative group Reference group ADL worsened (ref. Improved) Adj or (95 CI) p
Odd ratios 95% CI
Type Institutional care Home care 1.68 1.42 1.99 <.001
Grade Grade-2 Grade-1 3.54 2.93 4.27 <.001
Gender Female Male 1.04 0.91 1.19 .596
Age (year) 70~74 65~69 0.97 0.81 1.17 .767
75~79 65~69 1.07 0.89 1.29 .480
80~84 65~69 1.19 0.97 1.46 .095
≥85 65~69 1.41 1.12 1.77 .003
Care-giver No Yes 1.36 1.14 1.63 <.001
Insurance Medicaid NHI 0.98 0.82 1.19 .868
Dementia Yes No 1.27 1.10 1.47 .002
Nursing need score at baseline 1.09 0.97 1.22 .141
Cognitive function score at baseline 0.99 0.96 1.02 .361
Rehabilitation function score at baseline 0.98 0.96 0.99 .006

ADL=activities of daily living; NHI=national health insurance.

  • 1. Statistics Korea. Trend of stroke prevalence. [Internet] Daejeon: Statistics Korea; 2015;cited 2016 July 20. Available from: http://kosis.kr/wnsearch/totalSearch.jsp
  • 2. Kim MH, Jung YH, Lee DH. Cardiovascular diseases prevention and control campaign, 2015. Public Health Wkly Rep. 2015;8(39):925–928.
  • 3. Kwon YD, Chang HJ, Choi YJ, Yoon SS. Nationwide trends in stroke hospitalization over the past decade. J Korean Med Assoc. 2012;55(10):1014–1025.Article
  • 4. Kim HS, Kim JM, Yim HS, Hong JS, Ha DS, Kwon JB. Efficient recycling based on research generated through the use of analysis of acute care stroke patients. Goyang: National Health Insurance Service Ilsan Hospital; 2015. 12;Report No.: 2015-20-023.
  • 5. Dewey HM, Thrift AG, Mihalopoulos C, Carter R, Macdonell RA, McNeil JJ, et al. Informal care for stroke survivors: Results from the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke. 2002;33(4):1028–1033. ArticlePubMed
  • 6. Kang EJ, Kim DJ, Sun YD, Yoon SS. Development of health care system for the elderly with medical expenditure analysis. Seoul: Korea Institute for Health & Social Affairs; 2006. 12;Report No.: 2006-05.
  • 7. Hyun KR, Lee SM. Effects on the functional status changes of LTC (Long Term Care) services. J Korean Gerontol Soc. 2012;32(2):593–609.
  • 8. Lee S, Kwak C. Effects of visiting nursing services in long-term care insurance on utilization of health care. J Korean Acad Community Health Nurs. 2016;27(3):272–283.ArticlePDF
  • 9. National Health Insurance Service. Statistical yearbook of longterm care insurance for the elderly. Seoul: National Health Insurance Service; 2015. p. 685.
  • 10. Yoon JY, Lee JY. Development of outcome indicators of urinary incontinence for quality evaluation in long term care hospitals. J Korean Acad Nurs. 2010;40(1):110–118.ArticlePubMed
  • 11. Mitchell JB. Patient outcomes in alternative long-term care setting. Med Care. 1978;16(6):439–452. PubMed
  • 12. Marek KD, Popejoy L, Petroski G, Mehr D, Rantz M, Lin WC. Clinical outcomes of aging in place. Nursing Research. 2005;54(3):202–211. ArticlePubMed
  • 13. Braun KL, Rose CL, Finch MD. Patient characteristics and outcomes in institutional and community long-term care. Gerontologist. 1991;31(5):648–656. ArticlePubMed
  • 14. Lee TW, Cho EH, Yim EH, Lee HS, Ko YK, Kim BN, et al. Activities of daily living in nursing home and home care settings: A retrospective 1-year cohort study. J Am Med Dir Assoc. 2015;16(2):114–119.ArticlePubMed
  • 15. Park CJ. Cost-effectiveness analysis of long-term care services: care in institution vs in-home care. J Welf Aged. 50:145–172.
  • 16. You HJ, Lee HY, Kim KA, Jo JH, Kim DH. Strengthening longterm care facility services expertise. Seoul: National Health Insurance Service; 2013. 11 30 Report No.: 2013-12.
  • 17. Kown JH, Han EJ, Lee JS. Long-term care services payroll management improvement. Research Report. Seoul: National Health Insurance Corporation; 2009. 12;Report No.: 2009-33.
  • 18. Lee TW, Yim EH, Cho EH, Chung JN. Cognitive function, behavioral problems, and physical function in long-term care insurance beneficiaries with dementia in south Korea: Comparison of home care and institutional care services. J Am Geriatr Soc. 2014;62(8):1467–1475.ArticlePubMedPDF
  • 19. Lee K, Cho E. Activities of daily living and rehabilitation needs for older adults with a stroke: A comparison of home care and nursing home care. Jpn J Nurs Sci. 2016;7:1–9.ArticlePDF
  • 20. Kane RL, Chen Q, Finch M, Blewett L, Burns R, Moskowitz M. Functional outcomes of posthospital care for stroke and hip fracture patients under medicare. J Am Geriatr Soc. 1998;46(12):1525–1533. ArticlePubMed
  • 21. Kane RL, Chem Q, Blewett LA, Sangl J. Do rehabilitative nursing homes improve the outcomes of care? J Am Geriatr Soc. 1996;44(5):545–554. ArticlePubMed
  • 22. Mun BM, Lee YS, Lee BH. The relationship between the patient's health beliefs and the implementation of functional movement rehabilitation and ability to perform ADL in stroke patients. J Korea Acad Ind Coop Soc. 2012;13(7):3057–3064.Article
  • 23. Hwang HJ, Lee KY, Kim SH. Physical and emotional status of nursing home residents: long-term care of older people via Incheon nursing home network study. J Korean Geriatr Soc. 2010;14(3):139–146.Article
  • 24. Boyd M, Broad JB, Kerse N, Foster S, von Randow M, Lay-Yee R, et al. Twenty-year trends in dependency in residential aged care in Auckland, New Zealand: A descriptive study. J Am Med Dir Assoc. 2011;12(7):535–540.ArticlePubMed
  • 25. Hwang EH, Jung DY, Kim MJ, Kim KH, Shin SJ. Comparison of frequency and difficulty of care helper jobs in long term care facilities and client homes. J Korean Public Health Nurs. 2012;26(1):101–112.Article
  • 26. Jette DU, Warren RL, Wirtalla C. Rehabilitation in skilled nursing facilities: Effect of nursing staff level and therapy intensity on outcomes. Am J Phys Med Rehabil. 2004;83(9):704–712. PubMed
  • 27. Lee JS, Han EJ, Lee HY, Lee JS. The report on incentives institution improvement measurements for improving the quality of long-term care services. Seoul: National Health Insurance Service; 2012. 11 30 Report No.: 2012-17.
  • 28. Lee MK, Kim EK. Relationship between resource utilization and long-term care classification level for residents in nursing homes. J Korean Acad Nurs. 2010;40(6):903–912.ArticlePubMed
  • 29. Yang YA, An SJ, Park YH, Park BR, Heo J, Park JS, et al. A study of visiting rehabilitation service and implementation method. J Korean Assoc Occup Ther Policy Aged Ind . 2011;3(1):59–70.
  • 30. Lee S, Kwak C. Effects of Visiting Nursing Services in Long-term Care Insurance on Utilization of Health Care. J Korean Acad Community Health Nurs. 2016;27(3):272–283.ArticlePDF

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • Examination of the Educational Needs of Home Visit Nurses: A Cross-Sectional Descriptive Study
      Kyuri Lee, Dukyoo Jung
      International Journal of Environmental Research and Public Health.2021; 18(5): 2319.     CrossRef
    • Profile of Long-Term Care Recipients Receiving Home and Community-Based Services and the Factors That Influence Utilization in Taiwan
      Chia-Mei Shih, Yu-Hua Wang, Li-Fan Liu, Jung-Hua Wu
      International Journal of Environmental Research and Public Health.2020; 17(8): 2649.     CrossRef

    • PubReader PubReader
    • Cite
      CITE
      export Copy
      Close
    • XML DownloadXML Download
    We recommend
    Factors Associated with the Changes in Activities of Daily Living in Older Adults with Stroke: A Comparison of Home Care and Institutional Care
    Factors Associated with the Changes in Activities of Daily Living in Older Adults with Stroke: A Comparison of Home Care and Institutional Care
    Characteristics Categories Home care Institutional care p
    n (%) or M±SD n (%) or M±SD
    Grade Grade-1 894 (25.6) 410 (28.7) .025
    Grade-2 2,600 (74.4) 1,018 (71.3)
    Gender Male 1,672 (47.9) 482 (33.8) <.001
    Female 1,822 (52.1) 946 (66.2)
    Age (year) 65~69 1,351 (38.7) 391 (27.4) <.001
    70~74 755 (21.6) 239 (16.7)
    75~79 641 (18.3) 326 (22.8)
    80~84 449 (12.9) 279 (19.5)
    ≥85 298 (8.5) 193 (13.5)
    71.41±10.01 74.37±9.78 <.001
    Care-giver Yes 3,154 (90.3) 500 (35.0) <.001
    No 340 (9.7) 928 (65.0)
    Insurance type Medicaid 398 (11.4) 294 (20.6) <.001
    NHI 3,096 (88.6) 1,134 (79.4)
    Dementia No 2,633 (75.4) 893 (62.5) <.001
    Yes 861 (24.6) 535 (37.5)
    Disease number 1.68±1.21 1.63±1.17 .600
    Care need 0 2,919 (83.5) 1,073 (75.1) <.001
    1 465 (13.3) 240 (16.8)
    ≥2 110 (3.1) 115 (8.1)
    0.21±0.58 0.37±0.78 <.001
    Cognitive function 5.77±2.55 6.01±2.54 .255
    Rehabilitation function 16.88±3.89 16.07±3.98 .703
    Variables Service type 2009 2010 2011 Time Group Time×group
    M±SD M±SD M±SD p p p
    ADL Home care 30.90±3.75 28.17±4.95 28.02±5.69 <.001 <.001 <.001
    Institutional care 31.69±4.11 29.89±5.16 30.00±5.74
    Dressing Home care 2.77±0.42 2.65±0.49 2.62±0.49 <.001 <.001 <.001
    Institutional care 2.75±0.43 2.65±0.49 2.67±0.48
    Washing face Home care 2.32±0.48 2.13±0.45 2.10±0.46 <.001 <.001 <.001
    Institutional care 2.27±0.46 2.12±0.40 2.12±0.42
    Gargling Home care 2.35±0.48 2.17±0.45 2.15±0.45 <.001 <.001 <.001
    Institutional care 2.32±0.48 2.17±0.42 2.18±0.44
    Bathing Home care 2.91±0.28 2.78±0.41 2.73±0.44 <.001 <.001 <.001
    Institutional care 2.90±0.29 2.81±0.39 2.77±0.42
    Eating Home care 1.93±0.66 1.63±0.64 1.61±0.68 <.001 <.001 <.001
    Institutional care 1.83±0.71 1.54±0.61 1.56±0.67
    Transfer Home care 1.88±0.72 1.64±0.69 1.65±0.72 <.001 <.001 <.001
    Institutional care 1.84±0.75 1.72±0.73 1.75±0.77
    Sit up Home care 2.35±0.75 1.97±0.82 1.95±0.83 <.001 <.001 <.001
    Institutional care 2.29±0.78 2.08±0.85 2.10±0.87
    Sitting move Home care 2.39±0.77 2.09±0.85 2.09±0.87 <.001 <.001 <.001
    Institutional care 2.50±0.74 2.36±0.81 2.38±0.83
    Emerging out of the room Home care 2.76±0.52 2.53±0.66 2.50±0.68 <.001 <.001 <.001
    Institutional care 2.77±0.54 2.61±0.68 2.62±0.67
    Toileting Home care 2.74±0.44 2.55±0.55 2.53±0.55 <.001 <.001 <.001
    Institutional care 2.83±0.37 2.73±0.47 2.71±0.50
    Bowel control Home care 1.72±0.82 1.57±0.77 1.63±0.81 <.001 <.001 <.001
    Institutional care 2.16±0.87 2.07±0.86 2.11±0.88
    Bladder control Home care 1.86±0.80 1.65±0.76 1.73±0.80 <.001 <.001 <.001
    Institutional care 2.29±0.78 2.21±0.79 2.24±0.81
    Shampoo Home care 2.92±0.28 2.79±0.42 2.74±0.44 <.001 <.001 <.001
    Institutional care 2.94±0.29 2.82±0.39 2.79±0.42
    Variables Outcome Home care Institutional care p
    n (%) n (%)
    ADL Maintenance & improved 2,553 (73.1) 926 (64.8) <.001
    Worsened 941 (26.9) 502 (35.2)
    Dressing Maintenance & improved 3,176 (90.9) 1,268 (88.8) .026
    Worsened 318 (9.1) 160 (11.2)
    Washing face Maintenance & improved 3,238 (92.7) 1,297 (90.8) .031
    Worsened 256 (7.3) 131 (9.2)
    Gargling Maintenance & improved 3,235 (92.6) 1,271 (89.0) <.001
    Worsened 259 (7.4) 157 (11.0)
    Bathing Maintenance & improved 3,349 (95.9) 1,357 (95.0) .220
    Worsened 145 (4.1) 71 (5.0)
    Eating Maintenance & improved 3,080 (88.2) 1,187 (83.1) <.001
    Worsened 414 (11.8) 241 (16.9)
    Transfer Maintenance & improved 3,003 (85.9) 1,160 (81.2) <.001
    Worsened 491 (14.1) 268 (18.8)
    Sit up Maintenance & improved 3,055 (87.4) 1,198 (83.9) .001
    Worsened 439 (12.6) 230 (16.1)
    Sitting move Maintenance & improved 3,049 (87.3) 1,217 (85.2) .058
    Worsened 445 (12.7) 211 (14.8)
    Emerging out of Maintenance & improved 3,251 (93.0) 1,330 (93.1) .951
    Worsened 243 (7.0) 98 (6.9)
    Toileting Maintenance & improved 3,218 (92.1) 1,325 (92.8) .444
    Worsened 276 (7.9) 103 (7.2)
    Bowel control Maintenance & improved 2,864 (82.0) 1,118 (78.3) .003
    Worsened 630 (18.0) 310 (21.7)
    Bladder control Maintenance & improved 2,882 (82.5) 1,109 (77.7) <.001
    Worsened 612 (17.5) 319 (22.3)
    Shampoo Maintenance & improved 3,368 (96.4) 1,377 (96.4) .514
    Worsened 126 (3.6) 51 (3.6)
    Variables Comparative group Reference group ADL worsened (ref. Improved) Adj or (95 CI) p
    Odd ratios 95% CI
    Type Institutional care Home care 1.68 1.42 1.99 <.001
    Grade Grade-2 Grade-1 3.54 2.93 4.27 <.001
    Gender Female Male 1.04 0.91 1.19 .596
    Age (year) 70~74 65~69 0.97 0.81 1.17 .767
    75~79 65~69 1.07 0.89 1.29 .480
    80~84 65~69 1.19 0.97 1.46 .095
    ≥85 65~69 1.41 1.12 1.77 .003
    Care-giver No Yes 1.36 1.14 1.63 <.001
    Insurance Medicaid NHI 0.98 0.82 1.19 .868
    Dementia Yes No 1.27 1.10 1.47 .002
    Nursing need score at baseline 1.09 0.97 1.22 .141
    Cognitive function score at baseline 0.99 0.96 1.02 .361
    Rehabilitation function score at baseline 0.98 0.96 0.99 .006
    Table 1 Baseline Characteristics according to Service Type (N=4,922)

    NHI=national health insurance.

    Table 2 Profiles of Activities of Daily Living according to Service Type (N=4,922)

    ADL=activities of daily living.

    Table 3 Maintenance, Improvement and Worsening of Outcomes over Time according to Service Type (N=4,922)

    ADL=activities of daily living.

    Table 4 Multiple Logistic Regression to Predict Change of Activities of Daily Living by 2009~2010 (N=4,922)

    ADL=activities of daily living; NHI=national health insurance.

    Table 1

    Table 2

    Table 3

    Table 4

    RCPHN : Research in Community and Public Health Nursing
    Editorial Office
    College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
    E-mail: office@rcphn.org

    © Korean Academy of Community Health Nursing.
    TOP