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HOME > J Korean Acad Community Health Nurs > Volume 27(1); 2016 > Article
Original Article
The Effect of a Comprehensive Intervention Program on the Functional Status and Bone Density of the Socially-Vulnerable and Frail Elderly
In Sook Lee1, Kwang Ok Lee2
Journal of Korean Academy of Community Health Nursing 2016;27(1):51-59.
DOI: https://doi.org/10.12799/jkachn.2016.27.1.51
Published online: March 12, 2016

1College of Nursing, Seoul National University, Seoul, Korea

2Department of Nursing, Sangmyung University, Cheonan, Korea

Corresponding author: Lee, Kwang Ok Department of Nursing, Sangmyung University, 31 Sangmyungdae-gil, Dongnam-gu, Cheonan 330-720, Korea. Tel: +82-41-550-5432, Fax: +82-41-550-5545, E-mail: kolee@smu.ac.kr
• Received: February 21, 2016   • Revised: March 21, 2016   • Accepted: March 22, 2016

Copyright © 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.

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  • Purpose
    The purpose of this study is to provide a disease management, nutrition education, and group exercise program for three months to the moderately frail elderly whose physical functions have deteriorated, and to investigate its effects in order to develop an intervention program.
  • Methods
    As a quasi-experiment, this study was conducted based on non-equivalence studies designed as a similar experiment. The milk intake group and calcium intake group participated in the disease education, individual nutrition education, and group exercise program for three months, and the control group was visited once in the three months by a nurse who provided disease education, nutrition education, and oral instruction of exercise, and asked them to exercise on their own every day. For the data analysis, x2-test, ANOVA and Scheffé test were used.
  • Results
    After three months of intervention, there was a significant difference in the frailty level (p=.029) and bone density (p=.001) between the groups.
  • Conclusion
    The comprehensive intervention program had an effect on the bone density and the frailty level of the socially-vulnerable and moderately frail elderly, suggesting that the program can be used as a nursing intervention to prevent functional deterioration and damage of the moderately frail elderly.
  • Key Words: Elderly; Frail; Bone density
Table 1.
Homogeneity of General Characteristics before Intervention
Characteristics Categories Cont.
 Milk G.
 Calcium G.
 x2 or F p
n (%) or M±SD n (%) or M±SD n (%) or M±SD
Gender Male 15 (22.1) 13 (20.6) 14 (21.9) 0.05 .977
Female 53 (77.9) 50 (79.4) 50 (78.1)
Age (year) 74.09±5.39 73.71±4.28 75.52±5.76 2.15 .120
Academic ability No 30 (44.1) 33 (52.4) 30 (46.9) 5.82 .667
Elementary school 21 (30.9) 14 (22.2) 16 (25.0)
≥Middle school 17 (25.0) 16 (25.4) 18 (28.1)
Depression 6.63±3.47 6.51±3.84 7.19±3.79 0.61 .543
BMI (kg/m2) 24.01±3.27 24.85±3.63 23.71±3.09 1.97 .142
Frailty (range: 0~31) 10.44±3.06 10.40±2.94 10.34±3.24 0.09 .915
BMD (T score) −2.79±0.85 −2.78±0.65 −2.93±0.70 0.82 .441
Bone density 1.25 .870
Normal ≥-1.5 6 (8.8) 4 (6.3) 3 (4.7)
Osteopenia −2.5≤T＜-1.5 19 (28.0) 16 (25.4) 16 (25.0)
Osteoporosis ＜-2.5 43 (63.2) 43 (68.3) 45 (70.3)
Total cholesterol 196.66±41.20 197.97±35.74 194.84±39.83 0.10 .903
HDL 47.32±10.60 46.95±9.42 48.73±10.54 0.54 .582
TG 156.34±103.44 4 154.97±74.32 134.84±74.46 1.28 .281
LDL 118.07±40.26 120.02±33.28 119.14±33.82 0.05 .953
Total 68 (100.0) 63 (100.0) 64 (100.0)

Cont.=control group; Milk G.=milk group; Calcium G.=calcium group; BMI=body mass index; BMD=bone mineral density; HDL=high density lipoprotein; TG=tiglyceride; LDL=low density lipoprotein.

Table 2.
Differences before and after Intervention (N=195)
Variables Cont. (n=68)
 Milk G. (n=63)
 Calcium G. (n=64)
 F p
n (%) or M±SD n (%) or M±SD n (%) or M±SD
Frailty −1.31±2.67 −2.44±1.95 −2.20±2.97 3.59 .029
BMD 0.25±0.36 0.49±0.46 0.54±0.52 7.69 .001
Total cholesterol 1.44±30.09 9.52±29.58 −1.05±23.02 2.51 .084
HDL 2.46±7.11 4.13±6.85 1.91±6.54 1.82 .166
TG −11.00±66.13 3.17±80.41 0.11±62.01 0.76 .471
LDL 1.19±29.51 4.76±25.15 −2.98±20.93 1.46 .235
Depression −1.21±3.23 −1.14±2.80 −1.14±3.64 0.07 .933

Cont.=control group; Milk G.=milk group; Calcium G.=calcium group; BMD=bone mineral density; HDL=high density lipoprotein; TG=triglyceride; LDL=low density lipoprotein.

Table 3.
Frailty and BMD after Intervention
Variables Group (I) Group (J) Mean (I-J) SD p
Frailty Cont. Calcium G 0.894 .45 .138
Milk G. 1.135 .45 .043
Milk G. Calcium G −0.241 .46 .869
Cont. −1.135 .45 .043
Calcium G Milk G. 0.241 .46 .869
Cont. −0.894 .45 .138
BMD Cont. Calcium G −0.286 .08 .002
Milk G. −0.235 .08 .012
Milk G. Calcium G −0.050 .08 .820
Cont. 0.235 .08 .012
Calcium G Milk G. 0.050 .08 .820
Cont. 0.286 .08 .002

BMD=bone mineral density; Cont.=control group; Milk G.=milk group; Calcium G.=calcium group.

Table 4.
Differences of BMD before and after Intervention
Before Groups BMD
 x2 p
Normal Osteopenia Osteoporosis Total
Normal Cont. 6 (100.0) 0 (0.0) 6 (100.0) 2.45 .296
Milk G. 3 (75.0) 1 (25.0) 4 (100.0)
Cont. 3 (100.0) 0 (0.0) 3 (100.0)
Total 12 (92.3) 1 (7.7) 13 (100.0)
Osteopenia Cont. 3 (15.8) 12 (63.2) 4 (21.0) 19 (100.0) 6.17 .187
Milk G. 8 (50.0) 7 (43.8) 1 (6.3) 16 (100.0)
Calcium G 5 (31.3) 10 (62.5) 1 (6.2) 16 (100.0)
Total 16 (31.4) 29 (56.9) 6 (11.8) 51 (100.0)
Osteoporosis Cont. 0 (0.0) 7 (16.3) 36 (83.7) 43 (100.0) 6.09 .192
Milk G. 0 (0.0) 15 (34.9) 28 (65.1) 43 (100.0)
Calcium G 1 (2.2) 10 (22.2) 34 (75.6) 45 (100.0)
Total 1 (0.8) 32 (24.4) 98 (74.8) 131 (100.0)

BMD=bone mineral density; Cont.=control group; Milk G.=milk group; Calcium G.=calcium group.

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    • Effects of Calcium/Vitamin D Intake and Taekkyeon Exercise on the Elderly's Frailty
      Kwang Ok Lee
      Journal of Korean Biological Nursing Science.2016; 18(3): 185.     CrossRef

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