Journal List > J Korean Acad Community Health Nurs > v.26(4) > 1058402

Kim: The Effects of Home Visit Healthcare Using a Complex Program on Community-dwelling Frail Elders' Strength, Frailty, and Depression



The purposes of this study were to examine the effects of home visit healthcare using a complex program on community-dwelling frail elders' physical strength, frailty, and depression and to compare the effects among three regions.


This study was conducted as a quasi-experimental study using one-group pretest-posttest design. A total of 86 subjects were sampled from three regions (metropolis, small city, and rural area). The program was applied for 14 weeks. This program consisted of disease management by a visiting nurse, exercise with a visiting nurse, self exercise, telephone monitoring, health education, counseling, providing handbook, and incentive. Physical strength was measured by balance, upper-limb, and lower-limb muscle strength. Frailty was measured by the Korean Frail Scale and depression was measured by the Geriatric Depression Scale. Paired t-test and ANCOVA were used to analyze the effects.


Physical strength, frailty, and depression were significantly improved after applying the complex program. There were not differences among the regions.


Home visit healthcare using a complex program was effective in improving frail elders' physical strength, frailty, and depression. There were not differences among the regions. Therefore, home visit healthcare using a complex program needs to be expanded to other regions.

Figures and Tables

Figure 1

Home visit healthcare using complex program.

Table 1

The Visit Health Program Using Complex Program for the Frail Elderly

Domains Contents Instruments Frequency Personnels
Physical strength & mental status assessment · Measurement
· Planning
· Items
· Physical strength (Balance, upper-limb, and lower-limb strength)
· Frailty
· Depression
· Providing health mileage handbook, and poster on exercise, and self ckecklist
· Pre: at the beginning class
· Post: at the ending class
Visit nurse, physical therapist, exercise therapist
Complex exercise · Exercise without tools for muscle strength
· Hand exercise for preventing dementia
· Laughter Therapy
· Exercise with tools (Sera band, bean bag)
· Exercise with visit nurse
· Self ckecklist after exercise at home
· Telephone monitoring
· Providing mileage stickers
· 1 / week
· 2~3 / week
· 1 / week
· 1 / week
Visit nurse, physical therapist, exercise therapist
Health education · Nutrition
· Oral care
· Chronic disease management
· Providing mileage stickers · 1 / 4~6week Visit nurse, dietitians, dental hygiene agents
Table 2

General Characteristics of the Subjects

Variables Categories n (%) or M±SD
Region Metropolis 24 (27.90)
Small city 48 (55.81)
Rural area 14 (16.27)
Gender Male 9 (10.46)
Female 77 (89.53)
Age (year) 78.5±5.50
<80 55 (63.95)
≥80 31 (36.05)
Total 86 (100.00)
Table 3

Physical Function, Frailty, and Depression Before Home Visit Healthcare Using Complex Program

Indicators Region Pre F (p)
Physical function Balance (second) D-gu 4.13±6.16 0.53 (.594)
S-si 5.42±5.18
Y-gun 5.71±6.01
Low-limb strength (frequency) D-gu 6.50±2.99a 7.12 (.001)
S-si 10.02±4.18b
Y-gun 8.14±3.13ab
Upper-limb strength (frequency) D-gu 11.08±9.30 1.89 (.157)
S-si 13.19±4.95
Y-gun 9.86±3.84
Frailty D-gu 3.38±1.86 0.79 (.456)
S-si 3.58±1.39
Y-gun 4.00±1.11
Depression D-gu 4.96±3.94 0.42 (.662)
S-si 5.56±3.25
Y-gun 4.71±4.12
Physical function Balance (second) <80 6.11±6.37 2.27 (.008)
≥80 3.32±3.10
Low-limb strength (frequency) <80 9.15±4.25 1.26 (.210)
≥80 8.00±3.62
Upper-limb strength (frequency) <80 12.47±6.92 0.80 (.427)
≥80 11.32±5.40
Frailty <80 3.44±1.49 -1.32 (.191)
≥80 3.87±1.43
Depression <80 5.05±3.83 -0.69 (.490)
≥80 5.61±3.08
Table 4

Differences in Physical Function, Frailty, and Depression Before and After Home Visit Healthcare Using Complex Program

Indicators Pre Post t (p) Post-Pre
Physical function Balance (second) 5.31±5.70 9.85±12.63 -4.08 (<.001) 4.54±9.96
Lower-limb strength (frequency) 8.85±4.08 11.68±4.80 -6.10 (<.001) 2.83±3.85
Upper-limb strength (frequency) 12.12±6.46 17.16±5.82 -6.93 (<.001) 5.04±6.54
Frailty 3.59±1.52 2.19±1.69 1.77 (<.001) -1.41±1.63
Depression 5.22±3.58 4.35±3.57 1.64 (.025) -0.88±4.37
Table 5

Differences in Physical Function, Frailty, and Depression Before and After Home Visit Healthcare Using Complex Program by Regions and Age

Indicators Region Post-Pre Source F (p)
<80 ≥80
Physical function Balance (second) D-gu 2.94±4.71 2.29±2.69 Region 1.51 (.228)
S-si 8.00±14.85 3.81±6.08 Age 0.66 (.418)
Y-gun 1.75±7.25 0.20±1.31 Region*Age 0.24 (.778)
Low-limb strength (frequency) D-gu 3.88±4.19 2.71±1.70 Region 1.09 (.340)
S-si 3.24±4.81 2.43±3.39 Age 0.89 (.766)
Y-gun 0.75±1.16 1.80±1.41 Region*Age 0.35 (.709)
Upper-limb strength (frequency) D-gu 7.69±9.47 8.57±6.80 Region 3.73 (.029)
S-si 4.41±5.66 4.56±5.60 Age 0.41 (.525)
Y-gun 1.00±2.00 3.20±2.73 Region*Age 0.13 (.883)
Frailty D-gu -0.88±1.50 -2.00±1.15 Region 0.45 (.643)
S-si -1.70±1.67 -1.44±1.67 Age 0.33 (.566)
Y-gun -1.13±1.46 -1.00±2.45 Region*Age 1.22 (.301)
Depression D-gu -1.19±2.61 -3.00±4.65 Region 3.03 (.054)
S-si -1.45±3.26 0.06±4.02 Age 0.15 (.698)
Y-gun 0.25±2.87 1.60±2.87 Region*Age 1.68 (.194)


This research was supported by the National Health Insurance Corporation research fund of 2014(GCU-2015-0161).


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