Factors Affecting the Intention to Participate in Healthcare Programs among Elders Living Alone

Mi Sook Song; Sunjoo Boo

doi:10.12799/jkachn.2016.27.4.319

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Song and Boo: Factors Affecting the Intention to Participate in Healthcare Programs among Elders Living Alone

Original Article

Journal of Korean Academy of Community Health Nursing 2016; 27(4): 319-326.

Published online: 31 December 2016

DOI: https://doi.org/10.12799/jkachn.2016.27.4.319

Factors Affecting the Intention to Participate in Healthcare Programs among Elders Living Alone

Mi Sook Song, Sunjoo Boo

College of Nursing, Institutue of Nursing Science, Ajou University, Suwon, Korea.

Corresponding author: Boo, Sunjoo. College of Nursing · Institute of Nursing Science, Ajou University, 164 Worldcup-ro, Yeongtong-gu, Suwon 16449, Korea. Tel: +82-31-219-7032, Fax: +82-31-219-7020, sjboo@ajou.ac.kr

Received 27 September 2016 Revised 3 November 2016 Accepted 4 November 2016

(open-access):

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.

Abstract

Purpose

The aim of this study is to identify factors affecting elders' intention to participate in healthcare programs.

Methods

This secondary data analysis used data of 390 elderly people who lived alone and were enrolled in the Visiting Health Care Center of H-city. In 2014, questionnaires were used to collect data about demographics, social activity, depression, frailty, and intention to participate in healthcare programs. The data were analyzed by descriptive statistics and multivariate logistic regressions.

Results

Among the participants, 51.8% intended to participate in the offered healthcare programs. The strongest factor affecting the intention was gender. Women were 4.85 times more likely to participate in the programs than men. The women's intention was associated positively with increased levels of frailty. The men tended to participate in the program as they got older and as the level of frailty and the number of chronic diseases increased.

Conclusion

Gender-specific public healthcare programs for vulnerable elders living alone should be developed to maximize their participation in the programs and to promote good health. The healthcare programs must be tailored to the levels of the patients' physical functions.

Keywords: Aged, Community health center, Intention

Figures and Tables

Table 1

Characteristics of Participants by Gender (N=390)

Characteristics	Total (n=390)	Male (n=107)	Female (n=283)	x² or t	p
Characteristics	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	x² or t	p
Age (year)	77.56±5.80	76.09±5.81	78.12±5.70	−3.12	.002
Social activity (≥1/week)	251 (64.4)	59 (55.1)	192 (67.8)	5.46	.019
Number of chronic disease^†	2.08±1.21	1.66±1.10	2.24±1.22	−4.31	<.001
Depression	5.45±2.17	5.50±2.09	5.39±2.20	0.47	.638
Normal	141 (36.2)	38 (35.5)	103 (36.4)	1.31	.521
Mild	225 (57.7)	60 (56.1)	165 (58.3)
Severe	24 (6.2)	9 (8.4)	15 (5.3)
Frailty	5.13±3.60	3.58±2.98	5.72±3.65	−5.42	<.001

^†Diagnosed hypertension, diabetes, stroke, arthritis, heart disease, chronic obstructive pulmonary disease, and cancer.

Table 2

Differences in Characteristics by Intention to Participate in Healthcare Programs Pulmonary Disease, and Cancer (N=390)

Characteristics	Yes (n=202)	No (n=188)	x² or t	p
Characteristics	n (%) or M±SD	n (%) or M±SD	x² or t	p
Female	171 (60.4)	112 (39.6)	30.76	<.001
Male	31 (29.0)	76 (71.0)
Age (year)	77.67±5.32	77.45±6.28	-0.38	.702
Social activity (≥1/week)	143 (57.0)	108 (43.0)	7.56	.006
Number of chronic disease^†	2.13±1.16	2.04±1.23	-0.74	.460
Depression	5.23±2.14	5.62±2.18	1.78	.076
Normal	85 (60.3)	56 (39.7)	6.68	.036
Mild	107 (47.6)	118 (52.4)
Severe	10 (41.7)	14 (58.4)
Frailty	4.71±3.60	5.59±3.56	2.42	.016

^†Diagnosed hypertension, diabetes, stroke, arthritis, heart disease, chronic obstructive pulmonary disease, and cancer.

Table 3

Factors Affecting Intention to Participate in Healthcare Programs (N=390)

Variables	Total			Male			Female
Variables	OR	95% CI	p	OR	95% CI	p	OR	95% CI	p
Gender (female)	4.85	2.84~8.29	<.001
Age	1.03	0.98~1.07	.233	1.13	1.03~1.24	.013	0.99	0.95~1.05	.890
Social activity (≥1/week)	1.35	0.85~2.15	.211	1.95	0.67~5.65	.220	1.20	0.70~2.06	.504
Number of chronic disease^†	1.12	0.92~1.37	.253	1.86	1.10~3.13	.021	1.03	0.83~1.28	.803
Depression	1.05	0.93~1.18	.420	1.29	0.96~1.72	.088	1.00	0.88~1.14	.995
Frailty	0.84	0.78~0.92	<.001	0.06	0.41~0.74	<.001	0.90	0.83~0.99	.029

^†Diagnosed hypertension, diabetes, stroke, arthritis, heart disease, chronic obstructive pulmonary disease, and cancer.

References

1. Lee YH. Health status and health services utilization of older people and policy implications. Health Welf Policy Forum. 2012; 10:40–51.

2. Korea Institute for Health and Social Affairs. Health and welfare policy issues 2015. Research Report. Sejong: Korea Institute for Health and Social Affairs;2016. 01. Report No.: 2015-02.

3. Kim JG. Equity in health levels and health care utilization of elderly people in Korea. Soc Sci Res Rev. 2011; 27(2):65–87.

4. Jang HS, Kim YJ. A study on physical health, economical state and social relations of women elderly living alone in an island. J Agric Ext Community Dev. 2010; 17(2):233–259.

5. Choi K, Park E, Lee I-S. Homebound status and related factors according to age in female elders in the community. J Korean Acad Nurs. 2012; 42(2):291–301. DOI: 10.4040/jkan.2012.42.2.291.

6. Kwon Y, Kim C, Kwag OG. Factors influencing depression and quality of life in elderly customized home visiting health services. J Korean Acad Community Health Nurs. 2011; 22(3):262–271. DOI: 10.12799/jkachn.2011.22.3.262.

7. Lin Q, Kim H, Ann J. Relationship between depression and quality of life in elderly women living alone: The moderating and mediating effects of social support and social activity. J Korean Gerontol Soc. 2011; 31(1):33–47.

8. Park JY, Han JW, Jeong H, Jeong HG, Kim TH, Yoon IY, et al. Suicidal behaviors in elderly Koreans: One-month-point prevalence and factors related to suicidality. J Affect Disord. 2013; 150(1):77–83. DOI: 10.1016/j.jad.2013.02.025.

9. Baek HC, Lee J. Factors affecting suicidal ideation of the low-income elderly living alone. J Korean Acad Community Health Nurs. 2014; 25(3):180–186. DOI: 10.12799/jkachn.2014.25.3.180.

10. Hanam Health Center. Reports for visiting health management project. Hanam: Ajou University College of Nursing;2014. p. 181.

11. Lee SH, Jun SS. Effects of an empowerment program on self-esteem and depression for low-income elderly women living alone. J Korean Acad Psychiatr Ment Health Nurs. 2012; 21(4):311–320. DOI: 10.12934/jkpmhn.2012.21.4.311.

12. Lim SY, Lee KJ, Kim SJ. The effect of subjective xerostomia and salivary pH in salivary glands stimulated by laughter therapy in frail elderly women. J Korean Acad Community Health Nurs. 2016; 27(1):72–80. DOI: 10.12799/jkachn.2016.27.1.72.

13. Song MS, Boo S. The effect of an exercise program for preventing urinary incontinence among community-dwelling elderly females living alone. J Korean Public Health Nurs. 2016; 30(2):247–258. DOI: 10.5932/JKPHN.2016.30.2.247.

14. Eom E. Elderly suicide and its related factors: Focused on the role of social support and mastery in the effects of hopelessness and depression on suicidal ideation. Korean J Soc Welf. 2007; 59(2):355–379.

15. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: A preliminary report. J Psychiatr Res. 1983; 17(1):37–49.

16. Kee BS. A preliminary study for the standardization of geriatric depression scale short form-Korea version. J Korean Neuropsychiatr Assoc. 1996; 35(2):298–307.

17. Ministry of Health and Welfare Affairs. Guidebook for 2013 community integrated health promotion program: Visiting health care. Seoul: Ministry of Health and Welfare;2013. p. 102.

18. Choi KW, Park EA. The severity of urinary incontinence and relevant factors in low-income elderly women. J Korean Gerontol Soc. 2013; 33(2):335–347.

19. Park MH, Ha JC, Shin IH, Kim HG, Lee SY, Cho JH, et al. 2008 survey for the elderly-national living profiles and welfare service needs of older persons in Korean's survey. Research Report. Seoul: Ministry of Health, Welfare, and Family Affairs & Kyemyung University;2009. Report No.: 11-1351000-000316-12.

20. Statistics Korea. Elderly statistics 2015 [Internet]. Daejeon: Statistics Korea;2015. cited 2016 August 16. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&aSeq=348565.

21. Russell C, Porter M. Single older men in disadvantaged households: Narratives of meaning around everyday life. Ageing Int. 2003; 28(4):359–371.

22. Cho MK. A qualitative study of the experience of poor older men living alone. J Welf Aged. 2013; 61:7–34.

23. Kahng S. Does depression predict suicide?: Gender and age difference in the relationship between depression and suicidal attitudes. Korean J Soc Welf Stud. 2010; 41(2):67–100.

24. Kim MH, Jung-Choi K, Jun HJ, Kawachi I. Socioeconomic inequalities in suicidal ideation, parasuicides, and completed suicides in South Korea. Soc Sci Med. 2010; 70(8):1254–1261. DOI: 10.1016/j.socscimed.2010.01.004.

25. Lee YJ. Determinants of welfare service utilization among the single and the married couples elderly. J Korean Gerontol Soc. 2012; 32(4):1119–1135.

26. Kim YJ. Comparison of health habits, perceived stress, depression, and suicidal thinking by gender between elders living alone and those living with others. J Korean Acad Fundam Nurs. 2009; 16(3):333–344.

27. Lee I, Jeong IS. Frailty level and health-related characteristics among participants of a tailored home visiting service. J Korean Geriatr Soc. 2012; 16(2):74–83. DOI: 10.4235/jkgs.2012.16.2.74.

28. Suh KH, Kim YS. Investigation of social support and mental health among the elderly people living alone. J Welf Aged. 2003; 21:7–26.

29. Kim SH. Effects of a volunteer-run peer support program on health and satisfaction with social support of older adults living alone. J Korean Acad Nurs. 2012; 42(4):525–536. DOI: 10.4040/jkan.2012.42.4.525.

30. Choi YJ, Won MR. Effects of tailored case management using a gatekeeper for the depressed single-household elderly population: Focusing on the mental health case management. J Korean Acad Community Health Nurs. 2012; 23(4):376–385. DOI: 10.12799/jkachn.2012.23.4.376.

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