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A Study on the Effectiveness of Care of Patients with Alzheimer's Disease According to Residence Arrangement and Types of Services
Yeo Shin Hong, Hyeoun Ae Park, Nam Ok Cho
Journal of Nurses Academic Society 1996;26(4):768-781.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.4.768
AbstractAbstract PDF

The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive understanding of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included: the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows: 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions(CDRL), bizarre behaviors and the families's burden by living arrangement and/or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus, it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

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  • Introducing Economic Evaluation as a Policy Tool in Korea: Will Decision Makers get Quality Information?
    Kun-Sei Lee, Werner B F Brouwer, Sang-Il Lee, Hye-Won Koo
    PharmacoEconomics.2005; 23(7): 709.     CrossRef
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Psychometric Properties of the Alzheimer's Disease Knowledge Scale-Korean Version
Eun Joo Kim, Ji-young Jung
J Korean Acad Nurs 2015;45(1):107-117.   Published online February 27, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.1.107
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the psychometric properties of the Korean version of the Alzheimer's Disease Knowledge Scale (ADKS-K) to determine its applicability to Korean adults.

Methods

Cross-cultural validity was performed according to Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). The Kuder-Richardson Formula 20 for internal consistency and Intraclass Correlation Coefficient (ICC) for test-retest reliability were conducted. Content validity, criterion related validity and construct validity were evaluated. The Classical Test Theory (CTT) model and the Item Response Theory (IRT) model were applied in performing the item analysis.

Results

The KR 20 was .71, and the ICC was .90, indicating that the ADKS-K has internal consistency and stability reliability. Thirty items of the ADKS-K had significant Content Validity Ratio (CVR) values, i.e., mean of 0.82 and range of 0.60~1.00. Mean item difficulty and discrimination indices calculated by TestAn program were 0.63 and 0.23, respectively. Mean item difficulty and discrimination indices calculated by BayesiAn program were -0.60 and 0.77, respectively. These tests indicate that ADKS-K has an acceptable level of difficulty and discriminating efficiency.

Conclusion

Results suggest that ADKS-K has the potential to be a proper instrument for assessing AD knowledge in Korean adults.

Citations

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  • Expanding the health belief model on dementia knowledge, fear, and preventive behaviors among older adults in Korea: a cross-sectional descriptive study
    Jeong Eui Yun, Suyoung Choi
    Journal of Korean Biological Nursing Science.2025; 27(1): 60.     CrossRef
  • The Mediating Role of Attitudes Towards Dementia on the Relationship Between Dementia Knowledge and Behaviors Towards Persons with Dementia: A Cross-Sectional Study
    Yang-Tzu Li, Jing-Xuan Bai, Jia-Ming He, Shao-Wei Yang, Hsiu-Li Huang
    Journal of Multidisciplinary Healthcare.2023; Volume 16: 4213.     CrossRef
  • Alzheimer’s disease (AD) knowledge in Korean Americans: identifying knowledge gaps and misconceptions and examining predictors of AD knowledge
    Sang E. Lee, Michin Hong, Banghwa L. Casado
    Ethnicity & Health.2023; 28(3): 431.     CrossRef
  • Validity and Reliability of the Korean Version of Assessment of Health Literacy in Breast and Cervical Cancer Screening
    Hye Sook Shin, Eunlim Chi, Hae-Ra Han
    Journal of Korean Academy of Nursing.2021; 51(6): 769.     CrossRef
  • Quantifying Knowledge of Alzheimer’s Disease: An Analysis of the Psychometric Properties of the Alzheimer’s Disease Knowledge Scale
    Guillermo Garcia-Ribas, Elena García-Arcelay, Alonso Montoya, Jorge Maurino, Javier Ballesteros
    Neurology and Therapy.2021; 10(1): 213.     CrossRef
  • The Impact of Dementia Knowledge and Attitude on Caregiving Appraisal among Caregivers of Older Adults with Dementia Using Dementia Care Centers
    Ji Yeon Hong, Dukyoo Jung
    Journal of Korean Gerontological Nursing.2020; 22(4): 348.     CrossRef
  • Development of Knowledge and Attitudes Survey on Pain Management for Korean Long-term Care Professionals
    So-Hi Kwon, Hyunsim Kim, Seurk Park, Wooseok Jeon
    Asian Nursing Research.2020; 14(2): 105.     CrossRef
  • Reliability and Validity of the Korean version of the Pain in Older Adults Knowledge Survey (K-POAKS) among Nurses Who Have Worked in Long-term Care Hospitals
    Young Seun Ryu, Jeong Sook Park
    Journal of Korean Academy of Community Health Nursing.2020; 31(2): 130.     CrossRef
  • Validation of the Spanish Version of the Dementia Knowledge Assessment Tool 2
    Laura Parra-Anguita, Sara Moreno-Cámara, María Dolores López-Franco, Pedro L. Pancorbo-Hidalgo, Alden Gross
    Journal of Alzheimer’s Disease.2018; 65(4): 1175.     CrossRef
  • Knowledge and Attitudes in Alzheimer’s Disease in a Cohort of Older African Americans and Caucasians
    J. Christina Howell, Oretunlewa Soyinka, Monica Parker, Thomas L. Jarrett, David L. Roberts, Cornelya D. Dorbin, William T. Hu
    American Journal of Alzheimer's Disease & Other Dementias®.2016; 31(4): 361.     CrossRef
  • Knowledge about dementia in South Korean nursing students: a cross-sectional survey
    Jung Ha Shin, Hyun-Ju Seo, Kye Ha Kim, Kyoung-Hoon Kim, Youngjin Lee
    BMC Nursing.2015;[Epub]     CrossRef
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