Elderly Korean Americans Research Articles

The Mediating Role of Pain Catastrophizing on the Association Between Depression and Pain Severity and Interference Among Elderly Asian Immigrants with Chronic Pain.

PurposeThe association between depression and chronic pain is well established. However, few studies have examined the pathways from depression to chronic pain. The present cross-cultural study aimed to test the mediating effects of pain catastrophizing on associations between depression and chronic pain (eg, pain severity, pain intensity) among Korean American elderly.Patients and MethodsA total of 132 elderly Korean Americans with chronic pain were recruited from elderly daycare centers and Korean ethnic churches in the community. For mediation analyses, structural equation modeling with full information maximum likelihood estimation method was used. The bias-corrected bootstrap confidence interval (CI) method for inferential tests of the indirect effects was also conducted in mediation analysis.ResultsThe results indicated that the proportion of comorbid depression and chronic pain was 45.7%. Elderly Korean Americans with depression scored higher in pain severity, pain interference, and pain catastrophizing than those without depression. Pain catastrophizing was found to have a significant mediating effect on the relationship between depression and pain severity (indirect effect = 0.147, Bootstrap 95% CI = [0.079, 0.226]), controlling for demographic covariates, comorbidities and pain area. Pain catastrophizing also mediated the relationship between depression and pain interference (indirect effect =0.164, Bootstrap 95% CI = [0.097, 0.244]), controlling for the covariates.ConclusionThese findings add to the literature by providing evidence that pain catastrophizing plays a role in high levels of pain severity and pain interference comorbid chronic pain and depression in Asian elderly immigrants. Appropriate culturally tailored programs to redirect pain catastrophizing cognitive process should be developed and provided for elderly Asian Americans to reduce chronic pain disparity.

A Pilot Primary Stroke Prevention Program for Elderly Korean Americans.

Stroke is a significant health issue with devastating consequences among older adults in the United States. However, it can be prevented by improving stroke knowledge and managing risk factors. Many stroke education programs have been shown to be effective. Unfortunately, a minority of older adults, such as older Korean Americans, have not benefited from the programs because of language barriers. The purpose of this study was to examine the feasibility and preliminary impact of a primary stroke prevention program on stroke knowledge, healthy eating, and physical activity behaviors among Korean Americans. A randomized controlled pilot trial was conducted. A total of 73 persons were randomly assigned to either an intervention group (n = 37) or a control group (n = 36). The intervention program included in-person lectures and discussions. Sociodemographic data were analyzed using descriptive statistics. Analyses of covariance and logistic regression analysis were used to evaluate the effects of the intervention program. The mean age of participants was 71.49 ± 6.25 years, and most participants were female (74.0%) and married (65.8%). Upon intervention completion, the intervention group showed greater improvements than the control group in stroke knowledge and intake of sodium and total fats (F = 11.89, P = .001, ηp = 0.151; F = 4.04, P = .048, ηp = 0.057; and F = 4.51, P = .037,= ηp = 0.062, respectively). Step counts showed marginal effects (F = 3.27, P = .075, ηp = 0.049). This study demonstrated feasibility and effectiveness of the program to improve stroke knowledge and healthy behaviors in elderly Korean Americans.

재미 한인노인의 성공적 노화와 주관적 안녕에 영향을 미치는 요인: 호노룰루 거주 한인노인 중심으로

재미 한인노인의 성공적 노화와 주관적 안녕에 영향을 미치는 요인: 호노룰루 거주 한인노인 중심으로

Correlates of Health-Related Quality of Life Among Korean Immigrant Elders

Health-related quality of life (HRQOL) is a key clinical outcome, particularly for individuals with chronic conditions such as hypertension (HTN). While no previous research has examined contributors to HRQOL among Asian Americans in the United States, this study was conducted to identify correlates of HRQOL in hypertensive Korean immigrant elders (≥ 60 years of age) to address the gap. A total of 440 Korean elders with HTN participated in the study. The hierarchical regression model for HRQOL explained 32.8% of the variance. Female gender (β = .109, p = .036), a greater number of comorbid conditions (β = .183, p = .000), lower social support (β = -.240, p = .000), and greater depressive symptoms (β = .402, p = .000) were associated with poorer HRQOL. Depression was the most potent correlate of HRQOL among elderly Korean Americans (KA) with HTN. Future intervention should consider managing depression as an essential component of comprehensive HTN care for this minority population.

Abstract 228: Assessing Knowledge, Perceptions, and Cultural Attitudes Towards Stroke in Elderly Korean-Americans: The Strengthening Our Korean Elders Through Community-Partnered Education (STROKE-COPE) Project

Objective: Despite high stroke risk, few Korean-American stroke prevention interventions have been done. We examined conceptions of stroke, including knowledge of risk factors (RFs), symptoms (Sx), prevention, cultural beliefs and perceived consequences, in elderly Korean-Americans. Results were to inform the design of effective and culturally relevant interventions for Korean-American seniors. Methods: Twenty-nine senior Korean-Americans were recruited from 3 locations in southern California: a Korean-American megachurch, and a private and a non-profit adult day health care centers for elderly Korean-Americans. Subjects completed a questionnaire on stroke RFs and Sx, health information sources, health care barriers, personal medical history, comfort with English, and year of immigration. In 3 moderator-facilitated focus groups (FGs), subjects discussed: 1) knowledge of stroke Sxs and RFs, and what to do when stroke occurs; 2) cultural attitudes and perceptions about stroke; 3) personal anecdotes about stroke; 4) preferred methods of education intervention. Discussion audiotapes were transcribed, translated from Korean to English, and validated by 2 bilingual researchers. English transcripts were coded by themes and subthemes independently by 3 raters, who after discussion, came to consensus. An 8-member Community Advisory Panel guided development of discussion guide questions and translations, and collaborated in interpretation. Results: Mean age of subjects was 79.7 years, 62% were female. Mean years in U.S. was 23.9; 24% had less than 8 th grade education. 62% had history of hypertension; 59% had high cholesterol. 86% reported hypertension as a stroke RF, and slurred speech was most commonly identified as a stroke Sx (76%). Television (66%) and physician (59%) were the most common health information sources. 24% had difficulty accessing health care in the past year, with 62% citing discomfort with English language as the hindrance to access. In FGs, RFs emphasized were hypertension and family history, and the most common Sx discussed was being “knocked out.” A common stroke prevention theme was the balance of medication and wellness (exercise/diet). Cultural perceptions of stroke included “destiny,” and beliefs about the efficacy of blood-letting, acupuncture, and Oriental herbs. Attitudes towards stroke included fear and worry: though some viewed death as “fate,” others felt need for education. For stroke prevention, most preferred visual-aid presentations by Korean-speaking medical professionals in a locale familiar to senior Korean-Americans. Conclusions: Elderly Korean-Americans have substantial risk for stroke, but possess both language and belief barriers that may interfere with stroke prevention and response. A stroke education curriculum tailored for elderly Korean-Americans must address these culturally specific beliefs to be effective.

Abstract 170: Exploring Stroke Knowledge in Korean Seniors: Strengthening Our Korean Elders through Community-Partnered Education (STROKE-COPE) Project

Background: Stroke and cardiovascular diseases are the leading causes of death in Asian-Americans. Elderly Korean-Americans have a higher prevalence of stroke risk factors than elderly Caucasians, including uncontrolled hypertension and diabetes. Yet, little is known about the level of stroke knowledge Korean-American seniors possess, the impact of cultural remedies and health beliefs, and where Korean-American seniors obtain health information. Methods: A Community Advisory Panel of 7 Korean-American community and health care leaders was created to guide the research process, including approving translations and interpreting results. We recruited 64 Korean-American seniors from an adult day health care center and 98 from a large church, both in the Los Angeles area. Subjects met on-site at the facility and completed a written survey in Korean containing 6 open-ended questions about stroke including risk factors (RFs), symptoms (Sx), what to do when having a stroke, knowledge of any acute stroke therapies or time limit for therapies, and sources of stroke information. Other variables assessed were demographic information and comfort with English. Subjects were told to skip questions if they did not know the answer. Verbatim Korean responses were translated to English by bilingual study team members; 3 coders sorted responses into categories. Results: Mean age was 74.9 years old; 68.5% were female. Two of 162 subjects indicated they felt very comfortable speaking English; 53.1% were not comfortable speaking English. Regarding stroke RFs, 53.7% wrote correct responses, i.e. hypertension; 6.8% listed incorrect RFs, including culturally significant causes such as blackening of blood; 5.6% stated “I don’t know” and 33.9% chose not to answer. Regarding stroke Sx, 12.3% of subjects correctly identified Sx, 35.2% subjects listed stroke RFs, 6.1% wrote “I don’t know” or an illogical answer, and 45.7% left their answer blank. Sources of stroke information included physicians or community health centers (21.6%); television or newspapers (18.5%); and interpersonal relationships (9.3%). While 43.2% of subjects wrote to contact emergency medical services when someone was having an acute stroke, the next most common responses (6.2%)were culturally traditional emergency treatments, such as blood-letting and ingesting Oriental herbs; 50% either wrote they did not know or left it blank. 6.8% of subjects had correct knowledge of acute stroke treatments; 3.1% of subjects listed acute cultural remedies as acute stroke therapy; rest of subjects wrote “I don’t know,” or did not answer. Only 31.5% identified a time window of less than 3 hours to treat stroke. Conclusions: Korean-American seniors lack knowledge about stroke risk factors, symptoms, and response. Most elderly Korean-Americans are uncomfortable speaking English, and cultural traditional remedies are sometimes performed in lieu of seeking emergency Western medical treatment. Interventions to prevent and improve acute stroke response in Korean-American elderly communities must not only fill a knowledge gap, but also address significant cultural misperceptions about stroke and involve local community leaders and peers.

The Effects of the U.S. Public Welfare System Upon Elderly Korean Immigrants' Independent Living Arrangements

ABSTRACT Elderly Korean persons who immigrated to the United States often live in a situation coined ‘multiple jeopardy’ (being old, poor, and minority; having low educational attainment, language problems, and cultural differences). Contrary to the assumption that Asian elders often live with their adult children, these elderly tend to live separately, thus ignoring their traditional custom of intergenerational co-residence. Consequently, the lives of these elderly are dramatically different from their peers in Korea where the tradition of filial piety is still prevalent. This divergence of customs for elderly Korean Americans living in the United States has given rise to our research. Based on a review of the findings of three studies about elderly Korean immigrants, we discuss major factors influencing their decisions to live separately from their adult children. The results of this review show that public welfare programs are a major factor associated with their preference for more independent lifestyles.

Korean American Elderly's Knowledge and Perceptions of Elder Abuse

ABSTRACT “This study examines Korean American elders” perceptions of elder abuse and its perpetrators and explores cultural, as well as non-cultural influences on such perceptions. Face-to-face interviews were conducted with 100 elderly Korean Americans, 60 years of age or older, residing in Los Angeles County. Respondents reported 46 abuse cases, categorized into the following six types: financial abuse (36%), psychological abuse (24%), culturally specific abuse (17%), neglect (15%), physical abuse (4%), and other (4%). Most respondents identified elder abuse in terms of abrogation of filial piety, suggesting the centrality of “children” in Korean American elders5 lives and well-being. Findings demonstrate that employing a uniform definition of elder abuse across all cultures and ethnic groups without attending to the cultural and subjective aspects of a given situation may result in missing problems and needs identified as important by the elderly themselves. Implications for social work practice and program development are discussed.

Elderly Koreans' tendency to live independently from their adult children: adaptation to cultural differences in America.

Korean elderly persons who immigrated to America tend to live apart from their adult children, contrary to the assumption that they would adhere to their old custom of intergenerational family living prevalent in Korea where the tradition of filial piety is still influential. This paper explores factors associated with the elderly immigrants' living separate from their adult children and elicits the reasons they give for this residential pattern. Over 100 elderly Korean-Americans were interviewed. The results of this study show that public welfare programs, income, and education were major factors associated with the elderly's independent living from their adult children. Other factors influencing their preference for such a living pattern are also identified, including needs for privacy and freedom. Cultural factors related to family living patterns are discussed.

Oral disease beliefs, behaviors, and health status of Korean-Americans.

Previous research with other ethnic minorities has shown that culture and age cohort, as well as language and economic limitations, act as barriers to obtaining dental care and maintaining good oral health. This study compared self-reported oral health attitudes, self-efficacy, and dental practices of 20 younger and 23 elderly Korean-Americans. Oral assessments were also conducted to determine plaque and gingival status, and root and coronal caries. Significant differences emerged in health self-efficacy (P less than .01) and preventive health orientation (P less than .002). Elderly had fewer teeth (P less than .0001), more decayed and filled root surfaces (P less than .05 and P less than .004, respectively), and more decayed and filled coronal surfaces (P less than .001 and P less than .03). Both groups showed higher levels of distal and mesial plaque than occlusal and cervical plaque; however, the elderly had higher rates of both (P less than .0001). Gingival status was also worse for the elderly, on distal and mesial (P less than .01), facial (P less than .01), and lingual (P less than .01) surfaces. These differences are striking, since the elderly reported visiting the dentist more recently (P less than .0001); but most of these visits were for prosthodontic and emergency care. Better preventive dental care and education are necessary for elderly immigrants who have not been exposed to preventive dentistry in their home countries.

Dietary calcium intakes of elderly Korean Americans

Dietary calcium intake among elderly Korean Americans was examined. Results of this study indicate that calcium intakes of the women were considerably lower than the Recommended Dietary Allowance partly because of their lower consumption of dairy products and lower energy intakes. For the same reasons, nonparticipants in a nutrition program for the elderly were less likely than participants to consume adequate amounts of calcium. A number of other factors may have influenced low calcium intake by some subjects. The examination of their food habits revealed that the subjects rarely consumed their preferred calcium-rich Korean foods because of the high cost and limited availability of the foods and their own difficulty in chewing. Consumption of calcium-rich foods in the United States diet also was limited. The subjects disliked calcium-rich foods in the United States diet, with the exception of milk and ice cream. Although a majority of the subjects liked and consumed milk daily, the amount was not sufficient to meet the calcium requirements in their diets. Furthermore, a substantial proportion of the subjects disliked and seldom consumed milk. In addition to dairy products, grains, fruits, and vegetables were major sources of calcium in diets of the subjects. However, individuals did not consume enough of the calcium-rich foods from these food groups to meet the calcium requirements.