Purpose: To systematically identify the multidimensional factors affecting homebound older adults.Design: Systematic review.Methods: We searched PubMed, MEDLINE, Cochrane Library, CINAHL, EMBASE, and PsycINFO from inception to November 15, 2020. This systematic review followed the Preferred Reporting Items for Systematic Review and Meta‐analysis guidelines. The Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross‐Sectional Studies was used for quality assessment.Findings: Nineteen studies met the review criteria; the studies were either cross‐sectional or longitudinal. Most studies have focused on personal factors affecting homebound older adults. The individual construct consisted of demographic, biological, psychological, functional, and health‐related factors. The structural construct included architectural, environmental, community, and social factors. Based on the different definitions of homebound used in the studies, the prevalence of homebound status ranged from 3.5% to 39.8%.Conclusions: The prevalence of homebound status among older adults varied depending on how homebound was defined. Homebound status is the interaction between the individual and structural constructs. Variations in cultural, political, and economic conditions could influence homebound status across countries over time. Comprehensive assessment and interventions for homebound older adults based on multidisciplinary approaches are recommended for nurses.Clinical relevance: This research will impact the development of nursing strategies to screen homebound older adults and provide targeted preventive interventions so that older adults with many risk factors do not become homebound.

There is an increasing need for highly accessible health management platforms for comprehensive symptoms of Parkinson disease. Mobile apps encompassing nonmotor symptoms have been rarely developed since these symptoms are often subjective and difficult to reflect what individuals actually experience. The study developed an app for comprehensive symptom management and evaluated its usability and feasibility. A single-group repeated measurement experimental design was used. Twenty-two participants used the app for 6 weeks. Monitoring of nonmotor symptoms, games to address motor symptoms, and medication management were incorporated in the app. Quantitative outcomes were self-assessed through an online questionnaire, and one-on-one telephone interviews were conducted to understand the user's point of view. The successful experience of self-monitoring had improved participants' self-efficacy (Z = −3.634, P < .001) and medication adherence (Z = −3.371, P = .001). Facilitators included a simple-to-use interface, entertaining content, and medication helps. Barriers included simple forgetfulness and digital literacy, including unfamiliarity with mobile phone manipulation itself. The study suggested insight into the app use related to acceptability of mobile technology. The preliminary effects on self-efficacy and medication adherence will guide future nursing interventions using mobile health. Our approach will contribute to improving the continuum of care for Parkinson disease by promoting self-monitoring of symptoms.

Purpose: The purpose of this study was to identify the experiences of insomnia symptoms in the elderly living alone in the community. Methods: Eleven of the elderly with insomnia symptoms living alone in the community were interviewed. Data were collected through individual interviews July-September 2018. Colaizzi's phenomenological methodology was used. Results: Results showed that the experiences of insomnia symptoms of the elderly living alone comprised 11 themes clusters and five categories: 1) Insomnia symptoms triggered by various causes, 2) Physical symptoms exacerbated by insomnia, 3) Insomnia worsened by psychological symptoms, 4) Useless efforts to fix insomnia, 5) Living with adapted insomnia symptoms. Conclusion: It is necessary to develop a sleep intervention program that includes insomnia symptoms awareness, sleep health education, and social support factors. Community nurses should focus on insomnia symptoms as well as listen and empathize with various psychological phenomena in caring for the elderly with insomnia living alone.

Background: Physical activity in patients with chronic kidney disease is important as it helps lowers blood pressure, reduces inflammatory markers, improves cognitive function, and improves health-related quality of life. However, there is a lack of studies accurately assess physical activity levels in this population. Objective: This study aimed to examine the characteristics of chronic kidney disease patients across eGFR stages, assess the proportion of Korean adults with chronic kidney disease meeting recommended physical activity levels, and identify the factors associated with meeting the weekly physical activity recommendation. Methods: We conducted a secondary analysis of data from the 2016–2020 Korean National Health and Nutrition Examination Survey. Descriptive statistics and logistic regression were used to examine physical activity patterns and associated factors. Results: Among CKD patients, 79.5% engaged in insufficient physical activity. Factors significantly associated with sufficient activity included sex, smoking status, activity limitation, and eGFR. Conclusions: Tailoring physical activity interventions is crucial, considering the patient’s clinical condition, physical performance, and demographic factors.

Purpose: This cross-sectional study aimed to describe subjective health status of people with chronic kidney disease (CKD), identify factors that affect good subjective health status and investigate the relationship between good subjective health status and health-related quality of life (HRQOL) in people with CKD.Methods: This secondary analysis utilized data from the Korean National Health and Nutrition Examination Survey in 2019-2020. Participants (N=295) had an eGFR of ≤59 mL/min/1.73 m2. Descriptive and inferential statistics were used to analyze the data. Univariate and multivariate logistic regression analyses were performed to identify factors affecting good subjective health status and examine the association between good subjective health status and HRQOL.Results: Among all participants, 61.4% had good subjective health status, and the HRQOL index was 0.88 in people with CKD. Household income, activity limitation, stress, and the number of comorbidities in people with CKD were associated with good subjective health status. People with better subjective health status were more likely to be satisfied with self-care, usual activities, and pain/discomfort in HRQOL.Conclusion: Good subjective health status is associated with better HRQOL. Therefore, subjective health status should be assessed early, and a nursing intervention program should be developed considering factors that can improve subjective health status in people with CKD.