Health literacy is closely associated with poor health outcomes and mortality. However, only a handful of studies have examined the association between health literacy and frailty status. The current study used data from a nationwide sample of Korean adults aged 70–84 collected from 10 cities, each of which represents a different region of South Korea (n = 1521). We used the propensity score matching (PSM) method to minimize the potential selection bias and confounding factors that are present in observational studies. After PSM, demographic and health-related characteristics between the limited health literacy (n = 486) and the nonlimited health literacy (n = 486) groups were not significantly different. Multinomial logistic regression analyses were conducted for the PSM-matched sample to examine the association between health literacy and frailty outcomes, where the robust group was set as a reference. Limited health literacy significantly increased the risk of pre-frailty (RRR = 1.45, p = 0.02) and frailty (RRR = 2.03, p = 0.01) after adjusting for demographic and health-related factors. Our findings underscore the need to foster health literacy programs and provide preliminary evidence to inform tailored intervention programs so that we might attenuate the risk of frailty in the older population.

We evaluated a socially assistive robot (SAR) named Hyodol during a six-week intervention. This study enrolled 69 older adults with cognitive decline. To screen the eligibility, we have used the following three criteria, namely Korean-Mini-Mental Status Exam score ≤ 26). Clinical Dementia Rating 0.5-2), and Diagnostics and Statistical Manual V. Participants were divided into three groups based on their cognitive function (i.e. very mild cognitive impairment (vMCI), mild cognitive impairment (MCI), and moderate cognitive impairment (MOCI). The groups were instructed to use Hyodol at home for a six-week period. Baseline and post-intervention surveys were performed after six weeks to examine the changes in perceived health, depression, and cognitive function. The vMCI group showed a reduction in the depression score after the intervention (t=-2.447, p=0.040), in comparison to their peers in the control group. Further, the MCI group showed an improvement in the cognitive function score after the intervention (t = 2.690, p=0.021). No significant improvement was found among MOCI participants who used the SARs. The significance of this study was to examine whether participants with different levels of cognitive functioning would diverge after a period of intervention using the Hyodol SARs. Moreover, it presented preliminary data for services and policies for home care treatment targeted to cognitive decline in older adults.

This study aimed to systematically review the effects of transitional care programs on healthcare use and quality of life in patients with chronic obstructive pulmonary disease (COPD). Several databases were searched for randomized controlled trials conducted over the past five years, and their quality was evaluated using the Cochrane Risk of Bias 2.0 tool. For indicators with available statistical information, a meta-analysis was performed using RevMan 5.4, and a narrative review was performed for the rest of the results. In the meta-analysis, no statistically significant difference was observed between the intervention and control groups in the number of readmissions and emergency room visits due to COPD. The relative risk (RR) of readmission for COPD was lower in the intervention group. Respiratory-related quality of life tended to be better in the intervention group, though not significantly. Physical capacity was improved in the intervention group. Considering the characteristics of the complex intervention, the context and factors of cases where the expected results could be obtained and cases where the expected results could not be obtained were reviewed and discussed. Based on the results of the analysis, implications for the development of better protocols were presented.

Background: Approximately 60% of patients who have a stroke are discharged to their homes, after which they require ongoing community-based rehabilitation to support long-term recovery. Transitional care services (TCS) serve as an intervention aimed at reducing hospital readmissions by maintaining treatment continuity, either when patients transition between different levels of care within the same setting or when they move to a new care environment. Objectives: The purpose of this review was to evaluate the efficacy of TCS in reducing readmission rates, enhancing functional outcomes, improving self-efficacy, and boosting the quality of life for patients who had a stroke while also alleviating caregiver burden. Methods: To review randomized clinical trials performed between January 2014 and December 2023, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting systematic reviews. We established a search strategy combining “transitional care,” “stroke,” “cerebrovascular disorders,” “patient discharge,” and “continuity of patient care” and used the PubMed, Embase, Cochrane Library, and CINAHL databases. We selected readmission rate and functional status as the primary outcomes and quality of life, self-efficacy, and care burden as secondary outcomes. We conducted a meta-analysis for each outcome indicator where quantitative synthesis was possible. For the meta-analysis, we used RevMan 5.4 and performed subgroup analyses according to intervention intensity, postdischarge intervention method, and intervention duration. Results: In the meta-analysis for each outcome indicator, we observed that TCS was effective in reducing the readmission rate of individuals living with stroke and improving their functional status. Additionally, patients with stroke who received TCS showed better quality of life, improved self-efficacy, and reduced caregiver burden compared to those who received usual care. Subgroup analyses revealed that patients with stroke who received moderate or higher intensity of TCS for 2 months demonstrated improvements in functional status compared to those who received lower intensity or 3-month interventions. Discussion: This is the first known systematic review to synthesize studies on the efficacy of TCS for patients with stroke over the past 10 years, examining outcome indicators such as readmission rates and functional status. Based on subgroup analysis, we derived an effective TCS strategy (e.g., intensity and duration) to improve functional status.

Purpose: This study aimed to examine the effectiveness of social robots. When social robots are used by older adults with cognitive impairment, whether the care burden of family caregivers with cognitive impairment decreased, and if there is a change in personal and role strain.Methods: This study conducted a randomized controlled trial to examine the reduction in care burden (role strain, personal strain) of 27 family caregivers under the age of 60 after having older people with cognitive impairment use social robots at home for 6 weeks. For analysis, the Mann-Whitney U-test and Wilcoxon signed rank test were performed using SPSS version 26.Results: The pre-post survey result presented that care burden was not statistically significant but decreased in the experimental group (Z=-0.699, p=.485). Role strain, one of the sub-questions of care burden, presented a statistically significant reduction effect in the experimental group (Z=-2.031, p=.042). However, there was no statistically significant change in personal strain in both groups.Conclusion: The results of this study suggest the necessity of providing information reflecting the needs of family caregivers using social robots. In addition, the results present a way to respond to emergencies utilizing social robots’ monitoring functions and reduce family caregivers’ care burdens by offering services such as counseling and self-help groups. Furthermore, related organizations must educate formal and informal care workers on social robots.

Kim SK, et al. J Korean Med Sci. 2023 Jul;38(32):e246. https://doi.org/10.3346/jkms.2023.38.e246