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Experiences of frail Korean older adults and their families in a transitional care program: an exploratory qualitative study

2026-12-01T00:00:00Z

Title: Experiences of frail Korean older adults and their families in a transitional care program: an exploratory qualitative study Authors: Lee, Ji Yeon; Kim, Sue; Cho, Eunhee Abstract: PurposeFrail older adults may experience unsafe transitions from hospital to home owing to physical/psychological decline. This study was to explore the experiences of frail older adults and their caregiving family members participating in a transitional care program.MethodThis exploratory qualitative study implemented the Returning Home (Re-home) program, a 12-week transitional care program involving inpatient, discharge, and post-discharge interventions, with frail older adults discharged from hospital. Semi-structured interviews were conducted with 9 older adults and 9 family caregivers, individually or together, depending on older adults' preference, within 2 weeks after program completion. Eleven interviews were conducted, and thematic analysis followed Braun and Clarke's six-phase approach.ResultsThree themes-"frustration with health vulnerability," "seeking and receiving help," and "reconstructing daily routines"-contributed to an overarching theme of "accepting my health status and adapting to modified routines." The participants accepted their current health status and adapted to daily routine change through help from their families and the program.ConclusionsAmong frail older adults, post-discharge recovery is an adjustment process rather than a full restoration of health. By focusing on perceived stability and continuity of care, the findings extend existing transitional care research to include the lived experience during post-discharge recovery.

Somatic symptoms among trauma-exposed North Korean defectors: prevalence, correlates, and implications

2026-12-01T00:00:00Z

Title: Somatic symptoms among trauma-exposed North Korean defectors: prevalence, correlates, and implications Authors: Kang, Hun; Kim, Hokon; Kim, Ocksim; Chu, Sang Hui Abstract: Background: North Korean defectors (NKDs), a predominantly trauma-exposed population, are at high risk for somatic symptoms. Unrecognized and untreated somatic symptoms can profoundly affect health and psychosocial functioning. Therefore, it is crucial to understand and address somatic symptoms in the NKD population. Objective: This study aimed to assess the prevalence of somatic symptoms and to identify and quantify their correlates among trauma-exposed NKDs. Method: Cross-sectional survey data of 438 trauma-exposed NKDs in South Korea were analyzed. Participants completed a survey assessing somatic symptoms, sociodemographic, trauma-related (repatriation experience, trauma exposure, probable post-traumatic stress disorder [PTSD] and disturbances in self-organization [DSO]), health-related (physical activity), and social (loneliness and perceived discrimination) characteristics. Results: Overall, 42 of the 438 NKDs reported moderate-to-severe somatic symptoms. Multiple linear regression and relative importance analyses revealed that higher levels of loneliness (beta = 0.27, p < .001; 25.2% relative variance explained [RVE]) was the strongest correlates of somatic symptoms, followed by older age (beta = 0.24, p < .001; 17.2% RVE), probable PTSD (beta = 0.14, p = .001; 14.6%), greater perceived discrimination (beta = 0.15, p = .001; 14.5%), and probable DSO (beta = 0.10, p = .026; 13.0% RVE). Conclusions: This study provides evidence of the high severity of somatic symptoms among NKDs. Further research is needed to develop and test culturally appropriate interventions to address loneliness and perceived discrimination of NKDs, especially those with comorbid PTSD and DSO symptoms, to help mitigate somatic symptoms.

Relative importance of social connectedness indicators for depression and suicidal ideation among urban and rural older adults in South Korea

2026-07-01T00:00:00Z

Title: Relative importance of social connectedness indicators for depression and suicidal ideation among urban and rural older adults in South Korea Authors: Kang, Hun; Kim, Bomgyeol; Hyun, Jaewon; Chu, Sang Hui; Choi, Jiyeon Abstract: Objectives: This study aimed to examine the associations and relative importance of multiple social connectedness indicators for mental health outcomes among urban- and rural-dwelling older adults in South Korea. Methods: This study used data from the 2023 Korea Community Health Survey, a nationally representative crosssectional survey. Of 231,752 individuals who completed the survey, 77,930 adults aged 65 and older were included (mean age 74.7 +/- 7.0, 57.5% female). Social connectedness indicators included social contact frequency, social activity participation, neighborhood cohesion, and neighborhood satisfaction. Mental health outcomes included major depressive disorder (MDD), suicidal ideation (SI), and comorbid MDD and SI. Multiple logistic regression and dominance analyses were performed to identify and quantify the relative importance of social connectedness indicators associated with mental health outcomes across urban and rural groups. Results: Overall, 4.7% of participants screened positive for probable MDD, 9.2% for SI, and 3.2% for comorbid MDD and SI. Most social connectedness indicators were independently associated with lower odds of mental health outcomes in both urban and rural groups. Neighborhood cohesion was relatively important in urban context, while contact with neighbors was important in rural context. Participation in social gatherings, frequent contact with friends, and participation in leisure activities consistently emerged as the strongest factors. Discussion: While multiple social connectedness indicators are known to protect mental health of older adults, certain indicators have stronger associations depending on the regional context. These findings underscore the need for both universal strategies to expand meaningful social participation and context-specific approaches tailored to urban and rural environments.

Adverse childhood experiences and late-life depression in Korea: The role of developmental timing and gender-specific vulnerability

2026-07-01T00:00:00Z

Title: Adverse childhood experiences and late-life depression in Korea: The role of developmental timing and gender-specific vulnerability Authors: Kim, Bomgyeol; Lee, Kyung Hee Abstract: Background: This study examined the association between adverse childhood experiences (ACEs) and depressive symptoms among older adults in South Korea and explored variation by exposure timing and gender. Methods: We analyzed 10,067 older adults from the Korean Welfare Panel Survey. Depressive symptoms were measured via the 11-item Center for Epidemiologic Studies Depression scale. We assessed four ACEs: parental death, parental divorce, suspension of schooling due to financial strain, and being raised by relatives due to financial strain. Generalized estimating equations accounted for repeated measures, with exploratory stratified analyses by gender and exposure timing. Results: Any ACE exposure was associated with higher odds of later-life depressive symptoms (aOR = 1.25, 95% CI: 1.18-1.32), with a dose-response pattern (1 ACE: aOR = 1.20, 95% CI: 1.12-1.29; >= 2 ACEs: aOR = 1.38, 95% CI: 1.26-1.50). Among the four ACE indicators, parental death (aOR = 1.14, 95% CI: 1.07-1.22), school suspension (aOR = 1.18, 95% CI: 1.11-1.26), and being raised by relatives (aOR = 1.18, 95% CI: 1.03-1.35), were significantly associated with depressive symptoms. Parental divorce was associated with depressive symptoms among female when experienced during school-age (aOR = 2.61, 95% CI: 1.07-6.34) and adolescence (aOR = 2.04, 95% CI: 1.01-4.10). Among male, parental death during adolescence (aOR = 1.33, 95% CI: 1.09-1.62) and school suspension during school-age (aOR = 1.38, 95% CI: 1.16-1.63) were associated with depressive symptoms. Conclusions: ACEs showed long-term associations with significant depressive symptoms in later life. Exploratory findings by exposure timing and gender support life-course-informed and gender-sensitive approaches to prevention and mental health support in older adults.