• Title/Summary/Keyword: 지역사회 거주 노인

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Medication Use Review Tools for Community Dwelling Older Patients: A Systematic Review (지역사회 거주 노인을 위한 약물사용검토 도구에 대한 체계적 문헌고찰)

  • Park, Ji-Young;Jun, Kwanghee;Baek, Yang-Seo;Park, So-Young;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.1
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    • pp.61-78
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    • 2021
  • Background and Objective: The use of potentially inappropriate medications (PIMs) increases the risk of negative health outcomes, including drug-related admissions. Tools for structured medication review have been developed to ensure optimal medication use and safety. Here, we aimed to evaluate medication use review (MUR) tools for community-dwelling older patients. Methods: We performed a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). We searched PubMed, Embase, and the Cochrane Library from 1991 to 2020, excluding tools that are specifically applied to hospitalized patients or nursing home residents. We identified the most common inappropriate medications, drug-disease interactions, drug-drug interactions and prescribing omissions presented among tools. Results: From among 9,788 identified reports screened, 60 met our inclusion criteria; finally, 27 were eligible for data analysis considering originality and up-to-dateness. Most tools presented explicit criteria (93%), and only one was specific to community-dwelling elderly. The most common PIM was tricyclic antidepressants. Use of diltiazem and verapamil in patients with heart failure and the combination of nonsteroidal anti-inflammatory analgesics and warfarin were the most frequent disease-specific PIM and drug-interaction, respectively. Conclusions: Although several medication review tools have been developed for older adults, specific guidelines for community-dwelling populations remain limited. Furthermore, the list of PIMs differed among available tools. In future, specific but integrating MUR tools need to be developed for clinical practice considering this population.

Factors Associated with the Use of Over-the-Counter Medications in the Elderly Living Alone (독거노인의 일반의약품 사용에 영향을 미치는 요인)

  • Yoon, Yeosong;Paik, Ki Chung;Lee, Kyung Kyu;Lee, Seok Bum;Kim, Kyung Min;Lee, Jung Jae
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.172-178
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    • 2018
  • Objectives : This study aimed to describe the use of over-the-counter (OTC) drugs and to identify predictors for their use in the elderly living alone. Methods : This is a cross-sectional study that enrolled 1,099 subjects. Data regarding socio-demographic status, medical condition, cognition, mood disorder and use of OTC drugs were collected using self-administered questionnaire and from a specific semi-structured interview by a trained nurse. Data regarding use of OTC drugs were analyzed using descriptive statistics. Logistic regression analysis was applied to examine factors associated with the use of OTC drugs. Results : The use of OTC drugs were reported by 35.4% of the subjects. Analgesics (13.6%) was the most frequent drugs. Depression (OR=1.10, 95% CI=1.10-1.87) and comorbidities measured by cumulative illness rating scale (CIRS) (OR=1.08, 95% CI=1.03-1.12) were significantly associated with the use of OTC drugs in the elderly living alone. Conclusions : Depression and severity of underlying medical conditions could be a predictor of the use of OTC drugs in the elderly living alone. The clinicians should be vigilant regarding the potential use of nonprescription medications in the elderly.

A Study on the Awareness & Preferences about the Nursing Homes (노인요양시설에 대한 고령자 인식 및 시설 내부 색채선호 경향에 관한 연구)

  • Jeong, Mu Lin;Park, Hey Kyung
    • Korea Science and Art Forum
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    • v.29
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    • pp.319-331
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    • 2017
  • South Korea has entered the age of aging society since the elderly population over 65 reached 13.1% in 2015. This increase rate is the fastest in the OECD members. as a part of the precaution, the Korean government has enforced the long term care insurance from July 2008 and the increase of related nursing homes until 2015 was 220.2% which is rapid and quantitative. It was natural that quantitative expansion leads to qualitative improvement. With regard to service environment conditions, color environment draws attention as one of the most effective measures. color environment supports nursing home's spatial functions and the aged class is subject to the research as the potential customers. This study aims to understand color environment, conduct surveys for color preference and attitude toward color environment, and suggest directions for color environment plan. The ultimate goal is to improve the quality of Korean nursing home environment. It studied definition, state, color environment and space functions of nursing homes as well as the preceding researches. With 100 people over 60s in Busan and Gyeongnam area (52 male and 48 female), the survey examined attitudes for color environment and color preference by space functions in nursing home. The research method is as follows. First, as a result of the consciousness survey on color environment in elderly nursing home, it considers service (37%), medical service (20%), and location (19%) heavily in order. color environment plan is not recognized significantly. However, the need of indoor color plan in the elderly nursing homes has "agree (32%) and "strongly agree (25%), which suggests that color introduction is required to the nursing homes. Second, the indoor coloration for the elderly nursing homes has various color preferences. The color preference order for bedroom was R, P, and G but this order changes in nursing space (program room) to G, R, and Y. The communal space such as lobby prefers R, G and Y in order. R color was preferred in general.

The Effect of an Occupational Therapeutic Intervention Program using Horticultural Therapy on Cognition and Daily Living Performance of the Elderly with Dementia (원예치료를 적용한 작업치료적 중재 프로그램이 치매노인의 인지기능 및 일상생활수행능력에 미치는 효과)

  • Kim, Myong-Hwa;Kim, Jung-Mi
    • The Journal of Korean society of community based occupational therapy
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    • v.2 no.1
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    • pp.75-84
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    • 2012
  • Objective : This study aims to identify the effect of an occupational therapeutic intervention program including horticultural therapy on cognition and daily living performance of the elderly with dementia. Methods : For the purpose, the study measured the changes before and after the therapy, targeting sixteen women with dementia who were living in nursery facilities. We used MMSE-K to analyse the cognition, and evaluated daily living performance using K-MBI(p<.05). Results : The results of the study were presented as follows: 1. To identify changes of MMSE-K before and after the therapy between the control and test groups. As a result, it was discovered that MMSE-K of the control group was $16.25{\pm}1.38$ before the therapy and $16.00{\pm}.92$ after the therapy, which indicated no significant differences, but MMSE-K of the test group was $16.00{\pm}1.51$ before the therapy and $17.87{\pm}1.35$ after the therapy, which was statistically significant (p<.05). 2. To identify changes in daily living performance(K-MBI) between the two groups before and after the therapy, and it was discovered that scores of the control group were $74.00{\pm}1.30$ before the therapy and $74.25{\pm}1.16$ after the therapy, which showed no significant difference, but those of the test group were $73.75{\pm}1.28$ before the therapy and $76.37{\pm}1.30$ after the therapy, which was statistically significant(p<.05). Conclusion : Based on the results above, it was demonstrated that the an occupational therapeutic intervention program including horticultural therapy had a positive effect on cognition and daily living performance of elderly women with dementia and it is suggested that the results can be used as basic data for clinical intervention of the elderly with dementia.

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Development of Caregiver Guideline for Participation in Activities of Daily Living for the Elderly with Early Dementia: Focusing on the Delphi Survey (초기 치매 노인의 일상생활 참여 촉진을 위한 보호자 지침의 개발: 델파이 조사를 중심으로)

  • Kim, Seo-Eun;Koo, Seul-Gi;Park, Sang-M;Kim, Jung-Ran
    • 한국노년학
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    • v.37 no.2
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    • pp.461-474
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    • 2017
  • The purpose of this study was to develop the caregiver guideline for participation in activities daily living for the elderly with early dementia in home including easily adaptable and professional strategies as early intervetion. The process of this study was 3 stage. First stage, the development of preliminary caregiver guideline as the first stage of this study was to translate to Korean and reclassify the items about caregiver guideline for participation from reports of foreign association or government related dementia, and it consisted of 3 areas, 128 statements for questionnaire for Delphi investigation. Second stage, the guideline was to conduct the content validity, and delete, reclassify, integrate, revise inappropriate items through 2 rounds and 16 Delphi panels. Third stage, the establishment of the final version of caregiver guideline. It consisted of 8 areas: home modification and assistive device, home activities of daily living, health management, communication, psycho-emotional support, leisure activities, social participation, general strategies. All 68 items was arranged in important order. The content validity, stability, agreement index in this study were 0.81, 0.15, 0.79 respectively. When content validity, stability was above 0.49, below 0.5 in Delphi survey with 15 panels, it was not required additional survey. The result of this study meaned that it was not required to additional Delphi survey, and the result was stable and agreeable. This developed guideline was useful and practical to maintain the elderly's with dementia independent and healthy life as education materials for their caregivers, so it will expect to decrease caregiver's burden. Lastly, it stated limitation and suggestion for further study.

An Exploratory Study on the Children for Poverty Housing (아동 주거빈곤 정책 마련을 위한 탐색적 연구)

  • Ko, Ju-Ae
    • Land and Housing Review
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    • v.7 no.2
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    • pp.77-85
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    • 2016
  • The government has switched the purpose of housing policy, from the 'housing supply' to 'housing welfare', with the Housing Laws established in 2015 under evaluation that resident stability and resident standard were improved. But, as 'affordable' housing is gradually decreasing, residential environment has become more poor. Residential environment is a basic element for the child safety, health, and better education. This study explored that the poor resident environment had effect on the child, figured out the situation on housing poverty of domestic child and searched the situation of the residential policy of domestic and foreign child. The main results are as follows. First, the poor resident environment of childhood has a bad effect on the physical health, mental health, academic achievement and cognitive development. Second, 1.29 million children (11.9%) are living in condition of housing poverty below minimum resident standard and are concentrated in certain areas. Third, the policy on housing poverty of domestic child is almost absent and focuses on the elderly, young people. this study discussed political and practical solutions based on these research results. On the basis of these research results, as policy suggestions we proposed housing policy making based on the UN Convention on the Rights of the Child, evidence-based housing policy enforcement and, residential policy suggestions under the responsibility of central government, and as practical suggestions community working as the subject and related agency's solidarity from prevention activity of housing poverty and child advocacy point and we discussed way for issue and analyzed related laws, policies, commitments.

Factors associated with Experience of Diagnosis and Utilization of Chronic Diseases among Korean Elderly : Focus on Comparing between Urban and Rural Elderly (한국 노인의 만성질환 진단경험 및 의료이용에 관련된 요인 : 도시와 농촌 간 비교를 중심으로)

  • Lee, Min Ji;Kown, Dong Hyun;Kim, Yong Yook;Kim, Jae Han;Moon, Sung Jun;Park, Keon Woo;Park, Il Woo;Park, Jun Young;Baek, Na Yeon;Son, Gi Seok;Ahn, So Yeon;Yeo, In Uk;Woo, Sang Ah;Yoo, Sung Yun;Lee, Gi Beop;Lim, Soo Beom;Jang, Soo Hyun;Jang, In-Deok;Jeon, Jeong-U;Jeong, Su Jin;Jung, Yeon Ju;Cho, Seong Geon;Cha, Jeong Sik;Hwang, Ki Seok;Lee, Tae-Jun;Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.44 no.4
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    • pp.165-184
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    • 2019
  • Objectives: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. Methods: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. Results: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092-1.183) for diagnosis of diabetes, 1.278 (1.278-1.386) for diagnosis of dyslipidemia, 0.940 (0.904-0.977) for diagnosis of arthritis, 0.785(0.736-0.837) for treatment of arthritis, 1.159 (1.116-1.203) for diagnosis of cataracts, and 1.285(1.200-1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p <0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p <0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. Conclusion: Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.

A Survey on Utilization of Health Center and Health Service Demand of Residents in a Urban and Rural Unified Community (일개 도시·농촌 통합지역 주민의 보건기관 이용경험과 보건서비스 요구도 조사)

  • Lim, Bu-Doll;Lee, Ju-Young
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.99-112
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    • 2000
  • This survey was conducted to assess the utilization of health center including health sub-center and community health post and the health service demand of residents in a urban and rural unified community. Officials in Up·Myun·Dong offices visited randomly sampled 4,027 households(4.6% of total households in unified City) which included 3,337 households in urban area(4.9% of total households) and 690 households in rural area(3.7% of total households) and interviewed with heads or housewives of the households in September, 1995. There were significant differences in health-related demographic characteristics including age-sex distribution, educational level, period of residence in the community and medical insurance status of the interviewees between urban and rural areas. Of the respondents, 64.8% in urban area and 55.6% in rural replied that they had utilized the health center in the past. The most common purpose for visiting the health center was to get vaccination in urban area and to get outpatient care in rural area. The top priority health center activity that needs to be reinforced was communicable disease control and over 90% of the respondents preferred to have mobile clinic and home health care service in were also highly demanded. Eighty-six percent of the urban respondents replied that a health sub-center must be established in urban area. In the rural area, 90.3% of the respondents replied that they wanted to maintain the health sub-center and 88.3% wanted to maintain the community health post. Along with the improvement of facilities and equipments of the health center by Rural Health Service Improvement Project, new health service programs must be developed to meet the demand of the community.

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The Status of Mobility Disadvantaged Persons with Physical Disabilities & Suggested Improvements in Chungnam (충남지역 지체장애인의 이동권 실태 및 개선방안 연구)

  • Choi, Yun-Young;Yang, Jung-Bin;Kim, Ja-Young
    • Journal of Convergence for Information Technology
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    • v.11 no.4
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    • pp.130-136
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    • 2021
  • This study investigated the general characteristics of mobility disadvantaged persons with disabilities, and to suggest implications to ensure personal mobility with the greatest possible independence for the physically disabled in community. The survey questionnaire included the categories as follows: the general characteristics of the participants, the status of outing and mobility, usage of low-floor buses & taxi for the disabled, service improvement, and mobile support center. Data collected from 219 with physical disabilities were analyzed for this purpose by using descriptive statistics. The study results showed that 54.6% of the total tended to go out everyday, and 17.0% rarely. 53.4% could go out without any assistance, and the major obstacles not to go out were stairs and inconvenience of public transportation. 26.9% used low-floor buses, and 71.1% preferred to use taxi for the disabled. The average waiting time for the usage of low-flow buses and taxi was 66.57 minute and 42.65 minute, separately. 78.7% insisted that the function of mobile support center in the community should be expanded, whereas only 49.8% recognized the role of mobile support center. Based on the study results, the researchers suggested to facilitate access by persons with disabilities to mobility aids, and to improve the actual state of pedestrian environment. In addition, the function of mobile support center should be expanded to help the mobility disadvantaged persons live independently in community, thereby contributing to the promotion of their quality of life.

A Study on the Health Status and Dietary Intake of Rural Elderly Women in Kyeonggi Province (경기도 농촌 지역 여성노인의 건강 및 식생활 실태조사)

  • 이종현;김민선;이연숙;박양자
    • Korean Journal of Rural Living Science
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    • v.5 no.2
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    • pp.135-144
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    • 1994
  • This study was carried out to investigate health status and nutritional status based on dietary intake and food habit of elderly women in rural area of Keyonggi Province. The subject of this study were 133 elderly women aged 60 and over and interviewed with a questionaire. Main result was as follows : 1) Health score based on modified Cornell Medical Index, CMI(45 out of 195 items) was the average $29.1\pm6.8$ and was not significantly different with family size educational level and farmwork participation. In age, 44.0% of the subject in 60~65 years old was low score of CMI(11~25), but 50% of the subject in older than 80 years old was high score(33~44). The subject with disease was 82% and disease of musculoskeletal system was main type. 2) Dietary intake data obtained by a semiquantitative food frequency questionaire showed the average daily intake of energy, protein, Ca, retinol and riboflavin was lower than RDA Daily energy, protein and Ca intake was individually 84%, 67% and 55.1%. It was retinol that was the least sufficient as 49.1% of RDA. 3) The relation between CMI score(divided into three level : low, middle and high) showed low level was significantly different with others according to daily intake of energy, protein, retinol, thiamin, riboflavin and ascorbic acid. The correlation between CMI score and all nutrient intake were highly significant (p<0.001), thus we knew that health status was affected importantly by nutrient intake. 4) Family size, educational level and age showed not significant correlation with all nutrient intake. 5) In food habit, 84.8% of the subject had regular mealtime and 14.4% were skip meal sometimes. The main reason of skip meal was a poor appetite. Preference for salty taste of subject was insufficiently salty of somewhat salty. Preference for fishes and meats showed the subject consumed fishes more than meats, but 23.5% of the subject didn't consume both. The subject eaten supplement was 38.3%.

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