• KDI Journal of Economic Policy
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• 제31권1호
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• pp.139-167
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• 2009

본 논문은 65세 이상 고령인구의 수와 노인들의 건강상태 등만을 중심으로 한 기존의 연구에 더하여, 노인장기요양보험제도 제2차 시범사업의 자료를 이용한 계량분석을 통해 장기요양서비스 수요의 결정요인을 분석하였다. 분석 결과에 따르면, 우선 노인장기요양보험제도상 장기요양서비스 이용에 대한 보험 적용 대상자를 정하는 등급판정에 일상생활활동에서의 장애가 노인들이 많이 앓고 있는 고혈압, 관절염, 치매 등의 질환을 통제하고서도 통계적으로 유의한 영향을 미쳤다. 또한 노인들의 건강상태, 여성, 기초생활수급자 여부, 노인가구 형태, 노인가구의 월평균 소득 등이 장기요양서비스이용 및 이용 양태에 통계적으로 유의한 영향을 미치는 것으로 나타났다. 특히, 노인가구의 월평균 소득을 통제하고서도 장기요양서비스를 무료로 이용할 수 있는 기초생활수급 대상 노인들의 재가서비스 이용확률이 높게 나타나는데, 이는 소득과 더불어 장기요양서비스의 가격도 장기요양서비스 이용을 결정하는 중요한 요인임을 의미한다.

• Annals of Clinical Neurophysiology
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• 제4권2호
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• pp.140-145
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• 2002

Neurologic sequelae of tuberculous meningitis include hemiparesis, paraparesis, quadriparesis, aphasia, developmental delay, dementia, blindness, visual field defect, deafness, cranial nerve palsies, epilepsy, and hypothalamic and pituitary dysfunction. But cervical epidural abscess and cervical spondylitis are rare. A 64-year-old woman who was diagnosed as tuberculous meningitis presented a severe neck pain and stiffness after 3 weeks of anti-tuberculous medication. Electromyography and cervical X-ray showed a cervical spondylosis with polyradiculopathy. But cervical MRI showed an acute cervical epidural abscess and mild cervical spondylitis. After continuous anti-tuberculous medication with supportive care, she showed a slow clinical improvement. But about 1 month of anti-tuberculous therapy, she presented a more aggravation of neck pain, neck stiffness, radicular pain, and neck motion limitation. Follow-up cervical MRI showed an more advanced cervical spondylitis. Afterthen she has recovered slowly by cervical laminectomy with posterior stabilization and continuous anti-tuberculous medication.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2017년도 춘계 종합학술대회 논문집
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• pp.87-88
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• 2017

인권에 기반을 둔 사회복지 실천은 사회복지사의 존재 이유라고 해도 과언이 아닐 것이다. 사회복지사는 사회적 약자의 인권을 옹호하고, 사회의 문제를 해결하며, 사회정의를 실현하는 전문가이기에 인권과는 불가분의 관계에 있다. 최근 한국 사회에서 인권에 대해 많은 논의가 이루어지고 있다. 특히 고령화 사회 속에서 2008년 9월 치매와의 전쟁을 선포한 이후치매관리종합대책을 수립하여 정부가 주도적으로 추진해 오고 있는 시점에서 인권 관점에 근거한 치매노인 돌봄을 이해하기 위해, 인권 관점이 치매노인 돌봄을 위한 사회복지 실천 현장에 주는 장점과 과정은 무엇인지 검토해 볼 필요가 있다. 이에 본 연구에서는 노인의 보호와 치매의 정의, 원인과 치매노인 돌봄을 위한 기술과 장점을 살펴보고, 인권 관점에 근거한 치매노인 돌봄을 위한 방안을 제언하고자 한다.

• 한국건강관리협회지
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• 제2권2호
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• pp.160-166
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• 2004

The aging of population in Korea is proceeding in such a fast speed that other developed countries kaven't experienced. Korea already emerged in the aging society in 2000, and expected to become an aged society in 2019.There(ore, making effort to improve the quality of life of the aged people tv prolonging their social, economic activity, resulting in retrenchment of expenditure on health is very important. Developing nutrition and exercise programs to improve the quality of life of the elderly people, resulting in prolonged independent life is as important as medical care after onset of diseases. As a national preventive measure to save elderly people from becoming in need of assist, comprehensive program including teaching computer to prevent senile dementia, nutritional and exercise programs, along with programs of everyday life activity for the risk-group people should be carried out,

• 대한간호학회지
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• 제37권5호
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• pp.772-780
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• 2007

Purpose: Nursing communication has become more important than ever before because quality of nursing services largely depends on the quality of communication in a very competitive health care environment. This article was to introduce ways to improve nursing communication using conversation analysis. Methods: This was a review study on conversation analysis, critically examining previous studies in nursing communication and interpersonal relationships. Results: This study provided theoretical backgrounds and basic assumptions of conversation analysis which was influenced by ethnomethodology, phenomenology, and sociolinguistic. In addition, the characteristics and analysis methods of conversation analysis were illustrated in detail. Lastly, how conversation analysis could help improve communication was shown, by examining researches using conversation analysis not only for ordinary conversations but also for extraordinary or difficult conversations such as conversations between patients with dementia and their professional nurses. Conclusion: Conversation analysis can help in improving nursing communication by providing various structures and patterns as well as prototypes of conversation, and by suggesting specific problems and problem-solving strategies in communication.

• 수면정신생리
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• 제8권1호
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• pp.11-17
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• 2001

In 2000, the number of people aged 65 and over increased to 3.37 million, accounting for 7.1% of the total population of South Korea. The elderly population will increase up to 19.3% in 2030. Sleep disordered breathing (SDB) seems to increase with age. More than 50-60% of old people complain of SDB-related signs and symptoms including awakening headache, excessive daytime sleepiness, fatigue, cognitive dysfunction, memory loss, personality changes, and depression. The influence of a mild degree of SDB upon the elderly is unclear, but moderate to severe SDB is well known to be associated with many diseases including hypertension, arrhythmia, myocardial infarction, stroke, dementia, and sudden death. Therefore, physicians should pay attention to elderly patients who complain of SDB related symptoms and signs that may not be normal signs of aging. Physicians need to become more sensitive to treat SDB in the elderly.

• 대한가정학회지
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• 제36권3호
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• pp.61-76
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• 1998

The Purpose of this paper is to find out the middle aged wives need for the family life education(FLE). The data were collected from 317 middle aged wives who's last child age over-18th. 1. The need for the FLE is indicated at the middle level, and we can see the strongest need of the being educated about the parent-child relationship, and of the being educated about the wife itself, about the older parent relationship and about the spousal relationship by turn. 2. Wife's age, husband's age, duration of marriage, income, number of children, type of family have a significant influence on the need for the family life education. 3. The middle aged wives want to educate about emotional control of leaving child, economic stability, teaching their child about value of marriage, and prevention and care of dementia. 4. This paper proposes that we should develope and execute not only the program of the FLE with respect to enough the need of the being educated, but also the programs of education about the grand parent role because of the increasing of the number of old aged people.

• Journal of Korean Neurosurgical Society
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• 제43권3호
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• pp.143-148
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• 2008

Objective: Postoperative delirium (POD) is characterized by an acute change in cognitive function and can result in longer hospital stays, higher morbidity rates, and more frequent discharges to long-term care facilities. In this study, we investigated the incidence and risk factors of POD in 224 patients older than 70 years of age, who had undergone a neurosurgical operation in the last two years. Methods: Data related to preoperative factors (male gender, >70 years, previous dementia or delirium, alcohol abuse, serum levels of sodium, potassium and glucose, and co-morbidities), perioperative factors (type of surgery and anesthesia, and duration of surgery) and postoperative data (length of stay in recovery room, severity of pain and use of opioid analgesics) were retrospectively collected and statistically analyzed. Results: POD appeared in 48 patients (21.4%) by postoperative day 3. When we excluded 26 patients with previous dementia or delirium, 17 spontaneously recovered by postoperative day 14, while 5 patients recovered by postoperative 2 months with medication, among 22 patients with newly developed POD. The univariate risk factors for POD included previously dementic or delirious patients, abnormal preoperative serum glucose level, pre-existent diabetes, the use of local anesthesia for the operation, longer operation time (>3.2 hr) or recovery room stay (>90 mini, and severe pain (VAS>6.8) requiring opioid treatment (p<0.05). Backward regression analysis revealed that previously dementic patients with diabetes, the operation being performed under local anesthesia, and severe postoperative pain treated with opioids were independent risk factors for POD. Conclusion: Our study shows that control of blood glucose levels and management of pain during local anesthesia and in the immediate postoperative period can reduce unexpected POD and help preventing unexpected medicolegal problems and economic burdens.

• 한국병원경영학회지
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• 제8권4호
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• pp.149-181
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• 2003

It has been asserted that per diem payment system should be introduced, in place of the current fee-for-service system, for payment of the inpatient services of the geriatric hospitals, Based on the assentation, this study aims at calculating costs and profits per inpatient-day of the geriatric hospitals, and thereby at contributing to the managerial improvement from the both sides of the Government and the hospitals. Relevant data of the three months, May to August, 2002 were collected from the five geriatric hospitals, and per inpatient-day costs and profits were calculated for the three disease groups. Major results and conclusions are as follow : Firstly, total costs per insured inpatient-day of the geriatric hospitals are 65, 389 won for dementia (including optimal profit of 3,858 won), 69,730 won for stroke (including optimal profit of 4,117 won), and 70,085 won for other diseases (including optimal profit of 4,134 won). Secondly, the amount of the non-insured costs per inpatient-day occupies 34.5% of the total costs for dementia, 30.3% for stroke, and 30.1% for other diseases. Thirdly, the total amount of the per inpatient-day costs calculated including the optimal profits is, on the average, higher by 12% than the present price level calculated for the current fee-far-service system. This implies that the present price level should rise by 12% when the current fee-far-service payment system be maintained, and Finally, introduction of a sliding-scale payment system should be considered for the inpatient medical management fees for the length of stay over six months or more that are being cut in the claim examination process by the insurance corporation.

• 동의신경정신과학회지
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• 제29권4호
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• pp.255-266
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• 2018

Objectives: The objective of this study was to evaluate the reliability and validity of Pattern Identifications Tool for Cognitive Disorders (PIT-C) and verify the correlation with other related scales. Methods: The study in this protocol is a single group, prospective, observational one. The subjects of the study were men and women between the ages of 45 and 85, diagnosed with neurocognitive disorders by Diagnostic and Statistical Manual of Mental Disorder (fifth Edition) criteria (n=60, Clinical Dementia Rating (CDR)=0.5, Korean Version of Montreal Cognitive Assessment $(MoCA-K){\leq}22$). The reliability of PIT-C was evaluated as test-retest and inter-rater reliability. And correlation between PIT-C and other related scales was also assessed. Results: This study was approved by the Institutional Review Board (IRB) of Dunsan Korean Medicine Hospital of Daejeon University and registered in the Clinical Research Information Service (CRIS), and was made public in advance to ensure transparency of the research process and conduct ethical clinical trials. Conclusions: The results of this study can be used to classify neurocognitive disorders as Korean medicine and PIT-C will be helpful tool for primary health care.