• 한국노년학
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• v.40 no.4
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• pp.747-760
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• 2020

The purpose of this study is to prepare basic data necessary for the development of services or systems that can enhance the accessibility of health and medical services or enhance the efficiency of health and medical use of senior citizens by identifying factors for predicting health and medical use behavior of senior citizens in Incheon Metropolitan City through the Korea health panel data(version 1.5). Through the structural equation model established through the SPSS and AMOS, it was confirmed that the predisposing factors, health behaviors and needs factors had significant direct and indirect effects on the use of health care services. Since the imbalance in demand and supply of health and medical services is more severe than in other regions, the results of this study can be used as basic data when checking whether the current health and medical system in Incheon Metropolitan City can operate effectively in an aged society and discussing how to provide health and medical services to the elderly in Incheon.

• Journal of Nutrition and Health
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• v.53 no.1
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• pp.27-38
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• 2020

Purpose: This study assessed the food intake and nutritional status of the elderly in long-term care facilities in order to provide adequate food services and improve the nutritional status. Methods: The survey was carried out from August 2019 to October 2019 for the elderly in long-term care facilities located in Gwangju Metropolitan City. The survey was conducted to collect data from 199 elderly persons (34 males and 165 females) aged over 65 years old. The food intake was assessed using a 1-day 24-hour recall method. Results: More than 90% of the subjects were over 75 years old. Forty five percent of the subjects were active, 44.2% of the subjects perceived themselves as not being healthy. Dementia and Parkinson's disease were the most common diseases, followed by hypertension, musculo-skeletal disease, diabetes, and stroke. Only 25.6% of the subjects had most of their teeth intact, and 44.7% of the subjects had difficulty in chewing and swallowing. The total food intake was 1,127 g in males and 1,078 g in females. The most frequently consumed foods were kimchi, cooked rice with multi-grains, soybean soup, cooked rice with white rice, yogurt, pumpkin porridge, soy milk, and duck soup. The average energy intake of the subjects was 1,564.9 kcal in males and 1,535.5 kcal in females. The overall nutritional status of the elderly in the long-term care facilities was poor. In particular, the intake of vitamin D and calcium, vitamin C, riboflavin, and potassium were very low. The intake of vitamin D was 5 ㎍, and 86.4% of the elderly were below the estimated average requirement, while the intake of sodium was high. Conclusion: The results of this study can be used to understand the health and nutritional status and to improve the food services and nutrition management for the elderly in longterm care facilities.

• Proceeding of Spring/Autumn Annual Conference of KHA
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• 2011.04a
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• pp.215-219
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• 2011

Along with the rapid increase of the elderly population, our country is facing the elderly problem as a social issue due to nuclear family, the increase of female social activities and recognition changes about the elderly support. In this connection, the welfare services to protect the overall elderly is requested urgently and the countries which have been experiencing aging earlier than our country are studying a lot a community daycare method which delays moving of the elderly into facilities as long as possible, reduces costs and efficiently provides services in order to curtail the big burden to the national economy. As one of these solutions, there is the elderly daycare center and this can be considered to be a compromising service type to correspond to our social changes, make individual and social supports without damage to the sense of value about support. Therefore, the space for the elderly can keep up with the falloff of mental and physical functions, dementia and geriatric diseases according to aging and careful consideration about the space considering stability and convenience is required. At this point, this study has the purpose to plan a daycare center which reflects the characteristics of the elderly to protect them within the community safely and comfortably. As for the research method, case study was conducted to understand the overall situation on the space plan of the daycare center for 5 daycare centers located in Seoul and found out problems. In addition, interview research was conducted for the heads of daycare centers or social workers, care workers and photographing and drawing collection were performed simultaneously. From the generalization of the above study, a space plan for a daycare center considering the characteristics of the elderly was provided.

• Journal of Society of Preventive Korean Medicine
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• v.22 no.1
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• pp.61-67
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• 2018

Objectives : The purpose of this study was to examine the effectiveness and satisfaction of visiting Korean Medicine doctor program. Method : The senior center visiting Korean Medicine doctor program was conducted in ten senior centers in Seongnam city from April 2016 to December 2016. Korean Medicine doctors were assigned senior center one by one. The program consisted of health lectures and health counseling. The health lectures embraces stroke, musculoskeletal disease, dementia, depression and self care for the elderly Results : A total of 194 elderly persons participated the program. The self-health awareness level were changed from $50.86{\pm}25.31$ to $57.17{\pm}24.62$ (p-value=0.003). The physical pain level was decreased from $5.33{\pm}2.99$ to $5.04{\pm}2.86$. The quality of life were changed from $0.791{\pm}0.155$ to $0.792{\pm}0.144$ (p-value=0.923). Overall satisfaction of visiting Korean Medicine doctor program was $9.36{\pm}2.11$. The need for sustainability for visiting Korean Medicine doctor program was $9.76{\pm}0.60$. Conclusions : The study demonstrated that visiting Korean Medicine doctor program had a positive effect on the health awareness level. The overall satisfaction and further need were high. Further program for senior center will be needed.

• Korean Journal of Biological Psychiatry
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• v.22 no.4
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• pp.195-204
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• 2015

Objectives This study investigated the patterns of psychotropic medications prescribed to patients admitted to an open psychiatric ward. Methods We reviewed 4282 medical records of patients who were discharged from an open psychiatric ward from May 2003 through April 2014. Data were collected on each patient's age, sex, length of hospital stay, number of past admissions, discharge diagnosis, and kinds and dosages of psychotropic medications at discharge. Results Among the 1384 male and 2898 female patients, 3.56 psychotropic medications were prescribed on average, with the number increasing across years, from 3.30 in 2003-2008 to 3.76 in 2009-2014. Prescription rates of antipsychotics, anxiolytics, and hypnotics significantly increased in patients with depressive disorders, bipolar disorders, anxiety disorders, delirium, dementia, and amnestic and other cognitive disorders. Only lithium prescription rates decreased significantly. Prescriptions for two or more anxiolytics and antipsychotics increased during the survey years, while antidepressant polypharmacy rates decreased. Conclusions Recently, there has been a significant increase in the number of psychotropic medications prescribed, including antipsychotics, anxiolytics, and hypnotics. Caution should be exercised when prescribing medications to avoid cost increases and the risk of side effects, with uncertain gains in the quality of care.

• Research in Community and Public Health Nursing
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• v.15 no.1
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• pp.56-66
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• 2004

Objectives: The purpose of this study was to verify a change for family nursing phenomena and satisfaction of clients of vulnerable families in an urban community. Methods: The study subjects were 711 families, randomly selected, who had chronic diseases(arthritis diabetes, stroke, hypertension, mental disease, cancer, dementia) with basic social welfare services from the nation and had disabled persons in an urban community, South Korea. The instruments used were the family nursing phenomena in Korea by ICNP and client satisfaction. Client satisfaction consisted of client satisfaction on home visiting nurses(4 Likert scales) and home visiting services(3 Likert scales). Results: The average visiting number is 3.82. The service number of education and counseling is 3.16, patient and symptom management 3.08, assessment and diagnosis 3.08, test 2.02, medication service 1.71회, dressing 1.01, referral to social welfare institute 1.00회, referral to medical service institute 0.21. In both, pre home visiting and post home visiting, the highest rated phenomenon was the 'lack of social support system' and following that 'deficit of financial management skill and support'. 'lack of family interaction in community', and 'social isolation' 'unhealthy life style' and 'inadequate care management of sick member', in that order. The percentages of phenomena besides 'deficit of financial management skill and support' decreased. The satisfaction level of clients towards the nurses was 3.27 points on a scale of 4, and the nursing services was 2.70 points on a scale of 3. Conclusion: Home visiting nursing services should continue to provide comprehensive healthcare services and support for vulnerable families, in urban communities.

• Journal of Korean Academy of Nursing
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• v.29 no.3
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• pp.585-595
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• 1999

The purpose of this study was to examine the predictors of burnout among informal caregivers of older adults. One hundred thirty seven caregivers who had provided care to older adults over 60 years of age for more than one month were included in the study. Most of the caregivers were white (91%) and female (78%). Mean ages of the caregivers were 64 years and 78% of them were married. Seventy percent of the older adults suffered from Alzheimer and related disease. In this study, caregivers reported that they experienced burnout once a month. The scores of emotional exhaustion and reduced personal accomplishment of the caregivers were in the moderate burnout range. To examine the predictors of burnout, discriminant analysis was used. Caregivers were divided by two groups based on the sum of scores (cutpoint＝6) on three dimensions of burnout after each dimension was categorized into high(3), moderate(2), and low(1). Nine predictors were included in the analysis : Caregiver's age, employment status, Instrumental Activities of Daily Living (IADL) of the older adult, presence of dementia of the older adult, caregiver's empathy toward the older adult (emotional and cognitive), and 3 coping strategies (negative, problem-focused, cognitive reconstructioning). Caregivers who reported high burnout showed higher cognitive empathy toward the older adults than those who showed low burnout. Caregivers who experienced high burnout used negative coping more often, and cognitive reconstructioning coping and problem focused coping less often than their counterparts. Wilks' Lambda was .78 indicating that differences between the two groups were significant. Cognitive empathy and cognitive reconstructioning coping showed high standardized canonical discriminat function coefficients over .40. Discriminant function with 9 predictors correctly classified 71% of the sample. In conclusion, informal caregivers also experienced certain level of burnout. Cognitive empathy and coping strategies predicted burnout experience of the caregivers. Based on this study, nursing intervention to the informal caregivers to improve their cognitive empathy toward the older adults and to modify their coping strategies in a way to reduce burnout experience can be applied. Further research to develop effective nursing interventions for the purpose of reducing burnout experience by modifying predictors was suggested.

• The Journal of Korean Academic Society of Nursing Education
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• v.10 no.1
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• pp.7-19
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• 2004

This study has a purpose to devise an education program in relation to Gerontology and geriatrics applicable to Korean nurses through literature review and analysis of education programs utilized by the Geriatric Education Centers (GECs) of USA. Educational contents on gerontology and geriatrics are very diverse in precedent literatures. The education programs of GECs for health care personnel are equally very diverse. Among educational contents, subjects considered important are age-related changes, health problems of the aged, pharmacology, death, fall and osteoporosis, delirium, dementia, depression, urinary incontinence, communication with elderly. Methods used in education program are mainly seminar, workshop and lecture through internet. In addition, case study, small-group discussion and conference are also adopted. The program proposed in this study for nurses in relation to gerontology and geriatrics consists of 32 hours' education; 6 hours for age-related changes, 10 hours for health problems of the elderly, 14 hours for health problems in old age and 2 hours of communication technique. Educational method proposed is to utilize lecture through internet, direct education, workshop, practical exercise, case study and role play in parallel. This study proposed an education program on the basis of precedent literature and the program of GECs. Therefore, it is desirable to develop in the future more practical education program applicable to and required in practicing fields. Of course, this development needs to be based on nurses' educational needs by field in relation to gerontology and geriatrics.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.271-280
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• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

• BMB Reports
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• v.55 no.11
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• pp.547-552
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• 2022

Sorafenib, originally identified as an inhibitor of multiple oncogenic kinases, induces ferroptosis in hepatocellular carcinoma (HCC) cells. Several pathways that mitigate sorafenib-induced ferroptosis confer drug resistance; thus strategies that enhance ferroptosis increase sorafenib efficacy. Orphan nuclear receptor estrogen-related receptor γ (ERRγ) is upregulated in human HCC tissues and plays a role in cancer cell proliferation. The aim of this study was to determine whether inhibition of ERRγ with DN200434, an orally available inverse agonist, can overcome resistance to sorafenib through induction of ferroptosis. Sorafenib-resistant HCC cells were less sensitive to sorafenibinduced ferroptosis and showed significantly higher ERRγ levels than sorafenib-sensitive HCC cells. DN200434 induced lipid peroxidation and ferroptosis in sorafenib-resistant HCC cells. Mechanistically, DN200434 increased mitochondrial ROS generation by reducing glutathione/glutathione disulfide levels, which subsequently reduced mTOR activity and GPX4 levels. DN200434 induced amplification of the antitumor effects of sorafenib was confirmed in a tumor xenograft model. The present results indicate that DN200434 may be a novel therapeutic strategy to re-sensitize HCC cells to sorafenib.