• Title/Summary/Keyword: Elderly Care Hospital

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Extremely Low Serum Alanine Transaminase Level Is Associated with All-Cause Mortality in the Elderly after Intracranial Hemorrhage

  • Kim, Doo Young;Cho, Kwang-Chun
    • Journal of Korean Neurosurgical Society
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    • v.64 no.3
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    • pp.460-468
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    • 2021
  • Objective : Extremely low alanine transaminase (ALT) levels are associated with all-cause mortality in frail elderly individuals; the clinical significance of ALT as a reliable biomarker is now being considered. Predicting mortality with routine tests at the time of diagnosis is important for managing patients after intracranial hemorrhage. We aimed to investigate whether an extremely low ALT level is associated with mortality in the elderly after intracranial hemorrhage. Methods : A retrospective review was performed on 455 patients with intracranial hemorrhage admitted to a university-affiliated tertiary care hospital from February 2014 to May 2019. Multivariate Cox regression analysis was performed for all ages and for each age group to determine whether an extremely low ALT level is an independent predictor of mortality only in the elderly. Results : Overall, 294 patients were enrolled, and the mean age of the subjects was 59.1 years, with 99 (33.8%) aged ≥65 years. The variables associated with all-cause mortality in all subjects were age, C-reactive protein (CRP) levels, hemoglobin (Hb) levels (<11 g/dL), and initial Glasgow coma scale (GCS) scores. In young patients, CRP, low Hb levels, and initial GCS scores were significantly associated with all-cause mortality. However, in the elderly (≥65 years), the variables significantly associated with all-cause mortality were extremely low levels of ALT (<10 U/L) (adjusted hazard ratio, 3.313; 95% confidence interval, 1.232-8.909; p=0.018) and initial GCS scores. Conclusion : Extremely low ALT level (<10 U/L) at the time of diagnosis is a significant risk factor for all-cause mortality in the elderly after intracranial hemorrhage.

The Effects of Neurofeedback Training on Brain Function Quotient of Elderly with Long-term Care Insurance Service (뉴로피드백 훈련이 장기요양시설노인의 뇌기능지수에 미치는 효과)

  • Youn, Mee Kyung;Hyun, Kyung Sun;Park, Pyung Woon;Lee, Kuang Shim;Jeong, Dong Lye;Lee, Jung Eun
    • Journal of East-West Nursing Research
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    • v.18 no.2
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    • pp.111-119
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    • 2012
  • Purpose: Recently, Neurofeedback training system that based on biofeedback of brain wave was introduced. This study was performed to identify the effects of the improvement of brain function by Neurofeedback training on elders(the 2nd or 3rd grade of long-term care insurance services). Methods: A quasi-experimental design using a nonequivalent control group, pre-post test was used. Total 11 elderly were enrolled in this study (experimental group 5, control group 6). The intervention was conducted 3 times a week for 30 minutes from January to June, 2012 (total 60 times). Chi-square test and Mann-Whitney U-test were used to analyze the data. Results: After the Neurofeedback intervention, attention quotient (AQ), anti-stress quotient (ASQ), emotion quotient (EQ) and brain quotient (BQ) of the experimental group were significantly better than those of the control group. Conclusion: The findings indicate that the Neurofeedback training program was effective in reducing fatigue by AQ, increasing the physical and mental stress resistance by ASQ, emotional balance by EQ and improving of total brain function by BQ. Therefore Neurofeedback training be used as an effective training intervention for the health of elderly in geriatric facility.

Effect of Customized Visiting Exercise through Integrated Care Leading Project for the Elderly in the Community: Case Report (지역 사회 노인의 노화 예방에 따른 통합돌봄 선도사업 기반 맞춤형 방문운동의 효과: 증례 보고)

  • Kim, Jin-young;Park, Sung-doo;Bae, Jeong-hyun;You, Dal-young;Yang, Young-sik
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.3
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    • pp.99-105
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    • 2021
  • Purpose: This study aims to report on the effect of providing customized visiting exercise, a musculoskeletal intervention method, to the elderly in the community. Methods: In this study, subjective pain was measured to evaluate pain and physical ability of the elderly, and timed up & go (TUG) test and psychological level test were performed for myofascial pain perception symptoms and gait function. Measurements were performed twice before and 4 weeks after treatment. Participants in the exercise group (n=108) performed the spine exercise, whereas those in the spine exercise group (n=108) performed the spine exercise using complex exercise program (3 times/week for 4 weeks). Results: The significant test of visual analogu scale (VAS), pain pressure threshold (PPT), TUG, psychosocial factor according to applying the exercise within groups used T-test. In the result following analysis, there was significance on VAS (p=.000), PPT (p=.000), TUG (p=.000), Psychosocial factor (Depresion; p=.000, Anxiety; p=.000) within group. Conclusion: Then, exercise has benefit on the VAS, PPT, TUG, psychosocial factor in patients with myofacial pain syndrome. So, it may suggest that exercise will be helpful of the pain, gait and psychosocial factor improvement the patients with spine pain.

Medication Status and Adherence of the Elderly under Home Care Nursing (가정간호 노인대상자의 처방약물복용 실태 및 복용 이행도 영향요인)

  • Kim, Young-Hee;Lee, Mi-Kyoung;Lee, Sung-Ja;Cho, Myung-Sook;Hwang, Moon-Sook
    • Research in Community and Public Health Nursing
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    • v.22 no.3
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    • pp.290-301
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    • 2011
  • Purpose: This study is a descriptive research intended to clarify the medication status of community-dwelling elders and to identify factors affecting their medication adherence. Methods: Data were collected using questionnaires and interviews from 101 subjects who had taken prescribed drugs for at least 7 days sampled among elderly people using home care nursing at a general hospital in Seoul. Results: According to the results of this study, medication adherence measured by pill counting was 88.3% and that measured by self-reporting was 94.6%. There were statistically significant differences in medication adherence according to major disease (p=.006), the number of admissions (p=.032), the number of drugs (p=.051), the frequency of medication (p=.026), and depression (r=-.205). In addition, depression was found to be a significant variable explaining the medication adherence with explanatory power 3.8% (p=.035). Conclusion: The presence of depression affected the elderly subjects' the medication adherence. Therefore, more concern and educational approaches are required to encourage elderly people to comply correctly with medication regimens particularly for elderly patients who have a malignant or long-lasting disease or who have to take multiple drugs or maintain a daily dosing frequency.

Association of Health Outcomes with Frailty in Community-Dwelling Korean Older Adults: An Integrative Review (국내 지역사회 거주 노인의 허약과 건강결과 간의 관계에 대한 통합적 고찰)

  • Son, Youn-Jung;Lee, Suk Jeong;Choi, Yu Ri
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.26 no.1
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    • pp.5-18
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    • 2019
  • Purpose: Frailty is associated with an increased risk of adverse health outcomes. We aimed to review the relationships between frailty and health outcomes in community-dwelling Korean elderly individuals. Methods: Whittemore and Knafls' framework for conducting integrative reviews was used. PubMed, Cumulative Index to Nursing and Allied Health Literature, and six Korean databases were searched. For analysis, the study included articles written in English and Korean published between January 1960 and June 2018. Of the total 1,488 studies found in the databases, we analyzed 15 studies that met the quality of the evaluation criteria. Results: The prevalence of frailty in Korean elderly individuals ranged from 6.5% to 11.7% when divided into three levels of frailty. The health outcomes assessed in relation to frailty were divided into five domains: quality of life, physical health, psychosocial health, health behavior, and health care quality. Frailty was negatively associated with all five domains. Conclusions: Our study suggested that nurses should be aware of the limitations in the physical and cognitive functions of frail elderly individuals and provide tailored interventions for Korean elderly individuals. Furthermore, a large-scale study is needed to develop the Korean model of the frailty assessment tool and to verify the conceptual model of this study.

Analysis of the Current State of Home Health Nursing for Elderly Patients in Advanced General Hospital (일 상급종합병원 노인 환자의 가정간호 서비스 이용 현황 분석)

  • Park, Sung Hye;Jang, Yeon Soo;Kim, Su Jin
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.3
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    • pp.275-284
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    • 2019
  • Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.

Convergent factors affecting length of stay in the postanesthesia care unit among elderly from general anesthesia patients (노인 전신마취 환자의 회복실 체류에 영향을 미치는 융합적 요인)

  • Lee, Su-Jin
    • Journal of Internet of Things and Convergence
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    • v.3 no.2
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    • pp.21-32
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    • 2017
  • This study is a descriptive investigation for understanding factors influencing the length of stay in the postanesthesia care unit of elderly patients. Retrospective investigation was conducted on 300 patients aged 65 or older among those who had received an operation under general anesthesia and treated in postanesthesia care unit of hospital C located in Gyeonggi-do, from January 1 to December 31, 2014. The patients' average postanesthesia care unit stay was found to be 48.4 minutes and the 30-59 minute section accounted for the highest part with 58.0%. The postanesthesia care unit stay time according to intra-operative factors showed significant differences depending upon muscle relaxants, transfusion, ABGA, body temperature and total hours under anesthesia. Concerning the post anesthesia care unit stay length according to post-operative factors, significant differences were observed depending upon complications, PCA device, and circulatory drug use. In order to find out factors influencing the post anesthesia care unit stay length, the multiple regression analysis was conducted. As a result, the circulatory drug use and intra-operative lower body temperature were found to have an effect on the post anesthesia care unit stay length with the total explanatory power of 13%. Based on these findings above, it is deemed helpful to carefully monitor factors related to the post anesthesia care unit stay length and provide swift response accordingly for shorter post anesthesia care unit stay time of elderly general anesthesia patients.

Survey of the Food Preferences and Nutrient Intakes of Elderly People Hospitalized in a Nursing Hospital in Daegu (대구지역 요양병원 입원노인의 식품선호도 및 영양소 섭취 실태 조사)

  • Ju Yeon Park;Eunjung Kim
    • Journal of the Korean Dietetic Association
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    • v.30 no.1
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    • pp.41-60
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    • 2024
  • The number of elderly in care facilities is increasing in parallel with a rapid increase in the elderly population in Korea. We analyzed the meal satisfaction ratings, food preferences, and nutritional intakes of 74 patients aged ≥65 years living in a nursing hospital in Daegu. Food preferences were high for cooked rice, rice gruel, meat soup, soybean paste stew, beef, frozen pollack, squid, egg, spinach, sea mustard, cabbage kimchi, apple, peanut, drinking yogurt, pickled perilla leaves, and salted squid. Preferences for duck (P<0.01) and vegetable (P<0.01) cooking method were significantly different for men and women, and preference for soybean paste stew increased with age (P<0.05). Regarding nutrient intakes, men had higher energy (P<0.01), carbohydrates (P<0.05), and zinc (P<0.05) intakes than women, while women had higher vitamin C (P<0.05) intake than men. Furthermore, energy (P<0.001), carbohydrates (P<0.001), protein (P<0.05), dietary fiber (P<0.01), vitamin B6 (P<0.01), phosphorus (P<0.05), and zinc (P<0.001) intakes significantly decreased with age. Men had a significantly higher nutrient adequacy ratios (NARs) for carbohydrates (P<0.05) and cal- cium (P<0.01) than women, while women had a significantly higher NARs for protein (P<0.05), vitamin A (P<0.01), vitamin C (P<0.05), thiamine (P<0.01), riboflavin (P<0.001), iron (P<0.001), and zinc (P<0.01). Mean adequacy ratios were 0.69 for men and 0.75 for women. In particular, NARs for carbohydrates (P<0.01), vitamin B6 (P<0.01), and calcium (P<0.05) decreased significantly with age. In summary, the study shows that supplementing vitamin C, vitamin B6, calcium, and iron, reducing sodium, and providing meals that reflect preferences will improve the nutritional statuses of elderly residents in a nursing hospital.

Effect of an Integral Care System: a Combination of Oriental and Western Care for Older Adults with Degenerative Arthritis (퇴행성 관절질환을 앓고 있는 노인환자를 위한 한방과 양방을 적용한 통합의료 서비스의 효과)

  • Lee, Ji-A;Ji, Eun-Sun
    • Journal of Korean Academy of Nursing
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    • v.41 no.1
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    • pp.18-25
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    • 2011
  • Purpose: This study was done to examine the effect of an integrated care service which included a combination of oriental and western care on health outcomes in elderly patients with degenerative arthritis. Methods: A prospective comparative design was used. Data were collected from May 1, 2008 to June 30, 2009 from 85 elderly patients with degenerative arthritis in the lower extremities who were followed in a hospital out-patient department for 8 weeks. The integrated care service group (n=36) received a combination of physical therapy, acupuncture, western medicines or herbal medicines, and the western care group (n=49) received physical therapy or western medicines. Functional independence, walking speed, rotation balance, pain intensity, service satisfaction and total medical costs for the two groups were compared at 8 weeks. Results: Functional independence (t=2.14, p=.036) and walking speed (t=2.51, p=.014) improved significantly in the integrated care group while pain intensity improved significantly in the western care group (t=3.35, p=.002). The integrated care group reported higher scores for service satisfaction (t=2.09, p=.041) and higher medical costs than the western care group (t=2.15, p=.035). Conclusion: The results suggest that integrated care services are effective modalities to improve mobility and quality of life for elders with degenerative arthritis.

Oral health status of institutionalized elderly in Korea (노인장기요양시설 입소노인의 구강건강실태와 시사점)

  • Han, Dong-Hun;Kim, Nam-Hee;Ko, Seok-Min;Kwak, Jeong-Min;So, Jong-Seop;Lee, Seong-Keun;Lim, Soon-Ryun;Hwang, Ji-Young;Lee, Hye-Ju;Choi, Ho-Joon;Paek, Ji-Hyun;Kim, Yeon-Ju
    • The Journal of the Korean dental association
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    • v.53 no.10
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    • pp.688-695
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    • 2015
  • Purpose: The institutionalized elderly have placed the most vulnerable state, and the report about the oral health status of the institutionalized elderly was scarce. The aims of the current study were to investigate the oral health status of institutionalized elderly. Materials and methods: The survey of the oral health status was carried out on 487 institutionalized elderly from 4 longterm care facilities of Seoul metropolitan city, Gyunggi province, and Gangwon province in Korea. Results: The prevalence of dental caries, root caries, and dental calculus of the institutionalized elderly was 19.2%, 15.3%, and 23.7%, respectively. The percentage of edentulism among the institutionalized elderly was 26.2%. Those who had poor oral hygiene and tongue coating were 43.9% and 90.5%, respectively. The percentages wearing complete and removable partial denture on maxilla were 12.8% and 3.3%, respectively. The percentages wearing complete and removable partial denture on mandible were 7.8% and 5.6%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on maxilla were 29.7% and 27.2%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on mandible were 24.5% and 30.9%, respectively. Conclusion: The oral health stuatus of institutionalized elderly was poor. For the oral health promotion of elderly in longterm care facilities, it is essential to educate nurses and caregivers about the importance of the oral health and oral hygiene method.