• Journal of Trauma and Injury
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• v.36 no.4
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• pp.329-336
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• 2023

Purpose: In this study, we aimed to compare the characteristics of patients with trauma by age group in a single center in Korea to identify the clinical characteristics and analyze the risk factors affecting mortality. Methods: Patients aged ≥18 years who visited the Chungbuk National University Hospital Regional Trauma Center between January 2016 and December 2022 were included. The accident mechanism, severity of the injury, and outcomes were compared by classifying the patients into group A (18-64 years), group B (65-79 years), and group C (≥80 years). In addition, logistic regression analysis was performed to identify factors affecting death. Results: The most common injury mechanism was traffic accidents in group A (40.9%) and slipping in group B (37.0%) and group C (56.2%). Although group A had the highest intensive care unit admission rate (38.0%), group C had the highest mortality rate (9.5%). In the regression analysis, 3 to 8 points on the Glasgow Coma Scale had the highest odds ratio for mortality, and red blood cell transfusion within 24 hours, intensive care unit admission, age, and Injury Severity Score were the predictors of death. Conclusions: For patients with trauma, the mechanism, injured body region, and severity of injury differed among the age groups. The high mortality rate of elderly patients suggests the need for different treatment approaches for trauma patients according to age. Identifying factors affecting clinical patterns and mortality according to age groups can help improve the prognosis of trauma patients in the future.

• Journal of Digital Convergence
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• v.18 no.11
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• pp.273-283
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• 2020

This study was attempted to provide basic data for developing future clinical competency enhancement of long-term care hospital nurses. Data were collected from 166 long-term care hospital nurses in G-do. Analysis was done using t-test, ANOVA, Pearson correlation coefficient, and Multiple regression with IBM SPSS WIN/21.0. The subjects' clinical competency was positively correlated to death awareness (r=.28, p<.001). The most influential factor on the subjects' clinical competency was death awereness (β=.235, p=.002), followed by marital status 'married' (β=-.214, p=.004), and have choice in days off 'agree' (β=.235, p=.002). The explanatory power was 16.2% (F=10.528, p<.001). Therefore, educational programs raising awareness of death, consideration of fellow nurses to have days off when desired, and encouraging married nurses to work are needed to enhance the clinical competency of long-term care hospital nurses. Utilizing the results of this study as basic data for clinical competency enhancement and in working schedule adjustment of long-term care hospital nurses is expected.

• Korea Journal of Hospital Management
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• v.25 no.2
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• pp.45-56
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• 2020

Purpose: The purpose of this study is to investigate medical care behaviors influencing accuracy of the payment based New diagnosis-related groups (DRG) compared to fee for service (FFS) in hospitalized patients with medical illness. Methodology: In order to estimate the difference in medical costs between New DRG and FFS depending on medical care behaviors, medical records and hospital claims data (n=4,232) were utilized, which were collected from a single public hospital during the first-half of 2018. Data were analyzed by descriptive statistics, t-test, chi-square test, and multivariate binary logistic regression. Findings: The average difference in medical costs between New DRG and FFS were KRW 506,711±13,945 with incentives and KRW -51,506±12,979 without incentives, respectively. Forty-four point two percent (44.2%, n=1,872) of total subjects were shown to have negative compensation in overall medical costs with New DRG compared to the costs with FFS. Medical care behaviors that affected on the negative compensation were the presence of severe bed sores on admission, medical consultations, death, operations, medications and laboratory or imaging tests with unit price over KRW 100,000, hospital-acquired complications or underlying comorbidities, elderly patients (≧65 years), and hospitalized for more than average inpatient days defined by New DRG (p<0.001). The difference in average medical cost between New DRG and FFS for a group with mild illness was KRW -11,900±10,544, whereas it was KRW -196,800±46,364 for a group with severe illness (p<0.0001). Practical Implications: These findings suggest that New DRG payment model without incentives may incompletely cover the variation of medical costs in real clinical practice. Therefore, policy makers need to consider that the current New DRG reimbursement should be focused and refined to improve accuracy of payment on medical care resources utilized in severe and complex medical conditions.

• Journal of Korean Academy of Nursing
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• v.27 no.4
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• pp.943-952
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• 1997

This study was done to analyze the effects of prompted voiding therapy on urinary incontinence in elderly patients in an elderly care hospital. Specifically, this study looks to evaluate the effects of prompted voiding as an intervention for improving independent voiding and also identified the relationship of urinary continence to cognitive, emotional, and physical factors. The study was based on a pre-experimental design used to evaluate the effects of prompted voiding therapy on an experimental group without a control group. An experimental group of 143 patients was selected through convenience sampling from patients in an elderly care hospital. The data was collected from November 4 to December 14, 1996. Prompted voiding therapy is a behavioral therapy for managing incontinence and it is applied to patients who are cognitively impaired and dependent. In this study, the patients were asked at each designated time whether or not they had to urinate. If they answered yes, they were either given a bedpan or were assisted to the bathroom, and if the patient answered no, their diaper was checked to determine whether or not it was wet. The results were then recorded on the patients urinary voiding record. The urinary voiding score based on the model presented by Burton(1984), Burke and Walsh(1992), Chenitz, Stone & Salisbury(1991) was modified and used as a tool in this study. After forty six out of the total of 143 patients were selected for interviews through random sampling the levels of cognitive functions, mental depression and ADL(activities of dally life) within the given time frame were measured. In this study, the cognitive function was measured using the scale developed by Kabhn, Goldfarb, Pollack & Peck(1960), elderly mental depression, using the tool developed by Sheikh & Yesavage(1986), and the ADL(activities of dally living), through the Barthel Index. The data was analyzed through SPSS windows for descriptive statistics, repeated measured ANOVA and Pearson's correlation. According to the results of the study, the application of the prompted voiding therapy can improve the voiding pattern of patients. It was shown especially that incontinence could be controlled by the intervention developed according to the individual voiding pattern. In terms of the relationship between cognitive function, mental depression and ADL and the voiding function score, a close correlation was not found. It was shown that urinary incontinence can be improved through therapy even though patients have problems nth their cognitive, mental and physical functions.

• Journal of the Korea Convergence Society
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• v.11 no.6
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• pp.411-422
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• 2020

Purpose: The purpose of this study is to compare the prognosis of traumatic acute subdural hematoma between adults and the elderly to provide appropriate nursing according to age. Methods: A retrospective medical records research study was conducted on 239 patients(adults 104, elderly 135) at Gwangju C university hospital. For data analysis, χ² test, independent sample t-test, one-way ANOVA were used. Results: There was no difference between GCS at discharge(t=-0.03, p=.978) and GOS at discharge(t=0.17, p=.863). But there were differences in gender(χ²=4.19, p=.041), history(χ²=20.78, p<.001), GCS at admission(t=-2.22, p=.028), pupil reflection at admission(t=8.04, p=.005), pH(t=-3.30, p=.001), serum blood glucose(t=-0.85, p=.040), complications(χ²=6.450, p=.011) between adults and elderly. Conculsion: When nursing patients with traumatic acute subdural hematoma, it is thought that patients assessment and nursing care considering the clinical characteristics according to age can be provided. Future research needs to develop educational materials for medical staff.

• Quality Improvement in Health Care
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• v.3 no.1
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• pp.78-93
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• 1996

Background : The goal of this study was to establish the QA items and guidelines for preventing and improving of safety management. Therefore we investigated the nurses' recognition and knowledge of the safety and risk procedures and policies, and the agreement between the nurses beliefs on the degree of importance of those procedures and policies, with actual implementation in hospitals. Method : The subjects of this study were 201 nurses who participated in a program called continuing education for nurses, which held in December, 1993. Result: The results of this study were as follows: 1. Among 18 types of hospital risks, the items that scored highest or the need of closer attention in safety management was the needle stick, medication errors, falling, and bed sores. 2. In most questions of the 18 incidences, the nurses showed that the estimated result would have positive signs except for hospital infections, burns, and bed sores. 3. Even though the survey shows that incidences and types of occurences varies according to the person's age and the time of incident, they mostly occur between midnight to 6AM. Falls and bed sores can be seen more in the elderly. Medications errors, hospital infections and burns are frequently found between the ages of one through twenty. 4. There was a higher mean score for recognizing the importance of those items than the importance of implementing them. Conclusion : In summary, nurses did perceive the need of safety management but the hospital policy for proper safety management was not established. So we recommended that the hospital administration would undertake an early detection and proper management system for hospital precautions, based on QA items & guidelines presented in this study.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.36-46
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• 2015

Objectives: To understand the risk factors of demographic data in geriatric depression scale, and suicidality among in elderly who live alone at one urban region. Methods:In 2009, 589 elderly who live alone(age${\geq}$65) were carried out a survey about several socio-demographic data, Korean version of the Geriatric Depression Scale(SGDS-K) and Suicidal Ideation Questionnaire (SIQ). Statistical analysis was performed for the collected data. Results: Mean age of elderly who live alone is 75.69(SD 6.17). 40.1% of participants uneducated, 31.4% graduate from elementary school, 12.9% graduate from high school, 11.7% graduate from middle school, 3.2% graduate from university. Religionless, having past history of depression or physical diseases, low subjective satisfaction of family situation, and not having any social group activity have significance to depressive symptoms of elderly who live alone. Having past history of depression, religionless, low subjective satisfaction of family situation have significance to suicidality. Especially, low subjective satisfaction of family situation and having past history of depression are powerful demographic factor both depressive symptoms and suicidality of elderly who live alone. Conclusions: When we take care elderly who live alone, we should consider many things, but especially the social support network such as family satisfaction and past history of depression for reducing or preventing their depression and suicide both elderly depression and suicide who live alone.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.3
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• pp.295-305
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• 2010

Purpose: This study was conducted to evaluate the economic efficiency of a community-based nursing care center to help policy makers determine whether or not to invest in similar facilities. Methods: The subjects were 101 elderly people over 65 years who participated in a health management program from February 1 to July 31, 2007. Direct cost was estimated with center operations cost, medical cost for out-patients and pharmacy cost. Indirect cost was measured by transportation cost. Direct benefit was calculated by saved medical cost for out-patients, saved pharmacy cost, saved transportation cost, and reducing hospital charges. Indirect benefit was estimated with prevention of severe complications. Economic efficiency was evaluated by cost-benefit ratio and net benefit. Results: Operating a community-based nursing care center was found to be cost-effective. Specifically, the cost of operating the center evaluated here was estimated at 135 million won while the benefit was estimated at 187 million won. Benefit-cost ratio was 1.38. Conclusion: The Community-based nursing care center that was described here could be a useful health care delivery system for reducing medical expenditures.

• Health Policy and Management
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• v.15 no.4
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• pp.136-160
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• 2005

Before introducing the national long-term care insurance in 2008, the want for long term care service has to be estimated and analysed. This study estimates the demand and analyses what determines the want of long term care service. This study investigated data of 3f6 elderlies, that was collected by age stratified random sampling. The elderies resided in Onyang 4 - dong (urban area) and Dogo-myun (rural area) In the city of Asan. The researchers visited the elderlies and their care giver, and assessed their demand for the long term care service and examined physical, mental, socio-economic status by the assessment tools for Korean Long-Term Care System. $64\%$ of the those who are entitled to be served refuse the long term care service. $26.7\%$ of them wants for home care service and $7.9\%$ want facility care service. It is estimated that the want of home care service are three or four times as much as that of facility care service. The demand for long term care service is 5.155 times higher for those who live in rural area (p=0.000), 3.040 times higher for those who do not have spouse(p=0.057), and 3.356 times higher for the people who is in medicaid than medical insurance(p=0.029). However, income(p=0.782), means(p=0.614), living alone(p=0.223), number of family to live with (p=0.341) and age of the elderly(p=0.420) are not related with the demand of long term care service. The assessment tools for Korean Long-Term Care System for need evaluation of the long term care service can reflect the demand well.(p=0.024) If medical care will cover $80\%$ of total cost, the willingness to pay of the out of pocket money of the people with medical insurance is 67,400 Korean Won(66.77 US$) for the home care service and 182,500 Korean Won(180.78 US$) for the facility care service. There is possibility that long term care demand is still small after Introducing the long term care Insurance due to the care given by family members. When developing service delivery system of long term care insurance, rural area has to be given more consideration than urban area because of the higher demand. The people who do not have spouse or are in medicaid have to be given special consideration as well.

• Research in Community and Public Health Nursing
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• v.28 no.2
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• pp.196-205
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• 2017

Purpose: Art program has been found to enhance mood such as increasing motivation, self-expression and decreasing depression in older adults. This study was conducted to investigate the effects of clay art and drawing on depression and self-expression among elderly people at a long-term care center. Methods: The research was a pre-test and post-test non-equivalent design. Sixty older patients (clay art program=28. Drawing art program=32) over the age of 65 were recruited from 2 long-term care hospitals to participate in the 5 weeks program. Each group was scheduled with 10,120-minute evaluation sessions, twice per week. Test measures were completed before and after the 5 week intervention period for all participants. The data was collected from April 27 to May 29, 2015. It was analyzed with SPSS 22.0 using chi-square, t-test and paired t-test. Results: There were no significant difference in the levels of depression (t=0.21, p=.830) and total score of self-expression (t=-0.10, p=.919) between the two groups. However, the pre-post scores of self-expression in the clay art program (t=0.22, p=.826) were improved compared to the drawing art program (t=0.80, p=.430). Conclusion: Further studies are needed to evaluate the effectiveness of clay art program for extended senior care applications.