Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.9
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pp.167-174
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2019
The propose od this study was to examine the extent of using physical restraint on elderly patients (over 65 years old) and who were patients in long-term care hospitals. The data was collected, from March 3 2018 to March 29 2018, from the electronic nursing records by using a recording tool, and clinical observation was also used for assessing the use of physical restraint and the related factors. Descriptive statistics, Pearson correlation coefficients and logistic regression were then performed. The usage rate for physical restraints in long-term care hospital was 83.7%, and the most common type of physical restraint was side rails. The use of physical restraints showed a positive correlation with the fall risk scores and a negative correlation with the MMSE. Logistic regression analysis showed that the Fall Risk Score (OR=1.02, 95% CI=1.01~1.03), MMSE (OR=0.94, CI=0.88~0.99) and the use of medical devices (OR=0.80, 95% CI=0.65~0.98) were related with using physical restraints. Therefore, it was confirmed that physical restraint was used in cases of a high risk of falling, severe cognitive impairment and the use of complex and fragile medical devices to treat the patient. Clinical nursing practice should be changed so that treatment alternatives can be applied for elderly patients rather than using too many physical restraints.
The wireless sensor network (WSN) based ECG and body temperature measuring system for ubiquitous health-care were designed and developed. The system was composed of a wireless sensor network node, base station and server computer for the continuous monitoring of ECG signals and body temperatures of patients at home or hospital. ECG signal and body temperature data, important vital signals which are commonly used in clinical and trauma care, were displayed on a graphical user interface (GUI). The data transfer from sensor nodes on patients' body to server computer was accomplished through a base-station connected to a server computer using Zigbee compatible IEEE802.15.4 standard wireless communication. Real-time as well as historical, ECG data of elderly persons or patients, can also be retrieved and played back to assist the diagnosis. The ubiquitous health care system presented in this study can effectively reduce social medical expenses, which will be increased greatly in the coming aging society.
Purpose: During hospitalization, confusion occurs in 15~20% of older adults and persists in 5~10% of them. This study was designed to investigate effects of a five-day nursing intervention program designed to reduce confusion in hospitalized older adults. Subjects were inpatients over the age of 60 years old and were admitted in a surgical care unit. Methods: Data were collected from 111 patients. Subjects divided into one of two groups, 58 patients of the control group which received the usual nursing care; and 53 patients of the intervention group which received the usual nursing care plus nursing intervention program for reducing acute confusion. The Delirium Observation Screening Scale (DOS) and the Korean Mini-Mental Screening Examination (MMSE-K) were utilized. Results: 1) Acute delirium was significantly reduced in the intervention group compared to the control group ($x^2$=4.22, p=.034) as well as the duration of the delirious state was significantly shortened (F=56.62, p<.001). Cognitive function of the intervention group was improved (F=21.14, p<.001). Conclusion: The nursing intervention program reduced the incidence and duration of acute delirium of the elderly inpatients, as well as it helps them keep better cognitive function than the control group.
Background : Because unplanned readmissions to intensive care unit(ICU)might be related with undesirable patient outcomes, we investigated the pattern of and reason for unplanned ICU readmission to provide baseline data for reducing unplanned returns to ICU. Methods : The subjects included all patients who readmitted to ICU during the same hospitalization at a tertiary referral hospital between January 1st and June 30th 2002. Quality improvement(QI) nurse collected the data through medical records and a medical director reviewed the data collected. Results : 1) The average unplanned ICU readmission rate was 5.6%(gastroenterology 14.6%, pediatrics 12.7%, pulmonology 11.9%, neurosurgery 6.3%, general surgery 5.3%, chest surgery 3.9%, and cardiology 3.3%). 2) Among the unplanned readmissions, more than 50% of cases were from patients older than 60 years, and the main categories of diagnose at hospital admission were neurologic disease(29.9%) and cardiovascular disease(27.6%). 3) Of unplanned ICU readmissions, 41.8% had recurrence of the initial problems, 44.8% had occurrence of new problems. And 9.7% required post-operative care after unplanned operations. 4) The most common cause responsible for unplanned ICU readmission were respiratory problem(38.3%) and cardiovascular problem(14.3%). 5) About 40% of unplanned ICU readmission occurred within 3 days after ICU discharge. 6) Average length of stay of the readmitted patients to ICUs were much longer than that of non-readmitted patients. 7) Hospital mortality rate was much higher for unplanned ICU readmitted patients(23.6%) than for non-readmitted patients(1.5%) (P<0.001). Conclusions : This study showed that the unplanned ICU readmitted patients had poor outcomes(high morality and increased length of stay). In addition study results suggest that more attention should be paid to patients in ICU with poor respiratory function or elderly patients, and careful clinical decisions are required at discharged from ICU to general ward.
Background: Although the breast cancer incidence rate in Japan is lower than in western countries, the age-specific rates have markedly increased in recent years, along with the problems of declining birth rate and an aging population. Materials and Methods: We examined past trends of age-specific breast cancer incidence using data from the Osaka Cancer Registry from 1976 to 2010, and estimated future trends until 2025 based on the changes observed and population dynamics using a log linear regression model. Results: The age-specific breast cancer incidence rate has increased consistently from the 1970s, and the rates have caught up with those of Japanese-Americans in the US. Assuming the increasing tendency of age-specific breast cancer incidence to be constant, the average annual incidence of breast cancer will increase 1.7-fold from 2006-2010 to 2021-2025. Furthermore, the number of patients aged 80 years should increase 3.4-fold. Conclusions: The medical demand for breast cancer care in Japan may increase explosively in the future, particularly among the elderly. We need to prepare for such a future increase in demand for care, although careful monitoring is needed to confirm these results.
The purpose of this study was to identify the proper changing time of tracheal suction catheter by examining the microorganisms inside after used The samples were the adult and the elderly patients who were in the intensive cane unit of one university hospital in Korea from the early December, 2002 to the end of May 2003. Since the patients needed tracheal suction, sterile catheter including other equipments were used whenever tracheal suction provided, to the experimental group. The sterile catheter with others was provided when the catheter repeatedly used for four hours, to the comparative group. Research was permitted by the head of hospital administration, hospital nursing department; microbiology and intensive care unit. The main results of the study are as follows. 1) The demographic characteristics between the two groups present statistically no difference. 2) Every the experimental group showed various kinds of microorganisms, the numbers of the kinds and carries of the microorganisms were less than those of the comparative group. 3) The mean numbers of the microorganisms between the two groups were significantly different, p < 0.05. This study results strongly emphasize the needs of using sterile catheter whenever a nurse suctions to keep patient's airway open.
The purpose of this study is to establish the basic data for the management of the elderly patients aged more than 60 suffering from musculoskeletal disorders in geriatric hospitals. From January, 1 2012 to December 31, 2012, 2,500 patients who were taken the x-ray inspection and were analyzed x-ray order 5,042 cases above spines, upper lower extremities and joints. The elderly age was divided into 3 groups according to Brody elderly statistics. The majority of elderly patients who visited the hospital are exposed to spinal disorders and joint diseases. Shoulder, knee, L-spine examination cases had accounted for more than half the number of total. By age group, the number of the first quarter was most dominant commonly. Second and third quarter was maintaining slightly decrease. The fourth quarter had reduced compared to the first quarter. If the visiting purposes and the disease causes analysis and preventive measures are taken in a study, it is expected to utilize as basic data to make a plan of the education for preventing diseases and elderly behavior planning for geriatric hospitals and to redistribute health care resources of the rural areas efficiently.
Background: Lung cancer continues to increase and one half of all cases of lung cancer occur in patients age 65 years and older. However, it seems that lung cancer is less treatable in elderly patients because of co-morbid illness or poor tolerance of surgery and chemotherapy. The intention of this study is to seek an adequate treatment approach for lung cancer in the elderly through an understanding of its characteristics. Method: The clinical data of 207 patients who were diagnosed with histologically proven lung cancer at the department of internal medicine in Seoul Municipal Boramae Hospital between September 1994 and August 1998 were retrospectively analyzed according to their age groups; group I$\geq$65 years(n=122) and group II<65 years(n=85). Results: The peak incidence of age was 7th decade(36.2%) and male age 65 years and older were 42% of all patients. Although dyspnea was more common in group I(26%) than in group II(11%)(p=.0l), there were no significant difference in other symptoms, stage, and histologic type between two groups. Group I significantly had more patients with poor performance(ECOG 3&4) than group II(35.2% vs.12.9%, p=.000). The percentage of patients with non-small cell carcinoma received supportive care only was significantly higher in group I than in group I(74% vs. 35%, p=.000). However, survival of patients who had curative intent treatment was similar between two groups(median survival 11.3 mos vs. 23 mos, p>.05). The histologic subtype, stage and performance status were significant prognostic factors affecting survival, but age itself was not. Conclusion : Lung cancer is prevalent in the elderly and aggressive diagnosis and treatment should be considered in elderly patients with good performance status.
Park, Sung-Ji;Han, Hee-Won;Jung, Yu-Jin;Woo, Hee-Soon
The Journal of Korean society of community based occupational therapy
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v.10
no.3
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pp.15-26
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2020
Objective : Due to the rapid aging of the country, the elderly population is increasing and the ratio of face-to-face meetings with the elderly in major areas of occupational therapy is high. The purpose of this study was to investigate the overall perception of the elderly and the status of communication with the elderly. Methods : This survey was conducted From April to June 2020. Occupational therapists who provide interventions for the elderly in hospitals and public health centers across the country were collected using online questionnaires. A total of 91 questionnaires were collected through a self-administered questionnaire, of which 82 were used for data analysis, excluding 9 with insufficient responses. Results : Occupational therapists generally had a lot of negative perceptions of the elderly. In addition, as factors that hindered communication with the elderly, they responded in order of hearing-related, language understanding related, and articulation related. Lastly, occupational therapists were found to induce smooth communication with the elderly in the order of conversation response management, emotional expression, understanding enhancement, and relationship control. Conclusions : Occupational therapists are health care professionals who play a major role in improving the subjects' social participation and quality of life. Therefore, it is necessary to provide professional therapeutic interventions and related education using improved communication skills along with an understanding of the elderly's communication skills and their level of communication.
Kim, Kyung-Min;Park, Young-Nam;Lee, Min-Kyung;Lee, Jung-Hwa;Yoon, Hyun-Seo;Jin, Hye-Jung;Kim, Hye-Jin
Journal of Korean society of Dental Hygiene
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v.14
no.5
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pp.723-730
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2014
Objectives : This research was conducted to investigate geriatric care workers' oral care, and the oral care conditions of residents of elder care facilities in relation to workers' knowledge of oral care. Methods : A survey was conducted from November 2011 to February 2012 with geriatric-care workers in elder care facilities located in Busan and other areas of Gyeongsangnam-do. Results : With regard to their oral self-care practices, 52.5% of the geriatric workers "brushed their teeth from top to bottom" and 58.1% brushed their teeth 3 times a day. Further, 52.0% did not use any oral care products, while 36.5% used Mouthrinese. The workers who brushed their teeth in their own ways or from top to bottom had significantly higher oral care knowledge scores than those who brushed from left to right (p<.05). Concerning oral hygiene care for residents, 72.6% of the geriatric workers recommended that elders visit dentists for oral care, 96.6% helped elders oral wash their teeth every day, and 54.7% used oral care products for the elders. The workers who did not recommend visits to dental clinics scored slightly higher than those who did (p<.05). Additionally, those who did not help elders oral wash their teeth scored significantly higher than those who did (p<.05). Except for oral wash to recuperated old man and recommendation of visiting the dentist, relation between oral care and knowledge about oral health and oral hygiene care is plus mutual relation. Conclusions : To manage the accuracy and quality of oral care work performed by geriatric care workers in elder care facilities, enhancing standard training and education on oral care is necessary. Providing systematic, regular education on such knowledge and practices would also be essential.
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