• Title/Summary/Keyword: Elderly male

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Gender Differences in Pain in Cancer Patients (성별에 따른 암환자의 통증 차이)

  • Kim, Hyun-Sook;Lee, So-Woo;Yun, Young-Ho;Yu, Su-Jeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.1
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    • pp.14-25
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    • 2001
  • Purpose : To determine whether there exist gender differences in pain in Korean cancer patients and whether the depression and performance that are often expressed differently between men and women with cancer interact with pain. Method : The results of survey were collected from 140 in- and out-patients (78 male and 62 female) who had cancer treatment at one of the university hospital in Seoul for four months from February of 1999. The severity and interference of pain were examined with the self-reported survey based on Korean version of Brief Pain Inventory (BPI-K). Demographic and clinical information for all patient were compiled by reviewing their medical records, and the level of depression was examined with the Korean version of Beck Depression Inventory (BDI-K). Usual statistical methods, e.g., frequences, means and SDs were used to characterize the sample. The chi-square tests for categorical data and t-test for numerical data were used for group comparison. And the correlation between variables were performed using Pearson correlation coefficient. Resuts : 1) The mean scores of the worst pain for last 24-hours measured with the pain severity of BPI-K were 5.77 in male and 6.45 in female. The pain interference of BPI-K in men was in the order of mood (5.49), enjoy (5.36), and work (5.00), and in women were work (7.48), enjoy (7.16), and mood (6.53). 2) In pain severity, significant difference was found between men and women in the average pain for last 24-hours (t=-2.130, P=.035). In pain interference, significant difference was found between men and women in activity (t=-2.450, P=.015), mood (t=-2,321, P=.022), walk (t=-2.762, P=.007), work (t=-4.946, P=.000), relate (t=-2.595, P=.010), sleep (t=-2.071, P=.040), enjoy (t=-3.198, P=.001). 3) It was found that the items of pain and depression are significantly correlated in men but not in women. Men also exhibited higher correlation in the items of pain and performance status than women. Conclusions : Women report significantly greater average pain for last 24-hours and for all items of pain interference than men. Pain and depression are significantly correlated in men. The results of this study suggest that gender differences in pain should be considered for planning effective pain management program.

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The Short Term Clinical Follow-up Study for Hemiarthroplasty in Proximal Humeral Fracture (상완골 근위부 분쇄 골절에서의 상완골 두 치환술의 단기 추시 결과)

  • Sung, Chang-Meen;Cho, Se-Hyun;Jung, Soon-Taek;Hwang, Sun-Chul;Park, Hyung-Bin
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.92-98
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    • 2007
  • Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years(range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2($6{\sim}10$), 6.6($2{\sim}8$), and 6.9($4{\sim}8$). The total UCLA score was an average of 21.7($12{\sim}26$). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.

The Contents and Satisfation of Home Care Progral Delivered by Seoul Nurses Association (서울시 간호사회 가정간호시범사업 서비스 내용 및 만족도 분석)

  • Lim, Nan-Young;Kim, Keum-Soon;Kim, Young-lm;Kim, Kwuy-Bun;Kim, Si-Hyun;Park, Ho-Ran
    • The Korean Nurse
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    • v.36 no.1
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    • pp.59-76
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    • 1997
  • The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.

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The Assessment for Nutrient Intakes of Korean Patients with Heart Failure (우리나라 일부 심부전 환자의 영양소 섭취량 평가 연구)

  • Lee, Hye-Ran;Kang, Bo-Rum;Chung, Hye-Kyung;Do, Hyun-Joo;Shim, Jee-Seon;Bae, Soon-Hwa;Kang, Seok-Min;Shin, Min-Jeong
    • Journal of Nutrition and Health
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    • v.43 no.3
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    • pp.224-232
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    • 2010
  • The prevalence of heart failure (HF) is increasing globally and growing evidence has shown that dietary factors play an important role in preventing and improving prognosis of HF. However, little data on nutrient intake in Korean HF patients which are available to develop dietary guidelines for HF. The aims of this study were to estimate nutrient intake in 78 HF patients and evaluate whether the estimated nutrient intake is appropriate compared to dietary reference intake for Koreans. Data are presented as the ratio of actual intake and estimated average requirement (EAR) for each nutrient. The result showed that the average nutrient intakes including total energy and protein met EAR in total patients. However, the deficiencies in mineral and vitamin intakes were found. Moreover, the proportion of subjects with lower intake than EAR was substantial. The results showed that the proportion of male HF patients with inferior intakes to EAR in calcium, potassium (compared to adequate intake: AI), folate and vitamin $B_{12}$ were 38%, 79%, 38%, and 65%, respectively. Also, the proportion of female HF patients with inferior intakes to EAR in calcium, potassium (compared to AI), folate and vitamin $B_{12}$ were 35%, 88%, 38% and 40%, respectively. In particular, the elderly with HF ($\geq$ 70 yrs, n = 28) showed more serious deficiencies in calcium, potassium (compared to AI), folate and vitamin $B_{12}$. In summary, the intakes of potassium, calcium, folate, and vitamin B12 were not sufficient to meet EAR in HF patients. Furthermore, the proportions of subjects with lower intake than EAR in these nutrients were substantial, raising the possibility that these micronutrients may be involved in the pathogenesis of HF. Practical dietary guideline for HF patients is needed to improve prognosis of HF.

Cutoff Values of Body Mass Index and Body Fat Measures for Metabolic Syndrome in Korean Population (한국인에서 대사증후군의 선별검사로서 체성분 분석 및 체질량지수의 타당성연구)

  • Lee, Hyun-Jae;Kim, Byoung-Gwon;Kim, Joon-Youn;Kim, Jung-Man;Yoo, Byung-Chul;Kim, Eun-Jeong;Hong, Young-Seoub
    • Journal of Life Science
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    • v.20 no.1
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    • pp.9-16
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    • 2010
  • This study investigated cut-off values of body mass index (BMI) and body fat measures for metabolic syndrome (MS) in elderly Koreas. Questionnaire surveys, anthropometric measurements, medical examinations, and body composition analyses were conducted for 10,077 subjects aged 40-65 years in the health examinee cohort in Korea between 2004 and 2006. Cut-off values were identified using receiver-operating characteristic (ROC) curve analysis for both men and women. Stratified analyses by weight range (<60, 60-69, 70-79, and 80-89, ${\geq}90\;kg$ for men; <50, 50-59, 60-69, 70-79, ${\geq}80\;kg$ for women) were conducted. Among male subjects, the cut-off points were $25.5\;kg/m^2$ for BMI with a sensitivity of 70.0% and a specificity of 72.0%, and 26.1% for body fat percentage with a sensitivity of 60.6% and a specificity of 76.4%. Among female subjects, the cutoff points were $24.1\;kg/m^2$ for BMI with a sensitivity of 73.3% and a specificity of 68.8%, and 31.5% for body fat percentage with a sensitivity of 76.7% and a specificity of 65.6%. Stratified analysis by weight range showed that the cutoff points of BMI and body fat measures tended to higher as weight level increased. The results of our study suggest cut-off values of BMI and body fat measure for MS were similar to the general obesity criteria in Korea.

Nutritional Adequacy of Target Pattern in Dietary Guidance System - Dietary Reference Intakes for Koreans 2015 - (식사구성안 권장식사패턴의 영양 적정성 평가 - 2015 한국인 영양소 섭취기준 -)

  • Kim, Youngnam
    • Journal of Korean Home Economics Education Association
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    • v.29 no.3
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    • pp.77-88
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    • 2017
  • Nutritional adequacy of Target patterns in Dietary Guidance System were evaluated. Study subjects were 18 Target patterns designed for 2 children groups, 4 adolescent and 4 adult male and female groups in Dietary Reference Intakes for Koreans 2015. Nutrients examined were 4 macro-nutrients(protein, fat, carbohydrate, and dietary fiber), 5 minerals(Ca, P, Fe, Na, and K), and 5 vitamins(vitamin A, thiamin, riboflavin, niacin, and vitamin C). Energy and nutrients contents were calculated based upon assigned multiples of single serving in Target pattern and Representative Food Composition Table by Excel program. Among the 18 Target patterns, only 5 were mean adequacy ratio(MAR) of 1.0, fulfilled the expectations of Dietary Guidance System. Protein and Na contents were more than dietary reference intakes(DRI) in all 18 Target patterns. Dietary fiber, Ca, and K were deficient nutrient in 15, 10, and 9 Target patterns, respectively. The units of vitamin A were not same in Target pattern and DRI, retinol equivalent(RE) in Target pattern and retinol activity equivalent(RAE) in DRI. When calculate RE content of vitamin A in Target pattern to RAE content, 15 Target patterns did not reach to DRI of vitamin A. The Target pattern of elderly women showed the lowest mean adequacy ratio(MAR), 7 nutrients were less than DRI, need to be revised. Average energy contribution ratio of protein, fat, and carbohydrate were 16.04%, 24.35%, and 60.91%, respectively, fulfilled the adequate acceptable macro-nutrient distribution range(AMDR). To improve the nutritional inadequacy of dietary fiber, Ca, K, and vitamin A in Target pattern, effective mean may be the increasing vegetable group assignment. Also decreasing the meat fish egg legume group assignment in some Target pattern may be the way of preventing of protein overconsumption. The energy in adequate amount for condiment use also need to be considered.

Psychological, relational and financial resources: How do they influence happiness among Koreans (심리적, 관계적, 경제적 자원: 한국인의 행복에 어떠한 영향을 미치는가?)

  • Youngshin Park ;Uichol Kim
    • Korean Journal of Culture and Social Issue
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    • v.15 no.1
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    • pp.95-132
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    • 2009
  • Can money buy happiness? If not, what are the factors that influence happiness? What makes people happy? What are the factors that influence happiness among Korean adults? How can we better explain factors that influence happiness? These are the research questions that led to the analyses of psychological, relational, financial resources that influence happiness. To examine differences in socio-economic status, adults and elderly from three different districts that vary wealth and income were interviewed in their own home. A total of 313 respondents (male=133, female=180) between the ages of 20 through 80 completed a questionnaire that contained background information, emotional support scale and happiness scale developed by the present researcher and resiliency of efficacy developed by Bandura(1995). The results are as follows. First, monthly income influence happiness to some extent, but when the variable was excluded from the path analysis, the goodness-of-fit did not change significantly. Although those who have more money can be happier, those without much money can also be happy. These results indicate that financial resource has limited influence on happiness. In addition, monthly income did influence self-efficacy of respondents indicating that those with more money were not necessarily more confident about themselves. Second, an important factor influencing happiness is the relational resource. Emotional support was the most powerful predictor of happiness, four to five times more important than monthly income. Third, self-efficacy influenced happiness. Those respondents with higher resiliency of efficacy had higher happiness scores and the influence was two times greater than monthly income. Moreover, self-efficacy played a mediating role between emotional support and happiness. Fourth, those respondents with higher occupational achievement reported higher happiness score and the influence was two times greater than monthly income. Fifth, success of children influenced happiness score and the influence was 1.5 times greater than monthly income. Sixth, education did not directly influence happiness, but had an indirect influence through self-efficacy and occupational achievement. Seventh, age was not related to self-efficacy and happiness.

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A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire (퇴원환자의 가정간호 이용의사와 관련 요인)

  • Lee, Ji-Hyun;Lee, Young-Eun;Lee, Myung-Hwa;Sohn, Sue-Kyung
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.2
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    • pp.257-270
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    • 1999
  • The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

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Nutritional Risks Analysis Based on the Food Intake Frequency and Health-related Behaviors of the Older Residents (50 Years and Over) in Andong Area (1) (안동주변 농촌지역 50세 이상 주민의 식품섭취빈도 및 건강행위에 따른 영양위험 분석 (1))

  • Lee, Hye-Sang;Kwun, In-Sook;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.8
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    • pp.998-1008
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    • 2008
  • This study aimed to assess the nutritional status and the nutritional risks based on the food intake frequency and health-related behaviors of middle-aged and elderly people living in Andong area. Interviews were conducted with 1,384 subjects (532 males, 852 females) aged 50 years and over. Nutrient intakes, food intake frequency, and health-related behaviors including smoking, drinking, and exercise were investigated. The average energy intakes were 1410.5 kcal for males and 1279.2 kcal for females, and the percentages of the subjects consuming below the estimated energy requirement (EER) were 92.5% and 88.4%, respectively. The least consumed nutrients compared to the estimated average requirement (EAR) were riboflavin (92.5% for males, 89.6% for females), folic acid (89.7%, 88.5%), and calcium (78.9%, 85.8%), in order. According to the food intake frequency survey, the intakes of meat, fish and vegetable (except kimchi) were very poor, and this low intakes of meat and fish showed as poor status of protein, niacin, vitamin $B_6$, and zinc intakes. Health-related behaviors data showed that the ratio of cigarette smokers, especially male, was higher, while the ratio of the person exercising regularly was lower than that of the nationwide statistics, respectively. Cigarette smoking and drinking were not significantly related to the poor nutrition intake, while regular exercise positively influenced nutrient intakes in female subjects. These results showed that the nutritional status of the subjects was likely to be severely deficient and the low intakes of meat and fish to be highly related to the increase of nutritional risk. Therefore, in order to prevent the occurrence of the secondary disease related to the food intake and health-related behaviors of the subjects, the proper educational program on balanced dietary intake and the correction of health-related behaviors should be developed and applied to this area.

A Study on Serum Lipid Levels of Elderly People in Wando Area -Based on Dietary Behaviors- (완도지역 중·장년층의 혈중지질 수준에 관한 연구 -식행동을 중심으로-)

  • Kim, Eun-Ju;Cha, Bok-Kyeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.9
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    • pp.1148-1160
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    • 2007
  • This study was performed to document the association between eating behaviors and major risk factors for cardiovascular diseases. Those who stated that they ate a daily breakfast for male and female were 88.6% and 96.0%, $1{\sim}2$ times a week were 9.1% and 2.0%, $3{\sim}4$ times a week were 2.3% and 2.0%, respectively. Those who stated that they were overeating of $0{\sim}1$ time a week for man and female were 80.7% and 89.9%, overeating of $2{\sim}3$ times a week were 19.3% and 10.1%, respectively. Those who said that they were regular of meal time for man and female were 38.6%, and 37.4%, sometimes irregular of meal time were 14.8% and 19.2%, irregular of meal time were 46.6% and 43.4%, respectively. Those who said that they were light of eating volume for man and female were 20.5% and 25.3%, moderate of eating volume were 69.3% and 61.6%, heavy of eating volume were 10.2% and 13.1%, respectively. Those who said that they were very fast of eating speed for man and female were 15.9% and 8.1%, fast of eating speed were 51.1% and 34.3%, moderate of eating speed were 4.5% and 20.2%, slow of eating speed were 17.0% and 14.1%, and very slow of eating speed were 11.4% and 23.2%, respectively. Higher frequency of breakfast a week resulted in higher serum total cholesterol and blood sugar for the daily eating group for both genders with women having high LDL-cholesterol and HDL-cholesterol. Both group had high HDL-cholesterol and low blood sugar with less number of overeating, with men having low triglyceride and LDL-cholesterol. With regular meal, both group had low triglyceride, total-cholesterol, atherogenic index, and blood sugar with women having low LDL-cholesterol. For both groups, the triglyceride, total-cholesterol, LDL-cholesterol, atherogenic index, and blood sugar had higher figures for overeating, with men having low HDL-cholesterol and women having high HDL-cholesterol. This study revealed that less number of overeating, regular mealtime, and less volume of food intake are effective in preventing and treating for the cardiovascular diseases.