• The Korean Journal of Food And Nutrition
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• v.20 no.4
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• pp.467-475
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• 2007

The nutritional status and chronic disease occurrence of the elderly living in local areas is affected by certain factors, including low energy intakes, low food diversity, poor nutritional quality and living alone. Moreover, elderly people who live alone may have low incomes and be socially isolated. Thus, we have provided them adjustable and balanced menus using standard recipes. In this study, we investigated aspects of nutritional status and living conditions in the elderly status, in relation to food, activities of daily living(ADL), nutrition risk index, average intake of calories and nutrients, the mini dietary assessment index score, depression score, menu satisfaction, menu demand, satisfaction with menu offerings. The result indicated significant nutritional improvements by providing menus to the elders and suggest that by providing adjustable and balanced menus using standard recipes, the nutritional status of isolated elders can be changed and improved.

• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.768-781
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• 1996

The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.6 no.6
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• pp.923-930
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• 2002

This study aims at developing dialog system to improve the quality of life of the elderly with a dementia. The proposed system mainly consists of three modules including speech recognition, automatic search of the time-sorted dialog database, and agreeable responses with the recorded voices of caregivers. For the first step, the dialog that dementia patients often utter at a nursing home is first investigated. Next, the system is organized to recognize the utterances in order to meet their requests or demands. The system is then responded with recorded voices of professional caregivers. For evaluation of the system, the comparison study was carried out when the system was introduced or not, respectively. The occupational therapists then evaluated a male subjects reaction to the system by photographing his behaviors. The evaluation results showed that the dialog system was more responsive in catering to the needs of dementia patient than professional caregivers. Moreover, the proposed system led the patient to talk more than caregivers did in mutual communication.

• Journal of Preventive Medicine and Public Health
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• v.38 no.3
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• pp.276-282
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• 2005

Objectives : To evaluate the predictive validity of three scoring systems; the acute physiology and chronic health evaluation(APACHE) III, simplified acute physiology score(SAPS) II, and mortality probability model(MPM) II systems in critically ill patients. Methods : A concurrent and retrospective study conducted by collecting data on consecutive patients admitted to the intensive care unit(ICU) including surgical, medical and coronary care unit between January 1, 2004, and March 31, 2004. Data were collected on 348 patients consecutively admitted to the ICU(aged 16 years or older, no transfer, ICU stay at least 8 hours). Three models were analyzed using logistic regression. Discrimination was assessed using receiver operating characteristic(ROC) curves, sensitivity, specificity, and correct classification rate. Calibration was assessed using the Lemeshow-Hosmer goodness of fit H-statistic. Results : For the APACHE III, SAPS II and MPM II systems, the area under the receiver operating characterist ic(ROC) curves were 0.981, 0.978, and 0.941 respectively. With a predicted risk of 0.5, the sensitivities for the APACHE III, SAPS II, and MPM II systems were 81.1, 79.2 and 71.7%, the specificities 98.3, 98.6, and 98.3%, and the correct classification rates 95.7, 95.7, and 94.3%, respectively. The SAPS II and APACHE III systems showed good calibrations(chi-squared H=2.5838 p=0.9577 for SAPS II, and chi-squared H=4.3761 p=0.8217 for APACHE III). Conclusions : The APACHE III and SAPS II systems have excellent powers of mortality prediction, and calibration, and can be useful tools for the quality assessment of intensive care units(ICUs).

• The Journal of Korean society of community based occupational therapy
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• v.9 no.3
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• pp.21-30
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• 2019

Objective : This study was designed to identify the effects on the time usage and quality of life of seniors with stroke by applying lifestyle redesign programs on the theoretical basis of the Occupational Balance. Method : A pretest-posttest control group design was conducted for a total of 40 stroke elderly people living in nursing homes(20 experimental and 20 control groups). Prior assessment was conducted for two weeks before the application of the lifestyle redesign program. For the next 10 weeks, the lifestyle redesign program was applied seven times a week. After that, a week of post-evaluation was conducted. The time usage for the subjects was analyzed by Life Time Survey Table of the National Statistical Office(2009) and life quality for them was analyzed by World Health Organization Quality of Life-BRIEF (WHOQOL-BRIEF). Result : The comparison of time usage before and after application of the program demonstrated that for the experimental group, rest and sleep(t=-4.89, p<.001), and leisure(t=-4.67, p<.00b1) showed significant differences. In addition, intergroup comparison results showed that there were also significant differences in rest and sleep(t=-2.24, p<.01) and leisure(t=3.57, p<.01). The comparison of life quality showed a significant difference between two groups(t=6.80, p<.001). If you look at the sub-area of quality of life, a significant difference was identified in physical health(t=6.08, p<.001), psychological health(t=5.21, p<.001), living environment area(t=3.60, p<.01). Conclusion : Lifestyle redesign program actually reduced the time usage for rest and sleep for elderly with stroke living in nursing homes, and increased the time for participating in leisure life resulting in improved quality of life.

• Women's Health Nursing
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• v.4 no.2
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• pp.217-230
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• 1998

The purpose of this descriptive correlational study was to define the relationship between the experience of Sanhuujori, Korean traditional non-professional postpartal care after delivery and abortion and present health status of chronic arthritis female patient who visited to outpatient clinic of rheumatic internal medicine at a hospital located in Seoul, Korea. A convenience sample of 64 women who orally agreed to be a participant and data were collected form October 1996 to May, 1997 for sis months by way of interview with semistructured questionnaire. The data were analyzed by the SPSS pc program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; Mean age of participants was 53.2 years and mean number of children was 3.1. Mean frequency of abortion was 2.1 times per woman. Seventy four percentage of respondents did not have Sanhujori after abortion. The mean period of Sanhujori after delivery was 17.7, 15.2, 13.8 days from the first child to third child and shorter than that of general woman such as 20.0, 19.0, 17.3 days in the previous study. On the subjective evaluation of whether the women did Sanhujori well or not, the rate of 'did Sanhujori wrongly' was the highest rank in each child where as general woman 'did Sanhujori well' at the first child, 'moderate' at the second and third child and 'did Sanhujori wrongly' at the 4th and fifth child. The health status implies both subjective health status women perceived and the rate of complaints of physical symptom distress women are experiencing presently. The respondents of 82.5% perceived them as unhealthy or sick and 68.9% of women complained more than two symptoms. Mean number of physical symptom distress women complained was 2.33. The main sites of physical symptom distress were upper & lower extremities 69.1% including knee and hand, whole body 19.1%, neck 3.7%, waist & shoulders 2.7% respectively. The characteristics of the symptoms were mostly pain 60%, swelling 19.8%, rigidity & deformity 7.9% respectively, sensation of heat 6.8% and weakness 1.7%. Women perceived the etiology of the chronic arthritis as stress 25.8%, 'did Sanhujori wrongly' & overwork 23.4% respectively, genetic 12.9%, malnutrition, 4.8%, and aging process 3.2%. There were significant positive correlation between subjective health status and the period of Sanhujori after delivery of the second child(r=-0.22) and negative correlation with the number of child at the level of 5% of significance statistically(r=0.27). There were significant negative correlation between the rate of complaints of physical symptom distress and the subjective evaluation whether she did Sanhujori well or not at the level of 5% of significance statistically(r=-0.23). And the rate of complaints of physical symptom distress in the group of women who experienced abortion was significantly higher than that of women who did not experience it at the level of 5% significance statistically(t=2.00) In conclusion, this finding reconfirmed the possible relationship between health status of chronic arthritis female patient and the experience of Sanhujori after delivery & abortion. It provides a challenge to the professional care givers to research further on the effects of Sanhujori on the health status, health recovery after abortion or delivery from the various aspects through the crosssectional and longitudinal research for the refinement of the reality of not only as cultural phenomenon but as conceptual model for the appropriateness of intervention and quality of care for desirable health outcomes.

• Women's Health Nursing
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• v.5 no.3
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• pp.410-419
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• 1999

This study sought to figure out women's functional status after childbirth under the Sanhujori. Functioal status was defined as the women's readiness to assume infant care responsibilities and resume her usual activities including household, social and community, self-care and occupational activity. A convenience sample of 211 women who are in the postpartal period of the range from 1 week to 3 months above and residing in Seoul. Korea was studied from January, 1997 to December, 1998 for two years. Mean age of respondents was 29.9 years and mean of the present postpartal period was 7.5 weeks. The present postpartal period was of 5-8 weeks 26.5%, 3-4weeks 26.1%, 9-12 week 23.7% and below 2 weeks 7.1%, 32.7% of women had a job and the mean period of return to job was 2.76 weeks. During Sanhujori the non professional care giver was family members from women's maiden home 73.5% and only 2% of husband. The period women needed for the recovery from now was 5.39 weeks and it means that women need 12.9weeks for recovery after childbirth. For the present subjective health status after childbirth, bad was 20.2%, good 18.3 and average 61.5% and for the recovery status, completely recovered 29.5%, slightly 61.8% and rarely 8.7%. The mean of functional status at the 7.5weeks was baby care activity 3.65, household 2.57, self-care 2.46, occupational 2.44 and social 1.53 in rank. Except baby care the functional status was generally low or very low. The related factors to the functional status were the period and subjective evaluation of Sanhujori women experienced, the present period of postpartum, and subjective feeling of recovery. This result strongly reflects the effects of Sanhujori culture and Sanhujori per se on women's postpartal life including functional status and reconfirmed the relationship between health status and the experience of Sanhujori after delivery as the previous findings from various study showed. It provides a challenge to the professional care givers to research further on the effects of Sanhujori on the health status, health recovery after abortion or delivery from the various aspects through the cross-sectional and longitudinal research for the refinement of the reality of Sanhujori not only as cultural phenomenon but as an inseparable factor influencing in women's postpartal healthy adaptation and for the appropriateness of intervention and quality of care for desirable health outcome.

• Journal of Hospice and Palliative Care
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• v.12 no.2
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• pp.61-71
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• 2009

Purpose: The purpose of this study was to develop a CD program of applied logotherapy for psycho spiritual care of late adolescents with terminal cancer. Methods: Keller & Song's ARCS theory and a model for developing learning materials was applied to develop this program composed four distinct phases: planning, designing, developing, and evaluation stages. Results: This program was entitled 'Finding meaning in my life' and consisted of 5 sessions and its educational contents were made up as follows: "First Secret" is 'learning three natures of the human mind', "Second Secret" is 'learning creative values first method to find meaning of life', "Third Secret" is 'learning experiential value as second method to find meaning of life', "Fourth Secret" is 'learning attitudinal value as third method to find meaning of life', and "Fifth Secret" is 'Becoming the master of my life'. The sub-menu was made up of 'Beginning', 'Opening mind', 'Learning'. 'Laughing Song', 'Experiencing'. Conclusion: This CD program applied logotherapy with flash animation technique as an emotional and spiritual nursing intervention program for easier and more scientific application in pediatric oncology and hospice care area.

• Journal of Digital Convergence
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• v.10 no.3
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• pp.233-240
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• 2012

This study aimed to clarify any factors that may have effect on the appropriateness of hospital admission and hospitalization with the intention of facilitating more efficient occupancy of hospital beds and better medical services in the aspect of their quality, minimizing unnecessary occupancy of beds, and ultimately helping patients requiring acute treatments to use immediately hospitals. This paper selected 154 Stroke patients who left neurology department of one general hospital from March, 1, 2006 to September, 31, 2010 as targets to meet the rate according to medical care security and to see the trend of recent 4 years. As study method, this paper analized medical treatment record with AEP to evaluate the appropriateness of hospital admission and stay and the collected data was computerized through SPSS 12.0. Based upon the results above, the conclusion was drawn that the higher appropriateness of hospital admission and the shorter length of hospital stay will lead to the higher appropriateness of hospitalization. In other words, it is required to provide hospitalized patients with all kinds of behaviors including medical treatments and nursing care service, management of pharmaceuticals, tests, rehabilitation and symptoms, as well as instructions and information for patients. Meanwhile, as it was found that the length of hospital stay may affect the appropriateness of hospitalization, the longer length of hospital stay may result in reduced bed turnover rate. In this light, it is necessary to organize a task force team responsible for evaluation and control of the appropriateness of hospitalization and hospital stay length to improve the quality of medical service in a medical center, so that patients can leave the center timely. Ultimately, governmental supports such as expansion of long-term care facilities will reduce the necessary length of hospital stay so that patients with stroke can receive rehabilitative treatments and long-term care service shortly after completion of acute treatments.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9679-9685
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• 2014

Background: When evaluating health-economics for cervical cancer prevention policies in Japan, it is important to use Japanese value settings. This study aimed to obtain preference-based measures (preference measures) for hypothesized health states among healthy Japanese women, and to examine differences between the EuroQol-5D (EQ-5D) and standard gamble (SG) instruments. Materials and Methods: The investigation was performed among female students at a nursing university. We used written hypothetical scenarios describing three grades of cervical intraepithelial neoplasia (CIN) and eight stages of cervical cancer, both at diagnosis and after medical intervention. Preference measures were evaluated using both EQ-5D and SG. Results: We received responses from 136 women. The mean number of respondents per stage was 24.6 (SD: 2.7). At diagnosis, average EQ-5D scores for CIN1, CIN2, CIN3, IA1, IA2, IB1, IB2, IIA, IIB, III, and IV stages were 0.84 (0.14), 0.78 (0.12), 0.73 (0.10), 0.78 (0.12), 0.72 (0.12), 0.63 (0.13), 0.64 (0.12), 0.68 (0.08), 0.62 (0.13), 0.55 (0.21), and 0.18 (0.24), respectively. Using one-way analysis of variance with the Tukey-Kramer method for multiple comparisons (each stage vs. CIN1), we found significant differences for IB1 and more advanced stages (p<0.05). After medical intervention, corresponding EQ-5D scores were 0.84 (0.12), 0.81 (0.12), 0.84 (0.12), 0.80 (0.15), 0.78 (0.11), 0.64 (0.15), 0.63 (0.15), 0.71 (0.15), 0.50 (0.17), 0.52 (0.17), 0.21 (0.28). The multiple comparisons identified significant differences for IB1 and more advanced stages, excepting IIA (p<0.05). SG evaluations were more variable and relatively higher than EQ-5D evaluations. Conclusions: We obtained preference measures for three grades of CIN1-3 and eight stages of cervical cancer. In combination with appropriate sensitivity analyses, these preference measures will provide a basis for an economic evaluation of cervical cancer prevention in Japan. We suggest that EQ-5D is appropriate for cost-utility analysis of this topic.