• Title/Summary/Keyword: Geriatric medicine

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A Research Study on the Planning of the Rehabilitation Section in Geriatric Hospital (노인전문병원의 재활의학부 치료부문 기본계획을 위한 조사 연구)

  • Yoon, Soo-Jin;Chai, Choul-Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.13 no.2
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    • pp.37-44
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    • 2007
  • Rehabilitation medicine is an area which tries to help people who have physical inconvenience in everyday activities to live like healthy people as much as possible by training programs. As society gets more advanced and as the standard of living continuously rises, the need of the "Rehabilitation medicine" is also increasing. Also as we are entering into the aging society, especially geriatric rehabilitation medicine is getting more and more attention as a method to maintain the healthy lives of the elders. However, the standards related to medical care space for rehabilitation medicine is not thoroughly prepared. Although requirement for geriatric hospital is increasing, the standard of geriatric hospital is not following up to regulate them properly. Therefore, in this study, I will propose a 'suitable planning' needed in geriatric rehabilitation by analyzing the rehabilitation sections of 5 general hospitals and 1 geriatric hospital.

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Clinical Outcomes of Perioperative Geriatric Intervention in the Elderly Undergoing Hip Fracture Surgery

  • Jang, Il-Young;Lee, Young Soo;Jung, Hee-Won;Chang, Jae-Suk;Kim, Jung Jae;Kim, Hye-Jin;Lee, Eunju
    • Annals of Geriatric Medicine and Research
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    • v.20 no.3
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    • pp.125-130
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    • 2016
  • Background: Conventionally, elderly hip fracture patients are assessed by orthopedists to decide whether they need geriatric intervention. We aimed to evaluate the effect of perioperative geriatric intervention on healthcare outcomes in patients undergoing surgery for hip fractures. Methods: Our care model for hip fracture surgery resembles a combination of a routine geriatric consultation model and a geriatric ward model. We retrospectively reviewed the medical records of patients aged ${\geq}65years$ undergoing surgery for hip fracture at a single tertiary hospital from January 2010 to December 2013. We assessed comorbidity, indwelling status, fracture type, and mode of anesthesia. We also evaluated in-hospital expenditure, duration of admission, disposition at discharge and 1-year mortality as clinical outcomes. We developed a propensity score model using the variables of age, cholesterol, and creatinine and examined the effect of perioperative geriatric intervention on intergroup differences of clinical variables. Results: Among 639 patients, 138 patients received the geriatric intervention and 501 patients received the usual care. Univariate analysis showed that factors such as age; Charlson comorbidity index; and serum levels of cholesterol, albumin, and creatinine differed significantly between these 2 groups. There was no significant difference between the groups in terms of 1-year mortality, disposition at discharge, and in-hospital expenditure in the propensity matched model. However, the duration of hospitalization was shorter in the intervention group ($8.9{\pm}0.8days$) than in the usual care group ($14.2{\pm}3.7days$, p=0.006). Conclusion: This care model of geriatric intervention for patients with hip fracture is associated with reduced hospitalization duration.

Effects of Korean Medical Intensive Treatment Program on Geriatric Depression Disorder (노인성우울증에 대한 한방 집중치료 프로그램의 효과)

  • Kim, Ka-Na;Hwang, Wei-Wan;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.25 no.4
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    • pp.311-318
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    • 2014
  • Objectives: As the elderly population grows and the prevalence of depression increases, the incidence of geriatric depression disorder will continue to increase. The effect of an intensive Korean medicine treatment program on geriatric depression disorder was studied. Methods: Geriatric depression disorder patients who received treatment over a period of three years were reviewed, with the geriatric depression score (GDS) used as the primary outcome. The intensive Korean medical treatment program applied to the geriatric depression disorder patients consisted of herbal medicine, acupuncture, pharmacopuncture, moxibustion, meditation, qigong exercises, and reminiscence therapy. Results: The GDS scores of patients who received the intensive Korean medical treatment program decreased from an average of 19.57 (${\pm}5.52$) to 15.76 (${\pm}6.99$) and there was a significant difference. Conclusions: When the intensive Korean medical treatment program was applied to geriatric depression disorder patients, the symptoms of depression improved. This treatment program will be helpful for improving symptoms in patients and can be applied by trained clinicians.

Geriatric risk model for older patients with diffuse large B-cell lymphoma (GERIAD): a prospective multicenter cohort study

  • Ho-Young Yhim;Yong Park;Jeong-A Kim;Ho-Jin Shin;Young Rok Do;Joon Ho Moon;Min Kyoung Kim;Won Sik Lee;Dae Sik Kim;Myung-Won Lee;Yoon Seok Choi;Seong Hyun Jeong;Kyoung Ha Kim;Jinhang Kim;Chang-Hoon Lee;Ga-Young Song;Deok-Hwan Yang;Jae-Yong Kwak
    • The Korean journal of internal medicine
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    • v.39 no.3
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    • pp.501-512
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    • 2024
  • Background/Aims: Optimal risk stratification based on simplified geriatric assessment to predict treatment-related toxicity and survival needs to be clarified in older patients with diffuse large B-cell lymphoma (DLBCL). Methods: This multicenter prospective cohort study enrolled newly diagnosed patients with DLBCL (≥ 65 yr) between September 2015 and April 2018. A simplified geriatric assessment was performed at baseline using Activities of Daily Living (ADL), Instrumental ADL (IADL), and Charlson's Comorbidity Index (CCI). The primary endpoint was event-free survival (EFS). Results: The study included 249 patients, the median age was 74 years (range, 65-88), and 125 (50.2%) were female. In multivariable Cox analysis, ADL, IADL, CCI, and age were independent factors for EFS; an integrated geriatric score was derived and the patients stratified into three geriatric categories: fit (n = 162, 65.1%), intermediate-fit (n = 25, 10.0%), and frail (n = 62, 24.9%). The established geriatric model was significantly associated with EFS (fit vs. intermediate-fit, HR 2.61, p < 0.001; fit vs. frail, HR 4.61, p < 0.001) and outperformed each covariate alone or in combination. In 87 intermediate-fit or frail patients, the relative doxorubicin dose intensity (RDDI) ≥ 62.4% was significantly associated with worse EFS (HR, 2.15, 95% CI 1.30-3.53, p = 0.002). It was related with a higher incidence of grade ≥ 3 symptomatic non-hematologic toxicities (63.2% vs. 27.8%, p < 0.001) and earlier treatment discontinuation (34.5% vs. 8.0%, p < 0.001) in patients with RDDI ≥ 62.4% than in those with RDDI < 62.4%. Conclusions: This model integrating simplified geriatric assessment can risk-stratify older patients with DLBCL and identify those who are highly vulnerable to standard dose-intensity chemoimmunotherapy.

Estimating Radiation Therapy Toxicity and Tolerability with Comprehensive Assessment Parameters in Geriatric Cancer Patients

  • Ulger, Sukran;Kizilarslanoglu, Muhammet Cemal;Kilic, Mustafa Kemal;Kilic, Diclehan;Cetin, Bekir Eren;Ulger, Zekeriya;Karahacioglu, Eray
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1965-1969
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    • 2015
  • Cancer prevalance and incidence is increasing with aging of populations and age is a critical factor in decision-making for anti-cancer treatment. However it is believed that chronological age is not enough to guide management in elderly cancer patients. Multidisciplinary evaluation and comprehensive geriatric assessment has gained importance regarding the treatment selection especially for definitive anti-cancer therapy recently. We here aimed to analyse the effect of the comprehensive geriatric assessment parameters on radiotherapy toxicity and tolerability in a series of geriatric cancer patients in Turkey.

The Significance of Managing "Mibyeng" in Geriatric Health by Focusing on the Connection between Korean Medicine and Psychology: A Review (노년기 건강에 있어 미병(未病) 관리의 의의: 한의학과 심리학의 연관성을 중심으로)

  • Bae, Suhyun;Park, Miso;Lee, Siwoo;Beak, Younghwa;Yoo, Horyong;Kim, Giyeon
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.2
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    • pp.109-119
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    • 2020
  • Objectives: The aim of this study is to review the significance of managing "Mibyeong" in geriatric health in Korean medicine and psychology. Methods: We performed a literature search using OASIS, Koreantk, RISS, DBpia, and PubMed databases. We retrieved research articles using the keywords related to mibyeong (未病), sub-health (亞健康), Korean-medicine, psychology and geriatric health. Results: Both Korean medicine and psychology emphasize biological, psychological, and social balance and well-being. In addition, both value individual personality and constitution. Mibyeong is a Korean medical concept suggesting sub-health. Elderly individuals who are in a state of Mibyeong are frail and vulnerable to disorders and illness. Since depression, chronic diseases, low physical and mental activity have fatal outcomes in frail and elderly subjects, positive psychological support and active management of Mibyeong are very important. Conclusions: Geriatric health conditions are associated with chronic disease and multiple risk factors, including physiological, psychological, social, and economic conditions. A preventive and integrative approach is essential for geriatric health as prevention is better than cure for most geriatric diseases and illnesses.

Certificate Education for Geriatric Physician: Satisfaction and Feasibility (노인병 인정의 양성 교육: 만족도와 현실성)

  • Lee, Sung-Chun;Kim, Hwa-Joon;Park, Hyung-Joon;Yun, Jong-Lull;Kim, Chang-Yup;Moon, Ok-Ryun;Jang, Soong-Nang
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.1
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    • pp.10-16
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    • 2008
  • Objectives : Korea faces a number of challenges to meet demands in the area of geriatric professional medicine in a country with a rapidly ageing population. We evaluated the satisfaction and feasibility of the current education certification for geriatric physicians. Methods : Geriatric physicians who were deemed qualified by the Korean Geriatrics Society during the period of 2001 to 2005 (n=2,200) were asked to complete structured questionnaires sent to them by mail about their satisfaction of and need for certificates of education, as well as their opinions on their geriatric specialty training. A total of 419 physicians responded. Descriptive analysis and hierarchical regression were performed to rate the respondents' satisfaction, the characteristics of the need for clarity and utility in education certification, and the characteristics of their patients. Results : Although most respondents were satisfied with their education certification, those who had more elderly patients, aged 65 or older, and those who had more cognitively impaired patients, rated their education as significantly lower than did other physicians. Both groups expressed the need for more the comprehensive care and assessment concerning of their education. Multiple regression analysis indicated that satisfaction with geriatric physician qualification was associated with a physician's age, specialty, and percentage of elderly patients. Conclusions : This study suggests that the current system of education certification is limited in terms of feasibility and physician satisfaction.

A Study on the Status of Utilization of Health Care Institution by Geriatric Patients -Focus on the Utilization of Physical Therapy- (노인환자 보건의료기관 이용실태 분석)

  • Lee, Jong-Sub;Song, Myung-Soo
    • Journal of agricultural medicine and community health
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    • v.22 no.2
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    • pp.277-293
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    • 1997
  • This study was conducted to provide basic materials required to enforce and develop welfare policies, as well as the health system, for the aged, by surveying the status of health care utilized by the daily increasing old population and the importance of receiving physical therapy. Data that need in this research was gathered from over ages of 65, during the period from Jan 4, 1996 to Jan 31, using the inquiries previously made by geriatric researchers and through literatures investigator by this writer. The data were analyzed by $X^2$, Z-test, Likert scale. The findings were as follows : 1) General characteristics of subjects. People in the age group between 65 and 69 were 55.6% and the highest number, while male were 37% and female 63%. Analysis of income group disclosed 60.6% whose monthly income, including the pocket money given by children, was less than 200,000 won. 91.1% of the elderly people surveyed owned houses; only 36.4% live with spouses; while 15.6% live alone. 2) Characteristics with respect to utilization of health care institution. 56% of the total medical institutions used by the elderly people were clinics and the rates of chronic disease and musculoskeletal disease were 73.2%. 3) Characteristics with respect to approach of health care institution. 45.1% of the respondent stated it took 20 minutes to arrive at hospital, and bus accounted for 48.6% of all transportation means used to go to hospital. 4) Degree of cognition with respect to the rights of geriatric patients. (1) There is no financial support from the government for geriatric patients(71.4%). (2) Government financial support is needed for geriatric patients(95.3%). (3) Have never been regionally surveyed or called upon for interviews with respect to treatment desire and problems relating to geriatric patients(87.2%). (4) Health and medical policies for geriatric patients must be established rapidly(98.4). (5) Expansion and construction of specialized medical facilities for geriatric patients such as elderly hospital and medical center are needed(90.2%). (6) Government's welfare policies for the elderly people is insufficient(82.0%) 5) Degree of cognition on importance of physical therapy with respect to geriatric patient. (1) Physical therapy is considered most effective in treating geriatric patients(82.9%). (2) Physical therapists specializing in only elderly people must be need of separately(76.2%). (3) It is desirable for medical specialists to visit geriatric patients at home to provide physical therapy(82.9%). (4) Hospitals specializing in physical therapy for geriatric patient are required(85.6%). Based on the result for this research, the following suggestions are presented to facilitate the utilization of health care institution for the welfare of geriatric patients. Medical facilities such as elderly hospital and geriatric patient's medical center specializing in elderly people must be constructed as early as possible; and home-visiting physical therapist system must be important to treat chronic geriatric patients; our government must establish policies to provide the old ages with means for the health care and curing chronic diseases, and carry out the plans of reasonable distribution and effective untilization of medical resources.

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