• Title/Summary/Keyword: Geriatric patients

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The Influence of Care Stress for Older Patients, Self-perceptions of Aging, Aging Anxiety on Retirement Preparation in Nurses (간호사의 노인간호 스트레스, 노화인식, 노화불안이 노후준비에 미치는 영향)

  • Kang, Sujin;Yeom, Hye-Ah
    • Korean Journal of Occupational Health Nursing
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    • v.30 no.4
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    • pp.175-185
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    • 2021
  • Purpose: The purpose of this study was to explore the influence of care stress for older patients, self-perceptions of aging, and anxiety about aging on preparation for retirement in clinical nurses. Methods: This was a cross-sectional descriptive study in which participants were 222 nurses who had at least six months of work experience and were involved in caring for older patients in the last six months at the work site. Data were collected from August to September, 2020 using an online survey questionnaire. Data were analyzed using the IBM SPSS/WIN 25.0 program. Results: The mean level of preparation for retirement in the participants was moderate (3.21 out of 5 points). Among the sub-domains of preparation for retirement, financial preparation had the lowest score. Self-perceptions of aging and aging anxiety were significant predictors for retirement preparation in nurses, accounting for 16% of the variable's total variance. Conclusion: A greater level of preparation for retirement was associated with a positive perception of aging and a decreased level of aging anxiety in the clinical nurses. Further research should focus on exploration of specific determinants of financial preparation for retirement and development of intervention strategies for improving preparation for retirement in the nursing workforce.

Factors Associated with Vancomycin-Resistant Enterococcus Colonization in Patients Transferred to Emergency Departments in Korea

  • Kim, Hyun Soon;Kim, Dae Hee;Yoon, Hai-jeon;Lee, Woon Jeong;Woo, Seon Hee;Choi, Seung Pill
    • Journal of Korean Medical Science
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    • v.33 no.48
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    • pp.295.1-295.7
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    • 2018
  • Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

Extremely High Mortality Rate after a Successful Gastrectomy for Cancer in Older Adults

  • Ciesielski, Maciej;Kruszewski, Wieslaw Janusz;Szajewski, Mariusz;Walczak, Jakub;Spychalska, Natalia;Szefel, Jaroslaw;Zielinski, Jacek
    • Journal of Gastric Cancer
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    • v.19 no.2
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    • pp.202-211
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    • 2019
  • Purpose: Poor physiological reserve for withstanding major cancer surgery in older adults is an important concern in the selection of patients for oncologic gastrectomy. The present study aimed to analyze mortality patterns among patients who underwent gastrectomy for cancer according to age groups. The primary outcomes of this study were early- and middleterm results: 30-day and 3-, 6-, 12-, and 36-month mortality rates. Materials and Methods: A retrospective review of 288 patients who underwent surgical resection for gastric cancer in two centers was carried out. Patients were stratified into four groups according to age: 29-50 years (group I, n=27), 51-65 years (group II, n=117), 66-75 years (group III, n=81), and 76-92 years (group IV, n=58). Statistical calculations focused on the differences in the survival rates between groups I and II as well as between groups II and IV. Results: The middle-aged patients (group II) had significantly better 3-year survival than either the youngest (group I) or the oldest patients (group IV). The 6-month mortality rates were 16.9% in group III and 29.3% in group IV. Two-thirds of the patients from groups III and IV who died between 2 and 6 months after surgery had an uneventful postoperative course. Conclusions: Age is an important prognostic factor of middle-term survival after gastrectomy for cancer. Geriatric assessment and better patient selection for major surgery for cancer are required to improve the outcome of gastrectomy for cancer in patients aged over 75 years.

Mortality, Length of Stay, and Cost Associated with Hospitalized Adult Cancer Patients with Febrile Neutropenia

  • Chindaprasirt, Jarin;Wanitpongpun, Chinadol;Limpawattana, Panita;Thepsuthammarat, Kaewjai;Sripakdee, Warunsuda;Wirasorn, Kosin;Sookprasert, Aumkhae
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1115-1119
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    • 2013
  • Background: Febrile neutropenia (FN) is a serious complication following chemotherapy and is associated with significant mortality and financial expenditure. The aim of this study was to evaluate risk factors for longer length of stay (LOS) and mortality and cost of treatment among hospitalized adults with cancer who developed febrile neutropenia in Thailand. Materials and Methods: Information on illness of inpatients and casualties came from hospitals nationwide and from hospital withdrawals from the 3 health insurance schemes in fiscal 2010. The data covered 96% of the population and were analyzed by age groups, hospital level, and insurance year schemes in patients with febrile neutropenia. Results: A total of 5,809 patients were identified in the study. The mortality rate was 14%. The median LOS was 8.67 days and 69% of patients stayed for longer than 5 days. On bivariate analysis, age, cancer type, and infectious complications (bacteremia/sepsis, hypotension, fungal infections, and pneumonia) were significantly associated with longer LOS and death. On multivariate analysis, acute leukemia and infectious complications were linked with longer LOS and death significantly. The median cost of hospitalized FN was THB 33,686 (USD 1,122) with the highest cost observed in acute leukemia patients. Conclusions: FN in adult patients results in significant mortality in hospitalized Thai patients. Factors associated with increased mortality include older age (>70), acute leukemia, comorbidity, and infectious complications.

The Comparison of Iliopsoas Tightness Between Low Back Pain Patients and Healthy Subjects (요통환자와 정상인의 장요근의 긴장 도 비교)

  • Lee, Jun-Yong;Yoon, Hong-Il
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.12 no.2
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    • pp.11-20
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    • 2006
  • Low back pain is often experienced by many people who are in an activity flag. Their work and daily life are affected by low back pain. There are many causes of low back pain. Among those many causes, this study was focused on a relation between low back pain and the tightness of iliopsoas. The study was implemented by measuring the angles of the hip joints in subjects consisting of a 30 patients group, who had been selected from the outpatients at the Median Hospital, and a 30 people control group from the outpatients at the M Hospital and employee of M hospital. The patients group consists of the patients with low back pain who have intermittently or continuously experienced low back pain within the last 6 months. The group also had no symptom of spondylolysis or spondylolithesis and no muscular abnormality in terms of pathology without any experience of disc or spine fusion operation. The control group consisted out of persons who had never experienced lower back pain and had never been subjected to physical therapy due to lower back pain. The hip joint angles of the subjects of this study were measured by means of the modified Thomas test position. Data was analysed by independent sampling t-test using SPSS 11.0. The following results were obtained: 1. The measured angles of patient's both hip joints were significantly smaller than the control group's. 2. In the males group, The angles of patients' both hip joints were smaller than the controls'. In the females group, The angles of patients' both hip joints were smaller than the controls'. In conclusion, this study demonstrates that there is a significant difference in the tightness of the iliopsoas muscles when comparing the patient group with the control group. We should therefore pay more attention in releasing the muscle tightness of iliopsoas muscles when performing physical therapy with patients with lower back pain.

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The Effect of Alternative Medicine on Quality-of-Life Outcomes for Dementia Patients: A Systematic Review and Meta-Analysis

  • So Young, Lee;In Chul, Jung;Eun, Cho
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.4
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    • pp.401-424
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    • 2022
  • Objectives: As effective treatments for dementia are lacking in Western medicine, complementary and alternative medicine (CAM) is considered a useful option. While the quality of life (QoL) is a vital outcome for patients with dementia, the QoL of patients receiving CAM for dementia remains ambiguous. This study aimed to determine the effect of CAM on QoL outcomes in dementia patients. Methods: A search was performed using the keywords "dementia," "Alzheimer's," "cognitive impairment," "Chinese," "Korean," "oriental," "herbal," "acupuncture," and "quality of life". All quantitative data were synthesized using R version 4.1.1. Results: Twenty-five randomized controlled trials (RCTs), 16 pre-post trials, and two cohort studies were selected for the systematic review. QoL in Alzheimer's disease (QOL-AD) (n=11, 25.6%) and geriatric QoL in dementia (GQOL-D, n=9, 20.9%) were the most utilized QoL instruments. Significant benefits in QoL were observed after receiving mind, body, combined mind and body, nursing, oriental medicine, and acupuncture therapies. In the meta-analysis, the combined effect was shown to significantly increase QOL-AD compared to before CAM interventions (standardized mean difference, SMD: 0.507; 95% confidence interval (CI), 0.191~0.824; p<0.01). The overall synthesized estimates in the GQOL-D showed a significantly improved QoL (SMD: 0.537, 95% CI: 0.238~0.837 p<0.01; one group; SMD: 1.465, 95% CI: 0.934~1.996, p<0.01). The seven studies assessing the cost-effectiveness of CAM reported uncertain outcomes. Conclusions: This study showed that CAM interventions benefited patients with dementia by improving their QoL. While additional standardized research is required, CAMs are suggested as effective clinical management for patients with dementia. They are also suggested as complementing therapies for these patients.

The effectiveness of group combined intervention using animal-assisted therapy and integrated elderly play therapy

  • Kil, Taeyoung;Kim, Hak-man;Kim, Minkyu
    • Journal of Animal Science and Technology
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    • v.61 no.6
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    • pp.371-378
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    • 2019
  • The purpose of this study was to investigate the effects of group combined intervention that combined animal-assisted therapy and integrated elderly play therapy on the depression, self-esteem, and emotional expression of geriatric patients residing in nursing homes. This was achieved by providing cognitive, physical, and emotional activities and social interaction at the same time. The group combined intervention method was applied to twelve elderly patients (six in the control group, six in the experimental group) aged 65 or older who live in a nursing home for the elderly in C province, from May 3, 2019 to June 21, 2019, for a total of 8 times (once a week, 50 minutes at a time). The quantitative evaluation was analyzed through SPSS 21.0 for comparison before and after the program was implemented, using the Korean version of the depression and the self-esteem scale. The qualitative evaluation compared emotional expression pre-test and post-test. The major results of the study were as follows: First, the group combined intervention was effective in reducing depression levels of the experimental group among the elderly patients. Second, it was effective in improving the self-esteem of the experimental group among the elderly patients. Third, it showed a significant difference in the emotional expression of the experimental group among the elderly patients. Therefore, it was found that group combined intervention reduces depression and improves self-esteem and emotional expression of the elderly. Based on these results, it is hoped that this study will be a cornerstone in the development of concrete programs for the benefit of elderly patients living in facilities.

Poor Sleep Quality and Its Effect on Quality of Life in the Elderly with Late Life Depression (노년기 우울증 환자의 수면의 질 저하가 삶의 질에 미치는 영향)

  • Choe, Jin Yeong;Park, Joon Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.21 no.2
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    • pp.74-80
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    • 2014
  • Objectives More than half of the elders suffer from chronic sleep disturbances. Moreover, sleep disturbances are more prevalent in patients with depressive disorder than in community dwelling elderly. In this study, we aim to estimate the risk factors of poor sleep quality and its effect on quality of life in patients with late life depression. Methods This study included 159 depressive patients aged 65 years or older who completed Pittsburgh Sleep Quality Index (PSQI). A global PSQI score of 5 or greater indicates a poor sleeper. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview (MINI). Depression was evaluated by the Korean form of Geriatric Depression Scale (KGDS). Global cognition was assessed by Mini-Mental State Examination in the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet. Quality of life was evaluated by the Korean version of Short-Form 36-Item Health Survey (SF-36). Results The frequencies of poor sleepers were 90.5% in major depressive disorder, 71.8% in minor depressive disorder, 47.1% in subsyndromal depressive disorder, and 73.0% in all types of depressive disorders. Multivariate logistic regression analysis indicated that female [odds ratio (OR) = 2.83, 95% confidence interval (CI) = 1.20-6.67] and higher KGDS score (OR = 1.13, 95% CI = 1.05-1.21) were risk factors of poor sleep quality in patients with late life depression. In the analysis of ANCOVA adjusted for age, gender, education and KGDS score, the mean scores of vitality mental health and mental component summary of SF-36 were lower in poor sleepers than in good sleepers. Conclusions Poor sleepers among patients with late life depression are very common and are associated with female and higher KGDS scores. Poor sleep quality causes a significant negative effect on mental health quality. So researchers and clinicians should be more vigilant in the evaluation and treatment of sleep disturbances in patients with late life depression.

The Differences of Serum Homocysteine Levels in Mild Cognitive Impairment and Dementia of Alzheimer's Type with or without Depressive Symptoms (경도인지장애, 알쯔하이머형 치매 환자에서 우울증상 유무에 따른 혈중 호모시스테인의 차이)

  • Hwangbo, Ram;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.40-45
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    • 2014
  • Objectives : Mild cognitive impairment(MCI) and dementia of Alzheimer's type(AD) are characterized by progressive decline of cognitive abilities and a wide range of neuropsychiatric symptoms like depression. Among various diagnostic tools of AD, many studies showed that elevated levels of serum total homocysteine are associated with increased risk of developing Alzheimer's disease, depression and other neuropsychiatric disorders. We investigated whether elevated homocysteine concentrations are associated with depressive symptoms in MCI and AD. Methods : A total of 86 patients diagnosed with MCI or AD participated. Total serum homocysteine levels in fasting blood samples were measured. We examined cognitive symptoms by MMSE-KC, Global Deterioration Scale(GDS), Clinical dementia rating(CDR) and depressive symptoms by Korean version of Geriatric Depression Scale(K-GDS). Results : The total serum homocysteine levels were significantly higher in MCI with depression than in MCI without depression. There was no significant difference in the mean homocysteine levels between AD patients with depression and AD patients without depression. The total homocysteine levels showed a negative correlation with MMSE-KC and a positive correlation with CDR, GDS. Conclusions : These findings suggest that elevated homocysteine level is a risk factor for the decline of cognitive function and depression. We found a significant relationship between elevated serum homocysteine level and depressive symptoms in MCI. But our study had several limitations, thus more research is needed to confirm this finding.

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Effect of Sensory Activity-Based Cognitive Rehabilitation Group Program on Cognitive Function, Depression and Quality of Life of Dementia Patients Living in a Facility (감각활동기반 인지재활 그룹 프로그램이 시설거주 치매노인의 인지기능과 우울 및 삶의 질에 미치는 효과)

  • Lee, Hey-Sig;Yang, Min-Ah;Kim, Jung-Ran
    • Therapeutic Science for Rehabilitation
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    • v.12 no.3
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    • pp.79-88
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    • 2023
  • Objective : This study was to apply a cognitive rehabilitation group program based on sensory activity in patients with dementia living in a facility and to check its effectiveness on cognitive function, depression, and quality of life (QOL). Methods : Sensory-based cognitive rehabilitation group programs (20 sessions) were conducted for eight elderly with dementia over the age of 65 living in a nursing facility located in H-gun, Gangwon-do. The participants' cognitive function, depression level, and QOL were evaluated before and after the program. Results : The mean of Mini-Mental State Examination-Dementia Screening increased; however, there was no statistically significant difference. In contrast, the mean post-test score of the Subjective Memory Complaints Questionnaire decreased, and there was a statistically significant difference (p < .05). The mean post-evaluation score of Short Geriatric Depression Scale measured to confirm the decrease in depression compared to the pre-evaluation score, but there was no statistically significant difference. Finally, the mean post-evaluation score of the World Health Organization QOL assessment instrument-Brief confirmed the change in the QOL, and there was a statistically significant difference (p < .001). Conclusion : This study will provide the basis for suggesting the usefulness of developing a sensory activity-based cognitive rehabilitation group program for dementia patients living in facilities.