• Title/Summary/Keyword: Geriatric patients

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Analyzing the Problem of the Caregiver Education System through a Research of the Caregiving Service Activity (요양보호 서비스 활동 조사를 통한 요양보호사 교육과정의 문제점 분석)

  • Suh, Tae-Soo;Kim, Kyong-Tae;Jun, Kyoung-Hee
    • The Journal of Korean Physical Therapy
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    • v.20 no.4
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    • pp.61-69
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    • 2008
  • Purpose: We evaluated caregivers' understanding of patients' diseases and disuse syndrome, the understanding of exercise and massage related to rehabilitation and the necessity of education about these, the difference in education and realities of the care-giving field, and the extra services needed in the field. Methods: The survey using questionnaires was performed from June 2008 to August 2008 with 220 people participated in caregive education programme in daegu city and area near dagu city. Among the 220 submitted questionnaires, 184 which were faithfully answered were selected and they were analyzed by i-STATistics statistical program. Results: The educational focus of the first and second level caregivers, as defined by the second clause of the 29th article of the Elderly Welfare law, is on basic knowledge of diseases such as dementia, stroke, and depression. However, other diseases are not covered and the information does not include information on decreased function, complications, functional rehabilitating exercises, or preventing disuse syndrome for long term patients. The most common diseases, in order of prevalence, are stroke, dementia, diabetes mellitus, Parkinson disease, arthritis, and geriatric inertness. The general level of awareness about disuse syndrome was low, and patients, while understanding the need for massage and rehabilitative exercise, receive little education about the proper methods and therefore cannot use them. Patients also did not understand how participating in these activities could reduce medical fees, indicating that further education on massage and rehabilitative exercise is needed. Caregivers desired to include positive rehabilitation, massage, and exercise-related services in their services. Finally, differences in caregiver education and reality resulted from a lack of diversity in education. Conclusion: We suggest providing education on disuse atrophy and improving the lack of diversity in the care-giving education system.

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Antitumor Activity of Chloroquine in Combination with Cisplatin in Human Gastric Cancer Xenografts

  • Zhang, Hui-Qing;Fang, Nian;Liu, Xiao-Mei;Xiong, Shu-Ping;Liao, Yu-Qian;Jin, Wen-Jian;Song, Rong-Feng;Wan, Yi-Ye
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3907-3912
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    • 2015
  • Purpose: To investigate the antitumor activity and mechanism of chloroquine (CQ) in combination with cisplatin (DDP) in nude mice xenografted with gastric cancer SGC7901 cells. Materials and Methods: 35 cases of gastric cancer patients with malignant ascites were enrolled and intraperitoneal cisplatin injection was performed. Ascites were collected before and 5 days after perfusion for assessment of autophagy levels in cancer cells. In addition, 24 tumor-bearing mice were randomly divided into control, DDP, CQ and CQ + DDP groups. Results: In 54.3% (19/35) of patients the treatment was therapeutically effective (OR), 5 days after peritoneal chemotherapy, 13 patients had the decreased ascites Beclin-1 mRNA levels. In 16 patients who had NR, only 2 cases had decreased Beclin-1 (P=0.001). Compared with the control group, the xenograft growth in nude mice in the DDP group was low, and the inhibition rate was 47.6%. In combination with chloroquine, the inhibition rate increased to 84.7% (P<0.01). The LC3-II/I ratio, and Beclin1 and MDR1/P-gp expression were decreased, while caspase 3 protein levels increased (P<0.05). Conclusions: Antitumor ability of cisplatin was associated with autophagy activity and chloroquine can enhance chemosensitivity to cisplatin in gastric cancer xenografts nude mice.

Effects of home-based cognitive and physico - occupational therapy program on cognitive function, depression and quality of life in dementia patients of a community (가정방문 인지 및 신체활동 작업치료 프로그램이 재가 치매환자의 인지, 우울 및 삶의 질에 미치는 효과)

  • Yoon, Hyun-Sung;Lee, Kang-Sook;Jeong, Won-Mee;Park, Yong-Jun;Park, Hanul
    • Korean Journal of Health Education and Promotion
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    • v.33 no.1
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    • pp.23-32
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    • 2016
  • Objectives: The aim of this study was to examine the effects of home-based cognitive physico-occupational therapy(HBCPOT) on cognitive function, depression, and quality of life in dementia patients, using a cognitive impairment model. Methods: The data was analysed for Mini-Mental State Examination-Korean version (MMSE-KC) for assessing cognitive function, Quality of life-Alzheimer's Disease (QOL-AD) and Geriatric Depression Scale (GDS) in 31 dementia patients who received home-based cognitive physico-occupational therapy for one hour once a week for 12 weeks by a trained occupational therapist at the Dementia Prevention and Management Center of Y-city during 20111-2013. Results: Among these 31 patients, 18(58.1%) were female, and 25(80.6%) had Alzheimer's Disease. After HBCPOT, the mean scores of MMSE-KC and QOL-AD were significantly improved, but GDS score was not significantly decreased. Conclusions: It was suggested that HBCPOT was effective in improving cognitive function and quality of life.

Effect of the Virtual Reality Cognitive Rehabilitation Program on Cognition Ability and Activities of Daily Living in Patients with Mild Cognitive Impairment (가상현실 인지재활 프로그램이 경도인지장애 환자의 인지능력과 일상생활동작에 미치는 영향)

  • Kang, Hyeok-Jun;Kim, Sang-Ryul;Kim, Jeong-Heon;Song, Dae-Heon;Yang, Ji-Eun;Chu, Mi-Ran;Lee, Hyun-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.4
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    • pp.155-161
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    • 2020
  • PURPOSE: This study investigated the effect of a head-mounted display (HMD) based virtual reality (VR) cognitive rehabilitation program on the cognitive ability and activities of daily living in patients with mild cognitive impairment. METHODS: This study enrolled 5 mild cognitive impairment patients at the G welfare center in Gwangju metropolitan city. Patients were examined using the MMSEDS (Mini mental state examination-dementia screening). The VR cognitive rehabilitation program was applied twice a week for four weeks. The functional independence measure (FIM) and Loewenstein occupational therapy cognitive assessment-geriatric population (LOTCA-G) were compared before and after applying the VR cognitive rehabilitation program. RESULTS: Subsequent of application of the VR cognitive rehabilitation program, significant increase was observed in the LOTCA-G score. The FIM score was also perceived to increase, after the intervention, but was not statistically significant. CONCLUSION: Application of the VR cognitive rehabilitation program as a therapy is effective in improving the visual perception, and upper extremity executive ability, especially orientation, thinking organization, attention, and concentration.

Effects on Turnover Intention due to Terminal Care Stress of Nurses Working in Long-term Care Hospitals (요양병원 간호사의 임종간호 스트레스가 이직의도에 미치는 영향)

  • Ha, Shin-young;Song, Jun-Ah
    • Journal of Korean Gerontological Nursing
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    • v.20 no.3
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    • pp.217-228
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    • 2018
  • Purpose: This study was done to examine the effect on turnover intention (TI) of terminal care stress (TCS) on nurses working in long-term care hospitals (LCH). Methods: Participants were 182 nurses from 6 Seoul LCH. Data were collected from October to December, 2017. Self-report questionnaires were used to collect data on general characteristics, TCS, and TI. Results: Subjective satisfaction on the job (r=.52, p<.001), number of monthly terminal care elders (r=.16, p=.043), TCS (r=.16, p=.027), and sub-categories of TCS, 'difficulty for assigning timetable to care for terminally ill patients' (r=.17, p=.025), 'feeling a burden of caring for terminally ill patients' (r=.23, p=.002), and 'conflict with terminally patients' (r=.16, p=.034) showed statistically significant correlation with TI. Multiple regression analysis showed significant influence of subjective satisfaction with job (${\beta}=.52$, p<.001) and TCS (${\beta}=.23$, p=.001) with a 30.3% explanatory power. When sub-categories of TCS were entered, subjective satisfaction with the job (${\beta}=.50$, p<.001) and 'feeling burden of terminally ill patients' (${\beta}=.28$, p<.001) were factors significantly influencing TI with explanatory power of 32.8%. Conclusion: Findings of this study suggest that it is needed to develop standardized practice guidelines and educational programs for terminal care in LCH as well as stress healing programs for nurses.

The effects of a single-dose subacromial injection of a nonsteroidal anti-inflammatory drug in geriatric patients with subacromial impingement syndrome: a randomized double-blind study

  • Kim, Youngbea B;Lee, Woo-Seung;Won, Jun-Sung
    • Clinics in Shoulder and Elbow
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    • v.24 no.1
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    • pp.4-8
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    • 2021
  • Background: As nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids have similar effects, steroids can be avoided to reduce adverse effects. This study aimed to compare the differences in symptom improvement after subacromial injection of steroids or NSAIDs. Methods: Sixty patients with rotator cuff syndrome for at least 3 months were enrolled and divided into steroid and NSAID groups. The steroid group received a mixture of 1 mL of triamcinolone acetonide (40 mg/mL) and 1 mL of lidocaine hydrochloride 2%, while the NSAID group received a mixture of 1 mL of Ketorolac Tromethamine (30 mg/mL) and 1 mL of lidocaine hydrochloride 2%. The patients were assessed before and at 3, 6, and 12 weeks after the procedure. Shoulder scores from visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES), and University of California Los Angeles (UCLA) were used for evaluation. Results: Both groups showed improvements in the clinical outcomes. Overall VAS, ASES, and UCLA scores improved from 6.9, 32.7, and 16.0 before the procedure to 2.0, 1.2, and 1.1; 81.5, 87.6, and 88.5; and 29.7, 31.8, and 32.0 at weeks 3, 6, and 12 weeks after the procedure, respectively. Twenty-six patients (86.7%) in the steroid group and 28 (93.3%) in the NSAID group reported satisfactory treatment outcomes. There were no significant differences in the outcomes between the two groups (p=0.671). Conclusions: Subacromial injection of NSAIDs for rotator cuff tendinitis with shoulder pain had equivalent outcomes with those of steroid injection at the 12-week follow-up.

The Effect of Modified Constraint-induced Movement Therapy and Resistive Exercise Using Elastic Band with Pressure Belt on Affected Upper Limb Function in Stroke Patients (수정된 강제유도운동과 탄력밴드를 이용한 가압벨트 저항성 운동이 뇌졸중 환자의 상지 기능에 미치는 효과)

  • Kim, Tae-gon;Kim, Kyung-yoon;Bae, Sea-hyun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.3
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    • pp.25-36
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    • 2021
  • Background: This study aimed to investigate the effect of modified constraint-induced movement therapy (mCIMT) and resistive exercise using elastic band with pressure belt on improving upper extremity function in stroke patients. Methods: Sixteen patients with stroke were randomly assigned to a control group that received mCIMT and resistive exercise using elastic band (n=8) and an experimental group that received mCIMT and resistive exercise using elastic band with pressure belt (n=8). Over the course of four weeks, mCIMT were conducted 60 minute three times per week and resistive exercise using elastic band (with pressure belt) were conducted twice daily, three times per week. The function of the upper extremities were evaluated before, after 2 weeks and 4 weeks using the grip strength test (GST), the box and block test (BBT), and motor activity log (MAL). Results: The values for the GST, the BBT, and MAL increased in both groups as the treatment period progressed. The values for the GST (p<.01), the BBT (p<.001), and MAL (p<.001) were significantly higher in the experimental group than in the control group at 4 weeks after initiating the treatment. Conclusion: We found that mCIMT and wearing a pressure belt during resistive exercise was very useful in improving the function of the upper extremities in patients with stroke.

Prevalence and factors associated with hyponatremia in older adults who visited emergency department (응급실을 방문한 노인 환자의 저나트륨혈증 유병률 및 위험인자 분석)

  • Kim, Geonnyeon;Shin, Sangmi;Suh, Yewon;Namgung, Hyungwook;Lee, Jeonghwa;Lee, Euni;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.2
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    • pp.67-73
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    • 2022
  • Objectives: Hyponatremia is prevalent electrolyte disorder and can be fatal in older adults. Evaluative studies on hyponatremia among older adults are scarce, especially targeting for those who visited emergency department (ED). We aimed to estimate the prevalence and to identify risk factors of hyponatremia among elderly patients visiting the ED. Methods: A retrospective chart review was completed including 65 or older patients who visited ED at Seoul National University Bundang Hospital from September to December 2019. Patients with the serum sodium concentration of less than 130mEq/L was defined as a hyponatremia group. Logistic regression analysis was conducted to assess predictive factors for hyponatremia. Results: Of the total 2,445 patients, 155 (6.3%) were confirmed to have hyponatremia at the time of ED visits. Risk factors for hyponatremia identified in logistic regression analysis were thiazides (aOR=2.64, 95% CI 1.66-4.21), opioids (exclude tramadol) (aOR=3.45, 95% CI 1.72-6.94), and desmopressin (aOR=6.98, 95% CI 2.45-19.84). Compared to the use of thiazides alone, it was confirmed that the possibility of hyponatremia was more than quadrupled when proton pump inhibitor (PPI) was used together (aOR=4.08, 95% CI 1.74-9.55). Conclusions: About 6.3% of older adults visiting the ED had hyponatremia. Age, number of medications taken, previous history of hyponatremia, heart failure, cirrhosis, pneumonia, sepsis, prescribed drugs including thiazides, opioids (exclude tramadol), or desmopressin or taking PPI together with thiazides was confirmed to correlate with the risk of hyponatremia.

Central Sarcopenia, Frailty and Comorbidity as Predictor of Surgical Outcome in Elderly Patients with Degenerative Spine Disease

  • Kim, Dong Uk;Park, Hyung Ki;Lee, Gyeoung Hae;Chang, Jae Chil;Park, Hye Ran;Park, Sukh Que;Cho, Sung Jin
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.995-1003
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    • 2021
  • Objective : People are living longer and the elderly population continues to increase. The incidence of degenerative spinal diseases (DSDs) in the elderly population is quite high. Therefore, we are facing more cases of DSD and offering more surgical solutions in geriatric patients. Understanding the significance and association of frailty and central sarcopenia as risk factors for spinal surgery in elderly patients will be helpful in improving surgical outcomes. We conducted a retrospective cohort analysis of prospectively collected data to assess the impact of preoperative central sarcopenia, frailty, and comorbidity on surgical outcome in elderly patients with DSD. Methods : We conducted a retrospective analysis of patients who underwent elective spinal surgery performed from January 1, 2019 to September 30, 2020 at our hospital. We included patients aged 65 and over who underwent surgery on the thoracic or lumbar spine and were diagnosed as DSD. Central sarcopenia was measured by the 50th percentile of psoas : L4 vertebral index (PLVI) using the cross-sectional area of the psoas muscle. We used the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight (K-FRAIL) scale to measure frailty. Comorbidity was confirmed and scored using the Charlson Comorbidity Index (CCI). As a tool for measuring surgical outcome, we used the Clavien-Dindo (CD) classification for postoperative complications and the length of stay (LOS). Results : This study included 85 patients (35 males and 50 females). The mean age was 74.05±6.47 years. Using the K-FRAIL scale, four patients were scored as robust, 44 patients were pre-frail and 37 patients were frail. The mean PLVI was 0.61±0.19. According to the CD classification, 50 patients were classified as grade 1, 19 as grade 2, and four as grade 4. The mean LOS was 12.35±8.17 days. Multivariate stepwise regression analysis showed that postoperative complication was significantly associated with surgical invasiveness and K-FRAIL scale. LOS was significantly associated with surgical invasiveness and CCI. K-FRAIL scale showed a significant correlation with CCI and PLVI. Conclusion : The present study demonstrates that frailty, comorbidity, and surgical invasiveness are important risk factors for postoperative complications and LOS in elderly patients with DSD. Preoperative recognition of these factors may be useful for perioperative optimization, risk stratification, and patient counseling.

Effects of the Group Reminiscence Program for Elderly with Dementia (집단회상프로그램이 치매노인의 우울에 미치는 영향)

  • Hong, Ki-Hoon;Ju, A-Young;Koo, Sung-Min;Kim, Yun-Wan;Jung, Hye-Rim
    • The Journal of Korean society of community based occupational therapy
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    • v.5 no.2
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    • pp.57-64
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    • 2015
  • Objective : This study shown that effects of the group reminiscence program for dementia elderly. Methods : In this study, dementia was divided into two groups who has used K Welfare Center of day care facilities located in Gimhae, the experimental group(14 patients) and control group(15 patients) was carried out by dividing the experiment twice a week, total of 12 times. Using the evaluation tool of Korea type elderly depression scale(Geriatric Depression Scale in Korea; GDS-K), the level of depression in the dementia was compared before and after. Results : Experimental group of GDS-K was pre-score was $20.8{\pm}1.4$ point, post-score was $13.5{\pm}1.7$ point so statistically significant decreased(z=-3.30, p<.0.5), Pre-score of controlled group is $20.9{\pm}2.3$ point post score was $21.0{\pm}2.6$ point, there was no statistically significant difference(p<.05). As a result of this study, the experimental group decreased depression than control group(p<.05). Conclusion : Through this study, it shown that reminiscence program help depression of dementia decreased. Therefore, reminiscence program that anyone can easily adapt is proposed as a method of reducing depression in dementia.