• 간호행정학회지
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• 제4권2호
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• pp.351-361
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• 1998

The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.

• 한국산학기술학회논문지
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• 제18권5호
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• pp.268-277
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• 2017

본 연구는 국민건강보험공단의 건강검진 및 장기요양인정조사 자료를 이용하여 100세 이상 고령자들의 신체적 및 정신적 건강수준을 알아보고, 그의 관련 요인을 규명해 보고자 시도하였다. 연구대상은 2011년부터 2014년까지의 기간 동안에 국민건강보험공단에서 시행하는 건강검진 및 장기요양인정조사를 받은 주민등록상의 100세 이상 고령자 268명(남성 132명, 여성 136명)으로 하였다. 연구결과, ADL에 영향을 미치는 요인으로는 성별, 거주 지역, IADL, 인지기능장애 및 치매가 유의한 변수로 선정되었으며, IADL에 영향을 미치는 요인으로는 ADL과 인지기능장애가 유의한 변수로 선정되었다. 인지기능장애에 영향을 미치는 요인으로는 흡연상태, ADL 및 IADL이 유의한 변수로 선정되었으며, 치매에 영향을 미치는 요인으로는 성별, ADL이 유의한 변수로 선정되었다. 이상과 같은 연구결과는 조사대상자들의 신체적 건강(ADL, IADL) 및 정신적 건강(인지기능장애, 치매) 수준은 여러 인구사회학적 및 건강관련행위특성 변수에 따라 유의한 차이를 보이고 있으며, 특히 흡연, 음주 및 규칙적인 운동 등과 같은 건강관련행위특성이 좋지 않은 군은 좋은 군보다 신체적 및 정신적 건강수준이 저하되고 있음을 시사하고 있다.

• 대한간호학회지
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• 제39권5호
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• pp.741-750
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• 2009

Purpose: The purpose of this study was to identify the prevalence of cognitive impairment, behavioral problems, and the state of mental health for elderly Korean people who have been institutionalized. Methods: A cross-sectional, nationwide survey was performed using an anonymous questionnaire. The participants in this study were 2,521 institutionalized elderly Korean people. A proportional stratified random sampling method was employed. Results: 1) Elders admitted to subacute hospitals and long term care (LTC) facilities showed a higher level of cognitive impairment compared to elders admitted to acute care hospitals. 2) Elders confined in LTC facilities showed a higher level of behavioral problems compared to elders in acute or subacute hospitals. 3) Elders admitted to subacute hospitals and LTC facilities showed more serious mental health problems, such as depression or suicidal ideation, compared to elders in acute care hospitals. Conclusion: The results of this study indicate that the severity of cognitive-behavioral or mental health problems do not match well with type of care setting. Therefore, health personnel working with elderly people should be provided guidance on detection and management of cognitive-behavioral and mental health problems. The necessity of a decision support system for eligibility and placement in long-term care is also discussed.

• 한국학교ㆍ지역보건교육학회지
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• 제24권4호
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• pp.27-37
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• 2023

Objectives: The purpose of this study was to investigate the effect of handgrip strength level on cognitive impairment in hypertensive patients. Methods: This study used the first to eighth year data of the Korean Longitudinal Study of Aging (KLoSA). Of the 10,254 respondents who participated in the basic survey, respondents were included that they were diagnosed with high blood pressure and had no cognitive impairment. The handgrip strength was based on the highest value of handgrip strength for both hands. Cognitive function using MMSE results and 23 points or less were defined as cognitive impairment. Cox models were conducted to estimate the hazard ratios (HRs) of cognitive impairment in relation to handgrip strength adjusting for covariates. Results: In the case of hypertension patients, the probability of cognitive decline decreased by 3.0% every time the maximum handgrip strength increased by 1 unit. In the analysis by age, under the age of 64 had a 1.8% decrease in the probability of cognitive decline whenever the maximum handgrip strength increased by 1 unit, and a 3.6% decrease in those over the age of 65. In the gender analysis, male had a 3.2% decrease in the probability of cognitive decline for every 1 unit increase in the maximum handgrip strength, and female had a 2.6% decrease. Conclusions: The results of this study are expected to be used as basic data for the development of interventions to prevent cognitive decline in hypertensive patients by identifying the effect of handgrip strength level on cognitive decline. It is also expected to be used as basic data for health education on the necessity of increasing muscle strength for hypertension patients in the community.

• 대한간호학회지
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• 제39권5호
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• pp.622-631
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• 2009

Purpose: This study was conducted to analyze the factors that influence the life satisfaction of the elderly according to their cognitive impairment level. Methods: This study was conducted by dividing 3,012 elderly residents of a regional community into three groups based on the scores of the Korean version of the Mini-Mental State Examination: a normal group without any cognitive impairment, a suspicious group with a mild level of cognitive impairment, and a high risk group with a high level of cognitive impairment. Researchers made phone calls, house calls, and personal visits to health centers and shelters for the elderly to gather the information required for this study. Results: The results of this study revealed that social relationships, depression, and activities of daily living had a significant impact on life satisfaction for the normal group, while social relationships and depression had a high impact on life satisfaction for the suspicious group, and social relationships had high impact on the life satisfaction of the high risk group. Conclusion: Based on the results of this study, we suggest that programs that promote development of the social relationship networks of the elderly should be established to promote their life satisfaction.

• 산업보건소식
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• 제36호
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• pp.17-20
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• 1986

• 한국직업건강간호학회지
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• 제19권2호
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• pp.159-169
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• 2010

Purpose: This is a descriptive study to provide basic material that enables to prevent industrial hospital nurses from occupational stress, health problems and work impairment by understanding their work environment, stress, Presenteeism and correlation among them. Method: The subjects for this study consists of 272 industrial hospital nurses who have attended the training conducted by KAOHN from October to December 2009 and recognized the purpose of this study and agreed to participate. The questionnaire included Korean Version of Occupational Stress questionnaire developed by S.J. Chang and Stanford Presenteeism Scale questionnaire translated by Y.M. Lee. The data were analyzed using descriptive statistics, t-test, ANOVA, Scheff$\acute{e}$ test and Pearson's correlation coefficient with SPSS/WIN 17.0. Result: The industrial hospital nurses get much more stress than the average in three fields of occupational stress: interpersonal conflict, job insecurity and occupational climate. The study shows in particular, the age group of twenties with one to three year work experience having higher than any other groups in occupational stress, work impairment and perceived productivity of Presenteeism. Conclusion: It is necessary to develop management for these groups of nurses. In addition, institutional support and policy should be rendered to secure job conditions so that occupational stress can be relieved from these nurses and to prevent work impairment in advance as occupational stress has substantial correlation with health problems, work impairment and perceived productivity of Presenteeism.

• Journal of Preventive Medicine and Public Health
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• 제40권2호
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• pp.162-168
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• 2007

Objectives : This prospective population-based cohort study was conducted to evaluate the risk factors of cognitive impairment and the degree of cognitive function change through a 5-year follow-up. Methods : The baseline and follow-up surveys were conducted in 1998 and 2003, respectively, Among 176 subjects who had normal cognitive function in the baseline study, 136 were followed up for 5 years. The cognitive function was investigated using the Korean version of the Mini-Mental State Examination (MMSE-K). The collected data were analyzed using SPSS and Stata. Results : Of the 136 subjects analyzed, 25 (18.4%) were cognitively impaired. Old age and low social support in the baseline survey were risk factors for cognitive impairment after 5 years. In the generalized estimating equation for 128 subjects except severe cognitive impairment about the contributing factors of cognitive function change, the interval of 5 years decreased MMSE-K score by 1.02 and the cognitive function was adversely affected with increasing age, decreasing education and decreasing social support. Conclusions : Although the study population was small, it was considered that the study results can be used to develop a community-based prevention system for cognitive impairment.

• Journal of Preventive Medicine and Public Health
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• 제26권3호
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• pp.412-429
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• 1993

For the purpose of promotion of mental health in the rural elderly, the author surveyed 558 elderlies aged 60 years or more, and assessed the prevalence rates of depression and cognitive impairment by using self-rating depression scale of Zung (SDS) and the Korean version of mini-mental state examination (MMSEK). Also the association between depression or cognitive function and socio-environmental factors were investigated. The major findings were as follows ; 1. The prevalence rates of severe depression and cognitive impairment were 20.9% and 14.9% in all the elderly of both sexes, respectively. 2. The rates of depression and cognitive impairment increased with increasing age in both sex groups. The mean scores of SDS increased and the mean scores of MMSEK decreased significantly among them (p<0.01). 3. Those being female, widows or widowers, and those having low levels of physical activity, showed significantly high the mean scores of depression and had significantly low the mean scores of cognitive impairment (p<0.01). 4. The depression scores relating to decreased libido, confusion, psychomotor retardation, hopelessness and indecisiveness were relatively high in both sexes. 5. All the items of mini-mental state examination were significantly correlated with depression. 6. In stepwise multiple regression analysis on depression, MMSEK, level of physical activity, chronic disease, marital status and family income were selected as highly correlated variables, and the $R^2$-value for these variables was 33.7%. 7. In stepwise multiple regression analysis on cognitive function, level of physical activity, age, depression, sex and marital status were selected as highly correlated variables, and the $R^2$-value for these variables was 62.6%. The depression and cognitive impairment of the elderly were positively correlated with nearly all sociodemographic variables.

• Safety and Health at Work
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• 제14권4호
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• pp.445-450
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• 2023

Background: The impact of COVID-19 infection on workers' work function persists even after the acute phase of the infection. We studied this phenomenon in Japanese workers. Methods: We conducted a one-year prospective cohort study online, starting with a baseline survey in December 2020. We tracked workers without baseline work functioning impairment and incorporated data from 14,421 eligible individuals into the analysis. We estimated the incidence rate ratio for new onset of work functioning impairment due to COVID-19 infection during follow-up, using mixed-effects Poisson regression analysis with robust variance. Results: Participants reporting infection between January and December 2021 showed a significantly higher incidence of new work functioning impairment (adjusted incidence rate ratio: 2.18, 95% confidence interval: 1.75-2.71, p < 0.001). The formality of the recuperation environment correlated with a higher risk of work functioning deterioration in infected individuals (p for trend <0.001). Conclusion: COVID-19-infected workers may continue to experience work difficulties due to persistent, post-acute infection symptoms. Companies and society must urgently provide rehabilitation and social support for people with persistent symptoms, recognizing that COVID-19 is not just a transient acute infection.