Purpose: The purpose of this study was to determine whether poor preoperative nutritional status in elderly patients exhibited a negative influence on postoperative clinical outcomes. Methods: The medical records of 645 elderly patients were examined retrospectively. The patients had undergone major surgery between January 2017 and January 2018. Their nutritional status was measured using the Nutritional Risk Screening 2002. The data were analyzed using the chi-squared test, the Mann-Whitney U test, logistic regression, linear regression, Cox proportional hazards regression, and the Kaplan-Meier analysis. Results: Preoperative malnutrition was found in 73 patients (11.3%). Poor preoperative nutritional status was significantly associated with pressure ulcers, length of hospitalization, discharge to patient care facilities rather than home, and mortality rate at three months. Conclusion: Preoperative malnutrition in elderly patients was associated with negative postoperative clinical outcomes. These results indicate that an effective nutritional program before surgery can lead to a more rapid postoperative recovery.
This study was carried out in order to examine the health status of arthritis patients living in K city of southern part of Korea. The data were collected with AIMS2 instrument from 56 subjects who were asked to complete the questionnaire by the trained surveyor. The AIMS2 has been approved useful instrument for assessing the outcome of various treatments and programs in rheumatic diseases. The component variables of the AIMS2 are Mobility, Walking and Bending, Hand and finger function, Arm function, Self-care tasks, Household tasks, Social activity, Support from family and friends, Arthritis pain, Work, Mood, Level of tension, The total number of items of AIMS 2 are 78. The results are as follows: The average age of the subjects was 58 years old and no gender difference. The mean scores of the 12 sub-concepts of AIMS2 are 15.0 of mobility, 12.16 of walking and of bending, 9.32 of hand and finger function, 9.03 of arm function, 13.53 of self-care tasks, 10.19 of household tasks, 15.09 of social activity, 19.58 support from family and friends, 13.82 of arthritis pain, work, 14.85 of level of tension, 15.12 of mood. The Cronbach Cronbach $\alpha$. is 0.72-91 for RA patients and 0.74-96 for OA patients. This results showed that the health status of Arthritis patients at home in K-city was almost not so serious, but the level of tension and mood were quite higher than the average score. Considering the results of this particular subjects, an appropriate rehabilitation program should be developed and implemented.
Purpose: Many home care treatments can be used to promote the health and longevity of dental implants; however, few studies are available to support the concept that self-performed oral hygiene behaviors are an essential tool for improving and maintaining oral health. We investigated age-stratified associations between dental health behaviors related to tooth brushing (TB) and oral hygiene product use in Korean adults with implants. Methods: A total of 1,911 subjects over 19 years of age who had 1 or more implants and who participated in the 2013 to 2015 Korea National Health and Nutrition Examination Survey were reviewed. Periodontal status was assessed using Community Periodontal Index (CPI) scores, and periodontitis was defined as a CPI greater than or equal to 3. The complex sampling design of the survey was utilized to obtain the variance and individual weight of each analyzed factor. A high CPI was the outcome variable, and the main explanatory variables were oral hygiene behaviors, such as TB, dental floss (DF), interproximal brushing, and mouth rinsing. Results: Almost all individuals with a lower CPI brushed their teeth twice or more per day, in contrast to those with a higher CPI, and were likely to use DF. The adjusted odds ratio of not using DF for a higher CPI was 1.83 (95% confidence interval, 1.35-2.49). Conclusions: TB was implemented more than twice a day by patients with good oral health, and the combination of TB and DF significantly reduced the prevalence of a higher CPI. Self-performed oral hygiene practices combining TB and DF were significantly related to a low prevalence of periodontitis in implant patients.
The gynecologic oncology patients surveillance network program was conducted with the collaboration of 5 provincial hospitals located in the north of Thailand (Chiang Rai, Lamphun Nan, Phayao and Phrae). The aim was to identify ways of reducing the burden and the cost to the gynecologic cancer patients who needed to travel to the tertiary care hospital for follow up. The clinical data of each patient was transferred to the provincial hospital by the internet via the website www.gogcmu.or.th. All the general gynecologists who participated in this project attended the training course set up for the program. From January 2011 to February 2014, 854 patients who were willing to have their next follow-up at the network hospitals close to their home were enrolled this project. Almost of them were residents in Chiang Rai province and the most common disease was cervical cancer. After the project had been running for 1 year, 604 of the enrolled patients and 21 health-care personnel who had participated in this project were interviewed to assess its success. Some 85.3% of the patients and 100% of the health-care personnel were satisfied with this project. However, 60 patients had withdrawn, the most common reason being the lack of confidence in the follow up at the local provincial hospital. In conclusion, it is possible to initiate a gynecologic oncology patients' surveillance network program and the initiation could reduce the problems associated with and the cost the patients incurred as they journeyed to the tertiary care hospital.
Hyun, Min Kyung;Jung, Kyung Hae;Yun, Young Ho;Kim, Young Ae;Lee, Woo Jin;Do, Young Rok;Lee, Keun Seok;Heo, Dae Seog;Choi, Jong Soo;Kim, Sam Yong;Kim, Heung Tae;Hong, Seok-Won
Asian Pacific Journal of Cancer Prevention
/
제14권12호
/
pp.7309-7314
/
2013
Aim: To investigate factors that affect the place of death (POD) of terminal cancer patients. Materials and Methods: We recruited 702 consecutive patients (${\geq}18$ years) from 12 centers during July 2005 to October 2006, and 481 completed the questionnaire. In April 2011, we linked the data for 96.0% (n=462) of the deceased patients to the POD using the 2005-2009 death certificate data of Korea's National Statistical Office. The primary outcome variable was POD, and the predictive value of variables pertaining to patients and caregivers was evaluated using univariate and multivariate analyses. Results: Most patients died in a hospital (91.5%, n=441) and age, education, preference for place of terminal care, wish to use hospice/palliative care services, terminal cancer awareness, time between diagnosis and death, and global quality-of-life subscale of the EORTC QLQ-C30 of patients, and education and preference for place of terminal care of caregivers were significant predictors in univariate analyses. On multivariate analysis, patients and caregivers who preferred hospital/palliative care as the terminal care option over home care [adjusted odds ratio (aOR), 2.68; 95% confidential interval (CI), 1.18-7.04 and aOR: 2.65; 95%CI: 1.15-6.09 for patient and caregiver preferences, respectively] and caregivers who were highly educated (aOR, 3.19; 95%CI, 1.44-7.06) were predictors of POD. Conclusions: Most of the terminal cancer patients died in a hospital. Our findings indicate that major predictors of hospital deaths are preference of both the patient and caregiver for hospital/palliative care as the terminal care option and higher education of the caregiver.
Purpose: This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model. Methods: This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24. Results: In the final model, admission via emergency department (Β=.06, p=.019), age over 65 years (Β=.11, p=.001), unconsciousness (Β=.18, p=.001), dependent activities (Β=.12, p=.001), abnormal vital signs (Β=.12, p=.001), pressure ulcer risk (Β=.12, p=.001), enteral nutrition (Β=.12, p=.001), and use of restraint (Β=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (Β=.06, p=.038), hospital length of stay (Β=5.06, p=.010), and discharge to another facility (not home) (Β=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium. Conclusion: The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.
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.
Purpose: To exam how functional status varied according to age, gender, stage, treatment protocols, and pathologic types of cancer in lung cancer patients. Method: A Cross-sectional and descriptive study was used. Functional status was measured with the Medical Outcome Study Short Form-36. A total of 106 lung cancer patients participated. Their mean age was 61 years. Majorities were male, in advanced stages, and receiving chemotherapy. Result: Functional status of the subjects were relatively low compared to the results of previous studies. Women had more severe functional limitations in Role-Emotion(t=2.17, p <.05). Generally, older patients(> 60 yrs.) had relatively more severe limitations in all subcategories, but the difference was not statistically significant. Subjects in late lung cancer stage(stage III & IV) had more severe functional limitation in all subcategories. But the statistical difference was found only in General Health(t=2.10, p<.05). In terms of treatment protocol, no-current treatment group had lower General Health than those of the chemotherapy group(F=3.42, p<.01). There were no statistical differences in functional status among pathological cancer cell types. Conclusion: The results of this study suggest that effective management may be achieved when these factors are considered on individual basis in the clinical management of lung cancer patients.
The relationship between perceived social support and adaptation to maternal role for first-time mothers was investigated in this descriptive correlational study. A nonprobable sample of 90 first-time mothers were selected, who had uncomplicated perinatal experiences and delivered healthy and term newborns as well. The data was collected during a home interview at 4-6weeks postpartum. The outcome of adaptations was defined as the level of sensitivity in parent-infant interactions and of the self confidence in infant care. The perception of social support in the primiparous was assessed by the NSSQ during the postpartum. The results obtained from this study are summarized as follows : 1. The mean score of the perceived total functional support was $116.6{\pm}37.5$ points (affective : 38.1 affirmative : 39.3, aid : 39.3), and the score of the total network support was $45.2{\pm}13.9$ points (size : 4.9, duration :19.8 frequency : 20.4). These scores tended to be slightly low. 2. The mean score of the self confidence on the infant care activity as the subjective aspect of the maternal role adaptation (MRA) was 56.5 points (86.9%), whereas that of the sensitivity of the mother-infant interaction of the MRA was 78.9 points (63.2%). 3. The subjective aspect of the MRA has showed a positive relation ship with the aid dimension of the functional support. And the objective aspect of the MRA also showed a positive relationship with the total functional support and the total network support. However the correlating degrees were slightly low. In conclusion, the primiparous mothers perceived that they had received a small amount of social support during the postpartum period, suggesting the need of various kinds of social support to promote the MRA for the primiparous.
The purpose of this article was to identify trend in Arthritis research and to provide ba an approach of Arthritis research. The results of analysis of 69 Arthritis articles public year of between 1970-1999 found that most articles(27.6%, n=19) were published since few(10.1%, n=7) were before 1994. Vast majority of articles(79.8%, n=55) were printed in The Journal of Rheumatology Health, and 79.8%(n=55) of those were quantitative research, 8.7%(n=6) were qualitative research, and 14%(n=1) was methodological research. 29.0%(n=20) of quantitative research were carried in experimental design and over half(50.8%, n=35) in nonexperimental design. Having concerned the types of treatment(or intervention) used in experimental study, the most common treatment was 'exercise' (45.0%, n=9), and other less common were 'self-help education(15.0%, n=3), home care(10.0%, n=2) supportive care(10.0%, n=2), flexibility exercise combined with local heat therapy(5.0%, n=1), relaxation training(5.0%, n=1). Of the types of exercise, aquatic exercise was 30.0%(n=6). The effect of exercise on outcome variable was found to be most strong among the other types of treatment. 18 articles of nonexperimental research were correlational research. From the analysis of correlational research, 29 concepts were identified, and the relationship between depression and other variable were strongly reported. In descriptive studies, most commonly physiological variables were examined in 5 articles(29.5%). Only one study(5.9%) explored patient's perception of the causal factors and those causality. In qualitative researches, two study were carried out by the means of grounded theory. Majority of those subjects were RA patients, and the largest number of sample were 23 and the smallest was 1 In two studies, patient's perceived causality of RA was identified as a research problems, and an experience of ADL, fatigue Phenomenon, an experience of having a total knee replacement with osteoarthritis were each found in one study. Methodological research was carried out to test validity and reliability of the RA Fatigue Scale.
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