• Title/Summary/Keyword: Older patients

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Validity and Reliability of Korean Version of Older Patients in Acute Care Survey (한국어판 급성기 노인 환자 돌봄 측정도구의 타당도 및 신뢰도)

  • Kim, Jung-Min;Jeong, Hyo-Eun;Han, Jeong-Won
    • The Korean Journal of Health Service Management
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    • v.11 no.3
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    • pp.91-104
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    • 2017
  • Objectives : This study was a methodological study to verify the validity and reliability of the translated and modified Older Patients in Acute Care Survey-US (OPACS) tool, which was originally developed by Dikken and his colleagues. Methods : The OPACS was translated into Korean, and the content validity, composition validity, and reliability were verified using 348 nurses working for hospitals with over 200 beds and located in C city, B city, and K province. Results : The analysis showed that the Korean version of the OPACS had of eleven questions in the practice experience section and twelve in the general opinion section for older patients in the acute phase. Cronbach's ${\alpha}s$ were 0.84 for practice experience and 0.81 for general opinion. Conclusions : The study showed that the OPACS could measure the practice and opinion of Korean nurses who cared for elderly patients in the acute phase. The significance of the study was that it provided baseline data information regarding the performance and opinion of these nurses for nursing managers to improve the nursing environment.

Factors Influencing on Pressure Ulcer Incidence among Older Patients with Hip Fracture in a Hospital (고관절 골절로 입원한 노인 환자의 욕창 발생 위험요인)

  • Lee, Sun Jin;Jeong, Jae Shim;Lim, Kyung-Choon;Park, Eun Young;Kim, Hye Youn
    • Journal of Korean Biological Nursing Science
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    • v.21 no.1
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    • pp.54-61
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    • 2019
  • Purpose: This study aimed to identify the incidence and risks for pressure ulcer among older patients with hip fracture. Methods: The subject were 215 older patients suffering from hip fracture who were admitted for surgical operation from January 1, 2012 to April 30, 2016 in a university-affiliated hospital. The incidence of pressure ulcer was collected retrospectively through medical record review and the risk factors were analyzed using Cox's proportional hazard model. Results: Out of the total, 32 patients (14.9%) developed pressure ulcer with the average occurrence period being 4.72 (${\pm}3.81$) days. Stage II pressure ulcer was the most common at 72.0%. Risk factors included ambulation status before injury (p= .039), spinal anesthesia (p= .029), and stay at intensive care unit after operation (p= .009). Conclusion: Despite pressure ulcer prevention efforts, the incidence remained relatively high. Considering the identified risk factors, more efforts is needed for early detection and prevention of pressure ulcers in such patients.

Effectiveness of Helmet Cranial Remodeling in Older Infants with Positional Plagiocephaly

  • Kim, Hong Youl;Chung, Yoon Kyu;Kim, Yong Oock
    • Archives of Craniofacial Surgery
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    • v.15 no.2
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    • pp.47-52
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    • 2014
  • Background: Management of positional plagiocephaly by wearing a cranial molding helmet has become a matter of growing medical interest. Some research studies reported that starting helmet therapy early (age 5 to 6 months) is important and leads to a significantly better outcome in a shorter treatment time. The aim of the present study was to evaluate the effectiveness of cranial remodeling treatment with wearing helmet for older infants (${\geq}18$ months). Methods: We conducted a retrospective study of 27 infants with positional plagiocephaly without synostosis, who were started from 2008 to 2012. Every child underwent a computerized tomography (CT) before starting helmet therapy to exclude synostosis of the cranial sutures and had CT performed once again after satisfactory completion of therapy. Anthropometric measurements were taken on using spreading calipers in every child. The treatment effect was compared using cranial vault asymmetry (CVA) and the cranial vault asymmetry index (CVAI), which were obtained from diagonal measurements before and after therapy. Results: The discrepancy of CVA and CVAI of all the patients significantly decreased after cranial molding helmet treatment in older infants (${\geq}18$ months) 7.6 mm from 15.6 mm to 8 mm and 4.51% from 9.42% to 4.91%. Six patients had confirmed successful outcome, and all subjects were good compliance patients. The treatment lasted an average of 16.4 months, was well tolerated, and had no complication. Additionally, the rate of the successful treatment (final CVA ${\leq}5mm$) significantly decreased when the wearing time per was shorter. Conclusion: This study showed that treatment by cranial remodeling orthosis was effective if the patient could wear the helmet longer and treatment duration was somewhat longer than in younger patients, well tolerated in older infants and had no morbidity. This therapeutic option is available and indicated in these older infants before other cranial remodeling surgery.

Evaluation of Nutrition Education for Diabetes Mellitus Management of Older Adults (당뇨병 노인을 대상으로 한 영양교육의 효과 평가)

  • Kang, Hyun-Joo;Shin, Eun-Mi;Kim, Kyung-Won
    • Korean Journal of Community Nutrition
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    • v.14 no.6
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    • pp.734-745
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    • 2009
  • Diabetes mellitus is the prevalent disease among older adults. The purpose of this study was to implement and evaluate the nutrition education program for diabetes mellitus patients aged 60 and over. The one group pretest and posttest design was employed to evaluate the program effectiveness. Nutrition education program for diabetes mellitus patients was carried out at the public healthy center in Guri city. The 38 out of 63 patients completed education program. They received four sessions of group education during four weeks. Nutrition education materials (booklet, leaflet) for older adults were provided to participants. Data about blood glucose, blood pressure, nutrition and diabetes mellitus knowledge, dietary behavior, dietary intake by 24-hour recalls were collected before and after nutrition education to evaluate the program effectiveness. All data were statistically analyzed using SAS package (ver.8.2) and significant difference was evaluated by $X^2$-test, paired t-test and Wilcoxon signed rank test. Study results showed that blood pressure and blood glucose were slightly decreased after nutrition education but they did not reach statistical significance. There were positive changes in nutrition knowledge and dietary behavior. The total score of nutrition and diabetes knowledge increased significantly (p < 0.001), and the total score of dietary behavior was improved (p < 0.05) after nutrition education. Dietary intakes of most of nutrients examined were not significantly different between pre- and post-test. Based on study results, it appears that nutrition education program for the aged diabetes mellitus patients might effectively increase nutrition knowledge, dietary behavior and diet quality. This nutrition education program can be used at the public health centers or senior centers for the management of diabetes mellitus for older adults.

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.

Effects of Emotional Labor and Communication Competence on Geriatric Nursing-related Stress in Nurses Caring for Older Patients (노인 환자를 돌보는 간호사가 경험하는 감정노동과 의사소통능력이 노인간호 스트레스에 미치는 영향)

  • Nam, Hye Ri;Lee, Eun Ja;Heo, Ha Song
    • Korean Journal of Occupational Health Nursing
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    • v.29 no.1
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    • pp.20-28
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    • 2020
  • Purpose: The purpose of this study was to investigate the effects of emotional labor and communication competence on geriatric nursing in nurses-related stress in nurses caring for older patients. Methods: The sample consisted of 147 general hospital nurses. Data were analyzed through the SPSS/WIN 21.0 program using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression. Results: The factors of emotional labor (β=.38, p<.001)and positive communication competence (β=-.20, p=.021) had the greatest influence on the level of stress related to geriatric nursing in nurses caring for older patients. The total explanatory power was 20.3%. Conclusion: It was found that emotional labor and communication competence were influencing factors in the stress related to geriatric nursing. Therefore, to improve nurses' stress related to geriatric nursing, strategies to manage the emotional labor, and to strengthen and develop positive communication competence need to be developed.

Validation of the Korean Version of the General Practitioner Assessment of Cognition (K-GPCog) (한국형 실무자용 노인인지기능 사정도구(K-GPCog)의 신뢰도, 타당도 분석)

  • Park, Jee-Won;Kim, Yong-Soon
    • The Korean Journal of Rehabilitation Nursing
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    • v.13 no.1
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    • pp.5-12
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    • 2010
  • Purpose: The purpose of this study was to examine the psychometric properties of the Korean version of the General Practitioner Assessment of Cognition (K-GPCog) scale. Method: The K-GPCog consists of the 2 subscales, patients and caregivers. Using a sample of 412 community-based Korean older adults, internal consistency reliability was estimated using Cronbach's alpha. To evaluate validity of the K-GPCog, correlational analysis was conducted using Pearson r between K-GPCog and the Korean Dementia Screening Questionnaire (KDSQ). Results: Cronbach's alpha coefficients of the K-GPCog patients' and caregivers' subscales .788 and .794 respectively. Pearson's correlation coefficients were r=-.374, r=-.481, and r=-.493, respectively for the subscales of patients and primary caregivers, and total K-GPCog. The degree of diagnostic agreement about the risk for cognitive disorders of older adults showed 11.7% and 11.2% respectively for the K-GPCog and the KDSQ. Conclusion: The findings provided preliminary evidence of the K-GPCog as a useful screening measure for detecting mild cognitive disorders of Korean older adults. The K-GPCog is particularly useful to identify cognitive disorders from primary caregivers when it is difficult to assess the level of cognition of older adults.

Symptoms, Mood and Sleep Disturbance in Hemodialysis (혈액투석환자의 증상경험, 기분장애 및 수면장애)

  • Choi, Eun-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.13 no.2
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    • pp.105-113
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    • 2010
  • Purpose: The purpose of this study was to examine symptoms, mood and sleep disturbance in patients with hemodialysis. Method: A sample of 96 hemodialysis patients participated. Data were collected using symptom scale of hemodialysis patients, profile of mood state and the sleep scale. Statistical analytic methods included t-tes, ANOVA and Pearson correlation analyses. Results: Patients with spouse/partners experienced significantly less symptoms than those with no spouse (F=6.29, p=.003). Mood disturbance was not significantly correlated with age; but older patients experienced higher sleep disturbance (F=4.88, p=.010). Symptoms, mood and sleep disturbance are significantly related with each other. Conclusion: It is important to assess symptoms, mood and sleep disturbance in older hemodialysis patients with no spouse. It is needed to repeat extensive study and comparative study with other population in order to define clearly.

Patient and Hospital Characteristics of Long-Stay Admissions in Long-Term Care Hospitals in Korea (요양병원 장기입원 현황과 관련 노인 및 기관 특성 비교 연구)

  • Jeon, Boyoung;Kim, Hongsoo;Kwon, Soonman
    • Health Policy and Management
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    • v.26 no.1
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    • pp.39-50
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    • 2016
  • Background: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. Methods: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). Results: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. Conclusion: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.

Age-related Outcome of Arthroscopic Repair of Isolated Type II Superior Labral Anterior to Posterior Lesions

  • Kwon, Jieun;Kim, Yeun Ho;Yeom, Tae Sung;Oh, Joo Han
    • Clinics in Shoulder and Elbow
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    • v.18 no.1
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    • pp.36-42
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    • 2015
  • Background: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. Methods: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged ${\geq}40years$. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. Results: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. Conclusions: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.