Purpose: The aims of this study were to identify the reported attitudes of older patients with cancer toward advance directives (ADs) and the factors associated with their attitudes toward ADs. Methods: The design was a cross-sectional survey. The age mean of the 130 participants were 70.8, and 66.2% of the participants were male. The data were collected at one university hospital in Seoul, South Korea during the period from October $1^{st}$ to December $5^{th}$ in 2013. The data collecting instruments were the Advance Directives Attitude Survey (ADAS) and questionnaires including socio-demographic and disease-related characteristics, family function. Results: 30.0% of the participants were aware of ADs, only 9% of them had been informed by healthcare providers. Most participants (93.1%) intended to complete ADs. The mean score of ADAS was 48.29. The stepwise linear regression analysis indicated that family function, perceived health status, period of education, and age accounted for a significant percentage (52.0%, p<.001) of the variance in participants' ADAS. The variable with the greatest effect was family function. Conclusion: The findings suggest that family function and attitude of older cancer patients need to be considered for adapting ADs to Korean health care systems. Healthcare providers should include family members in advanced care planning discussions.
Purpose: During hospitalization, confusion occurs in 15~20% of older adults and persists in 5~10% of them. This study was designed to investigate effects of a five-day nursing intervention program designed to reduce confusion in hospitalized older adults. Subjects were inpatients over the age of 60 years old and were admitted in a surgical care unit. Methods: Data were collected from 111 patients. Subjects divided into one of two groups, 58 patients of the control group which received the usual nursing care; and 53 patients of the intervention group which received the usual nursing care plus nursing intervention program for reducing acute confusion. The Delirium Observation Screening Scale (DOS) and the Korean Mini-Mental Screening Examination (MMSE-K) were utilized. Results: 1) Acute delirium was significantly reduced in the intervention group compared to the control group ($x^2$=4.22, p=.034) as well as the duration of the delirious state was significantly shortened (F=56.62, p<.001). Cognitive function of the intervention group was improved (F=21.14, p<.001). Conclusion: The nursing intervention program reduced the incidence and duration of acute delirium of the elderly inpatients, as well as it helps them keep better cognitive function than the control group.
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.
Background: Urothelial carcinoma (UC) is a malignant neoplasm that most commonly occurs in the urinary bladder. The primary aim of this study was to evaluate the clinicopathologic features, recurrence and progression in patients with bladder urothelial cancer. Materials and Methods: The medical records of patients diagnosed with UC in the state pathology laboratory between January 2006 and July 2014 were retrospectively included. Carcinomas were categorized according to age, gender, histologic grade, tumor configuration, pathologic staging, recurrence status, and progression. Results: A total of 125 (113 men, 12 women) patients were examined. The mean age was 65.9 years and the male-to-female urothelial cancer incidence ratio was 9.4:1. Low-grade UCs were observed in 85 (68%) and high-grade in 40 (32%). A papillary tumor pattern was observed in 67.2% of the UCs. Cases were classified with the following pathological grades: 34 (27.2%) cases of pTa, 70 (56%) of pT1, and 21 (16.8%) of pT2. Recurrence occurred in 27 (21.6%) patients. Ten progressed to a higher stage (pT1 to pT2), and three cases to higher grade (low to high). We also analyzed the results separately for 70 (56%) patients 65 years of age and older. Conclusions: With early detection and diagnosis of precursor lesions in older patients, by methods such as standard urologic evaluation, urinary cytology, ultrasound scanning and contrast urography, and cystoscopy, in addition to coordinated efforts between pathologists and urologists, early diagnosis may reduce the morbidity and mortality of patients with urothelial carcinoma.
Purpose: This study aimed to identify falls and related risks of hospitalized patients in order to provide an baseline data to develop effective nursing intervention programs for fall prevention. Methods: The data on 120 patients who experienced falls from 2010 to 2013 during their hospitalization were collected from the patient' electronic medical records of an university hospital. Data were analyzed with descriptive statistics using SPSS/WIN 20.0. Results: Over 60% of the patients who experienced falls during their hospitalization was 65 years or older, and most of them had hypertension. Majority of the subjects needed help to perform daily activities (64%) and complained of general weakness (49.2%). Prior to the falls, the patients were taking average 2.52 medications to treat hypertension. The Fall accident was mostly frequently occurred in their hospital room (59.2%), or in bed (44.2%). The patients aged 70 years and older were significantly less alert than younger group, and taking more cardiovascular medications. Most fall risk factors were not significantly different for age, gender, and department category. Conclusion: The study findings suggest the need to emphasize the nurses to be more actively aware of fall risk factors and to provide aggressive interventions for preventing falls in hospitalized patients.
Objectives : Periodontal disease is a serious oral disease that frequently occurs among adults. The objective of this study is to provide necessary data for the development of an oral health care program that can effectively manage periodontal disease and subsequently maintain and enhance oral health. Methods : Data was collected from patients of a dental clinic in Daejeon, Korea from 1 July to 25 August 2009. A thesis submitted to the Committee of Graduate School of Public Health & Biotechnology Chungnam National University in partial fulfillment of the requirements for the degree of Master of Public Health conferred in February, 2010. Results : 68% of the patients were aware of periodontal disease, with older patients exhibiting better awareness. 48.0% replied that their periodontal health is good in general, with older patients inclined to say that their periodontal health was poor. 70.5% cited bad brushing habit or skipping the act of tooth brushing as the cause of periodontal disease, while 63.5% reported brushing their teeth an average of 3 times a day. 56.5% said that they brush their teeth correctly, and 63.5% told that they brush their teeth up and down, and left to right and 70.0% replied that they would attend an educational program for the prevention of periodontal disease, with older patients shown to more likely attend such a program. Conclusion : a program that can motivate people to become aware of the importance of oral health care should be developed and implemented. Such a program should include the dissemination of correct and accurate oral health care information and measures for educating people about the importance of prevention.
Postherpetic neuralgia is frequently painful, incapacitating, mood depressing, and sometimes lifelong. We investigated the influence of duration from eruption to nerve blocks in conjunction with patients age on analgesic and preventive effect for postherpetic neuralgia. We retrospectively evaluated 50 outpatient medical records for the above T4 dermatome. Patients had been referred to pain clinic and were treated over 2weeks from Jan. 1988 to Dec. 1993. Fifty patients were divided into 4 groups as follows: Group I (a): less than 4weeks from eruption to nerve block and younger than 65 years old. Group I (b): less than 4weeks from eruption to nerve block and older than 65 years old. Group II (a): more than 4weeks from eruption to nerve block and younger than 65 years old. Group II(b): more than 4weeks from eruption to nerve block and older than 65 years old. Mean number of stellate ganglion blocks were 29.7. Tramadol, amitriptyline, nicardipine were most commonly prescribed. Group I (a): had the most improvement rate(77.8%) as compared with other group(46.6, 52.7, 56.0%). Number of patients who complained of severe pain (VAS > 5) were 0, 3(39%), 2(15.4%), 5(30%) in I (a), I (b), II (a), II (b) group respectively. In conclusion, analgesic effect was best in cases of patients younger than 65 years old whose treatment were started within 4 weeks of eruption. Patients older than 65 yrs, analgesic effect did not vary on the timing of treatment.
Purpose: The social environment of easy access to medicines and arbitrary personal decisions leading to overdose aggravate unintentional medicine poisoning. This study aimed to investigate the characteristics of patients who visited emergency departments with unintentional medicine poisoning and reasons for poisoning based on age group. Methods: We retrospectively collected patients who experienced unintentional medicine poisoning based on data from the national injury surveillance system between 2013 and 2016. Subjects were classified into three groups based on age (0-14 years, 15-64 years, and ${\geq}65\;years$). We identified sex, insurance, time of poisoning, place, alcohol co-ingestion, hospitalization, death, and reason for poisoning in each age group. Results: A total of 27,472 patients visited an emergency department with poisoning during the study period; 1,958 patients who experienced unintentional poisoning were enrolled in this study. Respiratory medicine was the most frequent medicine in those younger than 15 years of age, and sedatives and antipsychotic drugs were the most common in patients older than 15 years of age. In total, 35.1% of patients older than 65 years were hospitalized. The most common reasons for poisoning were careless storage of medicine in those younger than 15 years of age and overdose due to arbitrary decisions in those older than 15 years of age. Conclusion: Unintentional medicine poisoning has distinct characteristics based on age group, and strategies to prevent poisoning should be approached differently based on age.
Background : Palivizumab is an intravenous monoclonal antibody which is used in the prevention of respiratory syncytial virus (RSV) infection. It is currently recommended for infants who are at high-risk for RSV infections due to preterm birth or other medical conditions such as congenital heart disease. Palivizumab is a humanized monoclonal antibody directed against an epitope in the antigenic site A of the protein F of RSV particles. Palivizumab is given once a month via intramuscular (IM) injection throughout the duration of the RSV season. Since palivizumab is known to have preventive effects against RSV infection for children with older siblings, the insurance coverage for palivizumab was expanded in October 2016. Methods : The electronic medical records of children under 2 years old who have older siblings who visited or were admitted to the Severance Hospital from October 2015 to May 2016 and from October 2016 to May 2017 were reviewed retrospectively. The data were then divided into two groups depending on the pilivizumab administration. Results : A total of 67 patients were enrolled in this study. The effectiveness in the reduction of hospitalization was statistically significant (p=0.009). Palivizumab decreased respiratory symptoms such as cough, rhinorrhea, and fever in patients with older siblings (p 0.05). Conclusions : In this study, palivizumab administration was effective in preventing RSV infection in infants with older siblings. Expanding palivizumab-prophylaxis administration to infants with older siblings may be effective in the prevention of upper respiratory infections.
Background: To explore the safety, efficacy, and oncological outcome of 3-port laparoscopic radical cystectomy (LRC) compared to open radical cystectomy (ORC) in patients older than 75 years. Materials and Methods: From June 2010 to July 2014, we analyzed 16 radical cystectomies in patients older than 75 years (LRC group=8; ORC group=8). Demographic parameters, operative variables, and perioperative outcome in the 2 groups were retrospectively collected, analyzed, and compared. Results: Patients in both groups had comparable preoperative characteristics. A significantly longer operating time (476 vs. 303 min, P=0.0002) and less estimated blood loss (627 vs. 2,106 mL, P=0.021) were observed in the LRC group compared to the ORC group. Infection and ileus were the most common early complications after surgery. Patients who underwent ORC suffered from more postoperative infection (22.2% vs. 0.0%, P=0.054) and ileus (25.0% vs. 12.5%, P=0.521) than the LRC group, but the difference was not significant. Conclusions: Judging from this initial trial, 3-port LRC can be safely carried out in elderly patients. We suggest 3-port LRC as the primary intervention to treat muscle-invasive or high-risk nonmuscle-invasive bladder cancer in elderly patients with an otherwise relatively long life expectancy.
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