• 제목/요약/키워드: Stroke elderly

검색결과 179건 처리시간 0.028초

Benefits of Surgical Treatment for Unruptured Intracranial Aneurysms in Elderly Patients

  • Jang, E-Wook;Jung, Jin-Young;Hong, Chang-Ki;Joo, Jin-Yang
    • Journal of Korean Neurosurgical Society
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    • 제49권1호
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    • pp.20-25
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    • 2011
  • Objective: Due to longer life spans, patients newly diagnosed with unruptured intracranial aneurysms (UIAs) are increasing in number. This study aimed to evaluate how management of UIAs in patients age 65 years and older affects the clinical outcomes and post-procedural morbidity rates in these patients. Methods: We retrospectively reviewed 109 patients harboring 136 aneurysms across 12 years, between 1997 and 2009, at our institute. We obtained the following data from all patients: age, sex, location and size of the aneurysm(s), presence of symptoms, risk factors for stroke, treatment modality, and postoperative 1-year morbidity and mortality. We classified these patients into three groups: Group A (surgical clipping), Group B (coil embolization), and Group C (observation only). Results: Among the 109 patients, 56 (51.4%) underwent clipping treatment, 25 (23%) patients were treated with coiling, and 28 observation only. The overall morbidity and mortality rates were 2.46% and 0%, respectively. The morbidity rate was 1.78% for Clipping and 4% for coiling. Factors such as hypertension, diabetes mellitus, hypercholesterolemia, smoking, and family history of stroke were correlated with unfavorable outcomes. Two in the observation group refused follow-up and died of intracranial ruptured aneurysms. The observation group had a 7% mortality rate. Conclusion: Our results show acceptable favorable outcome of treatment-related morbidity comparing with the natural history of unruptured cerebral aneurysm. Surgical clipping did not lead to inferior outcomes in our study, although coil embolization is generally more popular for treating elderly patients, In the treatment of patients more than 65 years old, age is not the limiting factor.

가족, 간병인, 간호사가 인지하는 노인요양보호사 교육의 중요도 (The Level of Importance on Education of long Term Care Nursing Assistants Perceived by Caregivers of the Elderly)

  • 조남옥;고성희;김춘길;양수;오경옥;이숙자;정유진
    • 한국간호교육학회지
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    • 제14권1호
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    • pp.127-137
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    • 2008
  • Purpose: This study aimed to explore the level of importance perceived by caregivers of elderly on the education of long term care nursing assistants (LTCNAs) taking care of elders with dementia or stroke. Method: Data was collected from 296 participants (112 families, 98 NAs, and 86 RNs) from October 2006 to February 2007. A structured questionnaire was used for data collection. Result: The item of 'attitude while caring for the aged' was identified as most important. The family group reported that 'position change' and 'understanding of geriatric diseases' were the most important for education, while LTCNAs, highly identified, 'bathing', and 'bed sheet change'. The RNs group regarded 'position change', and 'bathing' as most important. Institutions demanding LTCNAs' activities were special facilities for elderly care and special hospitals for the aged, and the need was also high in families with an elder incapacitated by illness. Conclusion: Nurses need to take an interest in education for enhancing the quality of LTCNAs and thus advance the quality of nursing care as well as the quality of life for the aged.

Issues and Directions in Developing Nutrition Education for Older Adults in Korea

  • Kim, Kyung-Won
    • Journal of Community Nutrition
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    • 제2권1호
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    • pp.71-84
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    • 2000
  • This paper presents the status of nutrition education for older adults in Korea, and examines considerations in developing effective nutrition education programs for the elderly based on literature reviews. Finally, strategies of nutrition education for older adults in Korea are examined. Status of nutrition education were examined by surveying 90 senior centers, and 46 public health centers providing nutrition services. Most senior centers(96%) provided health education programs, however, nutrition was only a part of health programs. Among the 41 public health centers which responded to the survey, 73.1% provided nutrition education for older adults. The frequently covered topics were prevention & management of hypertension/stroke, diabetes, nutritional management during later adulthood, and osteoporosis. Common barriers in planning and implementing elderly education were; lack of educational materials for older adults, reliance on lectures, difficulty in following-up. To develop effective nutrition education, four stages consisting of needs assessment, planning and implementation of programs, and evaluation should be carefully done. Needs assessment might be done using quantitative or qualitative assessment. Factors influencing nutrition behavior of older adults can be systematically examined using a theoretical approach such as the PRECEDE-PROCEED framework. Qualitative methods, such as focus group interviews, also provide insightful information regarding the needs of older adults. In planning nutrition education programs, physical and pshychological changes associated with aging should be considered. Literature regarding elderly education suggest that active participation or participatory learning is also effective for older adults. Educational materials are developed following the principle of KISS and pre-tested. Program evaluation has been rarely done in practice, although it provides valuable feedback to the program. Strategies for developing nutrition education for Korean elderly include; performing needs assessment, developing a standard program by topics in a logical and systematic way, developing programs for subgroups of elderly, applying diverse education methods developing educational materials for the elderly, evaluating programs using simple tools, and delivering a nutrition program as a part of health promotion program. Finally, the interaction and communication between researchers and practitioners is strongly recommended to ensure better nutrition education and services to the elderly.

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노인들의 걷기 운동과 건강관련 변인과의 관계 (The Relationship of Health-related Variables with Regular Walking Exercise in the Elderly based on: The Korea National Health and Nutrition Examination Survey(KNHNES))

  • 최연희;이춘지
    • 한국보건간호학회지
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    • 제27권1호
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    • pp.5-15
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    • 2013
  • Purpose: The purpose of this study was to determine factors related to regular walking exercise in the elderly using KNHNES data. Method: The study subjects, a total of 1437 adults over age 65, were classified into two groups based on their type of walking exercise: regular walking exercise group or irregular walking exercise group. The study variables were measured using scale physiological function, mental health status, chronic disease and quality of life. Results: The data was analyzed by $x^2$-test, t-test, and logistic regression using the SPSS 18.0 program. The factors related to regular walking exercise were male (OR=0.628, 95%CI=0.503-0.783), subjective health state (OR=0.832, 95%CI=0.751-0.921), thoughts of suicide (OR=0.753, 95%CI=0.586-0.967), hypoHDL-cholesterolemia (OR=0.742, 95%CI=0.591-0.930), and stroke (OR=0.604, 95%CI=0.366-0.997). Conclusion: The findings indicate that regular walking exercise in the elderly is related to physiological function, mental health status, and chronic disease. Therefore, providing for the education and awareness of health promotion for the elderly will may improve the quality of life in old age.

일개 노인요양병원의 피난안전성능 평가에 관한 연구 (A Study on the Evaluation of Evacuation Safety Function of an Elderly Care Hospital)

  • 김종범;김자옥;백은선
    • 한국화재소방학회논문지
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    • 제24권3호
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    • pp.9-19
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    • 2010
  • 최근 우리나라는 노인요양병원이 꾸준히 증가하고 있으며 화재등과 같은 비상 상황에서 노인의 행동 특성과 신체 상태를 고려한 종합적인 피난계획의 수립이 요구된다. 또한 시설 이용자의 대부분이 중증의 치매 및 뇌졸중을 앓고 있는 환자이기 때문에 자력으로 피난이 곤란하고 환자의 보행상태(침대, 휠체어, 각종 보조기구) 등에 따라 피난시간이 상이하여 이용자 전원을 피난시키는 것이 어렵기 때문이다. 본 논문은 성능위주의 설계 시 참고가 될 자료를 제시하기 위해 의료시설인 노인요양병원을 모델로 여러 수집된 자료들로 Simulex를 이용하여 피난시간을 측정하였다. 이 연구의 과정에서 몇 가지 문제시 되는 사항을 발견할 수 있었다.

동작관찰훈련이 뇌졸중 환자의 상지운동기능에 미치는 영향 : 다중기초선연구 (The Effect of Action Observation Training on Upper Motor Function in Stroke Patients : A Multiple Bbaseline Design)

  • 윤태원;박혜령;김태윤;이문규
    • PNF and Movement
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    • 제12권2호
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    • pp.123-132
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    • 2014
  • Purpose: The discovery of mirror neuron system may positively affect functional recovery; therefore, rehabilitation is needed that is practical for use in clinical settings. The purpose of this study was to examine the effect of action observation training on upper motor function in people who had suffered strokes. Methods: Three elderly patients with stroke, aged to years, were recruited from a stroke rehabilitation center. A nonconcurrent, multiple baseline subject approach was taken, with an A-B-A treatment single-subject experimental design, and the experiment was conducted for 3 weeks. The action observation training was repeated 5 times in 5 days during the intervention period. The arm function, including WMFT, BBT, and grip and pinch strength, was evaluated in each subject 5 times during the baseline period, the intervention period, and the baseline regression period. Results: The results of the evaluation for each subject were presented as mean values and video graphs. The WMFT scores of 2 subjects were improved during the intervention period in comparison with the baseline period, and this improvement was maintained even during the regression baseline period. The BBT and the grip and pinch strength were not improved. Conclusion: Based on these results, we suggest that the action observation training for 5 sessions was effective in improving upper limb function of stroke patients but was not effective in improving hand dexterity or grip and pinch strength.

65세 이상 노인들의 순환기계 질환 의사 진단 여부에 따른 주관적 구강건강과 구강관리 행태 (Subjective Oral Health and Oral Care Behavior of Elderly People Over 65 According to the Diagnosis of Circulatory Diseases)

  • 박충무;윤현서
    • 대한통합의학회지
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    • 제10권4호
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    • pp.35-47
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    • 2022
  • Purpose : As the number of patients with systemic diseases is increasing in the old, the relevance of oral health is gaining particular research interest. To provide fundamental resources for dental services, this study examined the relationship between doctors' diagnoses of circulatory diseases and patients' awareness of oral health and oral care behaviors. Methods : SPSS 26.0 was used to assess various variables, including doctor's diagnosis of circulatory diseases, gender, age, household income quintile, participation in economic activity, marital status, subjective level of oral health awareness, mastication discomfort, speaking and chewing discomfort, dental inspection, use of oral care goods, teeth brushing during the previous day, and untreated oral conditions. Results : The circulatory diseases suffered by the subjects were as follows: 56 % high blood pressure, 36 % dyslipidemia, 6 % stroke, and 8 % myocardial infarction or angina. A higher age meant a higher diagnosis rate of high blood pressure (p<.001) and stroke (p<.001). Those with dyslipidemia showed a higher rate of receiving oral inspection (p=.040), and an untreated oral condition was more frequently observed among those not diagnosed with the disease (p=.035). The subjects who were not diagnosed with stroke showed a higher rate of oral inspection (p<.001), while those who had a prior experience of stroke suffered a higher rate of mastication discomfort (p=.020). People who had high blood pressure showed a lower rate of using oral care goods (p<.001), and those diagnosed with stroke showed a lower rate of brushing teeth the previous day. Conclusion : This study found a correlation between the diagnosis of circulatory diseases and the awareness of oral health and oral care behavior. Consequently, oral health education should be included in mental health-related education, and customized training to teach teeth brushing and the use of oral care goods should be provided to patients with circulatory diseases during dentist visits.

뇌졸중 환각에서 알렌인지수준과 일상생활활동, 인지기능 및 상지기능의 상관관계 (Correlation between ACLT and FIM, MMSE-K, and MFT in Stroke Patients)

  • 이상헌
    • 한국콘텐츠학회논문지
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    • 제9권9호
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    • pp.287-294
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    • 2009
  • 연구를 통하여 뇌졸중 환자에서 알렌인지수준과 인지기능, 일상생활활동 및 상지기능과의 상관관계를 분석하고자 하였다. 연구 대상자는 뇌졸중 환자 38명으로 인지기능은 알렌인지주순검사(Allen Cognitive Level Test) 와 한국형 간이 정신상태검사(Mini-Mental Screening Exam-Korea)로, 일상생활활동은 기능적독립성측정(Functional Independence Measure)로, 뇌졸중 상기 기능은 뇌졸중 상지기능검사(Manual Function Test)로 검사하였다. 피어슨 상관관계 분석을 이용하여 상관관계를 분석하였다. 알렌인지수준과 한국형 간이정신상태검사, 기능적독립측정, 뇌졸중 상기기능검사 간에 상관관계가 유의하였다(p<.05). 본 연구에서는 알렌인지수준 검사와 일상생활활동과의 상관성 및 인지평가도구로서의 유용성을 제시하였고 편마비 환자 적용에 있어 문제의 가능성과 이에 따른 연구 필요성을 제기하였다.

요양시설 거주 뇌졸중 노인을 위한 연하 훈련 프로그램의 효과 (Effects of Swallowing Training Program for Nursing Home Residents with Stroke)

  • 김해숙;임경춘
    • 근관절건강학회지
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    • 제30권3호
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    • pp.230-241
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    • 2023
  • Purpose: This study aimed to verify the effects of a swallowing training program on swallowing function and depression for nursing home residents with dysphagia after stroke. Methods: This is a quasi-experimental study with non-equivalent control group pre-post test design. The program (oro-facial muscle strengthening exercises, swallowing exercises, expiratory muscle strengthening exercises, and brain stimulation exercises) applied to the experimental group three times per week for eight weeks, 40-45 minutes for each intervention. The final data from 42 people (21 experimental and 21 control) were analyzed by SPSS/WIN 25.0 using descriptive statistics. 𝜒2 test, t-test, Wilcoxon rank sum test, and Friedman test. Results: The experimental group was significantly improved than control group in oro-facial muscle strength, swallowing symptoms (Z=-2.22, p=.026), and oral intake function level (Z=-2.00, p=.046). However, there was no significant difference between two groups in depression. Conclusion: This study is meaningful in that it reorganized and mediated a swallowing training program as a safe, non-invasive exercise that nurses can implement in a nursing facility with limited medical personnel and it could be easily followed by older adults.

뇌졸중 후유증으로 나타나는 간질환자 치험 1례 (A Case Report of the Poststroke Seizure)

  • 이정호
    • 척추신경추나의학회지
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    • 제1권1호
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    • pp.27-33
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    • 2006
  • Objectives : This report is about a case of a patient who improvement in general condition, Infection and dysphagia after poststroke seizure. Methods : We observed a patiet who received treatment in hospital because of stroke sequelae. Her symptoms were left hemiplegia, right hemiparesis, dysphagia, dyspnea, sputum and general weakness, and acupunture and herb medicine were applied. Results : Stroke is the most common cause of seizures in the elderly. The impact of late onset GTC(generalized tonic-clonic) seizures is associated with worse outcomes. Conclusion : The patient of this case was attacked by intracerebal hemorrhage, cerebaral infarction and GTC seizures. Since then her neurologic disorder was progressed. As the treatments of the patient, herb medication and acupuncture therapy were applied and she got a wide improvement of dysphagia, dyspnea, URI sign and general condition.

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