• Title/Summary/Keyword: elderly care

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Esophagectomy for Esophageal Cancer in Elderly Patients Over 70 Years of Age (70세 이상의 식도암 환자에시 식도절제술 및 재건술)

  • Song Suk-Won;Lee Hyun-Sung;Kim Moon Soo;Lee Jong Mog;Zo Zae Ill
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.428-433
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    • 2005
  • Advanced age in Esophagectomy increases the risk of postoperative morbidity and mortality. However, the recent development of operative technique and perioperative care might have decreased the postoperative morbidity and mortality after esophagectomy. Material and Method: From March 2001 to July 2004, 174 patients underwent esophageal resection for esophageal cancer in the Center for Lung Cancer, National Cancer Center. The patients were divided into two groups : group 1 consisted of 27 patients aged 70 years or more, and group 2 consisted of 147 patients under 70 years of age. The two groups were compared according to preoperative risk factors, postoperative morbidity, operative mortality and survival. Result: The mean age was 63_4. There were 159 men. On histopathological examination, $93.1\%$ had squamous cell carcinoma. On the locations, $78.7\%$ were in mid and lower esophagus. Curative resections for esophageal cancer were possible in $162(93.1\%)$ patients. Mean hospital stay was 19.4 days with out difference between the groups. The overall postoperative morbidity were occurred in 61 patients $(35.1\%)$. The most frequent morbidity was pulmonary complication in $30(17.2\%)$. Preoperative incidence of hypertension, cardiac and pulmonary dysfunction were more common in Group I. However, there was no difference in overall postoperative morbidity, operative mortality and survival rate between the two groups. Conclusion: Esophagectomy for esophageal cancer could be carried out safely in patients over 70 years of age with satisfactory short-term results. Advanced age is no longer a risk factor for esophagectomy.

A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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The Factors Affecting the Population Outflow from Busan to the Seoul Metropolitan Area (지역별 수도권으로의 인구유출에 영향을 미치는 요인 연구: 부산시 사례를 중심으로)

  • LIM, Jaebin;Jeong, Kiseong
    • Land and Housing Review
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    • v.12 no.2
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    • pp.47-59
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    • 2021
  • This study aims to review the trends of the population outflows in the metropolitan area of Busan and to investigate the factors that affect population out-migration to the Seoul metropolitan area. The following variables are considered for analysis: traditional population movement variables and quality of life variables, such as population, society, employment, housing, culture, safety, medical care, greenery, education, and childcare. The 'domestic population movement data', provided by the MDIS of the National Statistical Office, was used for this research. Out of the total of 57 million population movement data in the period 2012 - 2017, population outmigration from Busan to the Seoul metropolitan area was extracted. Independent variables were drawn from public data sources in accordance with the temporal and spatial settings of the study. The multiple linear regression model was specified based on the dataset, and the fit of the model was measured by the p-value, and the values of Adjusted R2, Durbin-Watson analysis, and F-statistics. The results of the analysis showed that the variables that have a significant effect on population movement from Busan to the Seoul metropolitan area were as follows: 'single-person households', 'the elderly population', 'the total birth rate', 'the number of companies', 'the number of employees', 'the housing sales price index', 'cultural facilities', and 'the number of students per teacher'. More positive (+) influences of the population out-movement were observed in areas with higher numbers of single-person households, lowers proportions of the elderly, lower numbers of businesses, higher numbers of employees, higher numbers of housing sales, lower numbers of cultural facilities, and lower numbers of students. The findings suggest that policies should enhance the environments such as quality jobs, culture, and welfare that can retain young people within Busan. Improvements in the quality of life and job creation are critical factors that can mitigate the outflows of the Busan residents to the Seoul metropolitan area.

An Analysis of Infrastructure and Provision of Forest Welfare Service in Nursing Homes for the Elderly (노인요양시설의 산림복지서비스 인프라 및 제공 실태)

  • Lee, Insook;Kim, Sungjae;Bang, Kyung-Sook;Yi, Yunjeong;Kim, Miju;Moon, Hyojeong;Yeon, Poung Sik;Ha, Ei-Yan;Chin, Young Ran
    • The Journal of the Korean Institute of Forest Recreation
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    • v.22 no.4
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    • pp.59-69
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    • 2018
  • This is a cross-sectional study that suggests ways to activate forest welfare services (FWS) by investigating the infrastructure, service status, and perception on FWS in Korea. In August 2016, a structured email survey was conducted in nation widely. The respondents were mostly directors and general secretary (75.0%). The considerable number (16.3%) of nursing homes (NH) use some floors of the complex buildings that would be difficult to have FWS infrastructure and about 30% of those without forests near the facilities. The directors of NH recognize that FWS has positive effects on the elderly. However, FWS is not an requisite of the longterm care insurance benefit, and so costly and effort-intensive that FWS has not been activated so far. In order to activate FWS in NHs, it is necessary to develop and disseminate the guidelines on FWS that anyone can easily followed. In addition, when the National Health Insurance Corporation evaluates NHs, they should evaluate not only whether there is a wandering or walking space, but also whether it has forest healing factors such as forests. It is also necessary to create a barrier-free environment both inside and outside of NHs, increasing accessibility to the toilet in gardens, paving a passage for wheelchairs and lifts in forests near NHs. Through these efforts, it is expected that FWS will be activated to provide physical, mental rest and comfort, appropriate cognitive stimulation to the NH residents at the end of life.

Comparision of experiences of caring parent-in-law in Korean families among daughters-in-law from Korea, China and Japan (한국, 중국, 일본 며느리의 한국에서의 부양 경험)

  • Kim, Yun-Jeong
    • Journal of Digital Convergence
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    • v.12 no.8
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    • pp.501-513
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    • 2014
  • The purpose of this study was to examine experiences of caring parents-in-law in Korea among daughters-in-law who are currently caring their parents-in-law while living with them, or have experienced such care-giving, and who have been married for at least 5 years. Daughters-in-law this study deals with are from three countries: Korean women, Chinese and Japanese women who immigrated to Korea by getting married with Korean husbands. To find out those women who can express their experiences clearly, this study used an intentional sampling method where this study asked the Multicultural Family Support Center to recommend five Chinese and five Japanese housewives who matched the following qualifications: those who have experiences of caring their parents-in-law at home, who have lived in Korea for at least five years, and who had no difficulty in expressing their opinions in Korean language. Korean married women were recommended by the neighbors. This study conducted in-depth interviews to those 15 housewives from Korea, china, and Japan. Before doing the interview, this study gave explanation of the contents and aims of this study to those interview participants over phone, and got the written consent from each of the women. To analyze the interview data, Colaizzi's phenomenological method was used. The emergent themes identified in the findings were as follows: 'positive perception of traditional nature of filial duty', 'help and encouragement by those who are nearby', 'exhausting marriage life', 'Korean family culture that is hard to adapt to', and 'unreasonable male-focused patriarchal culture.'

Research on the Actual State of Environmental Disease and Health Education at Middle and High School Students (일 지역 중.고등학생들의 환경성 질환 및 보건교육 실태 조사)

  • Jung, Jong-Hyeon;Moon, Ki-Nai;Seo, Bo-Soon;Kim, Chang-Tae;Lee, Jae-Hong
    • The Journal of Korean Society for School & Community Health Education
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    • v.12 no.3
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    • pp.65-87
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    • 2011
  • Objectives: The purpose of this study was to perform basic study on environmental and respiratory diseases in Ulsan and vicinities. Also, this study evaluated the actual state of environmental disease and health education at middle and high schools in Ulsan and surroundings. Methods: For this study, we conducted a survey on the health of the general public, environmental effects, and investigated the characteristics of environmental disease, health and hygiene education, etc. The populations of this study were middle and high school students in Ulsan, Korea. This study investigated the knowledge of environmental disease and health education at schools in Ulsan and vicinities from November 2009 to December 2009. All statistical calculations were performed with Statistical Package for Social Sciences (SPSS) for Windows, and gained the following results by implementing Frequency Analysis, Cross-tabulation Analysis and ANOVA. Results: As more and more environmental diseases are increased, the interest of the people has been increasing on this. The incidence rates of asthma and atopy were represented the top 25% of the country in Korea. The source of heavy metal, PAHs and VOCs in Ulsan includes the Petrochemical Complex at Nam-gu and Ulju-gun, the Nonferrous Metal Industrial Complex at Onsan-eup, Ulju-gun, and the Heavy Industrial Complex at Dong-gu and Buk-gu. Especially, there are a number of fossil fuel combustion facilities such as waste incineration plants and boilers at Nam-gu and the Onsan Industrial Complex. It may help greatly to investigate the characteristics of environmental pollutants such as environmental air pollutant and indoor contaminant to better manage the local student's health. Conclusions: It has been revealed that the hazardous chemicals and environmental contaminants are main substances of cause for asthma, atopy, dermatitis, and allergy disease. Therefore, through with collecting basic data such as environmental disease of inhabitants, health education, conscious and knowledgeable level in parents of students and students, We have to exert to improve knowledge and prevention with health life in school through development of health education program systematically for preventing of environmental disease.

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Trends and Issues in Social Geography in the 2000s in S. Korea: (2) Empirical Researches (2000년대 한국 사회지리학의 경향과 논제들 -(2) 경험적 연구들-)

  • Choi, Byung-Doo
    • Journal of the Korean Geographical Society
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    • v.47 no.5
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    • pp.735-754
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    • 2012
  • Korean society in the 2000 has experienced new many social and spatial issues such as the process of neoliberalism and changes in urban and spatial policies, the development of information and communication technology and reconfiguration of informational social space, radically increasing foreign immigrants and transformation to multicultural society, global warming and environmental injustice, and these new issues have promoted development of social geography in Korea. In addition to a review on them, this paper provides a review on empirical researches on traditional issues which have been dealt with in social geography in the 2000 in Korea. Even though there have been numerous sub-issues, they can be divided into two categories: one is urban and communal social geography including urban housing and residential segregation, urban social problems such as poverty, crime, education, health care, social welfare, urban and rural community building, identity, sense of place, and social movement; the other is social geography of population and migration, including population movement, aged society and social welfare for elderly people, and foreign immigrants and formation of multicultural social space. As some difficult conditions such as path-dependent process of neoliberalism, transformation toward informational, aged, and multicultural society would continue, so social geography in Korea to tackle with these external conditions should deepen its theoretical insights and widen its research issues.

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Geographic information system (GIS) analysis on the distribution of patients visiting at a dental college hospital: a pilot study (Geographic information system (GIS) 이용한 대학치과병원에 내원하는 환자들의 공간적 분포의 분석)

  • Joo, Hyun-Tae;Jeong, Byung-Joon;Cho, In-Woo;Shin, Hyun-Seung;Lim, Mi-Hwa;Park, Jung-Chul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.4
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    • pp.283-293
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    • 2015
  • Purpose: The aims of this study are to analyze and to visualize distribution of patients visiting at a dental college hospital, using geographic information system (GIS). The visualized data can be utilized in patient care and treatment planning, ultimately leading to the assessment of risk evaluation and prevention of dental diseases. Materials and Methods: Patient information data was obtained from Dankook University Dental Hospital including the unit number, gender, date of birth, and address from 2007 to 2014. Patient distribution was visualized using GIS. Statistical analyses were performed using SAS 9.3 and ArcGIS 10.1. Five factors including proximity, accessibility, age, gender, and socioeconomic status were investigated as the explanatory variables of the patient distribution. Results: The visualized patient data showed a nationwide scale of the patient distribution. There was a little difference in characteristics for each department. As closer at Dankook University Dental Hospital, visitors increased. And it strongly showed that elderly patients in rural areas tend to visit more. Conclusion: The distribution of patients has been shown to be significantly affected by the proximity, accessibility, age, gender and socioeconomic status. The underlying reason remains to be further studied.

Child Health Behaviors and Health Education about Atopic Dermatitis in Ulsan Area (울산지역 초등학생들의 아토피 피부염과 천식 관련 생활습관과 보건교육 실태)

  • Moon, Ki-Nai;Jung, Jong-Hyeon;Pae, Hyang-Sun;Seo, Bo-Soon;Joo, Dong-Jin
    • The Journal of Korean Society for School & Community Health Education
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    • v.11 no.1
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    • pp.135-148
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    • 2010
  • Objectives: In this study, knowledge of environmental disease, experience of environmental health education and necessity of environmental health education of elementary school pupils were compared and analyzed. Methods: The population of this study was from grade 1 to 6 elementary school pupils in Ulsan city, Korea. Five elementary schools were randomly selected from Ulsan City. Seven hundred and twenty-eight responses from the five schools were analyzed (seventy-two were excluded). A self-administered questionnaire measuring sociodemographic variables, Knowledge of environment related disease(atopic dermatitis, asthma etc), as well as educational experience and necessity of environmental health education was analyzed. The survey results were analyzed using SPSS-PC Program 12.0 and the following results by implementing Frequency Analysis, Cross-tabulation Analysis and ANOVA are as follows. Result: Pupils of lower grades more informed than those of higher grades about atopic dermatitis. Among asthma sufferers, many responded that symptoms occurred or improved during the lower grades of elementary school. In terms of the lifestyles of patients with atopic dermatitis or asthma, female pupils, especially those in the lower grades, tended to make changes in their daily habits based on their disease. Also, parents tended to intervene/mediate more in the dietary habits and personal hygiene habits of lower-grade pupils compared to their higher-grade counterparts. Personal hygiene education is currently not provided in schools, and upper-grade pupils have more experience with personal hygiene education compared to lower grade pupils. 430 (59.0%) of pupils replied that education about personal hygiene is necessary in their curriculum. 490 (67.3%) of elementary pupils are aware of the close connection between education in hygiene and human health. When asked if education in hygiene should also be undertaken by teachers and parents, 406 (55.7%) students said that it should be done. Conclusions: Developing a concrete health education program and raising instructors' awareness of the necessity for education in hygiene. Placement of professionals in the personal hygiene education field, is important to provide good health education for elementary school pupils.

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Projections of Demand for Cardiovascular Surgery and Supply of Surgeons

  • Lee, Jung Jeung;Park, Nam Hee;Lee, Kun Sei;Chee, Hyun Keun;Sim, Sung Bo;Kim, Myo Jeong;Choi, Ji Suk;Kim, Myunghwa;Park, Choon Seon
    • Journal of Chest Surgery
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    • v.49 no.sup1
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    • pp.37-43
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    • 2016
  • Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.