• Title/Summary/Keyword: geriatric medical center

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Perception and practice of hospital infection control in nurses of geriatric hospital : for convergent approach (노인요양병원 간호사의 병원감염관리에 대한 인지도 및 실천도: 융복합적 접근 방안 모색)

  • Lee, Deok-Ja;Ko, Sung-Hee;Lee, Young-Hee
    • Journal of Digital Convergence
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    • v.13 no.11
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    • pp.461-470
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    • 2015
  • This study was to identify the level of perception and practice of hospital infection control among nurses at geriatric hospitals for the convergent approach. Data were collected from October 29 to November 3, 2012, using hospital Infection control questionnaire. Data analysis was performed using a t-test, ANOVA and Correlation. The mean values of hospital infection control practice were lower than that of perception, the differences were statistically significant. There were statistically significant differences in the perception on age, education, existence of guidelines for infection control, and in the practice according to the existence of guidelines. There was a statistically significant positive correlation between perceptions of hospital infection control and practice. Therefore, it is necessary to provide continual opportunities for systematic, professional, and practical education, as well as to develop relevant programs aimed at improving the capacity of hospital infection control.

CT-Based Leiden Score Outperforms Confirm Score in Predicting Major Adverse Cardiovascular Events for Diabetic Patients with Suspected Coronary Artery Disease

  • Zinuan Liu;Yipu Ding;Guanhua Dou;Xi Wang;Dongkai Shan;Bai He;Jing Jing;Yundai Chen;Junjie Yang
    • Korean Journal of Radiology
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    • v.23 no.10
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    • pp.939-948
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    • 2022
  • Objective: Evidence supports the efficacy of coronary computed tomography angiography (CCTA)-based risk scores in cardiovascular risk stratification of patients with suspected coronary artery disease (CAD). We aimed to compare two CCTA-based risk score algorithms, Leiden and Confirm scores, in patients with diabetes mellitus (DM) and suspected CAD. Materials and Methods: This single-center prospective cohort study consecutively included 1241 DM patients (54.1% male, 60.2 ± 10.4 years) referred for CCTA for suspected CAD in 2015-2017. Leiden and Confirm scores were calculated and stratified as < 5 (reference), 5-20, and > 20 for Leiden and < 14.3 (reference), 14.3-19.5, and > 19.5 for Confirm. Major adverse cardiovascular events (MACE) were defined as the composite outcomes of cardiovascular death, nonfatal myocardial infarction (MI), stroke, and unstable angina requiring hospitalization. The Cox model and Kaplan-Meier method were used to evaluate the effect size of the risk scores on MACE. The area under the curve (AUC) at the median follow-up time was also compared between score algorithms. Results: During a median follow-up of 31 months (interquartile range, 27.6-37.3 months), 131 of MACE were recorded, including 17 cardiovascular deaths, 28 nonfatal MIs, 64 unstable anginas requiring hospitalization, and 22 strokes. An incremental incidence of MACE was observed in both Leiden and Confirm scores, with an increase in the scores (log-rank p < 0.001). In the multivariable analysis, compared with Leiden score < 5, the hazard ratios for Leiden scores of 5-20 and > 20 were 2.37 (95% confidence interval [CI]: 1.53-3.69; p < 0.001) and 4.39 (95% CI: 2.40-8.01; p < 0.001), respectively, while the Confirm score did not demonstrate a statistically significant association with the risk of MACE. The Leiden score showed a greater AUC of 0.840 compared to 0.777 for the Confirm score (p < 0.001). Conclusion: CCTA-based risk score algorithms could be used as reliable cardiovascular risk predictors in patients with DM and suspected CAD, among which the Leiden score outperformed the Confirm score in predicting MACE.

The Clinical Impact of Advanced Age on the Postoperative Outcomes of Patients Undergoing Gastrectomy for Gastric Cancer: Analysis Across US Hospitals Between 2011-2017

  • Lee, David Uihwan;Fan, Gregory Hongyuan;Chang, Kevin;Lee, Ki Jung;Han, John;Jung, Daniel;Kwon, Jean;Karagozian, Raffi
    • Journal of Gastric Cancer
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    • v.22 no.3
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    • pp.197-209
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    • 2022
  • Purpose: This study systematically evaluated the implications of advanced age on post-surgical outcomes following gastrectomy for gastric cancer using a national database. Materials and Methods: The 2011-2017 National Inpatient Sample was used to isolate patients who underwent gastrectomy for gastric cancer. From this, the population was stratified into those belonging to the younger age cohort (18-59 years), sexagenarians, septuagenarians, and octogenarians. The younger cohort and each advanced age category were compared in terms of the following endpoints: mortality following surgery, length of hospital stay, charges, and surgical complications. Results: This study included a total of 5,213 patients: 1,366 sexagenarians, 1,490 septuagenarians, 743 octogenarians, and 1,614 under 60 years of age. Between the younger cohort and sexagenarians, there was no difference in mortality (2.27 vs. 1.67%; P=0.30; odds ratio [OR], 1.36; 95% confidence interval [CI], 0.81-2.30), length of stay (11.0 vs. 11.1 days; P=0.86), or charges ($123,557 vs. $124,425; P=0.79). Compared to the younger cohort, septuagenarians had higher rates of in-hospital mortality (4.30% vs. 1.67%; P<0.01; OR, 2.64; 95% CI, 1.67-4.16), length of stay (12.1 vs. 11.1 days; P<0.01), and charges ($139,200 vs. $124,425; P<0.01). In the multivariate analysis, septuagenarians had higher mortality (P=0.01; adjusted odds ratio [aOR], 2.01; 95% CI, 1.18-3.43). Similarly, compared to the younger cohort, octogenarians had a higher rate of mortality (7.67% vs. 1.67%; P<0.001; OR, 4.88; 95% CI, 3.06-7.79), length of stay (12.3 vs. 11.1 days; P<0.01), and charges ($131,330 vs. $124,425; P<0.01). In the multivariate analysis, octogenarians had higher mortality (P<0.001; aOR, 4.03; 95% CI, 2.28-7.11). Conclusions: Advanced age (>70 years) is an independent risk factor for postoperative death in patients with gastric cancer undergoing gastrectomy.

Effects of Good Death awareness and Spiritual Well-being on Elderly Nursing Performance of Geriatric Hospital Nursing providers (요양병원 간호제공자의 좋은 죽음인식, 영적안녕이 노인간호수행에 미치는 영향)

  • Song, Eun-Haeng;Lee, Hye-Kyung
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.3
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    • pp.975-984
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    • 2019
  • The purpose of this study was to investigate the good death awareness, spiritual well-being, and elderly nursing performance of geriatric hospital nursing providers, and the factors affecting the elderly nursing performance. The subjects were collected from 176 nursing providers in 5 Geriatric hospitals located in D, S, and C provinces. Collected data were analyzed by means, standard deviation, t-test, ANOVA, pearson correlation, and multiple regression analysis using spss 22.0. The result showed that good death awareness was 3.15 out of 4 points, spiritual well-being was 4.11 out of 6 points, and 4.15 out of 5 points for elderly nursing performance. There was a positive correlation between the elderly care performance and good death awareness (r=.19, p=.011) and spiritual well-being (r=.23, p=.002). The factors affecting the performance of elderly nursing were good death perception(${\beta}=.18$, p=.015) and spiritual well-being(${\beta}=.18$, p=.013). Based on the results of this study, it is necessary to develop an intervention program that considers good death and spiritual well-being in order to improve the elderly nursing care performance of geriatric hospital Nursing providers.

Diagnostic Tools for Alzheimer's Disease: A Narrative Review Based on Our Own Research Experience

  • So-Hee Park;Kyoung Ja Kwon;Min Young Kim;Jae-Hun Kim;Won-Jin Moon;Hui Jin Ryu;Jae Won Jang;Yeonsil Moon;K-ARPI
    • Dementia and Neurocognitive Disorders
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    • v.22 no.1
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    • pp.16-27
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    • 2023
  • Alzheimer's disease (AD), one of the most representative neurodegenerative diseases, has diverse neurobiological and pathophysiological mechanisms. Treatment strategies targeting a single mechanism have repeated faced failures because the mechanism of neuronal cell death is very complex that is not fully understood yet. Since complex mechanisms exist to explain AD, a variety of diagnostic biomarkers for diagnosing AD are required. Moreover, standardized evaluations for comprehensive diagnosis using neuropsychological, imaging, and laboratory tools are needed. In this review, we summarize the latest clinical, neuropsychological, imaging, and laboratory evaluations to diagnose patients with AD based on our own experience in conducting a prospective study.

Comparative Study on the Expertise, Convenience, and Interaction of Medical Treatment Systems Applied by Geriatric Hospital (요양병원 진료시스템에 따른 진료전문성, 편의성, 상호작용성의 역할 비교연구)

  • Yoon, Sung-Wook;Ryu, Jeong-Geon;Kim, Su-Bae
    • Journal of Distribution Research
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    • v.11 no.3
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    • pp.1-22
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    • 2006
  • Medical treatment for the aged has become an increasingly important concern as the aged population continues to grow. However, little research has been done on the issue. This study examines the roles of the expertise, convenience, and interaction of medical treatment systems applied by geriatric hospital. Medical treatment systems include oriental medicine, western medicine and integrated(oriental and western) medicine practices. The empirical results of the study are as follows. First, the relative impacts of the expertise, convenience and interaction on customer satisfaction are different depending upon the medical treatment systems. Second, convenience and interaction are shown to be more important factors in western medicine, while interaction is the case in oriental medicine. As for the integrated medicine practices, expertise is considered more important. Thus, it is necessary for the western medicine to make more efforts on interaction and convenience, while it is critical to enhance medical personnels' service quality in the oriental medicine. In the integrated medical treatment, actual and effective cooperation should be achieved to secure expertise. Third, the data demonstrate that customer satisfaction has a positive influence on relationship quality which, in turn, impacts on repurchase intention. Finally, relationship quality has a negative influence on intention to switch in the western medicine, whereas the impact of relationship quality is not significant in the oriental and integrated medicine practices.

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Standardization and Validation of Big Five Inventory-Korean Version(BFI-K) in Elders (노인에서 한국판 성격 5요인 척도의 표준화 및 타당도)

  • Kim, Seon-Young;Kim, Jae-Min;Yoo, Joon-An;Bae, Kyung-Yeol;Kim, Sung-Wan;Yang, Su-Jin;Shin, Il-Seon;Yoon, Jin-Sang
    • Korean Journal of Biological Psychiatry
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    • v.17 no.1
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    • pp.15-25
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    • 2010
  • Objectives : The Big Five Inventory(BFI) and the Big Five Inventory-10(BFI-10) are widely used instruments for the evaluation of personality in various cultures, while they have not been formally validated in Korea. This study aimed to develop the Korean versions of BFI(BFI-K) and BFI 10(BFI-K-10) with a Korean elderly population. Methods : The study sample consisted of 1,038 community dwelling elders. BFI-K and BFI-K-10 were administered. For the reliability analyses, scores on Guttmans' split half and Cronbach's ${\alpha}$ were estimated. For the validity analyses, the Korean version of Geriatric Depression Scale(KGDS) and the State-Trait Anxiety Inventory(STAI) were investigated. Results : The reliability of the BFI-K was good(Guttmans' split half=0.59-0.78, Cronbach's ${\alpha}$=0.52-0.75). Scores on the BFI-K-10 were significantly correlated with the scores on BFI-K. Scores on the BFI-K and the BFI-K-10 were significantly correlated with the scores on KGDS and STAI. Conclusion : Both BFI-K and BFI-K-10 might be reliable and valid instruments to evaluate the personality in Korean community elders. BFI-K-10 is short and easy to be administered, and therefore it would be very convenient to use.

Effects of Individual Reminiscence Therapy on Older Adults' Depression, Morale and Quality of Life (개인회상요법이 노인의 우울, 사기 및 삶의 질에 미치는 영향)

  • Kim Kwuy-Bun;Yun Ji-Hyeoun;Sok So-Hyune R.
    • Journal of Korean Academy of Nursing
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    • v.36 no.5
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    • pp.813-820
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    • 2006
  • Purpose: This study examined the effects of individual reminiscence therapy on older adults' depression, morale, and the quality of life. Methods: The design was a single-group pre-test and post-test study. Subjects consisted of 31 older adults from two senior centers and a welfare center in Seoul. Individual reminiscence therapy was applied to study subjects four times, once a week for an hour at each time. Measurement tools were the Geriatric Depression Scale Short Form Korea (GDSSF-K) for depression, Mun Ae-ri's (1996) scale for morale, and Medical Outcomes Study Short Form 36 (SF-36) for the quality of life. Data was analyzed using descriptive statistics, paired t-test, and pearson correlation. Results: The application of individual reminiscence therapy reduced older adults' depression (t=-5.65, p=.000), and enhanced older adults' morale (t=4.65, p=.000). The application of individual reminiscence therapy improved older adults' quality of life (t=5.00, p=.000). Conclusion: Findings of the study suggest that individual reminiscence therapy may be applied as a nursing intervention that contributesto the improvement of older adults' quality of life, reduces their depression, and enhances their morale.

Study of Importance of Grade Decision to Enforce the Insurance Policy for Long-Term Care (노인장기요양보험제도 시행에 따른 등급판정의 중요성에 대한 연구)

  • Lee, Tae-Sik;Goo, Bong-Oh
    • The Journal of Korean Physical Therapy
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    • v.20 no.2
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    • pp.43-48
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    • 2008
  • Purpose: The purpose of this study is to investigate the importance of grade decision and role of physical therapist which follows enforcement of elderly long-term residential care insurance system. Methods: One of the data from grade decision meeting in Bukgu, Busan on 2007 which was 88 case of attached finding of doctor was compared with findings of visited investigator. Result: Eighty-four investigation subjects had 186 diseases that included stroke and arthritis, requiring the need for physical therapeutic approaches. In addition, the results of the door-to-door research project in the northern district of Busan showed that there was no match out of 88 subjects who submitted the viewpoint of the doctor. Such a result was produced as the doctors did not diagnose the patient directly, but rather the diagnoses were obtained from guardians and a door-to-door researcher who had a poor understanding of geriatric motion and function. Conclusion: To enforce long-term care successfully, a re-investigation should be performed for the welfare of the aged.

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Hospital Nurses' Experience of Do-Not-Resuscitate in Korea (심폐소생술 금지와 관련된 병원간호사들의 경험)

  • Yi, Myung-Sun;Oh, Sang-Eun;Choi, Eun-Ok;Kwon, In-Gak;Kwon, Sung-Bok;Choi, Kyung-Mi;Kang, Young-Ah;Ok, Jeong-Hui
    • Journal of Korean Academy of Nursing
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    • v.38 no.2
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    • pp.298-309
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    • 2008
  • Purpose: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. Methods: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. Results: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. Conclusion: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.