This study examined the factors affecting forms of long-term care service use by elderly and the forms of use are classified facility care service, home care service, and unused. It is used data from the 2nd pilot program for the Long Term Care Insurance scheme and it is analysed 5,497 cases. Multi-nominal regression is used. According to the results, women use formal service more than man do, and wowen use facility care than home care. Those who eligible for National Basic Livelihood Security System(NBLSS) are shown to have higher use of formal care(especially facility care) than the middle income class, and the low income class than the middle income class has lower use of formal care. In addition, higher the family care is available, lower the taking part in the service. The big cities and mid sized cities than rural are used the formal service and moreover mid sized cities are used facility care than home care. Furthermore, the level of care need is determinants of service use and function of ADL, IADL, and abnormal behavior is also determinants of formal service(especially facility care). But nursing need and rehabilitation need are not determinants of formal service use. Based on the results, the recommendations are developed and implemented for the improvement the elderly long-term care insurance.
Objectives : This study aimed to identify unmet needs and influencing factors for patients who have breast cancer, colorectal cancer, lung cancer, and thyroid cancer. Methods : We reviewed the SCIE publications on unmet need of four prevalent cancer patients published after 2010 through a web search. Results : The measurement tools primarily used were Cancer Survivors' Unmet Needs and Supportive Care Needs Survey questionnaire. Lung cancer patients reported a relatively higher rate of unmet needs. Breast cancer patients frequently reported unmet needs in the healthcare system and information, while thyroid cancer patients in post-treatment management and psychological issues. Colorectal cancer patients reported unmet needs in psychological and comprehensive care domain, and lung cancer patients reported unmet needs in physical and daily life management. Younger age, a shorter time since diagnosis or treatment, and higher levels of anxiety, depression, distress, and reduced quality of life were associated with more significant unmet needs. Conclusions : Unmet needs and influencing factors vary by cancer type. Considering the characteristics of each patient group and unmet needs can help in development of more effective treatment and support programs.
Journal of agricultural medicine and community health
/
v.37
no.1
/
pp.12-22
/
2012
Objectives: This study aimed to compare the nutritional risk, health status and depression levels of young-old (65-74 years) and old-old (75-84 years) women on low-income. Methods: A total of 624 elderly women, each over 65 years of age, participated in this study under the auspices of a community social center. Data were collected from June to August 2011 by means of personal interviews which employed questionnaires. The research tools used in this study were the nutritional risk measuring Mini Nutritional Assesment (MNA) by Kim (2000), perceived health status developed by Lawton et al. (1982), Elderly Depression Criterion developed by Sheikh & Yesavage (1985). The collected data were analyzed using the SPSS WIN 12.0 Program. Results: Nutritional risk, perceived health status and depression levels showed a significant difference between young-old and old-old. There was a positive correlation between nutritional risk and depression and a negative correlation between nutritional risk and perceived health status. A 38.2% variance in depression levels of young-old and a 29.7% variance in depression levels of old-old were explained by perceived health status, nutritional risk and the number of people living together. Conclusion: The findings demonstrate variances in depression levels among low - income women differing in age. As a result, the outcomes of this study ought to be employed in the development of future programs aimed at promoting the health of elderly women.
Kim, Jae-Soog;Park, Jong;Ryu, So-Yeon;Lee, Chul-Gab;Kim, Hak-Ryul;Kim, Yang-Ok
Journal of agricultural medicine and community health
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v.24
no.1
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pp.131-143
/
1999
This study was attempted to find the mutual relationship between leisure activities and life satisfaction by the aged persons in a rural area. The data was obtained by interview with questionnaire and the data from 209 persons aged over 65, residing in Dohwa-myeon and Podu-myeon, Koheung-kun, Chollanam-do were analysed. The survey was carried out from Feb. 16th to May 3rd in 1998 and the results are as follows: 1. The survey showed that the major leisure activities were TV watching followed by talking with friends, club activities, taking a walk, visiting friends' or relatives' home and breeding domestic animals. 2. The types of leisure activities were classified into 8 patterns as active self-enlightenment, passive self-enlightenment, temporal amusements, passive self-activities, cozy introspective activities, friend oriented activities, family oriented activities and religious activities. Among the above 8 patterns active self-enlightenment type contributed most to the life satisfaction. 3. The major factors affecting leisure activities were sex, age, average income, religion and educational status. And the major factors affecting life satisfaction were sex, age average income, educational status and a state of health. In conclusion the more the aged persons participated in leisure activities, the better they felt life satisfaction.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.15
no.2
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pp.143-151
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2004
Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.
Statement of problems: In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective need of dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions. Purpose: The aims of the current study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze their dental treatment needs. Material and methods: The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was more than 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea. Results and conclusion: The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residual teeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (P < .05). The number of fixed partial denture in institutionalized elderly was lower than that of the same ages in control group (P < .05). The percentage wearing removable partial denture was not significant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institutionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institutionalized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was higher than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete denture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of institutionalized elderly were lower than that of the control group (P < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partial dentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in the maxilla (P < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teeth was less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of occluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase the awareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth are increasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control of dentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project of edentulous patients should be done by specialists who'll also be responsible for postmanagement. Through this research of institutionalized elderly, the oral health status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in order to solve the rising treatment needs of the elderly patients.
Journal of agricultural medicine and community health
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v.28
no.1
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pp.1-13
/
2003
Objectives: The purpose of this study is to summarize results from 11 domestic studies about sick role behavior applied health belief model and to assess the effectiveness of components on behavior change by using meta-analysis. Methods: We collected the existing literatures by using major web search of 'pulmonary tuberculosis patients', 'health belief model', and 'sick role behavior' as key words and by reviewing content of journals. Quantitative meta-analysis was performed by SAS program. Results: Among 66 articles, 11 studies were selected for quantitative meta-analysis. The knowledge level about pulmonary tuberculosis had more effect for only sick role behavior as general characterisitcs(d=0.7870). All the components of health belief model produced significant effects on sick role behavior with the magnitude of effect size from 0.31 to 0.73. The largest effects were benefits on actions of sick role behavior. Conclusions: Overall, these investigation provide very substantial empirical evidence supporting health belief model dimensions as important contributors to the explanation and prediction of sick role behavior among the type of health related behavior in pulmonary tuberculosis patients. Strategic intervention including health education, etc. based on health belief model showed clear advantage in improvement of behavioral change.
Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.
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