• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.195-218
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• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.2
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• pp.345-352
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• 2020

This study compared how falls can be reduced in disabled elderly people by using the Otago exercise program and ascertained the program's effects on physical function and psychological recovery. The subjects were 30 people, and were assigned to two groups. The experimental group had 17 people, and the other was the control group that had 13 people. The experimental group attended the 50-minute program twice a week for 12 weeks. The outcome measures for lower extremity muscle strength, postural balance, flexibility, and self-efficacy were tested at the pre-test and post-test phases. In the analysis, general characteristics were analyzed by descriptive statistics. Physical function and self-efficacy were analyzed by independent T-test between the two groups, and correspondence T-tests were used within the two groups. The result of this study demonstrated that the experimental group showed significant increases in lower extremity muscle strength, static balance, flexibility and dynamic balance, and self-efficacy showed a small increase in the experimental group. But the control group showed significant decreases in static balance, flexibility and fall efficacy. The control group also showed decreases in lower extremity strength and dynamic balance. So the results of this study proved that the Otago exercise program brought about positive changes to improve physical function and psychological function to help prevent disabled elderly people from falling.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.8
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• pp.210-220
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• 2017

This study investigated the effect of social support (MOS-SSS), and physical (ADL, IADL) and mental (CES-D, MMSE-K) function on the quality of life (WHOQOL- BREF) among the elderly at care facilities. The survey respondents were 524 elderly aged 65 and older living in 15 care facilities located in D city. Data were collected through a personal interview conducted by interviewers who visited each care facility from November 2015 to January 2016. As a result, the quality of life was significantly lower in the elderly group with lower social support, with dysfunction in ADL and IADL than in the normal range group, with depression and cognitive impairment group than in the normal range group. The quality of life had a significant positive correlation with social support, ADL, IADL and cognitive impairment, but a significant negative correlation with depression. According to the results of covariance structure analysis, physical function had a greater impact on the quality of life than mental function or social support. Lower quality of life was associated with lower physical and mental function and lower social support. Therefore, concrete measures need to be devised to enhance physical function in order to improve the quality of life among the elderly in care facilities.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.2
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• pp.172-180
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• 2000

Objectives : We investigated the characteristics of perceived stress response and relationship between some variables of gastrointestinal symptoms(esp., dyspepsia) and subscales of perceived stress response inventory(PSRI) in patients with upper gastointestinal disorder when they perceived stress. Methods : 84 patients with upper gastrointestinal disorder(gastritis, gastric ulcer, duodenal ulcer etc.) and 94 normal controls completed the PSRI developed by Korean psychiatrists. The patient group performed the questionnaire including some variables of gastrointestinal symptoms. Results : Internal consistency was statistically significant in all subscales of PSRI. The patient group was significantly higher at total score of PSRI, general somatic symptom subscale score, specific somatic symptom score than control group. As the result of stepwise regression analysis for relationship between some variables of gastrointestinal symptoms ans subscales of PSRI, specific somatic symptom subsclae closely related with illness duration, past illness history and severity of symptom, and the lowered cognitive function & general negative thinking subscale related with the existence of emotional distress. Conclusion : Patients with upper gastrointestinal disorder showed stronger perceived stress response than control group and they experiences somatic symptoms related to autonomic nervous system and/or gastrointestinal symtoms rather than emotional, cognitive, behavioral symtoms when they perceived stress. They also responded to stress as they expeirenced specific somatic symtom when they had long illness duration, past illness history, and high severity of symptom and the existence of emotional distress could develop lowered congnitive function and general negative thinking.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.136-144
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• 2017

Objectives : Cognitive complaints are reported frequently after breast cancer treatments. The causes of cognitive decline are multifactorial, a result of the effect of cancer itself, chemotherapy, and psychological factors such as depression and anxiety. However, cognitive decline does not always correlate with neuropsychological test performance. The purpose of this study was to examine the relationship of subjective cognitive decline with objective measurement and to explore associated factors of cognitive function in breast cancer survivors. Methods : We included 29 breast cancer survivors who complain cognitive decline at least 6 months after treatment and 20 age-matched healthy controls. Neuropsychological tests were performed in all participants. Multivariable regression analysis evaluated associations between neuropsychological test scores and psychological distress including depression and anxiety, also considering age, education, and comorbidity. Results : There were no statistically significant differences in neuropsychological test performances. However, the breast cancer survivors showed a significantly higher depression(p=0.002) and anxiety(p<0.001) than the healthy controls did. Among the cancer survivors, poorer executive function was strongly associated with higher depression(${\beta}=-0.336$, p=0.001) and anxiety(${\beta}=-0.273$, p=0.009), after controlling for age, education, and comorbidity. In addition, poorer attention was also significantly related with depression(${\beta}=-0.375$, p=0.023) and anxiety (${\beta}=-0.404$, p=0.013). Conclusions : The results of this study showed the discrepancies between subjective complaints and objective measures of cognitive function in breast cancer survivors. It suggests that subjective cognitive decline could be indicators of psychological distress such as depression and anxiety.

• Journal of Digital Convergence
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• v.11 no.1
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• pp.309-314
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• 2013

This study aimed to identify the effect of chronic mind-body function decline on health-related activities of daily living. Data collection was surveyed using interview and questionnaires by 148 subjects in a general hospital located in Seoul from June 8 to July 13, 2011. The results were as follows: First, based on exercise habit, patient group who do exercise regularly showed in male(26.7%) and female(22.7%), respectively. The risk ratio of it was 0.25 times. On the other hand, control group who do exercise regularly showed in male(42.2%) and female(31.8%), respectively. The risk ratio of it was 0.61 times. Secondly, the risk ratio of social factor in male was 45.18 times(p=.04) while the risk ratio of physical factor in female was 237.1 times(p=.001). In conclusion, to prevent declining of chronic mind-body function, it is necessary to solve stress through sound life rhythm maintenance, immunity enhancing food intake and continuous exercise.

• 한국노년학
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• v.30 no.4
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• pp.1293-1309
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• 2010

This study is aimed to evaluate the effects of community-based prehabilitation program developed to prevent functional decline in the frail elderly and to provide a basis to practically operate this program in the public health care service. From March to August 2009, 110 frail elderly people were recruited among the registered participants of the home visit program in Korea to perform a prospective randomized community trial. We randomly assigned these people into two groups. One group (n=50) participated in the visiting prehabilitation program for 3 months focusing on improving their muscle strength of upper and lower limbs, walking ability, and balancing. The other group (n=60) underwent our visiting fall prevention program for control. To assess the effectiveness of prehabilitation program, physical functioning (PF) and short physical performance battery (SPPB) were measured for the primary outcomes and also some other indicators: exercise performance, nutritional status, emotional functioning, experience of admission, and events of fall. As a result, significant improvements of geriatric functional status were noticed among the participants. After 3 months, PF increased by 1.3 ± 3.8 points in prehabilitation group and decreased by 1.1 ± 5.4 points in controls (p=.020). SPPB improved by 2.4 ± 2.0 points in prehabilitation group and increased only 0.3 ± 1.5 points in controls (p<.001). Significant effects were also shown in their exercise performance tests and emotional status, the number of multiple falls, and the experience of functional decline after the fall (p .002-.038). Visiting prehabilitation program is safe and effective program for frail older adults. Thus, it is strongly recommended to universally adopt this program to prevent functional decline in the frail elderly.

• 한국노년학
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• v.32 no.2
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• pp.377-395
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• 2012

This study was conducted to develop and evaluate the effectiveness of Multifactorial Fall Prevention Program (MFPP) for local low-income elderly people on physical·psychological, and home environmental hazards, and falling frequency. The selected elderly people was provided the MFPP during an eight-week period of time, once a week, 70 to 90 minutes per each section. The design of this study was non-equivalent control-group with repeated measuring by quasi-experimental study. Data were collected before treatment, 8 week after treatment and 4 week after retention from July to October, 2010. Data were analyzed with numbers, percentage, Fisher's exact test, x²-test, repeated measures ANOVA, ANCOVA and Logistic regression. There were significant differences in fall frequency, balance, fear of falling, fall efficacy, home environmental hazards between the experimental group (EG) and control group (CG). This study showed that the multifactorial fall prevention program(MFPP) was useful nursing intervention for strengthening physical·psychological and environmental functions of the low-income elderly people, as well as preventing fall.

• 한국노년학
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• v.29 no.3
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• pp.987-1000
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• 2009

The purpose of the study was to examine the effect of resistance training on joint flexibility and muscle strength of upper extremities of institutionalized elderly with impaired cognition. The study design was pretest-posttest control group study and inclusion criteria were elderly aged 65-year older, MMSE score 23 or less, ones who had no serious physical and/or mental problem except impaired cognition, and were capable to carry out resistance training. After consents were obtained participants were randomly assigned. Pre-post evaluation was performed by staff nurses trained beforehand. Among those 4-week study period, experiment was carried out during 5 consecutive days a week for 3 weeks. ROM and extension range of shoulder joints and muscle strength of shoulders and hands for both sides were measured. Flexion, extension, abduction range of right shoulder joint was significantly improved. Flexion and extension muscle strength of left side shoulder and abduction muscle strength of both sides of shoulder were significantly improved. With the study result, it could be concluded that resistance training has therapeutic effects on joint flexibility and muscle strength. More studies adopted longer experimental period to evaluate timing of effect and extinction to refine the protocol are called for.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.3-11
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• 2017

Objectives : The aim of this study was to draw attention toward so called 'behavioral variant frontotemporal dementia(bvFTD) phenocopy syndrome', which is difficult to discriminate with the primary psychiatric disorders, showing poor response to conventional therapeutic drugs, leading to higher risk to misdiagnoses and legal problems. Furthermore, the author insisted that our interest and study on them must be continued. Methods : English articles published during 2000 thru 2016 had been searched by internet with the combination of words such as 'frontotemporal', 'phenocopy' and 'behavioral', and reviewed. Besides, two clinical vignettes were described. Results : Precise diagnosis is important because patients' behavioral symptoms can influence on their families and community. However, disease-modifying treatment for bvFTD are not developed until now, and recent therapeutic drugs are only good for specific symptoms, while deterioration progresses in spite of proper psychiatric management. The possible bvFTD patients are not progressed into probable bvFTD clinically, showing no decline of cogntive and social function, no decrease of activity function, longer survival time, and normal neuroimaging for several years. Conclusions : Rather than expected, there are much more patients having clinical symptoms, course and diagnostic findings including neuroimaging, which are atypical to classical frontotemporal dementia and primary psychiatric disorders. If our knowledge and discriminating ability is improved, discovery rate of that cases will be increased. However, the identity of these atypical features are not clarified until now, it must be further actively investigated.