• KIPS Transactions on Software and Data Engineering
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• v.9 no.4
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• pp.137-144
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• 2020

Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

• The Korean Journal of Food And Nutrition
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• v.22 no.1
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• pp.141-149
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• 2009

The elderly population in Korea is growing rapidly and their needs for long-term care has also increased. By the year 2018, our society will be approaching aged society and by 2026 it will be a super-aged society. The purpose of this study was to employ conjoint analysis to establish the relative importance of foodservice encounters in terms of determining the utility values of hospital foodservice for elderly patients. According to the results pearson's R(0.420) and Kendall's tau(0.402) statistics showed that the model fits the data well(p<0.05). The relative importance scores of hospital foodservice encounters were as follows: dietary counseling with dietetics(51.2%), foodservice personnel(48.7%), and food(0.1%). A soft cooking method(0.001) was preferred to a general cooking method(0.001), and kind foodservice personnel(0.086) were preferred to quick service(-0.086). Finally, counseling with a dietitian once a week(-0.138) was preferred to counseling twice a week (-0.276). Based on this conjoint analysis, the most preferable model for foodservice at a long-term care facility would be; soft cooking methods, kind service by foodservice personnel, and dietetic counseling once a week. Overall, a better understanding of the specific needs of our institutionalized elderly is one of the key elements that can help our long-term care system develop improved foodservice programs.

• Journal of agricultural medicine and community health
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• v.35 no.1
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• pp.13-20
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• 2010

Objectives: This study was conducted to be identify the effects oral hygiene improvement of the elderly by caregiver in a rural. Methods: It recruited Fifty three elderly patients were recruited who admitted at a long-term hospital located in Mokchon city, Chungchungnam-do province. as the intervention group. Fifty two elderly patients group were selected another one long-term care hospital in Daegu city as control group. study was conducted for seven months. long-term care hospital. for seven months from Dec. 2007 to June 2008. For three months, the caregivers provide tooth brushing and cleaning artificial teeth once a day, to intervention group. once a day for three months. Results: Before the program there was no significant difference between the control and the intervention groups in general characteristics, prevalence rates of diseases, oral sanitary condition. Dental plague score was decreased significantly(p<0.001) before and after intervention in the intervention group. Using analysis of covariance for evaluation of the effect of the intervention, a significant difference was observed between the intervention group and the control group(p<0.01). Conclusions: These results were thought to be used as important basic data to develop oral health management program for elderly patients who needed long-term care.

• Tuberculosis and Respiratory Diseases
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• v.52 no.5
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• pp.529-538
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• 2002

Background : Many clinicians are reluctant to prescribe systemic corticosteroids to manage an asthmatic attack because of many complications such as osteoporosis, cushing's syndrome, diabetes, hypertension and bleeding tendency. The use of nebulized budesonide may be of value in some infants, old men, and in particular adult asthmatic patients who complain of severe dyspnea. A clinical validation and steroid-sparing effect of nebulized budesonide in asthmatic adults and COPD were evaluated, and the short-term effects of budesonide use on the HPA axis were assessed. Materials and Methods : Study A was prospectively done with 41 patients diagnosed with pure asthma and 30 patients diagnosed with COPD (including asthmatic component) in Soonchunhyang Hospital, Chunan from June. 2000 to Sep. 2001. They were treated with nebulized budesonide including systemic steroids (Group 1), a budesonide tubuhaler including a systemic steroid (Group 2), or only the systemic steroid(Group 3). The peak flow rate, arterial blood gas in room air, pulmonary function test, symptom scoring, steroid amount and hospital stay were analyzed. Study B was conducted with 19 patients to evaluate the short-term effects on the HPA axis of treatment with nebulized budesonide 1mg twice daily and a budesonide turbuhaler 5 puffs twice daily. The adrenal function was assessed prior to budesonide inhalation and after 7 days of budesonide inhalation. Results : In the pure asthmatic patients, the mean value of the symptoms (dyspnea, wheezing, cough, night asthma) or the arterial BGAs, total amounts of steroid or hospital stay and the difference in the results of the pulmonary function tests or peak expiratory flow rate were similar in the three groups. In COPD with an asthmatic component, there were no significant differences among the three groups. Although nebulized budesonide suppressed HPA function,(p=0.006) the HPA responses from the nebulized budesonide and turbuhaler budesonide were similar (p=0.288) Conclusion : This result suggests that systemic steroid should only be made available for acute asthmatic patients irrespective of the inhaled budesonides. Nebulized budesonide at the therapeutic dose has similar effects on the HPA axis compared to that of turbuhaler budesonide.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.18-31
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• 2000

Background : This study is to identify the inappropriate hospital services for elderly inpatients over 65 years in general hospital with acute care functioning. Consequently elderly inpatient care and the management of long-term care facilities are key issues for current government health policy. Method : The survey was conducted for two months for all inpatients over 65 in 7 general hospitals, 6 work sampling days randomly selected. In each survey day, the subjective judgement by medical staff on the degree of acute care needs and by nursing unit manager on hospital services of each inpatients was also conducted. Result : The total number of cases collected are 2,541 elderly inpatients, according to subjective judgements by medical staff on inpatient condition. However 46.8% of cases are turned out to be non-acute care group. The frequency of medical services provided to non-acute group are 2~3 vital sign checks per day 78.2%, IV injection 40.1%, antibiotics medication 20.2%. Conclusion : Lots of elderly patients' who are staving in acute hospitals, at present need to be transferred to long-term care facilities. However, there was been shortage of long-term care facilities. It is expected to identify the need of elderly inpatients and therefore, to provide cost-effective, appropriate and good quality health services to elderly inpatients depending on their needs.

• Physical Therapy Korea
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• v.12 no.2
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• pp.98-104
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• 2005

This study was done to research the general information, causes of stroke, risk factors, complications during admission of geriatric CVA inpatients. We retrospectively studied 208 above 65 years old geriatric CVA inpatients treated in Ajou university hospital from 1994 to 2003 by medical record. These were divided into two groups by following years. We were gathered information about sex, onset age, cause of stroke, number of stroke, complications, housing, family, insurance, smoking, alcohol. Most of incidence of the stroke was noted in the group of young old age (65~74 years old) and old age (75~84 years old). The occurrence rate of male stroke (38.5%) was less than of female stroke (61.5%) and the ratio of male to female was 1:1.6. The occurrence rate of ischemic stroke (72.6%) was higher than of hemorrhagic stroke. The occurrence rate of ischemic stroke increased more and more at the late stage. The most common risk factors for stroke was hypertension and complications during hospitalization were neurogenic bowl and bladder. These results of epidemiologic study may help above 65 years old geriatric CVA early treatment and prevention, rehabilitation and use basic data for multiple prospective study using stroke registry.

• Culinary science and hospitality research
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• v.6 no.3
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• pp.263-280
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• 2000

This survey was conducted to investigated the status of nutritional consumption and relationship of nutrition of patients in hospitals from 1998.9.1 to 1998.9.10. Calorie intake of male patients was lower than RDA but that of female patients were higher than RDA except female younger than 64 years old. Protein intake of male patients was 130% higher than RDA, and that of female patients was 150% more than RDA. Calcium intake was lower than RDA in male patients but higher than RDA in female patients except older than 75 years. Iron intake was higher than RDA in all patients except in male patients older than 75 years. while vitamin B$_1$and vitamin C intake was higher than RDA in all patients but vitamin A and niacin intake was lower than RDA. The rich patients intake enough iron through animal foods and stabilized patients intake vitamin B$_2$ more than RDA. All patients were recognized the importance of protein and vegetable for health and they were recognized also careful choosing of foods for health. Positive relationships were showed between intake of nutritional tablet and nutritional status, between less vegetable intake and less intake of calorie, fat, sugar and fiber and between appetite and vitamin B$_1$ and vitamin C. The result showed that the shorter period staying in hospital, the more intake of sugar, vitamin A and vitamin C.

• Korea Journal of Hospital Management
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• v.27 no.1
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• pp.31-42
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• 2022

Purposes: This study aims to investigate the changes in the length of stay and medical expenses by the impact of the admission decided by patients or their family. Methodology: The analysis was conducted using data from elder patients aged 65 or older who have used admission services more than once from year 6(2012) to year 12(2017) of the Korean Medical Panel Data(KOWEPS). The statistical analysis was performed through the Chi-square test, mean difference analysis, and generalized estimation equation analysis. Findings: Compared to the patients who used admission services decided by doctors, those who used admission services decided by patients or their family had a longer length of stay and a lower daily medical expense. Practical Implications: Inappropriate admission decided by patients or their family can increase the risk of hospital-acquired infections, impairing the health of elderly patients, and has a negative impact on the efficiency of health resources. Therefore, it is necessary to prevent and properly manage inappropriate admission decided by patients or their family

• Journal of Oriental Neuropsychiatry
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• v.34 no.4
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• pp.473-485
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• 2023

Objectives: The purpose of this study was to report the effectiveness of the combination of Korean medicine therapy on elderly patients with delirium due to overdose of sedative-hypnotics. Methods: The patient was diagnosed with delirium, which occurred after an overdose of sedative-hypnotics. The patient received Korean Medicine treatment, including herbal medicine, acupuncture, moxibustion and psychotherapy, and other treatments. The evaluation variables to check the effectiveness of the interventions were the Korean Version of the Delirium Rating Scale-Revised-98 (K-DRS-R-98) Mini-Mental State Examination-Korean (MMSE-K) Clinical Dementia Rating (CDR) and Manual Muscle Test (MMT). Results: During the hospitalization period, the K-DRS-R-98 score decreased from 31 to 4, MMSE-K score increased from 18 to 26. CDR score decreased from 2 to 0. MMT in the Right lower extremity was improved. Normal daily activities were possible. Conclusions: Combining Korean Medicine treatments, including herbal medicine, acupuncture, moxibustion, psychotherapy, and other treatments, may help alleviate delirium.

• Journal of the Korea Convergence Society
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• v.9 no.8
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• pp.77-85
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• 2018

Dementia among the diseases occurring in the old age is recognized as a disease to be solved at the national level and systematic management is being carried out. However, the awareness and response of the mild cognitive disorder, which is the middle stage of normal aging and dementia, are insufficient and social costs are increasing every year. The subjects of the study were 303 hospitalized patients whose primary diagnosis was mild cognitive impairment (F067) in a nursing hospital located in one district in 2016. The number of days of hospitalization was shorter in autumn and longer in winter or in hospital discharge. The cost of treatment for patients with mild cognitive impairment is lower in autumn and higher in winter or in 'discharge' of medical treatment results. The total cost of medical treatment was high in the winter by season in the ADL 6-12 and ADL 13-20 groups. Difference in the cost of medical treatment according to the characteristics of medical treatment, the medical expenses were the highest when the number of corporal disease was 5 ~ 8. In the medical treatment results, the ADL 6-12 point group and the ADL 13-20 point group had high medical expenses in 'continue'. Considering the clinical characteristics of mild cognitive impairment and considering that 10-15% of the patients with mild cognitive impairment progress to dementia every year, early detection and treatment of mild cognitive impairment is an effective and potentially important task for reducing potential social and dementia patients.