• Title/Summary/Keyword: 중증

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Determinants of Length of Stay in Geriatric Hospitals - Focused on Alzheimer Dementia's Inpatients (요양병원 입원 알츠하이머 치매노인의 재원일수 결정요인 분석)

  • Bang, Hyo-Jung;Lee, Kwang-Soo
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.900-909
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    • 2013
  • This study purposed to analyze the determinants of length of stay for patients having alzheimer dementia in geriatric hospitals. Sample data was collected from the National Patient Sample (NPS) produced by the Health Insurance Review & Assessment Service (HIRA) in 2009. Total 538 alzheimer inpatients over 65 years were used in the analysis. Patients were classified into 5 risk groups to represent the case-mix differences of patients. Organizational characteristics of geriatric hospitals such as number of beds, doctors, and nurses were included in the analysis model. In multivariate regression analysis, hospital variables were not statistically significant in explaining the length of stay. Two risk group were statistically significant in analysis, However, their signs of relationship with the dependent variable were opposite to the expectations. These results suggest that the characteristics of patients and hospitals did not have impacts on the length of stay. There will be needs to test the effects of other factor such as social needs which represents the socio-economic status of the family for the patients.

COMPARISON OF SEVERE EARLY CHILDHOOD CARIES PREVALENCES BY TWO DIAGNOSTIC CRITERIA (진단 기준에 따른 취학전 어린이의 중증 유아기 우식증 유병률 비교)

  • Lim, Kyoung-Uk;Lee, Kwang-Hee;Ra, Ji-Young;Lee,, Dong-Jin;An, So-Youn;Kim, Ji-Yeong;Song, Ji-Hyun;Kim, Yun-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.677-683
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    • 2008
  • The purpose of study was to compare the prevalences of severe early childhood caries(S-ECC) using two different diagnostic criteria. The subjects of this study included 401 preschool children from 36 to 71 months of the randomly selected seven nurseries in Iksan city. Severe early childhood caries was defined as (1) 1 or more cavitated, missing (due to caries), or filled smooth surfaces in primary maxillary anterior teeth or (2) a decayed, missing, or filled score of ${\geq}$4 (age 3), ${\geq}$5 (age 4), or ${\geq}$6 (age 5) surfaces. The prevalence determined by maxillary anterior caries and the prevalence determined by dmfs were 26.7%, 28.9% in 3 years, 32.4%, 30.4% in 4 years, 39.4%, 41.3% in 5 years, and 35.4%, 35.9% in all, respectively. The results suggest that the two diagnostic criteria of the severe early childhood caries yield almost the same results.

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The Factors that Influence Amount and Types of Informal Caregiving to the Severely Disabled Elderly (중증장애노인의 비공식 보호 제공량과 유형의 결정요인 연구)

  • Park, Chang-Je;Kim, Ki-Tae
    • Korean Journal of Social Welfare
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    • v.54
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    • pp.203-220
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    • 2003
  • The purpose of this study is to identify and empirically study the factors that significantly influence amount and types of Informal caregiving to severely disabled elderly who have functional limitations. For this research, a set of caregivers living with the severely elderly were surveyed. Among collected data, data for 211 caregivers were used for this study. The results suggest that a variety of factors determine informal caregivers do systematically determine their allocation of time to the provision of elderly care. The results of four OLS regressions using data surveyed are as follows. First, The hypothesized role of income is supported in model 1 of the four regression models. Second, the technological components of informal care production significantly influences caregiving hours include the number of ADLs and IADLS needs help, the number of caregivers in the team, the utilization of formal services. Third, any component of production technology of household goods do not significantly influence caregiving hours. Fourth, the components of preferences significantly influence caregiving hours include caregiver's participation in market work, willingness money to pay market-purchased care for the elderly.

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Robot-assisted Thymectomy with the 'da Vinci' Surgical System in a Patient with Myasthenia Gravis -A case report- (중증 근무력증 환자에서 da Vinci 로봇을 이용한 흉선절제술 -1예 보고-)

  • Yi, Jung-Hoon;Jeong, Sang-Seok;Woo, Jong-Soo;Cho, Gwang-Jo;Bang, Jung-Hee;Choi, Pill-Jo;Park, Kwon-Jae
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.557-561
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    • 2010
  • In the treatment of myasthenia gravis, thymectomy is generally accepted as the standard of therapy. For thymectomy, there have been various conventional open approaches including sternal splitting, but recently minimally invasive approaches have been increasingly applied. A 28-year-old man presenting with weakness of both hands and fatigability was diagnosed as having myasthenia gravis with thymic hyperplasia. He underwent a robot-assisted thymectomy with the 'da Vinci' surgical system. Through the right thoracic cavity, two thirds of the thymic gland was dissected, and the remainder was resected through the left; these procedures took, respectively, 1 hour and 30 minutes. The patient was discharged on the 8th postoperative day without complications. The minimally invasive approach with the 'da Vinci' surgical system is emerging as a popular choice and various advantages have been reported. Here we report the first successful case of robot-assisted thymectomy.

Comparison of Usefulness of Laboratory Tests in Diagnosis of Myasthenia Gravis (중증 근무력증 진단에 있어서 제반 검사법들의 유용도 비교)

  • Park, Seung-Kwon;Do, Hyun-Cheol;Kim, Min-Jung;Lee, Seung-Yeop;Park, Mee-Yeoung;Hah, Jung-Sang;Kim, Wook-Nyeun;Lee, Jun
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.125-134
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    • 1998
  • Purpose: This study was undertaken to evaluate the clinical usefulness of Tensilon test, repetitive nerve stimulation test(RNST), single fiber EMG(SFEMG) test and acetylcholine receptor antibody(AchR Ab) assay for making diagnosis of myasthenia gravis(MG). Method: These tests were performed in 21 MG patients which were classified into 11 ocular, 5 mild generalized, 4 moderate generalized, and 1 chronic severe MG. Result: The overall positivity of Tensilon test, SFEMG and AchR Ab was 95%, 87%, and 76% respectively. The overall positivity of RNST was 67%; 38% on flexor carpi ulnaris, 43% on adductor digiti quinti and 62% on orbicularis oculi muscles. The positivity of each test was higher in generalized MG group than in ocular MG group. But we could observe the statistically significant difference only in the RNST(p<0.05). Conclusion: Tensilon test showed the highest positivity in all MG groups. So we would like to recommend the, Tensilon test for the diagnosis of MG at first, followed by RNST and AchR Ab assay, and SFEMG would be indicated to MG group which showed relatively low postivity in other tests.

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Effects of Meaning-Centered and Mindfulness-Based Stress Management Program with Using Marine Resources on the Improvement of Emotion, Sleep Quality, Quality of Life and Cognitive Function in Family Caregiver of Patients with Severe Physical Disability : Preliminary Study (해양자원을 활용한 의미중심, 마음챙김기반의 집단스트레스중재프로그램이 중증장애환자 간병가족의 정서, 수면, 삶의질 및 인지기능 향상에 미치는 효과 : 예비연구)

  • Yu, Jeong-A;Lee, Jae-Hon;Shin, Sun-Han;Cho, Hwi-Young;Yoo, Mee;Shin, Ho-Jin;Kim, Sung-Hyeon;Kim, Hyo-Jin;Yook, Young-Sook;Lee, Sung-Jae
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.191-201
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    • 2019
  • Objectives : The purpose of this study was to investigate the effects of meaning centered and mindfulness-based stress management program with using marine resources on positive changes in mood, sleep, quality of life and cognitive function. Methods : Nine family caregivers of patients with severe disability experienced meaning centered and mindfulness-based stress management program for four-days in marine areas near Uljin-gun, Gyeongsangbuk-do in South Korea. Subjective questionnaires and objective assessments were conducted and statistically analyzed to examine changes in mood, sleep, quality of life, and cognitive function before, after, and after 6 weeks of participation. Results : After participating in the program, moods including depression improved significantly. This effect lasted until 6 weeks. Participants' sleep quality, quality of life and cognitive function improved significantly after 6 weeks of program participation. Conclusions : This new specialized stress management program using marine resources for family caregivers of patients with severe disability is expected to be used effectively in terms of improving their overall quality of life, mental health status and cognitive efficiency.

Comparison of Vessel Disease and Gensini Score according to Ankle-Brachial Index in Patients with Cardiovascular Disease (심혈관 질환자의 발목-상완 지수에 따른 Vessel disease 및 Gensini score 비교 융복합 연구)

  • Choi, Suk-Kyeong;Choi, Hye-Ran
    • Journal of Digital Convergence
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    • v.15 no.1
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    • pp.267-275
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    • 2017
  • The purpose of this study was to evaluate the clinical availability of ankle-brachial index(ABI) according to severity of cardiovascular disease. The subjects of this study were the patients who had ABI in a general hospital. In this study, total 441 patients were enrolled for analysis. Electric medical records were reviewed to investigate the result of ABI and severity of cardiovascular disease measured vessel disease and Gensini score. Collected data were analyzed using SPSS 21.0 program. Subjects with $ABI{\leq}0.90$ and > 0.90 were classified as having abnormal and normal ABI. There were significant differences in vessel disease categorization($x^2=4.731$, p=.030) and Gensini score(t=2.351, p=.019) between two groups. Therefore, ABI is an effective and non-invasive tool for the diagnosis of cardiovascular disease with high severity. ABI is a valuable predictive index of ischemic heart disease.

The Effect of Digital Divide on the Use of Online Services in the Severely Disabled People: Focusing on Online Accessibility (중증장애인의 온라인 서비스 이용에 대한 디지털 정보격차의 영향: 온라인 접근성을 중심으로)

  • Jang, Changki;Sung, WookJoon
    • Informatization Policy
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    • v.27 no.3
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    • pp.56-81
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    • 2020
  • The purpose of this research is to empirically examine the effects of motivation and skill for digital devices and the Internet on the use of online services in the severely disabled people. In addition to the general effect of digital divide, particularly for the case of severely disabled people, the effects of physical and mental inconvenience of individuals were taken into account and the moderating effect was confirmed by classifying the groups that need help with online activities and those that do not. The 2018 Digital Divide Survey data of the National Information Society Agency was used for the study. As a research method, path analysis and multi-group analysis using a sequence access model to Internet use were performed. As a result, it was confirmed that even in the case of the disabled, the motivational factor affects the skill for digital device operation and Internet use, and this access skill sequentially affects the use of online services. In particular, it was found that the effect of strategic and technical skill for internet use is the most important for the use of online services for the disabled rather than the motivation or a simple operational skill for digital devices. In addition, it was found that even in the disabled group, those requiring help in using the Internet was more passive in using the online service than the rest in the group. The results of this study suggest the need for stronger capacity for physical access as well as support in building strategic and technical skills that enhance responsibilities and protect from risks in using the Internet among the people with disabilities.

Diagnostic Sensitivity of Several Muscles in Repetitive Nerve Stimulation Test for Myasthenia Gravis (중증근무력증에서 반복신경자극검사시 각 근육들의 진단적 민감성)

  • Kim, Hyun-Jic;Lim, Sung-Hwan;Lee, Seung-Yeop;Hah, Jung-Sang;Kim, Wook-Nyeon
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.277-286
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    • 2001
  • Background: This study was undertaken to evaluate the diagnostic sensitivity of several muscles in repetitive nerve stimulation test (RNST) for myasthenia gravis (MG) patients. Materials and Methods: The study population consisted of 39 MG patients classified by modified Ossermann's classification. Using Stalberg's method, RNST was systematically performed in facial (orbicularis oculi and nasalis) and upper extremity (flexor carpi ulnaris, abductor digiti quinti and anconeus) muscles. Results: The significant electrodecremental response of RNST were noted in orbicularis oculi(58.9%), nasalis (51.3%), flexor carpi ulnaris(42%), anconeus(41%) and abductor digiti quinti muscles(27%). Among the 3 muscles of upper extremity(abductor digiti quinti, flexor carpi ulnaris and anconeus), the positive electrodecremental response of anconeus muscles was significantly higher than other two muscles(p<0.05) in type IIa, IIb and there were no statistical differences of the positive electrodecremental response between orbicularis oculi and nasalis muscles. The facial muscles showed more prominent decremental responses than upper extremity muscles in type I MG(p<0.05). In type IIa MG patients, there were no significant statistical differences between facial and upper extremity muscles but significant statistical differences among upper extremity muscles. In type IIb MG patients, there were no significant statistical differences in all tested muscles in spite of the increased positive electrodecremental response of RNST. Conclusion: On the basis of this study, RNST would be initially performed for the orbicularis or nasalis in type I MG and for the anconeus in type IIa or IIb MG.

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Factors Associated with the Quality of Life among Persons with Severe Mental Illness Living in Supported Housing (독립주거 거주 중증 정신장애인의 삶의 질에 영향을 미치는 요인에 관한 연구)

  • Lee, Sung-eun
    • Korean Journal of Social Welfare Studies
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    • no.36
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    • pp.281-299
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    • 2008
  • The objective of this study was to examine the association between personal, housing, program, and service characteristics and quality of life among persons with severe mental illness living in supported housing. A cross sectional survey of a random sample of 237 clients residing in supported housing in Philadelphia was used to assess the association between personal and environmental characteristics, and quality of life. Data were collected from structured interviews, administrative data, the 2000 U.S. Census data file and the Philadelphia police crime database. Multiple regression analyses were used to identify personal and environment characteristics that are associated with quality of life. Clients with diagnoses of schizophrenia, those with lower levels of psychiatric symptoms, those with higher levels of physical health status, and those with higher levels of perceived supportiveness with staff had higher levels of quality of life. Findings of this study suggested that clients' clinical characteristics and consumer staff relationships can be important variables for understanding quality of life among supported housing residents. Factors associated with quality of life identified in this study may help service providers design and plan services to promote quality of life and stable independent living in the community of supported housing residents.