• Journal of Digital Convergence
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• v.20 no.3
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• pp.517-527
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• 2022

This study aimed to compare changes in cognitive function, depression and ability to perform activity of daily living (ADL) in patients with dementia, mild cognitive impairment (MCI), and ischemic stroke (IS) and to identify factors associated with changes in instrumental ADL. A total of 86 patients (dementia=30, MCI=32, and IS=24) were included to analyse cognitive function, depression, and basic and instrumental ADL obtained at the time of diagnosis and 1 year after baseline. Repeated measures analysis of variance and multiple linear regression were used. A significant group by time interaction was found in executive function (p=.037) and instrumental ADL (p=.023) across groups. The MCI group has little change in executive function and instrumental ADL from the baseline to 1 year after diagnosis while other two groups showed changes with the dementia group showing declines and the group of IS having improvement in these factors over time. Changes in executive function(p=.030) and basic ADL (p<.001) explained 26.9% in the variance of changes in instrumental ADL. These findings showed a different changing pattern in executive function during the first year after diagnosis of dementia, MCI, and IS which have cognitive changes as their main symptoms, probably leading to a different changing pattern in instrumental ADL. Healthcare professionals should routinely assess for executive function and instrumental ADL problems and intervene to maintain and improve these functional outcomes immediately after disease.

• Journal of Digital Convergence
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• v.11 no.12
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• pp.495-505
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• 2013

This study aims to evaluate the effects of aromatherapy and a foot reflex massage program on the cognition, anxiety, aggressive behavior, and wandering behavior of elderly with dementia. The research design was a non-equivalent control group, quasi-experimental study where 43 subjects were divided into two groups. Aromatherapy and foot reflex massage was administered to the experimental group (N=21), and no treatment was administered to the control group (N=22). The data was analyzed using the ${\chi}^2$-test, t-test, while the repeated measures of ANOVA were utilized with the SPSS/Win 18.0 program. The experimental group did not show significant differences in cognitive function; however, it showed significant differences in anxiety, aggressive behavior, and wandering behavior in relation to the control group. Thus this research suggests aromatherapy and a foot reflex massage program as nursing intervention to improve the quality of life of elderly with dementia.

• Journal of Digital Convergence
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• v.16 no.1
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• pp.63-72
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• 2018

This paper examined the learning transfer of job training participants and its influencing factors. A survey of 279 care workers in the city of Seoul and Kyeong Gi province who recently participated dementia job training was conducted. The results of multiple regression analysis indicated that the self-efficacy of the care workers, the capability of instructor, the training methods and the transfer opportunity positively influenced the level of learning transfer. The findings suggested increasing care workers' self-efficacy, enhancing practical skill-based training program, hiring instructors with high workplace experiences, fostering work environment with higher transfer opportunity are required.

• Health Policy and Management
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• v.28 no.4
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• pp.352-359
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• 2018

Background: The purpose of this study is to propose an analysis of trends and characteristics of high-cost patients who take over 40% of total national health insurance medical expenses. Methods: It has been analyzed the tendency of high-cost patients by open data based on the medical history information of 1 million people among national health insurance subscriber from 2002 to 2015. To conduct detailed study of characteristics of high-cost patients, multiple regression has been performed by sex, age, residence, main provider, and admission status based on the top 5% group. Results: The amount of medical expenses and the number of high-cost patients have gradually increased in decades. The number of high-cost patients for Korean won (KRW) 5,000,000 category has increased by 7.6 times, KRW 10,000,000 category has increased by 14.1 times in comparing of year 2002 and 2015. Top 5% medical expenses have increased by 4.6 times. In consideration of the characteristics of patients, the incidence of high medical expenses has been higher in female patients than male ones, the older patients than in the younger. Patients residence in Gyeonsang or Jeonla province have had a high incidence of medical expenses than other area. The disease including dementia, cerebral infarction, and cerebrovascular disease for high-cost patients has been also increased. Conclusion: The major increase factor for high medical expenses is the aging of population. The elderly population receiving inpatient care residing in the province that increases high medical costs have to management. There is an urgent need to develop a mechanism for predicting and managing the cost of high-cost medical expenses for patients who have a heavy financial burden.

• Health Policy and Management
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• v.21 no.3
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• pp.381-396
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• 2011

This study is to investigate the factors affecting the regional rate of certification for long-term care insurance benefits. Analyzed data were the 253,935 certified beneficiaries (equivalent to 4.9% of total elderly population) as long-term care degree (LTC degree) 1~3 extracted from the applicants for long-term care in the beginning stage of the system from April 15 2008 to July 1 2009. Although the data were collected from individuals, after restructured into regional data and then analysed in the unit of 225 administrative regions for the Korean Long-term Care Insurance. The rate of certification was operated as the percentage of people of LTC degree 1~3 to the elderly population in each region. The average rate of certification among regions was 4.91%, and ranged from 2.20% to 8.32%. In the analysing regression models, most socio-demographic variables, applicants' disease characteristics, regional service infrastructure, and the certification interviewer's characteristics were included. The most influencing variables were the disease factors of applicants, especially dementia or cerebrovascular disease rather than arthritis, osteoporosis, or fracture patients were strong factors for the regional rate of certification. However, advanced studies adding more explainable factors on the regional variance of certification rate would be necessary to provide political agenda and measures for evidence-based certification process with high reliability and validity for a sustainable LTC system in Korea.

• Journal of The Korea Institute of Healthcare Architecture
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• v.16 no.2
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• pp.55-64
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• 2010

The Japanese elderly welfare policy has focused on facility policy for the aged and preventive care service for healthy elderly people. This paper has conducted a comparative analysis on Geriatric Gealth Services Facility and Special Nursing Home for the Elderly. For this, each service function has been divided into six categories; daily life / nursing and caring / medical service / management / supply / miscellaneous. Then the change in real structure by category has been analyzed through a plan analysis on case facilities. In the Geriatric Health Services Facility, the biggest change was observed in 'livelihood' among six categories. In the Special Nursing Home for the Elderly, 'the nursing and care parts' and 'medical service part' are decreased since 1999. At that time, the facilities started to be individualized and divided into a unit. To pursue home-like care instead of unit care, there was a change in construction planning to help the aged with dementia live a self-sufficient life.

• Journal of Digital Convergence
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• v.16 no.4
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• pp.221-229
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• 2018

The purpose of this study was to identify the characteristics and side effects relevance of physically restrained elderly patients with dementia in the nursing hospitals. The data were collected from nursing care providers working at the 5 nursing hospitals with survey and analyzed 190 data using SPSS 21.0 program. The finding showed that age of '75 to 84' years occupied 58.3%, '17-24' hours of the total restrained time of the day 22.6%, night time 57.4% and no fall down history 54.2%. Age showed relevance with local edema and problem of joint construction(p<.05), specifically '85 and over' years having 25% occurrence in the problem of joint construction. Walking ability showed relevance with pressure ulcer, but in the patients who could walk it showed more frequency than in the patients who could not walk. The total restrained time of the day showed relevance with skin redness, local edema, problem of joint construction(p<.05). Based on this finding, it would be necessary to apply differential care policies according to the characteristics of patients when we care the restrained patients with dementia.

• Journal of Digital Convergence
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• v.15 no.4
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• pp.511-519
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• 2017

This study developed a occupational therapy convergent activity program to provide dementia patients admitted to the daytime ward, and investigated the program's effect on the hand and cognitive functions and instrumental activities of daily living. A total of 34 dementia patients were divided into two groups: a convergent occupational therapy program and medication were provided for 17 patients, and medication alone was provided for a control group of 17. The intervention was performed for 24 weeks, 8 times per week, 192 times in total. A handgrip strength test was performed to examine hand function before and after the intervention, and the MMSE-K and GDS were performed to evaluate cognitive function. In addition, the K-IADL was used to assess instrumental activities of daily living. With intervention, the experimental group showed significant improvements in hand and cognitive function and instrumental activities of daily living. In contrast, the control group did not show improvements in hand and cognitive function or instrumental activities of daily living. In conclusion, the study showed that a convergent/integrated activity program for occupational therapy has a positive effect on hand and cognitive function as well as instrumental activities of daily living.

• Health Policy and Management
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• v.32 no.2
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• pp.190-204
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• 2022

Background: In Korea, the population is rapidly aging, and the types of households for the elderly are also diversifying. The self-rated health of the elderly is a valuable health indicator that can comprehensively represent the overall quality of life along with physical, mental, and functional health. On the other hand, studies on the association between household type and self-rated health of the elderly are still insufficient. Thus, this study analyzed the association between household type and self-rated health by gender in Korean older adults. Methods: Using data from the analysis of the National Survey of Older Koreans 2017, 10,299 elderly people aged 65 and over were targeted. For the accuracy of the analysis data, 9,910 people were selected as the study sample by excluding proxy responses, those diagnosed with dementia, and non-response. And technical analysis, univariate analysis using the Rao-Scott chi-square test, and logical regression analysis involving survey characteristics were conducted by gender. Results: According to the adjusted model with all variables, in both men and women, the odds ratio of self-rated health 'bad' in 'couple (with ill spouse)' was significantly higher than 'couple (with spouse)'. It was 2.54 (95% confidence interval [CI], 2.05-3.15) for men and 2.11 (95% CI, 1.70-2.62) for women. In addition, the odds ratio of self-rated health 'bad' in 'living with adult children' was 1.43 (95% CI, 1.09-1.87) for men and 1.42 (95% CI, 1.15-1.75) for women, which was more significant in women than men. Conclusion: This study states that there is an association between gender, household type, and self-rated health of the elderly, and the health of a spouse and cohabitation with children have a significant effect on self-rated health. As a result, in order to improve the health status of the elderly, health promotion and health care policies involving the characteristics of the elderly's gender and household type are needed.

• Health Policy and Management
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• v.22 no.1
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• pp.49-64
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• 2012

With the burden of chronic diseases mounting among the population as a result of its aging, the importance of health examination is being stressed in order to identify and manage diseases in the early stage. Health examination in Korea is divided largely into periodic health examination provided as a national health screening program and individual physical checkups. The advantages of the former include little economic burden on the examined and those of the latter include the freedom of the individual to select various examination headings depending on the individual's characteristics and preferences. With both examinations now being expanded, empirical analyses from various standpoints are needed. This study proposes to analyze traits of the examined and non-examined as shown in the facts and figures of the 1st and 2nd Korean Longitudinal Study of Ageing (KLoSA), thereby make the determinant factors clear leading to the acceptance of the examinations, and analyze the effects of the examinations upon maintaining or moving to healthy lifestyle. It was confirmed that demographic features such as gender and age, socioeconomic features such as the level of education, place of residence and household income, physical and mental state of health such as chronic disease and dementia, and daily living habits are significantly related with whether to accept physical examination. It is also confirmed that physical examination leads to non-smoking, regular physical exercises and regular dietary habits. It is suggested that, to enhance effects of health examinations, follow-up management programs making use of results of health examinations be further expanded, and the national health screening program be more actively put into operation for the bracket lying in the blind spot of the program.