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Study on Case-Mix in Long-Term Care Facilities for Elderly (장기요양시설 노인의 환자구성에 관한 연구)

  • Jeon, Yi-Jee;Kim, Suck-Il;Hum, Yu-Seung;Yi, Sang-Wook
    • Korea Journal of Hospital Management
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    • v.6 no.3
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    • pp.130-147
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    • 2001
  • This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

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Health Complaints of Elderly Persons Using a Modified C.M.I. (C.M.I.간이법에 의한 노인들의 건강수소율)

  • 박오장
    • Journal of Korean Academy of Nursing
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    • v.13 no.2
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    • pp.44-57
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    • 1983
  • The explosion of the aging population is changing the social environment of today's older people. Traditionally in Korea, a large percentage(over 90%) of elderly parents have lived with their married first son. But today, the number of elderly who live with their married sons has decreased(65.6%) The number of those who live in a different situation such as with their married daughter, unmarried offspring, with a spouse or alone has increased (34.4%) We can expect that the number of the elderly who have to live in institution will increase. The objective of this investigation was to determine differences in the number of health Complaints of older people according to their living situation with a view to planning more effective health care. The sample consisted of 231 persons over 65 years of age, 60 living in an Old Age Home ana 171 living in their own home in Kwangju. Data were gathered from July 9 to 26, 1983 by nursing students using a Questionnaire which was a modified form of the Cornell Medical Index. The data were categorized according to the subjects, living, sex, educational level, previous occupation, hobbies and sexual activity. The date were analyzed for statistical significant differences using F and X²tests. findings included the following: 1. There was a higher number of health complaints from persons who live in the institution than those living at home, but the difference was not significant. 2. The highest number of health Complaints were from persons who live alone, followed by those living with their daughters, and then by those living in the institution. Persons who live with their sons had the least Complaints. The difference in the number of Complaints accord-ing to with whom they were living was significant. 3. Women had signincantly more Complaints than men. Persons who were not living with their spouses had significantly more complaints than those living with their spouses.4. The higher eductional level the persons had, the less health Complaints they had. The number of Complaints accoraing to educational level was significantly different. 5. The highest number of health complaints were from persons who had involved in Commerce and industry, followed by those in Agriculture. Persons who were civil servant had the least 6. There were more complains from persons who had no hobby than those with hobbies. The complaints. The difference was significant. difference was significant. 7. Persons who said they were sexually inactive had significantly more complaints than those who said they were sexually active. As age increased, sexual activity significantly decreased. Those who lived with their spouse were significantly more sexually active. 8. The highest number of Somatic Complaints were eye fatigue, followed by nocturnal frequency, lumbago, cramps in extremities, vertigo, stiffness in Shoulder, tinnitus, common cold and constipation. The order of Psychic Complaints from higher to lower were anger. sensitivity, anxiety, depression and loneliness. 9. This group of Elderly persons said they valued Health the most, followed by Harmony, Religion, Money and Honor.

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Related Factors with Medication Task Ability in Rural Elderly (일부 농촌 노인에서의 약물복용 수행능력과 관련된 요인)

  • Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.35-47
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    • 1999
  • Medication non-compliance among the elderly results in medical problems and substantial cost to the health care system. This study investigate predicted variable related to the medication task ability among elderly. This study was done in the selected 4 villages in Kimchun County of Kyungbuk Province from July to August, 1996. The subject was the resident that 202 adults above 60 years of age. The questionnaire of interview included medication task ability, socio-demographic data, COOP/WONCA chart, family ABGAR score. BDI(Beck depression inventory), ADL(activities of daily living), IADL(instrumental activities of daily living), and MMSE-K(minimental state examination-Korean version). The results were as followed : 1. Approximately 49% of study population was taking drug medication currently. We found that 93% of study population was successful at the medication task all alone, 6% was failure at the medication task all alone, so need help partly or completely. 2. Significant variables between group of medication task ability were age, educational attainment, IADL, and MMSE-K in univariate analysis. And significant correlated variables with medication task ability were ADL, IADL, MMSE-K, and BDI in correlation analysis. 3. Major predictors to medication task ability on multiple logistic regression were IADL and sex finally. Findings suggest that IADL is related to medication task ability than other test battery of health status, so IADL could be used to necessary for medication management and add information to conventional methods of assessing mental status.

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DEVELOPMENT OF KOREAN ADOLESCENT FORM OF SUICIDAL IDEATION QUESTIONNAIRE (한국형 청소년 자살사고 설문 개발)

  • Suh, Dong-Soo;Yang, Suk-Hoon;Lee, Kil-Hong;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.168-177
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    • 2004
  • Objectives : This study was done to develop Korean form of Reynolds' SIQ-JR(Suicidal Ideational Questionnaire-Junior). Through this study we evaluated reliability and validity of Korean form SIQ-JR. Methods : Subjects were 1,160 middle and high school students and 114 adolescent psychiatric patients. SIQ-JR and 8 self-reporting scales highly related with suicidal ideation and suicide behaviors were applied to them. Results : In reliability aspect of Korean form of SIQ-JR, internal consistency, test-retest reliability and item-total correlation were statistically significant results. In factor analysis, concerning about other person was extracted as a indepenedent factor. This results reflect our cultural characteristics. There were statistical differences of SIQ-JR scores in groups by sex and age. Clinical group showed significantly(P<0.01) higher scores than general population. Among the 8 suicidal relating scales, depression(r=0.42), aggression(r=0.36), trait anxiety(r=0.35), and anger-in(r=0.31) were highly related with suicidal ideation but impulsivity and hopelessness were not significantly related with suicidal ideation. Conclusion : Korean form of SIQ-JR was useful instrument in reliability and validity. We hope that this instrument widely used in school mental health, community psychiatry and clinical setting for screening tool.

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Topiramate for the Treatment of Binge Eating Disorder or Bulimia Nervosa : A Systemic Review of Human Clinical Studies and Case Reports (Topiramate의 신경성 폭식증 치료효과: 국내외 보고된 임상연구결과 및 치험사례 중심으로)

  • Lee, Yu-Jeung;Bang, Joon-Seok
    • Korean Journal of Clinical Pharmacy
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    • v.17 no.1
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    • pp.6-12
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    • 2007
  • The clinical investigations above suggest that topiramate may be an effective agent in the treatment of BED or BN by reducing binging/purging episodes, improving the HRQOL, and decreasing weight. The case report and case series also support these findings. However, there are several limitations in the above studies and cases. All these had relatively small sample size, and two of them were only 10-week-period studies. Optimal duration of treatment with topiramate in patients with BED or BN is unknown. As most clinicians treat the patient with BED or BN for 6 to 12 months and then reassess, at least 6 months period is needed to show its efficacy. One of studies included only women in the patient group. In the case series, all patients had severe comorbid mood disorders such as major depression and bipolar disorder besides BN. Therefore, notwithstanding its clinical usefulness, additional researches are needed to define the role and the benefits of topiramate in the treatment of BED or BN more thoroughly.

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Right Amygdalar Laterobasal Subregional Differences in Healthy Adults with Different Novelty Seeking Tendencies (정상 성인에서 자극추구 기질에 따른 우측 편도체의 측기저 세부구조의 차이)

  • Cho, Han-Byul;Kim, Bin-Na;Choi, Ji-Hye;Jeon, Yu-Jin;Kim, Ji-Hyun H.;Jung, Ji-Young J.;Im, Joo-Yeon Jamie;Lee, Sun-Hea
    • Korean Journal of Biological Psychiatry
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    • v.19 no.2
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    • pp.71-76
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    • 2012
  • Objectives : Novelty seeking (NS) represents a dopaminergically modulated tendency toward frequent exploratory activity. Considering the reports showing the relationship between exploratory activity and amygdalar function and structure, and the fact that amygdala is one of the key structures that constitute the dopaminergic pathway in the brain, amygdala might be closely related to NS tendencies. Amygdalar subregional analysis method, which has the enhanced sensitivity compared to the volumteric approach would be appropriate in investigating the subtle differences of amygdalar structures among healthy individuals. The aim of the current study was to examine whether amygdalar subregional morphometric characteristics are associated with the NS tendencies in healthy adults using the amygdalar subregional analysis method. Methods : Twenty-six healthy adults (12 males, 14 females ; mean age $29.8{\pm}6.2$ years) were screened for eligibility. All subjects completed the Korean version of the Temperament and Character Inventory (TCI) and underwent high-resolution brain magnetic resonance imaging. Individuals were divided into 2 groups according to NS scores of the TCI. Results : Individuals of the high NS group had significantly larger laterobasal subregions in right amygdala, after adjustment with the brain parenchymal volumes. Sensitivity analyses for each potential confounding factor such as age, education years and Hamilton Depression Rating Scale (HDRS) scores demonstrated consistent results. Conclusions : This study suggests that NS differences are associated with the laterobasal subregion of the amygdala.

A Study on the Possibility of Homegrown Terrorism in Korea Depending on Internalization and Strategy to Cope with the Terrorism (국제화에 따른 한국내 자생테러 발생 가능성과 대응전략)

  • Yu, Hyung-Chang
    • Korean Security Journal
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    • no.31
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    • pp.125-155
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    • 2012
  • Terrorist organization has shown the trend of secret organization and it is harder to cope with terrorism because of uncertainty of terrorism. Homegrown terrorism is the one, whose preparation, execution and effect are restricted to domestic area. By the way, in the worldwide economic depression, violence and radical demonstration have shown the expansion trends as in Middle East, political revolution of Africa, anti-social resistance of Europe and Wall Street Occupation of USA. Homegrown terrorism is occurring in various countries such as UK and Spain as well as USA. Specialists warn homegrown terrorism in Korea. The purpose of this study was to prospect the possibility of homegrown terrorism that can be generated in the transfer to multi-culture society as various foreigners come to Korea rapidly and suggest the method to cope with the trend. The study analyzed environment and analysis of homegrown terrorism that Korea faces now. The methods to cope with homegrown terrorism are as follows. First, distribution of radical homegrown terrorism via internet should be prevented. Second, the connection between terrorist organization and homegrown terrorist should be prevented. Third, there should be a cooperation among government, residents and religious group. Fourth, there should be an open approach against multi-culture society. Fifth, there should be a systematic control for cause of new conflict. Finally, there should be a long-term approach to cause of new conflict. If we do not make an effort to prevent homegrown terrorism, terrorism environment may face new aspect and national and social cost for it will increase.

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D2 Dopamine Receptor (DRD2) Gene Polymorphism and Combat-Related Posttraumatic Stress Disorder in Vietnam Veterans (월남전 참전 재향군인에서 도파민 D2 수용체 유전자 다형성과 외상후 스트레스 장애)

  • Lee, Soo-Young;Chung, Hae-Gyung;Kim, Tae-Yong;Choi, Jin-Hee;Chung, Moon-Yong;So, Hyoung-Seok;Shin, Han-Sang;Lee, Shi-Eun
    • Anxiety and mood
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    • v.4 no.2
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    • pp.142-147
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    • 2008
  • Objective : Evidence from recent studies supports the role of genetic factors in the development of Posttraumatic Stress Disorder (PTSD). The primary aim of this study is to investigate the association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. The second aim is to examine the association between the DRD2 TaqI A polymorphism and clinical symptoms in patients with PTSD. Methods : We recruited 189 Vietnam veterans for participation in this study, among whom 99 were PTSD patients and 90 were control subjects. The presence of the DRD2 TaqI A polymorphism was determined by polymerase chain reaction (PCR). Several standardized research scales were used in the clinical assessment of PTSD, including the Combat Exposure Scale (CES), Clinician Administered PTSD Scale (CAPS), Beck Depression Inventory (BDI), and Clinical Global Impression (CGI). Results : There was no significant difference in the distribution of the DRD2 genotype, frequency and prevalence of the A1 allele, or the frequency of heterozygotes between the patients with PTSD and the controls. In the PTSD group, the patients with the A1 allele (A1A1, A1A2) scored higher on the CAPS-total (p=0.044), CAPS-avoidance symptoms (p=0.016) and BDI (p=0.024) than those without the A1 allele (A2A2). Conclusion : We could not find an association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. However, the A1 allele of DRD2 seemsto influence avoidance symptoms in patients with PTSD.

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The study of Literature Review on the pathological mechanism and Therapeutic methods of sudden coma -Focused on Different opinion of successive dynastic medical group in HwangJeNaeKyung and SangHanRon- (궐증(厥證)의 병인병기(病因病機) 및 치방(治方)에 관한 문헌적(文獻的) 고찰(考察) -내경(內經)과 상한론(傷寒論)에 대(對)한 역대의가(歷代醫家)의 견해(見解) 차이(差異)를 중심(中心)으로-)

  • Ryu Hyung-Cheon;Kwack Jeong-Jin;Choi Chang-Won;Lee Gang-Nyoung;Lee Young-Soo;Kim Hee-Chul
    • Herbal Formula Science
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    • v.11 no.1
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    • pp.57-90
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    • 2003
  • The result of Bibliographic studies on the pathological mechanism of the sudden coma, we got the conclusion like this. 1. The sudden coma is an acute syndrome that refers to be a sudden fainting, an unconsciousness, an aphasia or a cold clammy limb, and immediately awakes or dies, and awakes in a short time, and if we awake, it doesn't leave over and above a sequela. 2. The clinical presentation of the sudden coma can be summarized as follows : The 1st is a disease raising the sudden death due to unconsciousness accompanied by wry mouth & sudden syncope with coma. The 2nd is simply the state of cold limbs. The 3rd is the meaning of the physique and symptomes of the six meridians. The last is the ancient method of expression in contrast of the beriberi. 3. The pathological mechanism of the sudden coma consists of the toxoid from outside, Qi and Xie, fatigue, damp phegm, the damage from seven emotions and the damage from five mental elements, especially the mental disorder due to the angry energy, causes the problems when the fleming-up of liver fire and the depressed of liver qi raise the physiological disorder. 4. Therapeutic methods of sudden coma are soothing the liver and remove stasis, soothing depression and circulating of the qi, calming the liver and suppressing yang. When that is early stage, at first, we must checking upward adverse flow of the qi after promoting the circulation of qi and awakening, and then, we must regulate excessive deficiency of yin yang by therapy that is based on differentiated in symptoms according to heat & cold, deficiency & excess, and use invigorating herb medicine for supporting vigour.

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Factors Affecting Coffee Intake in Korean Adults (한국 성인의 커피 섭취량에 영향을 미치는 요인)

  • Kim, Myung-Gwan;Kim, Seung-Dae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.3
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    • pp.529-536
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    • 2020
  • This study aims to provide the basic data for coffee intake and health promotion by examining the conditions in which Korean adults consume the most coffee. The study used raw data from the second year of the 7th National Health and Nutrition Examination Survey (2017), and 3,325 subjects who were 19 years of age or older and who were not missing the required values. This number used as the average amount of coffee drank per day in the past year is at least one cup. In order to identify factors that affect coffee intake, the model included general characteristics such as gender, age, household income, education level, occupation, health behaviors such as smoking, drinking, high intensity and moderate intensity exercises, walking, physical activity during work and leisure, sleep time, stress and depression. The results showed that coffee intake was lower among women than men, coffee intake was higher for people 40-64 years than people 20-39 years old, physical occupations rather than non-physical occupations, smokers rather than non-smokers, and for high stress rather than low stress in life. Subjects with these factors are considered to be at risk of excessive caffeine intake from coffee. The risk group of this study should be studied for the effect of excessive consumption of coffee on personal health.