• Title/Summary/Keyword: Elderly age

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Status and related factors of private health insurance for severely ill patients (중증질환자의 민간의료보험 가입 현황 및 관련요인)

  • Kim, Seok-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.1
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    • pp.497-505
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    • 2018
  • This study was conducted to investigate the characteristics of private health insurance subscribers and non-subscribers as they relate to severely ill patients, and to identify the factors of participation. The study was conducted using the National Health and Nutrition Examination Survey for 2015, and data were analyzed using SPSS ver. 23.0. The subjects were 417 patients with severe disease (cancer, heart disease, cerebrovascular disease) over 19 years of age. Crossover analysis was employed to identify differences between the state of private health insurance participation, while binary logistic regression analysis was used to confirm the factors affecting private health insurance subscription. Analysis of the effects of the subjects on the private health insurance participation rate revealed that the social and demographic characteristics were higher in younger individuals regardless of sex, residence, or marital status. Moreover, higher household income, regardless of the education level, was associated with a higher participation rate of health insurance target individuals compared to medical benefit target individuals. The private health insurance participation rate was low and the explaining power was 51.7%, regardless of subjective health awareness and walking practice. Therefore, efforts should be made to improve the living environment and support local governmental programs for the elderly, low income households, socially vulnerable groups with limited activities and groups with limited health behavior. It is also necessary to consider various health policies, such as providing government health education or programs to prevent severe illness.

The Effects of the Older Adults' Depression on Metamemory and Memory Performance (노인의 우울이 메타기억과 기억수행에 미치는 영향)

  • Min, Hye Sook;Suh, Moon Ja
    • Korean Journal of Adult Nursing
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    • v.12 no.1
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    • pp.17-29
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    • 2000
  • The purpose of this study is to find out the effects of depression on older adults' metamemory and memory performances. The subjects of the study consisted of 103 older adults over the age of 60 who are living in Kangwon Province. Some data were collected by means of the interview method, using questionnaires for metamemory (MIA questionnaire by Hultsch, et al., 1988), and depression(GDS by Yesavage and Sheikl, 1986). Other data were collected by a testing method on the memory performance, such as the immediate word recall task, the delayed word recall task, the word recognition task(Elderly Verbal Learning Test by Kyung Mi Choi, 1998), and the face recognition task(Face Recognition Task tool developed by this study). The results of this study were as follows: 1) The average point of depressed older persons' metamemory is 3.2 on a 5 point scale and was significantly lower than nondepressed older persons' point of 3.6. Looking into each sub-concept of metamemory, depressed persons' points are higher in terms of task(4.1), but are lower in terms of change(2.3), locus(2.6), and strategy(2.9) in comparison with nondepressed persons' points. 2) Depressed older persons' memory performances are all significantly lower than nondepressed person's, especially in terms of face recognition task(t=7.26, p<.0082) and word recognition task(t=6.58, p<.01). 3) In both depressed and nondepressed persons, metamemory has a close correlation with all memory tasks. In particular, depressed older persons' correlation is higher across the board, especially in memory self-efficacy of metamemory(r=.36 - .49) in comparison with nondepressed persons. 4) According to the results of analysis on the relations between metamemory and memory performances of each memory task using canonical analysis, in the case of depressed older persons, strategy, locus, capability and task have high correlation with word recognition task and delayed word recall task. Also in the case of nondepressed persons, achievement, strategy, change and locus variable have high correlation with face recognition task and immediate word recall task. As mentioned above, depression variables have a negative effect on older persons' metamemory and memory performance. In conclusion, when we care for depressed older persons with less memory ability, we have to consider the outcomes of this study are relevant. In addition, it is necessary to develop nursing intervention in order to prevent memory loss and improve memory performance in depressed older persons.

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Analysis of the Continuity of Outpatient among Adult Patients with hypertension and its Influential Factors in Korea (우리나라 성인 고혈압환자의 외래진료 지속성과 이에 영향을 미치는 요인 분석)

  • Son, Kyung-Ae;Kim, Yoon-Shin;Hong, Min-Hee;Jeong, Mi-As
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.6
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    • pp.2161-2168
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    • 2010
  • The administration data of the national health insurance and health insurance bills were utilized in this study. The data of 485,953 patients who were at the age of 30 and up and used the out-patient departments of every medical institution located in some regions involving two southern and northern provinces once or more during a 184-day period from July to December, 2008. As a result of analyzing their Continuity of Ambulatory Care and factors affecting it, the following findings were given: The continuity of ambulatory care among the adult patients with hypertension in our country turned out to be on a high level(MMCI $0.96{\pm}0.13$, MFPC $0.96{\pm}0.12$). Given examining the outpatient medical-cure continuity level according to index, the averagely medical-cure continuity level was calculated to be high level with MMCI, $0.96{\pm}0.13$, and MFPC $0.96{\pm}0.12$. Thus, the tendency of visiting only one medical provider was high. The findings of the study illustrated that the average continuity of ambulatory care among the adult patients with hypertension in our country was on a high level, and it seemed that special care should be provided to patients with a low-level continuity of ambulatory care, such as women and elderly people aged 64 and over. The findings of the study are expected to serve as one of the barometers for the health care of patients with hypertension and for the performance of national hypertension management plans.

The Effect of the Fall Prevention Exercise Program Focussed on Strengthening of the Lower Extremity Muscles on the Change of Physical Function and Muscle Architecture of the Elderly (하지근력강화중심 낙상예방운동이 노인의 신체기능 및 근구조 변화에 미치는 영향)

  • Yang, Ji;Lee, Wan-Hee;Kang, Ki-Seon;Kim, Hyo-Sil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.1904-1919
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    • 2015
  • This study was conducted to verify the effect of the fall prevention exercise program (FPEP). From 1st June to 14th July in 2014, 52 subjects above the age of 65 in 2 health clinics of A town, J city were randomly assigned to two groups(exercise 31, control 21). While exercise group performed FPEP twice a week for 6 weeks, control group received education only. The results showed significant difference between the two groups in the TUG of physical function(P=.032). There were no statistically significant difference between the two groups in the fear of falls, falls efficacy of mental functions. The result of ultrasound measurement of lower extremity muscles showed statistically significant differences between groups in the 7 items(RF CSA Contraction RF DIS Resting, TA Thickness Contraction, TA P-angle Contraction, GCM Thickness Resting, GCM Thickness Contraction, GCM P-angle Contraction)(p<.05). In conclusion, the FPEP is very effective in the prevention of falls.

Pb, Hg and Cd Concentration of Blood and Exposure-Related Factors (혈중 납, 수은, 카드뮴 농도와 노출관련 인자)

  • Oh, Jung-Sook;Lee, Sun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.2089-2099
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    • 2015
  • This study examined the relationships between the blood heavy metal (Pb, Hg and Cd) concentration and exposure-related factors. The subjects were 2,042 (male: 953, female: 1,089) who were recruited through a National Health and Nutrition Examination Survey. Differences in the concentrations of mercury were observed in males, whereas females showed differences in lead and cadmium. Analyses of the blood concentrations according to body mass index and waist circumference showed significantly higher concentrations of mercury. In males, high-density lipoprotein cholesterol of dyslipidemia was higher than normal in the blood lead concentration. In females, low-density lipoprotein cholesterol of dyslipidemia was higher than normal in the blood lead concentration. The blood lead and cadmium concentrations of male smokers was higher than non-smokers, and cadmium showed the same results in females. The blood lead levels were higher in male alcohol consumers than non-drinkers. The blood concentrations of mercury and cadmium showed significant differences according to household income. Blood concentrations of heavy metals were closely related to exposure-related factors, and age, smoking, drinking alcohols, obesity, hyperlipidemia, and household income were found to be relevant.

Early Outcomes of Sutureless Aortic Valves

  • Hanedan, Muhammet Onur;Mataraci, Ilker;Yuruk, Mehmet Ali;Ozer, Tanil;Sayar, Ufuk;Arslan, Ali Kemal;Ziyrek, Ugur;Yucel, Murat
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.165-170
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    • 2016
  • Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used. Results: The mean age of the patients was $71.15{\pm}8.60years$. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was $56.9{\pm}9.93$. The CPB time was $96.51{\pm}41.27minutes$ and the cross-clamping time was $60.85{\pm}27.08minutes$. The intubation time was $8.95{\pm}4.19hours$, and the intensive care unit and hospital stays were $2.89{\pm}1.42days$ and $7.86{\pm}1.42days$, respectively. The mean quantity of drainage from chest tubes was $407.69{\pm}149.28mL$. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was $687.24{\pm}24.76days$. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

Evaluation of Methods Used in Nutrition Surveys in Korea(1960-1990) (국내 영양조사(1960-1990년)에서 적용된 영양평가 방법의 내용 및 추이분석)

  • 최영선
    • Journal of Nutrition and Health
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    • v.25 no.2
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    • pp.187-199
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    • 1992
  • The purpose of the study is to assess and evaluate methods employed in nutrition surveys and to give an information on methodological considerations for future studies in Korea. Three hundred thirty six papers of nutritional surveys published from 1960 to 1990 were classified into 9 groups according to the survey subject and analyzed for methods used in survey. The frequency of publications according to the survey subject was as the following order : 'in-fants and preschool children' 'school age children' 'adolescence' 'college students' 'preg-nant and lactating women' 'housewives' 'the elderly' 'workers' and 'patients' Eighty five percents of papers applied methods of dietary assessment. of which weighing method recall method an record method were extensively used in the order. Questionnairs included items related to nutrition such as food habit nutrition knowledge etc. Anthropometric techniques were employed in 53% of papers and in general growth measurement were undertaken for children and body composition was emphasized for adults. biochemical assessment was limited to 32% of papers and assessment of anemia was the major test. Clinical studies were applied to 26% of the studies. of which only 5% employed examination of clinical signs of malnutrition Recently self-reported health status assessed using questionnaires has been adopted frequently. Further researches are required for evaluation of the methods employed in nutrition surveys in order to develop the standard model for nutrtion survey so that obtained data can become more reliable and utilized efficiently.

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Case report : Postherpetic Neuralgia (포진후 신경통의 치료 증례)

  • Bae, Kook-Jin;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Cho, Young-Gon;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.35 no.1
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    • pp.93-99
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    • 2010
  • Herpes zoster (HZ) is the secondary manifestation of an earlier infection with the varicella-zoster virus in one or more dermatomes. As reactivation of the virus is linked to an age-related diminished virus-specific and cell-mediated immunity, HZ develops mainly in elderly people. Acute zoster is painful, but does not incur lasting morbidity. Reactivation of the varicella-zoster virus in the trigeminal nerve (Herpes zoster) occur with severe pain and rash in the oro-facial region. The acute pain decreases as the rash begins to heal. Postherpetic neuralgia(PHN), the most frequent complication of herpes zoster, is usually defined as pain in the involved dermatome that is still present 3 month after rash onset. The clinical characteristics of PHN are, eposodic stabbing pain, burning pain and allodynia, with hypoesthesia and/or dysesthesia. $Neurometer^{(R)}$(neuroselective sensory nerve conduction threshold: sNCT, Automated current perception threshold: CPT, neurotron incorporated. Baltimore, Maryland. 21209 U.S.A.) is convenient, rapid and noninvasive, and allows objective assessment of sensory disturbance. This case is about the postherptic neuralgia patient assessed with $Neurometer^{(R)}$. From this case, we reviewed the pathophysiology and the treatment of PHN and recommend the assessment of pain intensity with $Neurometer^{(R)}$ as quantitative and objective method.

Analysis of Dietary Characteristics of Participants Attending the Nutrition Education Program for Hypertensive Patients at a Public Health Center (보건소 고혈압 영양교육 참여자의 식생활 요인 분석)

  • Im, Gyeong-Suk;Han, Mun-Hwa;Gang, Yong-Hwa;Park, Hyei-Ryeon;Kim, Chan-Ho
    • Journal of the Korean Dietetic Association
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    • v.6 no.2
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    • pp.125-135
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    • 2000
  • Hypertension is a well-known degenerative disease whose prevalence rate increases with age. Management of high blood pressure is a critical concern in preventive strategies to reduce the morbidity and mortality for cardiovascular disease. The purpose of this study was to examine the dietary characteristics of hypertensive program participants, and to establish strategies based on their nutritional needs. Hypertensive patients were enrolled in the program in a public health center or in a local elderly center, at Suwon, in 1999-2000. Trained dietitians interviewed 62 enrollees(24-hour recall) and related variables. Mean body mass index of the subjects was 25.0kg/m². 30.7% of the subjects had a family history of hypertension. The majority of them ate regularly and partook of all available side dishes. They consumed grains and vegetables regularly, but seldom ate dairy products or food prepared with oil. Male enrollees frequently consumed more processed food and animal fat than did female enrollees(p<0.05). An analysis of the percentage of RDA(Recommended Dietary Allowances of Korea 1995) showed that but for ascorbic acid, enrollees consumed nutrients below the RDA. The food group intake pattern was not diverse, thus only 8.1% of enrollees consumed all food groups in a day. An analysis of eating attitude showed that 64.5% of enrollees always added salt to beef soup. Male enrollees showed low food-related self-efficacy compared to female enrollees, especially with reference to reduction of instant food intake(p<0.01), increase in vegetable intake(p<0.01), reduction of monosodium glutamate(MSG) intake(p<0.01). and not overeating(p<0.05). Their perceived barriers for participating in hypertension nutrition programs included lack of time, program necessity non-recognition, and program comprehension difficulty. These results suggest that nutrition education program necessity non-recognition, and program comprehension difficulty. These results suggest that nutrition education programs for community hypertensive patients should focus on increasing participant consumption of foods, expecially dairy products, and desirable eating attitudes. It also suggests that the program should consider should consider encouraging self-efficacy in changing eating behavior.

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A Study on the Determinants of Private Long-Term Care Insurance and First Home Care Use in the United States: Using Discrete Time Model (미국의 민간장기요양보험 가입과 재가요양서비스 이용의 결정요인에 관한 연구: 이산시간모델을 사용하여)

  • Kim, So-Yun;Hong, Gong-Soog;Montalto, Catherine P.
    • Survey Research
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    • v.11 no.2
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    • pp.97-121
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    • 2010
  • Using the 1998-2004 Health and Retirement Study(HRS), this study explored the determinants of private long-term care insurance(LTCI) ownership and the first home care use. To account for the interaction between LTCI purchase and home care use, this study used two-period utility model as theoretical framework. Discrete time model was used as an empirical model to incorporate the time-dependent feature of LTCI ownership. And this study accounted for the endogeneity of LTCI ownership and home care use by employing full information maximum likelihood estimation. This study indicated insignificant effects of private LTCI ownership and Medicaid eligibility on the home care use. Also, the effects of income and assets on home care utilization were negligible. Those who have poor health condition and who do not have potential informal caregivers were more likely to use home care. For private LTCI ownership, income and assets have positive relationship with LTCI purchase, and poor health status and age were negatively related to LTCI purchase. The elderly living with children and those who have more siblings were less likely to have private LTCI, and those who lived with spouses with no children were more likely to buy private LTCI. Based on the findings, this study provides implications to design long-term care(LTC) policies in the U.S. and to develop LTC planning education programs.

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