• 제목/요약/키워드: Frail Elderly

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국내 지역사회 거주 노인의 허약과 건강결과 간의 관계에 대한 통합적 고찰 (Association of Health Outcomes with Frailty in Community-Dwelling Korean Older Adults: An Integrative Review)

  • 손연정;이숙정;최유리
    • 가정간호학회지
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    • 제26권1호
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    • pp.5-18
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    • 2019
  • Purpose: Frailty is associated with an increased risk of adverse health outcomes. We aimed to review the relationships between frailty and health outcomes in community-dwelling Korean elderly individuals. Methods: Whittemore and Knafls' framework for conducting integrative reviews was used. PubMed, Cumulative Index to Nursing and Allied Health Literature, and six Korean databases were searched. For analysis, the study included articles written in English and Korean published between January 1960 and June 2018. Of the total 1,488 studies found in the databases, we analyzed 15 studies that met the quality of the evaluation criteria. Results: The prevalence of frailty in Korean elderly individuals ranged from 6.5% to 11.7% when divided into three levels of frailty. The health outcomes assessed in relation to frailty were divided into five domains: quality of life, physical health, psychosocial health, health behavior, and health care quality. Frailty was negatively associated with all five domains. Conclusions: Our study suggested that nurses should be aware of the limitations in the physical and cognitive functions of frail elderly individuals and provide tailored interventions for Korean elderly individuals. Furthermore, a large-scale study is needed to develop the Korean model of the frailty assessment tool and to verify the conceptual model of this study.

저소득 여성노인의 연령별 건강관련 삶의 질에 영향을 미치는 요인 (Factors Influencing the Health-Related Quality of Life by Age among Vulnerable Elderly Women)

  • 김윤희
    • 한국산학기술학회논문지
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    • 제14권3호
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    • pp.1342-1349
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    • 2013
  • 본 연구는 저소득 여성노인의 건강관련 삶의 질에 영향을 미치는 요인을 전기노인(65-69세), 중기노인(70-79세), 후기노인(80세 이상)으로 연령별로 구분하여 파악하고자 수행되었다. 자료는 B광역시의 5개 보건소의 맞춤형방문 보건사업에 등록된 기초생활수급자 여성 노인 383명으로부터 2010년 9월부터 11월까지 설문지를 통하여 수집되었으며 다중회귀분석으로 분석하였다. 저소득 여성노인의 건강관련 삶의 질, 생활 만족도, 인지기능, 허약수준은 연령별로 차이가 있었다. 저소득 여성노인의 건강관련 삶의 질에 영향을 미치는 요인은 연령별로 차이가 있었으며 생활 만족도, 인지기능, 허약수준, 주관적 건강수준, 만성질환개수를 포함한 모형은 전기노인의 건강관련 삶의 질을 42.8%, 중기노인의 28.9%, 후기노인의 31.5%를 설명하였다. 허약수준과 생활만족도는 저소득 여성노인의 전체 연령에 있어 건강관련 삶의 질에 영향을 미치는 요인으로 나타났다. 그러므로 저소득 노인여성의 건강관련 삶의 질 개선을 위한 건강증진 프로그램은 연령별 차이를 고려하여 개발되어 적용될 필요가 있다.

Prediction of Risk Factors after Spine Surgery in Patients Aged >75 Years Using the Modified Frailty Index

  • Kim, Ji-Yoon;Park, In Sung;Kang, Dong-Ho;Lee, Young-Seok;Kim, Kyoung-Tae;Hong, Sung Jin
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.827-833
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    • 2020
  • Objective : Spine surgery is associated with higher morbidity and mortality rates in elderly patients. The modified Frailty Index (mFI) is an evaluation tool to determine the frailty of an individual and how preoperative status may impact postoperative survival and outcomes. This study aimed to determine the usefulness of mFI in predicting postoperative complications in patients aged ≥75 years undergoing surgery with instrumentation. Methods : We retrospectively reviewed the perioperative course of 137 patients who underwent thoracolumbar-instrumentation spine surgery between 2011 and 2016. The preoperative risk factors were the 11 variables of the mFI, as well as body mass index (kg/㎠), preoperative hemoglobin, platelet, albumin, creatinine, anesthesia time, operation time, estimated blood loss, and transfusion amount. The 60-day occurrences of complication rates were used for outcome assessment. Results : Major complications after spinal instrumentation surgery occurred in 34 of 138 patients (24.6%). The mean mFI score was 0.18±0.12. When we divided patients into a pre-frail group (mFI, 0.09-0.18; n=94) and a frail group (mFI ≥0.27; n=44), only the rate of sepsis was statistically higher in the frail group than in the pre-frail group. There were significantly more major complications in patients with low albumin levels or in patients with infection or who had experienced trauma. The mFI was a more useful predictor of postoperative complications than the American Society of Anesthesiologists physical status score. Conclusion : The mFI can successfully predict postoperative morbidity and mortality in patients aged ≥75 years undergoing spine surgery. The mFI improves perioperative risk stratification that provides important information to assist in the preoperative counselling of patients and their families.

Breast and Colorectal Cancer Screening and Associated Correlates among Chinese Older Women

  • Leung, Doris Y.P.;Leung, Angela Y.M.;Chi, Iris
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권1호
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    • pp.283-287
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    • 2012
  • Objective: To explore the participation rates for breast and colorectal cancer screening and identify associated correlates among elderly women. Methods: Logistic regressions were conducted using data collected in 2006 from 1,533 elderly women aged 60 years or above who had completed a screening instrument, the Minimum Data Set-Home Care, while applying for long-term care services at the first time in Hong Kong. Results: The participation rates for breast and colorectal cancer screening among frail older Chinese women were 3.7% and 10.8% respectively. Cognitive status was inversely associated with the likelihood of participation in screening (breast: OR = 0.66, 95%CI = 0.47-0.94; colon: OR = 0.81, 95%CI = 0.66-0.99), as was educational level with the likelihood of participation in breast cancer screening (no formal education: OR = 0.20, 95%CI = 0.06-0.61, some primary education: OR = 0.31, 95%CI = 0.10-1.00). Conclusion: The delivery of cancer preventive health services to frail older women is less than ideal. Cognitive status and educational level were important factors in cancer screening behaviour. Tailor-made strategic promotion programmes targeting older women with low cognitive status and educational levels are needed to enhance awareness and acceptance within this vulnerable group.

가정간호서비스 이용 노인환자의 간호요양원(nursing home) 필요 예측에 관한 연구 (The needs of nursing home services for frail elderly people receiving home care nursing services)

  • 강임옥
    • 간호행정학회지
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    • 제5권3호
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    • pp.415-424
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    • 1999
  • The purpose of this study was to estimate the population requiring nursing home services for frail elders who received home care nursing services. This study identified the need of nursing home services and the proportion of elders over 60 years of age requiring nursing home services according to the admission eligibility including items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. In this study, survey research design was conducted. A total of 49 home care nurses were collected. They were asked to assess the need of nursing home services based on items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. Using secondary data analysis from the survey on 'The Evaluation of Home Care Nursing Service Program in 1994 in Korea', the proportion of elders requiring nursing home services was estimated. The estimated numbers and proportion of frail elders requiring nursing home services were 169 (86.2%) aged persons among community dwelling elders based on admission eligibility. However, the proportion of aged persons was 68% using the only criteria for screening of patients requiring for screening home care nursing services.

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포괄적 한국 노인 허약사정 도구의 적용가능성과 예측타당도 평가: 2008, 2011년 노인실태조사 자료 이용 (The Evaluation of Feasibility and Predictive Validity of Comprehensive Korean Frailty Instrument: Using the 2008 and 2011 Living Profiles of Older People Survey in Korea)

  • 오은미;홍(손)귀령
    • 지역사회간호학회지
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    • 제28권2호
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    • pp.206-215
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    • 2017
  • Purpose: This study aimed to verify the predictive validity of Comprehensive Korean Frailty Instrument (CKFI) among older adults. Methods: A secondary analysis of data from a prospective cohort study was conducted. Frailty was determined in older adults (N=9,188) according to the data in 2008 and the effects of frailty on adverse outcomes (such as institutionalization and death) were evaluated according to the data in 2011. The Cardiovascular Health Study (CHS) index was used to compare with the predictive validity of CKFI. Results: The prevalence of frailty was 26.3%. With the CKFI, the frail group had a higher risk of negative health outcomes compared to the robust and pre-frail groups after three years. The two of the highest risks identified using the CKFI and CHS index were institutionalization (5.522 times higher) and mortality (3.210 times higher). For both instruments, the survival analysis revealed that the risk of death increased as the degree of frailty increased. Conclusion: The CKFI consisting of self-report items and multidimensional aspects of frailty can be used as a simple instrument for assessing the frailty of older adults residing in a local community in Korea.

노인요양시설 주거부분 공유공간에 관한 연구 (A Study on the Shared Space in the Residential Part of Nursing Homes for the Elderly)

  • 손수진;이특구
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제5권9호
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    • pp.37-45
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    • 1999
  • Most of elderly residents who live in nursing home for a long time have been suffering from chronic sickness. Therefore, residential part should be the place to recover social relationship, to get over isolation and to be able to make communication through contact of personal activities. The purpose of this study is to offer the guideline of planning and scale of the shared place which makes better housing environment of the elderly. also, the character of the elderly and element of environments appropriate for the frail elderly people were study.

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노인 두경부암 환자의 생존에 있어 노쇠의 의의 (Frailty in Geriatric Patients with Head and Neck Cancer and its Implication in Survivorship)

  • 권민수
    • 대한두경부종양학회지
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    • 제39권2호
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    • pp.1-6
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    • 2023
  • The aging population, particularly those aged 65 and above, is on the rise, with projections indicating a substantial increase in the elderly demographic. This demographic shift brings challenges in managing age-related diseases, including head and neck cancers (HNCs). Frailty, often characterized by physiological decline and vulnerability to stressors, is a crucial factor affecting treatment outcomes of elderly cancer patients. Accordingly, the significance of assessing frailty in elderly HNC patients before their treatment should be emphasized, but current frailty assessment tools may not fully capture the unique challenges faced by HNC patients. Specific indicators, including respiratory and swallowing functions, are proposed for a more tailored assessment. This comprehensive review explores the impact of frailty on various treatment modalities, including surgery, radiation, and chemotherapy, highlighting the need for personalized interventions. Furthermore, it suggests avenues for future research to enhance frailty assessment tools and investigate interventions aimed at improving treatment outcomes in elderly HNC patients.

허약노인을 위한 방문재활 프로그램의 장애발생예방 효과에 대한 연구 (Effects of Visiting Prehabilitation Program against Functional Decline in the Frail Elderly: A Prospective Randomized Community Trial)

  • 김창오;이희연;호승희;박현숙;박철우
    • 한국노년학
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    • 제30권4호
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    • pp.1293-1309
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    • 2010
  • 본 연구는 허약노인의 장애발생예방을 위하여 개발된 지역사회 방문재활 프로그램의 효과성을 평가하고, 허약노인 대상의 방문재활사업이 공공부문의 보건기관에서 실제 수행될 수 있도록 그 근거를 마련하는 것을 목적으로 하고 있다. 2009년 4월부터 8월까지 맞춤형 방문건강관리사업에 등록된 저소득 취약계층 노인들 중 110명의 허약노인을 선정하여, 이들을 대상으로 지역사회 중심의 실험연구를 수행하였다. 연구대상자는 무작위 방식으로 실험군(n=50)과 대조군(n=60)으로 나뉘어, 이 중 실험군은 3개월 동안 상·하지 근력강화, 보행능력 강화, 균형능력증진 등에 초점 맞추어진 허약노인 방문재활 프로그램에 참여하게 하였고, 대조군은 가정방문을 통한 낙상예방교육을 받게 하였다. 프로그램의 평가를 위해 1차 결과지표로서 신체기능척도, 간이신체기능 평가를 프로그램 사전·사후에 측정하였고, 그밖에 운동수행능력검사, 영양지표, 정서기능, 입원 및 낙상경험 등을 측정하였다. 연구결과 방문재활 프로그램에 참여한 대상자에서 신체기능척도와 간이신체기능평가 등 주요 노인기능지표의 유의한 향상이 관찰되었다. 신체기능척도에 대해서 실험군은 1.3 ± 3.8점의 상승이 있었던 반면, 대조군에서는 1.1 ± 5.4점의 감소가 있었다 (p=.020). 간이신체기능평가에 대해서도 실험군은 2.4 ± 2.0점의 상승이 있었던 반면, 대조군에서는 0.3 ± 1.5점의 상승만이 관찰되었다 (p<.001). 그밖에 허약노인을 위한 방문재활 프로그램은 운동수행능력, 정서기능, 반복낙상 횟수 및 낙상 후 기능저하 발생에 대해서도 유의한 효과를 보여주었다 (p .002-.038). 향후 우리나라 노인들의 장애발생을 예방하고 이로 인한 중증 장기요양단계로의 진입을 억제하기 위하여 허약노인 대상의 방문재활 프로그램과 이에 근거한 건강관리사업이 보다 적극적으로 확대·보급되어야 할 것이다.