• Journal of International Academy of Physical Therapy Research
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• v.4 no.2
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• pp.545-551
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• 2013

The purpose of this study is to determine the correlations between problematic behaviors and activities of daily living(ADL) targeting 106 demented elderly people hospitalized in a geriatric hospital. To examine the cognitive function of the subjects, the study used Korean Mini Mental State Examination(K-MMSE). For problematic behaviors and ADL, the study collected data based on Patient Assessment Forms in the geriatric hospital. Among problematic behaviors, apathy/indifference had the highest correlation with the items of ADL. Irritability/lability, agitation/aggression, depression/ dysphoria, night-time behavior and wandering also showed to be correlated to items of ADL(p<.05). This study demonstrated that cognitive function, problematic behaviors and ADL of the demented elderly hospitalized in the geriatric hospital are correlated to each other.

• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.418-429
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• 2018

Background : To improve medication adherence in elderly patients, the role of pharmacists in teambased services has been highlighted in the literature. However, not much is known about the role and the service elements involved in comprehensive geriatric programs in South Korea. This study was designed to describe the current status of medication adherence in geriatric patients based on the comprehensive geriatric assessment program and analyze the predictive factors for medication adherence in a tertiary teaching hospital. Methods : A retrospective cohort study was performed using electronic medical records of 247 patients from March 1st, 2015 to August 31st, 2015. Medication adherence and the types of non-adherence were also collected. Predictive factors for adherence were evaluated by including factors related to demographics, medications, illness, and patterns of medical usage. Results : The mean age of the study population was 81.2 years (range 65~98 years) and they were taking 9.7 drugs on an average (SD 5.0 drugs). The overall rate of non-adherence was 34%. About 48% of the patients had any forms of assistance in the medication administration. The most common type of non-adherence was "self-adjustment". The multivariate analyses revealed that age (adjusted odds ratio, 0.87 [95% CI, 0.80-0.96]; p 0.05) and the number of inappropriate medications (adjusted odds ratio, 0.59 [95% CI, 0.40-0.89]; p 0.05) were strong predictors for non-adherence. Conclusions : These results indicate that strategic considerations of the predictors of non-adherence should be improved in medication counseling services targeting elderly patients.

• Annals of Geriatric Medicine and Research
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• v.20 no.3
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• pp.125-130
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• 2016

Background: Conventionally, elderly hip fracture patients are assessed by orthopedists to decide whether they need geriatric intervention. We aimed to evaluate the effect of perioperative geriatric intervention on healthcare outcomes in patients undergoing surgery for hip fractures. Methods: Our care model for hip fracture surgery resembles a combination of a routine geriatric consultation model and a geriatric ward model. We retrospectively reviewed the medical records of patients aged ${\geq}65years$ undergoing surgery for hip fracture at a single tertiary hospital from January 2010 to December 2013. We assessed comorbidity, indwelling status, fracture type, and mode of anesthesia. We also evaluated in-hospital expenditure, duration of admission, disposition at discharge and 1-year mortality as clinical outcomes. We developed a propensity score model using the variables of age, cholesterol, and creatinine and examined the effect of perioperative geriatric intervention on intergroup differences of clinical variables. Results: Among 639 patients, 138 patients received the geriatric intervention and 501 patients received the usual care. Univariate analysis showed that factors such as age; Charlson comorbidity index; and serum levels of cholesterol, albumin, and creatinine differed significantly between these 2 groups. There was no significant difference between the groups in terms of 1-year mortality, disposition at discharge, and in-hospital expenditure in the propensity matched model. However, the duration of hospitalization was shorter in the intervention group ($8.9{\pm}0.8days$) than in the usual care group ($14.2{\pm}3.7days$, p=0.006). Conclusion: This care model of geriatric intervention for patients with hip fracture is associated with reduced hospitalization duration.

• Korean Journal of Clinical Pharmacy
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• v.30 no.2
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• pp.113-119
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• 2020

Background: Reducing the total anticholinergic burden (AB) in older adults is recommended owing to the several peripheral and central adverse effects. This study aimed to identify the AB status of patients admitted to geriatric centers for assessing the influence of the pharmacist-involved multidisciplinary geriatric team care on reducing the AB. Methods: We retrospectively reviewed the medical records of 328 older patients hospitalized in geriatric centers from July 1, 2018 to June 30, 2019, who received comprehensive geriatric assessment and pharmaceutical interventions from a multidisciplinary geriatric team. We measured the total AB scores for the medications at the time of admission and upon hospital discharge using the Korean Anticholinergic Burden Scale (KABS). The pre-admission factors associated with high AB (KABS score ≥3) at the time of admission were identified. Results: The proportion of patients with high AB significantly decreased from 41.8% (136/328) at the time of admission to 25.0% (82/328) on discharge (p<0.001). The pre-admission AB of patients transferred from skilled nursing facilities (odds ratio[OR]: 2.85, 95% CI: 1.26-3.75), taking more than 10 medications (OR: 3.70, 95% CI: 1.55-8.82), suffering from delirium (OR: 2.80, 95% CI: 1.04-7.50), or depression (OR: 2.78, 95% CI: 1.04-7.41) were significantly high. Antipsychotics were the most frequent classes of drugs that contributed to the total KABS score at the time of admission, followed by antihistamines. Conclusions: This study demonstrated that the multidisciplinary teams for geriatric care are effective at reducing AB in older adults. The factors associated with high AB should be considered when targeting pharmaceutical care in geriatric individuals.

• Journal of Preventive Medicine and Public Health
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• v.41 no.1
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• pp.10-16
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• 2008

Objectives : Korea faces a number of challenges to meet demands in the area of geriatric professional medicine in a country with a rapidly ageing population. We evaluated the satisfaction and feasibility of the current education certification for geriatric physicians. Methods : Geriatric physicians who were deemed qualified by the Korean Geriatrics Society during the period of 2001 to 2005 (n=2,200) were asked to complete structured questionnaires sent to them by mail about their satisfaction of and need for certificates of education, as well as their opinions on their geriatric specialty training. A total of 419 physicians responded. Descriptive analysis and hierarchical regression were performed to rate the respondents' satisfaction, the characteristics of the need for clarity and utility in education certification, and the characteristics of their patients. Results : Although most respondents were satisfied with their education certification, those who had more elderly patients, aged 65 or older, and those who had more cognitively impaired patients, rated their education as significantly lower than did other physicians. Both groups expressed the need for more the comprehensive care and assessment concerning of their education. Multiple regression analysis indicated that satisfaction with geriatric physician qualification was associated with a physician's age, specialty, and percentage of elderly patients. Conclusions : This study suggests that the current system of education certification is limited in terms of feasibility and physician satisfaction.

• The Journal of Korean Society for School & Community Health Education
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• v.24 no.3
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• pp.37-50
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• 2023

Objectives: The aim of this study was to identify factors influencing communication satisfaction between geriatric caregivers and older adults in urban-rural complex communities. The ultimate goal was to design local community educational programs and policies to enhance communication satisfaction among geriatric caregivers and improve the quality of care services for older adults. Methods: To identify factors influencing communication satisfaction between elderly caregivers and older adults, a survey titled "CCEP: Assessment of Communication Status between Elderly Care Service Providers and Recipients" was conducted from February to July 2020, focusing on rural-urban complex areas. The survey was administered based on providers of elderly healthcare services. The survey targeted 131 respondents involved in providing care services for older adults. The dependent variable of this study was the communication satisfaction reported by elderly caregivers in their interactions with the elderly. The independent variables included perceptions of older adults, factors associated with communication difficulties, and communication efforts. Additionally, gender, working environment, working experience, and the proportion of face-to-face interactions with older adults during caregiving were controlled for the hierarchical multiple regression analysis. Results: The analysis revealed that communication efforts with older adults significantly influenced communication satisfaction (β=.09, p<0.01). However, perceptions of the elderly and communication hindrance factors did not have a significant impact on communication satisfaction among geriatric caregivers. Conclusion: Effective communication between geriatric caregivers and older adults is crucial for identifying and meeting the needs and demands of caregiving services, and it plays a vital role in overall caregiving service satisfaction. To enhance communication skills and satisfaction among geriatric caregivers and ensure the appropriate fulfillment of elderly care needs in the local community, the development of community-centered, specialized health communication programs and other initiatives will be necessary in the future.

• The Korean Journal of Rehabilitation Nursing
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• v.19 no.2
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• pp.118-127
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• 2016

Purpose: This study was to develop an evidence-based clinical practice protocol of physical restraints by adaptation process for patients with a geriatric hospital. Methods: Protocol adaptation process was conducted in accordance with manual for guideline adaptation version 1.0 by ADAPTE collaboration. Results: The adapted physical restraint protocol was consisted of 3 domains and 37 recommendations. The number of recommendations in each domain were: 7 nursing assessment, 19 nursing intervention, and 11 nursing evaluation. More than half (56.8%) of the recommendations were rated as grade B, 37.8% as grade C, and 5.4% were rated as grade D. Conclusion: The adapted physical restraint protocol is expected to contribute as an evidence-based clinical practice protocol for healthcare workers in geriatric hospitals for reducing and improving efficiency of appropriate physical restraints use.

• Nutrition Research and Practice
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• v.9 no.6
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• pp.637-643
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• 2015

BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged $73.5{\pm}5.2years$) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.

• Journal of Home Health Care Nursing
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• v.17 no.1
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• pp.5-11
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• 2010

Purpose: The study examined the psychometric properties of the Korean Geriatric Depression Scale Informant-15 (KGDSI-15), an instrument measuring geriatric depression through their primary caregivers. Methods: The participants were 370 Korean older adults $\geqq$65-years-of-age registered in a visiting health center in S city. The Korean version of Geriatric Depression Scale-Short Form (GDSSF-K) was used for comparison. Internal consistency measured tool reliability and Pearson correlation coefficient measured validity. One-way ANOVA was used to determine the clinical usability of the instrument: depression levels were classified as normal, mild depression, and severe using GDSSF-K, and the depression scores of these three groups were comparatively measured by KGDSI-15. Results: The Cronbach's alpha coefficient was .831. The correlation coefficient with GDSSF-K was r=.616 (p<.001). KGDSI-15 results showed the depression level of older adults with severe depression was highest followed by those with mild depression and normal. The group differences were also statistically significant, which indicated the clinical usability of the instrument. Conclusion: KGDSI-15 is suggested to be reliable and valid to measure the geriatric depression through the primary caregivers of older adult.

• Korean Journal of Clinical Pharmacy
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• v.26 no.1
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• pp.13-23
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• 2016

Background: South Korea is rapidly being an aging-society and the demand of long-term care insurance services for elderly patients is rising. In addition, because the elderly taking multiple medicines, the adherence is lowered and the adverse events are easily occurred. Therefore, many are interested in introducing the geriatric pharmacy specialist to manage this situation. Purpose: By applying a similar program such as the geriatric pharmacy specialist working in nursing home, we conducted this study to evaluate the potential contribution to both the health insurance services and financial savings for the elderly patients. Methods: We conducted a trial in an elderly nursing home to collaborate between doctor and pharmacist making a checklist for improving medication adherence and establish a consultation system. Also we applied a smart phone application in the pharmaceutical care processes. Results: Thereby completing the drug therapy related checklist apply to nursing facilities in South Korea. And we got a performance that improves medication adherence when used in the clinical practice settings. Conclusion: By introducing a training program of pharmacy care managers and geriatric professionals such as the United States and Japan, we revealed the elderly nursing home residents and vulnerable elderly people living alone were improved the medication adherence and it will contributed to the health and quality of life of the patients.