• Title/Summary/Keyword: Geriatric patient

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The Comparison of Iliopsoas Tightness Between Low Back Pain Patients and Healthy Subjects (요통환자와 정상인의 장요근의 긴장 도 비교)

  • Lee, Jun-Yong;Yoon, Hong-Il
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.12 no.2
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    • pp.11-20
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    • 2006
  • Low back pain is often experienced by many people who are in an activity flag. Their work and daily life are affected by low back pain. There are many causes of low back pain. Among those many causes, this study was focused on a relation between low back pain and the tightness of iliopsoas. The study was implemented by measuring the angles of the hip joints in subjects consisting of a 30 patients group, who had been selected from the outpatients at the Median Hospital, and a 30 people control group from the outpatients at the M Hospital and employee of M hospital. The patients group consists of the patients with low back pain who have intermittently or continuously experienced low back pain within the last 6 months. The group also had no symptom of spondylolysis or spondylolithesis and no muscular abnormality in terms of pathology without any experience of disc or spine fusion operation. The control group consisted out of persons who had never experienced lower back pain and had never been subjected to physical therapy due to lower back pain. The hip joint angles of the subjects of this study were measured by means of the modified Thomas test position. Data was analysed by independent sampling t-test using SPSS 11.0. The following results were obtained: 1. The measured angles of patient's both hip joints were significantly smaller than the control group's. 2. In the males group, The angles of patients' both hip joints were smaller than the controls'. In the females group, The angles of patients' both hip joints were smaller than the controls'. In conclusion, this study demonstrates that there is a significant difference in the tightness of the iliopsoas muscles when comparing the patient group with the control group. We should therefore pay more attention in releasing the muscle tightness of iliopsoas muscles when performing physical therapy with patients with lower back pain.

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Post-Surgical Recovery Patterns of the Elderly (노인환자의 수술후 회복패턴에 관한 연구)

  • Byun Young-Soon;Chung Eun-Joo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.1
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    • pp.51-63
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    • 1999
  • This study examined two differences in physical and psychological recovery patterns after surgery in the elderly. The sample consisted of 40 patients with abdominal surgery In five large hospitals in Seoul. The data for this study were collected from Apr. 20 to Nov. 26 by structured questionnaire, chart review and call. Physical recovery was assessed by ADL, a Cantril Ladder Scale and a Visual Analogue Scale. Psychological recovery was measured by the Geriatric depression Scale and a Cantril Ladder Scale. The data were analyzed using frequency, percentage, Pearson Correlation Coefficient, and MANOVA by SPSS/WIN. The result are as follows : 1. Physical recovery indicated significant improvement over time with the exception of ADL(F=.812 p=.449). Perceived physical health were significantly improved(F=6.189 p=.004). Pain & discomfort was significantly decreased(F=3.927 p=.025). 2. Perceived psychological health was significantly improved over time(F=20.648 p=.000), but depression showed no statistical significance improvement over time(F=1.393 p=.256). 3. There were no significant effects of sex, age, complication and combined chronic diseases on physical and psychological recovery patterns. 4. There were significant correlations between operation time and pain(r=-.331 p=.020), recovery time and perceived psychological health(r=-.320 p=.024), recovery time and pain(r=.404 p=.005). There were significant correlations between admision period and ADL(r=-.418 p=.004), perceived physical health(r=-.354 p=.014), depression(r=.280 p=.042), and perceived psychological health(r=-.447 p=.002). BRAS showed significant correlation with ADL(r=-.458 p=.002). 5. With an increase in the degree of perceived health(physical and psychological), ADL was significantly increased. With an increased in the degree of depression and pain, ADL and perceived health(physical and psychological) were significantly decreased. In conclusion, the elderly patient recovered significantly over time with the exception of ADL and depression. It these we suggested to considered when planning care for elderly patients.

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A Survey of the Nursing Activities Performed by Nursing Staffs in Long-term care Hospitals (요양병원 간호 인력의 간호행위 수행 실태)

  • Kim, Myung-Hee;Jeong, Chu-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.2
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    • pp.940-951
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    • 2014
  • This study was to investigate of nursing activities performed by nursing staffs in long-term care hospitals. A survey of was conducted with 131 nurses who were working in 15 geriatric hospitals using a structural questionnaire. Data were collected from March 7 to June 30, 2013 and analyzed with SPSS 17.0, using descriptive statistics and t-test, ANOVA. This survey confirmed that the 88 activities except to 'making nursing diagnosis', 'setting nursing goals', and 'writting patient evaluation checklist' had been practiced in a wide range of nurses with nurse assistants. The degree of performance by nurse assistant was significantly different among nurses group according to the total number of patient and number of nurse(p<.001). Therefore, it is necessary to establish the legal and institutional regulation and development of algorithm for delegation, classify the impossible nursing task and work that can be delegated long-term care hospital.

Factors Associated with Vancomycin-Resistant Enterococcus Colonization in Patients Transferred to Emergency Departments in Korea

  • Kim, Hyun Soon;Kim, Dae Hee;Yoon, Hai-jeon;Lee, Woon Jeong;Woo, Seon Hee;Choi, Seung Pill
    • Journal of Korean Medical Science
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    • v.33 no.48
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    • pp.295.1-295.7
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    • 2018
  • Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

Feasibility of Cultured Allogenic Keratinocyte Treatment for Third Degree Burns (3도 화상에 대한 동종 상피세포 치료제의 효과 보고)

  • Choi, Jangyoun;Cho, Jin Tae;Choi, Jong Yun;Seo, Bommie Florence;Jung, Sung-No
    • Journal of the Korean Burn Society
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    • v.22 no.2
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    • pp.45-48
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    • 2019
  • Allogenic keratinocyte application is widely used for treatment of second degree burns. However, there is no significant body of report on application of allogenic keratinocyte to third degree burns. A geriatric patient visited our burn center showing second to third-degree burn on dorsum of her left hand. Considering the surface area and wound depth, surgery was indicated but her medical condition and age made the surgery high risk for a long operation. Therefore, chemical escharolysis, serial bedside debridement, and cultured allogenic keratinocyte (Kaloderm®, Tegoscience, Seoul, Korea) application was done. The wound was completely epithelialized after four rounds of Kaloderm® application. For third-degree burns where definitive surgical reconstruction is precluded due to medical comorbidity of the patient, we investigated the possibility of allogenic keratinocyte treatment which may allow to avoid high-risk anesthesia and surgery.

Analysis of Hospital Foodservice Management and Health Insurance Coverage of Inpatient Meals in Seoul (서울지역 의료기관의 급식서비스 및 환자식 급여화 현황 분석)

  • Kim, Hye-Jin;Kim, Eun-Mi;Lee, Geum-Ju;Lee, Jung-Joo;Lim, Jung-Hyun;Lee, Jung-Min;Jeon, Hyun-Jung;Lee, Hae-Young
    • Journal of the Korean Dietetic Association
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    • v.16 no.4
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    • pp.378-396
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    • 2010
  • The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.

Acute postoperative myelopathy caused by spontaneous developed cervical disc herniation: Case report & literature review (수술후 자연발생 경추간판탈출에 의한 척수병증: 증례보고 및 문헌고찰)

  • Lee, Jeong-Woo;Lee, Keun Hyeong;Lee, Ju-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.303-308
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    • 2019
  • Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.

Wheelchair Usage and Satisfaction Survey of Elderly Patients (노인 환자들의 휠체어 사용 실태와 만족도 조사 연구)

  • Park, S.H.;Shin, J.I.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.9 no.4
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    • pp.257-263
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    • 2015
  • The purpose of this study was to survey the elderly patients through Basic information, Problems Wheelchair, Wheelchair Satisfaction, Usage and Requirements. The meaning of purpose is identify the problems and difficulties of wheelchair use in geriatric patients and an alternative for the correct use of wheelchairs elderly patients. The study investigated through questionnaires. That used questionnaires to modified to Gu Hyeon-Mo questionnaire (2005) and Quebec User Evaluation of Satisfaction with assistive Technology 2.0. 120 of 150 questionnaires were collected and one of them is excluded. Analysis results suggest the following. It was often feel joint pain results from physical damage. In addition when you use a wheelchair it was often feel discomfort in lower back and pelvis. And it feels uncomfortable when moving the tilt. Wheelchair satisfaction of the participants responded to the most 'Normal'. Results of the wheelchair operation ability is as follows. In the case of manual wheelchairs was feeling the difficulty to cross the threshold, Wheel lying, Stairs usage. Also In the case of an electric wheelchair was feeling the difficulty to use Tilt and Decline, Separate from the motor, and Replacement battery. In conclusion, To reduce of back pain and hip joints of elderly patients need to modify design and appearance of the wheelchair. In a later study will find to reduce discomfort and to improve satisfaction of the elderly who use wheelchairs. It will have to periodically examine the usage and satisfaction with them.

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Cranberry Juice to Reduce Bladder Biofilms and Infection in Geriatric and Spinal Cord Injured Patients with Dysfunctional Bladders

  • Reid, Gregor;Potter, Patrick;Lam, Dominique;Warren, Diny;Borrie, Michael;Hayes, Keith
    • Preventive Nutrition and Food Science
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    • v.8 no.1
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    • pp.24-28
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    • 2003
  • There is evidence to suggest that cranberry juice supplements improve the health of the urinary tract by inhibiting the binding of fimbriated uropathogenic E. coli to the bladder mucosa. In patients with neurogenic bladders, urinary tract infections (UTI) are particularly common and often poorly managed by antibiotic treatment. A double-blind, randomized, placebo-controlled trial was undertaken on 29 geriatric and spinal cord injured patients with dysfunctional bladders. They received three times daily at mealtimes a 4 oz bottle of cranberry juice (Ocean Spray Cranberries, USA) or a specially prepared synthetic placebo drink. Two episodes of UTI arose in week one of cranberry intake and none thereafter, compared to four episodes of UTI in 4 placebo patients in weeks four, six and 10. Mean bacterial adhesion counts on bladder cells of the patients rose during the first month of treatment in 71 % of the placebo patients compared to only 31 % of cranberry patients (p < 0.001). The difference persisted to some extent for the second and third months. Bacterial adhesion levels correlated with culture findings (higher adhesion and higher viable counts in urine) (p < 0.001), positive leukocyte nitrite tests (136$\pm$131 bacteria per cell versus 52$\pm$86 in negative tests) (p < 0.001), and higher white blood cell counts (> 10) per high power field (126$\pm$125 versus 48$\pm$85 bacteria per cell) (p<0.001). E. coli was the most frequently isolated organism (40% samples) followed by K. pneumoniae (17%) and a number of other uropathogens. Group B Streptococci, and coagulase negative Staphylococcus were recovered from urine in 4 samples but were not associated with any red blood cell presence. The daily intake of cranberry juice, in amounts which are not detrimental to long term compliance, appeared to have a role in reducing the risk of bladder colonization and infection in a highly susceptible patient population.

The Myth of Not Disclosing the Diagnosis of Cancer: Does it Really Protect Elderly Patients from Depression?

  • Silay, Kamile;Akinci, Sema;Ulas, Arife;Silay, Yavuz Selim;Akinci, Muhammed Bulent;Ozturk, Esin;Canbaz, Merve;Dilek, Imdat;Yalcin, Bulent
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.837-840
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    • 2015
  • Background: The disclosure of a diagnosis of cancer is complex, particularly in older patients. The aim of this study was to investigate the association between age and not knowing the diagnosis, and its impact on mood. Materials and Methods: The study included 70 patients with various types of solid and hematologic cancer in early stages, which were followed up in an outpatient oncology/hematology clinic in Turkey between January, 2014 and June, 2014. Initially the caregivers of patients were asked whether the patients knew their diagnosis or not. A questionnaire for the Geriatric Depression Scale was then administered to the patients. Patient age, gender, marital status and education level were noted and analyzed with respect to knowing the diagnosis and depression. Results: Of the 70 patients, 40% of them were female. The mean age was $68.2{\pm}8.9$. The rate of the patients who does not know their diagnosis was 37.1% (n=26). The overall depression rate with GDS was found 37.1% (n=26) among the participants. There was no association with knowing the diagnosis (p=0.208) although the association between not knowing the diagnosis and age was significant (p=0.01). Conclusions: In this study we revealed no association between not knowing the diagnosis and depression in elderly patients. Contrary to what some has thought, the patient is not protected from psychological distress by not being informed about the diagnosis. We believe this study and similar ones will help to discuss and further explore patient autonomy, the principle of respect to self-determination and end of life issues in different cultures.