• Title/Summary/Keyword: Geriatric patient

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Correlations among the Continence Function, Cognitive Function and Activities of Daily Living in Elderly Male Patients with Dementia in a Geriatric Hospital

  • Kim, Hong Rae;Shin, Hee Joon;Wang, Joong San
    • Journal of International Academy of Physical Therapy Research
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    • v.7 no.1
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    • pp.972-978
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    • 2016
  • The purpose of this study was to identify correlations among the continence function, cognitive function, and activities of daily living(ADL) in elderly male patients with dementia in geriatric hospitals. The subjects were 64 patients aged 65 or above who were diagnosed with dementia among the hospitalized male patients in a geriatric hospital. For the subjects' cognitive function, a questionnaire developed for the Korean Mini Mental Status Examination(K-MMSE) was used. For the continence function and ADL, data were collected using a patient evaluation table. As a result, a lower level of cognitive function resulted in corresponding higher levels of dependence in all items of ADL except bathing(p<.05), and a lower level of cognitive function led to corresponding declines in the continence function(bowel control, bladder control)(p<.01). In addition, a higher level of dependence in ADL resulted in corresponding higher levels of difficulty in bowel and bladder control(p<.01). This study showed correlations among the cognitive function, ADL, and continence function of elderly men with dementia. The results of this study may be used as basic data for the management and treatment of hospitalized elderly male patients with dementia in geriatric hospitals.

A Study on the Evaluation of the Cognition of the Circulation Efficiency in Geriatric Hospital (노인요양병원 진료부의 경로인지 효율성 평가에 관한 연구)

  • Bae, Sun-mi;Kim, Suk-Tae
    • Korean Institute of Interior Design Journal
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    • v.25 no.6
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    • pp.40-51
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    • 2016
  • The aim of this study is to quantitatively deduce the circulation efficiency and space arrangements of the outpatient department in geriatric hospitals in terms of spatial structure and to find a methodology that could promote the improvement of accessibility and spatial cognition while using the facilities. All space units of the selected twelve geriatric hospitals were located on the first floor. The study adopted the psychological distance concept of space syntax to the unitized spaces, and presented a set of indices, such as TD, PN, RF, PNT and TRF. These indices were calculated according to the standard clinical use procedures. The study evaluated the effectiveness of circulation. The analysis of circulation was based on the four major geriatric illnesses that were selected in this study. The study established the standard clinical use procedure with consideration of the medical treatment, examinations and space units of outpatient departments. The results are as follows: 1) Based on the statistical data, four major geriatric illnesses are examined, and space requirement and standard procedures are established. Development indicators are applied in order to quantitatively deduce the efficiency of spatial cognition. 2) The percentage of the risk of cognitive decline(TRF) has an inversely proportional correlation to the circulation efficiency(PNT) at a certain point. TRF is more influenced by the clinical use procedure than the scale. 3) The arrangement of the waiting space and types of corridor greatly affect the percentage of the risk of cognitive decline. 4) Vulnerable facilities are selected on the basis of the evaluation, and two alternatives that could promote the circulation efficiency are presented. The result of the reanalysis showed that cognitive efficiency had much improved compared to the existing facilities.

Calculation of the Costs and Optimal profits per Inpatient-day of the Geriatric Hospitals (노인병원의 재원환자 1인당 일평균 원가 및 적정이윤 계산)

  • Hwang, In-Kyoung;Kim, Jai-Sun;Choi, Whang-Gyu
    • Korea Journal of Hospital Management
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    • v.8 no.4
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    • pp.149-181
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    • 2003
  • It has been asserted that per diem payment system should be introduced, in place of the current fee-for-service system, for payment of the inpatient services of the geriatric hospitals, Based on the assentation, this study aims at calculating costs and profits per inpatient-day of the geriatric hospitals, and thereby at contributing to the managerial improvement from the both sides of the Government and the hospitals. Relevant data of the three months, May to August, 2002 were collected from the five geriatric hospitals, and per inpatient-day costs and profits were calculated for the three disease groups. Major results and conclusions are as follow : Firstly, total costs per insured inpatient-day of the geriatric hospitals are 65, 389 won for dementia (including optimal profit of 3,858 won), 69,730 won for stroke (including optimal profit of 4,117 won), and 70,085 won for other diseases (including optimal profit of 4,134 won). Secondly, the amount of the non-insured costs per inpatient-day occupies 34.5% of the total costs for dementia, 30.3% for stroke, and 30.1% for other diseases. Thirdly, the total amount of the per inpatient-day costs calculated including the optimal profits is, on the average, higher by 12% than the present price level calculated for the current fee-far-service system. This implies that the present price level should rise by 12% when the current fee-far-service payment system be maintained, and Finally, introduction of a sliding-scale payment system should be considered for the inpatient medical management fees for the length of stay over six months or more that are being cut in the claim examination process by the insurance corporation.

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Effects of Empathy for the Elderly, the Nursing Work Environment, and Person-centered Care on Geriatric Nursing Practice Among University Hospital Nurses (대학병원 간호사의 노인에 대한 공감능력, 간호근무환경 및 인간중심돌봄이 노인간호실천에 미치는 영향)

  • Kim, Ha Yeon;Song, Min Sun
    • Journal of Home Health Care Nursing
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    • v.30 no.1
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    • pp.59-68
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    • 2023
  • Purpose: We investigated the association between empathy for the elderly, the nursing work environment, person-centered care, and geriatric nursing practice among university hospital nurses and factors that affect geriatric nursing practice. Method: We administered questionnaires to 178 nurses between May 23 and June 21, 2022 at a university hospital in city D. We used descriptive statistics, the t-test, one-way analysis of variance, the scheffé test, Pearson correlation coefficients, and stepwise multiple regression analysis for data analysis. Results: We observed a statistically significant positive correlation between nurses' geriatric nursing practice and empathy for the elderly, the nursing work environment, and person-centered care. Empathy for the elderly was positively correlated with the nursing work environment and person-centered care, and the nursing work environment showed a statistically significant positive correlation with person-centered care. Empathy for the elderly and the nursing work environment significantly affected geriatric nursing practice. The overall explanatory power of the regression model was 33.4%. Conclusion: Greater awareness and implementation of various educational programs that promote empathy for the elderly are necessary to improve nursing care for the elderly population. Furthermore, adequate manpower and material support are important to improve the nursing work environment among nurses employed at university hospitals.

Single Case Report of a Stage IV Geriatric Gallbladder Cancer Patient treated with Korean Medicine Who Could Not Receive Conventional Therapies (항암 치료가 불가한 고령의 4기 담낭암 환자 한방치험 1례)

  • Ryu, Han Sung;Oh, Hye Kyung;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.21 no.1
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    • pp.27-33
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    • 2016
  • Background : This case is to report a gallbladder cancer patient treated with Korean Medicine who could not receive conventional cancer therapies such as operation and chemotherapy due to her underlying diseases, old age and poor performance. Method and Results : An eighty-year-old female patient was diagnosed with stage IV gallbladder cancer on Feb. 2014 and she already had hypertension, diabetes and Parkinsonism. Comprehensive Korean Medicine (KM) treatments instead of operation and chemotherapy were administrated due to her poor condition and old age. KM treatments were done focused on improving symptoms and quality of life combined with best supportive care. During KM treatments her abdominal pain was generally managed and she survived for 22 months. Conclusion : Further studies should be performed in the future to clarify the survival benefit and symptom management of comprehensive KM treatments.

Nonverbal Communication between Patients with Dementia and Their Nurses in an Elderly Care Institution (일개 노인요양기관에 입소한 치매노인과 간호사의 비언어적 커뮤니케이션 연구)

  • Yi, Myung-Sun
    • Korean Journal of Adult Nursing
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    • v.21 no.1
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    • pp.105-116
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    • 2009
  • Purpose: The purpose of the study was to describe nonverbal behaviors of nurses in communication with patients with dementia in an elderly care institution in Korea. Methods: Conversation analysis was utilized to analyze the data which were collected using video camera to capture non-verbal as well as verbal behaviors. A total of 66 episodes of everyday conversations were analyzed using seven nonverbal categories: affirmative head nodding; illustrative gestures; patient-directed eye gaze; smiling and/or laughing; forward leaning; affective touch; and instrumental touch. Results: Among seven categories, patient-directed eye gaze(94%) was the most frequently utilized among nurses followed by affirmative head nodding(67%) and forward leaning(67%), while smiling was the least used(32%). Affective touch was identified in 39 episodes(59%). Among them, the most frequently touched area was hand or handshaking(59%) followed by shoulder or back, arm, and face. There were wide differences among nurses in terms of using affective touch, ranging from 0% to 98%. Nonverbal behaviors were more frequently identified in effective episodes than in ineffective episodes. Conclusion: Actively utilizing effective nonverbal behaviors may help geriatric nurses in promoting communication and in establishing rapport with patients with dementia.

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Influence of Recognition for Health Care Accreditation on Patient Safety Managing Activities of Nursing Staffs in Geriatric Hospital (의료기관 인증제에 대한 인식이 요양병원 간호인력의 환자안전관리 활동에 미치는 영향)

  • Kweon, Myeung Sook;Jo, Hyun Sook
    • 한국노년학
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    • v.38 no.1
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    • pp.15-26
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    • 2018
  • This study was aimed to investigate the influencing level of nursing staff's recognition for the health care accreditation on patient safety managing activities by identifying the relationship between them and other factors affecting on patient safety managing activities. Subjects of this study were 182 nursing staffs working in six geriatric hospitals accredited for health care in Seoul metropolitan area. Data was collected during April, 2016 by structured questionnaires. And SPSS/WIN 15.0 program with t-test, ANOVA, Pearson's correlation, and stepwise multiple regression analysis were employed for analyzing them. 96.2% of the subjects have recognized the accreditation and 31.8% of them have acknowledge it in detail. The average level of recognition for the health care accreditation and patient safety managing activity were 3.60 and 4.39 point (max.5.0) respectively. Correlation between them was positive(r=.339, p<.001). Significant factors influencing patient safety managing activity were internal service quality promotion (t=5.292, p<.001) and academic background (t=2.836, p=.005). Education program or information on health care accreditation system, and action plans for promoting internal service quality for the nursing staffs including job standardization of the jobs are recommended for the better patient safety managing activities.

Impacts of Pharmacist-involved Multidisciplinary Geriatric Team Services on Reducing Anticholinergic Burden (다학제 팀의료에 의한 노인의료센터 입원환자의 항콜린약물부담 감소효과 분석)

  • Lee, Juhye;Park, Kayoung;Suh, Yewon;Lee, Junghwa;Lee, Eunsook;Lee, Euni;Choi, Jung-Yeon;Kim, Kwang-Il;Lee, Ju-Yeun
    • 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.

Influence of Workplace Learning, Job Satisfaction and Geriatric Nursing Practice of Nurses in Long-term Care Hospitals (요양병원 간호사의 일터학습과 직무만족이 노인간호실천에 미치는 영향)

  • Yoon, Sook-Rye;Chung, Eui-Nam;Park, Seon-Wook;Jung, Myeong-Soon;Ko, Ga-Yeon;Jang, Ji-Hye
    • 한국노년학
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    • v.37 no.3
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    • pp.655-667
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    • 2017
  • This study aimed to identify workplace learning, job satisfaction and geriatric nursing practice, find the correlations between each variable, and investigate affecting factors on geriatric nursing practice. Subjects were 146 nurses in 9 long-term care hospitals including G City, and data were collected from May 1, 2016 through Jun. 30, 2016. Data analysis included independent t-test, one-way ANOVA, Pearson's correlation coefficient and multiple regression using the SPSS/WIN 20.0 program. The results showed that the correlations between each variable showed that incidental learning, a subregion of workplace learning (r=.20, p=.014), and job satisfaction (r=.29, p<.001) had a positive correlation with geriatric nursing practice, respectively. The affecting factors on geriatric nursing practice were job satisfaction, daytime working and nursing experience, and the explanatory power of the model was 20%(F=4.91, p<.001). Based on the results, job satisfaction should be increased to improve the quality of nursing in long-term care hospitals and various methods might be discussed to improve the job satisfaction. Daytime working was suggested one factor on geriatric nursing practice because nursing was provided mainly during daytime, and nursing experience was also one factor on geriatric nursing practice, so highly experienced geriatric nurses could provide high quality elderly patient care.

Predictive Factors for Medication Adherence in a Geriatric Assessment Program in Korea (노인환자의 복약순응도 현황 및 영향인자 분석)

  • Kim, Minso;Choi, Nayae;Suh, Yewon;Park, Jinyoung;Lee, Junghwa;Lee, Eunsook;Lee, Euni;Kim, Sun-wook;Kim, Kwang-Il;Kim, Cheol-Ho
    • 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.