• Title/Summary/Keyword: Geriatric patient

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Literature Review of Postoperative Delirium in Geriatric Patients After Elective Gastrointestinal Cancer Surgery

  • Park, Da-In;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • v.20 no.3
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    • pp.177-186
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    • 2018
  • Purpose: Increasing number of older adults are receiving cancer surgeries especially for gastrointestinal cancers, which brings forth attention to age-related postoperative complication prevention. Postoperative delirium (POD) is a common complication that rises after surgical procedures involving general anesthesia, largely in the elderly population. Due to its sudden onset and fluctuating symptoms, POD often goes underdiagnosed and undertreated even though it may lead to various adverse outcomes. POD in GI cancer surgical elderly patients is poorly understood in terms of prevalence, pathophysiology, assessment, treatment and nursing management. We aimed to identify available literature and investigate study results to broaden our understanding of geriatric GI cancer POD. Methods: The search process involved six databases to identify relevant studies abided by inclusion criteria. Results: Eleven studies were selected for this review. Geriatric POD is closely related to frailty and surgical complications. Frailty increases vulnerability to surgical stress and causes cerebral changes that affect stress-regulating neurotransmitter proportions, brain blood flow, vascular density, neuron cell life and intracellular signal transductions. These conditions of frailty result in increased risks of surgical complications such as blood loss, cardiovascular events and inflammation, which all may lead to the POD. Mini Metal State Examination (MMSE), Confusion Assessment Method (CAM) and Delirium Rating Scale-revised-98 (DRS-R-98) are recommended for POD assessment to identify high-risk patients. Conclusion: The POD prevalence ranged from 8.2% to 51.0%. The multifactorial causative mechanism suggests nurses to identify highrisk elderly GI-cancer surgical patients by reviewing patient-specific factors and surgery-specific factors.

The Development of u-Drug Cap based on NFC for Medication Information Management (복약 정보 관리를 위한 NFC기반 u-Drug Cap 개발)

  • Yoon, Taebok;Lee, Jong-Hee;Lee, Kwang-Hyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.2165-2171
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    • 2015
  • Due to the development of improved living conditions and medical technology in recent periodic taking drugs is increasing through the outpatient rather than inpatient hospital care. Particularly in the case of patients suffering from geriatric diseases. This geriatric patients should have more attention to the taking medication management because it must keep the medication period. In this paper, we propose and describe an taking medicine information service system for the period and stable taking medicine in patients using the NFC-based u-Drug Cap and technology development and system test results. The developed system is through proper taking medicine information and alarm of geriatric patients or elderly patients. The patient's health can be maintained by preventing not taking and over taking of medicine.

The Factors Related to Depression of the Elderly patients in Four Geriatric Hospital Located in B Metropolitan City (B광역시 4개 요양병원 입원노인의 우울 관련요인)

  • Yoon, Ga-Bin;Jee, Young-Ju;Kim, Yoon-ji
    • Korean Journal of Adult Nursing
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    • v.22 no.6
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    • pp.561-569
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    • 2010
  • Purpose: The purpose of this study was to identify the factors related to depression of elderly patients in geriatric hospitals. Methods: The subjects were 195 elderly patients who met the inclusion criteria of scores more than 18 on the K-MMSE score and no reported mental disease. The data were collected from February 20 to March 20, 2009. The research instruments utilized in this study were depression (GDSSF-K), activities of daily living and self esteem (RSES), social support, life satisfaction. Data were analyzed Pearson correlation and Multiple Stepwise Regression using SPSS 15.0. Results: Depression score were negatively correlation with ADL, social support, life satisfaction and self-esteem. Among the factors studied related to depression, life satisfaction had highest explanatory power of 36.5% and it was followed by physical health status and activity of daily living. These explained 43.7% of the depression. Conclusion: The mean GDSSF-K 8.94, which indicates the higher than middle levels of depression. The findings suggest that it is important to develop educational programs to increase life satisfaction, physical health status and activity of daily living. Nursing interventions, including volunteer activities, health promotion program, and sports program could be useful in enhancing these factors.

Psychosomatic Management of Medically Ill Elderly : Focused on Consultation Psychiatry (신체질환이 있는 노인 환자의 정신신체 의학적 치료 : 자문정신의학을 중심으로)

  • Ryu, Seong-Gon;Kwon, Hee-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.1
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    • pp.25-30
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    • 2008
  • With the rapid growth of geriatric population, geriatric psychiatric consultation has come to play a more important role in recent years. It is necessary to find out characteristics of psychiatric consultation-liaison in elderly and applicate practical guideline of consultation in medical setting. Management of medically ill elderly in psychiatric consultation requires different guideline from that of other age group patient. Because aging and each organ-specific diseases change the pharmacokinetics of psychotropic drugs variably. These pharmacokinetic changes should be considered in psychosomatic treatment in medically ill elderly. The relatively low consultation rates for psychiatric disorders in the elderly indicate that research is needed into factors that both prevent and facilitate elderly patients with psychological symptoms from consulting their general practitioners.

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Effects of Lidocaine Patch Application to Decrease Pain and Fear during Blood Sugar Test in Elderly Patients with DM (리도카인 패치 적용이 당뇨노인환자의 혈당검사 시 통증과 두려움에 미치는 효과)

  • Kim, Se Young;Kim, Jin;No, In Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.23 no.1
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    • pp.12-20
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    • 2016
  • Purpose: This study was done to examine the effects of lidocaine patch application to decrease pain and fear during blood sugar testing in elderly patients with DM. Methods: The participants were 56 elderly patients admitted to J geriatric hospital in G city, Korea. Of the elderly patient, 27 were assigned to the experimental group and 29 to the control group. Participants in the experimental group applied a lidocaine patch on the fingertip for 30 minutes before a blood sugar test. The control group applied a plaster on the fingertip. Pain was evaluated using a visual analogue scale and fear using the Procedure Behaviour Check List. The results were compared using paired t-test and t-test. Results: The scores for pain and fear were significantly lower in the experimental group compared to the control group. Conclusion: The lidocaine patch was found to be an effective local anesthetic to relieve pain and fear during blood sugar test in elderly patients with DM without any severe adverse events.

Effects of a Stress Management Program on Perceived Stress, Depression and Somatic Symptom in the Elderly (스트레스 관리 프로그램이 노인의 지각된 스트레스, 우울 및 신체화 증상에 미치는 효과)

  • Lee, Young-Hee;Park, Chai-Soon
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.17 no.2
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    • pp.127-134
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    • 2010
  • Purpose: This study was done to identify the effects of stress management program on perceived stress, geriatric depression, and somatic symptom in elderly Korean subjects. Methods: A pre-post test design with a nonequivalent control group was used. Fifty elderly Korean subjects with mild depression were recruited from the registerants at four public senior citizen centers within S-gu in Seoul. They were randomly allotted to the experimental group(n=25) and control group(n=25). The intervention was performed for one hour each week at each center for 5 weeks. The effects were measured by Perceived Stress Scale, Geriatric Depression Scale-Korean, and Patient Health Questionnaire-15. Results: Perceived stress and depression were significantly reduced in experimental group. The somatic symptom was not significantly different in the experimental group. Conclusion: The stress management program may have merit in improving mental health of elderly Koreans, although this conclusion is equivocal pending further well-controlled studies that include mediation techniques such as conversion therapy and health gymnastics.

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The eleven reasons why dentist should study the geriatric dentistry (임상가를 위한 특집1 - 노년치의학을 배워야 하는 11가지 이유)

  • Choi, Yong-Geun
    • The Journal of the Korean dental association
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    • v.49 no.10
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    • pp.584-598
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    • 2011
  • The age structure has been experiencing substantial change due to the decreased birth rate as well as the increased life expectancy. Gorge Magnus, an English economist, casts warnings of population ageing which has the potential of huge socioeconomic impact human society has never experienced before. The prediction that proportion of elderly people in need of oral health care will increase substantially is a new challenge to dentists in the future. The old paradigm that the aged person is just the person who was born earlier and needs the same conventional oral health care should be shifted to the new one. Elderly people tend to express their political interest related with health care system by actively participating in the national elections. The need to sustain economic status for the extended life span makes them seek eagerly esthetic health care to maintain sound social function. Most of them are under multiple chronic diseases and take related medicines. In addition, many studies report about mental change as well as physical change among the aged people. Since the prevalence of dental diseases among the aged is higher than other chronic devastating diseases, the aged seeking oral health care will increase. The aged who has different physical and psychological status as well as chronic disease and related medicine will show unexpected response to the conventional oral health care. In addition, the impact of tooth loss is substantial physically, mentally and emotionally. Dentist should prepare different approaches for the elderly dental patient.

Prospects of Geriatric Nursing Application Based on Robot Technology (로봇 테크놀로지 기반의 노인간호 활용전망)

  • Oh, Jin Hwan
    • Journal of Korean Gerontological Nursing
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    • v.20 no.sup1
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    • pp.127-136
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    • 2018
  • Purpose: The purpose of this study was to investigate the possibility of using intelligent robot based nursing practice as discussed in previous research and also, to propose directions for robot care for elders. Methods: For this study 28 previous researches using robots in health care field were reviewed and related research trends introduced. Results: Robot applications in the healthcare field were mainly for rehabilitation, surgery, interaction, and nursing assistance through robotics. Especially types of robot include pet type robots, humanoid robots, surgical robots, rehabilitation robots, robot suit and entertainment robots with monitors. The research participants were patients with dementia and institutionalized elderly people. It was found that a human-robot interaction was effective from physical, mental, emotional and social aspects. Conclusion: Robots can be used for various purposes such as nursing assistance, patient health promotion and education. It is necessary to reduce the human burden of care work using robots and to introduce robot care programs which can meet the needs of elders. Therefore, korean nurses should make efforts to change their practice to new geriatric nursing through repeated research based on the scientific data.

Effects of the Nei-Guan (P6) Acupressure on Nausea, Vomiting, and Pain in Geriatric Patients after Total Knee Replacement Arthroplasty (내관지압이 슬관절 전치환술 받은 노인 환자의 오심, 구토 및 통증에 미치는 효과)

  • Yoo, Je-Bog;Jang, Hee-Jung;Na, Eun-Hee;Kim, Sun-Young;Shin, Dong-Soo
    • Journal of East-West Nursing Research
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    • v.17 no.2
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    • pp.96-102
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    • 2011
  • Purpose: Patient-controlled epidural analgesia (PCEA) is an effective method for controlling post surgical pain. However, it is associated with adverse drug reactions such as nausea and vomiting. In this, study we tested the effects of Nei-Guan (P6) acupressure on PCEA-associated nausea, vomiting, and pain in geriatric patients after total knee replacement arthroplasty (TKRA). Methods: Ninety-nine patients who had TKRA for the first time were randomly assigned to either, experiment group (n=50) or control groups (n=49). All patients received PCEA immediately after surgery, but acupressure on Nei-Guan (P6) point was applied to experiment group only. Ten minutes of finger acupressure on Nei-Guan (P6) acupressure point was applied twice with 15 minute-interval in the experiment group. The incidence of nausea, vomiting, and retching as well as pain intensity were assessed at 12 and 24 hours after surgery. Nausea, and vomiting were assessed by Index of Nausea, Vomiting and Retching (INVR) questionnaire. Pain intensity was measured with frequency of analgesics. Results: Vomiting both was significantly different between two groups at 12 hours (t=-2.18, p=0.03) and 24 hours (t=-2.64, p=0.01) after surgery. Total scores of nausea, vomiting and retching in experimental group was significantly lower than control group 24hours after surgery (t=-2.18, p=0.03). However, pain was not different between two groups. Conclusion: Nei-Guan (P6) acupressure may be considered as an effective nursing intervention to decrease PCEA-associated nausea and vomiting in older patients after TKRA.

Analysis of Importance of Development of Medical and Combined Products Using AHP (AHP를 이용한 의료관광 단계별 상품개발의 중요도 분석)

  • Yu, Tae Gyu
    • The Journal of the Convergence on Culture Technology
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    • v.4 no.2
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    • pp.75-80
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    • 2018
  • Since the introduction of the Foreign Patient Assistance Law in 2009, more than 300,000 foreign patients are visiting Korea each year due to the efforts of overseas patient attraction organizations, host companies and governments. Despite these achievements, however, the company is confronted with limitations in product development and the rate of patient population growth is slowing. Therefore, this study suggests the importance and meaning of various product development through the hierarchical analysis (AHP) on the major factors of product development of medical tourism services, and suggests direction of product development in domestic medical tourism industry in the future.