• 한국보건간호학회지
• /
• 제32권2호
• /
• pp.304-318
• /
• 2018

Purpose: This study examined the characteristic of the Injury Severity Score (ISS) of Korean geriatric patients with a traumatic injury in a nationally representative sample to determine the optimal cutoff of ISS of mortality according to age. Methods: The subjects were 3,018 non-elderly patients and 1,584 elderly patients with an ISS and Korean Triage and Acuity Scale (KTAS) in 2016 from the data of the Health Insurance Review and Assessment Service. The traumatic characteristics of the elderly and non-elderly were compared by stratifying the ISS. Receiver Operating Characteristic (ROC) curve analysis was used to find the optimal cutoff of ISS of mortality according to age. Results: The elderly were more prone to severe trauma than the non-elderly were. The distribution of KTAS grades was lower, even though the severity of ISS was as high as that of the non-elderly. The optimal cutoff score of the ISS for mortality in the ROC curve was lower in elderly over 65 years than in the other age group. Conclusion: The elderly are more prone to severe trauma and death than non-elderly, even though their ISS is low. Therefore, a strategy to prevent elderly from experiencing serious trauma and managing their geriatric trauma actively is needed.

• 성인간호학회지
• /
• 제21권1호
• /
• pp.105-116
• /
• 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.

• 성인간호학회지
• /
• 제28권4호
• /
• pp.388-398
• /
• 2016

Purpose: The purposes of this study were to identify nurses' empathy, attitude and pain management for patients with dementia and the factors associated with their performance of pain management. Methods: The study design was a cross-sectional survey. The participants in the study were 114 nurses working at 12 geriatric hospitals. This study utilized the Interpersonal Reactivity Index (IRI), which measures four empathy factors. Nurses' attitudes toward pain and performance of pain management, and general and pain related characteristics were measured by self-administered questionnaires. Results: Barriers to pain management for patients with dementia were absence of guidelines, prejudice of pain in dementia, and lack of time and knowledge deficit. There was a significant positive correlation between empathic concern and attitudes, perspective-taking of empathy and pain management. There was also a correlation between empathy and pain management. Stepwise linear regression analysis indicated that the significant factors affecting the performance of pain management included perspective-taking of empathy, use of pain management in dementia guideline and attitudes toward pain. These factors explained 24.0% of variance. Conclusion: The findings from this study suggest that empathy and positive attitude are the important provider attributes which needs to be enhanced by educational programs. It is also necessary to develop and disseminate guidelines for a dementia specific pain management.

• Journal of Korean Neurosurgical Society
• /
• 제43권3호
• /
• pp.143-148
• /
• 2008

Objective: Postoperative delirium (POD) is characterized by an acute change in cognitive function and can result in longer hospital stays, higher morbidity rates, and more frequent discharges to long-term care facilities. In this study, we investigated the incidence and risk factors of POD in 224 patients older than 70 years of age, who had undergone a neurosurgical operation in the last two years. Methods: Data related to preoperative factors (male gender, >70 years, previous dementia or delirium, alcohol abuse, serum levels of sodium, potassium and glucose, and co-morbidities), perioperative factors (type of surgery and anesthesia, and duration of surgery) and postoperative data (length of stay in recovery room, severity of pain and use of opioid analgesics) were retrospectively collected and statistically analyzed. Results: POD appeared in 48 patients (21.4%) by postoperative day 3. When we excluded 26 patients with previous dementia or delirium, 17 spontaneously recovered by postoperative day 14, while 5 patients recovered by postoperative 2 months with medication, among 22 patients with newly developed POD. The univariate risk factors for POD included previously dementic or delirious patients, abnormal preoperative serum glucose level, pre-existent diabetes, the use of local anesthesia for the operation, longer operation time (>3.2 hr) or recovery room stay (>90 mini, and severe pain (VAS>6.8) requiring opioid treatment (p<0.05). Backward regression analysis revealed that previously dementic patients with diabetes, the operation being performed under local anesthesia, and severe postoperative pain treated with opioids were independent risk factors for POD. Conclusion: Our study shows that control of blood glucose levels and management of pain during local anesthesia and in the immediate postoperative period can reduce unexpected POD and help preventing unexpected medicolegal problems and economic burdens.

• 한국산학기술학회논문지
• /
• 제10권2호
• /
• pp.432-437
• /
• 2009

2007년 1월 1일부터 2007년 12월 31일까지 1년 동안 국내 K대학병원의 60세 이상 노인환자 9,955(34.6%)명을 대상으로 정준상관분석을 통한 질병구조와 양상을 파악하였다. 분석결과 설명력이 가장 큰 변수는 수술유무이었으며, 일반적으로 노인은 젊은 계층에 비하여 신체적으로나 정신적으로 허약하기 때문에 수술에 대한 판단을 고려하는 것을 알 수 있었다. 이상과 같은 연구를 토대로 체계적인 노인건강 프로그램 구축과 질병통계 기초 자료로 활용되기를 기대한다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제13권4호
• /
• pp.7-14
• /
• 2007

Korea is entered to the aging society with 21C. Also it is forecast we will enter in aging society quickly. for 5 years there are some growth in facility at least 2~3 times but our society needs more. But this quantitative growth is worried about less quality. That's why we needs more research about the facility for an geriatrics hospital. The people who suffered from senile disease needs more treatment days in the ward of geriatric hospital. so we have to consider about better condition in ward of geriatrics than in general. Better environment for eldery is included not only the ward space but also the corridor and the dayroom. This study which it performed to improve their habitability is researched on public space. and this reserch deal with general feature against a public space in the ward of geriatric, and investigate 2 facility for divede the the general feature of the space. and this investigate is recorded according to behavior of patients. It can find us which factor of the space is prefered by them.

• 치위생과학회지
• /
• 제16권2호
• /
• pp.127-133
• /
• 2016

이번 연구는 영남대학교의료원 재활병동에 입원 중인 뇌졸중 환자 78명을 대상으로 구강위생 및 건강, 구강건강관련 삶의 질을 검사하였으며 다음과 같은 결과를 얻었다. Gingival index는 3명(3.8%)의 대상자만이 정상소견에 해당하는 code 0의 상태를 보였으며 이외 대다수의 대상자는 치은의 출혈 소견을 의미하는 code 2 이상의 수치를 보였다. CPI code의 경우에는 42명(53.8%)의 대상자가 중등도 치주염 및 중증의 치주염을 의미하는 code 3 또는 4의 상태를 보였다. CPI에 따라 대상자를 분류한 결과 치주염이 심한 그룹이 그렇지 않은 그룹에 비해 교육수준이 낮고 흡연경험이 있었으며 잔사, 치석 지수 및 치은 건강이 유의하게 불량하였다. 구강건강관련 삶의 질은 일상생활수행도 및 인지능력과 유의한 상관관계를 보였다(p<0.05). 이상의 결과를 종합해볼 때 재활병동에 입원 중인 뇌졸중 환자의 구강위생 상태는 개선할 필요가 있으며 이를 바탕으로 뇌졸중 환자의 구강건강의 악화를 방지하며 나아가 환자의 전신적 회복에 기여할 수 있을 것이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제30권6호
• /
• pp.536-539
• /
• 2004

The apicoectomy is an operation in which the root apex is removed and the adjacent periapical pathologic tissue is curetted. In this operation, there are several factors that may lead to the surgical wound infection, such as, local, systemic, environmental, endogenous and surgical factor. The systemic medical and surgical factor that may compromise patients defense are more important cause of the wound infection. The postoperative infection is likely to occur owing to poor systemic condition(especially geriatric cancer patient with operation, radiotherapy and chemotherapy), postoperative accumulation of hematoma & seroma and other contaminated factors. So, the authors established the immediate rubber drainage into the sutured wound of dental apicoectomy for the prevention of postoperative infection. The results are more favorable without the wound infection in total 31 cases of the dentistry of Dong San Medical Center & Wonju Christian Hospital.

• 생물정신의학
• /
• 제12권2호
• /
• pp.98-106
• /
• 2005

Objectives:Donepezil is a widely used drug for the treatment of patients with Alzheimer's disease(AD). The aim of the present study was to clarify the efficacy and the characteristics of responders to donepezil. Methods:Patients with probable AD(n=80;75.7 years) and small vessel dementia(SVD)(n=18;77.8 years) who received donepezil were retrospectively analyzed using Alzheimer's registry, and three questions were asked:1) Does donepezil therapy improves cognitive symptoms in patients with dementia? 2) If donepezil improves cognitive symptoms, which items of the K-MMSE are improved? 3) What are the characteristics of responder to donepezil medication? Results:1) After donepezil medication, cognitive function measured by the K-MMSE was significantly improved in both types of dementia(AD and SVD), However, statistical differences were not found between these groups. 2) In a clinical trial of donepezil, the patients performed better than before mediation on K-MMSE items assessing orientation, recall, construction, concentration, calculation. 3) In AD, the K-MMSE score before medication was closely related with response of donepezil. Conclusion:This study suggests that donepezil improves various cognitive functions in both types of dementia, and the responsive group had significantly lower K-MMSE scores than the non-responsive group before medication.

• 대한정형도수물리치료학회지
• /
• 제16권2호
• /
• pp.61-66
• /
• 2010

Purpose: The purpose of this study was to determine the effect of TENS by physiotherapist versus home based TENS intervention to reduce pain and improve disability in patients with mechanical neck disorder. Methods: The subjects of the study were 30 selected patients who had been diagnosed with subacute or chronic neck disorders without neurological damage, during the period of four weeks, three times a week, and thirty minutes for one session, 15 patients received TENS by physiotherapist. 15 patients received home based TENS intervention. The primary outcome was pain intensity measured in using the Visual Analog Scale(VAS). The second outcome was Neck Disability Index to patient's disability. Results: The change in the pain perception degree were statistically significant in both group(p<0.05). TENS by physiotherapist group showed significantly improvement in disability, but, Home based TENS intervention group is not. TENS by physiotherapist group showed significantly greater improvement in pain intensity and patient's disability than the home based TENS intervention group. Conclusion: This study shows that received TENS by physiotherapist was effective in reducing pain, improving disability for mechanical neck disorder patient, physiotherapist' knowledge need to improve patient's pain and disability.