• 고령자･치매작업치료학회지
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• 제12권2호
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• pp.47-55
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• 2018

목적 본 연구는 요양병원 노인에서 수면의 질에 따른 손 기능 변화와 수면의 질과 손 기능, 수면 장애 요인간의 상관관계를 알아보고자 하였다. 연구방법 2017년 11월부터 2018년 1월까지 6개월 이상 입원중인 23명의 환자를 대상으로 수면 측정도구 A를 사용하여 수면의 질, 악력계를 이용하여 악력을 평가 하였고 BBT, 9-Hole Peg test를 사용하여 협응력을 평가 하였다. 수집된 자료는 SPSS 21.0 통계 프로그램을 사용하여 대응 표본 t-검정, 피어슨 상관분석을 실시하였다. 연구결과 수면 점수 '상' 집단에서는 수면의 질과 BBT 간에, 악력과 BBT 간에 상관관계를 보였고 '중' 집단에서는 악력과 BBT 간에 상관관계를 보였다. 두군 모두에서 수면의 질과 수면 양상 간의 유의미한 높은 상관관계를 보였다. 결론 요양병원에 입소한 노인 중 수면 장애의 질적 차이를 보일 때 BBT와 악력 향상을 위한 치료의 병행은 수면의 질을 향상시킬 수 있으며 수면 양상 중재는 수면의 질을 개선하는데 효과적일 것으로 생각 된다.

• 한국치위생학회지
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• 제11권5호
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• pp.629-636
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• 2011

Objectives : The purpose of this study was to determine the effects of oral health on the quality of life of elderly patients with dentures or implants. It is our intention that through this analysis we can aid seniors in making the choice between dentures or implants, considering future masticatory function and the likely effects of this decision on the patients quality of life. Methods : This survey was conducted between November 1, 2010 and November 25, 2010, in Kyunggi-Do, whasung city. The research was carried out at one public health center, among elderly patients. 105 seniors were surveyed using the direct interviewing method, oral health related quality of life was measured by the Philadelphia Geriatric Center(PGC) Morale Scale. Collected data was examined using the SPSS 13.0 program, using frequency, mean, and standard deviation analysis, T-test and $x^2$ test. Results : The number of residual teeth for patients who have implants was $20.45{\pm}5.85$, while among those patients with dentures the number was considerably lower, $8.11{\pm}7.66$(p<0.05). The results of patients masticatory function, was $28.13{\pm}2.40$ for those with implants, and $25.35{\pm}4.15$ with dentures. The results were better for those with implants. Among implant patients overall satisfaction was rated $25.21{\pm}3.63$, higher than for those with dentures $20.20{\pm}6.79$(p<0.05). Quality of life was scored higher for patients with implants($12.76{\pm}2.61$) compared to those with dentures($10.47{\pm}3.52$)(p<0.05). The subjects masticatory function was highly related to the number of remaining teeth and greater masticatory function had a positive effect on patients quality of life and life satisfaction. Conclusion : Dental treatments such as dentures and implants will have a great influence on patients quality of life and life satisfaction. Implants can improve the oral health related quality of life and satisfaction and the general quality of life more than denture therapy.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.207-210
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• 2001

Objective : The prognosis of spontaneous intracerebral hemorrhage often depends on initial neurologic condition, size and location of hemorrhage and associated intraventricular hemorrhage. However, age of patient, coagulation state and other associated vascular diseases may also play a role when present. In recent years, the geriatric population has been increasing. The age distribution of the patients with intracerebral hemorrhages also has been increased, accordingly. However, such patients, especially when associated with poor initial conditions often tend to be managed rather conservatively. The authors analyzed retrospectively on forty-five patients with spontaneous intracerebral hemorrhage over the seventies with poor initial condition to find out whether there exists a difference of outcome between surgery and non-surgery group. Material and Method : A total of 45 patients over seventies with spontaneous intracerebral hemorrhage with Glasgow Coma Scale(GCS) 4-8 treated over last six years were included. The validity of surgical management for these patients as well as clinical variables which might have been operated on the outcome of these patients were evaluated. The Glasgow Outcome Scale(GOS) after three months was used for comparison of outcome. Results : In surgical group(19 cases), mean age was 74.5 years old, mean hematoma volume 67.2ml and mean GCS score 5.7 points. In nonsurgical group(26 cases), mean age was 79.3 years old, mean hematoma volume 32.1ml, and mean GCS score 6.8 points. Mortality rate in surgical group was 47.4%(9 patients), including 2 cases of post-operative rebleeding, while that in nonsurgical group was 46.2%. However, when patients with initial GCS 4-6 points and over 30ml in hematoma volume were regrouped, mortality rate in surgical group was 46.2%, whereas mortality rate in nonsurgical group was 66.7%. Conclusion : It is concluded that the mortality rate is much low in surgery group with initial GCS less than 6 points and hematoma volume over 30cc. There was no significant difference of outcome in patients with basal ganglia and thalamic hemorrhage. However, surgical treatment lowered the mortality and morbidity rate in patients with subcortical and cerebellar hemorrhage.

• Hip & pelvis
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• 제34권1호
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• pp.25-34
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• 2022

Purpose: Mortality rates following hip fracture surgery have been well-studied. This study was conducted to examine mortality rates in asymptomatic patients presenting for treatment of acute hip fractures with concurrent positive COVID-19(+) tests compared to those with negative COVID-19(-) tests. Materials and Methods: A total of 149 consecutive patients undergoing hip fracture surgery during the COVID-19 pandemic at two academic medical centers were reviewed retrospectively. Patients were divided into two groups for comparative analysis: one group included asymptomatic patients with COVID-19+ tests versus COVID-19- tests. The primary outcome was mortality at 30-days and 90-days. Results: COVID-19+ patients had a higher mortality rate than COVID-19- patients at 30-days (26.7% vs 6.0%, P=0.005) and 90-days (41.7% vs 17.2%, P=0.046) and trended towards an increased length of hospital stay (10.1±6.2 vs 6.8±3.8 days, P=0.06). COVID-19+ patients had more pre-existing respiratory disease (46.7% vs 11.2%, P=0.0002). Results of a Cox regression analysis showed an increased risk of mortality at 30-days and 90-days from COVID-19+ status alone without an increased risk of death in patients with pre-existing chronic respiratory disease. Conclusion: Factors including time to surgery, age, preexisting comorbidities, and postoperative ambulatory status have been proven to affect mortality and complications in hip fracture patients; however, a positive COVID-19 test result adds another variable to this process. Implementation of protocols that will promote prompt orthogeriatric assessments, expedite patient transfer, limit operating room traffic, and optimize anesthesia time can preserve the standard of care in this unique patient population.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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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.

• 생물정신의학
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• 제21권3호
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• pp.107-113
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• 2014

Objectives Restless legs syndrome (RLS) is a sleep disorder characterized by uncomfortable and unpleasant sensations in the legs and an urge to move the legs, usually at night. The aim of this study is to investigate the incidence of RLS in patients with late life depression and its influence on various clinical outcomes such as severity of depression, sleep quality, cognitive function, and quality of life and accordingly, to elucidate the clinical significance of RLS in patients with late life depression (LLD). Methods This study enlisted 170 depressive patients aged 65 years or older from an outpatient clinic. Structured diagnostic interviews were performed using the Korean version of the Mini-International Neuropsychiatric Interview. All patients completed the questionnaires, including the International RLS Severity Scale, the Korean version of Short-Form 36-Item Health Survey (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). The severity of depression was evaluated by the Korean form of the Geriatric Depression Scale (KGDS) and the level of global cognition was assessed by the Mini-Mental State Examination in the Korean version of The Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (MMSE-KC). Results The incidence of RLS was 17.6% in LLD patients. RLS was more prevalent among the subjects with major depressive disorder (MDD) than those with minor depressive disorder or subsyndromal depressive disorder. The RLS group showed higher score in the KGDS than the Non-RLS group but the difference did not reach the statistical significance (p = 0.095, Student t-test). The mean PSQI score was significantly higher in the RLS group than in the Non-RLS group (p = 0.001, Student t-test). The MMSE-KC score was also lower in the RLS group than in Non-RLS group (p = 0.009, analysis of covariance). But, there was no difference in the score of SF-36 between the RLS group and the Non-RLS group. Conclusions RLS is common in LLD patients, especially in the patients with MDD and is associated with poor sleep quality and cognitive dysfunction, indicating that RLS is clinically significant in patients with LLD. Therefore, RLS should be considered as an important clinical issue in the management of LLD.

• 대한간호학회지
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• 제38권2호
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• pp.298-309
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• 2008

Purpose: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. Methods: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. Results: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. Conclusion: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

• Journal of Acupuncture Research
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• 제34권3호
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• pp.49-58
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• 2017

Objectives : The purpose of this study is to provide data to guide dementia health-care policy in Korea and to establish the position of Korean medical specialists in long-term care hospitals by analyzing the data of dementia inpatients. We analyzed the actual condition of dementia patients in care hospital and the effect of Western-Korean cooperative medicine on the progress of dementia. Methods : From January 1, 2016 to December 31, 2016, inpatients who were diagnosed with dementia at Mungyeong municipal long-term care hospital and admitted for more than 3 months were enrolled. Their medical records and simple tests were analyzed retrospectively. Results : We examined the detailed diagnosis, including both main and sub diagnosis, and Alzheimer disease dementia, at 97%, was the most common. At the time of admission, Korean Version of the Mini-Mental State Exam (K-MMSE) analysis showed that severe dementia affected 52%, and most were rated as Geriatric Depression Scale (GDS) 6. Based on the admission date, the results of a simplified test applied to the dementia patients every 6 months showed an maintain in the K-MMSE and GDS scores in 83%. Conclusion : The results of this study show that the rate of progression of dementia is somewhat lower in inpatients with moderate to severe Alzheimer's who have received Western-Korean cooperative treatment. However, due to institutional limitations, long-term inpatients such as those with dementia do not receive active traditional Korean medical treatment; hence, it is necessary to improve the national institution of traditional Korean medicine in long-term care hospitals.

• 국제물리치료학회지
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• 제5권1호
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• pp.683-690
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• 2014

This study purposed to provide a scientific base for understanding the effect of therapeutic intervention using motivation on chronic stroke patients' balance and determining whether it is applicable as a new therapeutic intervention. For this study, we sampled 38 chronic stroke patients, and divided them randomly into a motivation training group(n=20) and a control group(n=18). To the control group was applied neurological physiotherapy 5 times a week, and 30 minutes each time, and to the motivation training group was applied neurological physiotherapy and then, additionally, a Nintendo Wii-Fit program 3 times a week, and 30 minutes each time. Before and after the experiment, the subjects' dynamic balance was measured with functional reach test(FRT), timed up & go test(TUG), and 10m gait test, and their static balance was measured with the Romberger Test. When dynamic balance ability was compared between before and after the experiment and between the motivation training group and the control group, significant difference was observed in the results of FRT, TUG, and 10m walking test between before and after the intervention(p<.05). As to static balance, in addition, body balance movement distance was not significantly different. Therapeutic intervention using dynamic motivation was found to be more effective than the control group in improving dynamic balance.

• 동의신경정신과학회지
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• 제22권1호
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• pp.13-23
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• 2011

Objectives : The aim of this survey study is to analysis clinical symptoms and patterns of dementia patients. The results of this study will be used to support development of the oriental herbal medicine for dementia. Methods : Clinical data were collected from 41 dementia patients and 20 aged persons who have no cognitive impairment in 3 sites including 2 hospitals and 1 sanatorium. 'The instrument of oriental medical evaluation for dementia' is used to evaluate clinical symptoms and patterns of all subjects. Results : 1. Subjects of deficiency syndrome patterns were nearly three times more than subjects of excess syndrome patterns. 2. In dementia patient group, the average rate for 4 clinical symptoms, related with treatment principle of clear heat, was 26.9%. 3. The average rate for 4 clinical symptoms, related with condition of urine and feces, was 15.6%. 4. The average rate for 5 clinical symptoms, related with anger, irritation, anxiety and restlessness, was 40.0%. Conclusions : 1. It is needed to develop new herbal medicine for dementia focuing on clear heat, anger, irritation, anxiety, restlessness, and condition of urine and feces. 2. 'The instrument of oriental medical evaluation for dementia' has strong tendency that excessively reflects general geriatric symptoms, related to deficiency syndrome patterns. so, more clinical symptoms of excess syndrome should be added in this tool.