• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.147-163
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• 2001

The purpose of this study was to find out the restructuring strategy for five provincial hospitals through the business analysis and survey of the service area. Through the survey of the service area of 5 hospitals. service area was classified into three groups, such as underserved area, adequate area, and overserved area. The strategy for the restructuring the clinical departments was set up based on the result of the business analysis and characteristics of the service area. The result of the study was as follows; 1) Whether or not a provincial hospital has specialized in specific area according to the circumstances and the needs of the community was the major factor influencing on the operating result of the hospital. 2) Provincial hospitals at the underserved area has to invest according to the changes of the occupancy rate and increasing pattern of the number of patients while maintaining the status as a general hospital. 3) Provincial hospitals at the adequate area has to lower the grade from the general hospital down to the hospital first and has to upgrade the competency through the restructuring the clinical departments and investment in specific area. 4) Provincial hospitals at the overserved area has to lower the grade from the general hospital down to the hospital first and has to seek ways to change the hospital fundamentally into geriatric hospital, pneumoconiosis hospital or psychiatric hospital etc. Provincial hospitals incapable to compete with private hospitals and clinics has to lower the grade from the general hospital down to the hospital first, to specialize in specific area and to restructure some clinical departments into rental base or self-operating basis. In case such methods are judged not so good solution, provincial hospitals has to find out ways such as shut-down of several departments or operating under the attending system.

• Journal of Families and Better Life
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• v.24 no.5 s.83
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• pp.113-128
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• 2006

This study was to verify the effectiveness of the Life Review-Narrative group therapy program on decreasing depression and death anxiety in the elderly. The program was organized according to a course of life from childhood to old age. The objectives were for the elderly to enhance self-worth, to become aware of their solitary existence, to accept aging and death, to accept the life: both past and present, and to make the most of experiences in overcoming difficulties. For the most part, the program used reminiscence and re-authoring of the narrative therapy as counseling techniques. Thirty-two elderly people(16 in the experimental group, 16 in the control group) aged 60 years and over were randomly selected from patients at the Daegu Metropolitan City General Welfare Center. Two groups were identified as equivalents for the study in the pre-test. The program for the experimental group was implemented twice a week for 90 minutes per session over a 6-week period(Sep. 8-Oct.14. 2005). The pre-test(Sep. 8 2005), the post-test(Oct. 14. 2005) and the follow-up test(Nov. 14. 2005) were implemented in order to verify the effectiveness of the programs. The instruments used in the study were the Geriatric Depression Scale Short Form(Korean Version) and the Death Anxiety Scale. The data were analyzed using t-testing and One-Factor Repeated Measures ANOVA. This study supplemented other qualitative research methods in order to verify the variation in the depression and death anxiety in the elderly. The findings of the study were as follows: Significant decrease in the depression and death anxiety were reported in the experimental group. The control group however did not show any significant changes in the depression and death anxiety rates. The result of the post hoc multiple comparisons showed that the effects of the life review-narrative group therapy program has lasted effects on decreasing of the death anxiety. Nevertheless, the effects of the life review-narrative group therapy program on decreasing depression are not lasting. The study has limitations so further research is suggested.

• Health Policy and Management
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• v.27 no.1
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• pp.56-62
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• 2017

Background: There have been deviations in the regional rate of certification in Korean long-term care insurance (LTCI). This study aimed to explore the determinants of the rate of certification in LTCI. Methods: The panel data of the year 2010-2014 of the 227 National Health Insurance Service (NHIS) regional office were used. Making use of 26 explanatory variables (socio-demographic factors, access to the long-term care services, etc.), we estimated the random effects model using STATA SE ver. 13.0 program (Stata Corp., College Station, TX, USA) and tried to find out the determinants of the regional rate of certification. Results: Estimation results showed that the most important determinants of the regional rate of certification in LTCI are the long-term care infrastructure such as capacity or number of the homecare service institution, sanatorium, or convalescent hospital. The number of the elderly who lives alone and the dimentia patients were positively related to the regional rate of certification in LTCI. Conclusion: The estimation results implied that the regional variation in the rate of certification in LTCI has nothing to do with the NHIS regional offices or their employees. To alleviate the deviation in the regional rate of certification in LTCI, we suggested the analysis of the deviation in the survey checklist. We also proposed to found the regional comprehensive support center to prevent the geriatric illness and to improve the residents' health, etc.

• Journal of Korean Public Health Nursing
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• v.28 no.3
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• pp.495-508
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• 2014

Purpose: This study was conducted in order to evaluate the reliability, validity, sensitivity, and specificity of the Short Form of Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS-SF). Methods: A validation study was conducted on 207 elderly patients aged over 65 who were admitted to Bobath Memorial Hospital. Fall risk scores of BMFRAS, composed of eight subscales (age, fall history, physical activity, consciousness level, communication, fall risk factors, underlying disease, and medications) were assessed from the electronic medical record. BMFRAS-SF was derived from eight subscales of the BMFRAS representing the significance between fallers and non-fallers (fall history, physical activity, fall risk factors, underlying disease, and medications). Internal consistency reliability and interrater reliability were assessed by Cronbach's alpha and kappa coefficient. Validity was assessed by Spearman correlation analysis, factor analysis. Sensitivity, specificity, positive predictive and negative predictive values, and a receiver-operating characteristic curve (ROC) were generated. Results: Fallers had significantly higher risk scores than non-fallers in fall history, physical activity, fall risk factors, underlying disease, and medication scales. The BMFRAS-SF demonstrated acceptable Cronbach's alpha (.706) and kappa coefficients of .95. The BMFRAS-SF subscales showed good convergent validity and construct validity. The BMFRAS-SF presented good sensitivity(86.7%), specificity(67.9%), positive predictive value(42.9%) and good negative predictive value(94.8%) at a cut-off score of 5. Areas under the ROC curves were .860 for the BMFRAS and .861 for the BMFRAS-SF. Conclusion: The BMFRAS-SF was proved to be reliable and valid. It could be used for time-saving assessment and evaluation of the high risks for falls in clinical practice settings.

• Nutrition Research and Practice
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• v.12 no.5
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• pp.415-425
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• 2018

BACKGROUND/OBJECTIVE: As aging progresses, the number of patients with cognitive impairment also increases. Cognitive function is not generally correlated with diet, and there is debate over that association. Thus, the present study aimed to investigate the association between dietary intake and cognitive function among adults aged 50 years or older. SUBJECTS/METHODS: Between July 2017 and March 2018, 324 adults aged over 50 years from Gwangju Sun-Han hospital participated in a dietary survey. The frequency of food intake and related information were collected using a semi-quantitative food frequency questionnaire (SQ-FFQ) and determining the mini-mental state examination (MMSE) level for 276 participants. The association between dietary intake and cognitive function was assessed by performing logistic regression analysis. RESULTS: Depending on the MMSE score, the participants' age, education level, inhabitation status, medications, alcohol consumption, sleep duration, physical activity, and short geriatric depression scale score were significantly different (P < 0.05). Moreover, those participant characteristics were associated with either decreased or increased odds ratios (OR) for the risk of mild cognitive impairment (MCI). Based on analysis of the participants' intake of 112 detailed food items, which were categorized into 20 food types, intakes of cooked white rice (< 2 times/day compared with ${\geq}3$ times/day) (P < 0.05), properly cooked rice with other grains and legumes (P < 0.001), fruits (P < 0.05), milk (low fat and normal) (P = 0.044), liquid-type yogurt (P = 0.019), and curd-type yogurt (P = 0.015) were found to significantly decrease the OR for the risk of MCI. CONCLUSIONS: Associations were significant between the risk of MCI and the intake of certain food types. Specifically, a moderate intake of cooked white rice and an adequate intake of whole grains, fruits, milk, and dairy products were associated with reduced risks of MCI among adults aged over 50 years.

• Journal of Korean Academy of Nursing
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• v.24 no.3
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• pp.448-460
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• 1994

This study was conducted to investigate risk factors for senile dementia as well as care givers' stresses and thier needs for nursing care. It was done using a retrospective survey. A convenience sample or In senile dementia patients and l20 nor-mal elders in a rural area was used. The tools used in the study were the MMSE-K(Mini-Mental State Examination-Korea) for dementia screening test and a questionaire developed by the research team. Data were collected through home visits by Com-munity Health Practitioners. Data were analyzed using descriptive statistics, T-test, and Chi-square test. The findings are as follows : 1. There were significant differences in age, marital status, and religions between the two groups. 2. There was a significant difference in smoling behavior between the two groups. 3. There was a significant difference in past his-tory of cancer between groups. 4. There was a significant difference in past and present elderftmily relationship between the two groups. 5. There were significant differences in intellectual activities, assuming major role in family and seeking other's help in daily life troubles between the two groups. 6. There were significant differences in stress factors such as child problem, family conflict, health problem and illegal behavior between the two groups. 7. The major problems out by families in caring for dementia patient were catastrophic reactions, dirtiness, mood change, devouring and tremor. The most serious problems faced by families was dirtiness. with catastrophic reactions, sleep distrubance, changeableness, and a suspcio-usness following. The care givers expressed chronic fatigue, anxiety, tension, depression, disorder in daily life, shamefulness, blame from neighbours and guiltiness. 8. There is need for geriatric hospitals, nursing homes, burden sharing, and counselling or education for family care givers. A replicate study in the urban area is recommended to validate the findings of this study. To explore the impact of stress in life and ‘han’ on senile dementia, a qualitative study is recommended.

• International journal of advanced smart convergence
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• v.9 no.1
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• pp.185-192
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• 2020

The number of dementia patients in Korea is expected to increase to 3.30 million in 2050, and the cost of dementia management will increase sharply to KRW 106.5 trillion of GDP. In August 2017, the Moon Jae-in government announced the 'Dementia National Responsibility System' through a five-year plan for government operation and expanded the Dementia Peace Center nationwide. However, for this, strategic dementia-related technology development strategies should be established and given the role of government and the role of the private sector. Therefore, in order to derive the corresponding strategy, this study developed the government's 'dementia' response technology development strategy through the situation analysis from the political, economic, social, and technological perspective and the environmental (PEST) analysis of the strengths, weaknesses, opportunities, and threats (SWOT). As a result, the direction of technology development in the dementia-related medical device market is expected to become a trend of developing dementia self-measurement by developing low-cost and high-efficiency diagnostic technology products. It has been shown that the development of various products for consumers should begin. As a result, the dementia market approach strategy should be premised, the related technical support and legal restrictions should be minimized, and the education of related experts should be strengthened to solve the government's development of dementia technology and the social problems of dementia. In addition, by developing joint projects with major companies around the world and actively participating in the technology platform, it is important to naturally build up skills accumulation for the development of dementia technology and competence skills of dementia technology experts in the long term.

• Physical Therapy Rehabilitation Science
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• v.9 no.3
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• pp.131-139
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• 2020

Objective: The purpose of this study was to evaluate the effect of virtual reality (VR)-based core stabilization exercise on upper extremity function, postural control, and depression among persons with stroke with hemiplegia. Design: Randomized controlled trial. Methods: This study was conducted with the inclusion of 24 participants and were randomly assigned to either the VR-based trunk stability exercise group (n=12) or control group (n=12). The VR-based trunk stability exercise group performed core stabilization exercises in a VR environment for 30 minutes. Meanwhile, the control group conducted general core stabilization exercises for 30 minutes. The participants trained 3 times a week for 4 weeks. The manual functional test (MFT), Box and Block Test (BBT), Berg Balance Scale (BBS), Trunk Impairment Scale (TIS), the Geriatric Depression Scale (GDS) were used to assess all participants before and after the intervention. Results: The VR-based core stabilization exercise group had a significant improvement in upper extremity function (MFT, BBT) and postural control (BBS) compared with the control group (p<0.05). The VR-based core stabilization exercise showed a significant difference after intervention in the TIS and GDS scores (p<0.05), but they did not significantly differ between the two groups. Conclusions: The result showed that VR-based core stabilization exercise can be effective in improving upper extremity function and postural control among patients with stroke more than the sole application of general physical therapy.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.3
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• pp.21-31
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• 2020

Purpose : The purpose of this study was to determine the effects of a cognitive-exercise program using step on the cognitive function, gait, and depression of elderly with mild cognitive impairment. Methods : The subjects comprised 30 elderly people with mild cognitive impairment who used elderly welfare centers in the provinces A, B, and C between March 21 and June 7, 2019. They were divided into an experimental group (n=15) and a control group (n=15) before undergoing an experiment based on a pretest-posttest control group design. The lowenstein occupational therapy cognitive assessment-geriatric population was used to assess the subjects' cognitive function, while the 4-stage balance test, 30-second chair-stand test, timed up & go test, and functional reach test were employed to evaluate their gait. In addition, the beck depression inventory was used to measure their levels of depression. Results : The cognitive-exercise program using step enhanced the subjects' cognitive function and gait and reduced their levels of depression. Furthermore, statistically significant differences were found between the experimental group and the control group. Conclusion : The cognitive-exercise program using step promoted the process of sensorimotor and cognition through the learning process of various steps taking left and right steps and cognitive activities. It improves gait by activating the coordination of the musculoskeletal and nervous systems of the body and positively affecting posture control, balance, flexibility, and lower extremity muscles. It also relieved depression by performing successful step learning and cognitive activities with forward-looking (doing) that leads to pleasure and achievement. The present study confirmed the value of a cognitive-exercise program using step to treat multiple domains of functional decline in elderly patients with mild cognitive impairment. This is therefore proposed as an intervention program for this patient group.

• Journal of Korean Academy of Nursing
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• v.37 no.5
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• pp.665-675
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• 2007

Purpose: The purpose of this study was to explore the experiences of people with chronic hepatitis B (CHB) in Korea. The specific aim was to identify major problems that people with CHB face and strategies that they are dealing with. Methods: A grounded theory method was utilized. The data were collected by individual in-depth interviews from 12 CHB patients from one of the major hospitals in Korea. Results: After constant comparative analysis, a core category emerged as "illness management with self-reliance and will." Seven major strategies that were identified in dealing with the illness were maintaining receptive and positive attitudes; restraining excessive work and greed; searching for information; controlling illness information; adhering to practices for not spreading the viral disease; abstaining from alcohol and smoking and maintaining healthy eating habits; nd using alternative therapies. The outcomes that result from employing these strategies were identified as burden, depression and helplessness, stress for maintaining compliance, and dispirited interpersonal relationships. Conclusion: The results of this study suggest that most people with CHB in Korea have problems in psychosocial area. Thus health professionals need to provide not only informational support but also emotional one to improve quality of life of the people with CHB.