• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.7
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• pp.490-499
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• 2017

In recent years, the introduction of complex systems analysis based on various variables has become more active in order to identify and analyze complex problems of Modern Society. Prediction of patients' spatial perception and usability according to the spatial arrangement of the outpatient department is a very important factor for providing high quality hospital service. For objective analysis, the standard program procedure and analysis index for the diseases of the elderly were prepared and the uniformity of the atmospheric space was evaluated through heat map analysis and quantitative analysis. In this study, 73 cells were installed and simulated to analyze the uniformity of the four alternatives according to the change of the arrangement of the medical care space, receiving space, and consultation space using the complex system analysis method for the nursing hospitals. The resulting density was derived. The results are as follows. 1)The layout of the reception space has the greatest influence on the total spatial density of the waiting space. 2) The uniformity of the waiting space can be increased by separating the examination space and the examination space. 3)The closer the location of the receiving space is from the entrance, the greater the density of the waiting space. Finally, this study applied discrete event simulation to the evaluation of uniformity of atmosphere space, and proved that the actor - based model can be utilized for utilization and evaluation as spatial analysis methodology.

• Korean Journal of Adult Nursing
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• v.19 no.1
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• pp.35-44
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• 2007

Purpose: This study was conducted to examine the knowledge level and assessment experience of nurses in regards to delirium, and to utilize the study results as baseline data for planning delirium education programs for nurses. Methods: Subjects were 465 nurses who were working in a general hospital. A 'delirium related knowledge and assessment experience' questionnaire was used to collect data. Results: Knowledge levels regarding delirium averaged 70 out of 100, and at each domain, they scored 87 for etiology of delirium, 62 for symptoms, and 69 for nursing management. The knowledge level of delirium was significantly different according to educational level (F=3.851, p=.022), past education related to geriatrics(t=2.471, p=.014), and awareness of need for in-service education on geriatric nursing(F=2.663, p=.032). About 85% of nurses had past experience of dealing with delirious patients and only 7.7% of nurses used delirious state assessment tools. Conclusion: According to the above results, it is necessary, not only to provide delirium related educational programs for nurses, but also to emphasize the usefulness of applying the assessment tool.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.2
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• pp.5-18
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• 1995

While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.10
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• pp.303-308
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• 2019

Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.

• Journal of Society of Occupational Therapy for the Aged and Dementia
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• v.12 no.2
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• pp.107-115
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• 2018

Objective : The purpose of this study is to investigate the effect of a group occupational therapy program on the depression and quality of life of the elderly with Mild Cognitive Impairment(MCI). Method : The elderly with Mild Cognitive Impairment were selected based on the Mini Mental State Examination-Dementia Screening(MMSE-DS). The group occupatinal therapy program consisted of various cognitive domains and was performed 12 times for 6 weeks. The Geriatric Depression Scale(SGDS-K) and Quality of Life(QOL) were used to assess depression and quality of life of the subjects before and after the intervention. Result : The elderly with MCI improved significantly on the SGDS-K and QOL after the intervention program(p<0.05). Particularly, in some items of the QOL, there was a statistically significant difference, but the results of the SGDS-K and QOL did not show any correlation(p>0.05). Conclusion : In the case of the elderly with MCI, the QOL scale and the depressive symptom test were statistically significant when the group occupational therapy program was applied for 6 weeks.

• Journal of Digital Convergence
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• v.17 no.11
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• pp.29-37
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• 2019

Elderly people want to live in the community even if they are in poor health. However, there is no integrated care support system suitable for the health and functional status of the elderly. So the elderly are choosing living facilities. The purpose of this study is to explore exploring whether the elderly are applying for a long-term care certification. First, mild geriatric patients were mainly using home care services such as visitation care. However, some of the milder elderly were enrolled in nursing homes. And the service that does not fit the functional status of the elderly is used. Second, it is concentrated on the use of visiting care services. Third, elderly people outside the class did not receive sufficient help for daily life, and the use of community welfare services such as the elderly welfare center was low. As a result, long-term care admitters are not able to continue to live in the community even though their health and functioning status is mild, and elderly people out of grade are unable to properly use the necessary community care services. The condition is likely to deteriorate.

• Journal of Oriental Neuropsychiatry
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• v.32 no.2
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• pp.81-93
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• 2021

Objectives: Mild cognitive impairment (MCI) is condition of cognitive decline shown in transition from normal aging to dementia. Hominis placenta pharmacopuncture (HPP) is a treatment that combines effects of medication and acupuncture by injecting Hominis placenta into acupoints. The objective of this study was to evaluate the efficacy and safety of HPP for MCI. Methods: This was a randomized, double-blind, placebo-controlled, two-center clinical trial. Eligible patients were randomly allocated to either the HPP group or the placebo group. HPP or saline as placebo was administered to participants for eight weeks. Changes in symptoms were observed. The primary outcome was difference in mean change of Korean Version of the Montreal Cognitive Assessment (MoCA-K) score between the HPP group and the placebo group. Cognitive function, overall status of mood and sleep, and quality of life (QoL) were also assessed. Safety assessment and economic analysis were then conducted. Results: Thirty participants were enrolled. One participant in the placebo group dropped out. The score of MoCA-K increased after treatment. Its mean change was smaller in the HPP group than in the control group. HPP ameliorated Global Deterioration Scale and Korean Dementia Rating Scale subtests for attention, organization, and memory compared to the placebo. However, none of them was significantly different between the two groups. Mood, sleep, and QoL all improved more in the HPP group than in the placebo group, although differences between the two groups were not statistically significant. There was no adverse event probably related to the drug. HPP treatment needed KRW 345,000 more than the placebo group in improving Geriatric Quality of Life scale-Dementia score by one point for one year. Conclusions: Although HPP treatment did not significantly improve cognition, it changed behavioral and psychological symptoms in MCI.

• Therapeutic Science for Rehabilitation
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• v.11 no.4
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• pp.69-83
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• 2022

Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

• Therapeutic Science for Rehabilitation
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• v.12 no.3
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• pp.61-77
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• 2023

Objective : This study analyzed the correlation between cognitive function and oral health-related quality of life (OHQoL). Methods : Demographic and clinical characteristics were extracted and utilized for subjects aged 45 years or older who participated in the 8th Korean Longitudinal Study on Aging in 2020. The dependent variable was the Geriatric Oral Health Assessment Index, and the independent variable was the level of cognitive function classified by the Mini-Mental State Examination scores. The analysis method used inverse probability of treatment weighting (IPTW). Then, the association between cognitive function and OHQoL was analyzed by multiple regression analysis. Results : Among the participants, 4,367 (71.40%) had normal cognition, 1,155 (18.89%) had moderate cognitive impairment, and 594 (9.71%) had severe cognitive impairment. As a result of analysis by applying IPTW, there was a negative correlation between the cognitive function group and OHQoL (normal vs. moderate: β = -2.534, p < .0001; normal vs. severe: β = -2.452, p < .0001). Conclusion : After propensity score matching, mild cognitive impairment showed a more negative association than severe cognitive impairment. Therefore, patients with cognitive impairment require oral health management education to improve OHQoL regardless of the level of cognitive impairment.

• Therapeutic Science for Rehabilitation
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• v.11 no.1
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• pp.69-85
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• 2022

Objective : This study aimed to develop a Comprehensive Oro-Facial Function Scale (COFFS) that can evaluate oro-facial function in patients with dysphagia. Methods : To verify the item composition and reliability of the COFFS, preliminary items were collected by selecting and analyzing four previous studies, and the Content Validity Ratio (CVR) was derived through a second survey of experts. Cronbach's 𝛼 was calculated for the internal validity of the evaluation items, and the test-retest reliability and inter-rater reliability were calculated using the internal classification coefficients (ICC). Results : The content validity ratio of all items was 0.67; in the case of Cronbach's 𝛼 value for each domain, 0.849 for communication domain, -0.224 for the oro-facial structure and shape, 0.831 for the ability to perform orofacial movements, and 0.946 for mastication and swallowing function. The test-retest reliability was 0.974 and the inter-rater reliability was 0.937, showing high reliability. Conclusion : In this study, the evaluation tool of COFFS was finally selected from 34 items in four areas and developed on a 3-5 point scale according to the evaluation items. In future studies, additional research is needed to prove its validity through correlation with other evaluation tools that measure oro-facial function.