• 제목/요약/키워드: Hospitalized Elderly Patients

검색결과 108건 처리시간 0.021초

노인의 일상활동수행에 대한 자기효능척도의 신뢰도 및 타당도 평가 (Psychometrics of Task Self-Efficacy Scale for Korean Elderly)

  • 엄영란;송라윤;서연옥;전경자
    • 대한간호학회지
    • /
    • 제27권4호
    • /
    • pp.831-842
    • /
    • 1997
  • The purpose of the study was to test the reliability and validity of the Korean version of Task Self-Efficacy Scale for activities of dally living (ADL). The Task Self-Efficacy Scale was developed by Roberts(1996) for low-intensity exercise study with older people to predict their performance of ADL. The scale was translated and back translated by bilingual persons, and then was modified to resolve variations in the translations. The Korean version of Self-Efficacy Scale for ADL was then administered to 193 elderly people including 95 hospitalized patients and 98 outpatients or healthy people. Face to face interview was used to fill out the structured questionnaire, and each interview took approximately 30 minutes. The subjects for the study were 80 women and 112 men with an age range of 65 to 95 years(M=71 years) of whom 82.6% classified themselves as moderate or quite active Most subjects(80.2%) had an education level of elementary school or less. The Self-Efficacy Scale for ADL is measured on a 0 to 10 VAS, assessing three areas of ADL : self care activities, household tasks, and motor tasks. The higher the score is, the higher person's confidence in performing ADL. Psychometric testing revealed that the scale was found to be internally consistent, showing a Cronbach's alpha of .97 The scale was significantly correlated with subjects' level of activity and subjective assessment of their health status. Moderate correlation with health-related hardiness scale also supported the validity. Factor analysis was performed to confirm whether the scale represents the three sub-areas as suggested in the literature. The results of the factor analysis led to a three factor solution according to Kaiser's criterion, but the items were not strongly and cleanly loaded for the third factor. This can be explained in that, among the three sub-ADL areas of the self-efficacy scale, the areas of self care activities and household tasks seem to have similar levels of difficulty in performance with not enough differences for the self-efficacy scale to distinguish between the two areas. Therefore, one factor solution was suggested since ADL can be seen as a unit of activities at similar level of difficulty in performance. One factor solution explained 68.1% of variance of the 19-item scale and all items were correlated over .6 with the factor, showing that the selected factor solution fits the model. The results indicated that the Korean version of Task Self-Efficacy Scale for ADL was reliable and valid in producing useful information to evaluate the effects of various interventions toward promoting health and quality of life for elderly people.

  • PDF

자문의뢰된 입원환자의 특성과 정신과 치료 순응도에 대한 연구 (A Studyof Psychiatric Treatment Compliance in Referred Patients at a General Hospital)

  • 심인보;고영훈;이문수;김용구;한창수
    • 정신신체의학
    • /
    • 제19권2호
    • /
    • pp.66-73
    • /
    • 2011
  • 연구목적: 종합병원에서 정신과에 자문 의뢰된 입원 환자 및 그 자문의뢰의 특성을 살펴보고 이를 통해 정신과 치료의 순응도에 관련된 요인을 찾아보고자 하였다. 방 법: 2009년 9월 1일부터 2010년 8월 31일까지 고려대학교 안산병원에서 정신과에 자문 의뢰된 입원환자 333명을 대상으로 자문기록지와 의무기록을 참고하여 연구를 진행하였다. 기본적인 인구 역학적 정보, 자문을 의뢰한 임상 각과, 의뢰 요청자, 의뢰된 사유, 정신과적 진단과 과거력, 입원 중 정신과 치료의 시행 여부 및 추후 통원 치료의 여부 등을 조사하였다. 이들 중 정신과 치료의 시행 여부 및 통원 치료의 여부를 치료순응도로 정하였다. 순응도와 기타 변수간의 이분형로지스틱 회귀분석을 시행하여 순응도에 영향을 미치는 요인을 확인하였다. 결 과: 입원 중 정신과 치료를 권유 받은 310명의 환자들 중, 치료에 순응한 환자는 82.9%이었으며, 외래 통원치료를 권유 받은 111명의 환자들 중에는 통원치료에 순응한 환자가 55.8%이었다. 64세 이하 연령층보다 65세 이상의 노인에서 입원 중 치료에 대한 순응도가 높았다(OR=4.838, p=0.004). 외래 통원치료를 권유받은 환자들 중 내과적 질환으로 인해 이차적인 정신과적 증상이 나타난 경우가 외래 순응도가 더 높았다(OR=8.520, p=0.008). 결 론: 노인 환자는 입원중 정신과 치료에 대해서는 순응도가 높았으나 신체 질환의경과에 영향을 미치는 섬망 및 기분장애가 흔하므로 정신과적 증상에 대한 평가와 치료가 보다 적극적으로 이루어져야 할 것이다. 또한, 내외과적 질환과 관련이 없는 정신과 문제로 자문 의뢰된 환자들은 외래 통원치료 순응도가 낮으므로 치료순응도를 높이기 위해 다방면의 치료적 접근 방법을 모색하여야 할 것으로 판단된다.

  • PDF

퇴원환자의 가정간호 이용의사와 관련 요인 (A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire)

  • 이지현;이영은;이명화;손수경
    • 재활간호학회지
    • /
    • 제2권2호
    • /
    • pp.257-270
    • /
    • 1999
  • The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

  • PDF

Efficacy of Lactobacillus fermentum Isolated from the Vagina of a Healthy Woman against Carbapenem-Resistant Klebsiella Infections In Vivo

  • Tajdozian, Hanieh;Seo, Hoonhee;Kim, Sukyung;Rahim, Md Abdur;Lee, Saebim;Song, Ho-Yeon
    • Journal of Microbiology and Biotechnology
    • /
    • 제31권10호
    • /
    • pp.1383-1392
    • /
    • 2021
  • Carbapenem-resistant Enterobacteriaceae (CRE) that produce Klebsiella pneumoniae carbapenemase are increasingly reported worldwide and have become more and more resistant to nearly all antibiotics during the past decade. The emergence of K. pneumoniae strains with decreased susceptibility to carbapenems, which are used as a last resort treatment option, is a significant threat to hospitalized patients worldwide as K. pneumoniae infection is responsible for a high mortality rate in the elderly and immunodeficient individuals. This study used Lactobacillus fermentum as a candidate probiotic for treating CRE-related infections and investigated its effectiveness. We treated mice with L. fermentum originating from the vaginal fluid of a healthy Korean woman and evaluated the Lactobacilli's efficacy in preventive, treatment, nonestablishment, and colonization mouse model experiments. Compared to the control, pre-treatment with L. fermentum significantly reduced body weight loss in the mouse models, and all mice survived until the end of the study. The oral administration of L. fermentum after carbapenem-resistant Klebsiella (CRK) infection decreased mortality and illness severity during a 2-week observation period and showed that it affects other strains of CRK bacteria. Also, the number of Klebsiella bacteria was decreased to below 5.5 log10 CFU/ml following oral administration of L. fermentum in the colonization model. These findings demonstrate L. fermentum's antibacterial activity and its potential to treat CRE infection in the future.

입원 환자에게서 졸피뎀 사용 후 나타나는 수면 연관 행동의 위험 요소 (Risk Factors for Zolpidem Induced Sleep-Related Behavior in Inpatients)

  • 김형인;이정섭;김원형;김혜영;맹세리;배재남
    • 정신신체의학
    • /
    • 제30권2호
    • /
    • pp.112-118
    • /
    • 2022
  • 연구목적 졸피뎀은 세계적으로 불면증에서 널리 쓰이고 있는 약물이다. 그러나 졸피뎀을 복용한 환자에게서 중추 신경계 부작용이나 수면 연관 행동을 보인다는 여러 보고가 있다. 본 연구는 입원 환자를 대상으로 졸피뎀 복용 후 나타나는 수면 연관 행동에 영향을 미치는 위험요인을 조사하기 위해 시행되었다. 방 법 2019년 1월 1일부터 2019년 12월 31일까지 인하대학교 병원에 입원한 졸피뎀을 복용한 환자들의 의무기록을 후향적으로 검토하였다. 졸피뎀 사용 후 나타나는 수면 연관 행동의 유무, 나이, 성별, 기저 질환, 투약력, 졸피뎀의 용량, 졸피뎀의 종류를 조사하였다. 결 과 졸피뎀을 복용한 907명의 환자 중 수면 연관 행동을 보인 환자는 102명(11.2%)이고, 65세 이상(OR 2.681, 95% CI 1.677-4.287, p<0.001), 남성(OR 1.556, 95% CI 1.007-2.404, p=0.046), 항정신병제 복용(OR 3.305, 95% CI 1.577-6.925, p=0.002), 항정신병제와 벤조디아제핀 동시 복용(OR 3.792, 95% CI 1.677-8.572, p=0.001)한 경우 수면 연관 행동이 발생할 확률이 유의하게 높았다. 결 론 졸피뎀 사용 후 생기는 수면 연관 행동의 위험 요소는 성별, 고령, 항정신병제 병용 투약, 항정신병제와 벤조디아제핀 동시 병용 투약 여부로 추정된다.

기침을 동반한 과민성 방광 증후군에 대한 한방 치료 1례 (The Effect of Korean Medical Treatment on the Overactive Bladder Syndrome with Coughing: Case Report)

  • 오주현;이유라;송진영;공건식;박진훈;김소원;강만호;이형철;엄국현;송우섭
    • 대한한방내과학회지
    • /
    • 제41권5호
    • /
    • pp.724-733
    • /
    • 2020
  • Objective: Overactive bladder syndrome refers to the symptom of frequent urination, as the function of the bladder is so sensitive that the bladder muscles contract regardless of the patient's intent and the patient feels the need to urinate quickly. Overactive bladder syndrome is common among the elderly, especially in women, and the prevalence increases with increasing age. Overactive bladder can decrease social activity, increase isolation, and decrease quality of life due to sleep disorders caused by night urination; therefore, active treatment is required. In this study, we report the effects of Korean medical treatment on a Korean hospital patient with overactive bladder symptoms, including urine frequency, urine incontinence, and night urination that began at a similar time to an onset of coughing. Methods: We treated the patient with herbal medicines and acupuncture therapy. The International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and a numeric rating scale (NRS) were used to assess symptom changes. Results: The patient with urine frequency, urine incontinence, and nocturia was hospitalized for 8 days, and the overall symptoms of overactive bladder syndrome were improved. Conclusion: The results indicate that Korean medical treatment is effective in patients with overactive bladder syndrome.

요양보호사의 노인 구강보건에 대한 지식과 인식도 연구 (A study on the knowledge and awareness of care workers on the geriatric oral health)

  • 김기욱;김지화
    • 한국융합학회논문지
    • /
    • 제6권6호
    • /
    • pp.9-15
    • /
    • 2015
  • 본 연구는 노인요양시설에 근무 중인 요양보호사의 구강보건지식정도와 인식도를 조사하여 구강보건의료서비스의 질적 향상과 발전 방안 연구를 목적으로 실시하였다. 연구방법은 D광역시 소재 노인요양시설(10개소)에 근무하는 요양보호사 중 연구 참여에 동의한 163명을 대상으로 2015년 5월 1일부터 5월 31일까지 설문조사한 자료를 SPSS Statistics 18. 프로그램을 이용하여 분석 하였다. 그 결과 요양보호사들의 구강보건지식은 총점 26점 만점에 20.09점(77.2%)로, 가장 높은 지식은 '올바른 칫솔질 방법' 93.0%, 가장 낮은 지식은 '구강보조용품사용 지식' 58.1%로 조사되었다. 구강보건교육경험이 있는 사람이 구강보건교육 요구도가 높았으며 (P<0.001), 구강보건교육경험횟수가 많은 사람이 구강보건지식(P<0.001), 요구도(P<0.01), 인지도(P<0.05)가 높아 유의하였다. 요양보호사들의 구강보건인식정도에 영향을 주는 것은 구강보건지식점수(P<0.01), 구강보건교육 요구도(P<0.01)가 높을수록 구강보건인식정도는 높은 것으로 나타났다. 따라서 향후 요양병원 장기입원환자의 구강특성을 고려한 효율적, 지속적, 실질적인 요양보호사의 구강보건교육이 이루어 질 수 있도록 하여야 할 것이다. 또한 구강보건교육의 담당자로 치과위생사의 역할이 필요 할 것으로 전문 인력의 배치를 위한 국가의 제도적 지원도 함께 이루어져야 할 것이다.

1개 종합병원 환자의 낙상에 관한 조사 (A Study on Fall Accident)

  • 이현숙;김매자
    • 대한간호
    • /
    • 제36권5호
    • /
    • pp.45-62
    • /
    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

  • PDF