Kim, Jun Kew;Kim, Sun Pyo;Kim, Sun Hyu;Cho, Gyu Chong;Kim, Min Joung;Lee, Ji Sook;Han, Chul
Journal of Trauma and Injury
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v.31
no.3
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pp.117-124
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2018
Purpose: This study was to analyze clinical and epidemiological characteristics of elderly patients who were admitted to the emergency department (ED) due to falls by separating male and female. Methods: We retrospectively analyzed the fall patients aged 65 years or older from the data of the in-depth surveillance study of injured patients visit to the ED under the supervision of the Korea Centers for Disease Control and Prevention (KCDC) from 2011 to 2016 by separating male and female. Results: A total of 361,588 elderly fall patients were analyzed and, among them, 14,429 (37.3%) were males and 24,208 (62.7%) were females. Male and female showed similar frequency of damage happening season. However, they showed falling accident mostly on winter. The time of injury occurrence is mostly from 12:00 to 18:00 with 4,949 (34.3%) male and 8,564 (35.4%) female. Most falls occurred in daily activities, accounting for 7,614 (52.8%) in males and 14,957 (61.8%) in females, respectively. Unintentional damage accounted for the most part and 7,395 (51.2%) of male and 15,343 (63.4%) of female were injured indoors. Head and neck were the most common site of injuring, with 8,392 (58.2%) in males and 7,851 (32.4%) in females. According to ED examination outcomes, most of the patients were discharged, while the majority of the hospitalized patients were admitted to the general patient room. Conclusions: The elderly falls occurred mostly from 12:00 to 18:00, during winter and to elderly women. Also, they happened unintentionally indoors in everyday life, mostly. Proved clinical, epidemiological characteristics from this research will be used as useful indicator at validity research of development of prevent program of falling accident for elderly people.
The prevalence of undernutrition in hospital populations is known to be high. The presence of malnutrition is associated with depression, infections, sarcopaenia, falls, fractures, reduced autonomy and increased mortality. This study specifically examined the prevalence of malnutrition in patients aged 65 or older at the time of admission as determined by the Mini Nutritional Assessment (MNA) which has been a frequently used nutritional risk screening tools in detecting undernutrition in old people. This study was done for one hundred eight hospitalized geriatric patients in Seoul National University Bundang Hospital, Seoul, Korea. On admission baseline history, anthropometrics measurements, laboratory data and nutritional status by MNA were assessed. Length of hospital stay was obtained by reviewing medical charts. We used one-way analysis of variance to compare the differences in variables. Spearman's rank correlation coefficients were calculated for associations between MNA and variables. On admission, $22.3\%$ of patients were malnourished and $40.7\%$ were at risk of malnutrition according to the MNA. Percent of ideal body weight, anthropometrics data, albumin, and hemoglobin were lower in the malnourished patients (p<0.05). The malnourished patients stayed in the hospital 7.3 days longer, as compared with well nourished patients (p<0.05). Percent of ideal body weight, albumin, hemoglobin and total cholesterol were correlated inversely with nutritional status according to MNA (p<0.05). MNA can be used for nutritional assessment in Korean old people, because MNA significantly correlated with other nutritional assessment parameters, such as, anthropometric and laboratory data in hospitalized geriatric patients. The high prevalence of malnutrition in the elderly was observed and the presence of malnutrition on admission predicted a significant increase in the length of hospital stay in this study. Therefore further studies are needed to determine whether nutritional interventions in old people with low MNA scores can improve clinical outcomes during the hospital course.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.9
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pp.203-215
/
2017
Delirium is an acute confused state associated with poor outcomes among hospitalized long-term care hospital elderly patients. This study was conducted to examine the effects of acomfort promotion program based on Kolcaba's comfort theory for prevention of delirium among elderly patients who have been hospitalized in long-term care hospitals. The study used was a quasi-experimental type, with two groups of patients; those who received their usual care plus comfort nursing intervention (n=34) and those who only received usual care methods. Using the IBMSPSS/PC (Version 21), the homogeneity of the control and intervention group wereevaluated by the chi-squared test and an independent t-test, and all collected data wereanalyzed. Hypotheses were tested by independent t-tests and repeated measures of ANOVA. Delirium occurred at a rate of 2.9% (1/34) in the intervention group and 14% (5/34) -in the control group ($x^2=3.98$, p=0.047). The severity of the delirium in theintervention group was lower than that of the control (t=2.27, p=.027). The duration of delirium was 2days in the intervention group and 2-10days in the control group, indicating delirium in the intervention group lasted for a significantly shorter period ($x^2=3.22$, p=0.048). According to the change of time, the intervention group showed improvement in all areas including comfort scores (F=108.85, p<0.001), anxiety scores (F=63.39, p<0.001), depression scores (F=89.78, p<0.001), quality of sleep scores (F=63.63, p<0.001), and pain scores (F=93.64, p<0.001). In conclusion, elderly patients who were admitted to nursing homes were advised to participate in nursing intervention,which effectivelyprevented delirium based on the Kolcaba's comfort theory of physical, psychological, spiritual, social, cultural and environmental approaches to prevent delirium. Therefore, it is necessary to extend the program for prevention of delirium in the physical, psychological, spiritual, social, cultural, and environmental contexts to prevent delirium in geriatric hospitalized elderly patients.
Delirium is not developed naturally and is not an endogenous disease. However, delirium has occurred in some specific populations, such as the elderly or medically compromised patients. These become limitations on the systematic study of the epidemiology of delirium. Many epidemiologic studies of delirium have been focused on the elderly due to the fact there are relatively few in the general population. In addition, assessment tools with various sensitivity and specificity have been used. Advanced age, male, poorer cognitive and functional status, and alcohol abuse are well known risk factors of delirium. the epidemiological data will be reviewed in the elderly, patients with dementia, hip fractures, patients hospitalized in intensive care units, terminal cancer and patients with stroke.
Seo, Nam-Sook;Moon, Ji-Seon;Hong, So-Hyoung;Park, Yang-Hee
The Korean Journal of Health Service Management
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v.10
no.2
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pp.179-191
/
2016
Objectives : The purpose of this study was to identify the factors influencing nursing care behavior for hospitalized elderly patients who have no family caregiver. Methods : Participants were 170 nurses working in general hospitals in G city. Data were collected from November to December, 2015 and analyzed by exploratory factor analysis, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression with the SPSS/WIN 20.0 program. Results : There were significant correlations among experience, empathy, and nursing care behavior. Experience and empathy were significant factors influencing nursing care behavior and explained 29.4% of the variance in the score; in particular, empathy had a positive effect on nursing care behavior. Conclusions : The results show that theempathy of nurses' is the most important factor in caring for elderly patients who have no family caregiver. Nurse education programs should be developed that increase the empathy of nurses to improve the quality of nursing care for the elderly.
Purpose: Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults. Methods: A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m2. Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older). Results: A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group. Conclusion: Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.
To investigate dietary habits and health and nutritional status of the elderly with cerebrovascular disease(CVD), 31 hospitalized patients and 28 old people who had experienced stroke and were living at home were interviewed for the dietary habits and drinking and smoking habits. Their blood pressure and triceps skinfold thickness were measured and biochemical assessment of blood samples were conducted. The results were compared with those from 30 healthy elderly. Ca Index reflecting ca intake and intake of dietary fiber were significantly lower in the patient elderly groups than in the healthy elderly. Cholesterol intakes were not significantly different among the groups. Although salt intakes were almost similar among the groups, patient elderly tended to like salty taste as compared to the healthy elderly. Systolic and diastolic blood pressures of the patient elderly were significantly higher than those of the healthy elderly. Triceps skinfold thickness and serum total protein and albumin were significantly lower in patient groups than the healthy elderly. Serum cholesterol and hemoglobin concentrations were not different among groups. Among the above variables only Ca index was inversely correlated with blood pressure significantly.
This study of elderly in-patient subjects' expected level of care given by family members and nurses is intended to provide foundational information for use by nurses is attending to elderly patients. The objects of the study were elderly in-patients over the age of 65 hospitalized at two General hospitals in Chonju: 102 subjects filled out the 60 question survey between December 16 and 24. 1996. The analysis process was conducted using SPSS producing percentage. mean and standard deviation. maximum and minimum values. t-test, ANOVA. and so on. The results are as follows: 1. From the general results of the survey. one can observe that statistically significant differences appeared in various levels of education of the subjects: no education(2.98). primary school completed(2.91). middle school or higher completed(2.77). As shown. the lower level of education correlates with higher care-giving expectation. 2. On a scale of 1(minimum) to 4(maximum). the mean levels of care expected by elderly inpatients from their families is 2.93. with a standard deviation of 0.28. The level of psychological care expected(mean 3.02. standard deviation 0.31) is higher than the level of care expected(mean 2.83. standard deviation 0.34). 3. The level of care expected among those of different levels of dependency for daily living (differentiated as dependent. partially dependent. independent) was highest among the partially dependent(mean 2.98. standard deviation 0.17). but the results were not statistically significant. 4. Elderly in-patients with high levels of emotive interaction with their families expected relatively high levels of physical care. while the highest levels of socio-psychological care were expected from those who reported normal levels of emotive interaction with their families. However. We can see that low levels of care are expected from those reporting low levels of emotive interaction with their families. Overall. the differences in the level of care expected between those reporting different levels of emotive interaction with their families was not shown to be statistically significant.
Objectives: This study aimed to put clinical emphasis on the importance of considering medical precautions, such as drug history and a possible infection, when treating elderly patients. Methods: We closely observed two elderly female patients aged 79 and 76 who had been hospitalized for the treatment of anorexia at the Department of Hepato-Hemopoietic System, Kyung Hee University Korean Medicine Hospital in April 2018 for 5 and 9 days, respectively. Results: Through an elaborate medical investigation including a detailed inquiry and laboratory examinations, modifying some drugs and treating a urinary tract infection were preferentially needed to treat these two patients. In the first case, her overall symptoms, including anorexia, were improved after taking Dansambohyeol-tang combined with three types of antacids adjusted by holding 10 drugs in total, including nonsteroidal anti-inflammatory drugs that mainly causing chronic gastric ulcer. In the second case, the urinary tract infection was detected by blood test and urine analysis during the hospitalization period. After taking Geummogpaljeong-san and antibiotics for the treatment of the infection, the chief complaints including anorexia and the negative reaction to nitrite in the urinary analysis were improved. Conclusion: Considering the clinical precautions, including medications and infection possibility, is important especially when treating elderly patients.
Journal of Korean Academy of Fundamentals of Nursing
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v.16
no.1
/
pp.39-45
/
2009
Purpose: This study was done to verify the effects of foot reflexology on the self-esteem and vitality of elders. Method: A non- equivalent control group pre- and post-test design was used. Research instruments to measure self-esteem and vitality were used in this study. The participants were elderly women hospitalized in a hospital in Okcheon County, Chungbuk Province, Korea. The 18 patients in the experimental group performed 40 minutes of foot reflexology per time for a total of 12 times over two weeks, and the 18 patients in the control group received regular care only. Before and after the experiment, both groups were tested for self-esteem and vitality. Frequencies, percentages, $\chi^2$-test, t-test and Mann-Whitney U test with the SPSS/WIN 10.0 program were used to analyze the collected data. Results: Vitality of the elderly women patients improved significantly in the experimental group. However self-esteem did not increase significantly. Conclusion: Foot reflexology is effective as a nursing intervention in improving the health of elders.
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