• Integrative Medicine Research
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• v.3 no.2
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• pp.60-66
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• 2014

Background: Medically unexplained symptoms (MUSs) are common in primary care. Atpresent, there are no proven, comprehensive treatments available in primary care forpatients with MUSs. However, MUS has parallels with "subhealth" or Mibyeong from tradi-tional East-Asian medicine, and thus, Mibyeong interventions could be effective in treatingMUS. Unfortunately, studies on Mibyeong and its intervention methods are relatively rare.Methods: We administered a web-based survey to 17,279 Korean medicine (KM) practitionersregistered with the Association of Korean Medicine. The response rate was 4.9% (n = 849).Based on the responses received, we assessed how much they agreed with concepts relatedto Mibyeong on a 7-point scale from "do not agree" to "strongly agree." Respondents werealso asked to indicate how frequently they encountered various subtypes and patterns ofMibyeong, and how frequently they use listed intervention methods.Results: Data from 818 respondents were analyzed after excluding those with no clinicalexperience. On average, respondents were male general practitioners aged between 30 yearsand 49 years, working or living in metropolitan areas such as Seoul, Incheon, and Gyeonggi-do. Responses did not differ by demographics. Respondents generally thought that Mibyeongreferred to subjective or borderline findings without certain disease, and that Mibyeong hasvarious subtypes and patterns. Subtypes included fatigue, pain, and digestion problems; pat-terns were either deficiencies (e.g., qi, blood, and yin deficiency) or stagnations (e.g., liver qidepression and qi stagnation). Decoction was the most frequently used type of interventionfor Mibyeong of all items listed, followed by acupuncture and moxibustion. Patient educa-tion was also recommended, suggesting healthy eating, promoting healthy environment,and exercise.Conclusion: We were able to provide preliminary results on KM practitioners' recognition ofand interventions for Mibyeong, but further research is needed to develop a detailed defi-nition of Mibyeong and its myriad subtypes and patterns, and evaluations of the efficacy ofMibyeong interventions.

• Nutrition Research and Practice
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• v.8 no.2
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• pp.192-197
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• 2014

BACKGROUND/OBJECTIVES: The body composition changes in aging increased the risk of metabolic disorder. Recent dietary studies have increasingly focused on the correlations between dietary patterns and chronic diseases to overcome the limitations of traditional single-nutrient studies because nutrients in food have complex relations that interact. SUBJECTS/METHODS: This study was conducted to classify a dietary pattern among Korean elderly using cluster analysis and to explore the relationships between dietary patterns and body composition changes in Korean elderly aged 65 years or older. The study subjects (n=1,435) were individuals who participated in the Korean National Health Examination and Nutrition Survey (KNHANES) in 2011. RESULTS: There were three dietary patterns derived by cluster analysis in this study: 'Traditional Korean' (37.49% of total population), 'Meat and Alcohol' (19.65%) and 'Westernized Korean' (42.86%). The (1) 'Traditional Korean' pattern was characterized by high consumptions of white rice and low protein, low fat, and low milk products, while (2) 'Westernized Korean' pattern ate a Korean-style diet base with various foods such as noodles, bread, eggs and milk, (3) 'Meat and Alcohol' pattern had high consumptions of meat and alcohol. In body composition changes, compared with the 'Traditional Korean' pattern, the 'Meat & alcohol' pattern was associated with a 50% increased risk of having elevated BMI ($kg/m^2$), 'Westernized Korean' pattern was associated with a 74% increased abnormality of ASM/Wt (kg) by logistics analysis. Most of the Korean adult population continues to follow ether a traditional Korean having beneficial effects for successful aging. However, the 'Traditional Korean' pattern showed low protein intake (0.7 g/kg), calcium intake, and vitamin D intake as well as low of appendicular skeletal muscle mass (ASM (kg)) among 3 groups. CONCLUSIONS: Considering the low ASM, consumption of protein, calcium and vitamin D should be increased for Korean elderly health body composition.

• Journal of Korean Academy of Nursing
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• v.40 no.1
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• pp.99-109
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• 2010

Purpose: The purpose of this study was to identify effective nurse interaction patterns with patients in the emergency department. Methods: For this study, video technology was used to record complete conversations between the nurse and patient. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data were collected from November, 2002 to April, 2003. The video recordings were observed for 4 hr for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS). The data were analyzed using cluster analysis to identify the patterns of nurse-patient interaction. Results: Cluster analysis revealed 4 distinct nurse interaction patterns; 1) "closed" characterized by orientation and negative talk, 2) "positive" characterized by positive affective talk, 3) "informative and directing" characterized by task-focused behavior including data gathering, and giving information about medical condition and treatment, 4) "facilitative" characterized by balance of psychosocial and biomedical topics. Patient satisfaction was highest in the facilitative interaction pattern. Conclusion: The patient centered interaction pattern, balancing information exchange and psychosocial exchange are the most effective interactions in the emergency department, suggesting that effective interaction skill is a core clinical nursing intervention in acute care.

• Journal of Gastric Cancer
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• v.15 no.2
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• pp.87-104
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• 2015

Purpose: To assess real-world treatment patterns, health care utilization, costs, and survival among Medicare enrollees with locally advanced/unresectable or metastatic gastric cancer receiving standard first-line chemotherapy. Materials and Methods: This was a retrospective analysis of the Surveillance, Epidemiology, and End Results-Medicare linked database (2000~2009). The inclusion criteria were as follows: (1) first diagnosed with locally advanced/unresectable or metastatic gastric cancer between July 1, 2000 and December 31, 2007 (first diagnosis defined the index date); (2) ${\geq}65$ years of age at index; (3) continuously enrolled in Medicare Part A and B from 6 months before index through the end of follow-up, defined by death or the database end date (December 31, 2009), whichever occurred first; and (4) received first-line treatment with fluoropyrimidine and/or a platinum chemotherapy agent. Results: In total, 2,583 patients met the inclusion criteria. The mean age at index was $74.8{\pm}6.0years$. Over 90% of patients died during follow-up, with a median survival of 361 days for the overall post-index period and 167 days for the period after the completion of first-line chemotherapy. The mean total gastric cancer-related cost per patient over the entire post-index follow-up period was United States dollar (USD) $70,808{\pm}56,620$. Following the completion of first-line chemotherapy, patients receiving further cancer-directed treatment had USD 25,216 additional disease-related costs versus patients receiving supportive care only (P<0.001). Conclusions: The economic burden of advanced gastric cancer is substantial. Extrapolating based on published incidence estimates and staging distributions, the estimated total disease-related lifetime cost to Medicare for the roughly 22,200 patients expected to be diagnosed with this disease in 2014 approaches USD 300 millions.

• Korean Institute of Interior Design Journal
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• v.22 no.1
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• pp.256-264
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• 2013

A bathroom in house has been stressed not only as a space for physiology and hygiene but also leisure and healthcare. However, the bathroom is the most likely space where an elderly person can have an accident and it is uncomfortable space for them because of their deteriorating physical ability. So the purpose of this study is to help the elderly use their bathroom conveniently by providing smart service. Therefore, we carry out 18 smart service patterns that contain assistive devices and sensors for bathroom. Considering applicability and frequency, from among these service patterns, we suggest 4 service patterns. First is a fall prevention service. This service helps elderly use the bathroom safely at night. Second is a getting ready to go out service. This service helps the situation that elderly use the bathroom after getting up in the morning. Third is a security service in daily life especially before or after meals. And final is a service regarding personal hygiene service after returning home. This service helps to shower or bathe after return home. These services have positive influence in medical expense reductions, good health care and self-reliance of elderly.

• Health Policy and Management
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• v.32 no.2
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• pp.173-179
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• 2022

Background: This study aimed to identify patterns of elderly patients who transferred from long-term care hospitals to emergency rooms and provide the evidence of emergency medical systems to prepare for a super-aged society. Methods: The data source was the National Emergency Department Information System database from January 2014 to December 2019 in Korea. We performed a cross-sectional study among elderly patients (≥65 years) who transferred from a long-term care hospital to an emergency room. Trend analysis was conducted by year. Results: We identified 225,765 elderly patients who were transferred from long-term care hospitals to emergency rooms between January 1, 2014 and December 31, 2019. The proportion of the study population and their mean age were recently increased (p<0.001, respectively). The proportion of elderly patients being re-transferred (p=0.049) and the patients re-transferred to long-term care hospitals is significantly increased (p=0.005). Conclusion: The establishment of efficient emergency medical services for an aging society is important. It is necessary to develop a healthcare network with the government, long-term care hospitals, and medical institutions in the community suitable for preventing disease deterioration.

• Nutrition Research and Practice
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• v.18 no.3
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• pp.387-399
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• 2024

BACKGROUND/OBJECTIVES: Poor oral health has been predicted the development of frailty and sarcopenia as well as the subsequent need for long-term care. This cross-sectional study examined the relationships among tooth loss, prefrailty, and dietary patterns in community-dwelling older Japanese females. SUBJECTS/METHODS: Information on the number of teeth, food consumption, and lifestyle factors was collected from 271 participants aged ≥ 65 yrs using a questionnaire. The number of teeth was self-reported and classified into 2 groups: natural teeth ≥ 20 and natural teeth < 20. Prefrailty was assessed using the Japanese version of the Cardiovascular Health Study. Three dietary patterns ("vegetables and dairy products" [VD], "rice and fish and shellfish" [RF], and "bread and beverages") were adopted from a cluster analysis of the intakes of 20 foods evaluated using the Food Frequency Questionnaire. The odds ratios (ORs) for prefrailty and dietary patterns were calculated using a binary logistic regression analysis. RESULTS: A total of 267 participants were analyzed, excluding those with frailty (n = 4). The rates of natural teeth < 20 and prefrailty were 57.3 and 37.4%, respectively. Natural teeth < 20 was positively correlated with prefrailty (OR, 4.66; 95% confidence interval [CI], 2.54-8.52) and inversely correlated with VD pattern (OR, 0.43; 95% CI, 0.27-0.69). Furthermore, both VD (OR, 0.38; 95% CI, 0.16-0.91) and RF (OR, 0.26; 95% CI, 0.11-0.62) patterns were inversely correlated with prefrailty. CONCLUSIONS: Maintaining the number of natural teeth ≥ 20 into old age plays an important role in preventing a prefrailty. The promotion of VD and RF dietary patterns has potential as an effective nutritional strategy for preventing tooth loss and prefrailty.

• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.109-113
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• 1999

Purpose : Because we don't have inappropriate health care system for the terminal cancer patients, there were abnormal behavior patterns of health care utilization. So, There were needs to develop the comprehensive care for terminal cancer patients. Increased attention is being paid to the futility of life-sustaining treatment and high cost of management of terminal cancer patients Materials and Methods : This study was performed on cancer patients, registered in 1996 Central Cancer Registry, who were as insured person of Korea Medical Insurance and died from January 1997 to June 1998. We studied the day of medical care and medical expenses of 151 cancer patients evaluable. Results : The mean day of inpatient care was 39 days, and the mean days of outpatient care was 14 days in study subjects. Mean expenses per day of medical care, day of inpatient, and day of outpatients care were 85,392 won, 105,908 won, and 40,173 won. 95% of medical expenses is paid to the general hospital, and 85% of medical expenses was paid for inpatient care. About half of all medical expenses in th last 6 months were incurred in the last 60 days of life, and about 30 percent were incurred in the last 30 days. Expenses of outpatients care increased between 6 month and 3 months, after which they decreased. Expenses of inpatients care increased during all last 6months Conclusion : The distribution or medical expenses during the last 6 months in our study is similar to the distribution of American Medicare costs. We need to study medical expenses during the last year of life with large scale and details in order to develop the plan about the management of terminal cancer patient.

• Research in Community and Public Health Nursing
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• v.9 no.2
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• pp.324-335
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• 1998

This study describes the extent of recognition of problems to the aged in a future society, the recognition and necessity of day care facilities, and the service contents and patterns preferred as a method of mediation for nursing the aged and increasing their quality of life. It also tries to certify the relations between those subjects. The result of the study is as follows: 1. Concerning problems of the aged of social significance the aged of the next generation consider the difficulties in nursing the aged to be the most important at 63.6%. 2. Concerning the nursing of parents, 49.4% of those answered 'children should take care of their parents and live together', while 46.7% answered that 'it is enough for children to provide an economic support, not necessarily living together. 3. Concerning information of day care facilities, 66.9% answered that they have no information. 4. Concerning the use of day care facilities, 54.6% answered that 'they would under certain circumstances', and 21.0% that 'they had better use them in the future'. 5. Concerning the feelings of the aged using day care facilities, 46.6% say 'they do not look poor', and 33.4% said that 'they look a little poor'. 6. Concerning the reasons for using day care facilities, 56.1% answered' because children do not proride care', and 48.5% answered 'because their economic ability is not sufficient'. 7. Concerning the programs potentially needed, food supply, medical services and physical therapy were ranked in that order. 8. Concerning social facilities necessary for the aged, centers that specialize in dementia, free day care facilities, home care services, and fee - based day care centers were ranked in that order. 9. Concerning institutions providing day care, welfare centers for the aged, those centers auxiliary to hospitals, asylums, and individuals were ranked in that order. 10. Concerning the responsibity running day care facilities, social workers, doctors/nursing assistants, nurses, and entrusted visitors were ranked in that order. Based on the results of this study, the study proposes that the study of applied cases of therapy in day care facilities for the aged continue.

• Journal of Korean Academy of Nursing
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• v.22 no.2
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• pp.238-247
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• 1992

Immigration of Koreans to the United States has increased since the 1960's. Adjusting to life in the United States produces a great deal of stress for immigrants. Despite better economic opportunites, many see the U.S. culture as threatening to their family and cultural values. Differences in culture, language, expectations and social behavior can lead to misunderstandings between health care providers and clients. These misunderstanding can leaf to frustration on the part of each. The ultimate result of this is that often Korean-immigrants do not get their health care needs met and stress response symptoms can lead to disease if there is no appropriate care. To determine the health care needs and concerns of Korean-Americans, a health needs assessment is needed. Appropriate and adequate information about the health care needs of these individuals is important as it relates to American policy changes allowing greater numbers of immigrants to enter the U.S. The purpose of this prospective study was to describe Korean-American stress response. This study focused on the primary presenting problems for which subjects reported having sought care. These included a variety of stress-related symptoms, including peripheral manifestations, cardiopulmonary symptoms, central-neurological symptoms, gastrointestinal symptoms, muscle tension, habitual patterns, depression, anxiety, emotional irritability and cognitive disorganization. Of the 300 subjects who entered the study, 80% (N＝223) completed the questionnaire in full. Demographically, the percentage of females and males was 50% each and they ranged in age from 20 to 69 years. Ninety percent of the subjects were highly educated, 25% owners of business, 25% white collar professionals, 15% employed in sales or as skilled /unskilled labor, 30% had no occupation : and 5% were housewives or students. The SOS inventory is designed to quantify self-perception of behavioral, cognitive, and physiological components of the stress response. It consisted of 94 items divided into 10 subscales. The result of this study are as follows : The total mean 505 of all subjects (N＝223 was .8129 ; the mean 505 for male(N＝114) was .7665 and for females, (N＝108) .8594. The level of symptoms for central-neurologic and muscle tension was higher for than for males. The highest stress response of all subjects was emotional irritability symptoms(1.0644) : the lowest stress response of all subjects was peripheral manifestation symptoms.