• Title/Summary/Keyword: Preliminary elderly

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Development of Eligibility Criteria for Comprehensive Medication Management Programs in Long-term Care Facilities Using RAND/UCLA Appropriateness Method (RAND/UCLA Appropriateness Method를 이용한 요양시설의 포괄적 약물관리 프로그램의 대상자 기준 개발)

  • Jang, Suhyun;Kang, Cinoo;Ah, Youngmi;Lee, Ju-Yeun;Kim, Jung-Ha;Jang, Sunmee
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.260-269
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    • 2022
  • Background: Comprehensive medication management is essential to achieve safe and optimal drug use for the elderly in long-term care facilities (LTCF). This study aimed to develop eligibility criteria for "Comprehensive medication management program in LTCF" using the RAND/UCLA Appropriateness Method (RAM). Furthermore, we attempted to estimate the number of beneficiaries who met the criteria by analyzing the National Health Insurance claims data. Methods: Twelve criteria were selected initially. We composed a panel of 14 experts with expertise in long-term care. We conducted two survey rounds to reach a consensus. Rating for appropriateness and decision regarding agreement were applied per RAM. We analyzed the National Health Insurance data to estimate the number of LTCF residents who met each eligibility criterion. Results: Of the 11 items agreed upon, ten items were determined to be appropriate. In 2018, 83.6% of 165,994 residents of LTCF met one or more eligibility criteria. The largest number of subjects met the "New residents of LTCF" criterion, followed by "Take high-alert drugs" and "Chronic excessive polypharmacy." Since the items evaluated as most appropriate by the expert panel and those with a large number of subjects were similar, we confirmed the external validity of our criteria. Conclusion: It is worth noting that this is the first attempt to establish the eligibility criteria for medication management in LTCF. Further preliminary research is needed to identify the selected subjects' drug-related problems and revise the criteria according to the results.

Development of Caregiver Guideline for Participation in Activities of Daily Living for the Elderly with Early Dementia: Focusing on the Delphi Survey (초기 치매 노인의 일상생활 참여 촉진을 위한 보호자 지침의 개발: 델파이 조사를 중심으로)

  • Kim, Seo-Eun;Koo, Seul-Gi;Park, Sang-M;Kim, Jung-Ran
    • 한국노년학
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    • v.37 no.2
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    • pp.461-474
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    • 2017
  • The purpose of this study was to develop the caregiver guideline for participation in activities daily living for the elderly with early dementia in home including easily adaptable and professional strategies as early intervetion. The process of this study was 3 stage. First stage, the development of preliminary caregiver guideline as the first stage of this study was to translate to Korean and reclassify the items about caregiver guideline for participation from reports of foreign association or government related dementia, and it consisted of 3 areas, 128 statements for questionnaire for Delphi investigation. Second stage, the guideline was to conduct the content validity, and delete, reclassify, integrate, revise inappropriate items through 2 rounds and 16 Delphi panels. Third stage, the establishment of the final version of caregiver guideline. It consisted of 8 areas: home modification and assistive device, home activities of daily living, health management, communication, psycho-emotional support, leisure activities, social participation, general strategies. All 68 items was arranged in important order. The content validity, stability, agreement index in this study were 0.81, 0.15, 0.79 respectively. When content validity, stability was above 0.49, below 0.5 in Delphi survey with 15 panels, it was not required additional survey. The result of this study meaned that it was not required to additional Delphi survey, and the result was stable and agreeable. This developed guideline was useful and practical to maintain the elderly's with dementia independent and healthy life as education materials for their caregivers, so it will expect to decrease caregiver's burden. Lastly, it stated limitation and suggestion for further study.

Bactericidal Efficacy of Fumagari OPP®, Fumigant Against Escherichia coli and Salmonella typhimurium (훈증소독제, Fumagari OPP®의 Escherichia coli와 Salmonella typhimurium에 대한 살균효과)

  • Park, Eun-Kee;Kim, Yongpal;Yu, Eun-Ah;Yoo, Chang-Yeol;Choi, Hyunju;Kim, Suk;Lee, Hu-Jang
    • Journal of Food Hygiene and Safety
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    • v.28 no.3
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    • pp.234-240
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    • 2013
  • This test was performed to evaluate the bactericidal efficacy of Fumagari OPP$^{(R)}$, fumigation disinfectant, containing 20% ortho-phenylphenol against Escherichia coli (E. coli) and Salmonella typhimurium (S. typhimurium). In preliminary tests, both E. coli and S. typhimurium working culture suspension number (N value) was $4.0{\times}10^8$ CFU/mL. And all of the colony numbers on the carriers exposed the fumigant (n1, n2, n3) were higher than 0.5N1 (the number of bacterial test suspentions by pour plate method), 0.5N2 (the number of bacterial test suspentions by filter membrane method) and 0.5N1, respectively. In addition, the mean number of bacteria recovered on the control-carriers (T value) was $3.4{\times}10^6$ CFU/mL. In the bactericidal effect of the fumigant, the reduction number of S. typhimurium and E. coli (d value) was 5.26 and 5.64 logCFU/mL, respectively. According to the French standard for the fumigant, the d value for the effective bactericidal fumigant should be over than 5 logCFU/mL. With the results of this study, Fumagari OPP$^{(R)}$ has an effective bactericidal activity, then the fumigant can be applied to disinfect food materials and kitchen appliances contaminated with pathogenic bacteria.

Development and Validation of the Post-bereavement Growth Inventory in Later Life (노년기 사별 후 성장척도의 개발 및 타당화)

  • Chang, Sujie
    • Korean Journal of Social Welfare
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    • v.67 no.2
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    • pp.61-84
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    • 2015
  • The purpose of this study was to develop the Post-bereavement Growth Inventory(PBGI) for the elderly and to evaluate its validity. The items for developing PBGI were compiled from a literature search, content validity review, and a preliminary survey. A main survey of 308 widowed persons(aged 60+) was conducted. The results were as follows. First, an exploratory factor analysis revealed six factors of the PBGI. The results of the confirmatory factor analysis supported a five-factor structure for the final 24 scale items of scale. Second, in terms of concurrent validity, the PGBI compared favorably with the "Personal Growth" scale from The Hogan Grief Reaction Checklist (HGRC: Hogan and Schimdt, 2001). Third, the results of contrast group validity tests demonstrated that the group scoring in the upper 30% on the scales of Psychological Well-being (PWB, Ryff and Keyes, 1995) and the Grief Reaction Inventory (GRI: Remondet and Hansson, 1987) showed a significantly higher degree of post-bereavement growth (PBG) than the group scoring in the lower 30%. Fourth, Cronbach's ${\alpha}$ values for the five factors were between .649-.856 and .907 overall, indicating high internal consistency. Finally, education had the most significant influence on PBG. All results indicated the high validity of the PBGI. The findings from this study could provide the rationale for practical interventions from a growth-oriented perspective for widowed persons, as well as an objective assessment tool for practitioners in clinical areas.

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Qualitative Study for Medication Use among Visually Impaired in Korea (국내 시각장애인의 의약품 안전사용 실태에 대한 심층면접조사)

  • Koo, Heejo;Jang, Sunmee;Oh, Jung Mi;Han, Nayoung;Han, Euna
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.24-32
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    • 2016
  • Objective: The visually impaired have limited access to health care services and related information, and thus, they can have serious hurdles against properly taking medications. Despite that it is important to improve self-care ability of the visually impaired for correct medication use, there have been few studies investigating their needs for health care services in Korea, particularly focusing on proper medication usage. This study is to explore safety-related issues regarding mediation usage among the visually impaired based on in-depth interview. We particularly focus on any obstacles for safe use of medicines including experience on medication-related adverse effects in order to provide preliminary evidence for policy measures to improve proper medication use among the visually impaired. Methods: Study sample was visually impaired individuals who resided in Seoul area and were registered in the National Association of Visually Impaired. The association helped the process of recruiting the study participants. In-depth interview for each study participants was conducted. Each interview was recorded and later converted into a written script to extract core contents for the analysis. Results: The study participants comprised of three women (42.9%) and four men (57.1%). One was in his 20's, and there were four participants in 30's and two in 40's. Fully impaired participants were majority (5 out of 7). Limitation to physical access to health care providers and health information were the key factors to hamper safe medication utilization among the study participants. Difficulty reading medication information and may take the wrong medication or incorrect doses of medication, resulting in serious consequences, including overdose or inadequate treatment of health problems. Visually impaired patients report increased anxiety related to medication management and must rely on others to obtain necessary drug information. Pharmacists have a unique opportunity to pursue accurate medication adherence in this special population. This article reviews literature illustrating how severe medication mismanagement can occur in the visually impaired elderly and presents resources and solutions for pharmacists to take a larger role in adherence management in this population. Conclusion: The visually impaired had difficulties reading medication information and identifying medicines, and took incorrect doses of medications. Public support for safe medication use and medication management among the visually impaired is necessary.

THE EPIDEMIOLOGIC STUDY OF THE PATIENTS WITH TEMPOROMANDIBULAR JOINT DISORDERS, USING RESEARCH DIAGNOSTIC CRITERIA FOR TMD (RDC/TMD): PRELIMINARY REPORT (턱관절장애의 연구진단기준을 이용한 역학적 연구;예비보고)

  • Im, Jae-Hyung;Kim, Young-Kyun;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.2
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    • pp.187-195
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    • 2008
  • Purpose: This epidemiologic research was carried out to investigate the degree and aspects of symptoms of patients suffered from TMD using RDC/TMD. Subjects and Methods: Subjects were the patients who had visited to SNUBH dental clinic from Jan. 2005 to Dec. 2005, and total 117 patients were included (M: 22, F:95). The signs and symptoms of physical, psychological and behavioral factors were retrospectively evaluated by questionnaires in the RDC/TMD. The patients were examined through clinical and radiological method, and diagnosed by same investigator. They were divided into 3 groups such as osteoarthritis group (group 1), internal deragnement (group 2), myofascial pain dysfunction syndrome group (MPDS, group 3). In addition, in patient with complex diagnosis they were divided into subgroups in detail (ex. group 1+group 2). In the questionnaire, several items were selected to calculate the graded pain score (grade $0{\sim}IV$), depression and vegetative symptoms, nonspecific physical symptoms(pain items included) and nonspecific physical symptoms(pain items excluded) in each group. Results: As a result of classification by diagnostic criteria of this study, the patients were distributed to 45% of group 1, 47% of group 2, 8% of group 3 in this study. In younger patients (under 25-year old, n=40), group 2 was occupied 57% (n=23) and group 1 was 35%, group 3 was 8%, while group 1 was occupied 75% in elderly-patients (over 40-year old, n=28) in present study (group 2: 21%, group 3: 4%). In the analysis of depression and vegetative symptoms, majority of patients in Group 2 were included in 'normal', and in Group 3 it appeared to have larger proportion of 'moderate' & 'severe' than others. According to nonspecific physical symptoms, there have been tendencies of higher ratio of 'severe' in patients with MPDS. In graded pain score, more than half (58%) of subjects were included in grade 0 and low disability (Grade I and II), and 27% were revealed high disability (grade III, IV).

Fabrication of suction denture by using the individual tray duplicated an existing denture through scan and milling process: A case report (스캔 및 밀링을 통해 기존 의치를 복제한 개인트레이를 이용한 흡착식 의치 제작 증례)

  • Park, Minhyuk;Kee, Wonjin;Yang, Hongso;Park, Sang-Won;Yun, Kwi-Dug;Park, Chan
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.3
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    • pp.221-227
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    • 2020
  • In the case of complete edentulous patients, as the mandibular alveolar bone absorption progresses, the maintenance and stability of the existing dentures, which had satisfactory functions in the past, are deteriorated. Despite of the need to fabricate new dentures, they often hesitate due to physical burdens on the duration and intensity of future treatment progress due to the effects of aging and systemic diseases. In the case of these completely edentulous patients, it is necessary to consider the treatment goals that can reduce the number of visits and the adaptation period for new dentures before starting the treatment. This case is a case of producing complete dentures of elderly patients with deteriorated physical ability. In addition to producing suction dentures through preliminary and definitive closed mouth functional impression suggested by Sato, CAD / CAM technique was used to transfer occlusal functional information of existing dentures to facilitate adaptation to new dentures.

Effect of Community-Based 'Goal-Achieving Program' in Patient with Late-Life Depression : Preliminary Study (노인성 우울증 환자에서 지역사회 기반 '목표달성 프로그램'의 효용성 : 예비 연구)

  • Kang, Gyu Ha;Chang, Ki Jung;Lim, Hyun Kook;Han, Jin joo;Lee, Eun Hee;Roh, Hyun Woong;Noh, Jai Sung;Chung, Young Ki;Lim, Ki Young;Hong, Chang Hyung;Son, Sang Joon
    • Journal of Korean geriatric psychiatry
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    • v.21 no.1
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    • pp.35-40
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    • 2017
  • Objective : This study aimed to investigate the effect of community-based Goal-Achieving program in geriatric depressive symptoms preliminarily. Methods : We obtained data from elderly Korean subjects with major depressive disorder (n=51) aged 60 years or older at baseline, taking case management from community mental health center. Subjects were randomly assigned to intervention group (n=24) and control group (n=27). We investigated depressive symptoms through Short Form Geriatric Depression Scale-Korean version (SGDS-K) at baseline and every month for 3 months to all subjects. We tested interaction between group and time in SGDS-K score to evaluate the effect of program. And post hoc test examined between group differences of SGDS-K at each time points. Results : In quadratic linear mixed effects model analysis, interaction between group and time was statistically significant (Total SGDS-K score : coefficient=0.29, p<0.001 ; SGDS-K dysphoria subscale : 0.18, p<0.001 ; SGDS-K hopelessness subscale : 0.05, p=0.089 ; SGDS-K cognitive impairment subscale : 0.06, p=0.003). And significant between group difference was shown in post hoc test at time points of third month (SGDS-K score of control group : SGDS-K score of intervention group=$10.74{\pm}3.482$ : $7.25{\pm}4.475$, p=0.0184). Conclusion : These results may suggest that 'Community-based the Goal-Achieving program' has efficacy in reducing geriatric depressive symptoms.

Analysis of Practical Use Cases and Proposal for Improvements of Machine Guidance System Utilized in Smart City Construction Projects (스마트시티 건설현장에 활용된 머신 가이던스 시스템의 실무 활용사례 분석 및 개선방안 제시)

  • Kim, Sung Yeop;Lee, Won Hyo;Kang, Leen Seok
    • Korean Journal of Construction Engineering and Management
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    • v.25 no.2
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    • pp.3-10
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    • 2024
  • The purpose of this study is to analyze the effects of smart construction equipment applied at the construction site of the first smart city in the Korea and derive an application strategy for the utilization of smart construction equipment. To achieve this, aythors examined the practical effects and issues of safety systems and construction systems utilizing machine guidance (MG) technology, which is a representative smart construction equipment used in civil engineering construction sites. Both the MG safety system and MG construction system were found to be sufficiently effective in improving construction productivity. However, there are challenges that need to be addressed, such as the approval process for work results using MG systems, system changes due to frequent replacement of on-site equipment, and usability improvements for elderly on-site workers. The study presented some solutions that have been implemented on-site to address these issues. The utilization effects and issues presented in the study were analyzed through direct feedback from workers and managers who have utilized the MG technology on-site for a considerable period of time. These results can be used as preliminary data for the similar construction projects, considering the limited availability of empirical analysis data for equipment automation.

A Preliminary Study for Evaluating on Demonstration Project of Community-based Home Health Care Nursing Services by the Seoul Nurses Association (지역사회중심 가정간호 시범사업 성과평가를 위한 기초연구- 서울시 간호사회 주관 -)

  • 유호신;이소우;문희자;황나미;박성애;박정숙;최행지;정기순;한상애
    • Journal of Korean Academy of Nursing
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    • v.30 no.6
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    • pp.1488-1502
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    • 2000
  • This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

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