The purpose of this study was to develop a wandering management guideline for family caregivers of community-dwelling elders with dementia (EWD). In the first stage of the study, focus group and individual interviews (n=10) were performed to analyze family caregivers' experiences about wandering of the EWD under their care. In the second stage, preliminary contents for the guideline were made based on the interview results of family caregivers and reviews of literature. Final version of the guideline with 86 items was established after experts' review using the Content Validity Index analysis. In the final stage, a pilot test was conducted to evaluate the guideline using a sample of 13 family caregivers of EWD. Family caregivers were educated about how to use the guideline and asked to complete a set of questionnaire to examine their knowledge about wandering, degree of application of the guideline, and satisfaction with the guideline. Family caregivers' knowledge score was significantly improved (p=0.014) and the average scores in the process evaluation (9 items) and user satisfaction (7 items) about the guideline were 2.69-3.46 (range: 1-4), and 2.85-3.38 (range: 1-4), respectively. Further study with a large random sample is necessary to confirm the results of this study.
The degree of benefits of living services related to the quality of life can solve the depopulation problem, and it is necessary to be able to quantitatively analyze problems related to the quality of life in rural areas in order to cope with the rural depopulation. The purpose of this study was to develop the assessment model of a village-level rural living service that reflects the regional characteristics of rural villages to evaluate the level of rural living services for response rural depopulation. Based on the review of previous related studies, the evaluation index was composed of seven sectors of education, health, welfare, culture, environment, safety, and convenience, and the assessment model of a rural living service was established. This model was evaluated through a sample survey of 90 villages in Nonsan-si, Seongju-gun, and Pyeongchang-gun. As a result of the rural life services evaluation by Si and Gun, Seongju-gun, which is affected by nearby large cities, has the largest variation by village level and is assessed at a lower level overall than other Si and Gun. As a result of the rural life services evaluation by 7 sectors, in the case of health and welfare, low scores were shown in the assessment model, but the level of residents' satisfaction was mid-level. In particular, in the case of Seongju-gun, there were significant differences in the assessment model and the survey results of the level of residents' satisfaction in the health and welfare sectors due to the influence of nearby large cities. As a result of analyzing the number of villages corresponding to the top 30% and the bottom 30% of the evaluation results for each sector, it was analyzed that the villages with the highest evaluation results in Pyeongchang-gun in both the assessment model and the level of residents' satisfaction. It implies that quantitative analysis of data based index and accessibility as well as level satisfaction of residents are necessary.
Objective : The purpose of this study was to analyze the effects of simultaneous dual-task training to assess executive function in older adults. Methods : We searched the PubMed, EMBASE, Cochrane, Web of Science, and RISS databases of publicated studies in the past decade. Seven studies were selected based on the inclusion and exclusion criteria. Qualitative assessment and meta-analysis were performed for the seven studies. Results : A randomized controlled trial design was used in the selected studies, and PEDro Scores above seven were obtained. The Trial Making Test (TMT) evaluated the effects of dual-task training on executive function in four studies. The Color Trail Test (CTT) was used in two studies, and Stroop test was used in three studies. The effect size for total executive function was 0.38, which was small. The effect sizes for TMT and CTT were 0.37. Stroop Test was 0.34, demonstrating that their effect sizes were also small. Only significant effects in total executive function, TMT, and CTT showed significant effects (all p<0.05). Conclusion : This study confirmed that dual-task training was effective in improving executive function in older adults. To improve the effectiveness of dual-task training, the difficulty of the dual-task training should be considered. It is also necessary to implement assessments that can evaluate performance under dual-task conditions as well as conventional test tools for executive function. In the future, dual-task training could be used as an appropriate intervention for executive function in older adults to delay the onset of dementia.
Kim, Youlim;An, Tai Joon;Park, Yong Bum;Kim, Kyungjoo;Cho, Do Yeon;Rhee, Chin Kook;Yoo, Kwang-Ha
Tuberculosis and Respiratory Diseases
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v.85
no.1
/
pp.74-79
/
2022
Background: The effect of underlying chronic obstructive pulmonary disease (COPD) on coronavirus disease 2019 (COVID-19) during a pandemic is controversial. The purpose of this study was to examine the prognosis of COVID-19 according to the underlying COPD. Methods: COVID-19 patients were assessed using nationwide health insurance data. Comorbidities were evaluated using the modified Charlson Comorbidity Index (mCCI) which excluded COPD from conventional CCI scores. Baseline characteristics were assessed. Univariable and multiple logistic and linear regression analyses were performed to determine effects of variables on clinical outcomes. Ages, sex, mCCI, socioeconomic status, and underlying COPD were selected as variables. Results: COPD patients showed older age (71.3±11.6 years vs. 47.7±19.1 years, p<0.001), higher mCCI (2.6±1.9 vs. 0.8±1.3, p<0.001), and higher mortality (22.9% vs. 3.2%, p<0.001) than non-COPD patients. The intensive care unit admission rate and hospital length of stay were not significantly different between the two groups. All variables were associated with mortality in univariate analysis. However, underlying COPD was not associated with mortality unlike other variables in the adjusted analysis. Older age (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.11-1.14; p<0.001), male sex (OR, 2.29; 95% CI, 1.67-3.12; p<0.001), higher mCCI (OR, 1.30; 95% CI, 1.20-1.41; p<0.001), and medical aid insurance (OR, 1.55; 95% CI, 1.03-2.32; p=0.035) were associated with mortality. Conclusion: Underlying COPD is not associated with a poor prognosis of COVID-19.
Hwang, Sung Hwan;Chung, Chun Kee;Kim, Chi Heon;Yang, Seung Heon;Choi, Yunhee;Yoon, Joonho
Journal of Korean Neurosurgical Society
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v.65
no.5
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pp.719-729
/
2022
Objective : The ossification of the ligamentum flavum (OLF) is one of the major causes of thoracic myelopathy. Surgical decompression with or without instrumented fusion is the mainstay of treatment. However, few studies have reported on the added effect of instrumented fusion. The objective of this study was to compare clinical and radiological outcomes between surgical decompression without instrumented fusion (D-group) and that with instrumented fusion (F-group). Methods : A retrospective review was performed on 28 patients (D-group, n=17; F-group, n=11) with thoracic myelopathy due to OLF. The clinical parameters compared included scores of the Japanese Orthopedic Association (JOA), the Visual analogue scale of the back and leg (VAS-B and VAS-L), and the Korean version of the Oswestry disability index (K-ODI). Radiological parameters included the sagittal vertical axis (SVA), the pelvic tilt (PT), the sacral slope (SS), the thoracic kyphosis angle (TKA), the segmental kyphosis angle (SKA) at the operated level, and the lumbar lordosis angle (LLA; a negative value implying lordosis). These parameters were measured preoperatively, 1 year postoperatively, and 2 years postoperatively, and were compared with a linear mixed model. Results : After surgery, all clinical parameters were significantly improved in both groups, while VAS-L was more improved in the F-group than in the D-group (-3.4±2.5 vs. -1.3±2.2, p=0.008). Radiological outcomes were significantly different in terms of changes in TKA, SKA, and LLA. Changes in TKA, SKA, and LLA were 2.3°±4.7°, -0.1°±1.4°, and -1.3°±5.6° in the F-group, which were significantly lower than 6.8°±6.1°, 3.0°±2.8°, and 2.2°±5.3° in the D-group, respectively (p=0.013, p<0.0001, and p=0.037). Symptomatic recurrence of OLF occurred in one patient of the D-group at postoperative 24 months. Conclusion : Clinical improvement was achieved after decompression surgery for OLF regardless of whether instrumented fusion was added. However, adding instrumented fusion resulted in better outcomes in terms of lessening the progression of local and regional kyphosis and improving leg pain. Decompression with instrumented fusion may be a better surgical option for thoracic OLF.
Journal of the Korean Society of Marine Environment & Safety
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v.28
no.6
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pp.1013-1022
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2022
Recently, with the worldwide development of the fourth industry, the development of technologies for smart and eco-friendly ships is accelerating. With the emergence of autonomous vessels with complete unmanned or minimum personnel on board and eco-friendly fuel (methane, ammonia, electricity, etc.), the role of existing seafarers on board is expected to change significantly. To improve the competitiveness of seafarers in the future, predicting future seafarer occupation groups, improving the educational curriculum, and creating an educational system are necessary. In this study, eight occupational groups that seafarers may have in the future were derived through a review of earlier studies and brainstorming of maritime university students, incumbent seafarers and expert groups. A survey was conducted on the eight occupational groups using the Likert scale, and based on the results, a leading occupational group related to future seafarer was derived. The most likely occupational groups with high scores were remote control centre operators and cargo remote manager. In addition, essential educational elements to be educated first for these occupational groups were derived and presented.
Lee, Eun Ju;Jang, Mi;Kim, Myung Hwa;Yun, Hye Jun;Kim, Eun Mi;Chung, Young In;Kim, Bo Kyung;Im, Eun Su;Hong, Kyoung Soon
Journal of Korean Clinical Nursing Research
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v.28
no.2
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pp.137-145
/
2022
Purpose: This retrospective chart review study was conducted to examine the frequency of delirium and to identify the risk factors of delirium in elderly surgical patients. Methods: The subjects of this study were 394 patients aged 65 years or older who underwent surgery. The diagnosis of delirium was based on the nursing assessment records with scores from the day of surgery to the 4th day after surgery. The collected data were analyzed by binary logistic regression analysis. Results: The incidence of delirium was 4.3%, and delirium occurred most frequently on the first day of surgery and lasted for 2.16 days on average. Of delirium patients, 76.5% underwent gastrointestinal surgery, and the most common delirium pattern was disorientation. In terms of the characteristics of the subjects, the occurrence of delirium was statistically different by age (𝝌2=10.79, p=.005), systemic-specific disease (𝝌2=9.63, p=.047), use of delirium-inducing drug(benzodiazepine) before surgery (𝝌2=15.90, p<.001), walking ability before surgery (𝝌2=7.65, p=.006), history of delirium (𝝌2=35.92, p<.001), and emergency surgery (𝝌2=16.40, p<.001). As risk factors of delirium, gastrointestinal surgery was found to increase the risk of delirium by 12.57 times (95% CI=2.45~64.46, p=.002), and the use of benzodiazepines before surgery was shown to increase delirium by 10.07 times (95% CI=2.21~45.87, p=.003). Conclusion: It is necessary for nurses to actively evaluate delirium using screening tools for early detection and prevention of delirium in elderly surgical patients with delirium risk factors.
Jeong, Hye Won;Moon, Sun Hee;Choi, Myoung Lee;Lee, Jung A;Ahn, Shin Hye;Jeon, Ji Hye;You, Ji Na;Kim, Hee Jin;Byeon, Ji Eun;Kim, Sook Young;Sung, In Suk
Journal of Korean Clinical Nursing Research
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v.29
no.2
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pp.198-209
/
2023
Purpose: The purpose of this study was to develop a Korean Adult Patients Delirium Screening Tool (K-APDS) for those admitted to general wards, and to verify its reliability and validity. Methods: For the development of the tool, 12 items were derived through the results of literature review and focus group interviews with general ward nurses, and the content validity was confirmed by experts. To verify the reliability and validity of the developed tool, 317 adult patients who were admitted to general wards of three tertiary general hospitals from October to November 2022 were evaluated by the attending nurse and data were collected. Results: After factor analysis for construct validity verification, two factors were extracted, which explained 60.1% of the total variance. After the validation of the control group, the difference in the delirium incidence scores calculated using the K-APDS between the delirium group and non-delirium group was very significant (Z=-10.82, p<.001). To verify the criterion validity, K-APDS, Delirium Observation Screening, and Pearson's correlation coefficient were checked and found to be .94 (p<.001). The predictive validity test reported that the sensitivity was 91.1%, specificity was 82.4%, positive predictive value was 52.6%, and negative predictive value was 97.8%. The reliability of K-APDS was found to be high with Cronbach's ⍺=.91. Conclusion: K-APDS can screen for delirium with 2 or more points, excellent validity and reliability have been verified. Therefore, this tool could be applied immediately in the clinical field, and will contribute to the early detection of delirium, enabling rapid interventions.
The purpose of this study were to investigate middle and high school students' food habits and food attitudes, and to assess student's nutrient consumption. A self-administered questionnaire was developed based on review of literature. The questionnaire consisted of three sections (food habits, food attitudes, and food consumption). The questionnaires were distributed to 4,050 students enrolled in 34 middle and high schools located in Seoul, Gyeonggi, and Gyeongnam provinces. A final response rate was 88.2% (3,570) excluding responses that had significant missing data. Data of the food habits and food attitudes were analyzed with descriptive analysis, $x^2$-test, and t-test using SPSS WIN(ver.11.0). The student's self-reported food consumption data was converted into nutrient consumption using conversion factor. Many middle and high school students skipped breakfast and/or dinner. Approximately 29% of the students did not eat vegetables and fruits. Scores of the middle school student's attitudes(19.1) towards foods were significantly higher than those of the high school student's attitudes(18.7)(p<.001). Student's nutrient intakes were estimated according to the student's self-reported food consumption data. The nutrient intakes were compared with DRIs(Dietary Reference Intakes: DRIs) for their age groups. The result of EAR(Estimated Average Requirement: EAR) cut-point method demonstrated 57.7% of middle school boys, 64.4% of middle school girls, 70.2% of high school boys, and 71.0% of high school girls did not meet EAR for Calcium. Additionally, it showed that 39.0% of middle school boys, 23.7% of middle school girls, 58.4% of high school boys, and 24.4% of high school girls did not consume EAR for Vitamin $B_1$. 25.7% of middle school boys did not meet EAR for Vitamin $B_2$, while 44.4% high school boys did not satisfy EAR for Vitamin $B_2$.
The present research is aimed at to examine the relationships between wisdom and age, also between wisdom and its psychological adaptation among middle and elder adults in Korea. Moreover, using data on 240 middle-aged and elder adults, the relationship between different aspects of wisdom and aging well were not only examined, but also explored age differences of wisdom through adulthood. The major findings from the study are summarized as follows. first, the wisdom scores of middle-aged and elder adults were significantly higher than those of young adults. While 'cognitive competency' and 'positive life attitude' factors had no significant differences. It means that 'cognitive competency' and 'positive life attitude' wisdom could be stable across adulthood. However, 'moderation and balance' and 'sympathetic interpersonal relationship' wisdom of elders were significantly higher than those of young adults. second, in middle and elder adults, Wisdom was found to be positively related with life satisfaction, well-being, death acceptance, experiences of positive emotion, generativity, ego integration, and positive life review. while on the other hand, contrast wisdom to be negatively related with depression, fear of death, perceived stress and experiences of negative emotion. The results from the study were examined by ecological validity of wisdom. Accordingly, a number of limitations and implications of the research were acknowledged.
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