• Clinical and Experimental Pediatrics
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• 제60권2호
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• pp.31-37
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• 2017

Steroid 21-hydroxylase deficiency is the most prevalent form of congenital adrenal hyperplasia (CAH), accounting for approximately 95% of cases. With the advent of newborn screening and hormone replacement therapy, most children with CAH survive into adulthood. Adolescents and adults with CAH experience a number of complications, including short stature, obesity, infertility, tumor, osteoporosis, and reduced quality of life. Transition from pediatric to adult care and management of long-term complications are challenging for both patients and health-care providers. Psychosocial issues frequently affect adherence to glucocorticoid treatment. Therefore, the safe transition of adolescents to adult care requires regular follow-up of patients by a multidisciplinary team including pediatric and adult endocrinologists. The major goals for management of adults with 21-hydroxylase deficiency are to minimize the long-term complications of glucocorticoid therapy, reduce hyperandrogenism, prevent adrenal or testicular adrenal rest tumors, maintain fertility, and improve quality of life. Optimized medical or surgical treatment strategies should be developed through coordinated care, both during transition periods and throughout patients' lifetimes. This review will summarize current knowledge on the management of adults with CAH, and suggested appropriate approaches to the transition from pediatric to adult care.

• 대한안전경영과학회지
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• 제15권2호
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• pp.135-141
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• 2013

As the country's elderly people who are 65 years or older recently exceeded 10% of the total population with development of medical technology and improvement of living standards, Korea has turned into an aging society. Especially in Gyeonggi-do, as of late December 2012, elderly people who were 65 years or older were 1,135,242 persons, taking up 18.98% of the region's population and registering the largest number of elderly people in the nation's cities or provinces. Due to such a sharp rise in elderly population, support for the elderly is increasing the burden on families and communities. The study aims to take as its subjects elderly people staying at authorized elderly welfare facilities, who are weak in mind and body and have difficulty in daily life with disabilities, or adult day care facilities that take care of elderly people during the day or at night, examine the concept of adult day care facilities and instances in foreign countries, and study the status of the adult day care facilities located in Gyeonggi-do, their services, and safety by figuring out space arrangement based on program implementation. Spacial arrangement in program operation should satisfy fuction and purpose from the manager and user's perspective, and a desirable program operation should provide separate spaces for the elderly with Alzheimer's and those without Alzheimer's. Compared to residential care facilities, adult day care facilities incur less financial burden and, compared to other authorized services, have many right functions that can upgrade the quality of users and satisfy their desires. Major countries like Japan, the UK, and Sweden recognize the right functions of day and night care services and aggressively support and utilize adult day care facilities. For adult day care facilities, quality services should be developed and use and choices should be enhanced as regards services. Development of special programs for the elderly with dementia and stroke, instead of simple protective functions of a program, must be actively promoted, while manpower training is required for program operation, conveniences, and safety. By developing and providing space arrangement models that focus on efficiency, convenience, and safety of program operation, adult day care operation can be revitalized, while quality of elderly care may be enhanced and welfare budget can be saved.

• Childhood Kidney Diseases
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• 제22권1호
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• pp.7-11
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• 2018

Significant advances in the diagnosis and medical care of children with chronic kidney disease (CKD) are major reasons for the better survival rates of children and adolescents with CKD than the survival rates reported in previous decades. These patients are reaching adulthood, and therefore require a transition to adult medical care. This transition phase is well-recognized to be associated with considerably increased morbidities and medical problems, such as non-adherence, graft loss after transplantation, and loss to follow-up. Low adherence increases morbidity and medical complications and contributes to poorer qualities of life and an overuse of the health care system. However, these tragic outcomes may be avoidable through a structured and well-defined transition program. In the last decade, there has been increasing interest to resolve these medical and psychological problems that occur during the transfer of young adult patients from pediatric to adult renal units. The aims of a successful transition from pediatric to adult medical care include enhancing the individual development of better health-competence and stabilizing, or even improving, the state of health. This review will focus on various aspects of the transition phase of adolescents who have CKD or who underwent kidney transplantation from pediatric to adult nephrology care.

• 가정∙방문간호학회지
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• 제16권2호
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• pp.135-144
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• 2009

Purpose: This study was to analysis the effect of spiritual nursing care on meaning of life and spiritual well-being of terminal cancer older adult patients. Method: The study was a one group pre-posttest design. Data collection and intervention were performed from May 10 to December 20, 2007. The participants were 28 older adults in Jeonju city. Data was analyzed with paired t-test and Pearson correlation coefficient using the SPSS/WIN 12.0 program. Result: Meaning of life, spiritual well-being, religious well-being and existential well-being scores were significantly higher than before spiritual nursing care (all p<.001). Meaning of life and the spiritual well-being were significantly correlated before and after spiritual nursing care, but it was not highly correlated after than before the spiritual nursing care. Conclusion: The study verified spiritual nursing care the improvement of the meaning of life and spiritual well-being for the terminal cancer older adult patients.

• 근관절건강학회지
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• 제27권2호
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• pp.81-93
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• 2020

Purpose: We developed and tested the effects of a care program for dementia patients among community- dwelling older adult men. Methods: This study used a non-equivalent control group pre-and post-test design. To verify the effectiveness of the care program for dementia patients, 26 community dwelling older adult men participated in this study. We used multiple intervention strategies including improving understanding of dementia through education, activities for dementia prevention, and promoting psychological change. In particular, based on the current understanding of the care of the men older adults, we used strategies to promote motivation and reinforce strengths. Results: After completing the 6-week intervention program, when compared with the control group, older adult men in the care program intervention group showed significant differences in scores for the following: cognitive functions (p=.035), attitude toward dementia (p=.026), preventive behavior (p=.007), geriatric depression (p=.013), caring confidence (p=.018), and self-esteem (p=.013). Conclusion: These results indicate that the care program for dementia patients has positive effects on increasing their cognitive function, attitude toward dementia, preventive behavior, caring confidence, self-efficacy, and on decreasing depression rates in this population. Based on this, we can recommend this program to men caregivers for the improved care of dementia in community centers.

• 가정과삶의질연구
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• 제19권1호
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• pp.63-75
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• 2001

The purpose of this study was to investigate those factors which are related to parent-adult child coresidence of Korean elderly. The data of 2,464 elderly over 65 from $\boxDr$National survey of elderlys life and welfare desires in 1998$\boxUl$collected by Korean Institute for Health and Social Affairs were used for this study. The major results of the study were summarized as follows: First, the elderly who live with their children were different from those who live independently from their children in socio-demographic characteristics, residential area, economic or physical abilities, and the value of elder care. Second, residential area, economic abilities, and the value of elder care were found to have an influence on the parent-adult child coresidence among Korean elderly. Third, the determinants of the parent-adult child coresidence for the elderly were different according to their value of elder care.

• 대한간호학회지
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• 제48권5호
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• pp.521-533
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• 2018

Purpose: The aims of this study are to provide a theoretical framework for improving the self-care of adults with severe hypertension and to examine the practical suitability of a middle-range theory of self-care for chronic illness by validating the structural model. Methods: Data were collected at a university hospital in D metropolitan city from July 1 to August 14, 2015. A total of 224 Korean adult patients with severe hypertension were recruited. Data were analyzed using SPSS 22.0 and AMOS 22.0. Results: The results show that the fit index of the hypothetical model meets the recommended level; 7 out of 8 hypothetical model paths were statistically significant. Motivation, self-efficacy, support from others, and accessibility to care showed statistical significance and explained 67.3% of the self-care process. The self-care process explained 45.3%, 63.6%, and 26.5% of quality of life, health, and illness stability, respectively. Conclusion: This model can be used as a theoretical framework for improving self-care among adult Korean patients with severe hypertension. Moreover, the practical suitability and validity of the middle-range theory of self-care for chronic illness is secured.

• 한국노년학
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• 제29권2호
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• pp.611-627
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• 2009

본 연구는 한국성인자녀와 미국성인자녀의 노부모와의 관계의 질과 부양행동을 비교하였다. 이를 통하여 한국과 미국 두 나라의 성인자녀와 노부모와의 관계 및 부양에 대한 문화적인 차이를 살펴보고, 나아가 우리나라 노부모 부양의 발전 방안모색에 유용한 자료를 제공하고자 한다. 연구대상자는 만 60세 이상의 노부모가 적어도 1명이상 살아있는 성인자녀로서, 미국 캘리포니아 주의 성인자녀 320명과 한국 경상남도의 성인자녀 554명 이다. 연구결과, 성인자녀의 노부모와의 관계의 질은 미국 성인자녀가 한국 성인자녀보다 더 높게 나타났으며, 성인자녀의 노부모 부양행동은 한국 성인자녀가 미국 성인자녀보다 더 높게 나타났다. 성인자녀의 노부모부양행동에 가장 영향을 미치는 변인은 미국은 노부모부양의식으로 나타났으며, 한국은 노부모와의 관계의 질로 나타나 나라간 차이를 보였다. 본 연구 결과를 통하여 노부모 부양행동에 있어서 미국의 경우 성인자녀의 노부모부양의식의 중요성을 알 수 있었고, 우리나라의 경우 성인자녀와 노부모의 세대 간 관계의 질이 중요함을 알 수 있었으므로 향후 우리나라의 노부모 부양정책 방안과 관련하여 성인자녀- 노부모 관계의 질을 강화할 수 있는 프로그램 모색이 필요하다하겠다.

• 대한간호학회지
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• 제37권4호
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• pp.613-623
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• 2007

Purpose: The purpose of this study was to describe the operation, staffing, and services provided at adult day care centers in Korea. Methods: The study was a cross-sectional descriptive survey. The subjects were 209 centers among 280 centers registered in Korea (response rate 74.6%). The data was collected from August to December in 2006. Results: 48.8% of centers were located in a city area. The centers were based on the Social Model 65.5% of the centers were open Monday to Friday, an average of $7{\sim}8$ hours per day Dementia, stroke or frail elderly could use the center, and 57.4% of centers were used for dementia and stroke elderly together. The enrollment of elderly was 13.5. The number of total staff was 8.27, the number of RN's and social workers was 0.67, and 2.54 respectively. The social services(Meal preparation 98.6%, Special event 98.1%, Transportation, 97.1%) were provided more than the health services(Physical therapy 98.1%, ADL training 95.2%, Counseling 84 7%, Vaccination 82.8%, Health monitoring 78.9%, Health education 78.5%, Bathing 66.1%, and Speech therapy 28.2%). Conclusion: These results suggest we have to develop a health-focused adult day health care model based on the needs of elderly and their families. Nurses will have an important role in adult day health care.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.28-40
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• 2019

The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.