Purpose: The purpose of this study was to compare the status of the dementia prevention programs, dementia support centers, and elderly welfare centers in major metropolitan cities to acquire data for future program development and dissemination and the specialization of dementia prevention personnel. Methods: Data were gathered through internet surveys and telephone questionnaires from 15 special demented elderly care centers and elderly welfare centers registered in five metropolitan cities from June 27 to Oct 25, 2016. Results: Dementia care programs were available at 15 centers. Seoul City was running the most diverse dementia programs, and all five cities were spending a significant amount of time on the cognitive therapy program within several dementia programs. In addition, many social workers hosted the program and the frequency of social welfare work was three times a week. Conclusion: To increase the dementia prevention policies' efficiency, an understanding of dementia has already been established. Experts who can provide client-centered, problem-solving programs will play the role of physical therapists and occupational therapists. However, more research is needed.
Polypharmacy is increasing owing to an increase in the elderly population and multimorbidities associated with the increased risk of administration of potentially inappropriate medications (PIMs). The negative effects of polypharmacy on various health conditions and aspects, such as fall, fracture, mortality, cognitive function, and dementia, have been reported. The management of excess and inappropriate polypharmacy through proper interventions and local or national guidelines has been highlighted. The purpose of polypharmacy management is to appropriately prescribe medicines that are essential to treat diseases in patients and to avoid inappropriate polypharmacy, such as interactive or duplicate medicines under prescription and PIMs for specific diseases. Community pharmacists in Australia, the EU, USA, and Japan are collaborating with prescribers to review medications to ensure that the patients can be prescribed appropriate medications. The service cost is reimbursed by public or private insurers. A study in the United States has shown that even with medication review costs, the overall medication cost has reduced. In Korea, various projects such as Drug Utilization Review service and safe use of medicines have been conducted; however, no national guidelines or management measures have been established. It is necessary to implement a national long-term plan on polypharmacy management. Furthermore, a phased implementation plan is required. Shortly, active medication review services and education programs for healthcare professionals with the support of the government should be considered in Korea with reference to other countries in order to raise awareness of seriousness and risks of inappropriate polypharmacy.
The purpose of this study is to examine the effect of parents knowledge on oral health status toward their children. This study was carried out to investigate and analyze the cognitive degree of dental subjects and general public who have an experience to be treated for their dental knowledge, operative dentistry, and dental prothesis in the oral health care through the questionnaires. The results are as follows : 1 : In questioning the frequency in the visitation of dental clinic, 68.8% usually go to see dentists, if children's teeth have trouble. It was the reason that economical standard and educational level were enhanced as before. 57.6% took a kind of medical measures. 2 : In surveying the preference of dentists’ age or gender, 56.9% preferred younger dentists to older or female dentists. On the contrary, 56.9% children want younger dentists, and 64.8% children want female dentist doctor. As a conclusion, the preference of dentists’ age or gender is relevant with a view to remove big horror, which can be evoked by dental measures. 3 : In questioning the possession amount of decayed teeth, 45.8% have more than four. Usually those parents who have children filled their decayed teeth with artificial or installed with dental prosthesis. As a conclusion, age is relevant in this study in p<0.05 level. 4 : In asking for efficient starting-year of tooth brushing, 42.6% said that 2 or 3 year age is the most efficient, and especially 80.6% teach children to learn brushing themselves. (P<0.05). As a conclusion, the voluntary brushing can be good behaviour for good dental health. 5 : In surveying the way they obtained dental information, 38.9% were given form mass media, but 90% were once not delivered with the education of dental health. Because parents have been known narrow and deficient information of dental health through mass media, experts in dental health have to deliver help their parents to be delivered with systematical dental information. The conclusion of this study can be summarized that parents' role is very important to their children's tooth health and the education program for systematical dental information should be delivered to their parents.
Purpose: The purpose of this study was to provide a survey of patients with dementia registered and managed by primary health care posts. Method: Computation of 2016 dementia data registered in Health Care Center programs of 14 municipalities in ChoongNam province was analyzed. Data collection was done based on a pretest for dementia prevention and general management of registered dementia patients. Results: Results showed; Screening tests for dementia, 40% of population 60 or over, average number of cases, 174, average number of dementia registrants, 3.1, programs for prevention, approximately 70% special policy measures and 28% cognitive rehabilitation programs, counseling and education operating well overall, average number of dementia registrants/clinic 11.8, with women accounting for 70%, elders with less than 3 years of education, 75%, residence type cohabitation by married couples, 41%, and elders with Alzheimer type dementia, 64%. Conclusion: During early detection of dementia and follow-up examinations, high-risk groups (women, elders) should receive a dementia examination. In management of dementia there is a need to develop various programs including physical, economic, and emotional support not only for patients, but also for families. Health care managers also need systematic education to give them expert knowledge of dementia and management of dementia.
Purpose: This study was conducted to investigate the cognition level and the performance level of universal precautions on blood-borne infections and to analyze related-factors on the performance level for universal precautions among the nurses. Method: A total of 166 nurses participated in the survey. We performed multiple linear regression to assess the related-factors on the performance level for universal precautions. Result: The mean scores of cognition and performance level for universal precautions were 65.61(${\pm}8.74$) and 53.98(${\pm}8.42$) respectively. The mean score of the cognition level was significantly lower than the performance level in all items. The cognition level was associated with the working field. The performance level was highest for nurses working over 36 years, nurses in university hospitals, and nurses in the operating room. The cognitive level for universal precautions, education level, exposure to blood-borne infection, family's income, and marital status significantly predicted the performance level for universal precautions in the multiple linear regression model (Adjusted $R^2=0.42$). Conclusion: The cognition level for universal precautions is the strongest predictor on the performance level for universal precautions. An integrated approach should incorporate training experiences to improve cognition and perception of risk on universal precautions for preventing blood-borne infections.
Purpose: The purpose of this study was to explore the quality of life (QoL) in patients with Alzheimer's disease (AD) and their and caregivers and its influencing factors. Methods: A descriptive research design was used. 211 pairs of AD patients and their caregivers were recruited from a neurology outpatient clinic of S medical center in Seoul, Korea. Caregivers completed several structured questionnaires regarding AD patients' QoL as well as their QoL, patients' behavioral and psychological symptoms, patients' activities of daily living (ADL), social support, and quality of relationship between AD patients and caregivers. Cognitive status of AD patients was assessed by the researchers using Korean Mini-Mental State Examination. Results: The scores of QoL were 26.91 for AD patients and 85.62 for their caregivers. In the multiple regression, factors associated with AD patients' QoL were the quality of relationship (${\beta}$=.44), ADL (${\beta}$=-.33), patient's age (${\beta}$=.20), caregivers' QoL (${\beta}$=.20), and patient's gender (${\beta}$=.11). Factors associated with caregivers' QoL were the quality of relationship (${\beta}$=.34), relationship (${\beta}$=.32), patient's QoL (${\beta}$=.26), caregivers' gender (${\beta}$=.18), social support (${\beta}$=.12), and the level of caregivers' education (${\beta}$=.12). Conclusion: To improve the QoL in AD patients and their caregivers, strategies to promote their quality of relationship are needed.
Purpose: The purpose of this study was to investigate caregiver burden and health related quality of life (HRQoL) among male spouses who cared for partners with a stroke. Methods: The subjects were spouses of 121 female patients who visited the neurology outpatients department in one tertiary hospital located in Seoul between February and April in 2011. Results: The mean age of the male caregivers was $71.25{\pm}5.51$ years. The mean score of caregiver's burden was moderate ($63.28{\pm}9.85$). The average reported caregiving time was $58.48{\pm}5.51$ min/day with the male spouses spending more time in house-working than with caregiving activities. The reported depression and care giving time, plus the cognitive status and functional dependencies of the spouse were significantly related to male caregiver's burden. The mean scores of 'physical health' and 'mental health' for quality of life for the male caregivers was moderate (47.49 and 47.33 respectively). Overall, caregiver's burden has a negative effect on the HRQoL of male spouses. Conclusion: Caregiver's burden and HRQoL are important problems which are in need of nurses' attention. It is suggested that intervention programs for male spouses be developed with a focus on emotional and social support as well as education about the caregiving role.
Stroke is a major cause of death and long-term disability. Because muscle weakness is one of the most prominent consequences of stroke, it was considered important to determine whether exercise in order to improve muscle strength and range of motion could have an effect in limiting the learned disuse of the affected side. The purpose of the study was to identify the effects of an 8 week rehabilitation program on physical and cognitive ability in stroke patients. A total of 18 patients who were admitted to the oriental medicine unit of a K medical center in Seoul were recruited : ten for the experimental group and eight for the control group. The rehabilitation program consisted of three level's of active and passive exercises for prevention of muscle contracture and at range of motion. Muscle strength, flexibility of the upper and lower extremity, perceived balance, functional independence, depression, and quality of life for the two groups were compared at the pretest and 4 and 8 weeks after the rehabilitation program. The results are as follows : 1) When measuring muscle strengths of shoulder abduction and elbow flexion, hip flexion and knee extensor, ankle dorsi-flexor and muscle strength of knee flexor. Muscle strength of knee flexor for the experimental group was significantly higher than the comparison group at the 4 weeks. 2) Muscle strength and flexibility of the ankle dorsi -flexor for the experimental group was significantly better than for the control group at 8 weeks. 3) Functional independence, perceived balance, and Tinetti balance for the experimental group as measured at 4 and 8 weeks were better than for the control group. Also, there were changes over time in physical balance and functional ability, but there was no significant differences between the groups. 4) The experimental group showed a higher quality of life and lower depression than the control group at 8 weeks. 5) Muscle strength and flexibility of ankle dorsi -flexor were significantly changed over time and an interaction between group and time. The findings suggested that the rehabilitation program would improve the physical and psychological status of the stroke patients. Thus, the gains in actual or perceived ability to perform physical activities was marked.
Purpose: Lack of a valid prognosis of gross motor development in children with cerebral palsy (CP) and the absence of longitudinal data on which to base an opinion in Korea have made it difficult to plan treatment and counsel prognosis issues accurately. The purposes of this study were to examine whether the Gross Motor Function Classification System (GMFCS) is valuable to prognostication about gross motor progress in children with CP in Korea. Methods: Medical records of 61 patients were retrospectively reviewed that visited outpatient department and were diagnosed as CP. Various information was surveyed including CP type, visual acuity, cognitive function, motor acquisition age, ambulatory status, development curves of Gross Motor Function Measure (GMFM) according to each of the 5 level of GMFCS. All of them were compared with other studies. Also the gross motor development curves and the maximum GMFM score derived from this study were compared with the Palisano's report and the Rosenbaum's report. Results: Based on a total of 494 GMFM assessments provided by this study, the 5 distinct motor development curves and the maximum GMFM score were created. These observations is corresponding with the Palisano's and the Rosenbaum`s Development curves. Conclusion: The 5 distinct motor development curves (GMFCS) that were created by Palisano's and Rosenbaum's study is useful in Korea, providing parents and clinicians with a means to plan interventions and to judge progress over time.
Objectives: The nutritional status of cancer patients undergoing chemotherapy is closely related to the compliance of nutrition education. However, as chemotherapy is conducted repeatedly, compliance with nutrition management is lowered, leading to malnutrition. Malnutrition is related directly to the quality of life after surgery in cancer patients. Therefore, this study examined the factors related to compliance with nutrition management during chemotherapy. Methods: In this study, five subjects with colorectal cancer undergoing adjuvant chemotherapy were interviewed in-depth using the Giorgi study method. The contents of the nutrition education visits and in-depth interviews were transcribed in the language of the subject after recording, and the appropriateness of the data was improved by reflecting the subject's actions and facial expressions. Results: After conducting the in-depth interviews for each subject, the experience of the subject's diet and adjuvant chemotherapy was drawn into two domains, six elements, and 26 sub-elements. In the cognitive domain, the patients experienced physical and psychological changes, and the need for nutrition management was recognized by analyzing the dietary causes of the diseases. In the domain of practice, a knowing-doing gap was formed, unlike the patient's will. Factors that inhibited compliance with nutritional management included digestive problems, sensory changes, loss of appetite, and social interaction stress. Conclusions: Dietary management is very important for patients receiving periodic anticancer therapy, and step-by-step training and personal monitoring based on the chemotherapy order is necessary to maintain the patient's will and social and environmental support.
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