• Title/Summary/Keyword: elderly medical

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Lack of Prognostic Impact of Adjuvant Radiation on Oncologic Outcomes in Elderly Women with Breast Cancer

  • Omidvari, Shapour;Talei, Abdolrasoul;Tahmasebi, Sedigheh;Moaddabshoar, Leila;Dayani, Maliheh;Mosalaei, Ahmad;Ahmadloo, Niloofar;Ansari, Mansour;Mohammadianpanah, Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7813-7818
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    • 2015
  • Background: Radiotherapy plays an important role as adjuvant treatment in locally advanced breast cancer and in those patients who have undergone breast-conserving surgery. This study aimed to investigate the prognostic impact of adjuvant radiation on oncologic outcomes in elderly women with breast cancer. Materials and Methods: In this retrospective study, we reviewed and analyzed the characteristics, treatment outcome and survival of elderly women (aged ${\geq}60years$) with breast cancer who were treated and followed-up between 1993 and 2014. The median follow up for the surviving patients was 38 (range 3-207) months. Results: One hundred and seventy-eight patients with a median age of 74 (range 60-95) years were enrolled in the study. Of the total, 60 patients received postoperative adjuvant radiation (radiation group) and the remaining 118 did not (control group). Patients in the radiation group were significantly younger than those in the control group (P value=0.004). In addition, patients in radiation group had higher node stage (P value<0.001) and disease stage (P=0.003) and tended to have higher tumor grade (P=0.031) and received more frequent (P value<0.001) adjuvant and neoadjuvant chemotherapy compared to those in the control group. There was no statistically significant difference between two groups regarding the local control, disease-free survival and overall survival rates. Conclusions: In this study, we did not find a prognostic impact for adjuvant radiation on oncologic outcomes in elderly women with breast cancer.

Influence of Math Education Utilizing Traditional Weights and Measures on Affective Domain of Elderly Learner (전통(傳統) 도량형(度量衡)을 활용한 수학교육(數學敎育)이 노인(勞人)학습자의 정의적(情意的) 영역(領域)에 미치는 영향)

  • Kim, Jae-Hyo;Ko, Ho-Kyoung
    • The Journal of Korean Medical History
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    • v.24 no.1
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    • pp.1-8
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    • 2011
  • As the value of living a complete life has spread, the importance of elderly education as a part of continuing education is ever increasing. As much as the bodily health, the activity to prevent dementia or healthy brain is being emphasized, the math utilizing traditional material was suggested to devise the curriculum appropriate for the emotional/cognitive level of the elderly. This could induce interests of the elderly, and ultimately improved the concept of self-consciousness and self-esteem. Also, a plan for effective application of such 'silver math' should be prepared, and the execution of a fusion study for a medical approach of its effects is proposed.

Metabolic Syndrome Perception and Exercise Behaviors in the Elderly (노인의 대사증후군 인지 및 신체활동 실천 요인)

  • Lee, Jung-A;Lee, Jin-Seok;Park, Jong-Heon
    • Korean Journal of Health Education and Promotion
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    • v.29 no.5
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    • pp.61-75
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    • 2012
  • Objectives: A great number of the elderly are not aware of having metabolic syndrome, and this pattern differs among regions of the nation. This issue is particularly important for the elderly people with chronic diseases. This study was conducted in order to identify the prevalence, predicting factors of perception and exercise behaviors of among the elderly population. Methods: Using data from the 2009 Korean Community Health Survey, we employed two-level logistic regression models to determine whether individual and community factors are associated with perception and exercise behaviors among the elderly population. Results: Results from weighted two-level logistic regression analyses indicated the individual-level factors of smoking, education level, health center education, community exercise program participation and unmet needs in men, and marital status (being separated), health center education women predicted the elders' perception. As for the community-level predictors, higher smoking and living in regions with high suicide rates significantly predicted the elders' perception and exercise behaviors of metabolic syndrome. Conclusions: These findings demonstrate that education according to stage would increase the perception and motivation toward healthier behavior particularly for the elderly with lower perception levels of metabolic syndrome.

Long-term Policy Development for the Aged on Medical and Health Care Security (노인의료보장 및 건강관리를 위한 장$cdot$단기 대책)

  • Rhee Seonja;Lee Yoon Sook
    • Journal of Korean Public Health Nursing
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    • v.5 no.1
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    • pp.70-95
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    • 1991
  • The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.

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Associations Between Classification of the Geriatric Screening for Care-10 and the Morse Fall Scale (노인환자 스크리닝 결과와 낙상위험도 간의 관계)

  • Kim, Yoon-Sook;Lee, Jong-Min;Choi, Jae-Kyung;Shin, Jin-Yeong;Han, Seol-Heui
    • Quality Improvement in Health Care
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    • v.23 no.2
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    • pp.69-78
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    • 2017
  • Background: The purpose of this study was to examine associations between classification of the Geriatric Screening for Care-10 (GSC-10) and the Morse Fall Scale (MFS) among elderly inpatients. Methods: Among elderly inpatients aged over 65 admitted to hospital (from November 1, 2016 to July 31, 2017), the data for 5,780 patients (who were evaluated using the Morse Fall Scale and the Geriatric Screening for Care-10) were analyzed using x2-tests and t-tests to examine differences between the GSC-10 and MFS, according to general characteristics of elderly inpatients (i.e., gender) using IBM SPSS Statistics 24. Results: : Scores for the GSC-10 were significantly higher in women than men for depression (p<.001), delirium (p=.048), functional decline (p<.001), incontinence (p<.001), and pain (p<.001). Statistically significant differences in all domains of the GSC-10 for elderly hospitalized patients were found for the classification of fall risk. Conclusion: The findings of this study, as supported by the GSC-10, indicate that the most common problems experienced by the elderly are related to the risk of falling. In order to reduce the incidence of falls in elderly inpatients, customized fall prevention based on the GSC-10 results is necessary.

Categorization of Regional Delivery System for the Elderly Chronic Health Care and Long-Term Care (지역별 노인 만성기 의료 및 요양·돌봄 공급체계 유형화)

  • Nan-He Yoon;Sunghun Yun;Dongmin Seo;Yoon Kim;Hongsoo Kim
    • Health Policy and Management
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    • v.33 no.4
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    • pp.479-488
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    • 2023
  • Background: By applying the suggested criteria for needs-based chronic medical care and long-term care delivery system for the elderly, the current status of delivery system was identified and regional delivery systems were categorized according to quantity and quality of delivery system. Methods: National claims data were used for this study. All claims data of medical and long-term care uses by the elderly and all claims data from long-term care hospitals and nursing homes in 2016 were analyzed to categorize the regional medical and long-term care delivery system. The current status of the delivery system with a high possibility of transition to a needs-based appropriate delivery system was identified. The necessary and actual amount of regional supply was calculated based on their needs, and the structure of delivery systems was evaluated in terms of the needs-based quality of the system. Finally, all regions were categorized into 15 types of medical and care delivery systems for the elderly. Results: Of the total 55 regions, 89.1% of regions had an oversupply of elderly medical and care services compared to the necessary supply based on their needs. However, 69.1% of regions met the criteria for less than two types of needs groups, and 21.8% of regions were identified as regions where the numbers of institutions or regions with a high possibility of transition to an appropriate delivery system were below the average levels for all four needs groups. Conclusion: In order to establish an appropriate community-based integrated elderly care system, it is necessary to analyze the characteristics of the regional delivery system categories and to plan a needs-based delivery system regionally.

The Efficient Management Method about the Workers of the Welfare Facilities for Improving the Quality of Elderly Medical Service (노인의료서비스의 질적 제고를 위한 시설종사자 관리의 효율화 방안)

  • Cho, Woo-Hong;Park, Chun-Gyu;Son, Myeong-Dong
    • Journal of the Korea Society of Computer and Information
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    • v.18 no.6
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    • pp.91-99
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    • 2013
  • This study has a purpose of analyzing the difference of care giver's subjective awareness of self-efficacy and job satisfaction according to the types of welfare facilities, before studying the structural relationship between the management variables about workers at the welfare facilities for improving the quality of elderly medical welfare service. As a result of empirical analysis, there was no awareness difference of care givers according to the types of the elderly medical welfare facilities, but in general it was emphasized that the care givers' satisfaction with self-efficacy and job satisfaction was very essential in providing the elderly medical service. Therefore, this study has significance that it provided the theoretical fundament for efficient management method about the workers of the elderly medical welfare facilities.

The effect of social capital, health risk behavior and health status on medical care utilization by the elderly (노인의 사회자본과 건강위해 행위 및 건강수준이 의료서비스 이용에 미치는 영향)

  • Woo, Kyung-Sook;Seo, Jae-Hee;Kim, Gye-Soo;Shin, Young-Jeon
    • Health Policy and Management
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    • v.22 no.4
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    • pp.497-521
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    • 2012
  • Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.

Threshold-based Pre-impact Fall Detection and its Validation Using the Real-world Elderly Dataset (임계값 기반 충격 전 낙상검출 및 실제 노인 데이터셋을 사용한 검증)

  • Dongkwon Kim;Seunghee Lee;Bummo Koo;Sumin Yang;Youngho Kim
    • Journal of Biomedical Engineering Research
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    • v.44 no.6
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    • pp.384-391
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    • 2023
  • Among the elderly, fatal injuries and deaths are significantly attributed to falls. Therefore, a pre-impact fall detection system is necessary for injury prevention. In this study, a robust threshold-based algorithm was proposed for pre-impact fall detection, reducing false positives in highly dynamic daily-living movements. The algorithm was validated using public datasets (KFall and FARSEEING) that include the real-world elderly fall. A 6-axis IMU sensor (Movella Dot, Movella, Netherlands) was attached to S2 of 20 healthy adults (aged 22.0±1.9years, height 164.9±5.9cm, weight 61.4±17.1kg) to measure 14 activities of daily living and 11 fall movements at a sampling frequency of 60Hz. A 5Hz low-pass filter was applied to the IMU data to remove high-frequency noise. Sum vector magnitude of acceleration and angular velocity, roll, pitch, and vertical velocity were extracted as feature vector. The proposed algorithm showed an accuracy 98.3%, a sensitivity 100%, a specificity 97.0%, and an average lead-time 311±99ms with our experimental data. When evaluated using the KFall public dataset, an accuracy in adult data improved to 99.5% compared to recent studies, and for the elderly data, a specificity of 100% was achieved. When evaluated using FARSEEING real-world elderly fall data without separate segmentation, it showed a sensitivity of 71.4% (5/7).

Comparison of Health-related Quality of Life of Elderly Aged more than 65 Years according to the Insurance Type (의료보장유형에 따른 65세 이상 노인의 건강관련 삶의 질 비교 연구)

  • Hong, Ju-youn;Kim, Gha-Jung
    • The Journal of the Korea Contents Association
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    • v.16 no.9
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    • pp.225-235
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    • 2016
  • In this study, we analyze the community health survey data for 3 years from 2011 to 2013 were analyzed for evaluation. This study attempts to comprehensively evaluate differences between elderly medical aid beneficiaries and elderly health insurance beneficiaries in terms of health-related quality of life, All of elderly medical aid beneficiaries who responded community health survey were included for study and elderly health insurance beneficiaries were randomly selected as a control group by matching gender, age and location. The findings show that the elderly medical aid beneficiaries can not receive sufficient health care services, even though they have pay a low socio-economic status, spouse or fewer households enemies and poorer health behavior and higher morbidity of chronic diseases than the elderly health insurance beneficiaries do. But elderly health insurance beneficiaries also showed that not enough care utilization is high morbidity of chronic diseases. These factors aggravate the medical aid beneficiaries' health-related quality of life This characteristic was analyzed to lower health-related quality of life of the elderly. Therefore, it is necessary to strive for the development of appropriate services and programs taking into account the characteristics of the elderly that may go though a limited resource and promote the quality of life for the elderly more effectively re-evaluation of social services systems and programs related to elderly.