• Archives of Reconstructive Microsurgery
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• 제21권2호
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• pp.97-105
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• 2012

Background: Increasing numbers of super-elderly patients (>80 years old) with cancer now require microvascular-free tissue transfer. The objectives of this study were to evaluate potential applications of microvascular tissue transfer in this patient population, and post-surgical changes in quality of life. Methods: The records of cancer patients 80 years or older who had undergone microsurgical tissue transfer were retrospectively reviewed. Structured interviews were conducted with patients and family caregivers after surgery, and the patients' quality of life was qualitatively assessed. Results: The study cohort consisted of seven patients with a mean age 87.6 years (range, 81 to 95). Wound and medically-related complications were minimal. During the patient interviews, eight of the nine respondents reported remarkable improvements in quality of life following surgery and expressed a high level of satisfaction with their surgical results. Conclusions: Our study showed that microsurgical reconstruction performed in super-elderly patient not only appropriately repairs post-oncologic defects but also significantly improves the patients' quality of life.

• The Korean Journal of Pain
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• 제10권1호
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• pp.131-133
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• 1997

Number of elderly patients requiring nerve blocks have been increasing in recent years. We had two elderly patients who suffered stroke one day and three days after lumbar facet joint block and lumbar single epidural block respectively. Both patients due to their advanced age had potential risk factor to suffer one or more of the following; stroke, hypertension, and diabetes mellitus. Due to our experience with these patients, we suggested the following: (1) Nerve blocks should be reconsidered for elderly patient who posesses a potential risk factor to suffer a stroke. (2) Prior to invasive block administration of mild sedatives or analgesics may provide beneficial effects for patients with hypertension. (3) Adequately informed consent must be fully discussed time of consultation with patient scheduled for nerve block especially for elderly and risky patient.

• 대한한의학회지
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• 제42권1호
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• pp.129-135
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• 2021

Objectives: The present study reports case of an elderly kwashiorkor patient who was treated with Korean Medicine. Methods: A 68-year-old female patient with weight loss, general weakness, chills, anorexia, and dizziness after over 100 episodes of diarrhea visited the hospital. Blood tests showed hypoalbuminemia and anemia, and ultrasonography revealed fatty liver disease. The patient was diagnosed with kwashiorkor, and her symptom differentiation was Yang deficiency followed by Both Qi-Blood deficiency. Sayeok-Tang, Soshiho-Tang, Insamyangyeong-Tang, and Gongjin-Dan, herbal drugs, were given to the patient during 40 days of hospitalization. Results: After 40 days of hospitalization, her symptoms were reduced, and the blood test results improved. Conclusion: This case presents the therapeutic potential of Korean medicine in the treatment of kwashiorkor.

• Journal of Yeungnam Medical Science
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• 제7권2호
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• pp.55-66
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• 1990

1. 임종통고에 대한 반대는 노인군과 환자가족군이 40.2%, 40.9%로 환자군과 의료인군의 23.%, 13.3%보다 유의하게 높았다(p<0.001). 2. 임종환자에 대한 의료인의 회피적 태도에서는 의료인군의 44%가 반대하여 전체평균 28.5%보다 유의하게 높았다(p<0.001). 3. 불치병 환자의 생명 연장에 대한 태도에서는 환자군과 보호자군의 반대율이 33.3%, 22.5%로 노인군과 의료인군의 54.5%, 56.0%보다 유의하게 낮았다(p<0.001). 4. 임종환자를 위한 특수시설 및 교육문제에 있어서는 의료인군의 찬성율이 81.3%로 가장 높았고 환자군이 56.8%로 가장 낮았다. 5. 임종환자에 대한 가족의 회피적 태도에 대해서는 노인군의 찬성율이 81.3%로 가장 높았고 가족군이 34%로 가장 낮았다. 6. 임종에 대한 지각문제에 있어서는 의료인군의 찬성율이 77.3%로 전체평균 58.8%보다 높았다.

• 한국병원경영학회지
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• 제6권3호
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

• 한국산학기술학회논문지
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• 제20권12호
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• pp.747-757
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• 2019

본 연구는 노인환자가 인식하는 간호사와의 상호작용을 측정하기 위해 개발된 the Korean version of Nurse-Patient Interaction Scale (K-NPIS)을 한국 요양병원에 입원한 노인환자를 대상으로 간호사와의 상호작용을 측정의 신뢰도와 타당도를 검증하려는 목적으로 시행되었다. 진주시, 순천시, 남원시에 소재하는 4개의 요양병원에 입원한 노인환자 202명을 대상으로 신뢰도와 타당도 검증을 실시하였다. 문항분석과 내적일관성 검증을 통해 K-NPIS의 Cronbach α 값은 .96이었다. 전문가들을 통한 내용타당도 검증에서 내용타당도 지수가 0.8 이상으로 확인되었으며, 확인적 요인분석을 거쳐 최종 단일속성으로 구성된 12개 문항 각 10점 척도의 최종 도구가 도출되었으며, 재원기간에 따라 K-NPIS의 점수가 유의하게 차이가 나(p=.042) 판별타당도도 검증되었고, 천장효과나 바닥효과는 나타나지 않았다. 이와 같이 K-NPIS는 신뢰도와 타당도가 높은 도구임이 검증되어 요양병원에서 노인환자를 대상으로 간호사-환자의 상호작용을 측정하는 도구로 사용되는데 적절한 것으로 보이나 장차 준거타당도를 검증할 필요가 있다. K-NPIS는 노인환자가 인식하고 있는 간호사와의 상호작용을 자가보고 형식으로 측정하는 것이므로, 노인환자와의 상호작용을 기반으로 한 돌봄 중재의 성과를 평가하여 간호서비스 질 향상에 기여할 수 있을 것으로 기대된다.

• 한국병원경영학회지
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• 제28권2호
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• pp.9-20
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• 2023

Purpose: This study classified the actual functions of geriatric hospitals and examined the differences in their characteristics, in order to provide a basis for discussions on defining the functions of geriatric hospitals and how to pay for care. Methodology: This study used various administrative data such as health insurance data and long-term care insurance data. Cluster analysis was used to categorize geriatric hospitals. To examine the validity of the cluster analysis results, we conducted a discriminant analysis to calculate the accuracy of the classification. To examine cluster characteristics, we examined structure, process, and outcome indicators for each cluster. Findings: The cluster analysis identified five clusters. They were geriatric hospitals with relatively short stays for cancer patients(cluster 1; cancer patient-centered), geriatric hospitals with relatively large numbers of patients using rehabilitation services(cluster 2; rehabilitation patient-centered), geriatric hospitals with a high proportion of relatively severe elderly patients(cluster 3; severe elderly patient-centered), geriatric hospitals with a high proportion of mildly ill elderly patients with various conditions(cluster 4; mildly ill elderly patient-centered), and geriatric hospitals with a significantly higher proportion of dementia patients(cluster 5; dementia patient-centered). The largest number of geriatric hospitals were categorized in clusters 4 and 5, and the structure and process indicators for these clusters were generally lower than for the other clusters. Practical Implications: We have confirmed the existence of geriatric hospitals where the medical function, which is the original purpose of a geriatric hospital, has been weakened. It has been observed that the quality level of these geriatric hospitals is likely to be lower compared to hospitals that prioritize enhanced medical functions. Therefore, it is suggested to consider the conversion of these geriatric hospitals into long-term care facilities, and careful consideration should be given to the review of care-giver payment coverage.

• 대한한의학회지
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• 제35권4호
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• pp.98-103
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• 2014

Objectives: Advanced malignant melanoma (MM) has a poor prognosis, with an expected 2-year survival rate of 10 to 20%. It has long been recognized as an immunogenic tumor, and is worse for elderly patients. Many studies have suggested that herbal treatments improve immune functions, but few clinical studies have reported on this topic. Patients and History: We present two cases of female patients (72 and 77 years old, respectively) with advanced MM. The 72-year-old female patient was, at first, diagnosed with MM with multiple bone metastases. She received resection of the primary lesion, but refused further chemotherapy. The 77-year-old female patient was diagnosed with cutaneous MM of the left heel, with suspicion of sentinel node lymphadenopathy; however, she also refused any conventional treatment due to old age. Course of Therapy and Results: Both patients were exclusively treated with standardized allergen-removed Rhus verniciflua stokes (aRVS) extract combined with Bojungikki-tang (BT, Bu-Zhong-Yi-Qi-Tang in Chinese or Hochu-ekki-to in Japanese). Both patients are still alive and doing well (Feb. 2014), demonstrating that the 72-year-old patient has lived for 27 months and the 77-year-old patient has lived for 31 months without disease progression since the aRVS and BT administration. Conclusion: We suggest that the combination of aRVS extract and BT could be a candidate for overcoming the cancer's immunoediting process especially for elderly MM patients intolerant of conventional treatment.

• 대한한방내과학회지
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• 제38권5호
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• pp.753-762
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• 2017

Objectives: We conducted this study to report the clinical effects of Sibak-tang (Saiboku-to) in an elderly patient suffering from sputum and dysphagia after conventional treatment for pneumonia. Methods: The Sibak-tang was administered to the patient to treat sputum and dysphagia. The results were assessed by measuring the frequency of the sputum and conducting a videofluoroscopic swallowing study. Results: After about three weeks of herbal medicine treatments, the patient's symptoms of respiratory problems improved. The results of the videofluoroscopic swallowing study were also improved. Conclusion: Sibak-tang could be an effective treatment for elderly patients suffering from sputum and dysphagia after conventional treatment for pneumonia.

• 센서학회지
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• 제15권6호
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• pp.417-424
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• 2006

An ubiquitous healthcare monitoring system for elderly person at home was designed for continuous healthy monitoring of elderly person or patients. Human vital signals, such as ECG and body temperature, were monitored by terminal PC or PDA via ECG and temperature sensor nodes on the patient's body. From the ECG data, the heart rate, tachycardia, bradycardia and arrhythmia were diagnosed on the terminal PC or PDA to assist doctor's or nurse's aid or patient itself to monitor the patient's condition and give medical examination. Artificial judgement support system was designed in server computer and the system support a doctor or nurser for management or treatment of the patient. This system can be applied to vital signal monitoring system for solitude elderly person at self house or home health care service part. And this ubiquitous healthcare system can reduce the medical expenses in coming aging or aged society.