• Journal of Korean Public Health Nursing
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• v.6 no.1
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• pp.15-24
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• 1992

This study was conducted to follow the patient referral system operated from the primary health care facilities to the hospital in a rural area of Korea. The subject for this study was sampled from a community health development project carried out by the Korea University in Yeoju Kun, Kyonggi Province. The data of referred patients from primary health care facilities were collected during the period from January 1989 to December 1989. The data was sorted out by a computer system using Database package. The results of this study were summarized as follows: 1. Characteristics of the referred patients were: males $32.0\%$. and females $68.0\%$. The more elderly of the patients visited to the hospital after having been referred there by CHPs or public physicians, $25.9\%$ has been to hospital on at least one previous occasion as against $74.1\%$ for whom it was there first visit. 2. The majority of patients who were referred to a hospital where: medicine $44.3\%$ and orthopedics$16.4\%$, major diseases were : diseases of digestive system $(21.3\%)$ ; symptoms and ill defined conditions $(17.3\%)$ ; diseases of the muscular skeletal system and connective tissue$(14.2\%)$. chronic illness was $82.0\%$ and acute illlness was $18.0\%$. 3. From Community health practitioners more patients referred than the public physicians. Categoris of diseases of the referred patients were different between community health practitioners and public physicians. Due to the. respective differences between the medical restrictions put on the nursing staffs at the community health practitioners and public physicians. From this study it was recommended to define the reason of differences between ~he two groups in futher study. Study as to 1) why one group should be referring more for hospital treatment than the other. And 2) why the two agencies should be referring different diseases.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.730-737
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• 2020

Objective : Spinal degeneration is a progressive disease, worsening over time. Lumbar degenerative disease (LDD) is a major spinal disease in elderly patients. Surgical treatment is considered for medically intractable patients with LDD and reoperation after primary surgery is not uncommon. The surgical outcome is occasionally unpredictable because of comorbidities. In the present study, the relationship between comorbidities and the incidence of reoperation for LDD over time was determined. Methods : The claims data of the health insurance national database were used to identify a cohort of patients who underwent spinal surgery for LDD in 2009. The patients were followed up until 2016. Medical comorbidity was assessed according to the Charlson comorbidity index (CCI). Cox proportional hazard regression modeling was used to identify significant differences in sex, surgery, age, causative disease, and comorbidity. Results : The study cohort included 78241 patients; 10328 patients (13.2%) underwent reoperation during the observation period. The reoperation rate was statistically higher (p<0.01) in males, patients 55-74 years and 65-74 years of age, and patients with decompression or discectomy. Significant association was found between increasing reoperation rate and CCI score (p<0.01). Based on multivariate analysis of comorbidities, the significantly higher reoperation rates were observed in patients with peripheral vascular disease, pulmonary lung disease, peptic ulcer, diabetes, and diabetes complications (p<0.01). Conclusion : The study results indicate the reoperation rate for LDD is associated with patient comorbidities. The comorbidities identified in this study could be helpful in future LDD studies.

• Korean Journal of Adult Nursing
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• v.29 no.3
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• pp.246-255
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• 2017

Purpose: This study was designed to identify factors affecting depression among hospitalized older adults prior to discharge from an acute care hospital. Methods: This descriptive study included adults aged 65 or older who were hospitalized in a general hospital in Seoul, Korea. Depression was measured by the Short Form Geriatric Depression Scale and illness perception was evaluated by the Brief Illness Perception Questionnaire. Social support was examined using the Perceived Geriatric Social Support Scale. Data were collected from August 25 to October 12, 2015. Data analysis included descriptive statistics, independent t-test, Kruskal-Wallis test, Pearson's correlation coefficient, and hierarchical multiple regression. Results: Among a total of 120 participants, 57 patients (47.5%) experienced depression. Mean depression score was $7.37{\pm}3.67$. Depression was associated with illness perception (r=.53, p<.001), social support (r=-.19, p=.043), number of admission due to the recurrence (r=.31, p=.001), and time to recognize discharge plan (r=.25, p=.044). In hierarchical multiple regression, illness perception (${\beta}=.45$, p<.001) and time to recognize discharge plan (${\beta}=.21$, p=.039) were predictors of depression (F=7.68, p<.001, Adjusted $R^2=.38$). Conclusion: The findings of this study suggest that management of illness perception and timely notice of discharge are important to reduce depression in hospitalized elderly patients.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.123-129
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• 2022

Objective : Chronic subdural hematoma (CSDH) is one of the most common pathology in daily neurosurgical practice and incidence increases with age. The aim of this study was to evaluate the prognostic factors and surgical outcome of CSDH in patients aging over 90 years compared with a control group of patients aging under 90 years. Methods : This study reviewed 25 patients with CSDH aged over 90 years of age treated in our department. This group was compared with a younger group of 25 patients aged below their eighties. At admission past medical history was recorded concerning comorbidities (hypertension, dementia, ictus cerebri, diabetes, and heart failure or attack). History of alcohol abuse, anticoagulant and antiplatelet therapy, head trauma and seizures were analyzed. Standard neurological examination and Markwalder score at admission, 48 hours after surgery and 1-6 months follow-up, radiologic data including location and CSDH maximum thickness were also evaluated. Results : Their mean age was 92.8 years and the median was 92.4 years (range, 90-100 years). In older group, the Markwalder evaluation at one month documented the complete recovery of 24 patients out of 25 without statistical difference with the younger group. This data was confirmed at 6-month follow-up. One patient died from cardiovascular failure 20 days after surgery. The presence of comorbidities, risk factors (antiplatelet therapy, anticoagulant therapy, history of alcohol abuse, and head trauma), preoperative symptoms, mono or bilateral CSDH, maximum thickness of hematoma, surgical time and recurrence were similar and statistically not significant in both groups. Conclusion : In this study, we demonstrate that surgery for very old patients above 90 years of age affected by CSDH is safe and allows complete recovery. Comparing two groups of patients above and under 90 years old we found that complication rate and recovery were similar in both groups.

• Journal of Society of Occupational Therapy for the Aged and Dementia
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• v.12 no.2
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• pp.19-28
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• 2018

Objective : The aim of current investigation was to standardize the grip strength of elders and to examine the correlation between grip strength, anthropometric parameters, depression and quality of life. Method : The researchers used Korea national health and nutrition examination surveys (2016) for analysis and analyzed the data of 919 elders who had completed the screening test among right-handed elderly without activity limitation. The researchers classified the age of the elders as 65~69, 70~74, 75~79, and 80 years old for standardization of grip strength. Anthropometric parameters are height, weight, body mass index, and waist circumference. Depression was measured by PHQ-9(Patient Health Questionnaire-9) and quality of life was assessed by EQ-5D. Result : The ratio of right handedness of the elderly was 87.8%, left handed 4.9%, and both handles 5.7%. In the standardization and correlation analysis, the grip strength decreased with age (p<.01, r=-.308~-.305). The grip strength showed a strong correlation with height (p<.001, r=.747~.741). There was a significant correlation between depression (p<.01, r=-.172~-.163) and quality of life (p<.01, r=.285~.267). Conclusion : The findings of this investigation suggest that height, depression, and quality of life need to be considered when assessing the level of grip strength in the elderly.

• Information Systems Review
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• v.14 no.2
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• pp.1-19
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• 2012

Recently due to the enhancement of education and lifestyle, the trend of healthcare services are changed to a more active and differentiated service in which a continuous self health care is possible. The Smart-Telemedicine system offers medical services by merging Blue-tooth and telecommunication modules to former blood pressure, blood sugar, heartbeat and temperature measuring devices. Moreover, it could analyze one's health pattern which would be helpful for the patient to prevent potential future illness. In addition, the easier accesses to various remote controllable medical check-up programs are offered to public as a number of available smart phone are rapidly escalating. The Smart-Telemedicine system provides the most ideal interactive medical service via accessible smart phones and mobile medical check-up devices at anywhere and anytime. It is very beneficial since it can save patients' time and money because people can reach to the service right at their home and be allowed to take charge of their health care process via longitudinal health data. Therefore, not only social costs that occur in elderly community would be saved, but also business in various forms of medical service field transactions could be possible. This paper will suggest the Smart-Telemedicine System for preventive medicine, its design and analysis of business models and the evaluation of those model.

• Health Policy and Management
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• v.9 no.1
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• Journal of agricultural medicine and community health
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• v.41 no.1
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• pp.13-26
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• 2016

Purpose: This study was performed to identify the association between family support, activities of daily living (ADL) and depression among hospitalized older patients with chronic diseases. Methods: This study subjects were 100 elderly patients with chronic diseases including chronic respiratory diseases, diabetes mellitus and et al. in a general hospital. The collected data were patient characteristics, family support, ADL, and depression by structured questionnaire and medical chart review. The used statistical analyses were t-test, analysis of variance, Pearson's correlational analysis and multiple regression analysis. Results: The mean scores of family support, ADL and depression were $49.95{\pm}8.68$, $8.65{\pm}2.65$, $6.66{\pm}3.78$, respectively. The prevalence rate of depression was 64.0%. In simple analysis, the statistically significant associated factors with depression were age, spouse, economic status, social activity, subjective health status, and number of pain. Depression had statistically a significant positive correlation with ADL and a negative correlation with family support. The final result of hierarchial multiple regression analysis (Model 3), the factors related to depression were family support (b=-.135, p<.001), subjective health status (b=2.510, p=.001). Conclusions: It is necessary to develop and apply the program for controlling the depression of elderly patients with health education, reinforcement of supportive systems in hospital. And, further multidisciplinary studies should be done.

• Journal of dental hygiene science
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• v.21 no.4
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• pp.275-281
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• 2021

Background: The aim of this study was to understand the importance of professional oral care for inpatients by examining the type and frequency of surgery and hospital discharge period at dental hospitals, and identify the types of professional oral care actually in progress. Methods: In this study, the type of surgery and length of hospitalization were investigated among patients admitted to the dental hospital for oral and maxillofacial surgery, and the professional oral care status of inpatients who had difficulty self-managing their oral care was retrospectively identified by collecting data on oral care before and after surgery, including the type and frequency. Results: The majority of inpatients at dental hospitals were male (57.6%), elderly patients over 60 years accounted for 20% of patients, and the average length of hospitalization was 4 days. In the 20s (aged 20~29 y), the number of orthognathic surgery patients (73.1%) was high, and the incidence of cysts was high in middle-aged patients. Regarding the oral care of hospitalized patients, scaling was performed once by a dentist before surgery. After surgery, surgical dressings using H₂O₂ balls were applied and oral care education was introduced before discharge. Conclusion: Based on the results of this study, professional oral care is essential to prevent infection and complications caused by oral bacteria among inpatients at dental hospitals. It is necessary to use various oral hygiene aids for inpatients and to conduct effective oral care instruction according to each patient's situation. In addition, it is necessary to raise awareness and the role of dental hygienists in professional oral care.

• Korean Journal of Clinical Pharmacy
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• v.32 no.2
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• pp.125-132
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• 2022

Background: Fixed-dose combinations have the advantage of improving patient compliance, but may increase the risk of duplicate prescriptions. As the use of fixed-dose combination antihypertensives increases, it is necessary to investigate the current status of class duplication prescriptions (CDP) in patients taking fixed-dose combination antihypertensives in Korea and to identify factors associated with CDP. Methods: We conducted a retrospective observational study using nationally representative claim data. Hypertensive patients aged 20 years or older taking fixed-dose combination antihypertensives were extracted. Among these patients, patients with CDP were identified. A chi-square test was applied to determine the differences between patients with CDP and non-CDP. The associated factors of CDP were identified through multiple logistic regression. Results: Of the 74,165 patients who were prescribed fixed-dose combination antihypertensives, 426 patients (0.6%) with CDP were identified. The most common antihypertensive class associated with CDP was calcium channel blockers (194 patients, 45.5%), followed by angiotensin II receptor blockers (136 patients, 31.9%). Patients aged 75 years or older (odds ratio [OR] 1.83, 95% confidence interval [CI] 1.02-3.52), chronic kidney disease (OR 4.45, 95% CI 2.15-8.25), chronic heart failure (OR 2.71, 95% CI 1.93-3.72), coronary artery disease (OR 2.22, 95% CI 1.60-3.03) and Medical Aid/Patriots and Veterans Insurance (OR 1.49, 95% CI 1.04-2.07) were significantly associated with increased CDP. Conclusions: The factors associated with CDP were the elderly, comorbidities, and low socioeconomic status. Since CDP can result in negative clinical outcomes, active intervention by the pharmacist is warranted.