The purpose of this study was to suggest the design guidelines for healthcare facilities for the elderly. D healthcare facility for the elderly in Busan was case studied. Subjects were 34 elderly patients, 35 families, and 36 nurses who were in this facility. The elderly Patients and their families were interviewed and the nurses were answered through self-administered questionnaires. Generally, the users of this facility were positively responded to the building and interior design of this facility. Also, the elderly patients and the families were mere satisfied with the design of this healthcare facility than the nurses. All users responded the functional aspects and the whole interior design of this healthcare facility positively and the environmental psychological aspects negatively Also, the nurses responded this facility's ambient environments negatively and the patients and the families positively. The elderly patients and their families wanted to share the inpatient room with 3-6 persons because of their economical conditions and social contacts. Almost half of them preferred to sit down on the floor Also, they tended to prefer to light interior color, wall papers, and the familiar and home-like environments.
Objectives: The purpose of this study is to identify oral health status and oral health care needs of elderly patients in long-term care hospital. Methods: Oral health examination was carried out by a dentist and questionnaire was completed by direct individual interview by a dental hygienist for 245 elderly patients in seven long-term care hospitals in Daegu from March 12 to April 16, 2011. Results: Those who need dental care were 188(76.7%) and was done by oral health examination by a dentist. 93 patients(38.0%) wanted dental care and 63 patients(25.3%) need dental care. The most important dental service in the elderly patients was denture and prosthetic service. As demand for denture and prosthetic service exceeds the supply, but only 35.9 percent of the elderly received the dental care service by the estimation of the caregivers. Conclusions: It will be necessary to establish the customized dental care service for the elderly patients in long term care hospitals. The oral health education for the caregivers is very important and the continuing education program must be implemented in the future.
Objective: To access the safety of chemotherapy for elderly cancer patients complicated with hypertension. Methods: Elderly cancer patients who were complicated with hypertension and treated by chemotherapy were recruited. All patients were treated by chemotherapy after an intervention on hypertension by psychotherapy, exercise guidance, salt regulation and nutrition support, therapy on hypertension, as well as prevention on hypertension associated complications. Results: In 68 eligible patients, two suspended chemotherapy because of adverse reactions and 4 because of disease progression. The remaining 62 patients completed chemotherapy smoothly based on good hypertension control. Conclusion: With effective control of blood pressure, chemotherapy for elderly cancer patients complicated with hypertension is generally safe.
Jung, Hong Sung;Park, Young Kyu;Ryu, Seong Yeob;Jeong, Oh
Journal of Gastric Cancer
/
제15권3호
/
pp.176-182
/
2015
Purpose: To compare the surgical outcomes of laparoscopic total gastrectomy between elderly and non-elderly patients. Materials and Methods: Between 2008 and 2015, a total of 273 patients undergoing laparoscopic total gastrectomy for gastric carcinoma were divided into two age groups: elderly (${\geq}70$ years, n=71) vs. non-elderly (<70 years, n=172). Postoperative outcomes, including length of hospital stay, morbidity, and mortality were compared between the groups. Results: The elderly group showed a significantly higher rate of comorbidities and American Society of Anesthesiologists scores than those in the non-elderly group. No significant differences were found with respect to lymphadenectomy or combined organ resection between the groups. After surgery, the elderly group showed a significantly higher incidence of grade III and above complications than the non-elderly group (15.5% vs. 4.1%, P=0.003). Among the complications, anastomosis leakage was significantly more common in the elderly group (9.9% vs. 2.9%, P=0.044). Univariate and multivariate analyses showed that old age (${\geq}70$ years) was an independent risk factor (odds ratio=4.42, 95% confidence interval=1.50~13.01) for postoperative complications of grade III and above. Conclusions: Elderly patients are more vulnerable to grade III and above complications after laparoscopic total gastrectomy than non-elderly patients. Great care should be taken to prevent and monitor the development of anastomosis leakage in elderly patients after laparoscopic total gastrectomy.
The purpose of the study was to compare the satisfaction level on hospital meal size and actual intake rate of hospital foods between elderly and middle aged patients. Sixty one middle aged and one hundered thirty two elderly patients were surveyed on the foods served in the hospital-rice, soup, meat/fish, vegetable, kimchi and daily products. Compared to the middle aged patients, the more elderly thought the serving size of rice was too big(p<0.05), and those of soup, meat/fish and kimchi tended to be too big. There was no difference in the satisfaction level on the serving size of vegetable dish between two age groups. In actual intake rates of hospital meal there were no significant differences between the elderly and middle aged patients. However, the elderly male ate significantly(p<0.05) less amount of rice than the middle aged male and the elderly female ate significantly(p<0.01) less amount of meat/fish then the middle aged female. Satisfaction levels and actual intake rates were significantly correlated in all food items.
Purpose: This study aimed to improve the quality of prehospital emergency care for elderly patients by determining current prehospital care status based on run sheets and level of knowledge, and prehospital care confidence toward the elderly through questionnaires answered by 119 emergency medical technicians (EMTs). Methods: This study was conducted with 4,946 elderly patients who were transferred to the hospital by 119 ambulances in D city from March 1, 2013 to February 28, 2014. This study was a descriptive study of 119 run sheets. The questionnaire was completed by 160 EMTs working in D city. All data were analyzed by using SPSS 21.0. Results: 74.2% was due to disease among the 4,946 elderly patients who were transferred by 119 ambulances, and a rest was due to injury. The mean knowledge score of the 119 EMTs regarding elderly patients was low. Their confidence on prehospital care of the elderly patients statistically significantly differed according to career at hospital and education. Conclusion: Theoretical knowledge, education on prehospital care of the elderly, and repeated technical prehospital care education and training accompanied by feedback assessment by 119 EMTs are needed.
Objective: Infection is very common in the elderly, so there is a high prevalence of antibiotics use among this population. Especially, due to the emergence of resistant bacteria, the use of vancomycin is growing. The purpose of this study was to evaluate risk factors associated with vancomycin-induced nephrotoxicity in elderly patients. Methods: The subjects of this study were patients over 18 years old who received intravenous vancomycin in a general hospital located in Gangneung-si, Korea between August 1, 2013 and July 31, 2015. Data collection regarding vancomycin use and baseline characteristics was conducted using computerized hospital database. Logistic regression analysis was used to identify risk factors associated with vancomycin-induced nephrotoxicity. Results: A total of 290 patients were finally included, and 191(66%) out of these patients were age 65 or older. The incidence of vancomycin-induced nephrotoxicity was 11.0%, 12.6%, and 7.0% in the all adult patients, the elderly patients, and the non-elderly patients, respectively. There were significant differences in comorbidities between patients with nephrotoxicity and patients without nephrotoxicity in the all adult patients, and there were significant differences in vancomycin duration, comorbidities, and number of nephrotoxic agents between patients with nephrotoxicity and patients without nephrotoxicity in the elderly patients. However, according to the logistic regression analysis, there was no significant risk factor that increases the incidence of vancomycin-induced nephrotoxicity in all three age groups. Conclusion: There were no differences in risk factors that increase the incidence of vancomycin-induced nephrotoxicity between all adult patients, elderly patients, and non-elderly patients. Further studies with larger sample sizes to identify risk factors associated with vancomycin-induced nephrotoxicity in the elderly to improve the outcome of pharmacotherapy are required.
Purpose: The prevalence of gastric cancer in the elderly is increasing. The purpose of this study was to clarify factors related to morbidity following gastric cancer surgery in elderly patients. Materials and Methods: For this study, data from 411 patients who underwent curative gastrectomies with lymph node dissections between March 2010 and January 2013 were retrospectively studied using a prospectively designed database. Patients were divided into 2 groups (<70 years vs. ${\geq}70$ years). For each group, perioperative factors were analyzed to determine if they were associated with postoperative morbidity and mortality. Results: Comorbidities were more prevalent in the elderly group (${\geq}70$ years). Intraoperative and postoperative transfusions were also more frequently required in the elderly group. There was no significant difference in the number of retrieved lymph nodes between the 2 groups (44.3 vs. 46.6 nodes). In a comparison of the elderly versus non-elderly groups, the postoperative morbidity rates were 22.7% versus 8.9% (P<0.001) and the postoperative mortality rates were 4.2% versus 0% (P=0.002), respectively. Of the possible non-surgical complications, pulmonary problems were predominately found in the elderly group (P<0.001). Surgical complications were evenly distributed between the 2 groups (P=0.463). Postoperative morbidity was significantly associated with older age and postoperative transfusion. Multivariate analysis showed that higher body mass index (BMI) and postoperative transfusion were important factors associated with postoperative complications in the elderly group. Conclusions: Pulmonary complications were frequently problematic in elderly patients. Higher BMI and postoperative transfusion were significant risk factors for postoperative complications in elderly patients with gastric cancer.
Purpose: To determine the extent and rate of prescription drug therapy, especially polypharmacy and the prevalence of potentially inappropriate medication use in Korean elderly ambulatory patients based on an explicit criterion. Methods: Performed a retrospective study of 65 years or older ambulatory patients visiting a university hospital based clinic from January 2002 to April 2004. Study determined the patterns of drug prescription per Anatomical Therapeutic Chemical Classification and the potentially inappropriate medication usage based on explicit Beers criteria. Results: Of the 4,042 elderly patients the mean number of prescription was $2.2{\pm}2.0$, which was similar between genders and all age groups within the elderly. 10.7% of patients were prescribed with more than 5 medications concurrently. The most frequently prescribed medication was the drugs used for treating nervous system diseases (44.3%), followed by alimentary tract/metabolism disorders (27.6%), cardiovascular disease (10.7%), blood/blood forming disorders (4.3%), respiratory disorders (6.5%), and musculoskeletal diseases (3.2%). A total of 511 elderly (13%) was prescribed with medication that met the criteria for=1 potentially inappropriate drugs for the elderly. This proportion was similar between genders and all age groups within the elderly. Among these 511 elderly patients the mean number of potentially inappropriate drugs prescribed was $5.1{\pm}3.3$ drugs. Potentially inappropriately prescribed drugs included amitriptyline (76 cases), diazepam (69 cases), ketorolac (57 cases), short acting nifedipine (44 cases), triazolam (38 cases), and hydroxyzine (38 cases). Conclusion: Potentially inappropriate drug prescribing in Korean ambulatory elderly patients are common. Education programs and interventions aimed at optimizing the prescribing and dispensing of the most appropriate drugs are needed.
Background: Nasal bone fractures are the most common type of facial bone fracture, but are under-studied in adults above 65 years of age. Therefore, we investigated the epidemiology and patterns of nasal bone fractures among older adults in comparison to different age groups. Methods: This retrospective study included 2,321 nasal bone fracture patients who underwent surgery at our hospital from January 2010 to December 2017. The patients were classified by age as preschoolers, school-age children, young and middle-aged adults, and the elderly. We performed pairwise comparisons between elderly patients and each other age group in terms of sex, cause of injury, and fracture type. Results: The 2,321 nasal bone fracture patients included 76 elderly patients (50 men [65.8%] and 26 women [34.2%]). In these patients, the two most common injury causes were falling or slipping down (n= 39; 51.3%) and road traffic accidents (n= 19; 25.0%). According to the Stranc and Robertson classification, the most common force vector was lateral, and plane 2 fractures with lateral forces predominated. Conclusion: The elderly showed similar patterns of nasal bone fractures to those observed in young and middle-aged adults, but significant differences from preschoolers (in the injury vector and plane of fracture) and from school-age children (in the sex ratio and plane of fracture). However, elderly patients presented significantly different epidemiological characteristics compared to the other three groups. Therefore, it is necessary to improve the quality of life of the elderly and prepare for the upcoming super-aged society by taking steps to reduce the incidence and severity of fractures. Possible options for doing so include strengthening individual-level safety factors and expanding the social safety net for the elderly.
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