• Korean Journal of Social Welfare
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• v.57 no.1
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• pp.121-146
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• 2005

The purpose of this paper is to analyze the structure and characteristics of the utilization support systems(USS), which has been institutionalized to aid the use of social welfare services in Japan's social welfare systems recently. In order to conduct such purposes, this paper made the process as follows. Firstly, this paper examined the developmental processes of social welfare systems, and the back ground of institutionalization of USS in Japan. Secondly, this paper formulated at ideal dimension the analytic model which was to explain the structure and characteristics of the USS. To build this model, this paper used two factors which were the connective dependency to the welfare support systems and the feasible-satisfying alternative setting for user. Thirdly, this paper analyzed the characteristics of the user-driven support facilities which has already activated in social welfare systems in Japan. According to the result of analyzing such model, this paper explained that USS in Japan has possessed the structure and characteristics, such as to aid self actualization and human right of user, to compose the inner coalition organization with supply systems, to emphasize the employee to train care management's skill, and to keep up bounded openness to USS's participation. Therefore, oligopoly market is formulated owing to bounded openness in the field of USS and the role of social worker such as a care manager is emphasized on making care plan.

• Journal of Convergence Society for SMB
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• v.6 no.4
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• pp.123-129
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• 2016

This study was conducted to understand influential factors in determining the advance directive attitudes of elderly patients. Structured survey questionnaires were distributed using a convenience sampling method to the residents of long-term-care facilities. As a result, the attitudes toward advance directives were accounted having 2.84 points, the functions of a family with 2.73 points, and the level of self-efficacy with 3.45 points. Participants who have higher family functions were found to have negative attitudes toward self-efficacy, as the relationship between two variables were in the negative correlation (r =-.324, p<.01). However, participants who have higher self-efficacy showed positive attitudes toward advanced directives as the two variables were in the positive correlation (r =.340, p<.01). This study will contribute to the settlement of the AD in Korea.

• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.254-263
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• 2015

Objectives: The present study assessed the prevalence of the potentially inappropriate medication (PIM) use in Korean elderly patients with Parkinson's disease. In addition, this study examined risk factors that affect PIM use. Method: A retrospective, observational study was conducted using Korean National Health Insurance claims database of 2009. PIM use in Parkinson's disease patients aged 65 years or older was examined based on 2012 Beers Criteria. Multivariable logistic regression was conducted to identify risk factors for PIM use. Results: Among 5,277 elderly patients with Parkinson's disease, 88.9% of patients used PIM(s) at least once. The average number of PIM items used per patient was 4.2. PIM use ratio, the proportion of total amount of PIMs to all medications per patient, was 12.6%. Frequently used PIM therapeutic classes were benzodiazepines (32.7%), first-generation antihistamines (19.2%), and prokinetics (17.5%). Individual PIMs most commonly used included chlorpheniramine (11.4%), levosulpiride (10.9%), diazepam (9.0%), and alprazolam (7.6%). Women (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.11-1.16), medical aid (OR 1.18, 95% CI 1.15-1.21), and long-term facilities (OR 2.43, 95% CI 2.22-2.65) were shown to be risk factors associated with PIM use. Of particular, wide variation in PIM use was associated with the types of healthcare facility. Conclusion: The PIM prevalence was very high in elderly Parkinson's disease patients. Nationally effective and systematic efforts to identify and prevent PIM use should be made to ensure patient safety and to improve quality of care in the elderly.

• Journal of Korean Neurosurgical Society
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• v.43 no.3
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• pp.143-148
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• 2008

Objective: Postoperative delirium (POD) is characterized by an acute change in cognitive function and can result in longer hospital stays, higher morbidity rates, and more frequent discharges to long-term care facilities. In this study, we investigated the incidence and risk factors of POD in 224 patients older than 70 years of age, who had undergone a neurosurgical operation in the last two years. Methods: Data related to preoperative factors (male gender, >70 years, previous dementia or delirium, alcohol abuse, serum levels of sodium, potassium and glucose, and co-morbidities), perioperative factors (type of surgery and anesthesia, and duration of surgery) and postoperative data (length of stay in recovery room, severity of pain and use of opioid analgesics) were retrospectively collected and statistically analyzed. Results: POD appeared in 48 patients (21.4%) by postoperative day 3. When we excluded 26 patients with previous dementia or delirium, 17 spontaneously recovered by postoperative day 14, while 5 patients recovered by postoperative 2 months with medication, among 22 patients with newly developed POD. The univariate risk factors for POD included previously dementic or delirious patients, abnormal preoperative serum glucose level, pre-existent diabetes, the use of local anesthesia for the operation, longer operation time (>3.2 hr) or recovery room stay (>90 mini, and severe pain (VAS>6.8) requiring opioid treatment (p<0.05). Backward regression analysis revealed that previously dementic patients with diabetes, the operation being performed under local anesthesia, and severe postoperative pain treated with opioids were independent risk factors for POD. Conclusion: Our study shows that control of blood glucose levels and management of pain during local anesthesia and in the immediate postoperative period can reduce unexpected POD and help preventing unexpected medicolegal problems and economic burdens.

• Journal of Families and Better Life
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• v.27 no.1
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• pp.61-71
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• 2009

The purpose of this study was to resolve the issues of inferior housing environment and the population decrease in rural community by improving the environment and attracting urban inhabitants. A simulation on the costs and the local programs was operated from a point of view that Pension Insurance House with Long-term Lease and a plan for the program in connection with local resources should be accompanied to attract urban inhabitants. The study was carried out through mainly documents analysis and specialists' opinions. The simulation results are as follows. Firstly, the pre-existing rural housing development projects have only emphasized the hardware, while underestimated the post-management with operating programs. The software should be underlined when Pension Insurance House is developed. Secondly, as a result of the simulation on construction expenditure and the operating and maintenance cost for 30 years, about 82.3 million Wons are necessary residential expenses for 15 years per unit. Thirdly, in case of MUJU County, it has made the most of its pre-existing institutions. It's medical institutions provide medical care system with health education, facilities related leisure and culture offer recreational programs and the local community center and its program of each town helps new habitants adopt to the rural life. Additionally, the employment project of a local welfare center allow people living in a rural community to continue their careers with their talents and interests through local class programs for a life worth living. Lastly, guide for getting information of rural life, local community gathering and preliminary education should be carried out to reduce expectant tenants' incompatibility and assist them settle down early. The community program expansion is also required at the local government level.

• Journal of the Korea Convergence Society
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• v.9 no.6
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• pp.347-355
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• 2018

A convergence study was conducted to identify effect size, intervention characteristics, and tendency of laughter therapies on depression for Korean older adults. Of the 486 studies searched in 10 databases, 20 studies in the inclusion criteria were selected. The risk of bias was assessed by SIGN's tool, and the data were analyzed using CMA 3.0 software. Overall effect size of laughter therapy on depression of older adults was medium (standardized mean difference [SMD]=-0.57, 95% CI: -0.70~-0.44, p<.001), and heterogeneity was small ($I^2=18%$). Subgroup analysis showed that the effect sizes of institutionalized group, mixed group, 4-6 weeks of duration, and group intervention were higher than the compared groups. Findings of this convergent meta-analysis would be helpful for health professionals to provide more effective laugher therapy sessions. Further replicative studies in long-term care facilities and more randomized controlled trials of laughter therapy are needed.

• Korean Journal of Adult Nursing
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• v.28 no.6
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• pp.691-700
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• 2016

Purpose: The aim of this study was to evaluate the effects of a computerized cognitive training on older adults affected by mild cognitive impairment (MCI) in terms of cognitive function, depression, self-esteem, and activities of daily living (ADL). Methods: This study used a non-equivalent control group non-synchronized design. A total of 53 older adults who reside in long-term care facilities were recruited, 26 subjects for an experimental group and 27 subjects for a control group. A computerized cognitive training was performed for 20~40 minutes/day, three days/week for ten weeks. Data were analyzed using SPSS/WIN 21.0 with $x^2$ test, Fisher's exact test, and t-test. Results: Scores of MMSE (t=3.30, p=.002), depression (t=-2.15, p=.036), and self-esteem (t=2.76, p=.008) were significantly better in the experimental group than the control group. However, the difference in ADL (t=-1.01, p=.316) was not significant between the two groups. Conclusion: These findings suggest that the computerized cognitive training can be used as an effective nursing intervention to improve cognitive function and self-esteem and lower depression among older adults with MCI.

• Journal of Digital Convergence
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• v.17 no.7
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• pp.401-408
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• 2019

The purpose of this research was to examine conduction of 12 week exercise program for the aged of sanatorium on their cognitive function, depression, uneasiness, and living satisfaction. The subject of this research was 60 aged persons of H sanatorium in H-si and mental status examination and survey on depression criterion, uneasiness measurement, and living satisfaction of the aged were conducted. To examine the effects of the program, paired t-test was conducted. As a result, there were significant differences after 12-week exercise program in all factors such as cognitive function, depression, uneasiness and living satisfaction of the subjects. In conclusion, regular exercise program may positive effects on mental status cognitive status, depression, uneasiness, and living satisfaction of the aged. Therefore proper exercise form and program are necessary to the aged in long term care facilities.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2022.05a
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• pp.406-409
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• 2022

In recent years, the developments in technologies, such as AI systems, Blockchain, VR/AR, 3D printing, robotics, and nanotechnology, are reshaping the future of healthcare right before our eyes. And also, healthcare has seen a paradigm shift towards prevention-oriented medicine, with a focus on consumers requirements. The spread of infectious diseases such as Covid-19 have altered the definition of healthcare and treatment facilities, necessitating immediate action to redesign hospitals' physical environments, adapt communication models to address social distancing requirements, implement virtual health solutions, and establish new clinical protocols. Hospitals, which have traditionally served as the hub of healthcare systems, are pursuing or being forced to reestablish themselves against this landscape. Rather than only treating ailments, future healthcare is predicted to focus on wellness and prevention. In personalized care, long-term prevention strategies, remote monitoring, early diagnosis, and detection are critical. Given the growing interest in smart healthcare defined by these modern technologies, this study looked into the definitions and service kinds of smart healthcare. The background and technical aspects of smart hospitals were also explored through a literature review.

• The Korean Journal of Rehabilitation Nursing
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• v.1 no.1
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• pp.111-123
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• 1998

The related factors of the quality of life (QOL) in stroke patients was identified empirically. The subjects were 254 stroke patients who were discharged and taken follow-up care at the outpatient department. In this model, the physical, psychological, and social status were assumed to affect the QOL. And the social support was assumed to moderate these effects. NIH stroke state, ADL, and IADL were used to measure the physical status. Using CES-D, the psychological status was measured. The social status was defined as the job change after stroke attack. The satisfaction with the care by primary caregivers, significant others, and health professionals was measured as the social support. To identify the effect of the physical, psychological, and social status on the QOL, multiple regression analysis was carried out. The psychological and social status were found to be the significant predictors of the QOL(R2=0.27, p=0.00). Next, to identify the moderating effect of the social support, the subjects were divided into two groups, that is, the low social support group and the high social support group. It is found that the predicting variance is different between these two groups. In the low social support group, the psychological, social, and physical status predicted as much as 42% of the QOL. On the contrary, the psychological status predicted only 8% of the QOL in the high social support group. So it is concluded that the social support moderates the effects of the physical, psychological, and social status on QOL. Finally, to identify the social support which moderates those effects, the social support was divided into three classes. Each social support class was divided into the low and high social support group again. In the every class of social support, the difference between two groups was also identified. So the model of the QOL is recommended for the framework of the care for the stroke patients. Also these results support the claim that the long-term facilities for stroke patients are necessary.