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Service Program and Job Description of Workers in Long-term Care Facilities for Older Adults (노인요양기관별 서비스 유형과 종사자의 업무분석)

  • Lee, Hung-Sa
    • Journal of Home Health Care Nursing
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    • v.12 no.1
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    • pp.70-91
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    • 2005
  • Purpose: Long-term care facilities have a responsibility to provide care service that enables residents to maintain their maximal functional capacity and quality of life. Also their needs must be reflected to the service programs. In oder to provide an adequate service, we should assess the elderly's physical, psychological and social health status and the need. In addition to this, the long-term care facilities must be defined clearly by the type of services. This study would contribute to conduct appropriate services in public long-term care policy for the older population in the future. This study would provide informations of long-term care facilities' services and older persons' needs for long-term care. Method: To achieve this objectives, this paper investigates the types, service programs of long-term care institutes and job descriptions of workers. The subjects were consisted of 150 long-term care institutes. 150 institutes of long-term care facilities were drawn from all over the country by a nonrandom, convenience sampling. The data were analyzed by frequency, percentage, $x^2$-test using SPSS program. The instruments of this study were self-reported questionnaires for long-term care institutes. The data were collected from March 1, 2004 to may 31, 2004. Results: Service programs of long-term care institutes were not enough for residents' demands. The job descriptions among nurse, social worker and physical therapist were not clearly defined. The nurse's main role was medication and checking vital sign(49.7%), that of social worker's was observation and supervising (31.2%). The most significant problems were lacking of diverse service programs for residents. Conclusion: Considering these findings and conclusion, the needs of long-term care services should be provided by individual physical and psychological level. And the professional manpower for elderly should be educated in multi disciplines.

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Clinical Observation on 1 Case of Patient with Bilateral Facial Palsy (양측성 안면신경마비 치험 1례에 관한 고찰)

  • Kim, Min-Jeong;Park, Sang-Dong;Lee, A-Ram;Kim, Kyung-Ho;Jang, Jun-Hyouk;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.19 no.2
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    • pp.238-249
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    • 2002
  • Facial palsy is commonly encountered disease in the clinic but bilateral facial palsy is known as rare disease. Type of facial nerve paralysis include unilateral, recurrent ipsilateral, recurrent alternating and bilateral simultaneous palsies. Among the types, the reported incidence of bilateral simultaneous palsy is 0.3~2% of facial paralysis patients. We experienced I case of patient with bilateral simultaneous facial palsy that was concluded as bilateral bell's palsy. Objective : The purpose of this paper is to report the patient with bilateral facial palsy, who improved by oriental medical treatment. Another purpose is to review the current literature and to differential diagnosis of bilateral facial paralysis. Methods and Results : The patient was treated by acupuncture, herb medication and self-massage on facial muscle for 14 weeks. House-brackmann grading score was improved into I/I (Rt/Lt) from IV/IV. Conclusion : Through reviewing some literatures and reports, It is concluded that bilateral facial palsy was related to many other disorders and more ominous than unilateral facial palsy. therefore, its work-up should include a complete neurologic assesment and thorough evaluation. also, we consider that bilateral Bell's palsy can improve by oriental medical treatments.

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The clinical analysis on 40 patients of industrial accident (산업재해환자(産業災害患者) 40례(例)를 통한 한의학적(韓醫學的) 치료(治療)의 접근성(接近性)에 대한 고찰(考察))

  • Park, Eun-ju;Cho, Myung-rae
    • Journal of Acupuncture Research
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    • v.20 no.3
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    • pp.75-85
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    • 2003
  • Objective : The main purpose of this research is to make a survey of the effective way of the Korean traditional medical care about Industrial accidental patients. Methods : In following research, 40 cases of industrial accidental patients who hospitalized in the Dong-Shin Korean Traditional Medicine Hospital from January 1, 1996 to October 21, 2002 were surveyed. Results : 1. The highest incidence was shown in the age of twenties to fifties as much as 92.5% and the ratio of malr to female was 35:5. 2. The highest type in the industrial is professional negligences. 3. The number of patients via other hospital(82.5%) was much than that of the first visitor to our hospital(17.5%) 4. In admission motives, the patients who had been treated by western medical treatment expressed the dissatisfaction of that treatment, so hoped to be treated by oriental medical styles. 5. CVA was 47.5%, disease of sinews and bones system was 52.5%. 6. Hemiplegia(47.5%) was the most frequent out of all CVA patients symptoms, back pain(32.5%) was the commonest pain region of all the condition of sinews and bones system. 7. At first stage of admission period, Acupunture and Herb-medication was frequently prescribed for hwalhyultonglakgige, but as going to end stage was frequently used for bogi, bohyul, gudam and ansingige. 8. The treatment methods which was used for treating industrial accident was acupunture, cupping therapy, physical therapy.

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A Case Report of Referral Pain on Mandibular Toothache Originated from Myofascial Pain (근막동통으로 인한 하악 구치부 연관통의 임상증례)

  • Kang, Jin-Kyu
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.455-460
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    • 2007
  • Majority of toothache is caused by abnormality of pulpal or periodontal tissues. However, there are numerous nonodontogenic sources that may be responsible for pain felt in the tooth. Nonodontogenic toothache may result from muscle, maxillary sinus, neuropathic, neurovascular, even cardiac and psychogenic problems. Myofascial pain is one of the most common abnormality characterized by palpation of a hard band which acts as the trigger point that causes stiffness and fatigue of the muscle, referral pain in tooth, tension-type headache, and hyperalgesia. Masseter muscle particularly induce referral pain in maxillary and mandibular molars. This case reported the treatment of the pain in right mandibular molar originated from myofascial pain of the right masseter. The pain is improved by general and reversible treatments such as muscle exercise, physical therapy, and medication. Nonodontogenic toothache should undergo proper differential diagnosis in order to avoid unnecessary dental treatments, such as endodontic, periodontic treatment, and tooth extraction, which would fail to alleviate the symptom of the patient.

Research on Alimentotherapy Definitions and Applied Theories (식치(食治)의 개념 정립 및 적용 이론의 이해)

  • Ahn, Sang-Young;Lee, Min-Ho;Pyo, Bo-Yong;Ha, Jeong-Yong;Ahn, Sang-Woo
    • Korean Journal of Oriental Medicine
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    • v.14 no.2
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    • pp.27-33
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    • 2008
  • Alimentotherapy refers to the treatment or prevention by means of food. As food is consumed in everyday life and its constituents varies enormously. the practice of alimentotherapy was often misunderstood. By the research on ancient classics we could find 3 prospective about this practice. Firstly, alimentotherapy was used during the recovery and also for prevention. This is a type of Life-nurturing method, which we suggest to be called life-nurturing alimentotherapy. Secondly, it was also used as a dietary prescription made by physicians. Sometimes they made prescriptions combining materials derived from food with herbal medication. This practice was exclusively made by physicians as they had to consider the characteristic of each food as well as the condition of the patient. Thirdly, sometime alimentotherapy was used in cuisine form. They used food components in major part and herbal medicine used as additional ingredients. It was primarily focused on the taste and in some part its functional aspects. The underlying theories in alimentotherapy is exactly the same as used for understanding herbal medicine in TKM. Therefore, except in the case of life-nurturing method, it should be used by expert physicians. Finally, we suggest to differentiate the terms of alimentotherapy in the aspect of life-nurturing, dietary prescriptions and cuisine to prevent confusions.

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Thromboprophylaxis in Abdominoplasty: Efficacy and Safety of a Complete Perioperative Protocol

  • Marangi, Giovanni Francesco;Segreto, Francesco;Poccia, Igor;Campa, Stefano;Tosi, Daniele;Lamberti, Daniela;Persichetti, Paolo
    • Archives of Plastic Surgery
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    • v.43 no.4
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    • pp.360-364
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    • 2016
  • Background Venous thromboembolism, a spectrum of diseases ranging from deep venous thrombosis to pulmonary embolism, is a major source of morbidity and mortality. The majority of cases described in plastic surgery involve abdominoplasty. Risk assessment and prophylaxis are paramount in such patients. General recommendations were recently developed, but the evidence in the literature was insufficient to prepare exhaustive guidelines regarding the medication, dosage, timing, or length of the prophylaxis. Methods A thromboprophylaxis protocol was developed for patients undergoing abdominoplasty. The protocol consisted of preoperative, intraoperative, and postoperative measures. Enoxaparin was administered as chemoprophylaxis in selected patients. The study involved 253 patients. The patients were analyzed for age, body mass index, enoxaparin dosage, risk factors, and complications. Results Deep venous thrombosis was documented in two cases (0.8%). No pulmonary embolism occurred. Three patients (1.2%) presented mild subcutaneous abdominal hematoma within the first postoperative week that spontaneously resorbed with neither aesthetic nor functional complications. Two patients (0.8%) presented severe hematoma requiring surgical re-intervention for drainage and hemostasis revision. Statistical analysis showed no significant correlation between enoxaparin dosage and hematoma (P=0.18) or deep venous thrombosis (P=0.61). Conclusions The described thromboprophylaxis protocol proved to be effective in the prevention of thrombotic events, with an acceptable risk of hemorrhagic complications. Furthermore, it provides new evidence regarding the currently debated variables of chemoprophylaxis, namely type, dosage, timing, and length.

Development and Validation of the Diabetes Management Self-efficacy Scale for Older Adults (DMSES-O) (노인의 당뇨병 관리 자기효능감 측정도구 개발 및 평가)

  • Song, Misoon;Choi, Suyoung;Kim, Se-An;Seo, Kyoungsan;Lee, Soo Jin;Kim, Eun Ho
    • Journal of muscle and joint health
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    • v.21 no.3
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    • pp.184-194
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    • 2014
  • Purpose: The purpose of this study was to develop and validate a diabetes management self-efficacy scale for older adults (DMSES-O). Methods: A preliminary DMSES-O of 22 items was derived from a literature review and seven domains of self-management behaviors. Content validity was confirmed by experts in diabetes self-management education. To test the reliability and validity of the DMSES-O, data were collected from 150 older adults with type 2 diabetes. The data were analyzed using exploratory factor analysis, and Cronbach's ${\alpha}$ and Pearson's correlation coefficients were calculated. Results: From the exploratory factor analysis, 17 significant items in six subscales were derived. Factors derived were named "problem solving for hypoglycemia and self-monitoring blood glucose," "problem solving for hyperglycemia," "coping with psychological distress and taking medication," "reducing risks of diabetes complications," "appropriate exercise," and "healthy eating." The criterion-related validity of the DMSES-O was established by its correlation with the Summary of Diabetes Self-care Activities Questionnaire. Cronbach's ${\alpha}$, a measure of internal consistency, was .84 for the overall scale and ranged from .54 to .80 for the subscales. Conclusion: The DMSES-O is a reliable and valid instrument to measure selfefficacy for diabetes self-management among older adults.

Aortocoronary bypass after PTCA (관상동맥 풍선확장술 후의 개심술)

  • 송명근
    • Journal of Chest Surgery
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    • v.26 no.1
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    • pp.32-35
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    • 1993
  • During the period from September 1989 through December 1992, 118 cases of coronary arterial bypass graft were performed at Department of Cardiothoracic Surgery, Asan Medical Center. Twenty-one of these had history of recent or remote percutaneous transluminal coronary angioplasty. They consisted of 13 males[age,58.7 + 5.4 years] and 8 females[age, 63.6 + 2.8years] with the mean age of 60.6. History of old myocardial infarction was noted in 24%[5/21] of the patients and congestive heart failure in 2 cases. The angina by type of presentation is unstable in all of the patients. The patterns of involvement of coronary arterial disease were left main disease[1], single vessel disease[5], double vessel involvement[10], and triple vessel involvement[5]. We performed 4 cases of single bypasses, 7 cases of double, 8 cases of triple, and 2 cases of quadruple bypasses. Total of 51 grafts[LIMA:12, RSVG:39] were inserted in 21 cases with average of 2.4 grafts per patient. The methods of myocardial protection were cold blood cardioplegia[8 cases], intermittent aortic occlusion[11], and continuous coronary perfusion with local coronary sharing[2]. There were no operative or late death. The only cardiac complication was 1 case of low cardiac output required IABP. The other complications were 1 case of sternal wound infection and 1 case of postoperative bleeding required reoperation. And there was no case of perioperative myocardial infarction. Postoperatively, 3 cases of recurrent angina were detected at 5, 7, and 18months after surgery. One of them was managed successfully with repeat PTCA[who was recurred 18 months postoperatively], and the other two with medication. I conclude that we can approach the patients more aggressively with PTCA, because of our acceptable operative risks.

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Diagnostic Radiology and Conservative Management of L1 Lumbar Spine with Compression Fracture (L1 요추 압박골절에 대한 진단방사선학 및 보존적 치료)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.11 no.2
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    • pp.165-170
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    • 1998
  • Diagnostic radiology and conservative management for S75 patient with L1 lumbar fracture by traffic accidents were discussed with references, and then the obtained results were as follows ; 1. Wedging compression fractures with 10% deformity was confirmed at anterior vertebral body of L1 lumbar spine through lateral plain X-ray film. 2. Irregular bony fractures were observed at anterior vertebral body of L1 lumbar spine by CT scans, anatomically T12-L1 sites showed highly frequency of injuries, Denis's fracture type was classified as multiple compression fracture at anterior column without abnormal middle and posterior column, also no Cobb's angle, and then Frankel's neurological classification was E grade. 3. Orthopaedic treatments were performed with conservative methods. With rest on the bed, anti-in-flammatory medication, electrolyte and nutritional solution, the pain diminished. 4. After 3 weeks, rehabilitation was worked with putting on polyethylene back corset, although pains remained slightly until after 8 weeks, thereafter the spine showed gradually stability.

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A Study on the Factors Influencing Injury Prevention Practices of the Elderly (노인의 사고예방 실천정도와 그 영향요인에 관한 연구)

  • Kim, Mi-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.8 no.1
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    • pp.38-50
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    • 2002
  • The purpose of this study is to identify the relationship among injury prevention practices, health locus of control, and response patterns to HLOC of the elderly. Subjects were 121 healthy elderly. The data had been collected from November 5 to 18 in 2001 and analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation and stepwise multiple regression. Health locus of control and injury prevention practices were measured by using MHLC scale and an instrument created by the researcher on the basis of the results of literature review respectively. The results of this study were as follows: The mean score of injury prevention practices was 2.80 and the mean scores for the health locus of control were internal health locus of control : 17.25, external health locus of control : 16.09, and chance health locus of control : 14.26. The response patterns of the HLOC identified were six types; pure internal, pure powerful others, pure chance, double external, believers in control, and complex control. The 'pure internal' was the largest group(35.5%), and the 'believers in control' was the next(31.4%). The relationship between internal health locus of control and the injury prevention practices of the elderly revealed a significant correlation(r=.215, p=.018). The relationship between external health locus of control and the injury prevention practices of the elderly revealed a significant correlation (r= .208, p=.022). There was significant difference between response patterns of the health locus of control and injury prevention practices(F=2.393, p=.042). There were significant differences between injury prevention practices and general characteristic factors, which were education, family type, administration of medication, injury experience, ADL, and self-directed search for health information. Self-directed search for health information, injury experience, and education explained 16.7% of the variance for injury prevention practices. The above results may be used as the basic data for seeking more efficient way of improving safety of the elderly.

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