• Title/Summary/Keyword: older patient

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A Study on Depression and Activities of Daily Living among Elderly Patients in Geriatric Hospitals (요양병원 노인 환자의 우울과 일상생활 수행능력에 관한 연구)

  • Hong, Ji-Youn;Hwang, Seon-Young
    • Korean Journal of Adult Nursing
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    • v.22 no.5
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    • pp.457-465
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    • 2010
  • Purpose: This study was conducted to examine the degrees of depression and activities of daily living (ADLs), and to identify factors that predict depression in elderly patients. Methods: The sample was149 patients (80% female; mean age 79.1) from three geriatric hospitals located in small cities and who agreed to participate in the study. Data were collected by staff nurses involved in direct patient care from October to September 2009. The level of depression was measured on a daily basis for seven days using a 13-item scale. Patients' ADLs was measured using a modified 10-item Bathel ADLs scale. Data were analyzed using SPSS/WIN 17.0. Results: Mean depression score was $10.05{\pm}4.77$ out of 26 points and about 27% was assessed as depressed with more than 13 points. Multiple regression analysis showed that low educational level, absence of spouse and fewer family visits predict depression. In addition, low ADLs and sleep disturbance predict depression. Conclusion: Nursing care providers need to be concerned about ADLs of older patients and should develop nursing activity programs to increase their in-hospital physical activities. It is also important care for older patients' sleep and encourages family visits to decrease their depression.

Identifying Characteristics of Fall Episodes and Fall-related Risks of Hospitalized Patients (일 종합병원 입원 환자의 낙상 실태 및 위험 요인 분석)

  • Kang, Young Ok;Song, Rhayun
    • Journal of muscle and joint health
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    • v.22 no.3
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    • pp.149-159
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    • 2015
  • Purpose: This study aimed to identify falls and related risks of hospitalized patients in order to provide an baseline data to develop effective nursing intervention programs for fall prevention. Methods: The data on 120 patients who experienced falls from 2010 to 2013 during their hospitalization were collected from the patient' electronic medical records of an university hospital. Data were analyzed with descriptive statistics using SPSS/WIN 20.0. Results: Over 60% of the patients who experienced falls during their hospitalization was 65 years or older, and most of them had hypertension. Majority of the subjects needed help to perform daily activities (64%) and complained of general weakness (49.2%). Prior to the falls, the patients were taking average 2.52 medications to treat hypertension. The Fall accident was mostly frequently occurred in their hospital room (59.2%), or in bed (44.2%). The patients aged 70 years and older were significantly less alert than younger group, and taking more cardiovascular medications. Most fall risk factors were not significantly different for age, gender, and department category. Conclusion: The study findings suggest the need to emphasize the nurses to be more actively aware of fall risk factors and to provide aggressive interventions for preventing falls in hospitalized patients.

A Concept Mapping Study of Good Service Experience among the Elderly Residents of Long-term Care Facilities (장기요양시설노인의 좋은 서비스 경험에 관한 개념도 연구)

  • Choi, Hyoungshim
    • Korean Journal of Adult Nursing
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    • v.28 no.6
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    • pp.669-679
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    • 2016
  • Purpose: The purpose of this study was to explore the reported good service experiences from the perspective of elderly residents of long-term care facilities. Methods: Of those residents who are 65 years old or older, 14 residents whose length of stay were one month or longer and scores of the K-Mini Mental State Examination were 15 or higher were interviewed. The interview data formed the basis for the empirical statements about the reported nature of patients' experiences as residents of long-term care facilities. These data were used in concept mapping. Results: Through multidimensional scaling analysis and hierarchical cluster analysis, 62 core statements, two dimensions, and six clusters of good service experiences were derived. The two dimensions were classified as 'care centered-participation centered services' and as 'physical-emotional services.' Six cluster themes emerged as good service experiences: 'safety of care and treatment', 'responsible and supportive staff', 'comfort of living environment', 'mental well-being', and 'respect and communication'. Conclusion: The result of the study provides information about what experiences are important to older adults with cognitive impairment. The concept map can be used to develop a patient experience index for the elderly residents of long-term care facilities.

The Study on Correlation between Carotid IMT and Colon Polyps (목동맥 내막과 중막 두께와 대장 용종 발생의 상관관계에 관한 연구)

  • Goo, Eun-Hoe
    • Journal of the Korean Society of Radiology
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    • v.12 no.7
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    • pp.853-859
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    • 2018
  • This study aims to investigate the correlation between the occurrence of colon polyps and carotid IMT by age. This study checked the correlation between the occurrence of colon polyps and carotid IMT, grouping patients who had a colonoscopy and carotid ultrasonography simultaneously by age based on cross-tabulation. As a result of the analysis, by age, the older the patients with metabolic syndrome, the higher the correlation between the occurrence of colon polyps and carotid IMT became. Also, when carotid IMT was more than 1.1mm, the incidence of polyps was high. In conclusion, there was a high correlation of the occurrence rate of colon polyps with carotid ultrasonography and colonoscopy, and the older the patient and the thicker the carotid IMT, the higher the correlation became.

Pre-immigration Screening for Tuberculosis in South Korea: A Comparison of Smear- and Culture-Based Protocols

  • Lee, Sangyoon;Ryu, Ji Young;Kim, Dae-Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.2
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    • pp.151-157
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    • 2019
  • Background: Tuberculosis (TB) is the most important disease screened for upon patient history review during preimmigration medical examinations as performed in South Korea in prospective immigrants to certain Western countries. In 2007, the U.S. Centers for Disease Control and Prevention (CDC) changed the TB screening protocol from a smear-based test to the complete Culture and Directly Observed Therapy Tuberculosis Technical Instructions (CDOT TB TI) for reducing the incidence of TB in foreign-born immigrants. Methods: This study evaluated the effect of the revised (as compared with the old) protocol in South Korea. Results: Of the 40,558 visa applicants, 365 exhibited chest radiographic results suggestive of active or inactive TB, and 351 underwent sputum tests (acid-fast bacilli smear and Mycobacterium tuberculosis culture). To this end, using the CDOT TB TI, 36 subjects (88.8 per $10^5$ of the population) were found to have TB, compared with only seven using the older U.S. CDC technical instruction (TI) (p<0.001). In addition, there were six drug-resistant cases which were identified (16.7 per $10^5$ of the population), two of whom had multidrug-resistance (5.6 per $10^5$ of the population). Conclusion: The culture-based 2007 TI identified a great deal of TB cases current to the individuals tested, as compared to older U.S. CDC TI.

Response Bias and Reliability of Patient Satisfaction Survey (환자만족도 조사의 응답편견과 신뢰도)

  • Cho, Young-Sik
    • Journal of dental hygiene science
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    • v.3 no.2
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    • pp.83-88
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    • 2003
  • Patient satisfaction is now recognized as a outcome indicator of health care quality. The objective of this research was to evaluate a patient satisfaction survey instrument specially applicable to dental care, and to examines the reliability and the effect of response biases on reported satisfaction. The acceptability of satisfaction as a quality indicators was qualified by several measurement problems. The patient questionnaire was administered in four different study samples to examine the consistency of data. Cronbach's alpha was used as the measure of internal consistency. A aquiesent bias was found in the sample of 80(20%) respondents. Response biases affacted level of measured satisfaction. Highly acquiesent respondents were older, less well educated than nonaquiesent subject.

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Effect of Patient's Satisfaction with Pharmacist's Medication Counseling on Medication Compliance Among Outpatients (복약지도 만족도가 복약순응도에 미치는 영향 : 외래환자를 대상으로)

  • Heo, Jae-Heon;Kim, Su-Jin;Kim, Joo-Hyek;Huh, Soon-Im
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.2
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    • pp.110-119
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    • 2009
  • Medication compliance is essential to improve person's health status through pharmacotherapy. Since separation of dispensing and prescription has been implemented, the importance of pharmacist's role on medication counseling have been emphasized, especially among outpatients. The objective of this study is to investigate the effect of patient's satisfaction with pharmacist's medication counseling on medication compliance among outpatients. We used the 2005 Korea National Health and Nutrition Survey data to examine medication compliance of persons who visited pharmacy. Ordered logistic regression analysis was conducted to assess whether patient's satisfaction with pharmacist's medication counseling was associated with medication compliance. Overall, 86.17% of study subjects(5,494) reported to take the prescribed medicines correctly and 80.54% of respondents were satisfied with pharmacist's medication counseling. Logistic regression analysis presents patient's satisfaction with pharmacist's counseling is significantly associated with medication compliance after controlling patient's characteristics(proxy-measured by age, family income, educational attainments, comorbid conditions). Interestingly, even patients who are dissatisfied with pharmacist's counseling have slightly higher odds of better compliance to medication therapy than those without pharmacist's counseling. In addition, higher educational attainments and older age groups are associated with better medication compliance. In conclusion, pharmacist's medication counseling appears to be effective in improving medication compliance. Further research that assess medication counseling in detail needs to develop strategies to improve medication adherence.

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An Analysis on the Factors Affecting Revisit and Defection of Long-term Outpatients in Neighboring Pharmacy of General Hospital (종합병원 장기처방환자의 인근 약국 재방문 및 이탈 요인 분석)

  • Oh, Chang-Kyun;Choi, Byung-Chul;Sohn, Uy-Dong
    • YAKHAK HOEJI
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    • v.49 no.6
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    • pp.449-458
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    • 2005
  • There have been rapid changes in the pharmaceutical environment after the separation of Dispensing and Prescribing practice. In the early stage of this system, outpatients had few options to choose their pharmacies due to various obstacles. Under these circumstances, this study on the defection tendency of long-term care patients was performed through the analysis of outpatients who quit visiting a pharmacy nearby general hospital. PowerBuilder ver 9.0 program was used to extract significant data, and SPSS package was employed for statistic analysis. 3,308 outpatients who visited a pharmacy nearby hospital for a month (in January, 2004) were studied. Patients' sex, age and location of residence, the class of medical insurance, the characteristic type of medication (powder, split form, medication for external use/injection), waiting time, disease (department) were considered as variable factors. It turned out that the patient revisit ratio was 80.8$\%$ and the patient defection ratio was 32.4$\%$. As was expected, those factors mentioned above influenced on the revisit and defection ratio considerably. In terms of patient factors, it proved that there was no relationship among sex, location of residence, the class of medical insurance and revisit (defection) ratio. Only age factor influenced the ratio; the older, the higher revisit ratio and the less defection ratio. In respect of dispensing factors, there were obvious relationships among the factors and the ratio: bill (money they had to pay individually), waiting time, number of medications, splitting of tablets, unit price of drug and revisit (defection) ratio showed significant relationship. The result of this study revealed an aspect of outpatients' behavior and it could be used as a reference for better patient service and customer relationship management.

Internal Fixation with a Locking T-Plate for Proximal Humeral Fractures in Patients Aged 65 Years and Older

  • Yum, Jae-Kwang;Seong, Min-Kyu;Hong, Chi-Woon
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.217-221
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    • 2017
  • Background: The purpose of this study was to evaluate the clinical and radiographic outcomes of internal fixation with locking T-plates for osteoporotic fractures of the proximal humerus in patients aged 65 years and older. Methods: From January 2007 through to December 2015, we recruited 47 patients aged 65 years and older with osteoporotic fractures of the proximal humerus. All fractures had been treated using open reduction and internal fixation with a locking T-plate. We classified the fractures in accordance to the Neer classification system; At the final follow-up, the indicators of clinical outcome-the range of motion of the shoulder (flexion, internal rotation, and external rotation) and the presence of postoperative complications-and the indicators of radiographic outcome-the time-to-union and the neck-shaft angle of the proximal humerus-were evaluated. The Paavolainen method was used to grade the level of radiological outcome in the patients. Results: The mean flexion was $155.0^{\circ}$ (range, $90^{\circ}-180^{\circ}$), the mean internal rotation was T8 (range, T6-L2), and the mean external rotation was $66.8^{\circ}$ (range, $30^{\circ}-80^{\circ}$). Postoperative complications, such as plate impingement, screw loosening, and varus malunion were observed in five patient. We found that all patients achieved bone union, and the mean time-to-union was 13.5 weeks of the treatment. The mean neck-shaft angle was $131.4^{\circ}$ at the 6-month follow-up. According to the Paavolainen method, "good" and "fair" radiographic results each accounted for 38 and 9 of the total patients, respectively. Conclusions: We concluded that locking T-plate fixation leads to satisfactory clinical and radiological outcomes in elderly patients with proximal humeral fractures by providing a larger surface area of contact with the fracture and a more rigid fixation.

Reproductive Outcomes after Microsurgical Reversal of Tubal Sterilization in Women 36 Years Age or Older (미세수술적 난관복원술을 시행받은 36세 이상 환자에서의 임신율에 관한 연구)

  • Kim, Seok-Hyun;Lee, Gyu-Chang;Choi, Soo-Hee;Choi, Young-Min;Shin, Chang-Jae;Kim, Jung-Gu;Moon, Shin-Yong;Lee, Jin-Young;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.3
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    • pp.341-348
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    • 1998
  • Objective: To determine the reproductive outcomes of women undergoing microsurgical reversal of tubal sterilization at age 36 years or older. Materials and Methods: A series of 133 patients who received microsurgical reversal of the previously sterilized fallopian tubes at Seoul National University Hospital from July, 1980 to January, 1992 was reviewed and evaluated for clinical characteristics, pregnancy rates, and factors influencing the outcome of tubal reversal. Results: Of 133 patients, 78 (58.6%) had been sterilized by laparoscopic cautery. Loss of children was a leading cause for tubal reversal. The mean interval from tubal sterilization to tubal reversal was 65.0 months. The overall pregnancy rate was 52.6% (70/133), and the mean interval was 9.4 months from tubal reversal to pregnancy. Excluding 7 patients who were lost to follow-up, 76 pregnancies were confirmed in 63 patients with the delivery rate per patient of 66.7% (42/63). There were no significant differences in age, duration of tubal sterilization, postoperative tubal length between pregnant and non-pregnant groups. Conclusions: Microsurgical reversal of tubal sterilization could be a justifiable method in women 36 years age or older.

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