• Therapeutic Science for Rehabilitation
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• v.4 no.1
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• pp.53-62
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• 2015

Objective : This study aimed to evaluate the effects of multisensory and Motor-Based group activity program on the problem behaviors and burden of care in persons with dementia. Methods : Five persons with moderate to severe dementia and significant problem behaviors, received 4 weeks of multisensory and Motor-based group activity program. The Neuropsychiatric Inventory was employed in the pretest and posttest. Analysis was performed using SPSS and including Wilcoxon signed rank test. Results : Participants' average problem behavior scores decreased from 70 in the pretest to 38 after program. Mean scores of burden of care decreased from 47 to 29. Conclusion : Multisensory and Motor-Based group activity program can be an effective method to decrease problem behaviors and burden of care for older people with dementia.

• The Journal of the Korea Contents Association
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• v.17 no.5
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• pp.45-55
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• 2017

The purpose of this study was to identify the participation in activities, emotions, and problem behaviors of elderly people residing in nursing homes. In this observational study targeting 81 elderly patients with dementia, each patient's participation in activities, emotion, and problem behaviors were observed for 4 hours per day with 20 minutes interval, which leads to 6,804 data based on 12 times a day for 7 days. According to this study, 90.1% of the participants were suffering from severe cognitive impairment. Their emotions were scored 4 out of 7. They mainly participated in activities such as sitting or lying down, which had no specific purpose, but they showed the most positive emotion when involved in social activities. The most frequent types of problem behaviors were repetitive behaviors and making noises, and the frequency of their behaviors were different depending on the time. There were significant correlation between cognitive functions, emotions, and problematic behaviors. Therefore, it is necessary to find effective ways to increase participation in activities, induce participation in positive emotional activities, and reduce problem behaviors manifested most prominently each hour of the elderly patients with dementia residing in nursing homes.

• 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.

• Fashion & Textile Research Journal
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• v.25 no.2
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• pp.185-198
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• 2023

The purpose of this study is to obtain information necessary for the development of patient clothes that can reduce physical fatigue of caregivers by quantitatively measuring the muscle load and fatigue. The patient clothes used in this study can be broken down into three types: A type (back center zipper open suit), B type (top-to bottom separated patient clothes), and C type (front zipper open suit). The EMG measurement sites are as follows: hand muscle (brachioradialis), upper arm (biceps, triceps), shoulder (anterior deltoid, medial deltoid, posterior deltoid, upper trapezius), and waist (erector spinae); additionally, the EMG signals were measured. Through this experiment, muscle load, muscle energy consumption, and muscle fatigue generation tendency were analyzed. The results of the study revealed that the C type patient clothes required the most strength in the muscles of the shoulders, upper arms, hands, and back when being put on and taken off compared to other patient clothes. The A type clothes required a relatively large force in opening the zipper. In terms of muscle energy consumption, B type generally called for more strength when it came to the zip-up and putarmsup motions. With regard to the cover the body and put legs/hips up motions, C type used the highest amount of muscle energy, whereas A type used relatively little energy. In terms of the occurrence of muscle fatigue during the putting on and taking off of the patient's clothing, there was a difference in the area and degree of muscle fatigue in the A, B, and C types, and there was also a tendency for muscle fatigue to occur when performing repetitive movements.

• Korea Journal of Hospital Management
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• v.28 no.2
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• pp.9-20
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• 2023

Purpose: This study classified the actual functions of geriatric hospitals and examined the differences in their characteristics, in order to provide a basis for discussions on defining the functions of geriatric hospitals and how to pay for care. Methodology: This study used various administrative data such as health insurance data and long-term care insurance data. Cluster analysis was used to categorize geriatric hospitals. To examine the validity of the cluster analysis results, we conducted a discriminant analysis to calculate the accuracy of the classification. To examine cluster characteristics, we examined structure, process, and outcome indicators for each cluster. Findings: The cluster analysis identified five clusters. They were geriatric hospitals with relatively short stays for cancer patients(cluster 1; cancer patient-centered), geriatric hospitals with relatively large numbers of patients using rehabilitation services(cluster 2; rehabilitation patient-centered), geriatric hospitals with a high proportion of relatively severe elderly patients(cluster 3; severe elderly patient-centered), geriatric hospitals with a high proportion of mildly ill elderly patients with various conditions(cluster 4; mildly ill elderly patient-centered), and geriatric hospitals with a significantly higher proportion of dementia patients(cluster 5; dementia patient-centered). The largest number of geriatric hospitals were categorized in clusters 4 and 5, and the structure and process indicators for these clusters were generally lower than for the other clusters. Practical Implications: We have confirmed the existence of geriatric hospitals where the medical function, which is the original purpose of a geriatric hospital, has been weakened. It has been observed that the quality level of these geriatric hospitals is likely to be lower compared to hospitals that prioritize enhanced medical functions. Therefore, it is suggested to consider the conversion of these geriatric hospitals into long-term care facilities, and careful consideration should be given to the review of care-giver payment coverage.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.2
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• pp.162-171
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• 2010

Purpose: Nursing home quality indicators have been focused widely on result outcomes, not for the environment in that quality of service are delivered, This study aimed to examine structural factors influencing quality management activities in nursing homes. Method: Sample was 170 nursing homes responded to the survey questionnaire which was distributed to the 543 nursing homes nation-wide, Data were collected on structural characteristics, types of services, and quality management activities, Data were analyzed with the descriptive statistics, Pearson correlations, and multiple regression. Result: Most of the nursing homes were operated as free of charge by the social welfare ownership. Average number of residents was 52.1 with severe and mild dementia and bedridden status, In terms of quality management activities, 34% of the sample had CQI committee that focused their activities on services delivery process, performance appraisal, record keeping regularly. 30.6% of quality management activities were accounted for by the number of residents with dementia, the ratio of RN to residents, rehabilitation services, and social wefare services in nursing homes. Conclusion: We recommend that more comprehensive quality management activities should be developed as process quality indicators in conjunction with the outcome indicators.

• Dementia and Neurocognitive Disorders
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• v.17 no.3
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• pp.120-129
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• 2018

Background and Purpose: Prospective memory (PM) has a known relationship with frontal function, and PM decline has been observed in amnestic mild cognitive impairment (aMCI). Cerebral small vessel disease, as evidenced by white matter hyperintensities (WMHs), is linked to frontal dysfunction. This study was undertaken to evaluate the relationship between PM decline and WMHs in patients with aMCI. Methods: Of 74 enrollees with aMCI, 69 completed this prospective study. We compared total scores and sub-scores of the Prospective and Retrospective Memory Questionnaire (PRMQ) administered at baseline and 3 months later, stratifying patients by degree of WMHs. Results: A significant decline was seen in PRMQ total scores and PM scores at the 3-month mark in patients with moderate (vs. mild) degrees of WMHs ($-2.8{\pm}7.2$ vs. $0.2{\pm}7.1$; p=0.032). In addition, patients with moderate (vs. mild) degrees of deep WMHs (DWMHs) showed greater PM decline, whereas PM loss in patients with mild, moderate, or severe degrees of periventricular WMHs (PVWMHs) did not differ significantly. Conclusions: Findings of this study indicate that the burden of WMHs is consistently implicated in PM deterioration experienced by patients with aMCI, and signifies greater PM decline, especially in instances of extensive DWMHs. Greater attention to the change of PM is therefore needed in aMCI patients with WMHs.

• Journal of Yeungnam Medical Science
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• v.36 no.3
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• pp.183-191
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• 2019

Some patients with type 1 and type 2 diabetes mellitus (DM) present with cognitive dysfunctions. The pathophysiology underlying this complication is not well understood. Type 1 DM has been associated with a decrease in the speed of information processing, psychomotor efficiency, attention, mental flexibility, and visual perception. Longitudinal epidemiological studies of type 1 DM have indicated that chronic hyperglycemia and microvascular disease, rather than repeated severe hypoglycemia, are associated with the pathogenesis of DM-related cognitive dysfunction. However, severe hypoglycemic episodes may contribute to cognitive dysfunction in high-risk patients with DM. Type 2 DM has been associated with memory deficits, decreased psychomotor speed, and reduced frontal lobe/executive function. In type 2 DM, chronic hyperglycemia, long duration of DM, presence of vascular risk factors (e.g., hypertension and obesity), and microvascular and macrovascular complications are associated with the increased risk of developing cognitive dysfunction. The pathophysiology of cognitive dysfunction in individuals with DM include the following: (1) role of hyperglycemia, (2) role of vascular disease, (3) role of hypoglycemia, and (4) role of insulin resistance and amyloid. Recently, some investigators have proposed that type 3 DM is correlated to sporadic Alzheimer's disease. The molecular and biochemical consequences of insulin and insulin-like growth factor resistance in the brain compromise neuronal survival, energy production, gene expression, plasticity, and white matter integrity. If patients claim that their performance is worsening or if they ask about the effects of DM on functioning, screening and assessment are recommended.

• Annals of Clinical Neurophysiology
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• v.4 no.2
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• pp.140-145
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• 2002

Neurologic sequelae of tuberculous meningitis include hemiparesis, paraparesis, quadriparesis, aphasia, developmental delay, dementia, blindness, visual field defect, deafness, cranial nerve palsies, epilepsy, and hypothalamic and pituitary dysfunction. But cervical epidural abscess and cervical spondylitis are rare. A 64-year-old woman who was diagnosed as tuberculous meningitis presented a severe neck pain and stiffness after 3 weeks of anti-tuberculous medication. Electromyography and cervical X-ray showed a cervical spondylosis with polyradiculopathy. But cervical MRI showed an acute cervical epidural abscess and mild cervical spondylitis. After continuous anti-tuberculous medication with supportive care, she showed a slow clinical improvement. But about 1 month of anti-tuberculous therapy, she presented a more aggravation of neck pain, neck stiffness, radicular pain, and neck motion limitation. Follow-up cervical MRI showed an more advanced cervical spondylitis. Afterthen she has recovered slowly by cervical laminectomy with posterior stabilization and continuous anti-tuberculous medication.

• Journal of the Korean Society of Physical Medicine
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• v.1 no.1
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• pp.139-146
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• 2006

Purpose : This study is to understand the reactive oxygen which is expected to be a causative factor of aging condition including dementia, atherosclerosis, even cancer. Methods : The reactive oxygen is generated usually when people do very hard exercise or is under severe stressful situation or in unhealthy environment and as a protective reaction to reactive oxygen, human body releases antioxidant enzyme systems like superoxide dismutase (SOD), catalase, glutathione peroxidase (GPX), glutathion-S-transferase (GST) and non-enzymetic antioxidant systems like glutathione, ascorbate, $\beta$-carotene, vitimin E. Results : Nowadays, we are getting more interested in the generation of reactive oxygen especially in the area of physical education, food and nutrition, alternative medicine etc. Conclusion : The study of reactive oxygen in patients with musculoskeletal disease is also required and among various physical therapeutic approaches, the method of general coordinative manipulation is considered more necessary.