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An Exploratory Study on the Experience of the female Elderly using a Long-Term Care: Centering on Users of Home-Visit Bath (장기요양보호를 이용하는 여성노인의 경험에 관한 탐색적 연구: 방문목욕 이용자를 중심으로)

  • Shin, Gun-cheol
    • 한국노년학
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    • v.30 no.4
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    • pp.1345-1357
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    • 2010
  • This research, with the participants of the female elderly using a home-visit bath among long-term care services, made an in-depth analysis of what they experience while getting a home-visit bath. We conducted in-depth interviews with 8 elderly people. According to the result, the female elderly experienced the absence of a caregiver, difficulty in carrying out daily life due to physical diseases, getting what they need by themselves, getting comfortable in body and mind, accepting their given situation though feeling shame at getting a bath, and expressing their desires. In addition, they had a close relationship with a care helper. On the basis of the results, a systematic training system which could intensify the professionalism of care helpers was suggested. For the enhancement of the elderly's emotional stability in a long-term care, an integrated case management system was also suggested, which supports the family by organizing an integrated network by region between a long-term care service, home-visit care service, welfare center, and the National Health Insurance Corporation.

Impact of Community Health Care Resources on the Place of Death of Older Persons with Dementia in South Korea Using Public Administrative Big Data (공공 빅데이터를 이용한 치매 노인 사망장소의 결정요인: 지역보건의료자원의 영향)

  • Lim, Eunok;Kim, Hongsoo
    • Health Policy and Management
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    • v.27 no.2
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    • pp.167-176
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    • 2017
  • Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

Natural History of Chronic Hepatitis in Korea (한국(韓國)에 만연(蔓延)하고 있는 만성간염(慢性肝炎)의 자연병력(自然病歷))

  • Chung, Whan-Kook
    • The Journal of the Korean life insurance medical association
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    • v.2 no.1
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    • pp.34-36
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    • 1985
  • Korea is an endemic area of chronic hepatitis in the world. Liver cirrhosis and liver cell carcinoma, presumed to be related to such chronic hepatitis, are the major causes of death in this country. The purpose of this study is disclosing the sources of chronic hepatitis in Korea establishing its histologic characteristics, disclosing the patterns of progression in chronic hepatitis, delineating its prognosis and finally speculating its etiology. The study group was composed of 183 patients with biopsy-proven acute icteric viral hepaticis, 32 patients with biopsy- proven anicteric hepatitis and 260 patients with biopsy- proven chronic hepatitis. These patients submitted to long-term follow-up by means of liver needle biopsy and/or clinicolaboratory evaluation. The period of follow-up ranged from two months to 18 years. The histological features of the initial biopsy specimens of chronic hepatitis permitted a division of the cases cases into the following five types: Type I. Persisting portal hepatitis : so called persisting hepatitis 43 Type II. Chronic inactive hepatitis with incomplete strand septal fibrosis. This type has thin fibrotic septation in addition to Type I with portal sclerosis 38 Type III. Chronic active periportal hepatitis(CAPH) : so called aggressive hepatitis, characterized by marked piecemeal necrosis. This type has been subdivided further into three groups: AB and C on the basis of histologic features. A CAPH without cirrhosis 15 B CAPH with cirrhosis 99 C CAPH with diffuse acinus type parenchymal nodules; characterized by rosette-forming micronodules 21 Type IV. Subacute hepatic necrosis; characterized by multilobular and/or bridging necrosis. 14 Type V. Persisting lobular hepatitis; characterized by spotty necrosis, which looks very similar to acute viral hepatitis. Such histologic changes should be persisted for more than six months 30 In Korea the main source of chronic hepatitis is the anicteric type. Of the chronic hepatitis observed in the hospital, Type IIIb was the most frequent in its incidence and occasionally exhibited development of hepatocellular carcinoma, but the mortality was highest in Type IIIc during the period of follow-up. Histologic characteristics of these five types suggest a spectrum of chronic hepatitis in Korea from an early and mild stage to advanced and fatal cirrhosis, which is occasionally associated with primary hepatic cell carcinoma. It seems that Type IV can be followed by flare-up of various stages of acute and chronic hepatitis with HBsAg and that many cases of liver cirrhosis prevalent in Korea occur through such an active process of Type IV. The etiology is not established, but in Korea it is mainly related to HBsAg.

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The compensation for damage by space accidents (우주손해배상법에 관한 약간의 고찰)

  • Kim, Sun-Ihee
    • The Korean Journal of Air & Space Law and Policy
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    • v.22 no.2
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    • pp.3-25
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    • 2007
  • In 2002 Republic of Korea successfully launched a self-made mined proportion rocket and it is expected that she will be able to have own space launching system by 2010. According to Article 14 of the Space Exploration Promotion Act, a new law should be established to impose the limit of compensation for the damage by space accident. Therefore, The Space Accident Liability Act was passed in Korean Congress on Nov. 22, 2007 and it will be enforced in six months. The purpose of this Act is to provide reparation for the damage of the third parties that a launch causes; and the Commonwealth should be insured against any possible space accidents to pay for such a damage. Here space accident means the damages to our life, body, and properties from the launching of space objects. There should be an actual loss to establish the compensation of Liability Act. Article 2 in Liability Act defines "damage" as follows: the term "damage" means loss of life, personal injury or loss of or damage to property of persons. Physical and material damages are included in the conception of damage. The meaning of a launching includes any test launch and launch for a real arrangement which will ultimately provides a wide range of compensation. Article 4 indicates that absolute liability should be imposed in compensating for damage by space accidents. Article 4 also indicates that a launching party should be absolutely liable to compensate for the damage caused by its space object on the surface of the Earth. In general, liability stands where fault is. But if the activity is ultra-hazardous and causes serious harm, the individual needs to compensate for the damage unlimitedly. Because of the many launchings for the Seattleite launching, a launching organization is obligated to the liability insurance in preparation for the space accidents. According to the Article 6 of Space Accident Liability Act, to be insured for the compensation for damage is obligatory. It says: "In accordance with Article 11 in the Space Exploration Promotion Act, the person who wants to receive an approval f3r launching needs to be insured in compensation for the possible damage by space accidents.

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The effects of AI Robot Integrated Management Program on cognitive function, daily life activity, and depression of the elderly at home (AI로봇 통합관리프로그램이 재가노인의 인지기능, 일상생활활동, 우울에 미치는 효과)

  • Kim, Yeun-Mi;Song, Mi-Young;Yang, Jung-Sook;Na, Hyun-Mi
    • Journal of Digital Convergence
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    • v.20 no.2
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    • pp.511-523
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    • 2022
  • This study was conducted using non-face-to-face care technology for the elderly with mild dementia and the physically weak living in the community, as various methods of care for the elderly have been raised due to the prolonged COVID-19. The purpose of this study is a similar experimental study before and after the inequality control group to compare cognitive function, daily living activities, and the degree of depression by applying an AI robot integrated management program using. The data was collected from June 4 to September 17, 2021, and the survey results of 17 people in the experimental group and 18 in the control group were analyzed using the SPSS 25.0 program. As a result of the study, the experimental group was significant in language function, activities of daily living, and depression. In particular, the results showed a decrease in moderate to severe depression and mild depression. Cognitive function was significant with long-term care grade and daily living activity with family living together. Therefore, if such non-face-to-face care technology is introduced to the elderly care field in the 'With Corona era', it is thought that it will contribute to cognitive function training and depression reduction of the elderly.

Cost-Utility Analysis of Pegfilgrastim and Pegteograstim in Patients with Breast Cancer using Doxorubicin and Cyclophosphamide (Doxorubicin과 Cyclophosphamide를 투여받는 유방암 환자에서 Pegfilgrastim과 Pegteograstim의 비용-효용 분석)

  • Kwon, Su Ji;Geum, Min Jung;Kim, Jae Song;Son, Eun Sun;Kwon, Kyeng Hee
    • Journal of Korean Society of Health-System Pharmacists
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    • v.35 no.4
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    • pp.409-417
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    • 2018
  • Background : Febrile neutropenia (FN) is one of the side effects in the patients treated with chemotherapy, and the patients who have FN generally need immediate treatment with extended-spectrum antibiotics and hospitalization. Pegfilgrastim and pegteograstim, which are used for the prevention of FN as a granulocyte-colony stimulating factor (G-CSF), have been granted insurance coverage in the Republic of Korea for certain breast cancer patients using doxorubicin and cyclophosphamide (AC) from September 2016. Methods : The data of the patients with breast cancer using AC regimen and G-CSF were collected retrospectively. This study involves cost-utility analysis of pegfilgrastim and pegteograstim. In this study, we constructed a simple decision tree model for short-term observation and calculated quality-adjusted life year (QALY) and the direct medical costs from the medical provider's perspective. Results : From September 2016 to May 2017, 15 patients were treated with pegfilgrastim and 15 patients were treated with pegteograstim. As a result of dividing the average cost by QALY for each treatment group, it was observed that pegfilgrastim and pegteograstim were consumed 24,923,384 won and 22,808,336 won per 1QALY, respectively. Consequently, incremental cost effectiveness ratio (ICER) showed 2,115,048 won more per pegfilgrastim than pegteograstim per 1QALY, and the cost per 1QALY of both the drugs was lower than 30,500,000 won; the Koreans were willing to pay this amount. Conclusions : This study suggests that pegfilgrastim and pegteograstim can be used to improve the quality of life of breast cancer patients undergoing AC therapy. Among the two drugs, pegteograstim seems to be more cost-effective. However, since this study was conducted as a retrospective observation method on a small scale, it is associated with many limitations. Therefore, a long-term prospective cohort study is needed to supplement the present findings.

Health and Economic Burden Attributable to Particulate Matter in South Korea: Considering Spatial Variation in Relative Risk (지역간 상대위험도 변동을 고려한 미세먼지 기인 질병부담 및 사회경제적 비용 추정 연구)

  • Byun, Garam;Choi, Yongsoo;Gil, Junsu;Cha, Junil;Lee, Meehye;Lee, Jong-Tae
    • Journal of Environmental Health Sciences
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    • v.47 no.5
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    • pp.486-495
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    • 2021
  • Background: Particulate matter (PM) is one of the leading causes of premature death worldwide. Previous studies in South Korea have applied a relative risk calculated from Western populations when estimating the disease burden attributable to PM. However, the relative risk of PM on health outcomes may not be the same across different countries or regions. Objectives: This study aimed to estimate the premature deaths and socioeconomic costs attributable to long-term exposure to PM in South Korea. We considered not only the difference in PM concentration between regions, but also the difference in relative risk. Methods: National monitoring data of PM concentrations was obtained, and missing values were imputed using the AERMOD model and linear regression model. As a surrogate for relative risk, hazard ratios (HRs) of PM for cardiovascular and respiratory mortality were estimated using the National Health Insurance Service-National Sample Cohort. The nation was divided into five areas (metropolitan, central, southern, south-eastern, and Gangwon-do Province regions). The number of PM attributable deaths in 2018 was calculated at the district level. The socioeconomic cost was derived by multiplying the number of deaths and the statistical value of life. Results: The average PM10 concentration for 2014~2018 was 45.2 ㎍/m3. The association between long-term exposure to PM10 and mortality was heterogeneous between areas. When applying area-specific HRs, 23,811 premature deaths from cardiovascular and respiratory disease in 2018 were attributable to PM10 (reference level 20 ㎍/m3). The corresponding socioeconomic cost was about 31 trillion won. These estimated values were higher than that when applying nationwide HRs. Conclusions: This study is the first research to estimate the premature mortality caused by long-term exposure to PM using relative risks derived from the national population. This study will help precisely identify the national and regional health burden attributed to PM and establish the priorities of air quality policy.

The Effects of the Expansion of Formal Home Care Services for the Elderly on Time Allocation of Family in Korea (노인 재가서비스의 확대가 가족의 생활시간에 미친 영향: 삼중차이 방법의 적용)

  • Lee, Seungho;Byun, Geumsun;Shin, Yumi
    • 한국사회정책
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    • v.23 no.1
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    • pp.227-256
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    • 2016
  • This study examines whether formal home care has led to a reduction in family member's allocation of time to care of elderly and changing the allocation of other time: informal care, market work, leisure, etc. Long-term care for the elderly is not the entire burden of elderly families anymore due to the increasing of the formal home care service for elderly since mid-2000's. This study uses triple difference(DDD) methods for evaluating policy reforms when reforms are equally and nation-wide accessible and analyzes data from the 2004 and 2009 Time Use Survey Data of the National Statistical Office in Korea. The treatment group is composed of the families of the elderly who need care and low- and middle- income family. Controlling for demographic characters, the three-way interaction term has statically significant and negative impact on care time of family members in treatment group statistically significant. The results reveal that the policy changes in elderly home care service affect time allocation of family members with old adults, which decreases caregiving time in a daily life. This result becomes apparent when we limit the case of women. But the level of reduction is not enough to change other kinds of time-informal care, market work, leisure, etc. The results indicate that formal home care for the elderly can reduce the burden of caregiving in families, but only minimally.

Psychosomatic Symptoms Following COVID-19 Infection (코로나19 감염과 그 이후의 정신신체증상)

  • Sunyoung Park;Shinhye Ryu;Woo Young Im
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.72-78
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    • 2023
  • Objectives : This study aims to identify various psychiatric symptoms and psychosomatic symptoms caused by COVID-19 infection and investigate their long-term impact. Methods : A systematic literature review was conducted, selecting papers from domestic and international databases using keywords such as "COVID-19" and "psychosomatic." A total of 16 papers, including those using structured measurement tools for psychosomatic symptoms, were included in the final analysis. Results : Psychiatric symptoms such as anxiety, depression, and somatic symptoms have been reported in acute COVID-19 infection, while long-term post-COVID symptoms include chest pain and fatigue. The frequency of long-term psychosomatic symptoms has been estimated to be 10%-20%. Factors contributing to these symptoms include psychological and social stress related to infectious diseases, gender, elderly age, a history of psychiatric disorders, and comorbid mental illnesses. It is suggested that systemic inflammation, autoimmune responses, and dysregulation of the autonomic nervous system may be involved. Conclusions : Psychosomatic symptoms arising after COVID-19 infection have a negative impact on quality of life and psychosocial functioning. Understanding and addressing psychiatric aspects are crucial for symptom prevention and treatment.

Psychological Systematic Consideration of Breast Cancer Radiotherapy (유방암 방사선 치료 환자의 심리의 체계적 분석)

  • Yang, Eun-Ju;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.629-635
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    • 2019
  • In term of the factors affecting psychosocial adjustment of breast cancer patients, their quality of life after surgical operation, radiation, and chemotherapy were systematically meta-analyzed. As a result, their qualities of life of the patients that had radiation therapy was the lowest right after the therapy, and gradually increased after the end of the therapy. However, after six months, their quality of life failed to reach the same level before the therapy. They had depression and side effects the most right after the therapy, and somewhat reduced them after the end of the therapy. In case of surgical operation, the more they were educated, the more they had psychosocial adjustment, and the more they had a medical examination and took out an insurance policy, the more they had psychosocial adjustment. In case of chemotherapy, their cognitive function is influenced so that they have impairments in memory, learning, and thinking stages. Since subjective cognitive impairment has a relationship with depression, it is necessary to monitor depression of chemotherapy patients. Given the results of this systematic meta-analysis, when three types of therapies (surgical operation, radiation therapy, and chemotherapy) are applied to patients with breast cancer, it is necessary to recognize their psychosocial adjustment, depression, anxiety, and quality of life in the nursing and radiation therapy fields and thereby to introduce an intervention program for a holistic approach.