• 한국병원경영학회지
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• 제20권4호
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• pp.50-61
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• 2015

Advances in healthcare technology and rapid economic growth lead to the increased life expectancy and consequently the size of elderly population. Korea is one of the countries that are rapidly aging. Thus, it is particularly important to prepare for the aging society. Recently, the number of healthcare institutions for the elderly citizens has increased. The purpose of selecting a hospital for the elderly is, in general, maintenance of health rather than improvement of health receiving proper treatment. Unlike choosing a hospital for treatment, customers of a long term care hospital have a different set of factors to consider. Especially, when choosing a long term care hospital, the influence of patient's family is greater than the patient. This study examines the factors they consider for long term care hospital. A total of 198 questionnaires were collected from the families of actual patients of long term care hospitals. Twelve questionnaires were found to be non-usable because of missing and unsatisfactory responses. Consequently, 186 questionnaires were used for the analyses. Findings of this study are as follows. First, seven factors have been identified to consider when choosing a long term care hospital for the elderly. They include convenience of facilities, costs variety of facility programs, service hours, reputation, accessibility, quality of medical staff, medical facilities, and facility size. Second, This study measured both importance and satisfaction with these attributes and analyzed the difference between them. Satisfaction was lower than importance in the categories of convenience of facilities, costs, and programs, and accessibility. On the other hand, satisfaction was higher in terms of service hours, reputation, and quality of medical staff. Finally, the current study found positive impact of accessibility and quality of medical staff on reuse intention of a long term care hospital.

• Journal of Yeungnam Medical Science
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• 제7권2호
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• pp.55-66
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• 1990

1. 임종통고에 대한 반대는 노인군과 환자가족군이 40.2%, 40.9%로 환자군과 의료인군의 23.%, 13.3%보다 유의하게 높았다(p<0.001). 2. 임종환자에 대한 의료인의 회피적 태도에서는 의료인군의 44%가 반대하여 전체평균 28.5%보다 유의하게 높았다(p<0.001). 3. 불치병 환자의 생명 연장에 대한 태도에서는 환자군과 보호자군의 반대율이 33.3%, 22.5%로 노인군과 의료인군의 54.5%, 56.0%보다 유의하게 낮았다(p<0.001). 4. 임종환자를 위한 특수시설 및 교육문제에 있어서는 의료인군의 찬성율이 81.3%로 가장 높았고 환자군이 56.8%로 가장 낮았다. 5. 임종환자에 대한 가족의 회피적 태도에 대해서는 노인군의 찬성율이 81.3%로 가장 높았고 가족군이 34%로 가장 낮았다. 6. 임종에 대한 지각문제에 있어서는 의료인군의 찬성율이 77.3%로 전체평균 58.8%보다 높았다.

• 대한한의학회지
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• 제42권1호
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• pp.129-135
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• 2021

Objectives: The present study reports case of an elderly kwashiorkor patient who was treated with Korean Medicine. Methods: A 68-year-old female patient with weight loss, general weakness, chills, anorexia, and dizziness after over 100 episodes of diarrhea visited the hospital. Blood tests showed hypoalbuminemia and anemia, and ultrasonography revealed fatty liver disease. The patient was diagnosed with kwashiorkor, and her symptom differentiation was Yang deficiency followed by Both Qi-Blood deficiency. Sayeok-Tang, Soshiho-Tang, Insamyangyeong-Tang, and Gongjin-Dan, herbal drugs, were given to the patient during 40 days of hospitalization. Results: After 40 days of hospitalization, her symptoms were reduced, and the blood test results improved. Conclusion: This case presents the therapeutic potential of Korean medicine in the treatment of kwashiorkor.

• 한국임상약학회지
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• 제25권4호
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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.

• 대한한방내과학회지
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• 제40권6호
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• pp.1259-1267
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• 2019

Introduction: The aim of this study was to report the effect of Korean medicine treatments on an elderly patient with acute hematochezia and anemia Case presentation: An 81-year-old female with chronic multifocal middle cerebral artery infarction had symptoms of acute hematochezia and anemia. Method: The patient was treated with Korean medicine therapy. Results: Treatment with Korean medicine, including herbal medicine, significantly improved the patient's symptoms. After treatment, her hematochezia was improved and the results of a complete blood count (CBC) also improved. No side effects were observed during treatment. Conclusion: Korean medicine treatment can be considered an effective treatment for acute hematochezia and anemia in an elderly patient.

• 한국산학기술학회논문지
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• 제20권12호
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• pp.747-757
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• 2019

본 연구는 노인환자가 인식하는 간호사와의 상호작용을 측정하기 위해 개발된 the Korean version of Nurse-Patient Interaction Scale (K-NPIS)을 한국 요양병원에 입원한 노인환자를 대상으로 간호사와의 상호작용을 측정의 신뢰도와 타당도를 검증하려는 목적으로 시행되었다. 진주시, 순천시, 남원시에 소재하는 4개의 요양병원에 입원한 노인환자 202명을 대상으로 신뢰도와 타당도 검증을 실시하였다. 문항분석과 내적일관성 검증을 통해 K-NPIS의 Cronbach α 값은 .96이었다. 전문가들을 통한 내용타당도 검증에서 내용타당도 지수가 0.8 이상으로 확인되었으며, 확인적 요인분석을 거쳐 최종 단일속성으로 구성된 12개 문항 각 10점 척도의 최종 도구가 도출되었으며, 재원기간에 따라 K-NPIS의 점수가 유의하게 차이가 나(p=.042) 판별타당도도 검증되었고, 천장효과나 바닥효과는 나타나지 않았다. 이와 같이 K-NPIS는 신뢰도와 타당도가 높은 도구임이 검증되어 요양병원에서 노인환자를 대상으로 간호사-환자의 상호작용을 측정하는 도구로 사용되는데 적절한 것으로 보이나 장차 준거타당도를 검증할 필요가 있다. K-NPIS는 노인환자가 인식하고 있는 간호사와의 상호작용을 자가보고 형식으로 측정하는 것이므로, 노인환자와의 상호작용을 기반으로 한 돌봄 중재의 성과를 평가하여 간호서비스 질 향상에 기여할 수 있을 것으로 기대된다.

• 한국병원경영학회지
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• 제28권2호
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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.

• 성인간호학회지
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• 제17권1호
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• pp.12-22
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• 2005

Purpose: The purpose of this study was to find out the quality of life and to identify the related characteristics for nursing care in pneumconiosis elderly patients. Methods: The subjects for this study were 206 elderly patients who received pneumoconiosis treatment in the two pneumoconiosis specialized hospitals located in Gangwondo, Korea. The instrument used for this study was Quality of Life Index Pulmonary version III. The data was collected from February 17 to March 10, 2003, and analyzed by t-test, ANOVA, Duncan test using SPSS. Results: The results of this study were as follows : 1. The highest frequency in chief complaints was dyspnea, 91 subjects(44.2%), and complications was tuberculosis, 88 subjects (42.7%). 2. The total mean score of the level of quality of life was $14.49{\pm}2.18$. 3. The score of quality of life showed higher in good family relationship group than the other after diagnosed pneumoconisis(F=5.486, P=0.001). 4. The comparison of quality of life was significant according to oxygen use(t=2.674, P=0.008), bronchodilators use(t=2.678, P=0.008), and prospect of future health status concerning pneumoconiosis(F=2.960, P=0.021). Conclusions: In conclusion, adequate nursing intervention as effective management of respiratory symptoms and improvement of family support will be needed to improve the quality of life in pneumoconiosis elderly patients.

• 한국임상약학회지
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• 제24권2호
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• pp.115-125
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• 2014

Purpose: The purpose of the present study was to assess the incidence of the potentially inappropriate medication (PIM) use in Korean elderly patients with heart failure, and to evaluate factors that influence PIM use. Method: Korean National Health Insurance claims database between January 2009 and December 2009 was used. Using 2012 updated Beers criteria, PIM use in heart failure patients aged 65 years or older was examined. Result: The incidence of PIM use in elderly heart failure patients was higher than in overall elderly patients. Among the 12,759 elderly patients with heart failure, 46.2% of study subjects were prescribed PIM(s) at least once. The number of PIM per 10 medications that patients received per patient was 1.53. The most commonly used PIMs in elderly heart failure patients were benzodiazepines (30.9%), non-steroidal anti-inflammatory drugs (NSAIDs) including COX-2 inhibitors (16.3%), digoxin (9.9%), and spironolactone (9.0%). Women (odds ratio, 1.20; 95% CI, 1.17-1.24), medical aid (odds ratio, 1.11; 95% CI, 1.08-1.13), and long-term facilities (odds ratio, 2.69; 95% CI, 2.44-2.96) were revealed to be important factors associated with PIM use. In addition, patient's age also seems to influence PIM use. Conclusion: Elderly heart failure patients are at a greater risk for adverse drug events attributed by inappropriate medication use. Efforts to increase awareness of PIM use in elderly heart failure patients are needed. In addition, various comprehensive strategies and policies to identify and prevent PIM use should be established nationwide.

• 한국보건간호학회지
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• 제13권2호
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• pp.1-11
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• 1999

The purpose of this study was to provide the elderly and their family kowledge about senile dementia and to get them to have positive attitude about senile dementia. The subjects were 204 elderly who lived in the whole country. The data were collected from Sep. to Dec., 1998, using a 36 items questionnaire and analyzed by SAS program for t-test, ANOVA. Scheffe test, Pearson Correlation Coefficients. The results were as follows: 1. The mean score of knowledge about senile dementia was $9.33\pm2.68$(range 0-15), The elderly who was unschooled, lived in Kyung Sang province, didn't have any hobby or interest, didn't access to informations about senile dementia got lower score than the others. 2. The examples of knowledge test items about senile dementia that the subjects above fifty percents answered uncorrectly were 'the patient of senile dementia doesn't die soon', 'senile dementia is uncurable disease', 'the symptoms of senile dementia is apparent in new and strange circumstances', 'the pood and lonely elderly is apt to have senile dementia'. 3. The mean score of attitude about senile dementia was $15.87\pm2.25$(range 0-20) and attitude about senile dementia was relatively positve. Attitude about senile dementia by general characteristic was not significantly different. 4. The examples of attitude test items about senile dementia to which the majority of subjects agreed were 'It is a pity to see the patient suffered from senile dementia', 'It is difficult to take care of senile dementia patient' and so on. 5. The correlation between kowledge and attitude about senile dementia was very low. Therefore this study suggests that it is crucial to educate the elderly and their family to induce positive attitude about senile dementia.