• 제목/요약/키워드: the Elderly In-patient

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The Effects of Abdominal Relaxed Breathing Training on Stress response and Blood Pressure for Elderly Hypertensionve Patient (고혈압 노인에서 복식호흡 이완훈련이 혈압 및 스트레스 반응에 미치는 영향)

  • 유수정;송미순
    • Journal of Korean Academy of Nursing
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    • v.31 no.6
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    • pp.998-1011
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    • 2001
  • In order to improve self-management of elderly hypertensives in this study, the researcher examined the effect of blood pressure regulation by an abdominal relaxed breathing training which regulates physical response to stress and lessens the activity of the sympathetic nerve. Method: A quasi-experimental pre-test and post-test design was used. Thirty elderly hypertensive patient ; Sixteen in the abdominal breathing group and fourteen in the control group participated in this study. The abdominal relaxed breathing training consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Result: 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of total stress response, physical stress response, behavioral-cognitive stress response between the experimental group and control group over three different times, and interaction by groups and over time. Conclusion: Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.

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The Effects of Patient and Facility Characteristics On the Resource Use by the Elderly in Long-term Care Services (환자 및 시설 특성이 장기요양서비스 이용 노인의 자원소모량에 미치는 영향)

  • 권순만;김홍수;김선민
    • Health Policy and Management
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    • v.12 no.1
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    • pp.21-53
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    • 2002
  • The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

Korean Medicine Treatments for Delirium in an Elderly Patient Caused by Sedative-Hypnotics Overdose (진정수면제를 음독한 노인 입원 환자에서 발생한 섬망에 대한 한의복합중재 증례보고)

  • Han-byul Cho;Byung-Soo Koo;Geun-Woo Kim
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.4
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    • pp.473-485
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    • 2023
  • Objectives: The purpose of this study was to report the effectiveness of the combination of Korean medicine therapy on elderly patients with delirium due to overdose of sedative-hypnotics. Methods: The patient was diagnosed with delirium, which occurred after an overdose of sedative-hypnotics. The patient received Korean Medicine treatment, including herbal medicine, acupuncture, moxibustion and psychotherapy, and other treatments. The evaluation variables to check the effectiveness of the interventions were the Korean Version of the Delirium Rating Scale-Revised-98 (K-DRS-R-98) Mini-Mental State Examination-Korean (MMSE-K) Clinical Dementia Rating (CDR) and Manual Muscle Test (MMT). Results: During the hospitalization period, the K-DRS-R-98 score decreased from 31 to 4, MMSE-K score increased from 18 to 26. CDR score decreased from 2 to 0. MMT in the Right lower extremity was improved. Normal daily activities were possible. Conclusions: Combining Korean Medicine treatments, including herbal medicine, acupuncture, moxibustion, psychotherapy, and other treatments, may help alleviate delirium.

Successful Outcome of Elderly Patients with Advanced Malignant Melanoma by Standardized Allergen-removed Rhus verniciflua Stokes Extract and Bojungikki-tang: Two Cases

  • Jung, Hyunsik;Lee, Sanghun
    • The Journal of Korean Medicine
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    • v.35 no.4
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    • pp.98-103
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    • 2014
  • Objectives: Advanced malignant melanoma (MM) has a poor prognosis, with an expected 2-year survival rate of 10 to 20%. It has long been recognized as an immunogenic tumor, and is worse for elderly patients. Many studies have suggested that herbal treatments improve immune functions, but few clinical studies have reported on this topic. Patients and History: We present two cases of female patients (72 and 77 years old, respectively) with advanced MM. The 72-year-old female patient was, at first, diagnosed with MM with multiple bone metastases. She received resection of the primary lesion, but refused further chemotherapy. The 77-year-old female patient was diagnosed with cutaneous MM of the left heel, with suspicion of sentinel node lymphadenopathy; however, she also refused any conventional treatment due to old age. Course of Therapy and Results: Both patients were exclusively treated with standardized allergen-removed Rhus verniciflua stokes (aRVS) extract combined with Bojungikki-tang (BT, Bu-Zhong-Yi-Qi-Tang in Chinese or Hochu-ekki-to in Japanese). Both patients are still alive and doing well (Feb. 2014), demonstrating that the 72-year-old patient has lived for 27 months and the 77-year-old patient has lived for 31 months without disease progression since the aRVS and BT administration. Conclusion: We suggest that the combination of aRVS extract and BT could be a candidate for overcoming the cancer's immunoediting process especially for elderly MM patients intolerant of conventional treatment.

A Case Report of Sibak-tang Effectiveness in an Elderly Patient with Sputum and Dysphagia after Conventional Treatment for Pneumonia (폐렴 양방 치료 종료 후 지속되는 가래 및 연하장애를 주소로 하는 노인 환자의 시박탕(柴朴湯) 치험례)

  • Lim, Bo-ra;Park, Young-hwa;Cho, Jun-ho;Kwon, Do-ick
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.753-762
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    • 2017
  • Objectives: We conducted this study to report the clinical effects of Sibak-tang (Saiboku-to) in an elderly patient suffering from sputum and dysphagia after conventional treatment for pneumonia. Methods: The Sibak-tang was administered to the patient to treat sputum and dysphagia. The results were assessed by measuring the frequency of the sputum and conducting a videofluoroscopic swallowing study. Results: After about three weeks of herbal medicine treatments, the patient's symptoms of respiratory problems improved. The results of the videofluoroscopic swallowing study were also improved. Conclusion: Sibak-tang could be an effective treatment for elderly patients suffering from sputum and dysphagia after conventional treatment for pneumonia.

A study on WSN based ECG and body temperature measuring system for ubiquitous healthcare: 2. Vital signal monitoring software system (유비쿼터스 헬스케어를 위한 센서 네트워크 기반의 심전도 및 체온 측정 시스템: 2. 생체신호 모니터링 소프트웨어 시스템)

  • Lee, Dae-Seok;Chung, Wan-Young
    • Journal of Sensor Science and Technology
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    • v.15 no.6
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    • pp.417-424
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    • 2006
  • An ubiquitous healthcare monitoring system for elderly person at home was designed for continuous healthy monitoring of elderly person or patients. Human vital signals, such as ECG and body temperature, were monitored by terminal PC or PDA via ECG and temperature sensor nodes on the patient's body. From the ECG data, the heart rate, tachycardia, bradycardia and arrhythmia were diagnosed on the terminal PC or PDA to assist doctor's or nurse's aid or patient itself to monitor the patient's condition and give medical examination. Artificial judgement support system was designed in server computer and the system support a doctor or nurser for management or treatment of the patient. This system can be applied to vital signal monitoring system for solitude elderly person at self house or home health care service part. And this ubiquitous healthcare system can reduce the medical expenses in coming aging or aged society.

Protein Electrophoresis Fraction in Serum of the Rural Elderly Patient

  • Kim Chong-Ho;Park Chung-Oh;Kang Young-Tae;Park Seung-Taeck
    • Biomedical Science Letters
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    • v.12 no.3
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    • pp.197-200
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    • 2006
  • We analyzed total protein (TP), albumin (AL), aspartic aminotransferase (AST), alanine aminotransferase (ALT), urea nitrogen (UN), creatinine (CRE) and serum protein electrophoretic fractions in sera of rural elderly patients to evaluate the health status in rural elderly patients. We observed that the frequencies of patients showed lower level of total protein, albumin, and both total protein and albumin than them of reference range were 20.3%, 22.8% and 19.0%, respectively. The rates of patients showed higher level of AST, ALT, both of AST and ALT, UN, creatinine and both of UN and creatinine than them of reference range were 33.8%, 40.0%, 30.0%, 17.7%, 15.2% and 7.9%, respectively. Comparison of protein fractions of each patient to reference range showed that 77.2% of patients showed normal in all of patterns. Few of patients showed abnormal pattern in albumin (13.6%), ${\alpha}1-globulin (0.0%),\;{\alpha}_2-g10bulin(1.1%),\;{\beta}-globulin(1.9%)\;and\;{\gamma}-globulin(6.2%)$. These data suggest that many of rural elderly patients may suffer from heart, liver and kidney diseases. The serum protein fractions are not typical criterion to evaluate the disease, but production of proteins in rural elderly patients may be affected by liver disease and kidney disease.

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Anterior Lumbar Interbody Fusion with Pedicle Screw Fixation for Elderly Isthmic Spondylolisthesis

  • Lee, Dong-Yeob;Lee, Sang-Ho;Maeng, Dae-Hyeon;Jang, Jee-Soo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.175-179
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    • 2006
  • Objective : The surgical outcome of anterior lumbar interbody fusion[ALlF] with pedicle screw fixation for elderly isthmic spondylolisthesis was analyzed. Methods : Consecutive nineteen elderly patients [aged 65 years or more] with isthmic spondylolisthesis [Grade I or II] who underwent single level ALIF with pedicle screw fixation in 2002 were analyzed. Using clinical chart and mailed questionnaires, preoperative and postoperative Visual Analogue Scale[VAS] of back and leg pain and postopertive Macnab criteria were evaluated. Results : The mean age at the time of operation was 68.4 years [range 65 to 78 years]. Twelve patients underwent ALIF with percutaneous pedicle screw fixation. Seven patients underwent ALIF followed by posterior decompression and pedicle screw fixation. The postoperative complication rate was 10.5% [wound dehiscence in 1 patient and incisional hernia in 1 patient]. There was no postoperative major morbidity or mortality. At a mean follow-up duration of 30.7 months [range 25 to 35 months], 93.3% [14/15] of the patients showed excellent or good outcomes in terms of Macnab criteria. The mean VAS scores of back pain and leg pain significantly decreased after surgery. Conclusion : ALIF with pedicle screw fixation yielded favorable results for elderly isthmic spondylolisthesis in selected cases.

A Study of Depression and Quality of Life in Family Care Givers of the Stroke Elderly Patient (뇌혈관질환 노인을 돌보는 가족원의 우울과 삶의 질에 영향을 미치는 요인에 관한 연구)

  • Roh Kuk hee
    • Journal of Korean Public Health Nursing
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    • v.14 no.1
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    • pp.41-60
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    • 2000
  • This study was designed and undertaken to identify the related factors of family caregivers' depression & quality of life with stroke elderly patient. The data was collected from August 16th to September 5th. 1999. The subjects in this study were 70 caregivers and 70 patients with stroke who were hospitalized in 2 oriental medicine hospitals and 3 hospitals located in Junla-buk do. The data was analized using percentage. means. t-test. ANOVA and pearson's correlation coefficients, step-wise multiple regression done with the SAS program. The results of this study are as follows; 1. The score for family caregivers' depression was 45.2 when total score was 80. The family caregivers who got more than 50 scores belongs to highly depression group amount to $29\%$. 2. The score for family caregivers' quality of life was 37.04 when total score was 56. 3. In the significant relationship between family caregivers' depression and general characteristics of the family caregivers ; age. sex, income. In the significant relationship between family caregivers' quality of life and general characteristics of family caregivers: age, education, income. In the significant relationship between family caregivers' depression and quality of life and general characteristics of stroke elderly patient ; sex. 4. The depression degree showed significant differences in the variables of family caregiver's physical health(r=-0.307, p=0.011), stress(r=0.463. p=0.011). social support (r=-0.241. p=0.046) and elderly stroke patient's ADL(r=-0.313, p=0.009). The quality of life degree showed significant differences in the variables of family caregivers' depression(r=-0.564, p=0.001), stress(r=-0.322, p=0.008), social support (r=0.353. p=0.003). 5. The most important variable affecting family caregiver's depression was caregivers' physical symptom which accounted for $32.0\%$ of the total variance in which multiple regression analysis. Total variance affecting the family caregivers' depression was $49\%$. The most important variable affecting family caregivers' quality of life was caregivers' depression which accounted for $48\%$ of the total variance in which multiple regression analysis. Total variance affecting the family caregivers' quality of life was $61\%$.

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Stroke after the Procedure of Lumbar Facet Joint block and Lumbar Epidural Block -Case reports- (요부 추간관절차단 및 요부 경막외차단 후 발생한 뇌졸증 -증례 보고-)

  • Lee, Hyo-Keun;Kim, Sung-Mo;Han, Kyung-Ream;Lee, Jong-Moo;Ko, Seok-Shin;Kim, Chan
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.131-133
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    • 1997
  • Number of elderly patients requiring nerve blocks have been increasing in recent years. We had two elderly patients who suffered stroke one day and three days after lumbar facet joint block and lumbar single epidural block respectively. Both patients due to their advanced age had potential risk factor to suffer one or more of the following; stroke, hypertension, and diabetes mellitus. Due to our experience with these patients, we suggested the following: (1) Nerve blocks should be reconsidered for elderly patient who posesses a potential risk factor to suffer a stroke. (2) Prior to invasive block administration of mild sedatives or analgesics may provide beneficial effects for patients with hypertension. (3) Adequately informed consent must be fully discussed time of consultation with patient scheduled for nerve block especially for elderly and risky patient.

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