1,721,017 research outputs found
National General Health Screening Program in Korea: history, current status, and future direction: A scoping review
No full textHealth screening is an important component of health promotion programs, and countries have promoted general health screening targeting the prevention and early management of common chronic diseases. In Korea, a General Health Screening Program (GHSP) began with workers in the 1950s and continuously expanded its target population, and currently includes the adult population. The main target diseases are cerebroand cardiovascular diseases, including hypertension, diabetes mellitus, dyslipidemia, obesity, and related health behaviors. Other target conditions include other diseases (e.g., anemia, liver disease, visual/auditory impairment), mental health (e.g., depression), and geriatric disease and function (osteoporosis, dementia, risk of fall, etc.). The National Health Information Database, including GHSP information, is now extensively used in clinical and public health research. The participation rate is currently 70% to 80%, but varies according to age, disability, and the socioeconomic status. There is a need for a more systematic evaluation of the screening items, reducing disparity gaps in participation, and linking GHSP to actual health promotion.N
Use of Exploratory Graph Analysis in Inspecting the Dimensionality of the Revised University of California Los Angeles (R-UCLA) Loneliness Scale Among Older Adults
No full text© 2023 Lee, Park, Cho.Exploratory graph analysis (EGA) based on network theory has been introduced as a highly reliable and effective method to assess scales dimensionality. We estimated the dimensional network structure of the Revised University of California Los Angeles Loneliness Scale using EGA among a cross-sectional cohort of Korean older adults living alone (N = 1,041). We also evaluated the stability of estimates using a bootstrap version of EGA (bootEGA) and verified the overall fit structure using confirmatory factor analysis (CFA). EGA revealed a two-dimensional structure of the scale initially. The bootEGA result revealed that Item 4 (I do not feel alone) did not sufficiently load on any dimension, and Item 20 (There are people I can turn to) was replicated in two or more dimensions. Removing these items resulted in better stability of the dimensions, leading to excellent structural consistency. CFA confirmed a satisfactory fit of the improved structure.Y
COVID-19 Patients with Mild Symptoms or without Symptom Using Residential Treatment Center Model
No full textBACKGROUND: The rapid rise in coronavirus disease worldwide has drastically limited the availability of hospital facilities for patients. Residential treatment centers were opened in South Korea for the admission of asymptomatic or patients with mild symptoms. This study discusses the appropriateness of the admission criteria set by the centers in a pandemic situation, the prioritization of patients for admission, and ways to minimize the risk of self-isolation. METHODS: A total of 217 low-risk patients (n=217) were admitted to the Nowon Residential Treatment Center between August 22 and October 14, 2020. The following criteria were met at the time of admission: patients (1) were asymptomatic or had mild symptoms, (2) had either a controlled or no underlying chronic disease, and (3) did not need oxygen treatment. Among them, 202 patients who were eligible for inclusion in the study were retrospectively investigated through periodic interviews. RESULTS: Of the 202 patients, 153 satisfied the criteria for symptomatic isolation standards, and 25 for asymptomatic isolation standards. The clinical conditions of 24 patients were aggravated, and these patients were transferred to other hospitals, among which 12 had persistent fever and 13 were suffering dyspnea with oxygen saturation (SpO(2)) <95%. CONCLUSION: In the event of another large-scale epidemic, it would be appropriate to prioritize accommodating patients who are elderly or have underlying diseases and self-isolate young patients with no underlying diseases and provide them with SpO(2) meters and thermometers to self-measure SpO(2) and body temperature
Older adults' perceptions of age-friendliness with an emphasis on community supports and health services in a city in South Korea
No full textPurpose: This study tries to comprehend older adults' perspectives of community supports and health services in a South Korean city and identify important sociodemographic and health characteristics that affect their perspectives. Methods: 166 older adults were involved in this cross-sectional study. Questions on background characteristics and community supports and health services criteria (categorized as service accessibility, offer of services, voluntary support, or emergency care planning) based upon the WHO's Age-Friendly Cities Guide were used. The data were analyzed using paired and independent t-tests, one-way ANOVA, and hierarchical multiple regression analyses. Results: emergency care planning was rated as the most important by the participants (mean age=76.24 years, 22.9% male), while its current level of performance was lowly appraised (p < .001). The rated importance for each category differed based on individual characteristics. Depression (p=.016), older age (p=.012), and restricted network type (p=.039) were significantly related to ascribing a higher degree of importance to community services. Conclusion: Community initiatives are warranted to optimize emergency care for older adults. This planning must be based on the unique characteristics of older adults in coordination with supportive resources. In addition, comprehensive assessments are warranted before implementing action plans to ensure that the multi-dimensional problems of older adults are incorporated.N
Effects of smoking cessation and weight gain on cardiovascular disease risk factors in Asian male population
No full textObjective: Smoking cessation leads to both beneficial and harmful changes in cardiovascular disease (CVD) risk factors. The basis of the harmful changes, however, is unknown. Our objective was to determine whether they are associated with the weight gain that accompanies smoking cessation. Methods: Study subjects were male cigarette smokers aged at least 30 years who visited the Health Promotion Center of Seoul National University Hospital between 1995 and 2007 repeatedly with a 1- to 3-year interval between first and second visit. Self-reporting questionnaires gathered clinical and socioeconomic characteristics on the initial visit, and CVD risk factors (blood pressure, fasting blood glucose, and serum lipid profile) were measured on both the visits. Results: We compared the CVD risk factors between smoking quitters and smoking continuers. The quitters were more likely than the continuers to have harmful health changes such as increase in body weight (P < 0.01), in systolic blood pressure, and in serum levels of total cholesterol, LDL-cholesterol, and non-HDL cholesterol (P < 0.05). When stratified by body weight change, quitters who had gained more than the median (1.3 kg) were more likely than those who had not to have increase in blood pressure (P < 0.01) and in serum levels of total cholesterol, triglycerides, non-HDL cholesterol, and fasting glucose (P < 0.05). Conclusions: Harmful changes in CVD risk factors associated with smoking cessation were mainly secondary to weight gain. To reduce the risk of cardiovascular disease in quitters, therefore, more attention should be focused on preventing weight gain. (c) 2009 Elsevier Ireland Ltd. All rights reserved.OAIID:oai:osos.snu.ac.kr:snu2010-01/102/0000052039/8SEQ:8PERF_CD:SNU2010-01EVAL_ITEM_CD:102USER_ID:0000052039ADJUST_YN:YEMP_ID:A077862DEPT_CD:801CITE_RATE:4.086FILENAME:24_Effects of smoking cessation and weight gain.pdfDEPT_NM:의학과EMAIL:[email protected]_YN:YCONFIRM:
Leveraging network analysis to determine sex differences in factors associated with frailty among older adults living alone
Get PDFBACKGROUND: Frailty is a complex geriatric syndrome typically characterized by multiple underlying etiological factors. We determined the contributing factors, by sex, using a network analysis. METHODS: The study sample consisted of a cross-sectional cohort of community-dwelling older adults aged ≥ 65 years living alone in a Korean city (N = 1,037). Frailty was assessed via the Korean Frailty Index. Participants were assessed for sociodemographic, health-related, mental and cognitive, and social characteristics. Mixed graphical models including all variables were estimated using the R-package mgm discretely by sex. We also used the Walktrap cluster algorithm to identify differences in the network structure in terms of connectivity around frailty between the sex groups for further insights. RESULTS: In both the networks for males and females, frailty correlated most strongly with nutritional status, presence of complex chronic disease, and self-efficacy, and exhibited proximity to decreased sleep quality and loneliness. However, frailty showed an association with suicidal ideation and the number of falls per year only in males, whereas it showed an association with functional disabilities only in females. The overall network connectivity around frailty was stronger with dense interactions (more edges) in the network for females than for males. CONCLUSIONS: The results signify the need for sex-group customized multi-domain assessments and interventions for the prevention and improvement of frailty among community-dwelling older adults
A Pilot Study of Machine Learning–Based Algorithms to Assist Integrated Care for Older Community-Dwelling Adults
No full textAs life expectancy increases, there is a growing consensus on the development of integrated care encompassing the health and daily activities of older adults. In recent years, although the demand for machine learning applications in healthcare has increased, only a few studies have implemented machine learning-based systems in integrated care for older adults owing to the complex needs of older adults and the coarseness of the available data. Our study aims to explore the possibility of implementing machine learning decision-support algorithms in the integrated care of older community-dwelling adults. Our experiment uses secondary data based on the community-based integrated service model. Such data were collected from 511 older adults through 162 assessment items in which tailored services were selected from 18 available services. We implemented four machine learning models: decision tree, random forest, K-nearest neighbors, and multilayer perceptron. The area under the receiver operating characteristic curve results of the four models were decision tree = 0.89, K-nearest neighbors = 0.88, random forest = 0.93, and multilayer perceptron = 0.88. The results suggest that machine learning-based decision-assisting algorithms can improve the quality of tailored services for integrated care with intensive involvement of face-to-face tasks by reducing the simple, repetitive tasks of care managers.N
Analysis of Continuity of Care and Its Related Factors in Diabetic Patients: A Cross-Sectional Study
No full textBACKGROUND: Continuity of care in primary care settings is crucial for managing diabetes. We aimed to statistically define and analyze continuity factors associated with demographics, clinical workforce, and geographical relationships. METHODS: We used 2014–2015 National Health Insurance Service claims data from the Korean registry, with 39,096 eligible outpatient attendance. We applied multivariable logistic regression to analyze factors that may affect the continuity of care indices for each patient: the most frequent provider continuity index (MFPCI), modified-modified continuity index (MMCI), and continuity of care index (COCI). RESULTS: The mean continuity of care indices were 0.90, 0.96, and 0.85 for MFPCI, MMCI and COCI, respectively. Among patient factors, old age >80 years (MFPCI: odds ratio [OR], 0.81; 95% confidence interval [CI], 0.74–0.89; MMCI: OR, 0.84; 95% CI, 0.76–0.92; and COCI: OR, 0.81; 95% CI, 0.74–0.89) and mild disability were strongly associated with lower continuity of care. Another significant factor was the residential area: the farther the patients lived from their primary care clinic, the lower the continuity of diabetes care (MFPCI: OR, 0.74; 95% CI, 0.70–0.78; MMCI: OR, 0.70; 95% CI, 0.66–0.73; and COCI: OR, 0.74; 95% CI, 0.70–0.78). CONCLUSION: The geographical proximity of patients’ residential areas and clinic locations showed the strongest correlation as a continuity factor. Further efforts are needed to improve continuity of care to address the geographical imbalance in diabetic care
Effectiveness of a community-based integrated service model for older adults living alone: A nonrandomized prospective study
No full textObjective: Older adults living alone face physical, emotional, and social health problems, and prefer to age in place (AIP) in their homes. A community-based integrated model for AIP is needed and few studies have identified its impact on older adults living alone. Methods: This was a non-randomized prospective study. Participants were 877 community-dwelling older adults living alone, aged above 65 years, in S* city in South Korea. The intervention group (n = 331) received a community-based integrated service (CBIS) model based on AIP for six months from October 2019 to April 2020. Results: Scores on frailty (beta =-0.377, p < .001), loneliness (beta =-1.897, p = .018), and health-related quality of life (beta = 4.299, p = .021) significantly improved in the intervention group. Among the intervention group, loneliness scores significantly improved among participants aged under 80 years than those aged over 80 years. Conclusion: The CBIS model improved frailty, loneliness, and quality of life in community-dwelling older adults living alone. (c) 2021 The Author(s). Published by Elsevier Inc.Y
Psychosocial risk profiles among older adults living alone in South Korea: A latent profile analysis
No full textObjectives. This study explored the psychosocial risk profiles and various characteristics associated with profile membership among Korean older adults living alone. Methods. Our analyses were based on a cross-sectional cohort of 1030 community-dwelling older adults (>= 65 years) living alone in one Korean city. Latent profile analysis was used to identify psychosocial risk profiles across a wide range of psychosocial dimensions (depressive symptoms, suicidal ideation, cognitive dysfunction, loneliness, and perceived social support). We then explored the characteristics associated with distinct profiles by conducting bivariate and regression analyses. Results. The three-profile was selected as the best solution: a group with high cognitive dysfunction, high loneliness, and low social support (profile 1), a group with low psychological risks and high social support (profile 2), and a group with high depression and high suicidal ideation (profile 3). Regression analyses showed that a lower frequency of interaction with neighbors or families, a greater frailty score, and lower quality of life were significantly associated with profile 1 or profile 3 than with profile 2 (p < .05). Further, being male and having a poorer nutritional status was more significantly related to profile 3 than profile 2 (p < .05). Conclusions. Findings provide evidence for healthcare professionals when developing interventions to prevent and reduce these psychosocial risks for older individuals living alone. In particular, factors associated with profile membership identified in the study may facilitate more tailored interventions.Y
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