Purpose: This study aimed to investigate the effectiveness of preoperative patient-controlled analgesia(PCA) education program on older patients with spine surgery. Methods: A quasi-experimental research with a non-equivalent control group pretest-posttest design was conducted to investigate the impact of a PCA education program before surgery on postoperative pain, pain knowledge and attitudes, and frequency of additional analgesic use. The sample size for experimental and control group was 55 respectively. Results: The experimental group, which underwent the PCA education program, had lower postoperative pain scores compared to the control group. Furthermore, the experimental group exhibited a higher level of knowledge on PCA (p<.001) and more positive attitudes toward analgesic use (p<.001). While there was a significant difference in the use of opioid analgesics for additional pain relief between two groups (p<.001), there was no significant difference in the use of non-opioid analgesics. Conclusion The implementation of the PCA education program was found to increase knowledge and positive attitudes on the use of PCA. Moreover, it significantly alleviated pain, particularly during physical activity, within initial 48 hours after spinal surgey in older patients. Therefore, the findings of this study supported that the PCA education program could be used as a preoperative intervention to alleviate postoperative pain for older patients with spinal surgery.

Purpose: The purpose of this study was to verify influencing factors affecting service quality provided by caregivers working for the elderly with dementia. Methods: Data were collected using a self-reported questionnaire from 214 caregivers in a long-term care facility in D city. The data were analyzed with service quality, dementia knowledge, work value, and job performance confidence. For data analysis, the descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression were performed using SPSS/WIN 21.0 program. Results: There were significant differences in service quality depending on the health status. Factors influencing service quality were work value, and job performance confidence with R2 value of 38%. The highly influencing factors were work value, and job performance confidence. Conclusion The results of this study indicate that the effort to improve the service quality of caregivers should focus on work value and job performance confidence.

Arrhythmias occurring during surgery are mostly benign and improve without special treatment, but sometimes life threatening and poor vital signs may require immediate antiarrhythmic or electrotherapy. In some cases, permanent arrhythmias may require continued treatment after surgery. A cardiac event occurred to a 28-year-old man who underwent Bile duct resection/Roux-en-Y hepaticojejunostomy due to cholelithiasis with cholecystitis and choledocholithiasis. He diagnosed mental retardation level 2. Pre-operation laboratory test is normal except liver function test (AST 64, ALT 141). Electrocardiography shows 57 bpm heart rate, sinus rhythm, first degree AV block and long corrected QT interval that was checked 462ms and echocardiography shows LVEF 67%, normal echocardiogram. When we prepared extubation after finishing operation, Sugammadex 200mg was injected. Suddenly, patient’s oxygen saturation was low at 85%. We started manual ventilation for oxygenation and saturation was increased at 100%. When we extubated endotracheal tube, his ECG changed NSR to idiopathic VT. Firstly we considered that is PSVT and infused adenosine 6mg twice and 12mg once. But arrhythmia was continuous and vital sign changed unstable. We performed reintubation and defibrillated at 200J. After defibrillation, arrhythmia converted sinus rhythm. We transferred the patient to the ICU and evaluated further to see if the patient had heart problems. During admission in ICU, attending surgeon tried to extubate endotracheal tube 2 more times. But, Idiopathic VT occurred whenever try to extubate. Finally, in the fourth attempt, extubation without occurrence of VT succeeded with continuous IV esmolol and dexmedetomidine.

Arrhythmias occurring during surgery are mostly benign and improve without special treatment, but sometimes life threatening and poor vital signs may require immediate antiarrhythmic or electrotherapy. In some cases, permanent arrhythmias may require continued treatment after surgery. A cardiac event occurred to a 28-year-old man who underwent Bile duct resection/Roux-en-Y hepaticojejunostomy due to cholelithiasis with cholecystitis and choledocholithiasis. He diagnosed mental retardation level 2. Pre-operation laboratory test is normal except liver function test (AST 64, ALT 141). Electrocardiography shows 57 bpm heart rate, sinus rhythm, first degree AV block and long corrected QT interval that was checked 462ms and echocardiography shows LVEF 67%, normal echocardiogram. When we prepared extubation after finishing operation, Sugammadex 200mg was injected. Suddenly, patient’s oxygen saturation was low at 85%. We started manual ventilation for oxygenation and saturation was increased at 100%. When we extubated endotracheal tube, his ECG changed NSR to idiopathic VT. Firstly we considered that is PSVT and infused adenosine 6mg twice and 12mg once. But arrhythmia was continuous and vital sign changed unstable. We performed reintubation and defibrillated at 200J. After defibrillation, arrhythmia converted sinus rhythm. We transferred the patient to the ICU and evaluated further to see if the patient had heart problems. During admission in ICU, attending surgeon tried to extubate endotracheal tube 2 more times. But, Idiopathic VT occurred whenever try to extubate. Finally, in the fourth attempt, extubation without occurrence of VT succeeded with continuous IV esmolol and dexmedetomidine.

Background: A high hematocrit level in patients with erythrocytosis is linked with increased blood viscosity and increased risk of thromboembolism. Therefore, it is necessary to adequately lower the hematocrit level before performing a high-risk surgery. Case: A 67-year-old man was scheduled for aortic valve replacement due to severe aortic stenosis. The preoperative hematocrit level of this patient was very high due to secondary polycythemia by hypoxia. We decided to perform acute normovolemic hemodilution after anesthetic induction to reduce the risk of thromboembolism in the patient. The patient was discharged after a successful surgery and a post-operative period without any side effects. Conclusions We estimate that patients with secondary polycythemia may benefit from acute normovolemic hemodilution to reduce their hematocrit levels while undergoing cardiac surgery using cardiopulmonary bypass. However, it is necessary to control the hematocrit level, since a significant decrease can cause side effects.

Purpose: This study was conducted to examine the effects of the oral care program for improving swallowing function of the elderly using welfare centers on depression, self efficacy, subjective oral health status and swallowing related quality of life. Methods: The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol (IMP) and was based on Mead’s symbolic interaction theory and Bandura's self efficacy theory. A non equivalent control group pre and post-test design was conducted on a total of 37 elderly people (experimental group: 19, control group: 18) from D city. The oral care program was administered to the experimental group once a week for five weeks, totaling five times, and the exact program ran for 50 minutes. The collected data were analyzed using the SPSS/WIN 25.0 program. Results: Following the intervention, subjective oral health score, and swallowing related quality of life were significantly improved in the experimental group. Conclusion The oral care program presented in this study was found to be effective in increasing subjective oral health status, and swallowing related quality of life for the elderly using welfare centers.

Purpose: This study was conducted to investigate the factors affecting the discrimination of the elderly using welfare centers. Methods: A cross-sectional study was conducted with 217 elderly people from a welfare center in D city. Data were collected using a self-administered questionnaire survey consisting of ageism experience, social participation attitude, social support, and empowerment. For data analysis, descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression were performed using SPSS/WIN 21.0 program. Results: As a result of analyzing the correlations among the variables, the discrimination experience of the elderly showed negative correlations in social participation attitude and child relationship support. The factors affecting the discrimination experience of the elderly include gender, job, smartphone use, and child relationship support had a significant effect. The explanatory power of the discrimination experience of these factors was 15.4%. Conclusion This study found that gender, job, social support, and smartphone use were factors influencing the discrimination experience of the elderly. It is hoped that public relations and policy measures should be considered.

OBJECTIVES: The purpose of this study was to evaluate the psychometric properties of the Korean version of the Richmond Compulsive Buying Scale (RCB-K). METHODS: Participants (n=598) included patients recruited through an online panel survey. For the semantic adaptation step, the scale was translated into Korean and then back-translated to English by one psychologist, one public health professional, one psychiatrist who could speak both Korean and English, and one professional translator, without communication between those involved. A confirmatory factor analysis was performed to test whether the factor structure of the RCB-K was consistent with the English version. Convergent validity was assessed by correlating the RCB-K scores with those of other scales (i.e., O'Guinn & Faber's Compulsive Buying Scale, Problem Gambling Inventory). RESULTS: The factor structure of the RCB-K was consistent with the two-factor structure established for the original RCB. Cronbach's α was high (0.906), indicating that the reliabilities of the items in each subscale were satisfactory. The RCB-K score was significantly correlated with those for the O'Guinn & Faber's Compulsive Buying Scale (r=0.7) and the Problem Gambling Inventory (r=0.422). CONCLUSION: The results of the present study indicate that the RCB-K is an effective and valid scale for evaluating the severity of compulsive buying. The findings suggest that the RCB-K is a promising assessment tool for use in the treatment and study of online compulsive buying behavior.
Gambling ; Humans ; Psychiatry ; Psychology ; Psychometrics ; Public Health ; Reproducibility of Results* ; Semantics ; Weights and Measures

Parricide, the crime of murdering a parent, accounts for about 5% of all homicides. Filicide is the crime of murdering one's own child. This study aimed to review demographic features and criminal characteristics of individuals who committed parricide and filicide in Republic of Korea (ROK). This study is based on data from the Korea Police Crime Analysis System, from 2006~2013. We assessed the diverse characteristics of both victims and perpetrators. Over the selected period, 381 parents were killed by their children and 230 children were killed by parents in the ROK. Parricides caused by schizophrenic murders accounted for 39.6% of all cases. Moreover, approximately 44.4% of the perpetrators attempted suicide following the maternal filicide. In our findings, psychiatric illness was a very important predictor in parricide, and these further suggest that young mothers with severe mental illness require careful monitoring by mental health support service.
Child ; Crime ; Criminals ; Homicide ; Humans ; Korea ; Mental Health ; Mothers ; Parents ; Police ; Republic of Korea ; Schizophrenia ; Suicide, Attempted

BACKGROUND AND PURPOSE: The objective of this study was to determine the benefits of cognitive training in patients with amnestic mild cognitive impairment (aMCI) and those with early Alzheimer's disease (AD). METHODS: Eleven patients with aMCI and nine with early AD (stage 4 on the Global Deterioration Scale) participated in this study. Six participants with aMCI and six with AD were allocated to the cognitive training group, while five participants with aMCI and three with AD were allocated to a wait-list control group. Multicomponent cognitive training was administered in 18 weekly, individual sessions. Outcome measures were undertaken at baseline, and at 2 weeks and 3 months of follow-up. RESULTS: In the trained MCI group, there were significant improvements in the delayed-recall scores on the Seoul Verbal Learning Test at both the 2-week and 3-month follow-ups compared with baseline (baseline, 1.6+/-1.5; 2 weeks, 4.4+/-1.5, p=0.04; 3 months, 4.6+/-2.3, p=0.04). The phonemic fluency scores (1.0+/-0.8 vs. 5.0+/-1.8, p=0.07) and Korean Mini-Mental State Examination scores (18.8+/-0.5 vs. 23.8+/-2.2, p=0.07) also showed a tendency toward improvement at the 2-week follow-up compared to baseline in the trained AD group. CONCLUSIONS: This study provides evidence of the effectiveness of cognitive training in aMCI and early AD. The efficacy of cognitive training programs remains to be verified in studies with larger samples and a randomized design.
Alzheimer Disease ; Cognitive Therapy ; Follow-Up Studies ; Humans ; Memory ; Mild Cognitive Impairment ; Outcome Assessment (Health Care) ; Verbal Learning