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Journal of the Korean Geriatrics Society 2007;11(1):1-8.
Published online March 31, 2007.
Results of 'Short-Form Comprehensive Geriatric Assessment' Application to Elderly Outpatients
Eun Jung Cho, Se Jun Park, Jai Eun Lee, Jun Seok Lee, Mee Young Kim, Jong Lull Yoon
Department of Family Medicine, Hallym University College of MedIcine, Seoul Korea. lull@hallym.ac.kr
외래 노인 환자에 대한 ‘단순형 포괄적 노인기능평가도구’ 적용의 결과
Abstract
BACKGROUND
The importance of comprehensive geriatric assessment(CGA) for the frail elderly can not be overemphasized. Recently, with increasing elderly population and patients, there are increasing need for simplified CGA tool for evaluation of general health and functional status during the limited time in outpatient clinic. This study was conducted to estimate the effectiveness of the 'Short-form Comprehensive Geriatric Assessment' for detecting hidden medical problems beside preexisting diseases.
METHODS
78 outpatients aged 65 or more who revisited to outpatient clinic in a Social Welfare Center answered questionnaires and were examined of the 'Short-form Comprehensive Geriatric Assessment. This screening tool included vision, hearing, arm and leg function, urinary incontinence, nutrition, mental status, depression, ADL, IADL and social support. These results were compared with patients' previous medical records.
RESULTS
Among the total 78 subjects, visual difficulty was detected in 63(80.8%)(Rt. eye)/67(85.9%)(Lt. eye). Right hearing difficulty was shown in 8(10.3%) subjects and left hearing difficulty was shown in 4(5.1 %) subjects. There were 2(2.6%) upper extremities dysfunctions and 25(32.1%) lower extremities dysfunctions. 24(30.8%) subjects had depression. The geriatric depression and age and number of disease showed positive correlations. These problems found by assessment tool were not identified on previous medical records.
CONCLUSION
Using the 'Short-form Comprehensive Geriatric Assessmen', we could find the new medical problems besides preexisting disease. These findings stress effectiveness and importance of routine application of screening 'Short-form Comprehensive Geriatric Assessment' on daily outpatient clinical practice to improve quality of medical care for the elderly patients.
Key Words: Elderly, Outpatients, Comprehensive geriatric assessment, Screening, Geriatric depression
초 록
연구배경: 노인 환자의 증가에 따라 외래에서 제한된 시간에 노인 환자의 전반적 건강상태의 평가를 위해 포괄적 노인평가가 중요하게 되었다. 본 연구에서는 노인 환자에 대한 포괄적 건강평가의 선별검사를 위해 고안된 ‘단순형 포괄적 노인기능평가도구’가 실제 임상외래에서 기존의 질환 외에 새로운 의학적 문제점들을 발견해 내는데 효과적인지를 파악하고자 하였다.

방법: 2006년 3월 1일부터 2006년 6월 30일까지 노인복지관 진료실을 방문한 65세 이상의 노인 환자 78명을 대상으로 하여, ‘단순형 포괄적 노인기능평가도구’를 이용하여 설문조사와 문진, 신체검사와 의무기록지 조사를 시행하였다.

결과: 대상자 78명 중 시력에서 이상 소견을 보인 경우는 우안 63명(80.8%), 좌안 67명(85.9%)이었고, 청력에 이상 소견을 보인 대상자는 우측 8명(10.3%), 좌측 4명(5.1 %)이었다. 상지기능에 이상을 보인 대상자는 2명(2.6%), 하지기능은 25명(32.1%)이었으며, 우울증을 보인 노인 환자는 24명(30.8%)이었고, 우울증은 대상자들의 연령, 질환의 개수와 상관관계를 보였다.

결론: 노인건강상태의 선별검사로서 ‘단순형 포괄적 노인기능평가도구’를 이용하여 기존의 질환 외에 간과되었던 의학적 문제들을 발견할 수 있었다. 노인 환자 진료 과정에 ‘단순형 포괄적 노인기능평가도구’를 활용한다면, 보다 효율적인 진료가 이루어질 수 있을 것이다.



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