• Title/Summary/Keyword: 기능장애 사정

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Convergence Study on the Corelation between Upper Limb Muscle Strength and Cognitive Function in Older Korean Adults (한국 노인의 상지근력과 인지기능 사이의 상관관계 융복합 연구)

  • Choi, Wonjae
    • Journal of the Korea Convergence Society
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    • v.11 no.2
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    • pp.37-43
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    • 2020
  • The aim of this study was to examine the relationships between upper limb muscle strength and cognitive function in older Korean adults. A total of 130 Community-dwelling older adults, who were able to independently conduct activities of daily living, participated in the study. We assessed upper limb muscle strength using a handgrip strength and arm curl test, and their cognitive function using a Montreal cognitive assessment (MoCA) and general practitioner assessment of cognition (GPCOG) tests. Out of 130 participants, 26 (20%) had normal cognitive functions, while 104 older adults (80%) had mild cognitive impairments (MCI). Handgrip strength was significantly different between older adults with and without MCI (p<.05) and was related to MoCA and GPCOG (p<.05). In the result, there is a correlation between physical ability and cognitive function of the older adults. Therefore, it is necessary to develop exercise program to improve mental health.

Pain Assessment in Nonverbal Older Adults with Dementia (언어적 의사소통이 어려운 치매환자에서의 통증 사정)

  • Kim, Hyun Sook;Yu, Su Jeong
    • Journal of Hospice and Palliative Care
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    • v.16 no.3
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    • pp.145-154
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    • 2013
  • This study was performed to evaluate the existing pain assessment methods including the tools developed for use with nonverbal older adults with dementia, and to suggest recommendations to clinicians based on the evaluations. Computerized literature searches published after year 2000 using databases - Google scholar, RISS, KoreaMed, Medline, ScienceDirect, CINAHL - were done. Searching keywords were 'pain', 'pain assessment', and 'cognitive impairment/dementia'. The pain assessments for non-communicative dementia patients who are unable to self-report their pains are often made using the assessment tools relying on the observation of behavioral indicators or alternatively the strategy of surrogate reporting. While several tools in English version and only one in Korean are suggested for the pain assessments based on the observation of behavioral indicators, none are commonly used. In this review, we selectively evaluated those tools known to show relatively higher degree of validity and reliability for nonverbal older adults with dementia, namely, CNPI, DOLOPLUS 2, PACSLAC, PAINAD, and DS-DAT. It is hoped that the present review of selected tools for assessing pain in those vulnerable population and the general recommendations given be useful for clinicians in their palliative care practice. And future studies should focus on enriching the validation of the useful tools used to observe the nonverbal patient's behavioral indicators for pain in Korean.

Pain, Disability, Emotional Status and Educational Needs between Acute and Chronic Low Back Pain Groups (급·만성 요통 환자군의 통증, 기능장애, 정서 상태 및 교육 요구)

  • Ahn, Ji-Hye;Kim, Hee-Seung;Kim, Hye-Jin
    • Journal of Korean Biological Nursing Science
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    • v.21 no.1
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    • pp.77-84
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    • 2019
  • Purpose: This study aimed to identify pain, disability, anxiety, depression and educational needs between acute and chronic low back pain groups. Methods: A total of 153 patients aged 18 to 64, recruited from S-neurosurgical clinic for low back pain in Gyeonggi-do. Out of 153 subjects, 70 were Acute Low Back Pain (ALBP) group and 83 were Chronic Low Back Pain (CLBP) group. The collected data was analyzed using the SAS System V 9.4 program by chi-square test/Fisher's exact test and t-test. Results: The pain and disability scores were higher in ALBP group while the depression score was higher in CLBP group. The educational needs score in the area for the time for lumbar operation was higher in CLBP group. In the Low Back Pain (LBP) treatment management, ALBP group visited clinic (60.0%) most frequently and CLBP group visited both clinic & traditional medicine (66.3%) regularly. Conclusion: In order to minimize the progression from acute to chronic LBP, it is necessary for patients who visited the clinic to be accompanied with an education program that reflects educational needs of patients and with proven alternative therapy.

Changes in the Concept of Disability and its Implications for Social Work Practice (장애개념의 변화와 사회복지실천 현장 함의)

  • Kim, Yong-Deug
    • Korean Journal of Social Welfare
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    • v.51
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    • pp.157-182
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    • 2002
  • This study attempts to identify the changes in social reactions to disabilities in general, and to research the contextual implication of these changes in social work practice in Korea. In the early years after the Industrial Revolution, disability was conceived as social unfitness and it was assumed that the cause and responsibility could be attributed to people with disabilities. But, in the midst and late 20th century, social responsibility for people with disabilities was argued and generally accepted. As the results of these changes, conceptual models explaining disabilities have changed gradually; there has been a transition, so called, from individual model to social model. In a similar vein, WHO has refined the definition and classification of disability. Related to these changes, social welfare service paradigm for people with disabilities has shifted. This paradigm shift can be explained with the perspective of strength approach, empowerment approach, case management and independent living model. In Korea, 1998 Act on welfare for people with disabilities meant that social service for the disabled were categorized with, namely, residential service, community rehabilitation service and vocational rehabilitation service. Recently, the extent of these services has been rapidly broadened. In these situation, this study researched to identify the implications on social work practice in the context of changes in social response, conceptual model, definition and also service paradigm. Such as the followings are enumerated for the implications: disabled person's participation in assessment process, development of assessment tools focusing on social and environmental perspectives, reinforcement of information service helping self-determination, supporting on formal and informal helping network, expanding self-help programs and, finally, a shift from displacement model to support model.

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The Guide System for Wheel Chair User's Safe Movement (휠체어 사용자의 안전 이동을 위한 안내 시스템)

  • Jun, Se-hong;Noh, Yong-Deok
    • Proceedings of the Korea Information Processing Society Conference
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    • 2010.11a
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    • pp.369-372
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    • 2010
  • 휠체어 사용자의 이동을 방해하는 요소에는 도로의 경사도, 보도 턱과 같은 물리적인 장벽이 있다. 하지만 물리적 장벽을 직접적으로 제거하기에는 한계가 있고, 힘든 곳들도 많다. 이러한 도로사정 속에서 휠체어 사용자들의 이동상의 어려움을 줄이기 위해 목적지까지 안전하게 이동 가능한 길에 대한 정보를 제공하는 시스템, 가디안을 제안한다. 가디안은 웹 상의 지도 서비스에 수치지도의 정보를 추가하여 도로 경사도 및 기타 장애시설의 정보를 제공한다. 또한, 도로마다 색상의 농도에 따른 안전함의 정도를 표시하고, 사용자 참여기능을 이용하여 도로의 돌발상황 상태를 입력하고 확인할 수 있으며, 보호자와의 실시간 연결 기능을 통해 혼자서 이동하는 두려움을 제거하여 안전한 이동의 완성도를 추구하였다. 여기서는 가디안 시스템의 구조 및 구현을 보인다.

A study on environmental status, FIM and Illness intrusiveness of home stayed stroke patients (재가 노졸중 환자의 환경상태, 기능적 독립, 질병으로 인한 장애영향에 관한 연구)

  • Kim, Keum Soon;Roh, Kook Hee
    • 한국노년학
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    • v.25 no.2
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    • pp.143-154
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    • 2005
  • This study was conducted to examine the environmental status, FIM(Function Independence Measure), Illness intrusiveness of home stayed stroke patients. Data were collected on 145 patients living in K city and the neighborhood located in southern part of Korea. The data were analyzed by means of SPSS program. Results : In assessment of environmental safety, 46.2%(67) felt unsafe around their residential area. The most dangerous facilities in their residence was stairs(58.2%), gas/electric facilities(14.9%). For sanitary problems, 28.2%(41) felt they have problems at their home. The most important problems were outdoor polluted toilet(22.0%) and scattered and dirty residential circumstances(22.0%). The average FIM score was 74.52(4.14) of total score 126(7). In motor area FIM was lowest at stair walking(3.01) and bathing(3.16). In cognitive area FIM was lowest at social activities(3.36). The mean score of Illness intrusiveness was 58.86(4.52) of total score 91(7). The major area largely impacted by stroke were health(5.61), working(5.68), active leisure activities(5.56). There was significant reverse correlation between FIM and illness intrusiveness(r=-0.66, p=0.00). Conclusion : It was needed environmental improvement and rehabilitation program for stroke patients, and repeated follow up study.

Case Manager's Perception and Practices of Case Management Process at Community Psychiatric Rehabilitation Centers -Focused on the community psychiatric rehabilitation centers in Busan- (사회복귀시설 사례관리자의 사례관리 과정에 대한 인식과 수행에 관한 연구 -부산지역 사회복귀시설의 사례관리를 중심으로-)

  • Kim, Sun-Joo;Kim, Gyo-Jung
    • The Journal of the Korea Contents Association
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    • v.13 no.1
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    • pp.221-233
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    • 2013
  • This study aims to explore how to cognize and perform case management process to community psychiatric rehabilitation center in Busan area. The case of case manager for 12 people obtained by conducting focus group interviews were in-depth analysis. Many commissioned by a variety of human service organizations in the contract and the client-centric intake has been received. Assessment, rather than a function of mental disabilities center service needs, planning difficulties in securing resource discovery and felt. Intervention phase focuses on direct service and when several agencies responsible for the case management approach. The possession of responsibility was unclear. Mainly monthly facilities within the checking step checks are being made, there was a desire for the realistic-supervision. Completion stage expectations showed a performance evaluation oriented, and individualized case management that can be represented well on the rating scale.

The effects of Moxibustion Therapy on Chronic Low Back Pain, Daily Living Disability and Sleep Pattern in Elderly Women (뜸요법이 여성노인의 만성요통, 일상생활기능장애 및 수면양상에 미치는 효과)

  • Kim, Hye-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.301-310
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    • 2016
  • This is a nonequivalent control group non-synchronized experiment research to verify the effect of moxibustion therapy on efficient management of daily living disabilities and sleep patterns in elderly women with chronic low back pain. Total 12 sessions of moxibustion therapy were applied to elderly women(30 subjects in an experimental group and 30 subjects in a control group) in G City once a week for 12 weeks from March 15th to May $31^{st}$ 2015. Then the follow-up study was conducted 2 weeks after the post survey. For moxibustion, was applied to Shen-shu, Ashi point, Ta chang shu, Yang kuan and Yosu. 5 sheets of moxibustion were applied to 7 acupuncture points of Mugeukboyang moxibustion; Zu san li & Chu chi, Chung wan, Chung chi & Shui tao, Fei shu, Kao hung and Tien shu, Wijung respectively and experimental treatment was conducted. For assessing the degree of back pain, Visual Analog Scale(VAS) developed by Scott & Huskisson(1979) was used and for measuring the degree of daily living disability, Oswestry Disability Index, which was developed by Fairbank et al(1980) and translated and revised by Yim, Hyeon-sul et al.(1998), was used. For measuring sleep patterns, the sleep pattern measurement tool developed by Oh, Jin-su, Song, Mi-soon and Kim, Sin-mi(1998) was used. For data analysis, SPSS/WIN 18.0 was employed and Chi-square test, t-test and repeated measures ANOVA were performed. There were significant differences in pain score(F=2510.32, p<.001), daily living disability score(F=1937.82, p<.001) and sleep pattern score((F=15.54, p<.001) of elderly women that were provided with moxibustion therapy, compared to the control group. Therefore, it was found that moxibustion therapy made a positive contribution to reduction in pain and daily living disabilities and improvement in sleep quality. Based on this study finding, there is a need to apply moxibustion therapy to elderly people with chronic low back pain as a nursing intervention in future.

Health and Nutrition Status of Grandparents on Grandparents-Grandchildren Family in Rural Area (농촌지역 조손가정 조부모의 건강과 영양상태)

  • Cho, Yoo-Hyang
    • Journal of agricultural medicine and community health
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    • v.34 no.2
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    • pp.244-255
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    • 2009
  • Objectives: This study was to identify and test the health and nutritional status of grandparents in grandparents-grandchildren family in rural area. Methods: The subjects of this study were 70 grandparents of grandparents - grandchildren family in Muan-Gun. The collected data were analyzed by descriptive statistics, regression analysis. Results: The average age of grandparents was 70.1${\pm}$6.6 years old, unhealthy of the subjective health status was 55.7%, MNA score was 21.0${\pm}$3.5 points and 62.2% of the grandparents were shown to have malnutritonal status. The ADL, IADL, depression and fall index of health status were significantly related to the relationship with gender(p<.01), age(p<.05), economic(p<.01) and educational level(p<.01), and partnership(p<.01). MNA score was significantly related to the relationship with acute disease(p<.05), ADL(p<.001), IADL(p<.01), cognitive function(p<.01) and gender(p<.01). And the health status variables and general characteristics were positively correlated while the relationships were positive between health status variables and MNA score. Conclusions: With the above findings, grandparents of grandparents-grandchildren family have the problems of health and nutritional status. Then health and nutritional intervention program for grandparents-grandchildren family is needed to serve.

The Study on the Relationship Between the Duration of Chest Vibration prior to Endotracheal Suctioning and the Changes in Oxygen Saturation in Low-Birth-Weight Infants (저체중아에 있어 기관내 흡인전 흉부진동법의 기관과 산소포화 변화간의 관계 연구)

  • Ahn, Young-Mee
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.597-607
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    • 1995
  • 1960년대 이후 인공호흡기(mechanical ventilator)의 보급과 최근 의료과학의 발달, 간호의 질적 향상의 결과로 저체중출생아를 포함한 고위험 신생아의 생존율이 높아져왔다. 호흡장애증후군(RDS)은 일차적으로 폐포의 완전한 확장을 위해 필요한 계면활성물질(surfactant)의 부족, 미발달된 심폐기능에 의한 병리적 현상으로 저체중아의 가장 큰 원인이 되어왔다. RDS로 인해 인공호흡기에 의존해 있는 저체중아의 경우 적절한 산소공급과 이를 위한 호흡의 유지는 치료의 가장 큰 핵심이 되며, 이를 위한 기관내 흑은 비인두 흡인 (nasopharyngeal suction)은 신생아 중환자실(NICU)의 가장 중요한 간호행위가 되어왔다. 인공호흡기를 위한 기관삽관은 그 자체가 기도의 성모운동을 방해하고 기침반사를 억제시켜 폐 분비물의 효과적 배출을 억제하며, 특히 저체중아의 경우 조산과 관련하여 미발달된 흥곽운등과 심폐기능은 폐분비물의 이동을 저해하는 요소이다. 따라서 기도내의 분비물의 이동을 효과적으로 하여 흡인 시에 최대한의 효과를 돕기 위해 흥곽 물리요법(chest physiotheraphy : CPT)의 한 형태인 흉곽진동법 (Chest Vibration : CV)가 행해져 왔다. 그러나 저체중아를 위한CV의 임상적 적용은 그 대상의 생리적 특성, CV의 적용부위(site)와 기간(duration)에 대한 과학적 근거 없이 만성감염이나 폐질환을 가진 성인이나 cystic fibrosis환자를 위한 CV protocol을 무분별하게 채택하여 저체중아에게 행하여져 왔다 이에 본 연구자는 저체중아에 대한 CV의 안전성을 평가하고, 이에 기초하여 저체중아에게 바람직한CV의 형태를 알아보고자 본 연구를 시작하였다. 연구설계는 CV의 안전성을 평가하기 위한 실험연구이다. CV의 안전성은 RDS치료의 가장 일차적 목표인 oxygenation변화에 의해 평가될 수 있으므로, 본 실험 연구에서는 Pulse oximeter에 의해 계속적으로 측정된 산소포화 변화(oxygen saturation change)를 측정하였다. 실험대상은 미국동부에 위치한 대학병원의 NICU에 입원하여 RDS와 관련된 호흡장애로 인공호흡기에 의존해 있는 10명의 저체중아였다. 인공호흡기에 의존된 모든 저체중아는 Pulse oximeter와 심폐기능 측정기(cardiopulmonary monitor)에 의해 산소공급과 호흡상태가 계속 측정되고 있었다. 실험대상의 평균 출생시 몸무게는 평균 1,3050gm(SD=580.6)이었고, 임신월령 은 평균 28.6주(SD=3.1)였다. RDS가 그들의 일차적 진단명이었고, 그중 4명은 pneumonia, atelectasis의 합병증을 가지고 있었다. 10명중 6명은 intermittent mandatory ventilation(IMV)의 형태로, 4명은 continuous positive airway pressure(CPAP)의 형태로 인공호흡기에 의존되어 있었고 CV시의 FiO2는 평균 42.3(SD=21.2)였다. CV는 중환아용 소형진동기 (minivibrator)를 이용해 가각 10명 의 간호사에 의해 행하여 졌고, 최소 22초에서 최대 100초 동안 실시되었다. 50%의 간호사는 30초에서 40초간 CV를 실시하였으며, CV의 적용부위도, 전후 흉곽부위, 혹은 병변이 있는 좌 우측, 흑은 양쪽 흉벽 등으로 다양했고, 적용방법도 원형으로 돌려가며(circular motion), 혹은 아래에서 위로, 혹은 아무런 기준없이 간호사의 기호에 따라 다양하게 적용되었다. 산소포화의 변화는 CV가 행해지기 전.후로 5초동안 관찰되었다. 연구의 결과, 산소포화 변화는 비 모수통계(non parametric statistics)의 일종인 Matched Paired Wilcoxon test로 분석 한 결과 CV후에 3%의 감소를 보였다(P<.05). 저체중아에 있어 산소포화의 3%감소는 임상적으로 중요한 의미가 없다고 사료되어지며, 실제 흡인전의 과도호흡에 의해 CV를 행하기 이전의 산소공급수준으로 돌아 왔다. CV실시 기간과 산소포화와의 상관관계는 비 모수통계인 Spearman rho correlation coefficient를 이용하여 분석하였는데, 이 두 변수는 서로 관계가 없는 것으로 나타났다(P>.05) 또한 CV와 흡인 후에 각각의 간호사들에게 CV를 필요로 한 저체중아의 기준, 적용부위, 기간, 방법등에 대한 기준을 물었으나 대상의 특성에 따른 간호사정에 의존하기보다는 간호사 각자의 선호하는 방법이나 습관에 라 행하는 것으로 나타났다. 결론적으로 CV와 산소포화 변화와의 관계, NICU에서 관찰된 CV의 임상적 적용을 기초로 저체중아에게 안전한 CV protocol은 신생아용 소형 진동기를 이용하여, 양쪽 흉곽의 늑골하측 변연 부위(low lateral costal margin)에서 시작하여 흉골 중앙부위 방향으로 30초 동안 진동기를 적용하는 것이 좋은 것으로 나타났다. 이에 CV의 효과를 평가하기 위한 보다 과학적인 접근방법으로, CV와 흡인의 결과인 가래(sputum)에 대한 연구를 제언하는 바이다.

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