• Title/Summary/Keyword: 일상생활활동장애

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Pain Disability of Orofacial Pain Patients (구강안면통증 환자의 통증활동제한)

  • Choi, Se-Heon;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.217-225
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    • 2009
  • As Pain is a comprehensive, biopsy chosocial phenomenon, improved understanding and successful management of pain need assessment of health-related quality of life and psychological states. The purpose of this study was to evaluate pain severity and pain-related interference to daily lives for patients with non-dental, orofacial pain(OFP) and a possible relation of OFP with psychological morbidity. Relation with such factors as gender, age, pain duration and diagnosis was also assessed. Inclusion criteria was all new patients with non-dental OFP attending the oral medicine.orofacial pain clinic of Dankook University Dental Hospital over 3 months' period, who completed the questionnaires of the Brief Pain Inventory (BPI) and Hospital Anxiety and Depression Scale (HADS). Prior to the first consultation, the patients were asked to fill out the questionnaire in the waiting room and were diagnosed through consultation and clinical examination. Total subjects were 163 with M:F ratio of 1:1.5 and mean age of 34.6${\pm}$17.7 years. Mean duration of pain was 13.3${\pm}$26.2 months and all patients were divided into; Trigeminal Neuralgia group (TN, N=8), Neuropathic Pain group (NeP, N=9), Persistent Idiopathic Facial Pain group (PIFP, N=8), and Temporomandibular Disorders group (TMD, N=138), subdivided into muscle problem (TMD-m, N=73), joint problem (TMD-j, N=24) and muscle-joint combined problem (TMD-c, N=41). OFP patients showed moderate pain severity and moderate pain-related interference. There was no gender difference in overall pain severity and interference and levels of anxiety and depression. Elderly patients aged ${\geq}$ 60 years showed higher pain severity (p<0.05). Patients with chronic pain ${\geq}$ 3 months reported more increased level of anxiety and depression than those with acute pain (p<0.05). Compared to TMD patients, patients with TN, NeP and PIFP suffered from higher level of pain and pain-related interference and reported higher level of anxiety and depression (p<0.05). Pain interference was closely correlated with their pain severity and with psychometric properties such as anxiety and depression. Pain severity was weakly correlated with levels of anxiety and depression. The results suggest a need for psychosocial assessment and support for successful management of OFP in addition to control of pain itself.

Quality of Life and Related Factors in Caregivers of Attention Deficit Hyperactivity Disorder Patients (주의력결핍 과잉행동장애 환아 보호자의 삶의 질과 관련요인)

  • Jeong, Jong-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Sung-Pil
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.2
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    • pp.102-111
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    • 2005
  • Objective : The purpose of this study was to investigate the quality of life and it's related factors in caregivers of attention deficit hyperactivity disorder patients. Methods : The subjects were 38 attention deficit hyperactivity disorder patients' caregivers(mean age : $37.5{\pm}6.5$, 38 women). Patients were diagnosed with DSM-IV-TR ADHD criteria. Korean version of WHOQOL-BREF(World Health Organization Quality of Life assessment instrument Abbreviated Version) was used for assessment. Results : 1) No significant differences were found in the score of WHOQOL-BREF, overall QOL, physical health domain, psychological domain, social relationships domain and environmental domain between caregiver and control group. 2) The score of Activity of daily living facet$(3.0{\pm}0.7\;vs.\;3.6{\pm}0.7)(p=0.008)$ and self-esteem facet $(2.8{\pm}0.7\;vs.\;3.3{\pm}0.7)(p=0.049)$ were significantly decreased in caregivers of ADHD. 3) Total score of WHOQOL-BREF(r=0.437, p=0.007) and physical health domain(r=0.370, p=0.024) were correlated with caregiver's educational age. 4) In the psychological domain, the score of self-esteem facet(r=-0.337, p=0.039) and thinking, learning, memory & concentration facet(r=-.341, p=0.036) were decreased with caregiver's age. 5) The score of environmental domain were significantly increased with caregiver's educational age (r=0.482, p=0.003), but decreased with patient's age(r=0.328, p=0.044). Conclusion : Although the quality of life in caregivers of ADHD patient had not significantly decreased than control, the quality of lift were positively correlated with educational age of caregives, and negatively correlated with chronological age of caregivers and children. Above results suggest that physicians should consider integrated approaches for caregiver's subjective quality of life in the management of ADHD.

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Increase of Spoken Number of Syllables Using MIT(Melody Intonation Therapy) : Case Studies on older adult with stroke and aphasia (MIT(Melodic Intonation Therapy) 중심의 음악활동을 이용한 실어증을 가진 뇌졸중 노인의 음절 수 증가에 대한 사례 연구)

  • Hong, Do Kyoung
    • Journal of Music and Human Behavior
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    • v.2 no.2
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    • pp.57-67
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    • 2005
  • Most of stroke patients have not only physical difficulty but speech and neurological disorder because of hemiplegia and such unexpected changes cause psychologic disadaptability and absent-mindedness. Particularly, lowering of physical ability can lead to serious emotional problem from failure or frustration in daily life. Generally, treatment of patient with stroke put emphasis on physical rehabilitation but actually this patient had considerable speech disorder such as aphasia or articulation disorder. Moreover, failing of recognition function, mental disorder as hypochondria, and even visual and auditory disorder are represented. So it is effective to integrate verbal remediation and other treatments in medical care environment. In particular, patients with language disorder very often wither psychologically therefore it is efficient to use of music therapy that gives opulent emotion to aphasia patients. And primarily to investigate the effects of 10 sessions treatments; change in spoken total number of syllables, to confirm their own value by success of given task and reassure about themselves ability. All of 10 sessions stages were scored by MIT manual and its improvement were measured, that is, accomplishment was analyzed within each level in order to prove detail change of spoken total number of syllables. The result of this program organized from 2 syllables to 4 syllables is summarized as follows. Subject A completed in preliminary stage Level I, in 2 syllables case advanced to Level III in fifth session and to Level IV in seventh session, in 3 syllables case advanced to Level III in seventh session and to Level IV in ninth session, and in 4 syllables case showed 8% low success rate in first session but after repeated practice increased considerably in sixth session and in advanced to Level III in eighth session to Level IV in tenth session. Subject B also completed in preliminary stage Level I, in 2 syllables case advanced to Level III in forth session and to Level IV in sixth session, in 3 syllables case advanced to Level III in fifth session and to Level IV in seventh session, and in 4 syllables case showed 10% low success rate in first session and increased considerably in fifth session and in advanced to Level III in seventh session but could not reach to Level IV until tenth session. As a result, it was shown that music therapy using MIT was not statistically meaningful but improved spoken total number of syllables and success rate of task had improved as a whole. Therefore, music intervention using MIT it has positive affect on verbal ability of patients with Broca's Aphasia and their language rehabilitation.

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Two Cases of MELAS Syndrome Manifesting Variable Clinical Cour (다양한 임상경과를 보인 멜라스(MELAS, mitochondrial encephalopathy, lactic acidosis, and stroke-like episode) 증후군 2례)

  • Choi, Seo Yeol;Lee, Seung-Ho;Myung, Na-Hye;Lee, Young-Seok;Yu, Jeesuk
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.2
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    • pp.102-108
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    • 2016
  • Mitochondrial encephalopathy, lactic acidosis, and stroke-like episode (MELAS) syndrome is one of mitochondrial encephalopathy. As the early clinical manifestations can be variable, it is important to suspect the disease, especially in patients with multiple organ dysfunctions. A boy was diagnosed with epilepsy when he was 9 years old. Two years later, severe headache and blurred vision developed suddenly. On examination, left homonymous hemianopsia was detected with corresponding cerebral parenchymal lesions in right temporo-occipito-parietal areas. MELAS syndrome was confirmed by genetic test, which showed m.3243 A>G mitochondrial DNA mutation. Multivitamins including coenzyme Q10 were added to anticonvulsant. He experienced 4 more events of stroke-like episodes over 5 years, but he is able to perform normal daily activities. A 13-year-old boy was brought to the hospital due to suddenly developed respiratory arrest and asystole associated with pneumonia. Past medical history revealed that he had multiple medical problems such as epilepsy, failure-to-thrive, optic atrophy, and deafness. He has been on valproic acid as an anticonvulsant which was prescribed from local clinic. He recovered after the resuscitation, but his cognition and motor function were severely damaged. He became bed-ridden. He was diagnosed with MELAS syndrome by brain MRI, muscle biopsy, and clinical features. Genetic test did not reveal any mitochondrial gene mutation. Four years later, he expired due to suddenly developed severe metabolic acidosis combined with hyperglycemic hyperosmolar nonketotic coma. The clinical features of MELAS syndrome are variable. Early diagnosis before the presentation to the grave clinical course may be important for the better clinical outcome.

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Changes in Reaction Time during Mental Rotation of Three-Dimensional Objects for Chronic Hemiparetic Stroke (3차원 물체의 심상회전이 만성 편마비 뇌졸중 환자의 반응시간에 미치는 영향)

  • Lee, Jeong-Weon;Ahn, Si-Nae;Hwang, Su-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.3
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    • pp.1114-1121
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    • 2012
  • There is a cause and effect relationship in that brain injury causes impairment of mental rotation and ultimately independent functional activities. The purpose of this study was to compare the effects of mental rotation on reaction time and precision between the normal adults and chronic hemiparetic stroke patients. Thirty-one patients with chronic hemiparetic stroke and twenty normal adults participated in this study. The participants conducted 2 types of tasks for mental rotation: a comparison task using mirror images, and a rotation task using angular disparity images for 2 different 3-dimensional objects. Each of the 3 possible angled shapes ($90^{\circ}$, $180^{\circ}$, and $270^{\circ}$) appeared in each pair. The test consisted of 6 mirror-reflected image pairs and 6 angular disparity image pairs visualized during angular rotation, and 12 test periods. The subjects were judged on how accurately and rapidly they could distinguish between the mirrored and non-mirrored pairs. The study measured reaction time and precision to compare the effect of mental rotation tasks. Reaction time during all 3 angular conditions were significantly longer in the stroke patients than that in the normal adult during the comparison tasks and the rotation tasks. In addition, precision during mental rotation tasks was not significantly different between normal adults and stroke patients. Our results suggest that rehabilitation therapists should keep in mind that mental rotation is more difficult in stroke population than in normal adults.

A Study on Actual state and Influencing Factors of Internet Addiction in Upper Class of Elementary School Children (초등학교 고학년 학생의 인터넷 중독 실태와 중독 요인 연구)

  • Lim, Mi-Ran;Goh, Byoung-O
    • Journal of The Korean Association of Information Education
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    • v.10 no.1
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    • pp.107-115
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    • 2006
  • As the use of computers and the Internet become more commonplace, many children are using the Internet. The Internet is rapidly permeating into the daily lives of elementary school students. There are some positive effects of using the Internet: it helps children's studies and communication skills and relives stress. However, some negative effects are arising, such as aggressive behavior caused by Internet games, sleeping disorders, and Internet addiction. The goal of this disquisition was to find out how an upper class of elementary school children are using the Internet and also the degree of their Internet addictions. The effects that Internet addiction had on various aspects, such as on the individual, family, and school were observed. In the individual aspect, self-respect, self-control, awareness of stress, depression, and personal taste were observed. In the aspect of family, communication with parents, the nursing behavior of parents, family functions, friendliness within the family, and the family's emotional support were observed. In the aspect of school, relationships with teachers, relationships with friends, study activities, compliance to rules and participation in events were observed. By analyzing each cause of Internet addiction, this disquisition hopes to help prevent Internet addiction and to support educational guiding about Internet addiction of elementary school children.

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Health Status of Institutional Elderly in a Rural Area (일부 농촌지역 시설노인의 건강상태)

  • Nam, Hae-Sung;Park, Kyeong-Soo;Rhee, Jung-Ae
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.291-299
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    • 1999
  • This study was conducted to evaluate the health status including mainly cognitive function and activities of daily living of institutional elderly in a rural area. We studied 466 subjects dwelling in ten institutions at Chonnam province, Korea. The participants consist of 148 males(31.8%) and 318 females(68.2%). We collected the information of socioeconomic state, mini-mental state examination(MMSE), activities of daily living(ADL), instrumental activities of daily living(IADL), and Dartmouth Primary Care Cooperative Information Project(COOP) chart. The results were followed: 1. Severe cognitive function impairment was appeared in 45 males(30.4%) and 115 females(36.2%). 2. The percentage of fully independent in the six ADL items was 50.0% of males and 42.8% of females, but 31.1% of males and 26.1% of females were fully dependent. 3. Males had more impairment in mode of transportation among IADL, but females had most impairment in laundry. 4. Observing health status by COOP chart, both had more grade in feeling and social activity than physical fitness.

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A Rationale for Instrumental Music Playing for Upper Extremity Rehabilitation in Subacute Stroke (아급성 뇌졸중 환자의 상지재활을 위한 악기 연주의 임상적 활용 근거 연구)

  • Jeong, Eunju
    • Journal of Music and Human Behavior
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    • v.10 no.1
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    • pp.1-23
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    • 2013
  • Upper extremity dysfunction is a common consequence following stroke. Spontaneous recovery during the first six months post-stroke is rigorous and considered as a significant indicator of potential long-term progress. Various approaches have been utilized to regain functional upper limb movement necessary for independent living; however, conventional therapy approaches have failed to prove consistency, especially for subacute stroke patients. There is, thus, a need for innovative therapeutic strategies that motivate stroke survivors to facilitate neural and functional recovery during the critical window immediately following stroke. The effect of music on physical enhancement has been frequently reported in the field of medicine as well as neurorehabilitation. The efficacy of rhythm on lower extremity deficits has been well established. Yet, the rationale for using instrumental music making enhancing subacute upper extremities rehabilitation is not clearly described to date. Based on the key mechanism of music as sensori-motor movement facilitator, this paper reviews previous empirical research that utilized music-based interventions for upper extremity rehabilitation for stroke patients, either in the form of receptive or expressive activity. This paper, further, focuses on the current research trends in subacute stroke upper limb rehabilitation and provides applicable rationale of using instrumental music playing.

Factors Influencing the Fear of Falling among Community-dwelling Elderly in Korea (지역사회 재가노인의 낙상 두려움 예측요인)

  • Park, Nan Ju;Shin, Yong Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.6
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    • pp.278-287
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    • 2019
  • This study was conducted to identify the predictors influencing fear of falling in community-dewelling elderly. A secondary data analysis was performed using data of 65 years or older elderly who participating in the 2014 Korean Elderly Survey(Jun. 11th ~ Sep. 4th 2014). Multivariated logistic regression analysis was used to identify the risk factors of fear of falling. 81.5% of the elderly had fear of falling. There were significant factors, sex(OR=2.87, p<.001), education(OR=1.73, p<.001), presence of cohabiting spouse(OR=1.19, p<.001), experience of falling(OR=6.35, p<.001), arthritis(OR=1.83, p<.001), depression(OR=2.25, p<.001), cognitive deficit (OR=1.24, p<.001), instrumental activities of daily living (OR=1.98, p<.001), exercise(OR=1.29, p<.001) and the number of chronic diseases(over 3: OR=2.53, p<.001, 1~2: OR=1.73, p<.001), predicting fear of falling in community-dwelling elderly. Fear of falling was associated with multifactorial condition, and arthritis was an important factor in chronic disease. This study will provide fundamental information on programming and a policy proposal related to fear of falling.

Determinants of Demand for Long-Term Care (장기요양서비스 수요의 결정요인)

  • Chung, Wankyo
    • KDI Journal of Economic Policy
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    • v.31 no.1
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    • pp.139-167
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    • 2009
  • A new public insurance for long-term care was introduced in July 2008 to provide for the rising demand for long-term care as the population is aging rapidly. The demand for long-term care is expected to rise further because more and more elderly are living alone or in households with only other elderly, such as his/her spouse, without informal care of their adult children. Even when the elderly are living together with their adult children, daughters and daughters in law, once the main informal care-givers, are not available because they choose to become economically active and work more over time. Experiences of countries such as Japan and Germany with similar public long-term care insurance scheme highlight the importance of detailed analysis on the demand for long-term care for the financial stability of the insurance scheme. Countries which had underestimated the demand for long-term care at the time of adopting the scheme went through financial instability of insurance schemes. This study analyzes the determinants of the demand for long-term care using data from the second demonstration project (April 2006~April 2007) of the long-term care insurance scheme for the elderly in Korea. Taking full advantage of detailed data on the long-term care, this paper analyzes the eligibility for the long-term care insurance scheme and its use. According to study results, even when common diseases among the elderly such as cancer, diabetes, arthritis, dementia, hypertension, etc. are controlled together with other individual and socioeconomic factors, limitations the elderly are faced with in their twelve activities of daily living significantly affect the eligibility for the Korean Long-term Care Insurance Scheme. This means that limitations in daily living activities are more critical than common diseases among the elderly are to the eligibility for the Korean Long-term Care Insurance Scheme. Bathing and toileting problems have been found to be the most important factor affecting the eligibility for the insurance scheme, followed by eating, dressing and moving around inside the house. Moreover, the choices of whether to use long-term care and which to use between home care and institutional care are found to be significantly influenced by health status and various socioeconomic factors of the elderly. In particular, those with more limitations in daily living activities and the female elderly are more likely to use long-term care and institutional care rather than home care. As for home care users, those living alone or with adult children and those with monthly household income of more than 500,000 won are more likely to use home care. Most importantly, even when the monthly household income of the elderly is controlled, the elderly recipients of the National Basic Living Security, who are not charged for long-term care, are more likely to choose home care. This implies that price as well as income is a critical factor for the decision to use long-term care. Further study on the duration of long-term care use will surely enhance the long-term care policy, when panel data is available for simultaneous analysis of the likelihood of long-term care use and its use duration.

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