• Title/Summary/Keyword: 중증장애환자

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Intervention of Swallowing Disorder in Dementia Patient: A Systematic Review (치매환자의 삼킴장애 중재에 관한 체계적 고찰)

  • Park, Chi-Soo;Ham, Min-Joo;Hong, Deok-Gi;Yoo, Doo-Han
    • Therapeutic Science for Rehabilitation
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    • v.11 no.1
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    • pp.21-33
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    • 2022
  • Purpose : The purpose of this study was to establish scientific evidence though a systematic review, of the existing interventional methods and their respective effects, for swallowing disorders among dementia patients. The interventional methods were based on patient characteristics. Methods : An electronic literature search was performed using five electronic databases from 2010 to 2020. The keywords were 'Dementia', 'Alzheimer disease', 'Deglutition disorder', 'Swallowing disorder', 'Dysphagia'. Five articles met the inclusion criteria. Results : One study with moderate-to-severe and four studies with severe dementia patients were included. The interventions consisted of one remedial intervention, three compensatory interventions, and one comprehensive intervention. Compensatory intervention, including behavioral and psychological management, were used in moderate-to-severe patients. For the severe patients, remedial, compensatory, and comprehensive intervention were used to address the feeding tube problem. The interventions used in each study had a positive effect on the outcome variables associated with swallowing ability. Conclusion : The purpose of the intervention and the intervention factors changed depending on the patient's dementia stage. The intervention was effective when considering the progressive stage of the patient. These results may serve as a guide in designing effective interventions for swallowing disorders in dementia patients.

Effects of Meaning-Centered and Mindfulness-Based Stress Management Program with Using Marine Resources on the Improvement of Emotion, Sleep Quality, Quality of Life and Cognitive Function in Family Caregiver of Patients with Severe Physical Disability : Preliminary Study (해양자원을 활용한 의미중심, 마음챙김기반의 집단스트레스중재프로그램이 중증장애환자 간병가족의 정서, 수면, 삶의질 및 인지기능 향상에 미치는 효과 : 예비연구)

  • Yu, Jeong-A;Lee, Jae-Hon;Shin, Sun-Han;Cho, Hwi-Young;Yoo, Mee;Shin, Ho-Jin;Kim, Sung-Hyeon;Kim, Hyo-Jin;Yook, Young-Sook;Lee, Sung-Jae
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.191-201
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    • 2019
  • Objectives : The purpose of this study was to investigate the effects of meaning centered and mindfulness-based stress management program with using marine resources on positive changes in mood, sleep, quality of life and cognitive function. Methods : Nine family caregivers of patients with severe disability experienced meaning centered and mindfulness-based stress management program for four-days in marine areas near Uljin-gun, Gyeongsangbuk-do in South Korea. Subjective questionnaires and objective assessments were conducted and statistically analyzed to examine changes in mood, sleep, quality of life, and cognitive function before, after, and after 6 weeks of participation. Results : After participating in the program, moods including depression improved significantly. This effect lasted until 6 weeks. Participants' sleep quality, quality of life and cognitive function improved significantly after 6 weeks of program participation. Conclusions : This new specialized stress management program using marine resources for family caregivers of patients with severe disability is expected to be used effectively in terms of improving their overall quality of life, mental health status and cognitive efficiency.

Trends of Dental Treatment under General Anesthesia and Patterns of Repeated General Anesthesia in Children and Adolescents with Severe Disabilities (소아청소년의 전신마취 하 치과 치료의 추세변화 및 치과 영역 중증 장애 유무에 따른 전신마취 재시행 양상에 대한 연구)

  • Ahreum Lee;Hyuntae Kim;Ji-Soo Song;Teo Jeon Shin;Hong-Keun Hyun;Jung-Wook Kim;Ki-Taeg Jang;Young-Jae Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.1
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    • pp.75-88
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    • 2023
  • The aim of this retrospective study was to evaluate the demographic characteristics of pediatric dental patients who underwent dental treatment under general anesthesia (DTGA) at the Seoul National University Dental Hospital from January 2011 through December 2020 and compare the patterns of repeated DTGA between dental patients with severe disabilities (DSD) and non-DSD (healthy or medically compromised patients without DSD). There were 1,857 DTGAs among 1,719 patients (mean age = 5.1 years; males = 59.3%; ASA 2 or above = 52.9%; DSD = 26.8%). Overall, 6.6% of patients underwent repeated DTGA, and the rate of repeated DTGA over a 10-year period was 7.4%. ASA 2 or above (p < 0.0001) and DSD (p < 0.0001) were more likely to undergo repeated DRGA compared to ASA 1 and non-DSD. At both GA1 and GA2, DSD received significantly more restorative treatment on permanent teeth than non-DSD (p = 0.002, p < 0.0001, respectively). There has been an increasing demand for DTGA in pediatric dentistry over the last 10 years. Regular check-ups and preventive oral health care are necessary for pediatric dental patients with severe disabilities to reduce the possibility of repeated DTGA.

The Environmental Control System for Quadriplegics using Speech Recognition (음성인식을 이용한 중증 장애인 생활환경 제어장치)

  • Rim Jaeyong;Jung Hyuckjun;Lee Hangsei
    • Proceedings of the Acoustical Society of Korea Conference
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    • spring
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    • pp.111-114
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    • 2000
  • 척수 손상에 의한 사지마비 중증 장애인이 일상 생활을 함에 있어서 가족이나 주변인의 도움을 받지 않고서는 가전제품의 작동이나 전화 통화 등과 같은 작은 일 조차 스스로 할 수 없는 현실에서 국내 여건에 적합한 생활환경 제어장치의 개발이 필요하나 현재 이를 위한 마땅한 제어장치가 없는 실정이다. 각 가정에 널리 보급되어 있는 PC를 활용할 수 있도록 PC기반의 음성인식기를 개발하고 이를 응용한 가전제품 제어기를 개발, 제작하여 사지마비 환자 스스로 간단한 동작만으로 환자와 가족의 신체적, 정신적 부담을 감소 하고자 한다 이장치는 음성인식기 부분과 제어장치 부분 그리고 I/O 인터페이스 부분으로 구성 되어있다. 중증장애인은 이 장치를 사용하여 일상생활에서 기본적인 자유로운 생활의 영위를 도모하며 환자 가족의 부담을 줄일 수 있으며 환자와 가족 모두 심리적인 만족을 얻은 것으로 나타난다. 그러나 기기 사용을 위한 환자의 음성인식을 위한 언어학습과정의 불편함과 인식에러의 과제가 남아있다.

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Effect of a New Spirometric Reference Equation on the Interpretation of Spirometric Patterns and Disease Severity (폐활량측정법의 새로운 정상예측식이 폐활량측정법 장애 양상 및 질병 중증도 해석에 미치는 영향)

  • Oh, Yeon-Mok;Hong, Sang-Bum;Shim, Tae Sun;Lim, Chae-Man;Koh, Younsuck;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Kim, Young Sam;Lee, Sang Do
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.215-220
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    • 2006
  • Background : A spirometric reference equation was recently developed for the general population in Korea. The applicability of the new Korean equation to clinical practice was examined by comparing it with the Morris equation, which is one of the most popular reference equations used for interpreting the spirometric patterns and for grading the disease severity in Korea. Methods : Spirometry was performed on 926 men and 694 women, aged 20 years or older, in November 2004 at the Asan Medical Center, Seoul, Korea. The subjects' age, gender, height, weight, and spirometric values ($FEV_1$ [forced expiratory volume in one second], FVC [forced vital capacity], and $FEV_1/FVC$) were obtained. The spirometric patterns and disease severity were evaluated using both equations, and the results of the Korean equation were compared with the Morris equation. The spirometric patterns were defined as normal, restrictive, obstructive, and undetermined according to the level of $FEV_1/FVC$ and FVC. The disease severity was defined according to the level of $FEV_1$ level for subjects with an airflow limitation, and according to the FVC level for those subjects without an airflow limitation. Results : Spirometric patterns were differently interpreted in 22.5% (208/926) of the men and 24.8% (172/694) of the women after the application of the Korean equation compared with the Morris equation. Of the subjects with airflow limitation, disease severity was differently graded in 30.2% (114/378) of the men and 39.4% (37/94) of the women after the application of the Korean equation. Of the subjects without airflow limitation, disease severity was differently graded in 27.9% (153/548) of the men and 30.2% (181/600) of the women after the application of the Korean equation. Conclusion : Achange in the reference equation for spirometry could have an effect on the interpretation of spirometric patterns and on the grading of disease severity.

Sleep-Related Respiratory Disturbances (수면과 관련된 호흡장애)

  • Moon, Hwa-Sik
    • Sleep Medicine and Psychophysiology
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    • v.2 no.1
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    • pp.55-64
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    • 1995
  • During sleep, relatively major respiratory physiological changes occur in healthy subjects. The contributions and interactions of voluntary and metabolic breathing control systems during waking and sleep are quite different Alterations of ventilatory control occur in chemosensitivity, response to mechanical loads, and stability of ventilation. The activities of intercostal muscles and muscles involved in regulating upper airway size are decreased during sleep. These respiratory physiological changes during sleep compromise the nocturnal ventilatory function, and sleep is an important physiological cause of the nocturnal alveolar hypoventilation. There are several causes of chronic alveolar hypoventilation including cardiopulmonary, neuromuscular diseases. Obstructive sleep apnea syndrome (OSAS) is an important cause of nocturnal hypoventilation and hypoxia. Coexistent cardiopulmonary or neuromuscular disease in patients with OSAS contributes to the development of diurnal alveolar hypoventilation, diurnal hypoxia and hypercapnia. The existing data indicates that nocturnal recurrent hypoxia and fragmentation of sleep in patients with OSAS contributes to the development of systemic hypertension and cardiac bradytachyarrhythmia, and diurnal pulmonary hypertension and cor pulmonale in patients with OSAS is usually present in patients with coexisting cardiac or pulmonary disease. Recent studies reported that untreated patients with OSAS had high long-term mortality rates, cardiovascular complications of OSAS had a major effect on mortality, and effective management of OSAS significantly decreased mortality.

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Prevalence and associated factors of dysphagia in patients hospitalized with acute stroke (급성 뇌졸중 입원 환자의 연하장애 유병률과 관련요인)

  • Chang, Hee-Kyung;Yun, Suk-Kyung;Gil, Cho-Rong
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.1
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    • pp.417-428
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    • 2019
  • The aims of this study were to evaluate the prevalence of dysphagia in patients hospitalized with acute stroke and to identify factors associated with dysphagia. The study was conducted in a tertiary hospital and a total of 131 patients hospitalized with acute stroke (aged 34-92 years old, 58.0% male) were enrolled. The prevalence of dysphagia was 24.4% out of 131 participants and risk factors associated with dysphagia were age, neurological severity, oral health status, and dependence in activity of daily living of participants. Considering the long-term rehabilitation trajectory, it is necessary to apply the early screening and preventive nursing intervention for dysphagia during acute stage of stroke patient.

Depression and Anxiety in Outpatients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 우울과 불안심리 평가)

  • Ryu, Yon Ju;Chun, Eun Mi;Sim, Yun Su;Lee, Jin Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.11-18
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    • 2007
  • Background: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. Methods: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. Results: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator $FEV_1$, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. Conclusion: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.

A study on the characteristics of severe trauma patients by health insurance system (건강보험제도에 따른 중증외상 환자 특성 비교 연구)

  • Choi, Mi-Young;Lee, Hyo-Ju;Yun, Seong-Woo
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.309-313
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    • 2022
  • This study was attempted to analyze the status of emergency room use of severe trauma patients using the health insurance system and to understand their characteristics. This study used data from the 'Community-based Severe Trauma Surveillance' investigated from January 1, 2018 to December 31, 2019. As a result, there were differences in the degree of disability after injury and whether treatment(surgery, trauma embolism, transfusion) was performed according to the type of medical insurance (p< .001), it was found that there was a statistically significant difference between the degree of disability before and after damage depending on the type of medical insurance (p< .001). Reviews of the health insurance system located for the well-being of the people should be continued from various angles, and specific improvement plans should be proposed.

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Factors Related to the Disability of Stroke Patients in Gyeongju, Korea (경주지역 뇌졸중 환자들의 장애정도와 관련요인)

  • Kang, Min-Soo;Jo, Min-Woo;Lim, Hyun-Sul;Kim, Sang-Kyu
    • Journal of agricultural medicine and community health
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    • v.35 no.4
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    • pp.405-416
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    • 2010
  • Objectives: This study was conducted to evaluate factors related to the degree of disability of stroke patients in a rural community. Methods: The study subjects included 641 patients selected from 975 stroke patients over the age of 50 with brain lesion-related disabilities living in Gyeongju, Korea, an urban-rural consolidated community. The data were obtained by interviews from July to October 2008. The subjects were divided into a seriously disabled group (1st and 2nd disability grade) and mildly disabled group (3th, 4th, 5th and 6th disability grade) by degree of disability according to registered disability grade. The collected data were analyzed using the SPSS 14.0 statistical package. Results: The study subjects included 379 males (59.1%) and 262 females (40.9%), and most patients were in their 70s (256 cases, 39.9%). The seriously disabled group included 287 patients (44.8%) and the mildly disabled group included 354 persons (55.2%). Age, prehospital delayed time and number of related chronic diseases were risk factors for serious disability (p<0.05). Conclusions: Our results indicate that the degree of disability can be reduced by decreasing prehospital delayed time. We suggest that education of high risk groups and establishment of emergency services as well as a transport system for stroke patients are required to reduce the degree of disability due to stroke.