• 보건행정학회지
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• 제9권1호
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• 한국사회복지학
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• 제37권
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• pp.171-193
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• 1999

본 연구는 1990년대 들어 점차 심각해지고 있는 산재장애인의 재취업실태를 살펴보고, 재취업에 영향을 미치는 요인을 밝혀, 산재보험 재활서비스 체계의 강화하기 위한 개입방안을 제시하고자 하는 데 목적이 있다. 조사대상자는 1996년과 1997년 산재보험 장해보상금 종결자 중 신규장해판정자 1,060명이며 조사방법을 전화면접조사를 사용하였다. 본 연구를 통해 밝혀진 주요 결과를 보면, 첫째, 산재장애인의 재취업율은 자영업을 합쳐 약 28.6%로 전체 응답자의 약 1/3에도 못미치는 낮은 수준이었다. 둘째, 신체적 손실을 나타내는 장해등급 뿐만 아니라 일상생활능력정도 역시 재취업에 유의한 영향을 미치는 것으로 나타났는데, 이는 재취업에 있어 신체적 손상을 보완해 줄 수 있는 재활공학서비스의 중요성을 보여준다. 셋째, 재취업에 있어 신체적인 요인뿐만 아니라 자신의 장애를 수용하는 시기나 자신의 장애를 인식하는 점도 등과 같은 심리적인 요인도 유의한 영향을 미치는 것으로 나타나 재취업에 있어 사회심리적 재활프로그램의 필요성울 확인할 수 있었다. 넷째, 직업재활서비스 이용여부는 재취업에 유리한 영향을 미치지 못하는 것으로 나타났는데, 이는 현재 장애인 직업재활프로그램의 비효과성 측면과 더불어 직업재활프로그램의 저조한 참여에서 기인한 결과로 보인다. 이러한 결과를 통해 얻을 수 있는 함의는, 우선적으로 현재의 산재보험에서 투자하는 재활사업비를 확대하는 방안이 필요하며, 재활공학서비스의 연구개발사업을 활성화시키고, 현재의 산재보험 직업재활훈련체계를 재정립하고 프로그램 개발하는 등의 노력과, 사회심리재활서비스의 산재보험 수가화를 통한 확대, 개별상담원 도입 등의 방안 등을 적극적으로 검토해야 할 필요가 있다는 점이다.

• 근관절건강학회지
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• 제22권2호
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• pp.105-113
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• 2015

Purpose: The purpose of this study was to examine the effects of the new version of the arthritis self-management program (ASMP) developed by the Korean Society of Muscle and Joint Health. Methods: A total of 150 patients with osteoarthritis (OA) were participated in a 6-week self-arthritis management program provided once a week in 3 community health centers. Each session took 1.5 hours. This study measured present health status, frequency of fall during last 3 months, pain, difficulties in activity of daily living, exercise-related efficacy, flexibility of both arms, balance, and health-related quality of life. Results: After a 6-week program, pain, difficulties in ADL, present health status, exercise-related efficacy, health-related quality of life, flexibility of both shoulders, and balance were significantly improved. Conclusion: The results showed the possibility of the 6-week ASMP program in improving health state, physical function, and health-related quality of life in patients with OA.

• 대한한의학회지
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• 제19권2호
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• pp.296-312
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• 1998

BACKGROUND The purpose of this study was to find out predictors influencing on the clinical course of stroke during the first 4 weeks after the onset through statistical research, especially whether the blood glucose level after stroke and the stroke with Diabetes Mellitus correlate with functional impairments and neurological outcome or not. METHOD During 7 months period(from 1-1-1997 to 7-31-1997), 32 selected patients prognosed as acute cerebral thrombosis were studied by using Modified Barthel Index, PULSES profile in an attempt to correlate Diabetes Mellitus and hyperglycemia(more than $120mg/d{\ell}$, $150mg/d{\ell}$) with functional impairment and neurological outcome and to evaluate the influence of sex, the side of hemiparesis and age at admission, 1 week and 4 weeks after admision(admitted within 2 days after the onset). RESULT 1. The sex, side of hemiparesis and age had no significant effect upon functional impairment during first 4 weeks after the onset, but recurrent-stroke resulted in significantly higher degree of functional impairment than first-stroke during first 4 weeks after the onset. 2. The patients with Diabetes Mellitusin in acute cerebral thrombosis resulted in significantly higher degree of functional impairment than the patients without Diabetes Mellitus in acute cerebral thrombosis during first 4 weeks after the onset. 3. The patients with hyperglycemia in acute cerebral thrombosis resulted in significantly more severe neurological outcome than the patients without hyperglycemia in acute cerebral thrombosis within 2 days after the onset. CONCLUSION The study suggested that recurrent-stroke and Diabetes Mellitus were the poorer prognosis factors of functional impairment in acute cerebral thrombosis patients during first 4 weeks after the onset. and the poorer prognosis factor of neurological outcome in acute cerebral thrombosis patients was hyperglycemia within 2 days after the onset.

• 대한한방내과학회지
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• 제38권5호
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• pp.628-640
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• 2017

Purpose: To describe the effectiveness of traditional Korean medicine (TKM) on the patients with secondary dementia (case 1: Rt. MCA infarction; case 2: traumatic subacute subdural hemorrhage and traumatic intracranial hemorrhage; case 3: delayed encephalopathy after carbon monoxide poisoning). Methods: We used a complete TKM treatment. The acupoints used were as follows: acupoints frequently used in hemiparesis (GV20, GV24, ST4, LI11, LI14, ST36, GB34, SP9, and LR3), and we used herbal medicine (補腎益腦湯加味, Boshiniknoe-tang-gami). The efficacy was evaluated using the Mini-Mental State Examination for Dementia Screening (MMSE-DS) and the Modified Barthel Index (MBI). Results: After treatment, the total MMSE-DS score was increased from 14 to 24 (case 1), 14 to 19 (case 2), and 0 to 17 (case 3). The total K-MBI was increased from 30 to 44 (case 1), 82 to 86 (case 2), and 30 to 86 (case 3) Conclusions: We suggest that TKM could positively influence cognition and improve activity of daily living (ADL). This study has limitations, so further studies are needed.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.199-214
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• 1996

노인들의 인지기능과 우울에 관련이 있는 요인을 알아보기 위해 대전시 및 대전시의 인근지역의 노인들 729명을 대상으로 MMSE 및 GDS를 이용한 면접조사를 실시하고 자료를 분석한 결과는 다음과 같다. 1. 조사대상군의 인지기능은 정상이 56.8%, 치매가 의심되는 경도장애가 24.1%, 치매가 거의 확실 한 중증의 장애가 19.1%로 나타났으며, 인지기능에 장애가 심할수록 우울의 정도가 증가하였다. 2. 연령이 증가함에 따라 인지기능은 감소하였으며, 남자보다는 여자에서 인지기능 및 우울증상의 정도가 높게 나타났다. 3. 연령의 효과를 보정한 후 인지기능 장애여부에 관련이 있는 요인은 성, 배우자 유무, 교육정도, 과거직업, 도구적 일상생활능력, 규칙적 운동, 외출빈도와 신체적 증상 중 흉부통중, 시력 및 청력장애, 어지러움증이었다. 4. 연령효과를 보정한 후에 유의한 관련성이 있는 변수를 이용한 회귀모형에서 도구적 일상생활 능력, 연령, 시력장애, 성, 집밖 외출의 요인이 통계적 유의성을 보였다. 5. 단계적 회귀분석을 통해 우울점수에 유의한 관련성을 보인 변수는 교육수준, 집밖 외출과 직업 활동 및 집안일의 참여, 규칙적 운동, 도구적 일상생활능력, 주관적으로 평가한 본인의 건강과 영양상태, 신체적 증상으로 어지러움증, 시력장애 및 흥부통증이었다. 이상의 결과를 볼 때 조사대상 노인들에 있어서 인지 기능과 우울에 관련성이 높은 주된 특성은 신체적 활동 능력과 주관적으로 평가된 건강상태라고 볼 수 있다.