• Title/Summary/Keyword: ADL: Activities of Daily Living

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Effect of Muscle Strength Training on Urinary Incontinence and Physical Function: A Randomized Controlled Trial in Long-term Care Facilities (시설거주 노인여성을 위한 근력강화 훈련이 요실금과 신체기능에 미치는 효과)

  • Kang, Hyekyung;HongSon, Gwi-Ryung
    • Journal of Korean Academy of Nursing
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    • v.45 no.1
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    • pp.35-45
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    • 2015
  • Purpose: This study was done to determine whether muscle strength training programs have an impact on improving symptoms of urinary incontinence (UI) and physical function among elderly women with UI who reside in long-term care facilities. Methods: A randomized controlled trial was conducted. Participants had to be over 65 years, score over 15 score on the mini-mental state examination, and be able to walk alone or with an assistant. Seventy residents were randomly allocated to either the training group (n=35) or control group (n=35). The program consisted of 50 minutes, twice a week for 8 weeks, and included Kegel's exercise, Thera-band training and indoor walking. Main outcomes were UI symptoms, peak vaginal pressure and physical functions measured with timed up and go test (TUG), one leg standing test (OLST), activities of daily living (ADL) and grip strength. Changes in outcome measurements were calculated from baseline to 4 weeks and to 8 weeks using repeated measures ANOVA. Results: There were significant differences in peak vaginal pressure (p<.001), TUG (p<.001), OLST (p=.012) and grip strength (p<.001) in the interaction between groups and time. Conclusion: Future studies are suggested to confirm the effect of muscle strength training in long-term care facilities where elderly women with UI reside.

A meta-analysis of intervention studies on the effects of self-management in knee osteoarthritis (무릎 골관절염 대상자에게 적용한 자가관리 중재의 효과 메타분석)

  • Kim, Young-Il;Park, Jeong Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.1946-1956
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    • 2015
  • The purpose of the this study was to provide objective evidence through a systematic review and meta-analysis regarding the effects of self-management in knee osteoarthritis. Articles published between 1999 and 2013 from periodicals indexed Ovid Medline, CINAHL, PubMed, RISS, KISS and other databases were selected, using the following key words: Osteoarthriti* OR OA, self-(management OR care OR help). A selection of 11 studies(7 randomized controlled trials and 4 quasi-experimental interventions that were used were exercise, education, massage and self-help group. As a result of mera-analysis, self-management significantly effected pain, physical function, activities of daily living, and self-efficacy. In particular, self-management showed great effect on ADL, and moderate effect on pain and physical function. Based upon these result, it is necessary to develop a standardized self-management program for knee osteoarthritis patients.

Development of Dementia Care Model in a Community (지역사회 치매관리 모형 개발 : 광명시의 경우)

  • 배상수;김동현;우영국;오진주;민경복;이수현;이미라;이상숙;표옥정
    • Health Policy and Management
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    • v.9 no.1
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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.

A Study on Pain, Discomfort, Depression and Coping Patterns in Chronic Arthritis Patients (만성관절염 환자의 동통, 불편감, 우울과 대응양상의 관계)

  • Mun, Mi-Suk
    • Journal of muscle and joint health
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    • v.1 no.1
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    • pp.71-87
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    • 1994
  • The purpose of this study was to assess pain, discomfort, depression and coping patterns and the relations between these in chronic arthritis patients. The sampling method was a purposive sampling technique. 1) Who have been diagnosed as having chronic arthritis and. 2) Who were at the out patients clinic of rheumatoid arthritis departments of one University hospital in seoul between september, 11, 1993 to september, 18, 1993. The instruments used for this study were Graphic Rating Scales of pain, discomfort level of the activities of daily living(ADL) developed by Lee, Eun Ok and The Beck Depression inventory. The research used to measure coping patterns was a tool developed by the present study researcher. Analysis of data was done frequency, Pearson correlation coefficients, ANOVA, regression and ANCOVA. The results were summerlized as follows ; 1. Female exceed male patients in number and onset of joint pain were more prevalent in the age groups of the 40s and the 50s. The average duration of suffering from the pain were seven years six mounths. 2. The mean pain score : The mean sensory score was 119mm and the affective score was 109mm. 3. The discomfort level of ADL, the mean score was 2.95 out of a possible score of 5.0 and depression syndrome subjects were 62.2%. 4. The coping responses for each pattern were as follows : 1) "Active coping" mean score was 2.28. 2) "Wishful coping" mean score was 2.89. 3) "Receptive coping" mean score was 3.31. 4) "Negative coping" mean score was 1.82. 5. Significant differences were found in age, religion, marriage status and the coping patterns of patients. 1) In the coping pattern of "receptive coping", the score of the age groups of the 50s were higher than that of 20s, and in the coping pattern of "negative coping", the score of the age groups of the 20s were higher than other age groups. 2) In the coping pattern of "wishful coping", the score of the christian were higher than other religion groups. 3) In the coping pattern of "negative coping", the score of the marrieds were lower than other groups. 6. Patients who scored low on factor 2, wishful coping, were much more likely to report having pain sensory than patioets scoring high on this factor. 7. Patients who scored high on factor 4, negative coping, were significantly more likely to report having pain sensory than patients scoring high on this factor. Consider overall, chronic arthritis patients report using a wide varity of strategies, certain strategies such as receptive, wishful and active coping are used frequently, whereas other strategies such as negative coping are rarely used. One of the most important finding of present study is that the reported use of coping strategies is related to adjustment to a chronic pain problem. The present study suggests that negative coping is related to poor emotional adjustment as assessed by depression, but not pain ratings. Considered overall, this pattern of findings suggests that counseling patients to decreased their use of negative coping may be useful. The present study has a number of limitations. First, the sample is restricted to chronic arthritis patients. Weather chronic pain patients suffering from other types of pain syndromes use similar coping strategies needs to be determined in subsequent research. Second, the tool of coping pattern must be studied further to obtain reliability.

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Analysis of bone bruise associated with anterior cruciate ligament injury (전방십자인대 손상과 관련된 골멍의 패턴 분석)

  • Jung, Dae-Won;Kim, Chang-Wan;Baik, Jong-Min;Seo, Seung-Suk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.44-50
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    • 2012
  • Purpose: The purpose of this study is to analyze the relationship between acute anterior cruciate ligament (ACL) injury and bone bruise using the survey for location and incidence of bone bruise. Materials and Methods: From Jan. 2006 to Feb. 2010, 87 knees from who had complaint a traumatic knee pain were diagnosed as acute ACL tear using MRI evaluation. Associated injury, location and incidence of bone bruise were analyzed using MRI. The location of bone bruise on the MRI was classified as medial, central and lateral area on anteroposterior and lateral view of femur and tibia. The bone bruise was classified with Costa Paz classification. Results: Bone bruise of injury during daily living activity were located at medial area on coronary view and anterior area on sagittal view of distal femur, at medial area on coronary view and anterior area on sagittal view of proximal tibia (p=0.024, p=0.021, p=0.025 and p=0.029, respectively). Bone bruise of injury during sports activity were located at lateral area on coronary view and central area on sagittal view of distal femur, at lateral area on coronary view and posterior area on sagittal view of proximal tibia (p=0.014, p=0.015, p=0.018 and p=0.017, respectively). Bone bruise patterns due to traffic accident were inconclusive (p=0.264, p=0.254, p=0.229 and p=0.267, respectively). Conclusion: Injury mechanism of acute ACL injury from activities of daily living or sports activities compared to that of traffic accident showed a more consistent bone bruise patterns. Special attention to acute ACL tear must be paid in case of bone bruise at lateral tibial plateau and lateral femoral condyle.

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The Pain Behavior of Patients with Joint Pain (관절통환자의 통증정도와 통증연관 행위에 관한 연구)

  • 이은옥;한윤복;김순자;이선옥;김달숙;김조자;김광주;김주희;박점희
    • Journal of Korean Academy of Nursing
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    • v.18 no.2
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    • pp.197-210
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    • 1988
  • The purposes of this study were : 1) to assess the level of pain and to identity the varieties and the degree of pain-related behavior, 2) to measure the level of correlation between the level of pain and the degree of pain- related behavior, 3) to test the correlation between the Korean Pain Rating Scale (KPRS) and Graphic Rating Scale(GRS), and 4) to gather data relevant to the Socio-demographic status of the subjects. The level of pain was measured by KPRS and GRS developed by the researchers. The KPRS consists of three dimensions ; the sensory, the affective and the miscellaneous and the GRS of two separate scales ; the intensity scale and the unpleasantness scale. Of the 2, 025 who had visited orthopedic and neurosurgical out-patients department of 11 university hospitals in various districts of Korea with the episode of Joint pain, 405 subjects were self-selected by responding to the data gathering tools and questionaires mailed. The results are summaried as follows : 1. Maale(217, 53.6%) exceeded female patients(188, 46.4%) in number and the onset of joint pain was more prevalent in the age groups of the 20s and the 30s. 160(39.5%) had been hospitalized for the treatment of, and 87(21.5%) had retired because of the joint pain. 2. Mean pain score measured by KPRS was 128.31 (range; 0-1.344.8) ; mean sensory score was 43.23(range ; 0-645.88%), mean affective score was 46.09(range ; 0- 356.72), and mean miscellaneous score was 39.99(range ; 0-341.68). Mean pain scores measured by GRS were ; sensory intensity score ; 109.1(range ; 0-200) and distress score ; 99.1 (range ; 0-200). 3. The prevalent sites of joint pain revealed to be the right knee joint(203; 50.1%), left knee joint(181(44.7%), left ilium(147, 36.3%), lumbar region (106; 26.2%), hip joint(92; 22.7%) and the ankle(84; 20.7%). 4. The average sleep hour was 6.8hours per day and the average rest hour during the day hours was 3.3hours (range 0-20). 5. The average duration of suffering from joint pain was 49.1 months. 6. Most of the subjects(298; 73.6%) used some sorts of pain relieving practices ; the most prevalent pain relieving practice was the compliance with the physician prescribed treatments(34.4%). 7. The level of discomfort in carrying out the ADL(activities of daily living was 101.16(38.83) and the level of needs for aid in carrying out the ADL was 76.62(31.79). 8. The interrelation between KPRS total score and GRS sensory intensity score(.4438), as well as that of GRS distress score(r=.4446) were not highly correlated, however, sensory and affective dimension within KPRS (.7547) and pain intensity and distress score of GRS(.6975) revealed moderate intercorrelation. 9. Pain-related behaviors such as discomfort in carrying out ADL, the need for aids in carrying out ADL, frequency of pain relieving practices, varieties of pain sites and length of rest hours during the day hours revealed to be highly correlated with the level of pain measured by KPRS, GRS sensory intensity scale and GRS distress scale. The following are recommended ; 1. Test for the correlation of KPRS total score and the summated score of GRS ; sensory intensity and distress scores. 2. Possibilities of utilization of the pain-related behaviors which revealed high correlation as indirect assessment tool for measuring the level of pain.

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Evaluation of the Elderly Gait Stability Using the Center of Mass and Center of Pressure Inclination Angles (전, 후방 기울기각을 이용한 노인의 보행안정성 평가)

  • Yoon, Suk-Hoon;Kim, Tae-Sam;Lee, Jae-Hun;Ryu, Ji-Seon;Kwon, Young-Hoo
    • Korean Journal of Applied Biomechanics
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    • v.17 no.4
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    • pp.99-106
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    • 2007
  • The gait instability in the elderly has been associated with age-related deterioration in physical strength and reducing the potential for elderly falls requires regular exercise. In 2005, National Center for Injury Prevention and Control(NCIPC) reported that most elderly falls occur during activities in daily living(ADL). To better reveal biomechanic mechanisms underlying age-related degeneration in gait stability, and to enhance the assessment of falls risk, an accurate quantification of a person's balance maintenance during locomotion is needed. Instantaneous orientation of the line connecting COP and COM can characterize whole body position with respect to the supporting foot during gait and the angle between this line and the vertical line passing through the COP known as a good assessment to detect the elderly gait instability. Therefore the purpose of this study was to investigate a 6-month walking exercise effects in reducing elderly fall risk factors by using COP-COM inclination angles. Twenty-two community-dwelling elderly participated this study. The participants performed a walking exercise(3 times/week, 1 hour/visit) for 6 months. Laboratory kinematics during walking was assessed at months 0, 3 and 6. Significant increased in gait velocity was found among periods(p=.011, $1.25{\pm}.03$, $1.32{\pm}.03$, and $1.39{\pm}.04\;m/s$ in 0-, 3-, and 6-month, respectively). Also, significant differences in anterior and posteriror inclination angles were found among the periods(p<.05; posterior inclination angles: $12.8{\pm}2.2$, $11.0{\pm}2.9$, & $10.9{\pm}1.9$; anterior inclination angles: $13.7{\pm}1.7$, $14.6{\pm}3.2$, & $1.46{\pm}.21$ in 0month, 3month, & 6month, respectively). These findings provide evidence of significant reduced fall risk factors of community-living older adults associated with a systematic walking program.

Effect of Regular Exercise on Depression among Korean Older Adults (노인의 규칙적 운동이 우울에 미치는 효과 분석과 이론 검증)

  • Nam, Ilsung;Yoon, Hyunsook;Hyun, Dhawoon;Choi, Ahyoung;Yeom, Sorim
    • Korean Journal of Social Welfare
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    • v.66 no.4
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    • pp.5-23
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    • 2014
  • This study performed a series of analyses to examine the effects of regular exercise on depression using data from the HAS (Hallym Aging Study) and the KLoSA(Korean Longitudinal Study of Ageing). The effect of regular exercise on depression was tested through propensity score matching methods. In addition, analyses of five indirect effect models were performed to verify a theoretical description about how regular exercise has an effect on depression. The results of analysis were as follows. First, it was found in the two samples that elderly people who exercise regularly have a lower level of depression compared to those who do not. Second, the results of analysis of five indirect effect models were all significant. The psycho-physiological models showed the effect of regular exercise on depression using ADL(Activities of Daily Living) and grip strength. The psycho-social models also demonstrated the effect of regular exercise on depression using variables related to social activities. Based on these findings, intervention strategies to prevent depression was discussed.

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The Effect of Self-Help Program for Promotion of Health for Arthritis Patients at various Health Centers in Seoul (서울시 보건소에서 실시한 관절염환자 자조관리과정 평가)

  • Lee, Eun-Ok;Suh, Moon-Ja;Kang, Hyun-Sook;Lim, Nan-Young;Han, Sang-Sook;Song, Kyeong-Yae;Eum, Ok-Boon;Lee, In-Ok;Kim, Mi-Ra;Choi, Hee-Jung
    • Journal of muscle and joint health
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    • v.5 no.2
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    • pp.155-173
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    • 1998
  • The purpose of this study was to evaluate the effects of self-help programs which had been conducted at each health center of Seoul using the protocol developed by Korean Rheumatology Health Professionals Society(KRHPS). This program was developed to initially increase self-efficacy, and then to decrease the symptoms and finally to increase the functions of the patients. This study was designed as one group pretest-posttest design. Data were collected by self-administered questionnaires for 140 out of 303 program participants, and only 102 subjects were analyzed because of missing values. The subjects were composed of 25.5% of rheumatoid arthritis patients and 60.8% of degenerative arthritis patients. The results showed that arthritis self-help program was effective in increasing self-efficacy and then improving pain, fatigue, depression, and activities of daily living. But the number of pain sites was not decreased. This result explains that degenerative arthritis patients composed of more than half of the participants has less number of pain sites than rheumatoid arthritis, and their pain was not completely relieved. As a result, it was confirmed that arthritis patients' physical and psychological states can be improved by self-help program in the community. These findings emphasize the implication of this program for each institute to promote health of arthritis patients.

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Factors Affecting the Quality of Life of Patients With Dementia: A Systematic Review of Literature Focusing on the Subjects Admitted to an Overseas Long-term Care Facility (치매 환자의 삶의 질에 미치는 요인 분석: 국외 요양시설에 입소한 대상자를 중심으로 체계적 문헌고찰)

  • Kim, Sun-Il;Jung, Min-Ye
    • Therapeutic Science for Rehabilitation
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    • v.8 no.1
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    • pp.7-25
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    • 2019
  • Objective: The purpose of this study was to perform a systematic literature review focusing on international studies to identify various factors affecting the quality of life(QOL) of dementia patients admitted to long-term care facilities. Methods: From January 2000 to July 2018, the articles published in foreign journals were searched through CINAHL and MEDLINE databases. The main search terms were'dementia or Alzheimer's'. 'quality of life', 'long-term care', 'care home', 'nursing home', 'care institution', 'residential care', 'small- scale setting'. The first 1706 articles were searched, but 10 studies were selected using the selection and exclusion criteria. Results: Analysis of ten cross-sectional studies showed that factors such as physical functioning status, ability to perform activities of daily living, and cognition showed a positive correlation with QOL. Depression and anxiety, severity of dementia, and neuropsychiatric symptoms were found to be negatively correlated with QOL. In addition, two longitudinal studies have confirmed that factors affecting QOL are affected by individual functional status and social environmental factors rather than the size and form of care facilities. Conclusion: This study summarized 10 papers and analyzed them through a systematic review of literature. We found that factors such as individual characteristics and social environment determine QOL of patients with dementia. In this study, various intervention methods to improve QOL of patients with dementia should be developed and used in long-term care facilities by identifying the factors affecting QOL of dementia patients and using them.