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

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The Pain Behavior of Patients with Back Pain (요통환자의 통증행위에 대한 조사연구)

  • 이은옥;임난영;김달숙;김순자;한윤복;김주희;김광주;박점희;이선옥
    • Journal of Korean Academy of Nursing
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    • v.17 no.3
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    • pp.184-194
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    • 1987
  • The purposes of this study were; 1) to gather data relevant to demographic features. major main management practices, and the level of impairment of the activities of daily living (ADL) of patients with back pain, 2) to test the sensitivity of the Korean Pain Rating Scale and the Graphic Rating Scales, and 3) to identify indirect indicators of back pain by analysing pain related-behaviors. The level of pain was measured by Korean Pain Rating Scale(KPRS) and Graphic Rating Scales(GRS) developed by the reserchers. The GRS consists of two dimensions; the pain intensity (sensory) and unpleasantness (affective) measures. Of the 1,650 diagnosed back pain patients, from January 4 through June 30, 1987 by visiting outpatients' clinics of orthopedic and neurosurgical departments at 11 university hospitals in different districts of Korea, 330 men and women patients were self-selected by responding to the mailed questionnaires. The results were summarised as follows: Male exceeded female patients in number and onset of back pain were more prevalent in the age groups of 20s and the 30s. The average duration of suffering from the pain were 11 months, sixty three (19.1%) of the subjects retired from their jobs, one third(36.7%) have teen hospitalized for the treatment of back pain. In two thirds(64.8%) of the cases pain was characterized as lower back pain. The average sleep hour was 6.8 hours per 24 hours and the average rest hour during the day was 3.3 hours. The mean percentage of pain measured by GRS was higher than that of KPRS. The level of sensory intensity as well as the affective level of pain measured by KPRS and GRS were not highly correlated (sensory intensity r=0.4986, affective r=0.5029) which indicated low discriminative power. On the other hand, intercorrelation between sensory and affective dimension measured by KPRS and GRS showed moderate interrelation(r=0.7247; r=0.7899). One-third(32.5%) of the subjects complied with the hospital prescribed treatment while the other one-third(31.5%) depended on self-remedy and traditional practices, and the last one-third did not imply any pain management practices. The following 6 pain-related behaviors such as length of hospitalization, rest hour during day hours, varieties of pain management practice implied, number of pain sites, need for ADL and discomfort accompanied by ADL revealed to be important indicators of back pain. An investigation of sociodemographic features of patients with back pain in a larger context, i.e. with bigger number of respondents is recommended. Tests for construct validity of KPRS, i.e. factor analysis is further recommended.

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Analysis on Muscle Activities in the Upper Body of Caregivers according to Drive-Assisting Speeds of a Shower Carrier

  • Ko, Cheol Woong;Cho, Deok Yeon;Bae, Tae Soo
    • Journal of the Ergonomics Society of Korea
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    • v.32 no.5
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    • pp.437-442
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    • 2013
  • Objective: The objective of this study was to investigate the effects of drive-assisting system in a shower carrier on the upper body muscle activities of caregivers through drivability tests. Background: In care facilities, one of the major ADL (Activities of Daily Living) factors is bathing/showering. Recently, bath/shower-assisting equipment is actively being introduced in care facilities to reduce caregivers' muscle burden. In particular, it is desirable to utilize a shower carrier equipped with drive-assisting system to effectively care for the elderly. However, there were few systematic studies on the relationship between muscle activities and drive-assisting speeds. Method: For the drivability tests to study the effects on the muscle activities according to the drive-assisting speeds(corresponding drive-voltages: 0.0V, 2.0V, 2.1V, 2.3V), 6 females in their 40s($43{\pm}4yrs$, $157{\pm}5cm$, and $54.5{\pm}1.5kg$) were selected. To measure muscle activities of caregivers through drivability tests, 7 muscles in the upper body(TM/Trapezius Muscle, DM/Deltoid Muscle, BBM/Biceps Brachii Muscle, TBM/Triceps Brachii Muscle, ECRLM/Extensor Carpi Radialis Longus Muscle, FCUM/Flexor Carpi Ulnaris Muscle, and ESM/Erector Spinae Muscle) were selected. Results: In the TM, muscle activities were decreased as 21% compared to 0.0V, when drive-voltage 2.0V was applied, as 57% by 2.1V, and 62% by 2.3V(p<0.05), whereas 40%, 56%, and 69% of muscles activities were decreased respectively from the DM(p<0.05). Also, from the UL(BBM+TBM+ECRLM+FCUM), muscle activities were decreased by 17% with 2.0V as against 0.0V, by 47% with 2.1V, and 52% with 2.3V, whereas decreases in muscle activities from the ESM were found by 20%, 34%, and 42% respectively by 2.0V, 2.1V, and 2.3V(p<0.05). Conclusion: The muscle activities were decreased in the order of the DM, TM, ESM, and UL. As muscle activities were remarkably reduced as drive voltage were increased, it was expected to reduce the upper body muscle burden on the caregivers when using shower carriers equipped with driving-assist system. Applications: The results from this study can be applied for the development of a shower carrier including other equipment to possibly reduce the muscle burden of the caregivers.

A Study on the Coping Behavior of Older People in the Warning Phase of Disaster (재난 시 노인의 대처행동에 관한 연구)

  • Chung, Soon-Dool;Park, Hyun-Ju;Choi, Yeo-Hee;Lee, Ji-Hyun
    • Journal of the Korean Society of Hazard Mitigation
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    • v.8 no.5
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    • pp.71-76
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    • 2008
  • The purposes of this study were to examine the coping behavior of the elderly in the warning phase of disaster and to explore factors influencing the coping behavior of the elderly. Data were collected from 130 senior citizens aged over 60 who are residing in Pyungchang and Injae of Kangwon province which had damaged by flood disaster in 2006. Perry & Lindell (1997)'s index, a series of six categories that represent coping behaviors which progressively approximate the action of evacuating in the warning phase of disasters was used. Results showed that respondents have high coping skills. Although Activities of Daily Living (ADL) has positive influence on the coping behavior, length of residence has negative effect on the coping behavior of the elderly. This finding proves the elderly are not uncompliant or uncooperative population in the warning phase of disaster. This result also emphasizes the importance of rapid and accurate giving of public warning system of disaster and necessity of prior notification of useful information about natural disaster and effective evacuation plan for the elderly.

The Influence of Family Support Degree on the Depression of the Elderly in a Rural Area (일부(一部) 농촌노인(農村老人)이 지각한 가족지지(家族支持)가 우울에 미치는 영향(影響))

  • Kim, Mi-Suk;Kim, Ki-Soon;Park, Jong;Cho, Yong-Rae;Kim, Yang-Ok
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.115-129
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    • 1999
  • To find the influence of family support degree on the depression of the elderly in a rural area, a questionnaire survey was made toward 163 persons who were more than 65 years old and living in a township at Chollanamdo province from January 1st to February 20th, 1998. The major findings are as follows : 1. By simple analysis significantly associated variables with depression score were residence, adequacy of pocket money, health consciousness, drinking alcohol, smoking, score of activity of daily living(ADL), score of instrumental activities of daily living(IADL), and degree of family support among female respondents(p<0.05). 2. To find the influence of family support on the depression score excluding other associated variables, multiple regression analysis was made and it was found that family support was associated significantly with affective, somatic, psychomotor and psychological domain of depression score among male, and somatic, psychomotor and psychological domain among female(p<0.05). The above finding suggest that family support degree is an important factor to be associated with the depression of the elderly in the rural area. So to deal with the depression of rural elderly, how to make close relation among family members must be considered.

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The Effect of Home Rehabilitation Exercise Program of Home Stayed Chronic Hemiplegic Stroke Patients (재가 만성 뇌졸중 편마비 환자의 가정 재활운동 프로그램의 효과)

  • Roh Kook Hee
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.77-94
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    • 2002
  • This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.

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The Correlation between Depression and Physical Health in the Elderly (노인의 신체적 건강과 우울과의 관계)

  • Kim, Hyo-Jung
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.193-203
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    • 2001
  • The purpose of this study was to identify the relationship between depression and physical health of the elderly and to provide fundamental data for programs which improve the health of this population. The subjects were 168 elderly people(55 years and older) who resided at home in Taegu. They were surveyed by interview using a closed- ended questionnaire. The survey was done from September 16 to October 16 in 2000. The instruments used in this study were general characteristics, Short form Geriatric Depression Scale(SGDS), Barthel Index, Muscular skeletal symptoms scale, Northern Illinois University's Health Self Rating Scale. The data were analyzed by using descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient, multiple regression with SPSS PC 10.0 version for Windows. The findings were as follows: 1. As compared 65-74 years elderly group, 75-84 years group was significantly higher score for depression(F=3.17, p=.026). As compared elderly group who has own spouse, the group who has no own spouse was significantly higher score for depression(t=- 2.44, p=.016). 2. The aged who have more limitation of Activities of Daily Living(ADL)(t=3.93, p=.000), pain of muscular skeletal symptoms(F=5.33, p=.002) and poor perceived health state(F=17.04, p=.000) showed the higher severity of depression than the aged who have not. 3. ADL correlated negatively with depression(r=- .293, p=.000), pain of muscular skeletal symptoms correlated positively(r=.251, p=.001), perceived health status correlated negatively(r=-.522, p=.000). 4. The combination of perceived health status and ADL explained 29.1% of the varience of depression. On the basis of the above findings the following recommendations are made; 1. Developing health programs is needed considering ADL, pain of muscular skeletal symptoms, perceived health status, demographic variables (age, spouse status) which have an significant effects on depression of the elderly. 2. In the following study, the use of the various scale is needed which reflects physical status of the elderly in home.

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Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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Prevalence and Characteristics of Mild Cognitive Impairment in the Community-dwelling Elderly Compared to Elderly with Normal Cognitive Function (지역사회 거주 경도인지장애 노인의 유병율과 정상 노인과의 비교연구)

  • Shin, Kyung-Rim;Kang, Youn-Hee;Jung, Duk-Yoo;Kim, Mi-Young;Kim, Jeong-Soo;Kim, Mi-Jung;Kim, Min-Jung
    • Korean Journal of Adult Nursing
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    • v.23 no.1
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    • pp.40-49
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    • 2011
  • Purpose: This study aimed to identify the prevalence of mild cognitive impairment (MCI) among a group of community-dwelling elderly and to determine if there were differences in general characteristics, activities of daily living (ADL), perceived health status (PHS) between the MCI group and group of elderly with normal cognitive function. Methods: This study utilized a descriptive survey design. Six hundred and five subjects over the age 65 were recruited from an S public health center, Seoul. Data were gathered through a variety of instruments: MoCA-K, K-MMSE, K-MBI, S-IADL, and PHS scale. Data were analyzed by SPSS/WIN 18.0 using descriptive statistics, Chi-Square test and t-test. Results: The prevalence of MCI among the subjects was 46.0%. Differences in IADL, PHS, age, education, sex, and residing with a spouse were statistically significant between groups. The MCI group had lower IADL, lower PHS, were older, and had lower educational levels than the group with normal cognitive function. Further, the MCI group was less likely to live with a spouse. Conclusion: It is suggested that MCI group should be targeted in developing and implementing nursing strategies to prevent dementia and improve the elderly cognitive function.

Recent RCT Research on the Effects of Acupuncture on Dementia - Based on a PubMed Search of Literature Published from 2000 to 2018 (치매의 침치료에 대한 해외 RCT 연구 동향 - pubmed의 2000~2018년 검색을 통하여 -)

  • Kim, Eun-ji;Choi, Ki-hoon;Jeong, Hui-gyeong;Kwon, Oh-hoon;Park, Ju-hun;Kim, Sang-gyun
    • The Journal of Internal Korean Medicine
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    • v.39 no.3
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    • pp.338-349
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    • 2018
  • Objective: The purpose of this study is to investigate recent clinical studies on the effects of acupuncture on dementia. Method: We searched RCTs (randomized controlled trials) using the database PubMed (2000-2018). Clinical RCT studies of acupuncture used to treat dementia in humans were included. Nine randomized controlled trials were included. Results: Various acupoints such as Baihui (GV20), Sishencong (EX-HN1), Fengchi (GB20), and Shenting (GV24) were used to treat symptoms. The studies reported a decrease in evaluation criteria, such as the Mini Mental State Examination (MMSE) and activities of daily living (ADL), for measuring cognitive ability. The acupuncture process, the results for outcome measure, and the effectiveness of studies were analyzed. We then assessed "risk of bias." Conclusions: Through this review, we found that acupuncture is applicable for the treatment of dementia. This can be used for future study.

Accessibility of Medical Care in an Elderly Population (일부 지역사회 노인들의 의료서비스 접근성에 관한 조사 연구)

  • Cho, Kyung Soon;Lee, Hiyn Ju
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.641-653
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    • 2000
  • A quantitative descriptive survey was conducted to assess the needs of elderly people in relation to accessibility of medical care. Identifying their functional status was done and accessibility of medical care was ascertained. Using a convenient sampling method, 856 elderly aged 65 and over in Taejon-city participated. A multi-dimensional questionnaire containing sections on health status, Activities of Daily Living(ADLs) and accessibility of medical care in terms of use, time, distance, transport, cost and feeling at ease was developed by the researchers of this study to collect data. Data were collected between October and December, 1999. In general, the result of the self-reports from this study found that approximately 40% of participants had difficulties with their health status and ADLs while about 45% of the population did not access medical care. The majority of respondents stated that they had no difficulties with time distance and transport to access medical care. About two-thirds of the respondents felt that they had many or some difficulties with expenses and strategies for emergency to access medical care. Even though these findings need to be generalized, several recommendations for appropriate medical care delivery for the elderly still can be outlined from the study findings. Recommendations suggested are: To identify impediments to access medical care in emergency in elderly people and to remove those factors preventively are required. Responsible governmental involvement for solving problems of the medical care cost and additional costs in relation to separation of dispensary from medical practice for the elderly is required. More constructive and practical uses of public health community centers are recommended.

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