• 농촌의학ㆍ지역보건
• /
• 제21권1호
• /
• pp.47-60
• /
• 1996

Home health care is one of the important components of health care services. Today, the need and demand for the home health care is increasing. To assess the effects of home visit health services by public health nurses in health center on the stat of health, use of medical services and quality of life by elderly people living at home, a randomized controlled trial was implemented for 65 years or more old people randomly allocated to intervention(93) and control(118) group. Intervention group received 2 visits a month over 6 months. Control group received no home visits. The data was collected in a one-year follow-up survey conducted at Kyongju before and after the intervention which composed of health risk assessment, risk factor education and health related behavior counseling. The prevalence rate of chronic illness was more decreased in intervention group than control group after intervention. The intervention group visited medical facilities less frequently than control group. And the home visit health services encouraged the elderly to practice regular exercise. After the intervention, the score of ADL(activities of daily living), LSI(life satisfaction index) and SSI(social support index) in intervention group were more increased than control group. And the increase of scores was more prominent in 70 years or more old people, female, non-smoker and non-chronic illed elderly rather than others. In conclusion, the regular home visit health services provided by public health nurses were beneficial for the elderly in terms of health promotion and quality of life.

• 한국보건간호학회지
• /
• 제16권1호
• /
• pp.13-29
• /
• 2002

The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.

• 지역사회간호학회지
• /
• 제14권1호
• /
• pp.106-119
• /
• 2003

This study was executed to develop the model of the format of the day care center which supplies the total service on the health care in the day time and social program related with the work and to evaluate the processing courses which was adjusted for 3 years from March 1999 to December 2001 in order to improve the quality of life of the family who experience dementia, dementia prevention, and the old and the burden of daily activities. The processing courses of this business model were evaluated to the confirmation on the health condition, application of the nursing processes, and the precise medical examination, and 20 sorts of social programs. The methods used in this model were the simplified MMSE-K, Ability for ,Daily Life(ADL), Instrumental Activities of Daily Living(IADL), and nursing process, and so on. The execution effects of this model are as follows. 1. It can contribute to the delay in the dementia process of the old people who are related with the dementia and maintenance and improvement of the health by confirming the stopping of the process of the dementia as the objective estimation method while the dementia symptom is maintained as the current condition through the medical and social total services. 2. The reduction of the burden for the daily care of the subject people and their families for the old people who are concerned with the dementia helped to improve the quality of life of the subject people and their family by enabling them to have jobs. 3. It enabled them to positively cope with the demand for the health and nursing of the local residents related to the old people. 4. It enabled them to enhance the recognition for the socialization of the local social organization and residents for the old people. 5. It enabled them to reinforce the related system among the local social organizations, and develop and provide the various social programs which are proper for the old people.

• 한국산학기술학회논문지
• /
• 제13권9호
• /
• pp.4119-4125
• /
• 2012

이 연구는 뇌졸중 환자를 대상으로 한국판 수정바델지수(Korean Version of Modified Barthel Index: K-MBI)의 타당도, 신뢰도와 문항변별도를 알아보기 위해 실시되었다. 223명의 뇌졸중 환자를 대상으로 K-MBI를 사용하여 일상생활활동을 측정하였다. 타당도를 알아보기 위해 요인분석을 실시하였고, 문항내적 합치도, 문항변별도를 알아보았다. 요인분석 결과, K-MBI의 10개 항목의 공통성은 .50이상으로 나타났으며, 하나의 요인에 적재되는 것으로 나타났다. 설명량은 72.184%이었다. 요인적재량은 용변처리, 개인위생, 의자/침대 이동, 보행/의자차, 옷 입기, 식사하기, 대변조절, 목욕하기, 소변조절, 계단 오르기 순으로 나타났다. K-MBI의 Cronbach ${\alpha}$ 값은 .944로 나타났으며, 각 항목의 문항변별도는 .783~.909로 만족할 만한 수준이었다. 요인분석을 통해 K-MBI의 일상생활활동이라는 하나의 구성요인을 확인하였으며, 신뢰도와 문항변별도를 확인하였다. 뇌졸중 환자의 일상생활활동의 타당한 평가를 위해, 앞으로의 연구에서는 K-MBI의 다양한 심리측정학적 특성을 알아보는 연구가 필요할 것으로 생각된다.

• 대한지역사회작업치료학회지
• /
• 제4권1호
• /
• pp.23-31
• /
• 2014

목적 : 본 연구는 정상 성인을 대상으로 일상생활활동 수행하는 동안 기존의 삼차원동작분석 장비와 가속도계에서 발생하는 변수를 동시에 측정하여, 기존의 삼차원동작분석 장비와 가속도계에서 측정된 값의 상관관계를 파악하고 가속도계의 활용 가능성을 제시하고자 하였다. 연구방법 : 성인 20명(남자 10명, 여자 10명)을 대상으로 전화하기, 물 마시기, 세수하기, 숟가락 사용하기를 수행하는 동안 피트미터(Model Fitmeter, Fit.Life, Korea)와 CMS-70P(Zebris Medizintechnik Gmbh, Germany)를 사용하여, 손목 관절과 팔꿉 관절에서 단일벡터크기(Signal Vector Magnitude: SVM) 합과 관절가동범위를 측정하였다. 결과 : 전화하기, 물 마시기, 세수하기, 숟가락 사용하기 수행 시 손목과 팔꿈치에서 발생하는 관절가동범위와 단일벡터크기 합은 과제에 따라 유의한 차이가 있었다(p<.001; p<.001; p<.001; p<.001). 관절가동범위와 단일벡터크기 합은 손목에서는 유의한 상관관계를 보이지 않았으나(p>.05), 팔꿈치에서는 유의한 상관관계를 보였다(p<.01; p<.001; p<.01; p<.05). 손목과 팔꿈치에서 발생하는 단일벡터크기 합의 차이는 전화하기와 세수하기는 손목과 팔꿈치에서 유의한 차이를 보였으나(p<.001; p<.05), 물 마시기와 숟가락 사용하기는 손목과 팔꿈치에서 유의한 차이를 보이지 않았다(p>.05; p>.05). 결론 : 가속도계는 일상생활활동의 역학적 변수를 측정할 때 유용하게 사용할 수 있을 것으로 생각되며, 손목보다는 팔꿈치에서 가속도계가 삼차원동작분석 장비의 기능을 대체할 수 있을 것으로 사료된다.

• 한국산학기술학회논문지
• /
• 제20권8호
• /
• pp.431-440
• /
• 2019

이 연구는 경직성 뇌성마비 아동을 대상으로 1년간 물리 및 작업치료 후 대동작 기능분류체계에 따라 일상생활동작 변화정도가 차이가 있는지 그리고 소아장애척도지수와 아동용 일상생활 기능독립 측정 중 어떤 평가도구가 일상생활 동작의 변화에 민감하게 반응하는지를 알아보기 위해 시행되었다. 48명의 경직성 뇌성마비 아동이 참여하였고, 대동작 기능분류체계, 아동용 일상생활 기능독립 측정, 그리고 소아장애척도지수를 측정하였다. 연구결과, 대동작 기능분류체계는 소아장애척도지수와 유의한 상관을 보였지만(p<0.05) 아동용 일상생활 기능독립 측정과 유의한 상관을 보이지 않았다. 또한 중재 전과 후 일상생활동작의 변화는 아동용 일상생활 독립측정인 경우 유의한 차이를 보이지 않았지만, 소아장애척도지수인 경우 유의한 차이를 보였다(p<0.05). 대동작 기능분류체계에 따라 일상생활동작의 변화는 유의하게 차이가 있었으며, 기능수준이 높은 경우 일상생활동작이 변화가 유의하게 컸었다(p<0.05). 물리 및 작업치료 후 대동작 기능 분류체계에 따라 일상생활동작의 향상정도는 다르지만 임상적으로 의미 있게 향상되는 것으로 보이며, 소아장애척도지수는 일상생활동작의 변화에 민감하게 반응하므로 임상에서 폭 넓게 활용하는 것이 필요한 것으로 여겨진다.

• Clinics in Shoulder and Elbow
• /
• 제13권2호
• /
• pp.250-259
• /
• 2010

목적: 광범위 이상의 회전근 개 전층 파열에 대해서 UU 봉합법을 이용한 관절경 하의 이중 봉합술의 임상 결과와 수술의 유효성을 알아보는 것이 이 연구의 목적이다. 대상 및 방법: 2007년 1월부터 2009년 7월까지 광범위 회전근 개 전층 파열로 대결절의 중간부위까지 봉합이 가능하여 관절경하 봉합술을 시행한 36예의 환자중에서 1년 이상의 추시가 가능하였던 31예에 대하여 UU 봉합법을 이용하여 이열 봉합술 (Double Row Repair)을 시행하였던 11예를 1군으로, 단순 봉합법으로 일열 봉합술을 시행하였던 20예를 2군으로 하여 비교하였으며, 술전과 6개월, 1년, 최종 추시 때의 VAS of pain, ADL (Activity of Daily Living), UCLA 점수를 측정하였다. 통계적인 검정은 student t-test와 paired t-test로 비교하였다. 평균 연령은 59 (48~70)세였고 평균 추시기간은 28 (12~43)개월이었다. 결과: 동통에 대한 VAS 점수에서 1군의 경우 술 전 평균 7.5에서 술 후 최종 추시에서 1.5로 감소하였고 (p<0.05), 2군의 경우 술 전 평균 7.6에서 술 후 최종 추시에서 1.8로 감소하였다 (p<0.05). 두 군 간의 임상적으로 의미있는 차이는 없었다 (p>0.05). 평균 ADL은 1군의 경우 술 전 평균 11.5에서 술 후 최종 추시에서 평균 25.1으로 증가하였고 (p<0.05), 2군의 경우 평균 11.3에서 27.5으로 증가하였으며 (p<0.05), 두 군 간에 임상적으로 의미있는 차이가 없었다 (p>0.05). UCLA 점수는 1군의 경우 술 전 평균 13.9에서 술 후 최종 추시에서는 31.6으로 증가하였으며 (p<0.05), 2군의 경우 술 전 평균 13.8에서 술 후 최종 추시에서는 30.1으로 증가하였으며 (p<0.05), 두 군 간에 임상적으로 의미있는 차이가 없었다 (p>0.05). 술 후 3개월에서 6개월 사이에 촬영한 MRI를 이용한 재파열의 비교에서 1군에서 9예 중 3예가, 2군에서 15예 중 8예에서 재파열이 있어서 두 군간에 임상적으로 의미있는 차이가 있었다 (p>0.05). 결론: 광범위 회전근 개 전층 파열에서 UU 봉합법을 이용한 관절경하 이열 봉합술은 일열 봉합술과 비교하여 임상적으로 차이가 없으나 재파열에서 차이가 있었다.

• 재활치료과학
• /
• 제10권2호
• /
• pp.109-128
• /
• 2021

목적 : 본 연구는 타문화권에서 개발된 일상생활활동중심 작업기반 신경행동평가(A-ONE)를 국내 임상에서 사용할 수 있도록 한국판을 개발하고 한국 환자에게 적용하여 신뢰도와 타당도를 검증하고자 하였다. 연구방법 : 영문판 A-ONE을 한국어로 번역하고 문화적 차이를 검토하였다. 완성된 한국판을 13명의 작업치료학과 교수와 작업치료사에게 국내 적용 가능성을 확인받고, 뇌졸중 환자 42명을 대상으로 신뢰도와 타당성을 검증하였다. 결과 : 총 3개의 문항을 국내 문화에 알맞도록 수정한 결과, 한국판 A-ONE은 Index at the item level(I-CVI)=0.92-1.00을 보이며 평가 문항들이 국내 문화를 잘 대표하고 있는 것으로 나타났다. Functional Independence Measure(FIM)과 상관관계는 의사소통영역을 제외하고 r=0.52-0.77(p>0.01)로 높게 나타난 반면, Lowenstein Occupational Therapy Cognitive Assessment(LOTCA)와는 전반적으로 유의미한 상관관계를 보이지 않았다(p>0.05). 내적일치도는 기능적 독립성이 Cronbach's α=0.58-0.93, 신경행동손상이 α=0.42-0.93을 보였다. 검사-재검사 신뢰도는 기능적 독립성이 Intraclass correlation coefficient(ICC)=0.79-1.00, 신경행동손상이 ICC=0.74-1.00으로 높은 수준을 보였다. 마지막으로, 검사자간 신뢰도는 기능적 독립성이 ICC=0.75-1.00, 신경행동손상이 ICC=0.72-1.00으로 높은 신뢰도를 보였다. 결론 : 한국판 A-ONE은 뇌졸중 환자의 일상생활활동 수행능력과 신경행동손상의 종류 및 손상정도를 평가하기 위해 국내 임상에서 사용될 수 있는 유용한 평가도구이다.

• 대한간호학회지
• /
• 제17권3호
• /
• pp.184-194
• /
• 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.

• 대한인간공학회지
• /
• 제32권5호
• /
• pp.437-442
• /
• 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.