• 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.

• Korean Journal of Social Welfare
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• v.37
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• pp.171-193
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• 1999

The ultimate goal of rehabilitation is social integration. Reemployment is, for the disabled workers, the primary source of not only income, but also identity and interaction. Unfortunately, for most disabled workers employment represents only a yet-to-be-fulfilled hope, a close but inaccessible goal, a daily reminder that they are not among the majority. The purpose of this study is to estimate reemployment rate in the industrial injured and to find factors affecting reemployment of disabled workers owing to industrial injury, and to make policy implication for the better industrial injury compensation rehabilitation system. The data were obtained through telephone interview with disabled worker who completed work injury compensation process in 1996-1997. The final sample was consisted of 1,060 respondents. The major findings were that almost lout of 3 disabled worker returned to work, and that the factor affecting reemployment of the disabled workers were severity injury, ADL(activity of Daily Living), the perception of disability severity, controlling for the demographic factors such as sex, age, education, marital status. The results indicated that psychosocial factors as well as physical function had influces on returning to work. The current findings suggests that rehabilitation services and policy aimed at enhancing vocational rehabilitation program and rehabilitation engineering services, and improving psychosocial resources should be considered by rehabilitation professionals and policy makers.

• Journal of muscle and joint health
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• v.22 no.2
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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.

• The Journal of Korean Medicine
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• v.19 no.2
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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.

• The Journal of Internal Korean Medicine
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• v.38 no.5
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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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• v.29 no.2 s.53
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• pp.199-214
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• 1996

To investigate the factors which affecting the cognitive function and depression of the 65 or more age group, the authors surveyed for the subjects in the region of Taejon and nearby Taejon area. 729 studied subjects were tested for cognitive function with MMSE and depression with GDS. The main results were followings; In the studied subjects, the rate of normal cognitive function was 56.8%, the rate of mildly impaired was 24.1% and the rate of severe impairment was 19.1%. The cognitive function level was closely related to the depression score. As the age increased, the cognitive function was more impaired. Sexual difference was also existed in the cognitive function level and the depression score. After adjusting the effect of age, the variables such as sex, marital status, education level, past job, instrumental ability of daily living, regular physical exercise, frequencies of going out the house, chest discomfort, visual and auditory disturbance, and dizziness had the significant relationship with cognitive function impairment. Among these variables instrumental ADL, age, visual disturbance, and sex showed statistical significance in the logistic regression model. In the multiple stepwise regression, the variables which had significant relationship to depression score were education level, frequencies of going out house, current job and house work activity, regular physical exercise, instrumental ADL, self-rated health and nutritional status, dimness, visual disturbance, and chest pain. In conclusion, main characteristics which had close relationship to the cognitive function and depression symptoms in the studied subjects were physical function and self rated health status.