• The Journal of Korean society of community based occupational therapy
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• v.1 no.1
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• pp.7-17
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• 2011

Objective : This study aimed to understand the experience of taking a bus, investigate successful strategies to overcome the psychological difficulties of people with disabilities. Method : In this study, a phenomenological and hermeneutic approach was used to gain a deeper understanding of the behavior, the language, the process. For participants through interviews and participant observation data were collected. Phenomenological interpretation of the way through technology and to evaluate the results. Result : Ambulatory persons with disabilities in the community have confidence in the bus-independent movement in the community possible. And get on and off the bus at the moment of urgent strategies to use in the bus seats were taken. To cope with unexpected situations like that do not put stress was confirmed. In addition, by bus and go sit on the seat to look at the patient's burden was to. Conclusion : Ambulant disabled people's confidence in the bus had a significant impact on the independent movement. Always on the lookout for falling, and many psychological difficulties and to overcome unforeseen circumstances to predict and know that public transportation could be.

• Korea Journal of Hospital Management
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• v.27 no.1
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• pp.1-10
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• 2022

Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data. Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program. Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant. Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

• Journal of The Korean Dental Society of Anesthesiology
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• v.8 no.2
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• pp.122-126
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• 2008

A 15-years-old female patient with seizure disorder and pervasive developmental disorder was scheduled for dental treatment under ambulatory general anesthesia. She had past history of pneumonia and herpes encephalitis when she was 3 year old. Because of sever mental retardation and behavior disorder, routine laboratory test was substituted with physical exam and medical records of department of pediatrics. A few days before general anesthesia, she showed slight common cold, but pediatric consult had reported that there was minimal risk in general anesthesia. After 4-hour general anesthesia, she became critically sick with high fever, cough and malaise. After 10-day hospitalization with pneumonia and sepsis, she could go home.

• Korean Institute of Interior Design Journal
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• v.21 no.1
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• pp.258-268
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• 2012

The bathroom is a space where humans fulfil certain daily needs, but for the disabled, it can be the most difficult space to use and may even be a cause of accidents and a source of danger. Previous studies on the bathroom have mostly proposed an ideal model of bathroom, but the majority of disabled people live in small homes of about $50m^2$ in size. As their bathrooms are usually very small, and existing houses have various structural limitations, more research should be conducted on the remodeling of residential bathrooms. This study analyzed a number of remodeling items in bathrooms, all of which were listed in previous studies. Based on 17 cases of residential bathroom remodeling in the homes of disabled people residing in Incheon in 2009, this study analyzed several remodeling items required according to the subject's characteristics, such as a lifestyle, gender, and family composition; and proposed the following remodeling requirements and improvement measures for ambulatory-disabled persons and sedentary-disabled people. First, as ambulatory-disabled people have lower-limb impairments, they required bathroom remodeling designed to improve their mobility in the bathroom. These subjects desired the installation of grab bars, as well as the elimination of floor level differences, the installation of non-slip flooring, a counter-top, a sink stand, and a shower holder whose height can be adjusted. Second, sedentary-disabled people move around in a sitting or crawling position, so many of them asked to eliminate floor level differences and vertically-installed bathroom furnishings. Basically, both people with ambulatory disabilities and people with non-ambulatory impairments requested the elimination of floor level differences and the installation of non-slip flooring and grab bars for the toilet and bathtub. They also asked for the heights of sinks, faucets, mirrors, shower holders, and cabinets to be adjusted to suit their needs.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.2
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• pp.146-152
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• 2011

Background: Elderly patients with progressive dementia including Alzheimer's disease (AD) are more and more often scheduled to undergo general anesthesia for various pathologies including dental problem. But, there is high risk of deterioration of underlying mental diseases and other co-morbidities. So it is important to implement preventive strategies and take adequate measures to minimize negative perioperative events in these patients. Methods: We reviewed the 17 cases of 11 patients with AD who underwent ambulatory general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 68 (57-81) years. All of them were diagnosed with AD and some had hypertsnsion, bronchiectasis, urinary incontinence. For anesthesia induction, 3 cases (1 patient) was needed physical restraint, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (11 cases), propofol (3 cases) and sevoflurane (3 cases). All patients received nasotracheal intubation without difficulties. Mean total anesthetic time was 3 hour 44 min ${\pm}$ 60 min and staying time at PACU was 83 ${\pm}$ 34 min. All the patients except one who showed hypertension discharged without any complication. There was no death or long term hospitalization because of severe complications. Conclusions: If general anesthesia is needed, pertinent diagnostic tests and workup about other medical problems, and appropriate anesthetic planning are essential for safety.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.2
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• pp.125-132
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• 2011

Background: Adult patients with intellectual disabilities often strongly resist the anesthetic administration for dental procedures. This study aimed to evaluate the effect of midazolam premedication in improving the cooperation level of patients who are likely to be combative and irritated during general anesthesia (GA) induction. Methods: The patients who had received dental treatment under ambulatory GA for more than two times were included. And we selected 13 patients total that needed physical restraint or ketamine IM prior to induction at the first GA, and were prescribed midazolam tablet (7.5-15 mg) at the following GA. We reviewed pre-anesthetic records and anesthesia records, and evaluated cooperative levels of patients (4 levels scale) during anesthesia induction and recovery time retrospectively. Results: All 13 patients (Male 11, Female 2) had severe mental disabilities. The average age of the patients was 24 ${\pm}$ 7 (13-37) years and their average weight was 58 ${\pm}$ 16 (34-91) kg. At the first GA, 10 patients needed physical restraint prior to induction (level 3). And 3 patients were so poorly cooperative that the induction procedure was performed after intramuscular injection of ketamine (level 4). But after the midazolam intake, 7 patients were willing to receive the anesthetic induction (level 1, 2), and 6 patient needed physical restraint (P < 0.05). There were no statistical differences in the duration of general anesthesia and postoperative recovery. Conclusions: Oral intake of midazolam was effective in improvement of cooperation without any complications.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.1
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• pp.5-10
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• 2015

Background: Patients were subjected to post-discharge follow-up (by telephone) in order to investigate the potential complications of outpatient general anesthesia or deep sedation that could develop in disabled dental patients discharged from the hospital. The ultimate aim of this study was to establish an appropriate response measure for such complications. Methods: The caregivers of 79 disabled patients who underwent dental procedures under general anesthesia at our outpatient clinic were interviewed over telephone. Necessary care instructions were provided during the phone calls when required. The patient satisfaction level regarding the telephonic follow-up care was surveyed by additional telephone calls. Results: Most of the patients did not suffer any serious complications; however, some reported fever and bleeding. The data obtained in this study can be utilized towards the development of caregiver education pertaining to the ambulatory general anesthesia of dental patients with disabilities. Conclusions: Additionally, we hope that the findings of this study will help minimize the effects of complications experienced by disabled dental patients undergoing ambulatory general anesthesia, as well as increase the overall patient satisfaction level.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.3
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• pp.177-183
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• 2008

Purpose : The purpose of this study was to investigate characteristics of the muscle activities during level walking and stairs ascending in young adults. Methods : Fifteen young adult were recruited this study. Muscle activity (BIOPAC System Inc., Santa Barbara, U.SA). Statistical analysis was difference between level and stair walking. Results : In stance phase, muscle activity of low extremity generally more increased during ramp ascent both young adults. In swing phase, muscle activity of low extremity generally more increased during stairs ascent in young adults. Conclusion : These results indicate that stair and ramp ascent is more difficult task than level walking in young adults. Muscle activity was more changed at ramp ascent. In the future, we suggest that studies of stair and ramp gait pattern regarding ambulatory patient with disabilities be further studied and an appropriate stairs and ramp inclination will be indicated.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.309-316
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• 2019

Purpose: This study examined the residential environment and accessibility of rehabilitation for cerebral palsy (CP) to identify the problems with residential laws pertaining to the disabled and provide basic data on the health legislation for the rights of the disabled. Materials and Methods: The literature was searched using three keywords: residence, rehabilitation, and accessibility. Two items were selected: residential environment and rehabilitation accessibility. The questionnaire included 51 items; 24 were scored using a Likert scale and 27 were in the form of multiple-choice questions. Results: This study included 100 subjects, of which 93 lived at home and seven lived in a facility. Of these 93 subjects, 65% were living in apartments, usually two or more floors above ground, and 40% of them were living without elevators. According to the Gross Motor Function Classification System, subjects with I to III belonged to the ambulatory group and IV, V were in the non-ambulatory group. Subjects from both groups who lived at home found it most difficult to visit the rehabilitation center by themselves. In contrast, among those who lived at the facility, the ambulatory group found it most difficult to leave the facility alone, while the non-ambulatory group found it most difficult to use the toilet alone. Moreover, 83% of respondents thought that rehabilitation was necessary for CP. On the other hand, 33% are receiving rehabilitation services. Rehabilitation was performed for an average of 3.6 sessions per week, 39 minutes per session. Conclusion: There is no law that ensures secure and convenient access of CP to higher levels. Laws on access routes to enter rooms are insufficient. The disabled people's law and the disabled person's health law will be implemented in December 2017. It is necessary to enact laws that actually reflect the difficulties of people with disabilities. Based on the results of this study, an investigation of the housing and rehabilitation of patients with CP through a large-scale questionnaire will necessary.